WorldWideScience

Sample records for resid conversions compared

  1. Conversations with Holocaust survivor residents.

    Science.gov (United States)

    Hirst, Sandra P; LeNavenec, Carole Lynne; Aldiabat, Khaldoun

    2011-03-01

    Traumatic events in one's younger years can have an impact on how an individual copes with later life. One traumatic experience for Jewish individuals was the Holocaust. Some of these people are moving into long-term care facilities. It was within this context that the research question emerged: What are Holocaust survivor residents' perceptions of a life lived as they move into a long-term care facility? For this qualitative study, Holocaust survivors were individually interviewed. Findings emphasize that nursing care needs to ensure that Holocaust survivor residents participate in activities, receive timely health care, and receive recognition of their life experiences. Copyright 2011, SLACK Incorporated.

  2. Psychopathology and resident status - comparing asylum seekers, refugees, illegal migrants, labor migrants, and residents.

    Science.gov (United States)

    Heeren, Martina; Wittmann, Lutz; Ehlert, Ulrike; Schnyder, Ulrich; Maier, Thomas; Müller, Julia

    2014-05-01

    This study aimed to describe, compare, and predict mental health outcomes of different migrant groups and native residents in Switzerland. Asylum seekers (n=65); refugees holding permanent protection visas (n=34); illegal migrants (n=21); labor migrants (n=26); and residents (n=56) completed an assessment by questionnaire. Main outcome variables were symptoms of posttraumatic stress, anxiety and depression. It was tested whether resident status predicted psychopathology over and above the influence of control variables including social desirability, traumatic event types and post-migration resources. Asylum seekers (54.0%) and refugees (41.4%) fulfilled criteria of PTSD most frequently. Clinically relevant symptoms of anxiety and depression were most frequently reported by asylum seekers (84.6% and 63.1%, resp.) and illegal migrants (both 47.6%). Resident status contributed to psychopathology over and above the influence of control variables. Overall, asylum seekers, refugees, and illegal migrants showed high psychiatric morbidity. Differences in resident status appear to be specifically associated with mental health outcomes. This association persists even when controlling for social desirability, post-migration resources and traumatic events. This emphasizes the importance of current socio-political living conditions for mental health, even with respect to the psychopathological sequelae of past traumatic experiences. Copyright © 2014 Elsevier Inc. All rights reserved.

  3. Prevalence of mental disorders in migrants compared with original residents and local residents in Ningxia, China

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    Zhizhong Wang

    2016-10-01

    Full Text Available Abstract Background Ecological migrants has a special background compared with other types of migrant. However, the mental health status of ecological migrants who were expected to benefit from a massive “ecological migration project” initiated by the Chinese government is unknown. This study aims to explore the influence of environmental change on individuals’ mental health and to improve current understanding of the mechanisms that mental disorders occurred. Methods The data were extracted from a cross-sectional study. Anxiety disorders, mood disorders and substance use disorders were assessed using the Chinese version WHO-CIDI. The prevalence of mental disorders was stratified by migration status into ecological migrant, local resident and original resident groups. Unconditional logistic regression models were used to calculate the risk of prevalence among these three groups. Results After controlling for gender, ethnicity, age, marriage, and education, the migrants had lower risk of mental disorders than original residents [OR = 0.70 (95 % CI: 0.57–0.86], p < 0.001, but had a higher risk of mental disorders than local residents [OR = 1.29 (95 % CI: 1.06–1.55], p = 0.007. Conclusion The ecological migration project may be beneficial to people’s mental health by improving their living environment and social economy.

  4. Enculturating Conversational Agents based on a Comparative Corpus Study

    DEFF Research Database (Denmark)

    Lipi, Afia Akhter; Yamaoka, Yuji; Rehm, Matthias

    2008-01-01

    When encountering people who have a different cultural background from our own, many of us feel uncomfortable because gestures and facial expressions may not be familiar to us. Thus, to enhance the believability of conversational agents, culture-specific nonverbal behaviors should be implemented ...... a more detailed analysis about posture shifts, and proposes a chat system with an embodied conversational agent (ECA) that can act as a language trainer....... into the agents. In our previous study, with the goal of building a user interface that incorporates a user’s cultural background, we have collected comparative conversation corpus in Germany and Japan, and investigated the differences in gestures and posture shifts between these two countries. This paper reports...

  5. Communication skills training in surgical residency: a needs assessment and metacognition analysis of a difficult conversation objective structured clinical examination.

    Science.gov (United States)

    Falcone, John L; Claxton, René N; Marshall, Gary T

    2014-01-01

    The objective structured clinical examination (OSCE) can be used to evaluate the Accreditation Council for Graduate Medical Education Core Competencies of Professionalism and Interpersonal and Communication Skills. The aim of this study was to describe general surgery resident performance on a "difficult conversation" OSCE. In this prospective study, junior and senior residents participated in a 2-station OSCE. Junior stations involved discussing operative risks and benefits and breaking bad news. Senior stations involved discussing goals of care and discussing transition to comfort measures only status. Residents completed post-OSCE checklist and Likert-based self-evaluations of experience, comfort, and confidence. Trained standardized patients (SPs) evaluated residents using communication skill-based checklists and Likert-based assessments. Pearson correlation coefficients were determined between self-assessment and SP assessment. Mann-Whitney U tests were conducted between junior and senior resident variables, using α = 0.05. There were 27 junior residents (age 28.1 ± 1.9 years [29.6% female]) and 27 senior residents (age 32.1 ± 2.5 years [26.9% female]). The correlation of self-assessment and SP assessment of overall communication skills by junior residents was -0.32 on the risks and benefits case and 0.07 on the breaking bad news case. The correlation of self-assessment and SP assessment of overall communication skills by senior residents was 0.30 on the goals of care case and 0.26 on the comfort measures only case. SP assessments showed that junior residents had higher overall communication skills than senior residents (p = 0.03). Senior residents perceived that having difficult conversations was more level appropriate (p skills are correlated, and that skills-based training is needed across all residency levels. This well-received method may be used to observe, document, and provide resident feedback for these important skills. © 2014 Published by

  6. Assessing experiential education factors contributing to a PGY1 residency match: Pharmacy residency program director and comparative student survey.

    Science.gov (United States)

    Prisco, Jennifer L; Hritcko, Philip M; Feret, Brett; Yorra, Mark L; Todd, Noreen E; Kim Tanzer; Basile, Cathy; Bonaceto, Kara; Morelli, Rita; Carace, Nicole; Szumita, Andrew

    2018-02-01

    To compare and contrast experiential education perceptions of pharmacy residency program directors (RPDs) and doctor of pharmacy students in their last year of the curriculum for residency application considerations. The New England Regional Departments of Experiential Education (NERDEE) consortium developed a 17-question survey to assess residency factors, including those related to experiential education. The survey was dispersed to advanced pharmacy practice experience (APPE) students from six colleges/schools of pharmacy and RPDs nationwide. Students have different values on experiential preferences compared to RPDs. Sample findings include internal medicine and specialty clinical elective experiences prior to American Society of Health-System Pharmacists (ASHP) Midyear were extremely important to important for students, while RPDs viewed these experiences as somewhat important at best (p hinder a successful postgraduate year 1 (PGY1) residency match. Copyright © 2017 Elsevier Inc. All rights reserved.

  7. Comparing IM Residents with EM Resident for Their Skills of ECG Interpretation and Outlining Management Plan Accordingly

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    Hamid Reza Karimpoor Tari

    2009-06-01

    Full Text Available Background and Purpose: Electrocardiogram (ECG is one of the most commonly performed investigations in cardiac diseases and ECG abnormalities can reveal the early manifestations of cardiac ischemia, metabolic disorders, or life-threatening disrhythmias. Misinterpretation of ECG and its consequent mistreatment or performing inessential  interventions may cause life-threatening cardiac events. Since EM residents and internal medicine (IM residents are usually the first to visit at bedside and start treatments based on patient’s ECG, we intended to evaluate the ability of EM residents to interpret ECGs and to compare it with that of IM residents using various ECG samples.Method: 63 participants including 33 IM residents and 30 EM residents from two education hospitals of Shahid Beheshti University of Medical Sciences were enrolled in our study. A diagnosis test consisting of 15 ECG samples associated with a questionnaire containing questions about gender, academic year and proficiency in ECG interpretation was taken from all participants. This study was conducted under the supervision of a cardiologist and an emergency specialist who supervised the ECG selection, answers and scoring of each ECG. The maximum score for each ECG was 6 which were given to a completely correct diagnosis and -0.25 negative point was given if the answer was wrong or any differential diagnosis was mentioned. After the test, the answer sheets were collected and wereanalyzed with SPSS program, by two of study authors who were kept blind to the real identities of participants.Results: After classification of groups, the overall mean score was 45.5/100 (38-60. The mean score of IM and EM residents was 56.0/100 (44.9-72 and 38.9/100 (31.5-45.5, respectively (p< 0.001.No significant correlation was found between the diagnosis scores and participant’s self-judgment on her/his ECG interpretation skills (p=0.897, r=0.017. Five ECGs were considered as the most important and

  8. Comparative genomic analysis of Vibrio parahaemolyticus: serotype conversion and virulence

    Directory of Open Access Journals (Sweden)

    Gil Ana I

    2011-06-01

    Full Text Available Abstract Background Vibrio parahaemolyticus is a common cause of foodborne disease. Beginning in 1996, a more virulent strain having serotype O3:K6 caused major outbreaks in India and other parts of the world, resulting in the emergence of a pandemic. Other serovariants of this strain emerged during its dissemination and together with the original O3:K6 were termed strains of the pandemic clone. Two genomes, one of this virulent strain and one pre-pandemic strain have been sequenced. We sequenced four additional genomes of V. parahaemolyticus in this study that were isolated from different geographical regions and time points. Comparative genomic analyses of six strains of V. parahaemolyticus isolated from Asia and Peru were performed in order to advance knowledge concerning the evolution of V. parahaemolyticus; specifically, the genetic changes contributing to serotype conversion and virulence. Two pre-pandemic strains and three pandemic strains, isolated from different geographical regions, were serotype O3:K6 and either toxin profiles (tdh+, trh- or (tdh-, trh+. The sixth pandemic strain sequenced in this study was serotype O4:K68. Results Genomic analyses revealed that the trh+ and tdh+ strains had different types of pathogenicity islands and mobile elements as well as major structural differences between the tdh pathogenicity islands of the pre-pandemic and pandemic strains. In addition, the results of single nucleotide polymorphism (SNP analysis showed that 94% of the SNPs between O3:K6 and O4:K68 pandemic isolates were within a 141 kb region surrounding the O- and K-antigen-encoding gene clusters. The "core" genes of V. parahaemolyticus were also compared to those of V. cholerae and V. vulnificus, in order to delineate differences between these three pathogenic species. Approximately one-half (49-59% of each species' core genes were conserved in all three species, and 14-24% of the core genes were species-specific and in different

  9. Comparing selection criteria of residency directors and physicians' employers.

    Science.gov (United States)

    Villanueva, A M; Kaye, D; Abdelhak, S S; Morahan, P S

    1995-04-01

    In 1993, the Medical College of Pennsylvania (MCP), mindful of the rapidly changing environments of health care delivery, created three surveys to gather information from outside the school that would help the faculty plan how the curriculum and advising system could better prepare students and residents for the demands of twenty-first-century medicine. The first survey focused on the MCP seniors graduating that year and asked about their perceptions of their medical education and their specialty and residency choices. The second survey, directed to 40 medical residency program directors in family medicine, internal medicine, pediatrics, and surgery, sought to identify the characteristics of applicants that these directors valued when selecting entrants to their programs. The third survey, of 30 employers of physicians representing four practice environments (private practice, hospitals/other health systems, academic medical centers, and health maintenance organizations), sought information on hiring and recruitment practices and the skills, competencies, and attitudes these employers valued most when hiring recently graduated physicians. The responses showed several differences and/or misperceptions among the views held by the three groups surveyed and suggest that medical educators have not adapted as rapidly as have employers to changes in the health care environment. Academic health centers must broaden their missions and make changes in their own institutional cultures, both to maintain their own viability and to train physicians who have the balance between scientific and technical competency and essential personal characteristics (such as empathy) that the next century's practice will probably demand.

  10. Governing farmland conversion: Comparing China with the Netherlands and Germany

    NARCIS (Netherlands)

    Tan, R.; Beckmann, V.; Berg, van den L.M.; Qu Futian, F.

    2009-01-01

    Farmland conversion has become an increasing concern in China and other parts of the world, including Europe and the USA. Be it for environmental or food security reasons, questions arise concerning how urbanization should be governed, i.e. what rules and regulations could enhance the efficiency and

  11. Portuguese migrants in Switzerland: healthcare and health status compared to Portuguese residents.

    Science.gov (United States)

    Alves, Luís; Azevedo, Ana; Barros, Henrique; Paccaud, Fred; Marques-Vidal, Pedro

    2013-01-01

    Most migrant studies have compared health characteristics between migrants and nationals of the host country. We aimed at comparing health characteristics of migrants with nationals from their home country. Portuguese national health survey (2005-6; 30,173 participants aged 18-75 years) and four national health surveys conducted in Switzerland (2002, 2004, 2007 and 2011, totalling 1,170 Portuguese migrants of the same age range). Self-reported data on length of stay, cardiovascular risk factors, healthcare use and health status were collected. Resident Portuguese were significantly older and more educated than migrants. Resident Portuguese had a higher mean BMI and prevalence of obesity than migrants. Resident Portuguese also reported more frequently being hypertensive and having their blood pressure screened within the last year. On the contrary, migrant Portuguese were more frequently smokers, had a medical visit in the previous year more frequently and self-rated their health higher than resident Portuguese. After adjustment for age, gender, marital status and education, migrants had a higher likelihood of smoking, of having a medical visit the previous year, and of self-rating their current health as good or very good than resident Portuguese. Compared to Portuguese residents, cholesterol screening in the previous year was more common only among migrants living in Switzerland for more than 17 years. Portuguese migrants in Switzerland do not differ substantially from resident Portuguese regarding most cardiovascular risk factors. Migrants consider themselves healthier than Portuguese residents and more often had a recent medical visit.

  12. Compassion Fatigue is Similar in Emergency Medicine Residents Compared to other Medical and Surgical Specialties

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    M. Fernanda Bellolio

    2014-09-01

    Full Text Available Introduction: Compassion fatigue (CF is the emotional and physical burden felt by those helping others in distress, leading to a reduced capacity and interest in being empathetic towards future suffering. Emergency care providers are at an increased risk of CF secondary to their first responder roles and exposure to traumatic events. We aimed to investigate the current state of compassion fatigue among emergency medicine (EM resident physicians, including an assessment of contributing factors. Methods: We distributed a validated electronic questionnaire consisting of the Professional Quality of Life Scale with subscales for the three components of CF (compassion satisfaction, burnout and secondary traumatic stress, with each category scored independently. We collected data pertaining to day- versus night-shift distribution, hourly workload and child dependents. We included residents in EM, neurology, orthopedics, family medicine, pediatrics, obstetrics, and general surgery. Results: We surveyed 255 residents, with a response rate of 75%. Of the 188 resident respondents, 18% worked a majority of their clinical shifts overnight, and 32% had child dependents. Burnout scores for residents who worked greater than 80 hours per week, or primarily worked overnight shifts, were higher than residents who worked less than 80 hours (mean score 25.0 vs 21.5; p=0.013, or did not work overnight (mean score 23.5 vs 21.3; p=0.022. EM residents had similar scores in all three components of CF when compared to other specialties. Secondary traumatic stress scores for residents who worked greater than 80 hours were higher than residents who worked less than 80 hours (mean score 22.2 vs 19.5; p=0.048, and those with child dependents had higher secondary traumatic stress than those without children (mean score 21.0 vs 19.1; p=0.012. Conclusion: CF scores in EM residents are similar to residents in other surgical and medical specialties. Residents working primarily

  13. Hospital Costs of Foreign Non-Resident Patients: A Comparative Analysis in Catalonia, Spain.

    Science.gov (United States)

    Arroyo-Borrell, Elena; Renart-Vicens, Gemma; Saez, Marc; Carreras, Marc

    2017-09-14

    Although patient mobility has increased over the world, in Europe there is a lack of empirical studies. The aim of the study was to compare foreign non-resident patients versus domestic patients for the particular Catalan case, focusing on patient characteristics, hospitalisation costs and differences in costs depending on the typology of the hospital they are treated. We used data from the 2012 Minimum Basic Data Set-Acute Care hospitals (CMBD-HA) in Catalonia. We matched two case-control groups: first, foreign non-resident patients versus domestic patients and, second, foreign non-resident patients treated by Regional Public Hospitals versus other type of hospitals. Hospitalisation costs were modelled using a GLM Gamma with a log-link. Our results show that foreign non-resident patients were significantly less costly than domestic patients (12% cheaper). Our findings also suggested differences in the characteristics of foreign non-resident patients using Regional Public Hospitals or other kinds of hospitals although we did not observe significant differences in the healthcare costs. Nevertheless, women, 15-24 and 35-44 years old patients and the days of stay were less costly in Regional Public Hospitals. In general, acute hospitalizations of foreign non-resident patients while they are on holiday cost substantially less than domestic patients. The typology of hospital is not found to be a relevant factor influencing costs.

  14. Comparing video games and laparoscopic simulators in the development of laparoscopic skills in surgical residents.

    Science.gov (United States)

    Adams, Barbara J; Margaron, Franklin; Kaplan, Brian J

    2012-01-01

    The video game industry has become increasingly popular over recent years, offering photorealistic simulations of various scenarios while requiring motor, visual, and cognitive coordination. Video game players outperform nonplayers on different visual tasks and are faster and more accurate on laparoscopic simulators. The same qualities found in video game players are highly desired in surgeons. Our investigation aims to evaluate the effect of video game play on the development of fine motor and visual skills. Specifically, we plan to examine if handheld video devices offer the same improvement in laparoscopic skill as traditional simulators, with less cost and more accessibility. We performed an Institutional Review Board-approved study, including categorical surgical residents and preliminary interns at our institution. The residents were randomly assigned to 1 of 3 study arms, including a traditional laparoscopic simulator, XBOX 360 gaming console, or Nintendo DS handheld gaming system. After an introduction survey and baseline timed test using a laparoscopic surgery box trainer, residents were given 6 weeks to practice on their respective consoles. At the conclusion of the study, the residents were tested again on the simulator and completed a final survey. A total of 31 residents were included in the study, representing equal distribution of each class level. The XBOX 360 group spent more time on their console weekly (6 hours per week) compared with the simulator (2 hours per week), and Nintendo groups (3 hours per week). There was a significant difference in the improvement of the tested time among the 3 groups, with the XBOX 360 group showing the greatest improvement (p = 0.052). The residents in the laparoscopic simulator arm (n = 11) improved 4.6 seconds, the XBOX group (n = 10) improved 17.7 seconds, and the Nintendo DS group (n = 10) improved 11.8 seconds. Residents who played more than 10 hours of video games weekly had the fastest times on the simulator

  15. Effects of Environmental Radioactive Pollution on the Cardiovascular Systems of Ural Region Residents: A Comparative Study

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    Ekaterina Konstantinova

    2018-03-01

    Full Text Available Objective: The aim of this comparative study was to evaluate the effects of radioactive pollution in river water and confounding risk factors on the prevalence of cardiovascular symptoms in people living in the Ural region. Methods: We selected this region as a case territory for study because it is exposed to chronic ionizing radiation. The area is composed of coastal localities situated along the Techa River, into which liquid radioactive waste materials have been released. As a control, we selected settlements that were not subjected to ionizing radiation. Results: We found a statistically significant relationship between radioactive contamination of a territory and the prevalence of pathologies of the cardiovascular systems of people living in the Techa riverside villages (OR=2.31, p<0.001. The influence of covariates (gender, age, overweight status, and others on the development of cardiovascular pathologies was analyzed. Some of these factors have been recognized as confounding factors. After accounting for confounding factors, the odds ratio for the impact of radiation on the prevalence of pathologies of the cardiovascular system decreased to (OR=1.58, p=0.02. Conclusions: Statistically significant gender and age differences were observed in the prevalence of pathologies of the cardiovascular system in residents of radioactively contaminated areas compared to residents of control areas. These differences show a more pronounced reaction to contamination in older residents, residents with an overweight status and residents with meteotropic reactions.

  16. Comparative study of perioperative complication rates of cervical laminoplasty performed by residents and teaching neurosurgeons.

    Science.gov (United States)

    Niimura, Manabu; Takai, Keisuke; Taniguchi, Makoto

    2017-11-01

    Early surgical education is required for neurosurgical residents to learn many surgical procedures. However, the participation of less experienced residents may increase perioperative complication rates. Perioperative complication studies in the field of neurosurgery are being increasingly published; however, studies have not yet focused on cervical laminoplasty. The study population included 193 consecutive patients who underwent cervical laminoplasty in Tokyo Metropolitan Neurological Hospital between 2008 and 2014. Patient and surgeon background factors, as well as perioperative complication rates were retrospectively compared between resident and board-certified spine neurosurgeon groups. Deteriorated or newly developed neurological deficits and surgical site complications within 30days of cervical laminoplasty were defined as perioperative complications. Out of 193 patients, 123 (64%) were operated on by residents as the first operator and 70 (36%) by board-certified spine neurosurgeons. No significant differences were observed in patient and surgeon factors between the two groups, except for hyperlipidemia (13 vs 17, p=0.02). Furthermore, no significant differences were noted in perioperative complication rates between the two groups (7 [5.7%] vs 4 [5.7%], p=1). Cervical laminoplasty performed in a standardized manner by residents who received their surgical training in our hospital did not increase perioperative complication rates, and ensured the safety of patients. Copyright © 2017 Elsevier Ltd. All rights reserved.

  17. Comparing face-to-face, synchronous, and asynchronous learning: postgraduate dental resident preferences.

    Science.gov (United States)

    Kunin, Marc; Julliard, Kell N; Rodriguez, Tobias E

    2014-06-01

    The Department of Dental Medicine of Lutheran Medical Center has developed an asynchronous online curriculum consisting of prerecorded PowerPoint presentations with audio explanations. The focus of this study was to evaluate if the new asynchronous format satisfied the educational needs of the residents compared to traditional lecture (face-to-face) and synchronous (distance learning) formats. Lectures were delivered to 219 dental residents employing face-to-face and synchronous formats, as well as the new asynchronous format; 169 (77 percent) participated in the study. Outcomes were assessed with pretests, posttests, and individual lecture surveys. Results found the residents preferred face-to-face and asynchronous formats to the synchronous format in terms of effectiveness and clarity of presentations. This preference was directly related to the residents' perception of how well the technology worked in each format. The residents also rated the quality of student-instructor and student-student interactions in the synchronous and asynchronous formats significantly higher after taking the lecture series than they did before taking it. However, they rated the face-to-face format as significantly more conducive to student-instructor and student-student interaction. While the study found technology had a major impact on the efficacy of this curricular model, the results suggest that the asynchronous format can be an effective way to teach a postgraduate course.

  18. Performance of Vascular Exposure and Fasciotomy Among Surgical Residents Before and After Training Compared With Experts.

    Science.gov (United States)

    Mackenzie, Colin F; Garofalo, Evan; Puche, Adam; Chen, Hegang; Pugh, Kristy; Shackelford, Stacy; Tisherman, Samuel; Henry, Sharon; Bowyer, Mark W

    2017-06-01

    Surgical patient outcomes are related to surgeon skills. To measure resident surgeon technical and nontechnical skills for trauma core competencies before and after training and up to 18 months later and to compare resident performance with the performance of expert traumatologists. This longitudinal study performed from May 1, 2013, through February 29, 2016, at Maryland State Anatomy Board cadaver laboratories included 40 surgical residents and 10 expert traumatologists. Performance was measured during extremity vascular exposures and lower extremity fasciotomy in fresh cadavers before and after taking the Advanced Surgical Skills for Exposure in Trauma (ASSET) course. The primary outcome variable was individual procedure score (IPS), with secondary outcomes of IPSs on 5 components of technical and nontechnical skills, Global Rating Scale scores, errors, and time to complete the procedure. Two trained evaluators located in the same laboratory evaluated performance with a standardized script and mobile touch-screen data collection. Thirty-eight (95%) of 40 surgical residents (mean [SD] age, 31 [2.9] years) who were evaluated before and within 4 weeks of ASSET training completed follow-up evaluations 12 to 18 months later (mean [SD], 14 [2.7] months). The experts (mean [SD] age, 52 [10.0] years) were significantly older and had a longer (mean [SD], 46 [16.3] months) interval since taking the ASSET course (both P knowledge, correct procedural steps, and decreased errors from 60% to 19% after the ASSET course regardless of clinical year of training (P knowledge (the 2 IPS components most improved with training) indicates the resident's performance was within 1 nearest-neighbor classifier of experts after ASSET training. Five residents had no improvement with training. The Trauma Readiness Index for experts (mean [SD], 74 [4]) was significantly different compared with the trained residents (mean [SD], 48 [7] before training vs 63 [7] after training [P = .004

  19. Comparative Stress Levels among Residents in Three Chinese Provincial Capitals, 2001 and 2008

    Science.gov (United States)

    Yang, Tingzhong; Wu, Dan; Zhang, Weifang; Cottrell, Randall R.; Rockett, Ian R. H.

    2012-01-01

    Objectives To compare stress levels among residents in large Chinese cities between 2001 and 2008. Methods Survey data were collected in three mainland Chinese capital cities in two waves, in 2001 and 2008, respectively. Participants were recruited through a multi-stage stratified sampling process. Stress was assessed using the Perceived Stress Scale, Chinese version (CPSS). Descriptive methods were used to estimate mean stress levels and associated 95% confidence intervals. Estimates were adjusted by post-stratification weights. Results Indicating stable stress levels, respective adjusted mean stress scores for the combined samples of study participants were 23.90 (95%CI: 23.68–24.12) in 2001 and 23.69 (95%CI: 23.38–24.01) in 2008. A lower stress level in 2008 than in 2001 manifested among residents who were under 25 years of age; female; with a college or higher level education; divorced, widowed, or separated; members of the managerial and clerical group; students or army personnel; or with an annual income of at least 30,000 RMB. Conclusion The overall stress level did not change among the combined sample of residents in the three Chinese study cities between 2001 and 2008. However, levels remained high and varied across social strata, and may have reflected a national trend among urban residents. Findings indicate a need for a new health policy, and call for the design and implementation of evidence-based interventions that target the highest-risk groups. PMID:23152832

  20. Assessing comparability of dressing disability in different countries by response conversion

    NARCIS (Netherlands)

    Buuren, S. van; Eyres, S.; Tennant, A.; Hopman-Rock, M.

    2003-01-01

    Background: Comparability of health data is a major challenge within the context of the Health Monitoring Programme of the European Commission. A common problem in surveys is that many variations of essentially the same question exist. Methods: Response conversion is a new method for improving

  1. Comparative reliability of structured versus unstructured interviews in the admission process of a residency program.

    Science.gov (United States)

    Blouin, Danielle; Day, Andrew G; Pavlov, Andrey

    2011-12-01

    Although never directly compared, structured interviews are reported as being more reliable than unstructured interviews. This study compared the reliability of both types of interview when applied to a common pool of applicants for positions in an emergency medicine residency program. In 2008, one structured interview was added to the two unstructured interviews traditionally used in our resident selection process. A formal job analysis using the critical incident technique guided the development of the structured interview tool. This tool consisted of 7 scenarios assessing 4 of the domains deemed essential for success as a resident in this program. The traditional interview tool assessed 5 general criteria. In addition to these criteria, the unstructured panel members were asked to rate each candidate on the same 4 essential domains rated by the structured panel members. All 3 panels interviewed all candidates. Main outcomes were the overall, interitem, and interrater reliabilities, the correlations between interview panels, and the dimensionality of each interview tool. Thirty candidates were interviewed. The overall reliability reached 0.43 for the structured interview, and 0.81 and 0.71 for the unstructured interviews. Analyses of the variance components showed a high interrater, low interitem reliability for the structured interview, and a high interrater, high interitem reliability for the unstructured interviews. The summary measures from the 2 unstructured interviews were significantly correlated, but neither was correlated with the structured interview. Only the structured interview was multidimensional. A structured interview did not yield a higher overall reliability than both unstructured interviews. The lower reliability is explained by a lower interitem reliability, which in turn is due to the multidimensionality of the interview tool. Both unstructured panels consistently rated a single dimension, even when prompted to assess the 4 specific domains

  2. Comparative Life Cycle Assessment of Lignocellulosic Ethanol Production: Biochemical Versus Thermochemical Conversion

    Science.gov (United States)

    Mu, Dongyan; Seager, Thomas; Rao, P. Suresh; Zhao, Fu

    2010-10-01

    Lignocellulosic biomass can be converted into ethanol through either biochemical or thermochemical conversion processes. Biochemical conversion involves hydrolysis and fermentation while thermochemical conversion involves gasification and catalytic synthesis. Even though these routes produce comparable amounts of ethanol and have similar energy efficiency at the plant level, little is known about their relative environmental performance from a life cycle perspective. Especially, the indirect impacts, i.e. emissions and resource consumption associated with the production of various process inputs, are largely neglected in previous studies. This article compiles material and energy flow data from process simulation models to develop life cycle inventory and compares the fossil fuel consumption, greenhouse gas emissions, and water consumption of both biomass-to-ethanol production processes. The results are presented in terms of contributions from feedstock, direct, indirect, and co-product credits for four representative biomass feedstocks i.e., wood chips, corn stover, waste paper, and wheat straw. To explore the potentials of the two conversion pathways, different technological scenarios are modeled, including current, 2012 and 2020 technology targets, as well as different production/co-production configurations. The modeling results suggest that biochemical conversion has slightly better performance on greenhouse gas emission and fossil fuel consumption, but that thermochemical conversion has significantly less direct, indirect, and life cycle water consumption. Also, if the thermochemical plant operates as a biorefinery with mixed alcohol co-products separated for chemicals, it has the potential to achieve better performance than biochemical pathway across all environmental impact categories considered due to higher co-product credits associated with chemicals being displaced. The results from this work serve as a starting point for developing full life cycle

  3. Comparative study of energy conversion system dedicated to a small wind turbine; Etude comparative de chaines de conversion d'energie dediees a une eolienne de petite puissance

    Energy Technology Data Exchange (ETDEWEB)

    Mirecki, A

    2005-07-01

    This study presents a comparison of architectures and strategies of energy management dedicated to VAWT turbines such as Savonius. A Maximum Power Point Tracking must be implemented in order to optimize the energetic behavior. A torque or a speed control, or an indirect control of the DC bus current is possible. In the fact that the wind turbine characteristic is unknown, an operational research based on fuzzy logic is proposed. Aiming to minimize the cost of the static conversion structure, simple structures (diode bridge inverter, associated with DC-DC chopper) are analyzed and compared with a system based on a PWM Voltage Source Inverter. A test bench has been realized in the meantime as a system simulation. Comparisons of the provided energy are made for different wind speeds allowing to evaluate the performance of each structure and of the control strategies. (author)

  4. A comparative study between three sensorless control strategies for PMSG in wind energy conversion system

    Energy Technology Data Exchange (ETDEWEB)

    Brahmi, Jemaa; Krichen, Lotfi; Ouali, Abderrazak [Advanced Control and Energy Management Research Unit ENIS, Department of Electrical Engineering, University of Sfax, 3038 Sfax (Tunisia)

    2009-09-15

    This paper presents a comparative study of sliding mode, artificial neural network and model reference adaptive speed observers for a speed sensorless permanent magnet synchronous generator (PMSG) in wind energy conversion system (WECS). Wind velocity and position sensorless operating methods for wind generation system using observer are proposed only by measuring phase voltages and currents. Maximum wind energy extraction is achieved by running the wind turbine generator in variable-speed mode. In addition the three speed observers are compared to verify the robustness against parameter variations. (author)

  5. Comparing resident cataract surgery outcomes under novice versus experienced attending supervision

    Directory of Open Access Journals (Sweden)

    Puri S

    2015-09-01

    Full Text Available Sidharth Puri,1 Amanda E Kiely,2 Jiangxia Wang,3 Alonzo S Woodfield,4 Saras Ramanathan,5 Shameema Sikder21Johns Hopkins School of Medicine, Baltimore, MD, 2Wilmer Eye Institute, Johns Hopkins University School of Medicine, Baltimore, MD, 3Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, 4Kaiser Permanente South Sacramento Medical Center, Sacramento, 5San Francisco School of Medicine, University of California, San Francisco, CA, USAPurpose: To determine whether supervision by an attending new to surgical teaching or an experienced attending measurably influences intraoperative complications rates or outcomes in phacoemulsification performed by ophthalmology residents.Setting: Single tertiary hospital.Design: Retrospective cohort study. Methods: Resident-performed phacoemulsification cases supervised by one novice attending (N=189 and experienced attending (N=172 over 1 year were included. Data included: resident year, patient age, sex, preoperative risk factors (4+ dense/white/brunescent cataracts, Flomax, zonular dialysis, pseudoexfoliation, glaucoma risk, post-vitrectomy, intraoperative risk factors (Trypan blue, iris hooks, and intraoperative complications (capsule tears, vitreous loss, zonular dialysis, zonular dehiscence, burns, nuclear fragment loss, Descemet’s tear. Experienced attending data were compared against those of the novice attending.Results: Regarding preoperative risks, experienced attending cases more likely involved 4+ cataract (P=0.005, Flomax (P<0.001, or glaucoma risk (P=0.001. For intraoperative risks, novice attending cases more likely involved Trypan blue (P<0.001. Regarding complications, novice attending cases were associated with vitreous loss (P=0.002 and anterior capsule tears (P<0.001. When comparing total complications, the novice attending was more likely to have both increased number of cases with complications and total complications than the experienced attending. The novice

  6. Comparative efficiency of technologies for conversion and transportation of energy resources of Russia's eastern regions to NEA countries

    Science.gov (United States)

    Kler, Aleksandr; Tyurina, Elina; Mednikov, Aleksandr

    2018-01-01

    The paper presents perspective technologies for combined conversion of fossil fuels into synthetic liquid fuels and electricity. The comparative efficiency of various process flows of conversion and transportation of energy resources of Russia's east that are aimed at supplying electricity to remote consumers is presented. These also include process flows based on production of synthetic liquid fuel.

  7. Comparing frailty measures in their ability to predict adverse outcome among older residents of assisted living

    Directory of Open Access Journals (Sweden)

    Hogan David B

    2012-09-01

    Full Text Available Abstract Background Few studies have directly compared the competing approaches to identifying frailty in more vulnerable older populations. We examined the ability of two versions of a frailty index (43 vs. 83 items, the Cardiovascular Health Study (CHS frailty criteria, and the CHESS scale to accurately predict the occurrence of three outcomes among Assisted Living (AL residents followed over one year. Methods The three frailty measures and the CHESS scale were derived from assessment items completed among 1,066 AL residents (aged 65+ participating in the Alberta Continuing Care Epidemiological Studies (ACCES. Adjusted risks of one-year mortality, hospitalization and long-term care placement were estimated for those categorized as frail or pre-frail compared with non-frail (or at high/intermediate vs. low risk on CHESS. The area under the ROC curve (AUC was calculated for select models to assess the predictive accuracy of the different frailty measures and CHESS scale in relation to the three outcomes examined. Results Frail subjects defined by the three approaches and those at high risk for decline on CHESS showed a statistically significant increased risk for death and long-term care placement compared with those categorized as either not frail or at low risk for decline. The risk estimates for hospitalization associated with the frailty measures and CHESS were generally weaker with one of the frailty indices (43 items showing no significant association. For death and long-term care placement, the addition of frailty (however derived or CHESS significantly improved on the AUC obtained with a model including only age, sex and co-morbidity, though the magnitude of improvement was sometimes small. The different frailty/risk models did not differ significantly from each other in predicting mortality or hospitalization; however, one of the frailty indices (83 items showed significantly better performance over the other measures in predicting long

  8. Comparing Hospitalist-Resident to Hospitalist-Midlevel Practitioner Team Performance on Length of Stay and Direct Patient Care Cost.

    Science.gov (United States)

    Iannuzzi, Michael C; Iannuzzi, James C; Holtsbery, Andrew; Wright, Stuart M; Knohl, Stephen J

    2015-03-01

    A perception exists that residents are more costly than midlevel providers (MLPs). Since graduate medical education (GME) funding is a key issue for teaching programs, hospitals should conduct cost-benefit analyses when considering staffing models. Our aim was to compare direct patient care costs and length of stay (LOS) between resident and MLP inpatient teams. We queried the University HealthSystems Consortium clinical database (UHC CDB) for 13 553 "inpatient" discharges at our institution from July 2010 to June 2013. Patient assignment was based on bed availability rather than "educational value." Using the UHC CDB data, discharges for resident and MLP inpatient teams were compared for observed and expected LOS, direct cost derived from hospital charges, relative expected mortality (REM), and readmissions. We also compared patient satisfaction for physician domain questions using Press Ganey data. Bivariate analysis was performed for factors associated with differences between the 2 services using χ(2) analysis and Student t test for categorical and continuous variables, respectively. During the 3-year period, while REM was higher on the hospitalist-resident services (P higher for resident teams. There were no differences in patient demographics, daily discharge rates, readmissions, or deaths. Resident teams are economically more efficient than MLP teams and have higher patient satisfaction. The findings offer guidance when considering GME costs and inpatient staffing models.

  9. Improving education under work-hour restrictions: comparing learning and teaching preferences of faculty, residents, and students.

    Science.gov (United States)

    Jack, Megan C; Kenkare, Sonya B; Saville, Benjamin R; Beidler, Stephanie K; Saba, Sam C; West, Alisha N; Hanemann, Michael S; van Aalst, John A

    2010-01-01

    Faced with work-hour restrictions, educators are mandated to improve the efficiency of resident and medical student education. Few studies have assessed learning styles in medicine; none have compared teaching and learning preferences. Validated tools exist to study these deficiencies. Kolb describes 4 learning styles: converging (practical), diverging (imaginative), assimilating (inductive), and accommodating (active). Grasha Teaching Styles are categorized into "clusters": 1 (teacher-centered, knowledge acquisition), 2 (teacher-centered, role modeling), 3 (student-centered, problem-solving), and 4 (student-centered, facilitative). Kolb's Learning Style Inventory (HayGroup, Philadelphia, Pennsylvania) and Grasha-Riechmann's TSS were administered to surgical faculty (n = 61), residents (n = 96), and medical students (n = 183) at a tertiary academic medical center, after informed consent was obtained (IRB # 06-0612). Statistical analysis was performed using χ(2) and Fisher exact tests. Surgical residents preferred active learning (p = 0.053), whereas faculty preferred reflective learning (p style more often than surgical faculty (p = 0.01). Medical students preferred converging learning (42%) and cluster 4 teaching (35%). Statistical significance was unchanged when corrected for gender, resident training level, and subspecialization. Significant differences exist between faculty and residents in both learning and teaching preferences; this finding suggests inefficiency in resident education, as previous research suggests that learning styles parallel teaching styles. Absence of a predominant teaching style in residents suggests these individuals are learning to be teachers. The adaptation of faculty teaching methods to account for variations in resident learning styles may promote a better learning environment and more efficient faculty-resident interaction. Additional, multi-institutional studies using these tools are needed to elucidate these findings fully

  10. Comparative study of energy conversion system dedicated to a small wind turbine

    International Nuclear Information System (INIS)

    Mirecki, A.

    2005-01-01

    This study presents a comparison of architectures and strategies of energy management dedicated to VAWT turbines such as Savonius. A Maximum Power Point Tracking must be implemented in order to optimize the energetic behavior. A torque or a speed control, or an indirect control of the DC bus current is possible. In the fact that the wind turbine characteristic is unknown, an operational research based on fuzzy logic is proposed. Aiming to minimize the cost of the static conversion structure, simple structures (diode bridge inverter, associated with DC-DC chopper) are analyzed and compared with a system based on a PWM Voltage Source Inverter. A test bench has been realized in the meantime as a system simulation. Comparisons of the provided energy are made for different wind speeds allowing to evaluate the performance of each structure and of the control strategies. (author)

  11. Attending Surgeons' Leadership Style in the Operating Room: Comparing Junior Residents' Experiences and Preferences.

    Science.gov (United States)

    Kissane-Lee, Nicole A; Yule, Steven; Pozner, Charles N; Smink, Douglas S

    2016-01-01

    Recent studies have focused on surgeons' nontechnical skills in the operating room (OR), especially leadership. In an attempt to identify trainee preferences, we explored junior residents' opinions about the OR leadership style of teaching faculty. Overall, 20 interns and 20 mid-level residents completed a previously validated survey on the style of leadership they encountered, the style they preferred to receive, and the style they personally employed in the OR. In all, 4 styles were explored; authoritative: leader makes decisions and communicates them firmly; explanatory: leader makes decisions promptly, but explains them fully; consultative: leader consults with trainees when important decisions are made, and delegative: leader puts the problem before the group and makes decisions by majority opinion. Comparisons were completed using chi-square analysis. Junior resident preference for leadership style of attending surgeons in the OR differed from what they encountered. Overall, 62% of residents encountered an authoritative leadership style; however, only 9% preferred this (p styles (41%). Preferences differed by postgraduate year. Although 40% of interns preferred a consultative style, 50% of mid-level residents preferred explanatory leadership. Junior resident preference of leadership style in the OR differs from what they actually encounter. This has the potential to create unwanted tension and may erode team performance. Awareness of this difference provides an opportunity for an educational intervention directed at both attendings and trainees. Copyright © 2015 Association of Program Directors in Surgery. Published by Elsevier Inc. All rights reserved.

  12. Residents' perceived barriers to communication skills learning: comparing two medical working contexts in postgraduate training.

    Science.gov (United States)

    van den Eertwegh, Valerie; van Dalen, Jan; van Dulmen, Sandra; van der Vleuten, Cees; Scherpbier, Albert

    2014-04-01

    Contextual factors are known to influence the acquisition and application of communication skills in clinical settings. Little is known about residents' perceptions of these factors. This article aims to explore residents' perceptions of contextual factors affecting the acquisition and application of communication skills in the medical workplace. We conducted an exploratory study comprising seven focus groups with residents in two different specialities: general practice (n=23) and surgery (n=18). Residents perceive the use of summative assessment checklists that reduce communication skills to behavioural components as impeding the learning of their communication skills. Residents perceive encouragement to deliberately practise in an environment in which the value of communication skills is recognised and support is institutionalised with appropriate feedback from role models as the most important enhancing factors in communication skills learning. To gradually realise a clinical working environment in which the above results are incorporated, we propose to use transformative learning theory to guide further studies. Provided it is used continuously, an approach that combines self-directed learning with observation and discussion of resident-patient consultations seems an effective method for transformative learning of communication skills. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

  13. Trees in the small city retail business district: comparing resident and visitor perceptions

    Science.gov (United States)

    Kathleen L. Wolf

    2005-01-01

    Many small cities and towns are located near resource lands, and their central business districts serve both residents and visitors. Such quasi-rural retail centers face competitive challenges from regional shopping malls, online purchasing, and big box discount retailers. District merchants must strategically enhance their market...

  14. Assessing and Comparing Physical Environments for Nursing Home Residents: Using New Tools for Greater Research Specificity

    Science.gov (United States)

    Cutler, Lois J.; Kane, Rosalie A.; Degenholtz, Howard B.; Miller, Michael J.; Grant, Leslie

    2006-01-01

    Purpose: We developed and tested theoretically derived procedures to observe physical environments experienced by nursing home residents at three nested levels: their rooms, the nursing unit, and the overall facility. Illustrating with selected descriptive results, in this article we discuss the development of the approach. Design and Methods: On…

  15. Cost-Effectiveness of Emissions Reduction through Vehicle Repair Compared to CNG Conversion.

    Science.gov (United States)

    Guenther, Paul L; Lesko, Jon M; Stedman, Donald H

    1996-10-01

    In return for a temporary waiver from converting five vehicles to operate on compressed natural gas (CNG) for the Denver Clean Fuels program, the University of Denver identified, tested, repaired, and retested nine employee commuter vehicles. The results of the study validated the concept that employer-based identification and repair programs can be carried out in a cost-effective way. On average, each repaired vehicle removed fifty times more carbon monoxide (CO) emissions from Denver air than each CNG conversion. The average cost of each repair was eight times less than the average cost of each conversion. The average fuel economy benefit from the repairs was enough to pay for the average cost of repairs in less than three years of normal driving. When the expected lifetimes of repairs and conversions are included, the targeted repair program appears to be over sixty times more cost-effective as a CO emissions reduction strategy than CNG conversion.

  16. Online and offline conversations about alcohol: Comparing the effects of familiar and unfamiliar discussion partners

    NARCIS (Netherlands)

    Hendriks, H.; de Bruijn, G.-J.; Meehan, O.; van den Putte, B.

    2016-01-01

    Although research has demonstrated that interpersonal communication about alcohol influences drinking behaviors, this notion has mainly been examined in offline contexts with familiar conversation partners. The present study investigated how communication mode and familiarity influence

  17. Residents' training to retinal photocoagulation: virtual reality compared to conventional apprenticeship

    Science.gov (United States)

    Peugnet, Frederic; Dubois, Patrick; Rouland, Jean-Francois

    1998-06-01

    Virtual reality is one of these recent technologies which can provide an efficient help in the field of surgical apprenticeship. We achieved an original training simulator for retinal photocoagulation destined to the residents of the ophthalmological department. This paper describes the comparison between this new training tool and the conventional practice. Two groups of residents, randomly selected, were trained exclusively by one of these methods. These two groups were under the responsibility of two distinct experts. A final evaluation was made by a third and different expert, ignoring the training mode practiced by each of the residents. The study lasted six months. The results show that this new training mode is at least as efficient as the current one in terms of elapsed time and efficiency. It may even reduce the training duration. These results confirm that a pedagogical simulator could give a new approach in the medical teaching, particularly in its management. Such a device may solve the problems of practitioner's lack of disponibility and of patients' safety and comfort during a conventional training. Furthermore, it could bring an objective way to value the students; practical ability. On the other hand, this preliminary study emphasizes the difficulties in introducing a new modality in a traditional teaching environment.

  18. COMPARATIVE ANALYSIS OF MOTIVATION METHODSAPPLIED TO HAVE THE KRASNOYARSK REGION RESIDENTS CHANGE THEIR LIFESTYLE

    Directory of Open Access Journals (Sweden)

    Olga Yurevna Kutumova

    2015-11-01

    Full Text Available The sociological research carried showed that provision of educational information is the main method of motivating people to change their lifestyle and break harmful habits. The mass media are in the first position in the rating as the most effective public awareness development means and healthcare professional advice goes second.A patient usually receives such advice when visiting a healthcare institution to be given diagnosis or treatment or in the course of health assessment or scheduled preventive medical examination. 45% of the Krasnoyarsk Region smokers considered changing their lifestyle and quitting smoking, 36,9% of the residents made such attempt and 8,4% broke the harmful habit after watching television features and under the influence of outdoor advertising. Information that was received from a doctor about risks of developing major no communicable diseases (cardiovascular, oncology, respiratory due to smoking motivated only 36, 9% of the population to change the lifestyle, which mostly included young people aged 18-24. For 63,6% of the region residents there was no positive effect of health professional advice received during a visit to a healthcare institution for a certain purpose. Thus, the received results testify to the bigger importance of educational promotion of mass media in motivation to change of a way of life and refusal of smoking, in comparison with information received from health workers.

  19. Increased Eye Contact during Conversation Compared to Play in Children with Autism

    Science.gov (United States)

    Jones, Rebecca M.; Southerland, Audrey; Hamo, Amarelle; Carberry, Caroline; Bridges, Chanel; Nay, Sarah; Stubbs, Elizabeth; Komarow, Emily; Washington, Clay; Rehg, James M.; Lord, Catherine; Rozga, Agata

    2017-01-01

    Children with autism have atypical gaze behavior but it is unknown whether gaze differs during distinct types of reciprocal interactions. Typically developing children (N = 20) and children with autism (N = 20) (4-13 years) made similar amounts of eye contact with an examiner during a conversation. Surprisingly, there was minimal eye contact…

  20. Securing an OTL-HNS residency: how competitive is it? Comparing medical student perceptions to actual Canadian statistics.

    Science.gov (United States)

    Kay-Rivest, E; Varma, N; Scott, G M; Manoukian, J J; Desrosiers, M; Vaccani, J P; Nguyen, L H P

    2017-02-27

    The residency match is an important event in an aspiring physician's career. Otolaryngology - Head and Neck Surgery (OTL-HNS) is a surgical specialty that has enjoyed high numbers of applicants to its residency programs. However, recent trends in Canada show a decline in first-choice applicants to several surgical fields. Factors thought to influence a medical student's choice include role models, career opportunities and work-life balance. The notion of perceived competitiveness is a factor that has not yet been explored. This study sought to compare competitiveness of OTL-HNS, as perceived by Canadian medical students to residency match statistics published yearly by CaRMS (Canadian Residency Matching Service), with the hope of informing future decisions of surgical residency programs. An electronic survey was created and distributed to all medical students enrolled in the 17 Canadian medical schools. After gathering demographic information, students were asked to rank what they perceived to be the five most competitive disciplines offered by CaRMS. They were also asked to rank surgical specialties from most to least competitive. Publically available data from CaRMS was then collected and analyzed to determine actual competitiveness of admissions to Canadian OTL-HNS residency programs. 1194 students, from first to fourth year of medical school, completed the survey. CaRMS statistics over the period from 2008 to 2014 demonstrated that the five most competitive specialties were Plastic Surgery, Dermatology, Ophthalmology, Emergency Medicine and OTL-HNS. Among surgical disciplines, OTL-HNS was third most competitive, where on average 72% of students match to their first-choice discipline. When students were questioned, 35% ranked OTL-HNS amongst the top five most competitive. On the other hand 72%, 74% and 80% recognized Opthalmology, Dermatology and Plastic Surgery as being among the five most competitive, respectively. We found that fourth-year medical students

  1. Higher Rate of Tuberculosis in Second Generation Migrants Compared to Native Residents in a Metropolitan Setting in Western Europe

    Science.gov (United States)

    Marx, Florian M.; Fiebig, Lena; Hauer, Barbara; Brodhun, Bonita; Glaser-Paschke, Gisela; Haas, Walter

    2015-01-01

    Background In Western Europe, migrants constitute an important risk group for tuberculosis, but little is known about successive generations of migrants. We aimed to characterize migration among tuberculosis cases in Berlin and to estimate annual rates of tuberculosis in two subsequent migrant generations. We hypothesized that second generation migrants born in Germany are at higher risk of tuberculosis compared to native (non-migrant) residents. Methods A prospective cross-sectional study was conducted. All tuberculosis cases reported to health authorities in Berlin between 11/2010 and 10/2011 were eligible. Interviews were conducted using a structured questionnaire including demographic data, migration history of patients and their parents, and language use. Tuberculosis rates were estimated using 2011 census data. Results Of 314 tuberculosis cases reported, 154 (49.0%) participated. Of these, 81 (52.6%) were first-, 14 (9.1%) were second generation migrants, and 59 (38.3%) were native residents. The tuberculosis rate per 100,000 individuals was 28.3 (95CI: 24.0–32.6) in first-, 10.2 (95%CI: 6.1–16.6) in second generation migrants, and 4.6 (95%CI: 3.7–5.6) in native residents. When combining information from the standard notification variables country of birth and citizenship, the sensitivity to detect second generation migration was 28.6%. Conclusions There is a higher rate of tuberculosis among second generation migrants compared to native residents in Berlin. This may be explained by presumably frequent contact and transmission within migrant populations. Second generation migration is insufficiently captured by the surveillance variables country of birth and citizenship. Surveillance systems in Western Europe should allow for quantifying the tuberculosis burden in this important risk group. PMID:26061733

  2. Investigation of residence time and groundwater flux in Venice Lagoon: comparing radium isotope and hydrodynamic models.

    Science.gov (United States)

    Rapaglia, John; Ferrarin, Christian; Zaggia, Luca; Moore, Willard S; Umgiesser, Georg; Garcia-Solsona, Ester; Garcia-Orellana, Jordi; Masqué, Pere

    2010-07-01

    The four naturally-occurring isotopes of radium were coupled with a previously evaluated hydrodynamic model to determine the apparent age of surface waters and to quantify submarine groundwater discharge (SGD) into the Venice Lagoon, Italy. Mean apparent age of water in the Venice Lagoon was calculated using the ratio of 224Ra to 228Ra determined from 30 monitoring stations and a mean pore water end member. Average apparent age was calculated to be 6.0 d using Ra ratios. This calculated age was very similar to average residence time calculated for the same period using a hydrodynamic model (5.8 d). A mass balance of Ra was accomplished by quantifying each of the sources and sinks of Ra in the lagoon, with the unknown variable being attributed to SGD. Total SGD were calculated to be 4.1 +/- 1.5, 3.8 +/- 0.7, 3.0 +/- 1.3, and 3.5 +/- 1.0 x 10(10) L d(-1) for (223,224,226, 228)Ra, respectively, which are an order of magnitude larger than total mean fluvial discharge into the Venice Lagoon (3.1 x 10(9) L d(-1)). The SGD as a source of nutrients in the Venice Lagoon is also discussed and, though significant to the nutrient budget, is likely to be less important as the dominant control on SGD is recirculated seawater rather than freshwater. 2009 Elsevier Ltd. All rights reserved.

  3. Investigation of residence time and groundwater flux in Venice Lagoon: comparing radium isotope and hydrodynamical models

    International Nuclear Information System (INIS)

    Rapaglia, John; Ferrarin, Christian; Zaggia, Luca; Moore, Willard S.; Umgiesser, Georg; Garcia-Solsona, Ester; Garcia-Orellana, Jordi; Masque, Pere

    2010-01-01

    The four naturally-occurring isotopes of radium were coupled with a previously evaluated hydrodynamic model to determine the apparent age of surface waters and to quantify submarine groundwater discharge (SGD) into the Venice Lagoon, Italy. Mean apparent age of water in the Venice Lagoon was calculated using the ratio of 224 Ra to 228 Ra determined from 30 monitoring stations and a mean pore water endmember. Average apparent age was calculated to be 6.0 d using Ra ratios. This calculated age was very similar to average residence time calculated for the same period using a hydrodynamic model (5.8 d). A mass balance of Ra was accomplished by quantifying each of the sources and sinks of Ra in the lagoon, with the unknown variable being attributed to SGD. Total SGD were calculated to be 4.1 ± 1.5, 3.8 ± 0.7, 3.0 ± 1.3, and 3.5 ± 1.0 x 10 10 L d -1 for 223,224,226,228 Ra, respectively, which are an order of magnitude larger than total mean fluvial discharge into the Venice Lagoon (3.1 x 10 9 L d -1 ). The SGD as a source of nutrients in the Venice Lagoon is also discussed and, though significant to the nutrient budget, is likely to be less important as the dominant control on SGD is recirculated seawater rather than freshwater.

  4. Urology residents experience comparable workload profiles when performing live porcine nephrectomies and robotic surgery virtual reality training modules.

    Science.gov (United States)

    Mouraviev, Vladimir; Klein, Martina; Schommer, Eric; Thiel, David D; Samavedi, Srinivas; Kumar, Anup; Leveillee, Raymond J; Thomas, Raju; Pow-Sang, Julio M; Su, Li-Ming; Mui, Engy; Smith, Roger; Patel, Vipul

    2016-03-01

    In pursuit of improving the quality of residents' education, the Southeastern Section of the American Urological Association (SES AUA) hosts an annual robotic training course for its residents. The workshop involves performing a robotic live porcine nephrectomy as well as virtual reality robotic training modules. The aim of this study was to evaluate workload levels of urology residents when performing a live porcine nephrectomy and the virtual reality robotic surgery training modules employed during this workshop. Twenty-one residents from 14 SES AUA programs participated in 2015. On the first-day residents were taught with didactic lectures by faculty. On the second day, trainees were divided into two groups. Half were asked to perform training modules of the Mimic da Vinci-Trainer (MdVT, Mimic Technologies, Inc., Seattle, WA, USA) for 4 h, while the other half performed nephrectomy procedures on a live porcine model using the da Vinci Si robot (Intuitive Surgical Inc., Sunnyvale, CA, USA). After the first 4 h the groups changed places for another 4-h session. All trainees were asked to complete the NASA-TLX 1-page questionnaire following both the MdVT simulation and live animal model sessions. A significant interface and TLX interaction was observed. The interface by TLX interaction was further analyzed to determine whether the scores of each of the six TLX scales varied across the two interfaces. The means of the TLX scores observed at the two interfaces were similar. The only significant difference was observed for frustration, which was significantly higher at the simulation than the animal model, t (20) = 4.12, p = 0.001. This could be due to trainees' familiarity with live anatomical structures over skill set simulations which remain a real challenge to novice surgeons. Another reason might be that the simulator provides performance metrics for specific performance traits as well as composite scores for entire exercises. Novice trainees experienced

  5. Residential care : Dutch and Italian residents of residential care facilities compared

    NARCIS (Netherlands)

    de Heer-Wunderink, Charlotte; Caro-Nienhuis, Annemarie D.; Sytema, Sjoerd; Wiersma, Durk

    2008-01-01

    Aims - Characteristics of patients living in residential care facilities and the availability of mental hospital- and residential beds in Italy and The Netherlands were compared to assess whether differences in the process of deinstitutionalisation have influenced the composition of their

  6. Wellbeing, activity and housing satisfaction - comparing residents with psychiatric disabilities in supported housing and ordinary housing with support.

    Science.gov (United States)

    Eklund, Mona; Argentzell, Elisabeth; Bejerholm, Ulrika; Tjörnstrand, Carina; Brunt, David

    2017-08-30

    The home is imperative for the possibilities for meaningful everyday activities among people with psychiatric disabilities. Knowledge of whether such possibilities vary with type of housing and housing support might reveal areas for improved support. We aimed to compare people with psychiatric disabilities living in supported housing (SH) and ordinary housing with support (OHS) regarding perceived well-being, engaging and satisfying everyday activities, and perceived meaning of activity in one's accommodation. The importance of these factors and socio-demographics for satisfaction with housing was also explored. This naturalistic cross-sectional study was conducted in municipalities and city districts (n = 21) in Sweden, and 155 SH residents and 111 OHS residents participated in an interview that included both self-reports and interviewer ratings. T-test and linear regression analysis were used. The SH group expressed more psychological problems, but better health, quality of life and personal recovery compared to the OHS residents. The latter were rated as having less symptom severity, and higher levels of functioning and activity engagement. Both groups rated themselves as under-occupied in the domains of work, leisure, home management and self-care, but the SH residents less so regarding home management and self-care chores. Although the groups reported similar levels of activity, the SH group were more satisfied with everyday activities and rated their housing higher on possibilities for social interaction and personal development. The groups did not differ on access to activity in their homes. The participants generally reported sufficient access to activity, social interaction and personal development, but those who wanted more personal development in the OHS group outnumbered those who stated they received enough. Higher scores on satisfaction with daily occupations, access to organization and information, wanting more social interaction, and personal

  7. Surgical Training and Education in Promoting Professionalism: a comparative assessment of virtue-based leadership development in otolaryngology-head and neck surgery residents.

    Science.gov (United States)

    Schulz, Kristine; Puscas, Liana; Tucci, Debara; Woodard, Charles; Witsell, David; Esclamado, Ramon M; Lee, Walter T

    2013-10-29

    Surgical Training and Education in Promoting Professionalism (STEPP) was developed in 2011 to train tomorrow's leaders during residency. It is based on virtue ethics and takes an approach similar to West Point military academy. The purpose of this research was: (i) to compare the virtue profiles of our residents with that of the military cohort using a standardized virtue assessment tool; and (ii) to assess the value of virtue education on residents. As part of STEPP, otolaryngology residents participated in a virtue-based validated assessment tool called Virtue in Action (VIA) Inventory. This was completed at the initiation of STEPP in July 2011 as well as 1 year later in June 2012. Comparison of the VIA to a military cohort was performed. Leadership 'Basic Training' is a series of forums focused on virtues of initiative, integrity, responsibility, self-discipline, and accountability. A pre- and post-test was administered assessing resident perceptions of the value of this 'Basic Training'. Virtues are shared between otolaryngology residents (n=9) and military personnel (n=2,433) as there were no significant differences in strength scores between two military comparison groups and otolaryngology-head and neck surgery (OHNS) residents. There was a significant improvement (pvirtue-based approach is valued by residents as a part of leadership training during residency.

  8. Specialist inpatient treatment for severe motor conversion disorder: a retrospective comparative study.

    Science.gov (United States)

    McCormack, Ruaidhri; Moriarty, John; Mellers, John D; Shotbolt, Paul; Pastena, Rosa; Landes, Nadine; Goldstein, Laura; Fleminger, Simon; David, Anthony S

    2014-08-01

    Gold standard protocols have yet to be established for the treatment of motor conversion disorder (MCD). There is limited evidence to support inpatient, multidisciplinary intervention in chronic, severe cases. To evaluate the characteristics and outcomes of MCD patients admitted to a specialist neuropsychiatric inpatient unit. All patients admitted to the Lishman Unit (years 2007-2011) with a diagnosis of MCD were included. Data relevant to characteristics and status with regard to mobility, activities of daily living (ADLs) and Modified Rankin Scale (MRS) score at admission and discharge were extracted. Thirty-three cases (78.8% female) were included; the median duration of illness was 48 months. In comparison with brain injury patients admitted to the same unit, more cases had histories of childhood sexual abuse (36.4%, n=12), premorbid non-dissociative mental illness (81.1%, n=27) and employment as a healthcare/social-care worker (45.5%, n=15). Cases showed significant improvements in MRS scores (p<0.001), mobility (p<0.001) and ADL (p=0.002) following inpatient treatment. Patients with severe, long-standing MCD can achieve significant improvements in functioning after admission to a neuropsychiatry unit. 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.

  9. A randomized trial comparing didactics, demonstration, and simulation for teaching teamwork to medical residents.

    Science.gov (United States)

    Semler, Matthew W; Keriwala, Raj D; Clune, Jennifer K; Rice, Todd W; Pugh, Meredith E; Wheeler, Arthur P; Miller, Alison N; Banerjee, Arna; Terhune, Kyla; Bastarache, Julie A

    2015-04-01

    Effective teamwork is fundamental to the management of medical emergencies, and yet the best method to teach teamwork skills to trainees remains unknown. In a cohort of incoming internal medicine interns, we tested the hypothesis that expert demonstration of teamwork principles and participation in high-fidelity simulation would each result in objectively assessed teamwork behavior superior to traditional didactics. This was a randomized, controlled, parallel-group trial comparing three teamwork teaching modalities for incoming internal medicine interns. Participants in a single-day orientation at the Vanderbilt University Center for Experiential Learning and Assessment were randomized 1:1:1 to didactic, demonstration-based, or simulation-based instruction and then evaluated in their management of a simulated crisis by five independent, blinded observers using the Teamwork Behavioral Rater score. Clinical performance was assessed using the American Heart Association Advanced Cardiac Life Support algorithm and a novel "Recognize, Respond, Reassess" score. Participants randomized to didactics (n = 18), demonstration (n = 17), and simulation (n = 17) were similar at baseline. The primary outcome of average overall Teamwork Behavioral Rater score for those who received demonstration-based training was similar to simulation participation (4.40 ± 1.15 vs. 4.10 ± 0.95, P = 0.917) and significantly higher than didactic instruction (4.40 ± 1.15 vs. 3.10 ± 0.51, P = 0.045). Clinical performance scores were similar between the three groups and correlated only weakly with teamwork behavior (coefficient of determination [Rs(2)] = 0.267, P teamwork training by expert demonstration resulted in similar teamwork behavior to participation in high-fidelity simulation and was more effective than traditional didactics. Clinical performance was largely independent of teamwork behavior and did not differ between training modalities.

  10. A Randomized Trial Comparing Didactics, Demonstration, and Simulation for Teaching Teamwork to Medical Residents

    Science.gov (United States)

    Keriwala, Raj D.; Clune, Jennifer K.; Rice, Todd W.; Pugh, Meredith E.; Wheeler, Arthur P.; Miller, Alison N.; Banerjee, Arna; Terhune, Kyla; Bastarache, Julie A.

    2015-01-01

    Rationale: Effective teamwork is fundamental to the management of medical emergencies, and yet the best method to teach teamwork skills to trainees remains unknown. Objectives: In a cohort of incoming internal medicine interns, we tested the hypothesis that expert demonstration of teamwork principles and participation in high-fidelity simulation would each result in objectively assessed teamwork behavior superior to traditional didactics. Methods: This was a randomized, controlled, parallel-group trial comparing three teamwork teaching modalities for incoming internal medicine interns. Participants in a single-day orientation at the Vanderbilt University Center for Experiential Learning and Assessment were randomized 1:1:1 to didactic, demonstration-based, or simulation-based instruction and then evaluated in their management of a simulated crisis by five independent, blinded observers using the Teamwork Behavioral Rater score. Clinical performance was assessed using the American Heart Association Advanced Cardiac Life Support algorithm and a novel “Recognize, Respond, Reassess” score. Measurements and Main Results: Participants randomized to didactics (n = 18), demonstration (n = 17), and simulation (n = 17) were similar at baseline. The primary outcome of average overall Teamwork Behavioral Rater score for those who received demonstration-based training was similar to simulation participation (4.40 ± 1.15 vs. 4.10 ± 0.95, P = 0.917) and significantly higher than didactic instruction (4.40 ± 1.15 vs. 3.10 ± 0.51, P = 0.045). Clinical performance scores were similar between the three groups and correlated only weakly with teamwork behavior (coefficient of determination [Rs2] = 0.267, P didactics. Clinical performance was largely independent of teamwork behavior and did not differ between training modalities. PMID:25730661

  11. Comparing the Quality and Complications of Tube Thoracostomy by Emergency Medicine and Surgery Residents; a Cohort Study

    Directory of Open Access Journals (Sweden)

    Parvin Kashani

    2017-01-01

    Full Text Available Introduction: Tube thoracostomy complications depend on the operator’s skill, patients’ general condition and the place in which the procedure is done. The present study aimed to compare the quality and complications of tube thoracostomy carried out by emergency medicine residents (EMRs and surgery residents (SRs.Methods: This cohort study was conducted on 18-60 years old trauma patients in need of tube thoracostomy presenting to two academic emergency departments. Quality of tube placement and its subsequent complications until tube removal were compared between SRs and EMRs using SPSS 20.Results: 72 patients with the mean age of 37.1±14.1 years were studied (86.1% male. 23 (63.8% cases were complicated in SRs and 22 (61.1% cases in EMRs group (total= 62.5%. Chest drain dislodgement (22.2% in SRs vs. 22.2% EMRs; p>0.99, drainage failure (19.4% in SRs vs. 16.7% EMRs; p=0.50, and surgical site infection (11.1% in SRs vs. 19.4% EMRs; p=0.25 were among the most common observed complications. The overall odds ratio of complication development was 0.89 (95% CI: 0.35-2.25, p = 0.814 for SRs and 1.12 (95% CI: 0.28-4.53, p = 0.867 for EMRs.Conclusion: The findings of the present study showed no significant difference between SRs and EMRs regarding quality of tube thoracostomy placement and its subsequent complications for trauma patients. The rate of complications were interestingly high (>60% for both groups.

  12. Comparing Technologies for Online Writing Conferences: Effects of Medium on Conversation

    Science.gov (United States)

    Wolfe, Joanna; Griffin, Jo Ann

    2012-01-01

    This study directly compares face-to-face writing center consultations with two closely related variations of Online Writing Instruction (OWI). Although the study takes place in a busy, dynamic writing center, the authors try to make their comparisons as systematic as possible so they can better foreground some of the benefits and disadvantages of…

  13. Do residents of food deserts express different food buying preferences compared to residents of food oases? A mixed-methods analysis

    Science.gov (United States)

    2012-01-01

    Background Many people lack access to food stores that provide healthful food. Neighborhoods with poor supermarket access have been characterized as “food deserts” (as contrast with “food oases”). This study explored factors influencing food buying practices among residents of food deserts versus food oases in the city of Boston, USA. Methods We used the mixed-methods approach of concept mapping, which allows participants to identify, list, and organize their perceptions according to importance. Resulting maps visually illustrate priority areas. Results Sixty-seven low-income adults completed the concept mapping process that identified 163 unique statements (e.g. relating to affordability, taste, and convenience) that influence food buying practices. Multivariate statistical techniques grouped the 163 statements into 8 clusters or concepts. Results showed that average cluster ratings and rankings were similar between residents of food deserts and food oases. Conclusions The implication of this study pertains to the importance of community resources and emergency food assistance programs that have served to minimize the burden associated with hunger and poor food access among low-income, urban populations. PMID:22490237

  14. Do residents of food deserts express different food buying preferences compared to residents of food oases? A mixed-methods analysis

    Directory of Open Access Journals (Sweden)

    Walker Renee E

    2012-04-01

    Full Text Available Abstract Background Many people lack access to food stores that provide healthful food. Neighborhoods with poor supermarket access have been characterized as “food deserts” (as contrast with “food oases”. This study explored factors influencing food buying practices among residents of food deserts versus food oases in the city of Boston, USA. Methods We used the mixed-methods approach of concept mapping, which allows participants to identify, list, and organize their perceptions according to importance. Resulting maps visually illustrate priority areas. Results Sixty-seven low-income adults completed the concept mapping process that identified 163 unique statements (e.g. relating to affordability, taste, and convenience that influence food buying practices. Multivariate statistical techniques grouped the 163 statements into 8 clusters or concepts. Results showed that average cluster ratings and rankings were similar between residents of food deserts and food oases. Conclusions The implication of this study pertains to the importance of community resources and emergency food assistance programs that have served to minimize the burden associated with hunger and poor food access among low-income, urban populations.

  15. Surgical Training and Education in Promoting Professionalism: a comparative assessment of virtue-based leadership development in otolaryngology-head and neck surgery residents

    Directory of Open Access Journals (Sweden)

    Kristine Schulz

    2013-10-01

    Full Text Available Introduction: Surgical Training and Education in Promoting Professionalism (STEPP was developed in 2011 to train tomorrow's leaders during residency. It is based on virtue ethics and takes an approach similar to West Point military academy. The purpose of this research was: (i to compare the virtue profiles of our residents with that of the military cohort using a standardized virtue assessment tool; and (ii to assess the value of virtue education on residents. Methods: As part of STEPP, otolaryngology residents participated in a virtue-based validated assessment tool called Virtue in Action (VIA Inventory. This was completed at the initiation of STEPP in July 2011 as well as 1 year later in June 2012. Comparison of the VIA to a military cohort was performed. Leadership ‘Basic Training’ is a series of forums focused on virtues of initiative, integrity, responsibility, self-discipline, and accountability. A pre- and post-test was administered assessing resident perceptions of the value of this ‘Basic Training’. Results: Virtues are shared between otolaryngology residents (n=9 and military personnel (n=2,433 as there were no significant differences in strength scores between two military comparison groups and otolaryngology-head and neck surgery (OHNS residents. There was a significant improvement (p<0.001 in the understanding of components of the leadership vision and a significant improvement in the understanding of key leadership concepts based on ‘Basic Training’. All residents responded in the post-test that the STEPP program was valuable, up from 56%. Conclusions: A virtue-based approach is valued by residents as a part of leadership training during residency.

  16. Surgical Training and Education in Promoting Professionalism: a comparative assessment of virtue-based leadership development in otolaryngology-head and neck surgery residents

    Science.gov (United States)

    Schulz, Kristine; Puscas, Liana; Tucci, Debara; Woodard, Charles; Witsell, David; Esclamado, Ramon M.; Lee, Walter T.

    2013-01-01

    Introduction Surgical Training and Education in Promoting Professionalism (STEPP) was developed in 2011 to train tomorrow's leaders during residency. It is based on virtue ethics and takes an approach similar to West Point military academy. The purpose of this research was: (i) to compare the virtue profiles of our residents with that of the military cohort using a standardized virtue assessment tool; and (ii) to assess the value of virtue education on residents. Methods As part of STEPP, otolaryngology residents participated in a virtue-based validated assessment tool called Virtue in Action (VIA) Inventory. This was completed at the initiation of STEPP in July 2011 as well as 1 year later in June 2012. Comparison of the VIA to a military cohort was performed. Leadership ‘Basic Training’ is a series of forums focused on virtues of initiative, integrity, responsibility, self-discipline, and accountability. A pre- and post-test was administered assessing resident perceptions of the value of this ‘Basic Training’. Results Virtues are shared between otolaryngology residents (n=9) and military personnel (n=2,433) as there were no significant differences in strength scores between two military comparison groups and otolaryngology-head and neck surgery (OHNS) residents. There was a significant improvement (p<0.001) in the understanding of components of the leadership vision and a significant improvement in the understanding of key leadership concepts based on ‘Basic Training’. All residents responded in the post-test that the STEPP program was valuable, up from 56%. Conclusions A virtue-based approach is valued by residents as a part of leadership training during residency. PMID:24172053

  17. Efficacy and Safety of Citalopram Compared to Atypical Antipsychotics on Agitation in Nursing Home Residents With Alzheimer Dementia.

    Science.gov (United States)

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

    2017-09-01

    To assess efficacy and safety of citalopram compared to quetiapine and olanzapine for the treatment of agitation in patients with Alzheimer disease (AD). Longitudinal, 6-month study. Nursing home (NH). 75 NH residents with AD and agitation, randomized to citalopram (n = 25), quetiapine (n = 25), or olanzapine (n = 25). Changes in Neuropsychiatric Inventory (NPI) agitation subscale score and the modified Alzheimer Disease Cooperative Study-Clinical Global Impression of Change (mADCS-CGIC) were used to assess treatment efficacy. Participants were surveilled for adverse health outcomes. Citalopram treatment (30±5.8 mg/d) resulted in similar 6-month efficacy compared to both quetiapine (94.0±40.4 mg/d) and olanzapine (5.2±1.6 mg/d), lower occurrence of falls than olanzapine [odds ratio (OR) = 0.81, 95% confidence interval (CI) = 0.68-0.97, P = .012], lower incidence of orthostatic hypotension than both quetiapine (OR = 0.80, 95% CI = 0.66-0.95, P = .032) and olanzapine (OR = 0.75, 95% CI = 0.69-0.91, P = .02), and less all-cause hospitalizations than both quetiapine (OR = 0.92, 95% CI = 0.88-0.95, P = .016) and olanzapine (OR = 0.78, 95% CI = 0.64-0.92, P = .004), after multiple adjustment for potentially confounding variables. No differences were observed for cognitive and functional decline, QTc prolongation, and infections. Citalopram resulted in similar efficacy and less adverse outcomes when compared to 2 atypical antipsychotics for treatment of agitation in NH residents with AD. Replication of these findings and assessment of long-term efficacy and safety of citalopram for treatment of neuropsychiatric symptoms in dementia are needed. Copyright © 2017 AMDA – The Society for Post-Acute and Long-Term Care Medicine. Published by Elsevier Inc. All rights reserved.

  18. Comparative study of energy conversion system dedicated to a small wind turbine; Etude comparative de chaines de conversion d'energie dediees a une eolienne de petite puissance

    Energy Technology Data Exchange (ETDEWEB)

    Mirecki, A

    2005-07-01

    This study presents a comparison of architectures and strategies of energy management dedicated to VAWT turbines such as Savonius. A Maximum Power Point Tracking must be implemented in order to optimize the energetic behavior. A torque or a speed control, or an indirect control of the DC bus current is possible. In the fact that the wind turbine characteristic is unknown, an operational research based on fuzzy logic is proposed. Aiming to minimize the cost of the static conversion structure, simple structures (diode bridge inverter, associated with DC-DC chopper) are analyzed and compared with a system based on a PWM Voltage Source Inverter. A test bench has been realized in the meantime as a system simulation. Comparisons of the provided energy are made for different wind speeds allowing to evaluate the performance of each structure and of the control strategies. (author)

  19. Comparative analysis of supercritical CO2 power conversion system control schemes

    International Nuclear Information System (INIS)

    Vilim, R.B.; Moisseytsev, A.

    2008-01-01

    A comparative analysis of control system performance was carried out for the S-CO 2 re-compressing cycle. In this study two control strategies were developed for managing process variables for a change in load at the electrical generator. Both relied on inventory control to reduce power but differed in other significant respects. In inventory control turbomachine mass flow rates are reduced through density change with the goal of preserving velocity triangle similarity and, hence, cycle efficiency. An inventory and low temperature control scheme was operated to maintain a trajectory that avoids close approach to the critical point by controlling the main compressor inlet temperature. Shaft power tracks a setpoint by controlling density. This control scheme may be preferred in plant configurations that use a flow-split. There the rapid density change with pressure near the critical point can lead to flow rate instability. An inventory and turbine bypass control scheme was operated to more closely approach the critical point. Inventory in addition to turbine bypass was used to control shaft power. The first control scheme yielded greater efficiency at reduced power as a result of two factors. First, bypassing coolant around the turbine increases the mass flow rate through the compressors while shaft speed is maintained constant. As a result the compressor velocity triangles are altered from their peak efficiency values. Second, the bypass flow rate results in non-isothermal mixing downstream where the turbine and bypass flow combine which also penalizes efficiency. (authors)

  20. Southern Nevada residents' views about the Yucca Mountain high-level nuclear waste repository and related issues: A comparative analysis of urban and rural survey data

    International Nuclear Information System (INIS)

    Krannich, R.S.; Little, R.L.; Mushkatel, A.; Pijawka, K.D.; Jones, P.

    1991-10-01

    Two separate surveys were undertaken in 1988 to ascertain southern Nevadans' views about the Yucca Mountain repository and related issues. The first of these studies focused on the attitudes and perceptions of residents in the Las Vegas metropolitan area. The second study addressed similar issues, but focused on the views of residents in six rural communities in three counties adjacent to the Yucca Mountain site. However, parallel findings from the two data sets have not been jointly analyzed in order to identify ways in which the views and orientations of residents in the rural and urban study areas may be similar or different. The purpose of this report is to develop and present a comparative assessment of selected issues addressed in the rural and urban surveys. Because both urban and rural populations would potentially be impacted by the Yucca Mountain repository, such an analysis will provide important insights into possible repository impacts on the well-being of residents throughout southern Nevada

  1. Associated factors of different nutrition indicators in German nursing home residents: comparative results of a multicenter cross-sectional study.

    Science.gov (United States)

    Palm, R; Reuther, S; Bartholomeyczik, S

    2012-10-01

    Malnutrition is one of the most important care problems in the nursing home care sector. The subject of this analysis is the investigation of associative factors for different indicators of malnutrition of residents in nursing homes in Germany. A secondary data analysis was conducted using data from 4,478 nursing home residents. Unintended weight loss or reduced intake and BMI ≤ 20 were analysed as indicators for malnutrition. The influence of age, sex, co-morbidities and care dependency were investigated in logistic regression models. Residents with a high care dependency had a higher risk of suffering weight loss/reduced intake. With regard to BMI ≤ 20, residents aged > 85 years, female gender, cancer, musculoskeletal disease as well as high care dependency had a higher risk. In both models, care dependency plays a major role in explaining malnutrition. Associative factors for malnutrition must be interpreted according to the indicators used to define malnutrition.

  2. Using stable isotopes to estimate and compare mean residence times in contrasting geologic catchments (Attert River, NW Luxembourg)

    Science.gov (United States)

    Martínez-Carreras, N.; Fenicia, F.; Frentress, J.; Wrede, S.; Pfister, L.

    2012-04-01

    In recent years, stable isotopes have been increasingly used to characterize important aspects of catchment hydrological functioning, such as water storage dynamics, flow pathways and water sources. These characteristics are often synthesized by the Mean Residence Time (MRT), which is a simple catchment descriptor that employ the relation of distinct stable isotopic signatures in the rainfall input and streamflow output of a catchment that are significantly dampened through sub-surface propagation. In this preliminary study, MRT was estimated in the Attert River catchment (NW Luxembourg), where previous studies have shown that lithology exerts a major control on runoff generation. The Attert catchment lies at the transition zone of contrasting bedrock lithology: the Northern part is characterized by Devonian schist of the Ardennes massif, while sedimentary deposits of sandstone and marls dominate in the south of the catchment. As a consequence of differing lithologic characteristics, hydrological processes change across scales. The schistose catchments exhibit a delayed shallow groundwater component, sandstone catchments have slow-responding year-round groundwater component, whereas flashy runoff regimes prevails in the marly catchments. Under these circumstances, the MRTs are expected to vary significantly according to lithology, and provide additional understanding in internal catchment processes and their scale dependencies. In order to test this, bi-weekly monitoring of rainfall and discharge stable water isotope composition (oxygen-18 and deuterium) has been carried out since 2007 in 10 nested sub-catchments ranging in size from 0.4 to 247 km2 in the Attert catchment. MRT was estimated using different lumped convolution integral models and sine wave functions with varying transit times distributions (TTDs). TTDs were evaluated through calibration. Further research efforts will deal with the application of conceptual models to simulate and compare TTD, using

  3. Health Service Accessibility and Risk in Cervical Cancer Prevention: Comparing Rural Versus Nonrural Residence in New Mexico

    Science.gov (United States)

    McDonald, Yolanda J.; Goldberg, Daniel W.; Scarinci, Isabel C.; Castle, Philip E.; Cuzick, Jack; Robertson, Michael; Wheeler, Cosette M.

    2018-01-01

    Purpose Multiple intrapersonal and structural barriers, including geography, may prevent women from engaging in cervical cancer preventive care such as screening, diagnostic colposcopy, and excisional precancer treatment procedures. Geographic accessibility, stratified by rural and nonrural areas, to necessary services across the cervical cancer continuum of preventive care is largely unknown. Methods Health care facility data for New Mexico (2010-2012) was provided by the New Mexico Human Papillomavirus Pap Registry (NMHPVPR), the first population-based statewide cervical cancer screening registry in the United States. Travel distance and time between the population-weighted census tract centroid to the nearest facility providing screening, diagnostic, and excisional treatment services were examined using proximity analysis by rural and nonrural census tracts. Mann-Whitney test (P < .05) was used to determine if differences were significant and Cohen's r to measure effect. Findings Across all cervical cancer preventive health care services and years, women who resided in rural areas had a significantly greater geographic accessibility burden when compared to nonrural areas (4.4 km vs 2.5 km and 4.9 minutes vs 3.0 minutes for screening; 9.9 km vs 4.2 km and 10.4 minutes vs 4.9 minutes for colposcopy; and 14.8 km vs 6.6 km and 14.4 minutes vs 7.4 minutes for precancer treatment services, all P < .001). Conclusion Improvements in cervical cancer prevention should address the potential benefits of providing the full spectrum of screening, diagnostic and precancer treatment services within individual facilities. Accessibility, assessments distinguishing rural and nonrural areas are essential when monitoring and recommending changes to service infrastructures (eg, mobile versus brick and mortar). PMID:27557124

  4. Morbidity at elementary school entry differs by sex and level of residence urbanization: a comparative cross-sectional study

    Directory of Open Access Journals (Sweden)

    Lin Kuan-Chia

    2007-12-01

    Full Text Available Abstract Background Health is vital to a child's learning in school and success in life. Therefore, early physical examination, and follow-up if necessary, would bring parents' attention to their child's health and would likely improve outcomes. The purposes of this study are twofold: to assess the health status of first-graders and to examine the health status differences between sexes, levels of residence urbanization, and quantity of available medical resources. Methods This is a comparative descriptive study. Data from the 2002 Student Entry Physical Examination (SEPE and Student Medical History Inventory (SMHI were obtained from 203 public and private elementary schools in northern Taiwan where a population of 53,053 students was included. Frequencies, independent sample t test, one-way ANOVA along with Scheff's post hoc test, and Pearson's correlation were conducted using SPSS. Results This study showed that 13.7% of students had at least one diagnosed disease from the SMHI reported by parents. Moreover, the SEPE indicated that 79.5% students had at least one health concern. Dental caries, myopia, and obesity were the most prevalent health problems among the first-graders (69.6%, 27.1%, and 9.5%, respectively. Research results show that there were significant differences in the prevalence of dental caries, myopia, and obesity between different sexes and among levels of urbanization. However, the quantity of available medical resources made no significant difference. Conclusion Elementary school entry physical examination is an important way to detect students' health problems. It is suggested that school health interventions consider students' health profiles along with their sex and level of urbanization in planning. More research is needed to find the risk factors of the health problems. Additionally, the creation of a school health committee is suggested to implement and evaluate the entry health examination program.

  5. Health outcomes and quality of life of residents of shared-housing arrangements compared to residents of special care units - results of the Berlin DeWeGE-study.

    Science.gov (United States)

    Wolf-Ostermann, Karin; Worch, Andreas; Fischer, Thomas; Wulff, Ines; Gräske, Johannes

    2012-11-01

    To compare different health outcomes as well as quality of life (QoL) between people with dementia living in shared-housing arrangements (SHA) and special care units (SCU) in nursing homes. Often situated in large apartments in mostly urban settings, SHA are a specific German kind of small-scale living facilities for older care-dependent persons, predominantly suffering from dementia. SHA are completely disconnected from traditional nursing homes. In a longitudinal design, all new residents of SHA and SCU suffering with dementia in Berlin were surveyed for one year. They were assessed when they moved into the SHA or SCU and again 6 and 12 months later. We surveyed physical and psychological health outcomes including ADL-functioning (Barthel), neuropsychiatric symptoms of dementia (NPI) and challenging behaviour (Cohen-Mansfield agitation inventory) as well as QoL (Qualidem). Fifty-six persons (43 women, 13 men) were recruited into the longitudinal study. The average age was 82·5 years at admission, participants mostly had a moderate level of cognitive impairment (mean Mini Mental State Examination = 13·3), prevalence of neuropsychiatric symptoms was high. During the one-year follow-up, analyses show a significant decrease in cognitive abilities but also of neuropsychiatric symptoms in both groups. In SHA, QoL increases on average during the one-year study period. Both types of facilities attract slightly different populations according to our data. Comparison of SHA residents to SCU residents documented no significant beneficial effects of settings in terms of health outcomes. As no clear advantage of either SHA or SCU in nursing homes can be demonstrated for residents with dementia who move in newly, it is impossible to give a clear evidence-based recommendation and the decision for one setting or the other can be made according solely to personal preference of the resident. © 2012 Blackwell Publishing Ltd.

  6. [Selection of medical graduates for residency posts. A comparative study of the methodologies used in different countries].

    Science.gov (United States)

    Lobato, Ramiro D; Lagares, Alfonso; Villena, Victoria; García Seoane, Jorge; Jiménez-Roldán, Luis; Munarriz, Pablo M; Castaño-Leon, Ana M; Alén, José F

    2015-01-01

    The design of an appropriate method for the selection of medical graduates for residency posts is extremely important, not only for the efficiency of the method itself (accurate identification of most competent candidates), but also for its influence on the study and teaching methodologies operating in medical schools. Currently, there is a great variation in the criteria used in different countries and there is no definitively appropriate method. The use of isolated or combined criteria, such as the marks obtained by students in medical schools, their performance in tests of theoretical knowledge and evaluations of clinical competence, or personal interviews, have a limited value for identifying those candidates who will perform better during the residency and later on during independent practice. To analyse the variability in the methodologies used for the selection of residents employed in different countries, in particular those used in the United Kingdom and USA, where external agencies and medical schools make systematic analyses of curriculum development. The advantages and disadvantages of national or transnational licensing examinations on the process of convergence and harmonization of medical degrees and residency programmes through Europe are discussed. The present analysis is used to design a new and more efficient multi-criteria methodology for resident selection in Spain, which will be published in the next issue of this journal. Since the multi-criteria methods used in UK and USA appear to be most consistent, these have been employed for designing the new methodology that could be applied in Spain. Although many experts in medical education reject national examinations for awarding medical degrees or ranking candidates for residency posts, it seems that, when appropriately designed, they can be used to verify the level of competence of graduating students without necessarily distorting curriculum implementation or improvement. Copyright © 2014

  7. Comparative validation of proxy-based montgomery-asberg depression rating scale and cornell scale for depression in dementia in nursing home residents with dementia

    NARCIS (Netherlands)

    Leontjevas, R.; Gerritsen, D.L.; Vernooij-Dassen, M.F.J.; Smalbrugge, M.; Koopmans, R.T.C.M.

    2012-01-01

    Objective: To 1) compare the accuracy of the Montgomery-̊Asberg Depression Rating Scale (MADRS) and the Cornell Scale for Depression in Dementia (CSDD) in nursing home residents with dementia when professional caregivers are the only available source of information and 2) explore different methods

  8. Screening for malnutrition among nursing home residents - a comparative analysis of the mini nutritional assessment, the nutritional risk screening, and the malnutrition universal screening tool.

    Science.gov (United States)

    Diekmann, R; Winning, K; Uter, W; Kaiser, M J; Sieber, C C; Volkert, D; Bauer, J M

    2013-04-01

    The European Society for Clinical Nutrition and Metabolism (ESPEN) has recommended the Mini Nutritional Assessment (MNA®), the Nutritional Risk Screening 2002 (NRS), and the Malnutrition Universal Screening Tool (MUST) for nutritional screening in various settings and age groups. While in recent years all three tools have been applied to nursing home residents, there is still no consensus on the most appropriate screening tool in this specific setting. The present study aims at comparing the MNA, the NRS, and the MUST with regard to applicability, categorization of nutritional status, and predictive value in the nursing home setting. MNA, NRS, and MUST were performed on 200 residents from two municipal nursing homes in Nuremberg, Germany. Follow-up data on infection, hospitalization, and mortality were collected after six and again after twelve months. Among 200 residents (mean age 85.5 ± 7.8 years) the MNA could be completed in 188 (94.0%) and the NRS and MUST in 198 (99.0%) residents. The prevalence of 'malnutrition' according to the MNA was 15.4%. The prevalence of 'risk of malnutrition' (NRS) and 'high risk of malnutrition' (MUST), respectively, was 8.6% for both tools. The individual categorization of nutritional status showed poor agreement between NRS and MUST on the one hand and MNA on the other. For all tools a significant association between nutritional status and mortality was demonstrated during follow-up as classification in 'malnourished', respectively 'high risk of malnutrition' or 'nutritional risk', was significantly associated with increased hazard ratios. However, the MNA showed the best predictive value for survival among well-nourished residents. The evaluation of nutritional status in nursing home residents by MNA, NRS, and MUST shows significant differences. This observation may be of clinical relevance as nutritional intervention is usually based on screening results. As the items of the MNA reflect particularities of the nursing home

  9. A comparative study of bulk-fill composites: degree of conversion, post-gel shrinkage and cytotoxicity

    Directory of Open Access Journals (Sweden)

    Flávia Gonçalves

    2018-03-01

    Full Text Available Abstract: Bulk-fill composites are claimed to be restorative materials used in deep preparations and effectively photoactivated in layers up to 4 mm. The aim of the present study was to evaluate the degree of conversion, post-gel volumetric shrinkage, and cytotoxicity of six bulk-fill and two conventional composites. Degree of conversion was determined by FTIR spectroscopy; post-gel volumetric shrinkage was determined using the strain gauge method; and cytotoxicity in human fibroblasts was evaluated indirectly by the MTT assay. Data were subjected to one-way ANOVA/Tukey's test (α = 0.05. All materials, including bulk-fill and conventional composites, were classified as non-toxic, with cell viability higher than 70%. Bulk-fill composites exhibited volumetric shrinkage similar to or lower (1.4 to 0.4% than that of conventional composites (1.7–2.1%. However, only four of the bulk-fill composites were able to sustain a homogeneous conversion at the 4-mm depth. Despite their non-toxicity and shrinkage similar to that of conventional materials, not all commercial bulk-fill materials were able to maintain a conversion as high as 80% of the superficial layer, at the 4-mm depth, indicating some failure in the bulk-fill design of some commercial brands. Therefore, the use of bulk-fill materials in dental practice is advantageous, but special attention should be given to the selection and correct use of the materials.

  10. Ovarian cancer survival population differences: a "high resolution study" comparing Philippine residents, and Filipino-Americans and Caucasians living in the US.

    Science.gov (United States)

    Redaniel, Maria Theresa M; Laudico, Adriano; Mirasol-Lumague, Maria Rica; Gondos, Adam; Uy, Gemma Leonora; Toral, Jean Ann; Benavides, Doris; Brenner, Hermann

    2009-09-24

    In contrast to most other forms of cancer, data from some developing and developed countries show surprisingly similar survival rates for ovarian cancer. We aimed to compare ovarian cancer survival in Philippine residents, Filipino-Americans and Caucasians living in the US, using a high resolution approach, taking potential differences in prognostic factors into account. Using databases from the SEER 13 and from the Manila and Rizal Cancer Registries, age-adjusted five-year absolute and relative survival estimates were computed using the period analysis method and compared between Filipino-American ovarian cancer patients with cancer patients from the Philippines and Caucasians in the US. Cox proportional hazards modelling was used to determine factors affecting survival differences. Despite more favorable distribution of age and cancer morphology and similar stage distribution, 5-year absolute and relative survival were lower in Philippine residents (Absolute survival, AS, 44%, Standard Error, SE, 2.9 and Relative survival, RS, 49.7%, SE, 3.7) than in Filipino-Americans (AS, 51.3%, SE, 3.1 and RS, 54.1%, SE, 3.4). After adjustment for these and additional covariates, strong excess risk of death for Philippine residents was found (Relative Risk, RR, 2.45, 95% confidence interval, 95% CI, 1.99-3.01). In contrast, no significant differences were found between Filipino-Americans and Caucasians living in the US. Multivariate analyses disclosed strong survival disadvantages of Philippine residents compared to Filipino-American patients, for which differences in access to health care might have played an important role. Survival is no worse among Filipino-Americans than among Caucasians living in the US.

  11. A comparative analysis of health-related quality of life for residents of U.S. counties with and without coal mining.

    Science.gov (United States)

    Zullig, Keith J; Hendryx, Michael

    2010-01-01

    We compared health-related quality of life (HRQOL) in mining and non-mining counties in and out of Appalachia using the 2006 Behavioral Risk Factor Surveillance System (BRFSS) survey. Dependent variables included self-rated health, the number of poor physical and mental health days, the number of activity limitation days (in the last 30 days), and the Centers for Disease Control and Prevention Healthy Days Index. Independent variables included the presence of coal mining, Appalachian region residence, metropolitan status, primary care physician supply, and BRFSS behavioral (e.g., smoking, body mass index, and alcohol consumption) and demographic (e.g., age, gender, race, and income) variables. We compared dependent variables across a four-category variable: Appalachia (yes/ no) and coal mining (yes/no). We used SUDAAN Multilog and multiple linear regression models with post-hoc least-squares means to test for Appalachian coal-mining effects after adjusting for covariates. Residents of coal-mining counties inside and outside of Appalachia reported significantly fewer healthy days for both physical and mental health, and poorer self-rated health (p mining counties, but disparities were greatest for people residing in Appalachian coal-mining areas. Furthermore, results remained consistent in separate analyses by gender and age. Coal-mining areas are characterized by greater socioeconomic disadvantage, riskier health behaviors, and environmental degradation that are associated with reduced HRQOL.

  12. Comparative-Effectiveness of Simulation-Based Deliberate Practice Versus Self-Guided Practice on Resident Anesthesiologists' Acquisition of Ultrasound-Guided Regional Anesthesia Skills.

    Science.gov (United States)

    Udani, Ankeet Deepak; Harrison, T Kyle; Mariano, Edward R; Derby, Ryan; Kan, Jack; Ganaway, Toni; Shum, Cynthia; Gaba, David M; Tanaka, Pedro; Kou, Alex; Howard, Steven K

    2016-01-01

    Simulation-based education strategies to teach regional anesthesia have been described, but their efficacy largely has been assumed. We designed this study to determine whether residents trained using the simulation-based strategy of deliberate practice show greater improvement of ultrasound-guided regional anesthesia (UGRA) skills than residents trained using self-guided practice in simulation. Anesthesiology residents new to UGRA were randomized to participate in either simulation-based deliberate practice (intervention) or self-guided practice (control). Participants were recorded and assessed while performing simulated peripheral nerve blocks at baseline, immediately after the experimental condition, and 3 months after enrollment. Subject performance was scored from video by 2 blinded reviewers using a composite tool. The amount of time each participant spent in deliberate or self-guided practice was recorded. Twenty-eight participants completed the study. Both groups showed within-group improvement from baseline scores immediately after the curriculum and 3 months following study enrollment. There was no difference between groups in changed composite scores immediately after the curriculum (P = 0.461) and 3 months following study enrollment (P = 0.927) from baseline. The average time in minutes that subjects spent in simulation practice was 6.8 minutes for the control group compared with 48.5 minutes for the intervention group (P < 0.001). In this comparative effectiveness study, there was no difference in acquisition and retention of skills in UGRA for novice residents taught by either simulation-based deliberate practice or self-guided practice. Both methods increased skill from baseline; however, self-guided practice required less time and faculty resources.

  13. Use of the learning conversation improves instructor confidence in life support training: An open randomised controlled cross-over trial comparing teaching feedback mechanisms.

    Science.gov (United States)

    Baldwin, Lydia J L; Jones, Christopher M; Hulme, Jonathan; Owen, Andrew

    2015-11-01

    Feedback is vital for the effective delivery of skills-based education. We sought to compare the sandwich technique and learning conversation structured methods of feedback delivery in competency-based basic life support (BLS) training. Open randomised crossover study undertaken between October 2014 and March 2015 at the University of Birmingham, United Kingdom. Six-hundred and forty healthcare students undertaking a European Resuscitation Council (ERC) BLS course were enrolled, each of whom was randomised to receive teaching using either the sandwich technique or the learning conversation. Fifty-eight instructors were randomised to initially teach using either the learning conversation or sandwich technique, prior to crossing-over and teaching with the alternative technique after a pre-defined time period. Outcome measures included skill acquisition as measured by an end-of-course competency assessment, instructors' perception of teaching with each feedback technique and candidates' perception of the feedback they were provided with. Scores assigned to use of the learning conversation by instructors were significantly more favourable than for the sandwich technique across all but two assessed domains relating to instructor perception of the feedback technique, including all skills-based domains. No difference was seen in either assessment pass rates (80.9% sandwich technique vs. 77.2% learning conversation; OR 1.2, 95% CI 0.85-1.84; p=0.29) or any domain relating to candidates' perception of their teaching technique. This is the first direct comparison of two feedback techniques in clinical medical education using both quantitative and qualitative methodology. The learning conversation is preferred by instructors providing competency-based life support training and is perceived to favour skills acquisition. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

  14. Effects of residents' tourism development expectation and tourism impacts perception on their attitude towards tourism in natural tourist destination: A Comparative study between China's Jiuzhaigou and the UK's New Forest National Parks

    OpenAIRE

    Cheng, S.; Zhang, J.; Xu, Feifei; Liang, Y.

    2010-01-01

    Local residents' perception of tourism impacts in tourist destinations has been found to affect their attitude towards tourism; however, there have been relatively few studies on the influence of residents' tourism development expectation on their attitude towards tourism. With the utilization of SPSS16.0 software, this paper, taking China's Jiuzhaigou and the UK's New Forest National Parks as case study areas, makes a comparative study on the influence of local residents' tourism development...

  15. Male and female residents in postgraduate medical education – A gender comparative analysis of differences in career perspectives and their conditions in Germany

    Directory of Open Access Journals (Sweden)

    Ziegler, Stine

    2017-11-01

    Full Text Available Aim: This article focuses on the gender-specific career differences of residents in their postgraduate medical education in Germany. In particular the structural obstacles female physicians have to overcome during residency are investigated. Moreover, the study examines the position preferences of male and female physicians in the hospital and in how far occupational self-efficacy corresponds to the interest in a hospital leading position.Methods: The KarMed-Study’s database consists of annual postal surveys throughout the entire residency of medical students, who were in their “Practical Year” in 2008/2009. Descriptive statistics and regression models were used in the analysis.Results: Male and female physicians differ in terms of their preferred work place (hospital, ambulatory care, others, hospital position and working hours. Female physicians prefer part-time work and rarely assume leading positions compared to male physicians. In addition, female physicians, especially those with children, need more time to complete their postgraduate training. Female physicians with children are burdened and disadvantaged more often than their female colleagues without children as well as male physicians in general (e.g. belated start and completion of residency, lower rate of doctorate titles, higher quota of part-time contracts, short-term employment contracts, and higher rates of residency interruption or termination. Besides gender and doctorate title, the occupational self-efficacy expectation has an influence on the preference of leading positions in hospitals. Respondents with a low occupational self-efficacy score are less likely to strive for leading positions with more responsibilities than those with a high score. Conclusion: The results demonstrate clear gender disparities in postgraduate training. Female physicians, especially those with children, are disadvantaged in various areas when compared with their male colleagues. In particular

  16. Preference dominance reasoning for conversational recommender systems: a comparison between a comparative preferences and a sum of weights approach

    OpenAIRE

    Trabelsi, Walid; Wilson, Nic; Bridge, Derek G.; Ricci, Francesco

    2011-01-01

    A conversational recommender system iteratively shows a small set of options for its user to choose between. In order to select these options, the system may analyze the queries tried by the user to derive whether one option is dominated by others with respect to the user's preferences. The system can then suggest that the user try one of the undominated options, as they represent the best options in the light of the user preferences elicited so far. This paper describes a framework for prefe...

  17. A randomized clinical trial of the anti-caries efficacy of 5,000 compared to 1,450 ppm fluoridated toothpaste on root caries lesions in elderly disabled nursing home residents

    DEFF Research Database (Denmark)

    Ekstrand, K.R.; Poulsen, J.E.; Hede, B.

    2013-01-01

    Root caries is prevalent in elderly disabled nursing home residents in Denmark. This study aimed to compare the effectiveness of tooth brushing with 5,000 versus 1,450 ppm of fluoridated toothpaste (F-toothpaste) for controlling root caries in nursing home residents. The duration of the study was 8...... months. Elderly disabled residents (n = 176) in 6 nursing homes in the Copenhagen area consented to take part in the study. They were randomly assigned to use one of the two toothpastes. Both groups had their teeth brushed twice a day by the nursing staff. A total of 125 residents completed the study...

  18. Comparing Hp(3) evaluated from the conversion coefficients from air kerma to personal dose equivalent for eye lens dosimetry calibrated on a new cylindrical PMMA phantom

    Science.gov (United States)

    Esor, J.; Sudchai, W.; Monthonwattana, S.; Pungkun, V.; Intang, A.

    2017-06-01

    Based on a new occupational dose limit recommended by ICRP (2011), the annual dose limit for the lens of the eye for workers should be reduced from 150 mSv/y to 20 mSv/y averaged over 5 consecutive years in which no single year exceeding 50 mSv. This new dose limit directly affects radiologists and cardiologists whose work involves high radiation exposure over 20 mSv/y. Eye lens dosimetry (Hp(3)) has become increasingly important and should be evaluated directly based on dosimeters that are worn closely to the eye. Normally, Hp(3) dose algorithm was carried out by the combination of Hp(0.07) and Hp(10) values while dosimeters were calibrated on slab PMMA phantom. Recently, there were three reports from European Union that have shown the conversion coefficients from air kerma to Hp(3). These conversion coefficients carried out by ORAMED, PTB and CEA Saclay projects were performed by using a new cylindrical head phantom. In this study, various delivered doses were calculated using those three conversion coefficients while nanoDot, small OSL dosimeters, were used for Hp(3) measurement. These calibrations were performed with a standard X-ray generator at Secondary Standard Dosimetry Laboratory (SSDL). Delivered doses (Hp(3)) using those three conversion coefficients were compared with Hp(3) from nanoDot measurements. The results showed that percentage differences between delivered doses evaluated from the conversion coefficient of each project and Hp(3) doses evaluated from the nanoDots were found to be not exceeding -11.48 %, -8.85 % and -8.85 % for ORAMED, PTB and CEA Saclay project, respectively.

  19. Breaking bad news in the emergency department: a comparative analysis among residents, patients and family members' perceptions.

    Science.gov (United States)

    Toutin-Dias, Gabriela; Daglius-Dias, Roger; Scalabrini-Neto, Augusto

    2018-02-01

    Our main objective was to assess patient and family members' perception of bad news communication in the emergency department (ED) and compare these with physicians' perceptions. This is a cross-sectional study carried out at the ED of a tertiary teaching hospital. To compare physicians' and receivers' (patient and/or family member) perceptions, we created a survey based on the six attributes derived from the SPIKES protocol. The surveys were applied immediately after communication of bad news occurred in the ED. We analyzed agreement among participants using κ-statistics and the χ-test to compare proportions. A total of 73 bad news communication encounters were analyzed. The survey respondents were 73 physicians, 69 family members, and four patients. In general, there is a low level of agreement between physicians' and receivers' perceptions of how breaking bad news transpired. The satisfaction level of receivers, in terms of breaking bad news by doctors, presented a mean of 3.7±0.6 points. In contrast, the physicians' perception of the communication was worse (2.9±0.6 points), with P value less than 0.001. Doctors and receivers disagree in relation to what transpired throughout bad news communications. Discrepancies were more evident in issues involving emotion, invitation, and privacy. An important agreement between perceptions was found in technical and knowledge-related aspects of the communication.

  20. A comparative study of nitrogen conversion during pyrolysis of coconut fiber, its corresponding biochar and their blends with lignite.

    Science.gov (United States)

    Liu, Zhengang; Balasubramanian, Rajasekhar

    2014-01-01

    In the present study, the conversion of fuel-N to HCN and NH3 was investigated during rapid pyrolysis of raw biomass (coconut fiber), its corresponding biochar and their blends with lignite within a temperature range of 600-900°C. The results showed that the raw biomass and the biochar showed totally different nitrogen partitioning between NH3 and HCN. HCN was the dominant nitrogen pollutant from pyrolysis of raw biomass, while for the biochar pyrolysis the yield of NH3 was slightly higher than that of HCN. Synergistic interactions occurred within both raw biomass/lignite and biochar/lignite blends, especially for the biochar/lignite blend, and resulted in reduced yields of HCN and NH3, decreased the total nitrogen percentage retained in the char and promoted harmless N2 formation. These findings suggest that biochar/lignite co-firing for energy production may have the enhanced benefit of reduced emissions of nitrogen pollutants than raw biomass/lignite. Copyright © 2013 Elsevier Ltd. All rights reserved.

  1. A comparative study on the performance of photogalvanic cells with different photosensitizers for solar energy conversion and storage: D-Xylose-NaLS systems

    International Nuclear Information System (INIS)

    Bhimwal, Mahesh Kumar; Gangotri, K.M.

    2011-01-01

    The comparative performance of photogalvanic cells has been studied for solar energy conversion and storage by using Methyl Orange, Rose Bengal, Toluidine Blue and Brilliant Cresyl Blue as different photosensitizers with D-Xylose as reductant and Sodium Lauryl Sulphate (NaLS) as surfactant in the different systems. The photogeneration of photopotential are 890.0, 885.0, 945.0 and 940.0 mV whereas the maximum photocurrent is 625.0, 575.0, 510.0 and 480.0 μA, respectively. The short circuit current or photocurrent at equilibrium is 480.0, 460.0, 430.0 and 440.0 μA, respectively. The observed conversion efficiencies for Methyl Orange, Rose Bengal, Toluidine Blue and Brilliant Cresyl Blue with D-Xylose and Sodium Lauryl Sulphate systems are 1.6245, 1.5261, 1.4323 and 1.1057%, respectively. The fill factors 0.3244, 0.3151, 0.3120, and 0.2408 are experimentally determined at the power point of the cell where the absolute value is 1.0. The photogalvanic cells so developed can work for 160.0, 145.0, 130.0 and 140.0 min in dark if it is irradiated for 180.0, 165.0, 135.0 and 150.0 min, respectively where the percentage of storage capacity of photogalvanic cells are found 87.87%-96.29%. All observed results are the higher among the reported results so far in the literature. -- Research highlights: → The discussed photogalvanic cells have higher storage capacity and conversion efficiency of sunlight, in comparison to the present solar cells. → A comparative performance of photogalvanic cells was studied by applying different photosensitizers (dyes) systems. → A more reliable estimate of the maximum conversion efficiency and storage capacity are achieved 1.1057%-1.6245% and 96.29%, respectively. → On the basis of sunlight conversion data, the observed maximum photocurrent and photopotential are 1200.0 μA and 2360.0 mV, respectively. → The literature survey reveals that the reported results in the present research work are the highest so far.

  2. Resident fatigue in otolaryngology residents: a Web based survey.

    Science.gov (United States)

    Nida, Andrew M; Googe, Benjamin J; Lewis, Andrea F; May, Warren L

    2016-01-01

    Resident fatigue has become a point of emphasis in medical education and its effects on otolaryngology residents and their patients require further study. The purpose of our study was to evaluate the prevalence and nature of fatigue in otolaryngology residents, evaluate various quality of life measures, and investigate associations of increased fatigue with resident safety. Anonymous survey. Internet based. United States allopathic otolaryngology residents. None. The survey topics included demographics, residency structure, sleep habits and perceived stress. Responses were correlated with a concurrent Epworth Sleep Scale questionnaire to evaluate effects of fatigue on resident training and quality of life. 190 residents responded to the survey with 178 completing the Epworth Sleep Scale questionnaire. Results revealed a mean Epworth Sleep Scale score of 9.9±5.1 with a median of 10.0 indicating a significant number of otolaryngology residents are excessively sleepy. Statistically significant correlations between Epworth Sleep Scale and sex, region, hours of sleep, and work hours were found. Residents taking in-house call had significantly fewer hours of sleep compared to home call (p=0.01). Residents on "head and neck" (typically consisting of a large proportion of head and neck oncologic surgery) rotations tended to have higher Epworth Sleep Scale and had significantly fewer hours of sleep (p=.003) and greater work hours (potolaryngology residents are excessively sleepy. Our data suggest that the effects of fatigue play a role in resident well-being and resident safety. Copyright © 2016 Elsevier Inc. All rights reserved.

  3. Impact of Residency Training Redesign on Residents' Clinical Knowledge.

    Science.gov (United States)

    Waller, Elaine; Eiff, M Patrice; Dexter, Eve; Rinaldo, Jason C B; Marino, Miguel; Garvin, Roger; Douglass, Alan B; Phillips, Robert; Green, Larry A; Carney, Patricia A

    2017-10-01

    The In-training Examination (ITE) is a frequently used method to evaluate family medicine residents' clinical knowledge. We compared family medicine ITE scores among residents who trained in the 14 programs that participated in the Preparing the Personal Physician for Practice (P4) Project to national averages over time, and according to educational innovations. The ITE scores of 802 consenting P4 residents who trained in 2007 through 2011 were obtained from the American Board of Family Medicine. The primary analysis involved comparing scores within each academic year (2007 through 2011), according to program year (PGY) for P4 residents to all residents nationally. A secondary analysis compared ITE scores among residents in programs that experimented with length of training and compared scores among residents in programs that offered individualized education options with those that did not. Release of ITE scores was consented to by 95.5% of residents for this study. Scores of P4 residents were higher compared to national scores in each year. For example, in 2011, the mean P4 score for PGY1 was 401.2, compared to the national average of 386. For PGY2, the mean P4 score was 443.1, compared to the national average of 427, and for PGY3, the mean P4 score was 477.0, compared to the national PGY3 score of 456. Scores of residents in programs that experimented with length of training were similar to those in programs that did not. Scores were also similar between residents in programs with and without individualized education options. Family medicine residency programs undergoing substantial educational changes, including experiments in length of training and individualized education, did not appear to experience a negative effect on resident's clinical knowledge, as measured by ITE scores. Further research is needed to study the effect of a wide range of residency training innovations on ITE scores over time.

  4. Permanent resident

    Directory of Open Access Journals (Sweden)

    John F. Fisher

    2016-05-01

    Full Text Available The training of physicians in the past century was based primarily on responsibility and the chain-of-command. Those with the bulk of that responsibility in the fields of pediatrics and internal medicine were residents. Residents trained the medical students and supervised them carefully in caring for patients. Most attending physicians supervised their teams at arm's length, primarily serving as teachers of the finer points of diagnosis and treatment during set periods of the day or week with a perfunctory signature on write-ups or progress notes. Residents endeavored to protect the attending physician from being heavily involved unless they were unsure about a clinical problem. Before contacting the attending physician, a more senior resident would be called. Responsibility was the ultimate teacher. The introduction of diagnosis-related groups by the federal government dramatically changed the health care delivery system, placing greater emphasis on attending physician visibility in the medical record, ultimately resulting in more attending physician involvement in day-to-day care of patients in academic institutions. Without specified content in attending notes, hospital revenues would decline. Although always in charge technically, attending physicians increasingly have assumed the role once dominated by the resident. Using biographical experiences of more than 40 years, the author acknowledges and praises the educational role of responsibility in his own training and laments its declining role in today's students and house staff.

  5. Comparative bonding ability to dentin of a universal adhesive system and monomer conversion as functions of extended light curing times and storage.

    Science.gov (United States)

    Sampaio, Paula Costa Pinheiro; Kruly, Paula de Castro; Ribeiro, Clara Cabral; Hilgert, Leandro Augusto; Pereira, Patrícia Nóbrega Rodrigues; Scaffa, Polliana Mendes Candia; Di Hipólito, Vinicius; D'Alpino, Paulo Henrique Perlatti; Garcia, Fernanda Cristina Pimentel

    2017-11-01

    The purpose of this in vitro study was to evaluate the bonding ability and monomer conversion of a universal adhesive system applied to dentin as functions of different curing times and storage. The results were compared among a variety of commercial adhesives. Flat superficial dentin surfaces were exposed on human molars and assigned into one of the following adhesives (n = 15): total-etch Adper Single Bond 2 (SB) and Optibond Solo Plus (OS), self-etch Optibond All in One (OA) and Clearfil SE Bond (CSE), and Scotchbond Universal Adhesive in self-etch mode (SU). The adhesives were applied following the manufacturers' instructions and cured for 10, 20, or 40s. Specimens were processed for the microtensile bond strength (µTBS) test in accordance with the non-trimming technique and tested after 24h and 2 years. The fractured specimens were classified under scanning electron microscopy (SEM). Infrared (IR) spectra were obtained and monomer conversion (%) was calculated by comparing the aliphatic-to-aromatic IR absorption peak ratio before and after polymerization (n=5). Data were analyzed by 2-way ANOVA/Tukey's tests (α = 0.05). At 24-h evaluation, OA and CSE presented similar bond strength means irrespective of the curing time, whereas SB and SU exhibited significantly higher means when cured for 40s as did OS when cured for 20 or 40s (p storage, only the self-etching adhesive Optibond All-In-One exhibited the same bonding ability when cured for longer periods of time. Copyright © 2017 Elsevier Ltd. All rights reserved.

  6. To compare PubMed Clinical Queries and UpToDate in teaching information mastery to clinical residents: a crossover randomized controlled trial.

    Science.gov (United States)

    Sayyah Ensan, Ladan; Faghankhani, Masoomeh; Javanbakht, Anna; Ahmadi, Seyed-Foad; Baradaran, Hamid Reza

    2011-01-01

    To compare PubMed Clinical Queries and UpToDate regarding the amount and speed of information retrieval and users' satisfaction. A cross-over randomized trial was conducted in February 2009 in Tehran University of Medical Sciences that included 44 year-one or two residents who participated in an information mastery workshop. A one-hour lecture on the principles of information mastery was organized followed by self learning slide shows before using each database. Subsequently, participants were randomly assigned to answer 2 clinical scenarios using either UpToDate or PubMed Clinical Queries then crossed to use the other database to answer 2 different clinical scenarios. The proportion of relevantly answered clinical scenarios, time to answer retrieval, and users' satisfaction were measured in each database. Based on intention-to-treat analysis, participants retrieved the answer of 67 (76%) questions using UpToDate and 38 (43%) questions using PubMed Clinical Queries (PPubMed Clinical Queries (PPubMed Clinical Queries users (PPubmed Clinical Queries can lead to not only a higher proportion of relevant answer retrieval within a shorter time, but also a higher users' satisfaction. So, addition of tutoring pre-appraised sources such as UpToDate to the information mastery curricula seems to be highly efficient.

  7. Energy conversion alternatives study

    Science.gov (United States)

    Shure, L. T.

    1979-01-01

    Comparison of coal based energy systems is given. Study identifies and compares various advanced energy conversion systems using coal or coal derived fuels for baselaoad electric power generation. Energy Conversion Alternatives Study (ECAS) reports provede government, industry, and general public with technically consistent basis for comparison of system's options of interest for fossilfired electric-utility application.

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

    Science.gov (United States)

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

    2016-05-01

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

  9. UBC-Nepal expedition: markedly lower cerebral blood flow in high-altitude Sherpa children compared with children residing at sea level.

    Science.gov (United States)

    Flück, Daniela; Morris, Laura E; Niroula, Shailesh; Tallon, Christine M; Sherpa, Kami T; Stembridge, Mike; Ainslie, Philip N; McManus, Ali M

    2017-10-01

    Developmental cerebral hemodynamic adaptations to chronic high-altitude exposure, such as in the Sherpa population, are largely unknown. To examine hemodynamic adaptations in the developing human brain, we assessed common carotid (CCA), internal carotid (ICA), and vertebral artery (VA) flow and middle cerebral artery (MCA) velocity in 25 (9.6 ± 1.0 yr old, 129 ± 9 cm, 27 ± 8 kg, 14 girls) Sherpa children (3,800 m, Nepal) and 25 (9.9 ± 0.7 yr old, 143 ± 7 cm, 34 ± 6 kg, 14 girls) age-matched sea level children (344 m, Canada) during supine rest. Resting gas exchange, blood pressure, oxygen saturation and heart rate were assessed. Despite comparable age, height and weight were lower (both P sea level children. Mean arterial pressure, heart rate, and ventilation were similar, whereas oxygen saturation (95 ± 2 vs. 99 ± 1%, P sea level children. This was reflected in a lower ICA flow (283 ± 108 vs. 333 ± 56 ml/min, P = 0.05), VA flow (78 ± 26 vs. 118 ± 35 ml/min, P sea level children (425 ± 92 vs. 441 ± 81 ml/min, P = 0.52). Scaling flow and oxygen uptake for differences in vessel diameter and body size, respectively, led to the same findings. A lower cerebral blood flow in Sherpa children may reflect specific cerebral hemodynamic adaptations to chronic hypoxia. NEW & NOTEWORTHY Cerebral blood flow is lower in Sherpa children compared with children residing at sea level; this may reflect a cerebral hemodynamic pattern, potentially due to adaptation to a hypoxic environment. Copyright © 2017 the American Physiological Society.

  10. An innovative brioche enriched in protein and energy improves the nutritional status of malnourished nursing home residents compared to oral nutritional supplement and usual breakfast: FARINE+ project.

    Science.gov (United States)

    Van Wymelbeke, Virginie; Brondel, Laurent; Bon, Francis; Martin-Pfitzenmeyer, Isabelle; Manckoundia, Patrick

    2016-10-01

    To compare the effects of a 12-week nutritional intervention, in which an innovative protein-and-energy-enriched brioche, an oral nutritional supplement or a usual breakfast were eaten, on food intake and nutritional status in nursing home residents. Three-armed, multicentre, controlled trial. Eight nursing homes in Burgundy, France. Sixty-eight malnourished participants aged between 70 and 99 years old. Participants were randomly assigned to one of three groups according to the breakfast provided: brioche group, one portion of 65 g brioche enriched in protein and energy (12.8 g and 180 kcal) added to usual breakfast; supplement group, 200-ml of a ready-to-use, energy-dense liquid (14 g protein and 200 kcal) added to usual breakfast or control group, a usual breakfast only. Total energy intakes were assessed for three days at different periods of the study (day 0, day 30 and day 90); blood parameters, nutritional status (mini nutritional assessment, weight) and functional capacities (grip strength and activity level) were measured at the beginning and at the end of the nutritional intervention study (day 0 and day 90). The participants of the brioche group had higher total energy intakes at day 30 (p value 0.004) and at day 90 (p value 0.018) compared with the supplement group and the control group. At the end of the interventional study, 72% of the participants in the brioche group had reached the recommended minimum level of protein of 0.8 g/kg/day, compared with 53% in the supplement group and 36% in the control group (p value 0.036). In addition, between day 0 and day 90 in the brioche group, blood levels of vitamins B 9 , B 2 , D (all p value <0.001), B 6 (p value 0.026) and B 12 (p value 0.036) had increased and plasma homocysteine had decreased (p value 0.024). The protein-and-energy-enriched brioche effectively increased energy and protein intakes and improved the nutritional status of elderly people living in nursing homes. It could be a good

  11. Comparative Evaluation of Phase 1 Results from the Energy Conversion Alternatives Study (ECAS). [coal utilization for electric power plants feasibility analysis

    Science.gov (United States)

    1976-01-01

    Ten advanced energy conversion systems for central-station, based-load electric power generation using coal and coal-derived fuels which were studied by NASA are presented. Various contractors were selected by competitive bidding to study these systems. A comparative evaluation is provided of the contractor results on both a system-by-system and an overall basis. Ground rules specified by NASA, such as coal specifications, fuel costs, labor costs, method of cost comparison, escalation and interest during construction, fixed charges, emission standards, and environmental conditions, are presented. Each system discussion includes the potential advantages of the system, the scope of each contractor's analysis, typical schematics of systems, comparison of cost of electricity and efficiency for each contractor, identification and reconciliation of differences, identification of future improvements, and discussion of outside comments. Considerations common to all systems, such as materials and furnaces, are also discussed. Results of selected in-house analyses are presented, in addition to contractor data. The results for all systems are then compared.

  12. Uranium conversion

    International Nuclear Information System (INIS)

    Oliver, Lena; Peterson, Jenny; Wilhelmsen, Katarina

    2006-03-01

    FOI, has performed a study on uranium conversion processes that are of importance in the production of different uranium compounds in the nuclear industry. The same conversion processes are of interest both when production of nuclear fuel and production of fissile material for nuclear weapons are considered. Countries that have nuclear weapons ambitions, with the intention to produce highly enriched uranium for weapons purposes, need some degree of uranium conversion capability depending on the uranium feed material available. This report describes the processes that are needed from uranium mining and milling to the different conversion processes for converting uranium ore concentrate to uranium hexafluoride. Uranium hexafluoride is the uranium compound used in most enrichment facilities. The processes needed to produce uranium dioxide for use in nuclear fuel and the processes needed to convert different uranium compounds to uranium metal - the form of uranium that is used in a nuclear weapon - are also presented. The production of uranium ore concentrate from uranium ore is included since uranium ore concentrate is the feed material required for a uranium conversion facility. Both the chemistry and principles or the different uranium conversion processes and the equipment needed in the processes are described. Since most of the equipment that is used in a uranium conversion facility is similar to that used in conventional chemical industry, it is difficult to determine if certain equipment is considered for uranium conversion or not. However, the chemical conversion processes where UF 6 and UF 4 are present require equipment that is made of corrosion resistant material

  13. Do immigrants from Turkey, Pakistan and Yugoslavia receive adequate medical treatment with beta-blockers and statins after acute myocardial infarction compared with Danish-born residents? A register-based follow-up study

    DEFF Research Database (Denmark)

    Hempler, Nana Folmann; Diderichsen, Finn; Larsen, Finn Breinholt

    2010-01-01

    We undertook a study investigating whether immigrants from Turkey, Pakistan and Yugoslavia received adequate medical treatment with beta-blockers and statins after acute myocardial infarction (AMI) when compared with Danish-born residents and explored whether associations between patient origin...

  14. Patient Participation at Health Care Conferences: Engaged Patients Increase Information Flow, Expand Propagation, and Deepen Engagement in the Conversation of Tweets Compared to Physicians or Researchers.

    Science.gov (United States)

    Utengen, Audun; Rouholiman, Dara; Gamble, Jamison G; Grajales, Francisco Jose; Pradhan, Nisha; Staley, Alicia C; Bernstein, Liza; Young, Sean D; Clauson, Kevin A; Chu, Larry F

    2017-08-17

    conferences compared to physicians, they represent only 1.4% of the stakeholder mix of the top 100 influencers in the conversation. Health care conferences that fail to engage patients in their proceedings may risk limiting their engagement with the public, disseminating scientific information to a narrow community and slowing flow of information across social media channels. ©Audun Utengen, Dara Rouholiman, Jamison G. Gamble, Francisco Jose Grajales III, Nisha Pradhan, Alicia C Staley, Liza Bernstein, Sean D Young, Kevin A Clauson, Larry F Chu. Originally published in the Journal of Medical Internet Research (http://www.jmir.org), 17.08.2017.

  15. Conversation Analysis.

    Science.gov (United States)

    Schiffrin, Deborah

    1990-01-01

    Summarizes the current state of research in conversation analysis, referring primarily to six different perspectives that have developed from the philosophy, sociology, anthropology, and linguistics disciplines. These include pragmatics; speech act theory; interactional sociolinguistics; ethnomethodology; ethnography of communication; and…

  16. Impact of the «Conversation Map™» tools on understanding of diabetes by Spanish patients with type 2 diabetes mellitus: a randomized, comparative study.

    Science.gov (United States)

    Penalba, Maite; Moreno, Luis; Cobo, Amelia; Reviriego, Jesús; Rodríguez, Angel; Cleall, Simon; Reaney, Matthew

    2014-12-01

    This paper presents results from the Spanish subpopulation of a study comparing Conversation Maps™ (CM)-based education with regular care (RC) in type 2 diabetes mellitus (T2DM). Adult patients with T2DM who were considered as not demonstrating ideal disease management were randomly assigned to CM or RC with assessments following (Visit 2), and at follow-up 6 months after (Visit 3), the final CM session. The primary endpoint was diabetes knowledge at Visit 3. 310 patients were randomised to receive CM education (n=148) or RC (n=162). Median knowledge scores were ranked significantly higher in the CM group than the RC group at Visit 2 and Visit 3 (p<0.001). No significant differences in clinical and other outcomes were identified between the interventions, except satisfaction with care (p<0.001, Visit 2; p=0.055, Visit 3) and perception of goal attainment (p<0.001 and p = 0.046, respectively) that were both higher in the CM group. In these patients from Spain, CM was superior to RC in terms of diabetes knowledge 6 months after education was completed, suggesting that CM should be considered for use in patients requiring diabetes education. Copyright © 2014 SEEN. Published by Elsevier Espana. All rights reserved.

  17. Comparative investigation of the adhesion of Ce conversion layers and silane layers to a AA 2024-T3 substrate through mechanical and electrochemical tests

    Directory of Open Access Journals (Sweden)

    Luis Enrique Morales Palomino

    2007-12-01

    Full Text Available Cerium conversion layers and silane films are among the potential substitutes for the carcinogenic chromate conversion layers used to protect high-strength Al alloys. In the present work the adhesion of a cerium conversion layer and of a silane film to an aluminium alloy (AA 2024-T3 substrate was investigated using mechanical and electrochemical tests. Scanning electron microscopy (SEM- X ray energy dispersive spectroscopy (EDS, Fourier transform infrared spectroscopy (FT-IR and X ray photoelectron spectroscopy (XPS were used to characterize the layers prior and after the mechanical test consisting of ultrasonic rinse in deionized water during 30 minutes. Mechanically tested and untested layers were also submitted to electrochemical impedance spectroscopy (EIS and anodic polarization measurements in 0.1 M NaCl solution. The results of the characterization tests have pointed to a stronger adhesion of the Ce layer to the substrate in comparison with the silane film, which was confirmed by the electrochemical tests. The adhesion between the silane film and the Ce conversion layer was also tested, to evaluate the possibility of using the system as a protective bi-layer in accordance with the new trends being developed to substitute chromate conversion layers.

  18. An Analysis of Publication Productivity During Residency for 1506 Neurosurgical Residents and 117 Residency Departments in North America.

    Science.gov (United States)

    Khan, Nickalus R; Saad, Hassan; Oravec, Chesney S; Norrdahl, Sebastian P; Fraser, Brittany; Wallace, David; Lillard, Jock C; Motiwala, Mustafa; Nguyen, Vincent N; Lee, Siang Liao; Jones, Anna V; Ajmera, Sonia; Kalakoti, Piyush; Dave, Pooja; Moore, Kenneth A; Akinduro, Olutomi; Nyenwe, Emmanuel; Vaughn, Brandy; Michael, L Madison; Klimo, Paul

    2018-05-30

    Bibliometrics is defined as the study of statistical and mathematical methods used to quantitatively analyze scientific literature. The application of bibliometrics in neurosurgery continues to evolve. To calculate a number of publication productivity measures for almost all neurosurgical residents and departments within North America. These measures were correlated with survey results on the educational environment within residency programs. During May to June 2017, data were collected from departmental websites and Scopus to compose a bibliometric database of neurosurgical residents and residency programs. Data related to authorship value and study content were collected on all articles published by residents. A survey of residency program research and educational environment was administered to program directors and coordinators; results were compared with resident academic productivity. The median number of publications in residency was 3; median h-index and Resident index were 1 and 0.17 during residency, respectively. There was a statistically significant difference in academic productivity among male neurosurgical residents compared with females. The majority of articles published were tier 1 clinical articles. Residency program research support was significantly associated with increased resident productivity (P productivity. This study represents the most comprehensive bibliometric assessment of neurosurgical resident academic productivity during training to date. New benchmarks for individual and department academic productivity are provided. A supportive research environment for neurosurgical residents is associated with increased academic productivity, but a scholarly activity requirement was, surprisingly, not shown to have a positive effect.

  19. Pictorial Conversations.

    Science.gov (United States)

    Hooper, Kristina

    1982-01-01

    Provides the rationale for considering communication in a graphic domain and suggests a specific goal for designing work stations which provide graphic capabilities in educational settings. The central element of this recommendation is the "pictorial conversation", a highly interactive exchange that includes pictures as the central elements.…

  20. Teaching Residents How to Talk About Death and Dying: A Mixed-Methods Analysis of Barriers and Randomized Educational Intervention.

    Science.gov (United States)

    Miller, David C; Sullivan, Amy M; Soffler, Morgan; Armstrong, Brett; Anandaiah, Asha; Rock, Laura; McSparron, Jakob I; Schwartzstein, Richard M; Hayes, Margaret M

    2018-01-01

    We present a pilot study exploring the effects of a brief, 30-minute educational intervention targeting resident communication surrounding dying in the intensive care unit (ICU). We sought to determine whether simulation or didactic educational interventions improved resident-reported comfort, preparation, and skill acquisition. We also sought to identify resident barriers to using the word "dying." In this mixed-methods prospective study, second- and third-year medical residents were randomized to participate in a simulation-based communication training or a didactic session. Residents completed a pre-post survey after the sessions evaluating the sessions and reflecting on their use of the word "dying" in family meetings. Forty-five residents participated in the study. Residents reported increases in comfort (Mean [M]-pre = 3.3 [standard deviation: 0.6], M-post = 3.7 [0.7]; P educational intervention improves internal medicine residents' self-reported comfort and preparation in talking about death and dying in the ICU. Residents in simulation-based training were more likely to report they learned new skills as compared to the didactic session. Residents report multiple barriers to using the word "dying" EOL conversations.

  1. The pregnant female surgical resident

    Directory of Open Access Journals (Sweden)

    Shifflette V

    2018-05-01

    Full Text Available Vanessa Shifflette,1 Susannah Hambright,2 Joseph Darryl Amos,1 Ernest Dunn,3 Maria Allo4 1Associates in Surgical Acute Care, Methodist Dallas Medical Center, Dallas, TX, USA; 2Methodist Surgical Associates, Methodist Dallas Medical Center, Dallas, TX, USA; 3Graduate Medical Education - General Surgery, Methodist Dallas Medical Center, Dallas, TX, USA; 4Santa Clara Valley Medical Center, San Jose, CA, USA Background: Surgery continues to be an intense, time-consuming residency. Many medical students decide against surgery as a profession due to the long work hours and family strain. The pregnant female surgical resident has an added stress factor compared to her male counterpart. Methods: We distributed an electronic, online 26-question survey to 32 general surgery programs in the southwestern region of the United States. Each program distributed our survey to the female surgical residents who had been pregnant during residency in the last 5 years. Each program was re-contacted 6 weeks after the initial contact. Most questions were in a 5-point Likert scale format. The responses were collected and analyzed using the Survey Monkey website. Results: An unvalidated survey was sent to 32 general surgery programs and 26 programs responded (81%. Each program was asked for the total number of possible responses from female residents that met our criteria (60 female residents. Seven of the programs (27% stated that they have had zero residents pregnant. We had 22 residents respond (37%. Over half of the residents (55% were pregnant during their 2nd or 3rd year of residency, with only 18% pregnant during a research year. Thirty-one percent had a lower American Board of Surgery In-Training Exam (ABSITE score. Ninety percent of the residents were able to take 4 weeks or more for maternity leave. Most of the residents (95% stated that they would do this again during residency given the opportunity, but many of the residents felt that returning back to work

  2. Education Research: Neurology resident education

    Science.gov (United States)

    Mayans, David; Schneider, Logan; Adams, Nellie; Khawaja, Ayaz M.; Engstrom, John

    2016-01-01

    Objective: To survey US-trained graduating neurology residents who are American Academy of Neurology members, in an effort to trend perceived quality and completeness of graduate neurology education. Methods: An electronic survey was sent to all American Academy of Neurology members graduating from US neurology residency programs in the Spring of 2014. Results: Of 805 eligible respondents, 24% completed the survey. Ninety-three percent of adult neurology residents and 56% of child neurology residents reported plans to pursue fellowship training after residency. Respondents reported a desire for additional training in neurocritical care, neuro-oncology, neuromuscular diseases, botulinum toxin injection, and nerve blocks. There remains a clear deficit in business training of neurology residents, although there was notable improvement in knowledge of coding and office management compared to previous surveys. Discussion: Although there are still areas of perceived weakness in neurology training, graduating neurology residents feel generally well prepared for their chosen careers. However, most still pursue fellowship training for reasons that are little understood. In addition to certain subspecialties and procedures, practice management remains deficient in neurology training and is a point of future insecurity for most residents. Future curriculum changes should consider resident-reported gaps in knowledge, with careful consideration of improving business training. PMID:26976522

  3. A comparative study of the effect of automobile pollution on pulmonary function tests of people who reside in high traffic density urban areas and relatively traffic free rural areas

    Directory of Open Access Journals (Sweden)

    Amrith Pakkala

    2014-01-01

    Full Text Available Background: Motor vehicle emissions constitute the most significant source of ultra particles in an urban environment. Traffic related air pollution is an occupational health hazard to individuals who live and work in an environment close to traffic. The present study intends to study the effect of air pollution on the pulmonary system in people who reside in areas exposed to automobile exhaust. Material and Methods: This study was conducted by performing pulmonary function tests (PFT on 20 people who are exposed to automobile exhaust by virtue of their residence nearer to traffic junctions and comparing them with 20 others of age and gender matched and similar anthropometric profile people, who reside in a rural setting free from vehicular air pollution. Statistical analysis was done by Student′s t-test (two-tailed, independent for inter group analysis. Results: There was a statistically significant difference between the two groups as far as parameters like FVC, FEV 1 , PEFR, FEV 1 /FVC, FEF 25-75% . It can be seen that there is decline in dynamic pulmonary function parameters in the study group when compared to controls, which is statistically significant. Conclusion: The respiratory system are particulate matter (PM 10 and sulphur dioxide (SO 2 produced by the combustion of fossil fuels. These pollutants react with each other, forming hazardous acid sulfate particles, which are capable of reaching deep inside the tracheo-bronchial tree producing a bronchoconstrictor response, as their predominant site of action are the small airways. This was a comparative study to demonstrate the effect of air pollution due to automobile exhaust on pulmonary functions of people who reside in areas exposed to a polluted urban environment with a similar group in the rural relatively pollution free environment.

  4. Quantum conversion

    OpenAIRE

    Mazilu, Michael

    2015-01-01

    ICOAM 2015 The electromagnetic momentum transferred transferred to scattering particles is proportional to the intensity of the incident fields, however, the momentum of single photons ℏk does not naturally appear in these classical expressions. Here, we discuss an alternative to Maxwell's stress tensor that renders the classical electromagnetic field momentum compatible to the quantum mechanical one. This is achieved through the introduction of the quantum conversion which allows the tran...

  5. Conversational sensemaking

    Science.gov (United States)

    Preece, Alun; Webberley, Will; Braines, Dave

    2015-05-01

    Recent advances in natural language question-answering systems and context-aware mobile apps create opportunities for improved sensemaking in a tactical setting. Users equipped with mobile devices act as both sensors (able to acquire information) and effectors (able to act in situ), operating alone or in collectives. The currently- dominant technical approaches follow either a pull model (e.g. Apple's Siri or IBM's Watson which respond to users' natural language queries) or a push model (e.g. Google's Now which sends notifications to a user based on their context). There is growing recognition that users need more flexible styles of conversational interaction, where they are able to freely ask or tell, be asked or told, seek explanations and clarifications. Ideally such conversations should involve a mix of human and machine agents, able to collaborate in collective sensemaking activities with as few barriers as possible. Desirable capabilities include adding new knowledge, collaboratively building models, invoking specific services, and drawing inferences. As a step towards this goal, we collect evidence from a number of recent pilot studies including natural experiments (e.g. situation awareness in the context of organised protests) and synthetic experiments (e.g. human and machine agents collaborating in information seeking and spot reporting). We identify some principles and areas of future research for "conversational sensemaking".

  6. Conversational sensing

    Science.gov (United States)

    Preece, Alun; Gwilliams, Chris; Parizas, Christos; Pizzocaro, Diego; Bakdash, Jonathan Z.; Braines, Dave

    2014-05-01

    Recent developments in sensing technologies, mobile devices and context-aware user interfaces have made it pos- sible to represent information fusion and situational awareness for Intelligence, Surveillance and Reconnaissance (ISR) activities as a conversational process among actors at or near the tactical edges of a network. Motivated by use cases in the domain of Company Intelligence Support Team (CoIST) tasks, this paper presents an approach to information collection, fusion and sense-making based on the use of natural language (NL) and controlled nat- ural language (CNL) to support richer forms of human-machine interaction. The approach uses a conversational protocol to facilitate a ow of collaborative messages from NL to CNL and back again in support of interactions such as: turning eyewitness reports from human observers into actionable information (from both soldier and civilian sources); fusing information from humans and physical sensors (with associated quality metadata); and assisting human analysts to make the best use of available sensing assets in an area of interest (governed by man- agement and security policies). CNL is used as a common formal knowledge representation for both machine and human agents to support reasoning, semantic information fusion and generation of rationale for inferences, in ways that remain transparent to human users. Examples are provided of various alternative styles for user feedback, including NL, CNL and graphical feedback. A pilot experiment with human subjects shows that a prototype conversational agent is able to gather usable CNL information from untrained human subjects.

  7. Conversational flow promotes solidarity.

    Science.gov (United States)

    Koudenburg, Namkje; Postmes, Tom; Gordijn, Ernestine H

    2013-01-01

    Social interaction is fundamental to the development of various aspects of "we-ness". Previous research has focused on the role the content of interaction plays in establishing feelings of unity, belongingness and shared reality (a cluster of variables referred to as solidarity here). The present paper is less concerned with content, but focuses on the form of social interaction. We propose that the degree to which conversations flow smoothly or not is, of itself, a cue to solidarity. We test this hypothesis in samples of unacquainted and acquainted dyads who communicate via headsets. Conversational flow is disrupted by introducing a delay in the auditory feedback (vs. no delay). Results of three studies show that smoothly coordinated conversations (compared with disrupted conversations and a control condition) increase feelings of belonging and perceptions of group entitativity, independently of conversation content. These effects are driven by the subjective experience of conversational flow. Our data suggest that this process occurs largely beyond individuals' control. We conclude that the form of social interaction is a powerful cue for inferring group solidarity. Implications for the impact of modern communication technology on developing a shared social identity are discussed.

  8. Conversational flow promotes solidarity.

    Directory of Open Access Journals (Sweden)

    Namkje Koudenburg

    Full Text Available Social interaction is fundamental to the development of various aspects of "we-ness". Previous research has focused on the role the content of interaction plays in establishing feelings of unity, belongingness and shared reality (a cluster of variables referred to as solidarity here. The present paper is less concerned with content, but focuses on the form of social interaction. We propose that the degree to which conversations flow smoothly or not is, of itself, a cue to solidarity. We test this hypothesis in samples of unacquainted and acquainted dyads who communicate via headsets. Conversational flow is disrupted by introducing a delay in the auditory feedback (vs. no delay. Results of three studies show that smoothly coordinated conversations (compared with disrupted conversations and a control condition increase feelings of belonging and perceptions of group entitativity, independently of conversation content. These effects are driven by the subjective experience of conversational flow. Our data suggest that this process occurs largely beyond individuals' control. We conclude that the form of social interaction is a powerful cue for inferring group solidarity. Implications for the impact of modern communication technology on developing a shared social identity are discussed.

  9. Comparative X-ray studies on the behaviour of amalgam and gold fillings at the margins in the approximal space as a function of time of residence

    International Nuclear Information System (INIS)

    Hansen, R.

    1982-01-01

    Within the framework of this thesis, X-ray pictures have been made of 430 gold or amalgam fillings in order to measure the gap between approximal cavity margin and filling margin. With amalgam fillings, the gap width measured after a residence time of half a year was 9.3 μm and widened to 136.9 μm after 8 years, which represents an increase to the 14-fold. The gap widths measured with gold inlays only doubled within this period, increasing from 38.8 μm after half a year to 77.4 μm after 8 years. The number of retention spots found in the approximal-cervical space with amalgam fillings was at least twice that found for gold fillings. From this it is concluded that gold inlays are by far the better solution for dental restorations. (orig./MG) [de

  10. Comparing a Dynamic Fed-Batch and a Continuous Steady-State Simulation of Ethanol Fermentation in a Distillery to a Stoichiometric Conversion Simulation

    Directory of Open Access Journals (Sweden)

    G.C. Fonseca

    Full Text Available Abstract An autonomous sugarcane bioethanol plant was simulated in EMSO software, an equation oriented process simulator. Three types of fermentation units were simulated: a six parallel fed-batch reactor system, a set of four CSTR in steady state and one consisting of a single stoichiometric reactor. Stoichiometric models are less accurate than kinetic-based fermentation models used for fed-batch and continuous fermenter simulations, since they do not account for inhibition effects and depend on a known conversion rate of reactant to be specified instead. On the other hand, stoichiometric models are faster and simpler to converge. In this study it was found that the conversion rates of sugar for the fermentation systems analyzedwere predictable from information on the composition of the juice stream. Those rates were used in the stoichiometric model, which accurately reproduced the results from both the fed-batch and the continuous fermenter system.

  11. COMPAR

    International Nuclear Information System (INIS)

    Kuefner, K.

    1976-01-01

    COMPAR works on FORTRAN arrays with four indices: A = A(i,j,k,l) where, for each fixed k 0 ,l 0 , only the 'plane' [A(i,j,k 0 ,l 0 ), i = 1, isub(max), j = 1, jsub(max)] is held in fast memory. Given two arrays A, B of this type COMPAR has the capability to 1) re-norm A and B ind different ways; 2) calculate the deviations epsilon defined as epsilon(i,j,k,l): =[A(i,j,k,l) - B(i,j,k,l)] / GEW(i,j,k,l) where GEW (i,j,k,l) may be chosen in three different ways; 3) calculate mean, standard deviation and maximum in the array epsilon (by several intermediate stages); 4) determine traverses in the array epsilon; 5) plot these traverses by a printer; 6) simplify plots of these traverses by the PLOTEASY-system by creating input data blocks for this system. The main application of COMPAR is given (so far) by the comparison of two- and three-dimensional multigroup neutron flux-fields. (orig.) [de

  12. Electrochemical solar energy conversion

    International Nuclear Information System (INIS)

    Gerischer, H.

    1991-01-01

    The principles of solar energy conversion in photoelectrochemical cells are briefly reviewed. Cells for the generation of electric power and for energy storage in form of electrochemical energy are described. These systems are compared with solid state photovoltaic devices, and the inherent difficulties for the operation of the electrochemical systems are analyzed. (author). 28 refs, 10 figs

  13. Predicting AD conversion

    DEFF Research Database (Denmark)

    Liu, Yawu; Mattila, Jussi; Ruiz, Miguel �ngel Mu�oz

    2013-01-01

    To compare the accuracies of predicting AD conversion by using a decision support system (PredictAD tool) and current research criteria of prodromal AD as identified by combinations of episodic memory impairment of hippocampal type and visual assessment of medial temporal lobe atrophy (MTA) on MRI...

  14. Residency Allocation Database

    Data.gov (United States)

    Department of Veterans Affairs — The Residency Allocation Database is used to determine allocation of funds for residency programs offered by Veterans Affairs Medical Centers (VAMCs). Information...

  15. On the ideal and real energy conversion in a straight bladed vertical axis wind turbine. The actuator cylinder flow model compared with experiment

    Energy Technology Data Exchange (ETDEWEB)

    Aaagard Madsen, H.

    1983-01-01

    The ideal and the real energy conversion in a straight bladed vertical axis wind turbine (VAWT) with variable pitch has been studied on basis of the actuator cylinder flow model and experimental data from free wind tests on a 9 m/sup 2/ turbine. Particularly, the theoretical upper power limit of VAWT's has been focused upon in the light of the already existing theories for horizontal axis wind turbines (HAWT's). A remarkable result, differing from prior theories, has turned out through the computations with the actuator cylinder flow model and that is: The maximum ideal power coefficient for VAWT's seams neither to be bounded by the Lanchester-Betz power coefficient limit of 16/27 (actuator disc concept), nor by Glauert's ideal power coefficient curve (taking into account the tip speed ratio), both limits derived with particular reference to HAWT's. Concerning the agreement between analysis and the measurements of the power coefficient, the rotor drag coefficient and the flow velocity vector adjacent to the swept area, it was in general found to be good. However, there seems still to be need for future research on the influence of turbulence in the free wind and dynamic stall on the real energy conversion in VAWT's.

  16. The IRSN Risk Perception Barometer: analyzing the 1997 - 2008 period and comparing expert, public and residents of a nuclear facility perceptions

    International Nuclear Information System (INIS)

    El Jammal, Marie H.

    2008-01-01

    Full text: Since 1997, IRSN conducts a yearly survey designed to understand how the French population perceives risk: the IRSN barometer. In this survey, 30 risks are investigated from three different angles: a) Seriousness of the risk; b) Trust in the authorities; c) Credibility of information given about these risks. The 30 risks include situations widely covered by the media (traffic accidents, smoking, alcohol, etc.), as well as situations of which the public can be unaware (such as radon in homes) and situations perceived as low risk (X-rays, noise, etc.). The list includes nuclear power plants, nuclear waste storage, Chernobyl pollution impacts, chemical industries, chemical waste, transportation of hazardous chemicals, etc. Statistical analysis of the answers highlighted five groups of risks in relation with a common rationale of perception by the French people. This will be presented as the first part of the paper. The conclusion will show that the risk perceptions of the French population are not at all versatile. Their perception logic is based on the perceived seriousness of the risk, on their 'trust in the protective measures taken by the French authorities' and on the perceived credibility of information. Risk perception varies greatly with age, gender, culture and level of education. We know this with the IRSN Barometer and others opinion pools. However, few surveys are carried out among experts in risk. Do they have a different perception of risk from the general public? It's the subject of a study entitled PERPLEX (Perception of Risk by the Public and Experts) who was realized in October 2004. This will be presented in the second part of the paper. The same question can be asked for the population who live near a nuclear power plant or other nuclear facility. So, in November 2007, 318 residents in the vicinity of twenty nuclear facility have answered at the IRSN's annual barometer questionnaire. The results of these three surveys will be presented

  17. Comparative study on Ti/Zr/V and chromate conversion treated aluminum alloys: Anti-corrosion performance and epoxy coating adhesion properties

    Energy Technology Data Exchange (ETDEWEB)

    Zhu, Wen; Li, Wenfang, E-mail: mewfli@163.com; Mu, Songlin; Fu, Nianqing; Liao, Zhongmiao

    2017-05-31

    Highlights: • The surface roughness and surface free energy of the AA6063 are significantly increased after TZVCC treatment. • The anti-corrosion performance of the AA6063 is effectively enhanced after TZVCC treatment. • Both the corrosion resistance and wet adhesion properties of the epoxy coating on the AA6063 are noticeably improved after TZVCC treatment. - Abstract: In this study, a Ti/Zr/V conversion coating (TZVCC) was deposited on the surface of aluminum alloy 6063 (AA6063) as an alternative of the chromate conversion coating (CCC). Both the TZVCC treated AA6063 (TZVCC/AA6063) and CCC treated AA6063 (CCC/AA6063) were characterized by scanning electron microscopy (SEM), X-ray photoelectron spectroscopy (XPS), atomic force microscope (AFM) and contact angle measuring device. The anti-corrosion performance of the TZVCC/AA6063 and CCC/AA6063 was evaluated by electrochemical measurements and neutral salt spray tests. It showed that both the surface roughness and surface free energy of the AA6063 were significantly increased after TZVCC treatment. The anti-corrosion performance of TZVCC/AA6063 was superior to that of CCC/AA6063. In addition, the effects of the TZVCC and CCC on the adhesion properties and anti-corrosion performance of epoxy coating applied on samples were examined by pull-off tests and electrochemical impedance spectroscopy (EIS). The dry, wet and recovery adhesive strengths of the epoxy coating on TZVCC treated samples (epoxy coated TZVCC/AA6063) were very close to those of epoxy coating on CCC treated ones (epoxy coated CCC/AA6063). The epoxy coated TZVCC/AA6063 showed better corrosion resistance than the epoxy coated CCC/AA6063 and epoxy coated AA6063.

  18. A longitudinal comparative study of the physical and mental health problems of affected residents of the firework disaster Enschede, The Netherlands

    NARCIS (Netherlands)

    Grievink, L; Velden, P.G. van der; Stellato, R.K.; Dusseldorp, A.; Gersons, B.P.R.; Kleber, R.J.; Lebret, E.

    Objectives: After the firework disaster in Enschede, The Netherlands, on 13 May 2000, a longitudinal health study was carried out. Study questions were: (1) did the health status change over this period; and (2) how is the health status 18months after the disaster compared with controls? Study

  19. A longitudinal comparative study of the physical and mental health problems of affected residents of the firework disaster Enschede, The Netherlands

    NARCIS (Netherlands)

    Grievink, L.; van der Velden, P. G.; Stellato, R. K.; Dusseldorp, A.; Gersons, B. P. R.; Kleber, R. J.; Lebret, E.

    2007-01-01

    OBJECTIVES: After the firework disaster in Enschede, The Netherlands, on 13 May 2000, a longitudinal health study was carried out. Study questions were: (1) did the health status change over this period; and (2) how is the health status 18 months after the disaster compared with controls? STUDY

  20. Tourism practices of Chinese residents in South Africa | Potgieter ...

    African Journals Online (AJOL)

    Chinese consumers are different due to their cultural background and way of life and this necessitates a conversion of the business model and products offered by leisure and tourism service providers. Very little is known about tourism practices of resident Chinese in South Africa. Research was conducted amongst resident ...

  1. Subsyndromal delirium compared with delirium, dementia, and subjects without delirium or dementia in elderly general hospital admissions and nursing home residents

    OpenAIRE

    Sepulveda, Esteban; Leonard, Maeve; Franco, Jose G.; Adamis, Dimitrios; McCarthy, Geraldine; Dunne, Colum; Trzepacz, Paula T.; Gaviria, Ana M.; de Pablo, Joan; Vilella, Elisabet; Meagher, David J.

    2016-01-01

    Introduction Subsyndromal delirium (SSD) complicates diagnosis of delirium and dementia, although there is little research comparing their symptom profiles. Methods Cross-sectional study of 400 elderly patients' admission to a general hospital or nursing home diagnosed with delirium, SSD, dementia, or no-delirium/no-dementia (NDND). Symptom profiles were assessed using the Delirium Rating Scale-Revised-98 (DRS-R98). Results Twenty percent patients had delirium, 19.3% had SSD, 29.8% had dement...

  2. The Nanticoke conversion study

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    2001-04-01

    A study was conducted to assess the conversion of the Nanticoke coal-fired power plant to cleaner burning natural gas combined-cycle gas turbines. The Nanticoke Generating Station on Lake Erie is responsible for more than 50 per cent of Ontario Power Generation's (OPG) coal-fired electricity production. The OPG is proposing to work towards compliance with the newly signed Ozone Annex to the 1991 Canada-United States Air Quality Agreement which will require fossil-fueled power plants in southern Ontario to reduce their smog-causing nitrogen oxides emissions by about 50 per cent by 2007. This study assessed the emission reduction benefits and financial costs of conversion compared to continuing to operate Nanticoke as a coal-fired plant. The analysis includes a base case set of data on fuel prices, retrofit costs, fuel efficiencies, annual capacity factors and other parameters. It was determined that conversion would cost the average household less than $3 per month on their electricity bill. Conversion would also reduce emissions nitrogen oxide, a major smog pollutant, by 83 per cent and the particulates that form the most health-threatening portion of smog would be reduced by 100 per cent. 15 tabs., 1 fig.

  3. Perioperative self-reflection among surgical residents.

    Science.gov (United States)

    Peshkepija, Andi N; Basson, Marc D; Davis, Alan T; Ali, Muhammad; Haan, Pam S; Gupta, Rama N; Hardaway, John C; Nebeker, Cody A; McLeod, Michael K; Osmer, Robert L; Anderson, Cheryl I

    2017-09-01

    We studied prevalence and predictors of meaningful self-reflection among surgical residents and with prompting/structured interventions, sought to improve/sustain resident skills. Residents from six programs recorded 1032 narrative self-reflective comments (120 residents), using a web-based platform. If residents identified something learned or to be improved, self-reflection was deemed meaningful. Independent variables PGY level, resident/surgeon gender, study site/Phase1: July2014-August2015 vs. Phase2: September2015-September2016) were analyzed. Meaningful self-reflection was documented in 40.6% (419/1032) of entries. PGY5's meaningfully self-reflected less than PGY1-4's, 26.1% vs. 49.6% (p = 0.002). In multivariate analysis, resident narratives during Phase 2 were 4.7 times more likely to engage in meaningful self-reflection compared to Phase1 entries (p self-reflection, compared to Phase1. Surgical residents uncommonly practice meaningful self-reflection, even when prompted, and PGY5/chief residents reflect less than more junior residents. Substantial/sustained improvements in resident self-reflection can occur with both training and interventions. Copyright © 2017 Elsevier Inc. All rights reserved.

  4. Comparative study of the more promising combinations of blanket materials, power conversion systems, and tritium recovery and containment systems for fusion reactors

    International Nuclear Information System (INIS)

    Fraas, A.P.

    1975-11-01

    The many possible combinations of blanket materials, tritium generation and recovery systems, and power conversion systems were surveyed first by reviewing the principal design studies that have been prepared and then by examining a comprehensive set of designs generated by using a common set of ground rules that included all of the boundary conditions that could be envisioned. The results indicate that, of the wide variety of systems that have been considered, by far the most promising employs lithium recirculated in a closed loop within a niobium blanket structure and cooled with boiling potassium or cesium. This approach gives the simplest and lowest cost tritium recovery system, the lowest pressure and thermal stresses, the simplest structure with the lowest probability of a leak, the greatest resistance to damage from a plasma energy dump, and the lowest rate of plasma contamination by either outgassing or sputtering. The only other blanket materials combination that appears fairly likely to give a satisfactory tritium generation and recovery system is an Li 2 BeF 4 -Incoloy blanket, and even this system involves major uncertainties in the effectiveness, size, and cost of the tritium recovery system. Further, the Li 2 BeF 4 blanket system has the disadvantage that the world reserves of beryllium are too limited to support a full-blown fusion reactor economy, its poor thermal conductivity leads to cooling difficulties and a requirement for a complex structure with intricate cooling passages, and this inherently leads to an expensive blanket with a relatively high probability of leaks. The other blanket materials combinations yield even less attractive systems

  5. Passenger and Cell Phone Conversations in Simulated Driving

    Science.gov (United States)

    Drews, Frank A.; Pasupathi, Monisha; Strayer, David L.

    2008-01-01

    This study examines how conversing with passengers in a vehicle differs from conversing on a cell phone while driving. We compared how well drivers were able to deal with the demands of driving when conversing on a cell phone, conversing with a passenger, and when driving without any distraction. In the conversation conditions, participants were…

  6. Effect of residence on mothers' health care seeking behavior for common childhood illness in Northwest Ethiopia: a community based comparative cross--sectional study.

    Science.gov (United States)

    Gelaw, Yalemzewod Assefa; Biks, Gashaw Andargie; Alene, Kefyalew Addis

    2014-10-08

    Children are at higher risk of acquiring infections and developing severe disease. This study assessed the health care seeking behavior and associated factors of urban and rural mothers for common childhood illness in Northwest Ethiopia. A comparative community based cross-sectional study was conducted among urban and rural mothers living in the district. A multistage sampling technique was used to select the study participants. A pre-tested and structured questioner via interview was used to collect the data. Binary logistic regression analysis was used to identify associated factors. Odds ratio with 95% CI was computed to assess the strength of the associations. A total of 827 (274 urban and 553 rural) mothers were interviewed. Among these, 79.3% (95% CI: (76.5%, 82.06%)) of the mothers were sought health care in the district. Health care seeking behavior was higher among urban mothers (84.6%) than rural mothers (76.7%). Marital status, completion health extension package, and sex of child were significantly associated with health care seeking behavior of urban mothers. Whereas age of child, age and occupation of mothers, educational level of fathers, wealth quintile, and type of reported illness were significantly associated with rural mothers. Perceived severity of illness was significantly associated with both urban and rural mothers for health care seeking behavior. The overall health seeking behaviors of mothers for common childhood illness was high. However, urban mothers seek health care more than rural. Socio Economic position and types of reported illness has an effect for health seeking behavior of rural mothers. Whereas child sex preference and graduation status for health extension package has an effect for health care seeking behavior of urban mothers. Work on strengthen accessibility of health care services in the rural mothers and increase awareness of mothers about the disadvantage of sex preferences will improve the health care seek behavior of

  7. How do urology residents manage personal finances?

    Science.gov (United States)

    Teichman, J M; Bernheim, B D; Espinosa, E A; Cecconi, P P; Meyer, J; Pearle, M S; Preminger, G M; Leveillee, R J

    2001-05-01

    To examine personal financial management among residents to answer three research questions: do residents make reasonable financial choices; why do some residents not save; and what steps can be taken to improve residents' personal financial decisions. Portions of the Federal Reserve Board's Survey of Consumer Finances were modified and piloted to elicit demographic, expense, saving, and income data. The final questionnaire was completed by 151 urology residents at 20 programs. Comparing residents with the general population in the same age and income categories, the median debt/household income ratio was 2.38 versus 0.64. Residents had greater educational debt, greater noneducational debt, and lower savings. Resident participation in retirement accounts was 100% at institutions with employer-matching 401k or 403b plans, 63% at institutions with nonmatching 401k or 403b plans, and 48% at institutions without retirement plans for residents (P = 0.002). Fifty-nine percent of residents budgeted expenses, 27% had cash balances below $1000, 51% had paid interest charges on credit cards within the previous year, and 12% maintained unpaid credit card balances greater than $10,000. The median resident income was $38,400. A significant minority of residents appear not to make reasonable financial choices. Some residents save little because of a failure to budget, indebtedness, high projected income growth, or insufficient attention to personal financial management. Residents save more when they are eligible for tax-deferred retirement plans, particularly when their institution matches their contributions. Many residents would benefit from instruction concerning prudent financial management.

  8. Peer observation and feedback of resident teaching.

    Science.gov (United States)

    Snydman, Laura; Chandler, Daniel; Rencic, Joseph; Sung, Yung-Chi

    2013-02-01

    Resident doctors (residents) play a significant role in the education of medical students. Morning work rounds provide an optimal venue to assess resident teaching. The purpose of this study was to assess the feasibility of peer observation of resident work rounds, to evaluate resident perceptions of peer observation and to evaluate resident perceptions of peer feedback.   Twenty-four internal medicine residents were simultaneously observed by an attending physician and a peer while teaching during work rounds (between August2008 and May 2009). At year-end, residents received a survey to characterise their attitudes towards peer observation and feedback. Twenty-one residents (87.5%) completed the survey. Half (52.4%) felt that participating in the peer observation study stimulated their interest in teaching during work rounds. Prior to participation in the study, fewer than half (42.9%) felt comfortable being observed by their peers, compared with 71.4 percent after participation (p=0.02). The proportion of residents who felt comfortable giving feedback to peers increased from 26.3 to 65.0percent (p=0.004), and the proportion of residents who felt comfortable receiving feedback from peers increased from 76.2 to 95.2 percent (p=0.02). Peer observation and feedback of resident teaching during work rounds is feasible and rewarding for the residents involved. Comfort with regards to being observed by peers, with receiving feedback from peers and with giving feedback to peers significantly increased after the study. Most residents reported changes in their teaching behaviour resulting from feedback. Residents felt that observing a peer teach on work rounds was one of the most useful activities to improve their own teaching on work rounds. © Blackwell Publishing Ltd 2013.

  9. Resident Characteristics Report

    Data.gov (United States)

    Department of Housing and Urban Development — The Resident Characteristics Report summarizes general information about households who reside in Public Housing, or who receive Section 8 assistance. The report...

  10. The database of chromosome imbalance regions and genes resided in lung cancer from Asian and Caucasian identified by array-comparative genomic hybridization

    Directory of Open Access Journals (Sweden)

    Lo Fang-Yi

    2012-06-01

    Full Text Available Abstract Background Cancer-related genes show racial differences. Therefore, identification and characterization of DNA copy number alteration regions in different racial groups helps to dissect the mechanism of tumorigenesis. Methods Array-comparative genomic hybridization (array-CGH was analyzed for DNA copy number profile in 40 Asian and 20 Caucasian lung cancer patients. Three methods including MetaCore analysis for disease and pathway correlations, concordance analysis between array-CGH database and the expression array database, and literature search for copy number variation genes were performed to select novel lung cancer candidate genes. Four candidate oncogenes were validated for DNA copy number and mRNA and protein expression by quantitative polymerase chain reaction (qPCR, chromogenic in situ hybridization (CISH, reverse transcriptase-qPCR (RT-qPCR, and immunohistochemistry (IHC in more patients. Results We identified 20 chromosomal imbalance regions harboring 459 genes for Caucasian and 17 regions containing 476 genes for Asian lung cancer patients. Seven common chromosomal imbalance regions harboring 117 genes, included gain on 3p13-14, 6p22.1, 9q21.13, 13q14.1, and 17p13.3; and loss on 3p22.2-22.3 and 13q13.3 were found both in Asian and Caucasian patients. Gene validation for four genes including ARHGAP19 (10q24.1 functioning in Rho activity control, FRAT2 (10q24.1 involved in Wnt signaling, PAFAH1B1 (17p13.3 functioning in motility control, and ZNF322A (6p22.1 involved in MAPK signaling was performed using qPCR and RT-qPCR. Mean gene dosage and mRNA expression level of the four candidate genes in tumor tissues were significantly higher than the corresponding normal tissues (PP=0.06. In addition, CISH analysis of patients indicated that copy number amplification indeed occurred for ARHGAP19 and ZNF322A genes in lung cancer patients. IHC analysis of paraffin blocks from Asian Caucasian patients demonstrated that the frequency of

  11. The database of chromosome imbalance regions and genes resided in lung cancer from Asian and Caucasian identified by array-comparative genomic hybridization

    International Nuclear Information System (INIS)

    Lo, Fang-Yi; Nandi, Suvobroto; Salgia, Ravi; Wang, Yi-Ching; Chang, Jer-Wei; Chang, I-Shou; Chen, Yann-Jang; Hsu, Han-Shui; Huang, Shiu-Feng Kathy; Tsai, Fang-Yu; Jiang, Shih Sheng; Kanteti, Rajani

    2012-01-01

    Cancer-related genes show racial differences. Therefore, identification and characterization of DNA copy number alteration regions in different racial groups helps to dissect the mechanism of tumorigenesis. Array-comparative genomic hybridization (array-CGH) was analyzed for DNA copy number profile in 40 Asian and 20 Caucasian lung cancer patients. Three methods including MetaCore analysis for disease and pathway correlations, concordance analysis between array-CGH database and the expression array database, and literature search for copy number variation genes were performed to select novel lung cancer candidate genes. Four candidate oncogenes were validated for DNA copy number and mRNA and protein expression by quantitative polymerase chain reaction (qPCR), chromogenic in situ hybridization (CISH), reverse transcriptase-qPCR (RT-qPCR), and immunohistochemistry (IHC) in more patients. We identified 20 chromosomal imbalance regions harboring 459 genes for Caucasian and 17 regions containing 476 genes for Asian lung cancer patients. Seven common chromosomal imbalance regions harboring 117 genes, included gain on 3p13-14, 6p22.1, 9q21.13, 13q14.1, and 17p13.3; and loss on 3p22.2-22.3 and 13q13.3 were found both in Asian and Caucasian patients. Gene validation for four genes including ARHGAP19 (10q24.1) functioning in Rho activity control, FRAT2 (10q24.1) involved in Wnt signaling, PAFAH1B1 (17p13.3) functioning in motility control, and ZNF322A (6p22.1) involved in MAPK signaling was performed using qPCR and RT-qPCR. Mean gene dosage and mRNA expression level of the four candidate genes in tumor tissues were significantly higher than the corresponding normal tissues (P<0.001~P=0.06). In addition, CISH analysis of patients indicated that copy number amplification indeed occurred for ARHGAP19 and ZNF322A genes in lung cancer patients. IHC analysis of paraffin blocks from Asian Caucasian patients demonstrated that the frequency of PAFAH1B1 protein overexpression was 68

  12. Comparative "in vitro" evaluation of the antiresorptive activity residing in four Ayurvedic medicinal plants. Hemidesmus indicus emerges for its potential in the treatment of bone loss diseases.

    Science.gov (United States)

    Di Pompo, Gemma; Poli, Ferruccio; Mandrone, Manuela; Lorenzi, Beatrice; Roncuzzi, Laura; Baldini, Nicola; Granchi, Donatella

    2014-06-11

    Four Indian plants, traditionally used in Ayurvedic medicine: Asparagus racemosus Willd., Emblica officinalis Gaertn., Hemidesmus indicus R. Br., and Rubia cordifolia L. were selected on the basis of their ethnobotanical use and of scientific evidence that suggests a potential efficacy in the treatment of bone-loss diseases. The antiresorptive properties of the four plants have been investigated. The aim was to provide adequate evidence for the exploitation of natural compounds as alternative therapeutics for the treatment of diseases caused by increased osteoclast activity. Decoctions were prepared from dried plant material according to the traditional procedure and standardization by HPLC was performed using marker compounds for each species. Total polyphenols, flavonoids and radical scavenging activity of the decoctions were also determined. The bioactivity of the plant decoctions was evaluated in subsequent phases. (1) A cytotoxicity screening was performed on the mouse monocytic RAW 264.7 cell line to define the concentrations that could be utilized in the following step. (2) The antiresorptive properties of plant decoctions were compared with that of a "gold standard" drug (alendronate) by measuring osteoclastogenesis inhibition and osteoclast apoptosis. (3) The toxic effect on bone forming cells was excluded by evaluating the impact on the proliferation of osteogenic precursors (mesenchymal stem cells, MSC). All the decoctions inhibited osteoclastogenesis similarly to alendronate at the highest doses, but Hemidesmus indicus and Rubia cordifolia were also effective at lower concentrations. Apoptosis increased significantly when cells were exposed to the highest concentration of Emblica officinalis, Hemidesmus indicus, and Rubia cordifolia. All concentrations of Emblica officinalis tested inhibited the proliferation of osteogenic precursors, while only the highest doses of Asparagus racemosus and Rubia cordifolia were toxic. On the contrary, Hemidesmus indicus

  13. A fully integrated, wide-load-range, high-power-conversion-efficiency switched capacitor DC-DC converter with adaptive bias comparator for ultra-low-power power management integrated circuit

    Science.gov (United States)

    Asano, Hiroki; Hirose, Tetsuya; Kojima, Yuta; Kuroki, Nobutaka; Numa, Masahiro

    2018-04-01

    In this paper, we present a wide-load-range switched-capacitor DC-DC buck converter with an adaptive bias comparator for ultra-low-power power management integrated circuit. The proposed converter is based on a conventional one and modified to operate in a wide load range by developing a load current monitor used in an adaptive bias comparator. Measurement results demonstrated that our proposed converter generates a 1.0 V output voltage from a 3.0 V input voltage at a load of up to 100 µA, which is 20 times higher than that of the conventional one. The power conversion efficiency was higher than 60% in the load range from 0.8 to 100 µA.

  14. How Residents Learn From Patient Feedback: A Multi-Institutional Qualitative Study of Pediatrics Residents' Perspectives.

    Science.gov (United States)

    Bogetz, Alyssa L; Orlov, Nicola; Blankenburg, Rebecca; Bhavaraju, Vasudha; McQueen, Alisa; Rassbach, Caroline

    2018-04-01

    Residents may view feedback from patients and their families with greater skepticism than feedback from supervisors and peers. While discussing patient and family feedback with faculty may improve residents' acceptance of feedback and learning, specific strategies have not been identified. We explored pediatrics residents' perspectives of patient feedback and identified strategies that promote residents' reflection on and learning from feedback. In this multi-institutional, qualitative study conducted in June and July 2016, we conducted focus groups with a purposive sample of pediatrics residents after their participation in a randomized controlled trial in which they received written patient feedback and either discussed it with faculty or reviewed it independently. Focus group transcripts were audiorecorded, transcribed, and analyzed for themes using the constant comparative approach associated with grounded theory. Thirty-six of 92 (39%) residents participated in 7 focus groups. Four themes emerged: (1) residents valued patient feedback but felt it may lack the specificity they desire; (2) discussing feedback with a trusted faculty member was helpful for self-reflection; (3) residents identified 5 strategies faculty used to facilitate their openness to and acceptance of patient feedback (eg, help resident overcome emotional responses to feedback and situate feedback in the context of lifelong learning); and (4) residents' perceptions of feedback credibility improved when faculty observed patient encounters and solicited feedback on the resident's behalf prior to discussions. Discussing patient feedback with faculty provided important scaffolding to enhance residents' openness to and reflection on patient feedback.

  15. A Time Study of Plastic Surgery Residents.

    Science.gov (United States)

    Lau, Frank H; Sinha, Indranil; Jiang, Wei; Lipsitz, Stuart R; Eriksson, Elof

    2016-05-01

    Resident work hours are under scrutiny and have been subject to multiple restrictions. The studies supporting these changes have not included data on surgical residents. We studied the workday of a team of plastic surgery residents to establish prospective time-study data of plastic surgery (PRS) residents at a single tertiary-care academic medical center. Five trained research assistants observed all residents (n = 8) on a PRS service for 10 weeks and produced minute-by-minute activity logs. Data collection began when the team first met in the morning and continued until the resident being followed completed all non-call activities. We analyzed our data from 3 perspectives: 1) time spent in direct patient care (DPC), indirect patient care, and didactic activities; 2) time spent in high education-value activities (HEAs) versus low education-value activities; and 3) resident efficiency. We defined HEAs as activities that surgeons must master; other activities were LEAs. We quantified resident efficiency in terms of time fragmentation and time spent waiting. A total of 642.4 hours of data across 50 workdays were collected. Excluding call, residents worked an average of 64.2 hours per week. Approximately 50.7% of surgical resident time was allotted to DPC, with surgery accounting for the largest segment of this time (34.8%). Time spent on HEAs demonstrated trended upward with higher resident level (P = 0.086). Time in spent in surgery was significantly associated with higher resident levels (P time study of PRS residents, we found that compared with medicine trainees, surgical residents spent 3.23 times more time on DPC. High education-value activities comprised most of our residents' workdays. Surgery was the leading component of both DPC and HEAs. Our residents were highly efficient and fragmented, with the majority of all activities requiring 4 minutes or less. Residents spent a large portion of their time waiting for other services. In light of these data, we

  16. [Burnout in nursing residents].

    Science.gov (United States)

    Franco, Gianfábio Pimentel; de Barros, Alba Lúcia Bottura Leite; Nogueira-Martins, Luiz Antônio; Zeitoun, Sandra Salloum

    2011-03-01

    Nursing residents may experience physical and emotional exhaustion from the daily life of attending the Program. The aim of this study was to determine the Burnout incidence among Nursing Residents. An investigative, descriptive, analytical, longitudinal-prospective study was conducted with 16 Residents over two years. The Maslach Burnout Inventory was used, translated and validated for Brazil, as well as a sociodemographic/occupational data tool. Of all residents, 17.2% showed high rates in Emotional Exhaustion and Depersonalization; 18.8% showed impaired commitment in Personal Accomplishment, 75% of which belonged to specialty areas, such as Emergency Nursing, Adult and Pediatric Intensive Care. Age and specialty area were positively correlated with Personal Accomplishment. One of the Residents was identified with changes in three subscales of the Maslach Burnout Inventory, thus characterized as a Burnout Syndrome patient. Nursing Residents have profiles of disease. Knowing these factors can minimize health risks of these workers.

  17. Soil Carbon Residence Time in the Arctic - Potential Drivers of Past and Future Change

    Science.gov (United States)

    Huntzinger, D. N.; Fisher, J.; Schwalm, C. R.; Hayes, D. J.; Stofferahn, E.; Hantson, W.; Schaefer, K. M.; Fang, Y.; Michalak, A. M.; Wei, Y.

    2017-12-01

    Carbon residence time is one of the most important factors controlling carbon cycling in ecosystems. Residence time depends on carbon allocation and conversion among various carbon pools and the rate of organic matter decomposition; all of which rely on environmental conditions, primarily temperature and soil moisture. As a result, residence time is an emergent property of models and a strong determinant of terrestrial carbon storage capacity. However, residence time is poorly constrained in process-based models due, in part, to the lack of data with which to benchmark global-scale models in order to guide model improvements and, ultimately, reduce uncertainty in model projections. Here we focus on improving the understanding of the drivers to observed and simulated carbon residence time in the Arctic-Boreal region (ABR). Carbon-cycling in the ABR represents one of the largest sources of uncertainty in historical and future projections of land-atmosphere carbon dynamics. This uncertainty is depicted in the large spread of terrestrial biospheric model (TBM) estimates of carbon flux and ecosystem carbon pool size in this region. Recent efforts, such as the Arctic-Boreal Vulnerability Experiment (ABoVE), have increased the availability of spatially explicit in-situ and remotely sensed carbon and ecosystem focused data products in the ABR. Together with simulations from Multi-scale Synthesis and Terrestrial Model Intercomparison Project (MsTMIP), we use these observations to evaluate the ability of models to capture soil carbon stocks and changes in the ABR. Specifically, we compare simulated versus observed soil carbon residence times in order to evaluate the functional response and sensitivity of modeled soil carbon stocks to changes in key environmental drivers. Understanding how simulated carbon residence time compares with observations and what drives these differences is critical for improving projections of changing carbon dynamics in the ABR and globally.

  18. Responsive turns in Indonesian informal conversation

    Directory of Open Access Journals (Sweden)

    M.J. van Naerssen

    2015-04-01

    Full Text Available People have all sorts of expectations about how interlocutors will and should behave linguistically when engaged in a conversation. These conversational norms are usually implicit and are sometimes difficult to master in a language that is new to you. This paper presents a model of different types of responses in informal conversation, illustrated with Indonesian examples. It builds upon the conversation analytic notion of preference; distinguishing preferred – or constructive – responses and dispreferred – or competitive – responses. The model is meant as a tool to cross-linguistically compare response behaviour to gain insight in language specific expectations about interaction in informal conversation.

  19. Comparison of Emergency Medicine Malpractice Cases Involving Residents to Non-Resident Cases.

    Science.gov (United States)

    Gurley, Kiersten L; Grossman, Shamai A; Janes, Margaret; Yu-Moe, C Winnie; Song, Ellen; Tibbles, Carrie D; Shapiro, Nathan I; Rosen, Carlo L

    2018-04-17

    Data are lacking on how emergency medicine (EM) malpractice cases with resident involvement differs from cases that do not name a resident. To compare malpractice case characteristics in cases where a resident is involved (resident case) to cases that do not involve a resident (non-resident case) and to determine factors that contribute to malpractice cases utilizing EM as a model for malpractice claims across other medical specialties. We used data from the Controlled Risk Insurance Company (CRICO) Strategies' division Comparative Benchmarking System (CBS) to analyze open and closed EM cases asserted from 2009-2013. The CBS database is a national repository that contains professional liability data on > 400 hospitals and > 165,000 physicians, representing over 30% of all malpractice cases in the U.S (> 350,000 claims). We compared cases naming residents (either alone or in combination with an attending) to those that did not involve a resident (non-resident cohort). We reported the case statistics, allegation categories, severity scores, procedural data, final diagnoses and contributing factors. Fisher's exact test or t-test was used for comparisons (alpha set at 0.05). Eight hundred and forty-five EM cases were identified of which 732 (87%) did not name a resident (non-resident cases), while 113 (13%) included a resident (resident cases) (Figure 1). There were higher total incurred losses for non-resident cases (Table 1). The most frequent allegation categories in both cohorts were "Failure or Delay in Diagnosis/Misdiagnosis" and "Medical Treatment" (non-surgical procedures or treatment regimens i.e. central line placement). Allegation categories of Safety and Security, Patient Monitoring, Hospital Policy and Procedure and Breach of Confidentiality were found in the non-resident cases. Resident cases incurred lower payments on average ($51,163 vs. $156,212 per case). Sixty six percent (75) of resident vs 57% (415) of non-resident cases were high severity claims

  20. Plagiarism in residency application essays.

    Science.gov (United States)

    Segal, Scott; Gelfand, Brian J; Hurwitz, Shelley; Berkowitz, Lori; Ashley, Stanley W; Nadel, Eric S; Katz, Joel T

    2010-07-20

    Anecdotal reports suggest that some residency application essays contain plagiarized content. To determine the prevalence of plagiarism in a large cohort of residency application essays. Retrospective cohort study. 4975 application essays submitted to residency programs at a single large academic medical center between 1 September 2005 and 22 March 2007. Specialized software was used to compare residency application essays with a database of Internet pages, published works, and previously submitted essays and the percentage of the submission matching another source was calculated. A match of more than 10% to an existing work was defined as evidence of plagiarism. Evidence of plagiarism was found in 5.2% (95% CI, 4.6% to 5.9%) of essays. The essays of non-U.S. citizens were more likely to demonstrate evidence of plagiarism. Other characteristics associated with the prevalence of plagiarism included medical school location outside the United States and Canada; previous residency or fellowship; lack of research experience, volunteer experience, or publications; a low United States Medical Licensing Examination Step 1 score; and non-membership in the Alpha Omega Alpha Honor Medical Society. The software database is probably incomplete, the 10%-match threshold for defining plagiarism has not been statistically validated, and the study was confined to applicants to 1 institution. Evidence of matching content in an essay cannot be used to infer the applicant's intent and is not sensitive to variations in the cultural context of copying in some societies. Evidence of plagiarism in residency application essays is more common in international applicants but was found in those by applicants to all specialty programs, from all medical school types, and even among applicants with significant academic honors. No external funding.

  1. Optical Energy Transfer and Conversion System

    Science.gov (United States)

    Hogan, Bartholomew P. (Inventor); Stone, William C. (Inventor)

    2018-01-01

    An optical energy transfer and conversion system comprising a fiber spooler and an electrical power extraction subsystem connected to the spooler with an optical waveguide. Optical energy is generated at and transferred from a base station through fiber wrapped around the spooler, and ultimately to the power extraction system at a remote mobility platform for conversion to another form of energy. The fiber spooler may reside on the remote mobility platform which may be a vehicle, or apparatus that is either self-propelled or is carried by a secondary mobility platform either on land, under the sea, in the air or in space.

  2. Prevalence and factors associated with underutilization of antenatal care services in Nigeria: A comparative study of rural and urban residences based on the 2013 Nigeria demographic and health survey.

    Science.gov (United States)

    Adewuyi, Emmanuel Olorunleke; Auta, Asa; Khanal, Vishnu; Bamidele, Olasunkanmi David; Akuoko, Cynthia Pomaa; Adefemi, Kazeem; Tapshak, Samson Joseph; Zhao, Yun

    2018-01-01

    Antenatal care (ANC) is a major public health intervention aimed at ensuring safe pregnancy outcomes. In Nigeria, the recommended minimum of four times ANC attendance is underutilized. This study investigates the prevalence and factors associated with underutilization of ANC services with a focus on the differences between rural and urban residences in Nigeria. We analyzed the 2013 Nigeria Demographic and Health Survey dataset with adjustment for the sampling weight and the cluster design of the survey. The prevalence of underutilization of ANC was assessed using frequency tabulation while associated factors were examined using Chi-Square test and multivariable logistic regression analysis. The prevalence of underutilization of ANC was 46.5% in Nigeria, 61.1% in rural residence and 22.4% in urban residence. The North-West region had the highest prevalence of ANC underuse in Nigeria at 69.3%, 76.6% and 44.8% for the overall, rural and urban residences respectively. Factors associated with greater odds of ANC underuse in rural residence were maternal non-working status, birth interval urban residence, mothers professing Islam, those who did not read newspaper at all, and those who lacked health insurance, had greater odds of ANC underuse. In both rural and urban residence, maternal and husband's education level, region of residence, wealth index, maternal age, frequency of watching television, distance to- and permission to visit health facility were significantly associated with ANC underuse. Rural-urban differences exist in the use of ANC services, and to varying degrees, factors associated with underuse of ANC in Nigeria. Interventions aimed at addressing factors identified in this study may help to improve the utilization of ANC services both in rural and urban Nigeria. Such interventions need to focus more on reducing socioeconomic, geographic and regional disparities in access to ANC in Nigeria.

  3. Is past academic productivity predictive of radiology resident academic productivity?

    Science.gov (United States)

    Patterson, Stephanie K; Fitzgerald, James T; Boyse, Tedric D; Cohan, Richard H

    2002-02-01

    The authors performed this study to determine whether academic productivity in college and medical school is predictive of the number of publications produced during radiology residency. The authors reviewed the records of 73 radiology residents who completed their residency from 1990 to 2000. Academic productivity during college, medical school, and radiology residency, other postgraduate degrees, and past careers other than radiology were tabulated. The personal essay attached to the residency application was reviewed for any stated academic interest. Residents were classified as being either previously productive or previously unproductive. Publication rates during residency and immediately after residency were compared for the two groups. For the productive residents, a correlation analysis was used to examine the relationship between past frequency of publication and type of previous activity. Least-squares regression analysis was used to investigate the relationship between preresidency academic productivity, advanced degrees, stated interest in academics, and other careers and radiology residency publications. There was no statistically significant difference in the number of articles published by those residents who were active and those who were not active before residency (P = .21). Only authorship of papers as an undergraduate was weakly predictive of residency publication. These selected measures of academic productivity as an undergraduate and during medical school are not helpful for predicting publication during residency. There was no difference in publication potential between those residents who were academically productive in the past and those who were not.

  4. Special issue: Plasma Conversion

    NARCIS (Netherlands)

    Nozaki, T.; Bogaerts, A.; Tu, X.; van de Sanden, M. C. M.

    2017-01-01

    With growing concern of energy and environmental issues, the combination of plasma and heterogeneous catalysts receives special attention in greenhouse gas conversion, nitrogen fixation and hydrocarbon chemistry. Plasma gas conversion driven by renewable electricity is particularly important for the

  5. A Model for Conversation

    DEFF Research Database (Denmark)

    Ayres, Phil

    2012-01-01

    This essay discusses models. It examines what models are, the roles models perform and suggests various intentions that underlie their construction and use. It discusses how models act as a conversational partner, and how they support various forms of conversation within the conversational activity...

  6. Direct Conversion of Energy.

    Science.gov (United States)

    Corliss, William R.

    This publication is one of a series of information booklets for the general public published by the United States Atomic Energy Commission. Direct energy conversion involves energy transformation without moving parts. The concepts of direct and dynamic energy conversion plus the laws governing energy conversion are investigated. Among the topics…

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

    Science.gov (United States)

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

    2012-11-01

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

  8. Child Neurology Education for Pediatric Residents.

    Science.gov (United States)

    Albert, Dara V F; Patel, Anup D; Behnam-Terneus, Maria; Sautu, Beatriz Cunill-De; Verbeck, Nicole; McQueen, Alisa; Fromme, H Barrett; Mahan, John D

    2017-03-01

    The aim of this study was to evaluate whether the current state of child neurology education during pediatric residency provides adequate preparation for pediatric practice. A survey was sent to recent graduates from 3 pediatric residency programs to assess graduate experience, perceived level of competence, and desire for further education in child neurology. Responses from generalists versus subspecialists were compared. The response rate was 32%, half in general pediatric practice. Only 22% feel very confident in approaching patients with neurologic problems. This may represent the best-case scenario as graduates from these programs had required neurology experiences, whereas review of Accreditation Council of Graduate Medical Education-accredited residency curricula revealed that the majority of residencies do not. Pediatric neurologic problems are common, and pediatric residency graduates do encounter such problems in practice. The majority of pediatricians report some degree of confidence; however, some clear areas for improvement are apparent.

  9. Contemporary Trends in Radiation Oncology Resident Research

    International Nuclear Information System (INIS)

    Verma, Vivek; Burt, Lindsay; Gimotty, Phyllis A.; Ojerholm, Eric

    2016-01-01

    Purpose: To test the hypothesis that recent resident research productivity might be different than a decade ago, and to provide contemporary information about resident scholarly activity. Methods and Materials: We compiled a list of radiation oncology residents from the 2 most recent graduating classes (June 2014 and 2015) using the Association of Residents in Radiation Oncology annual directories. We queried the PubMed database for each resident's first-authored publications from postgraduate years (PGY) 2 through 5, plus a 3-month period after residency completion. We abstracted corresponding historical data for 2002 to 2007 from the benchmark publication by Morgan and colleagues (Int J Radiat Oncol Biol Phys 2009;74:1567-1572). We tested the null hypothesis that these 2 samples had the same distribution for number of publications using the Wilcoxon rank-sum test. We explored the association of demographic factors and publication number using multivariable zero-inflated Poisson regression. Results: There were 334 residents publishing 659 eligible first-author publications during residency (range 0-17; interquartile range 0-3; mean 2.0; median 1). The contemporary and historical distributions were significantly different (P<.001); contemporary publication rates were higher. Publications accrued late in residency (27% in PGY-4, 59% in PGY-5), and most were original research (75%). In the historical cohort, half of all articles were published in 3 journals; in contrast, the top half of contemporary publications were spread over 10 journals—most commonly International Journal of Radiation Oncology • Biology • Physics (17%), Practical Radiation Oncology (7%), and Radiation Oncology (4%). Male gender, non-PhD status, and larger residency size were associated with higher number of publications in the multivariable analysis. Conclusion: We observed an increase in first-author publications during training compared with historical data from the mid-2000s. These

  10. Contemporary Trends in Radiation Oncology Resident Research

    Energy Technology Data Exchange (ETDEWEB)

    Verma, Vivek [Department of Radiation Oncology, University of Nebraska, Omaha, Nebraska (United States); Burt, Lindsay [Department of Radiation Oncology, University of Utah, Salt Lake City, Utah (United States); Gimotty, Phyllis A. [Department of Biostatistics and Epidemiology, University of Pennsylvania, Philadelphia, Pennsylvania (United States); Ojerholm, Eric, E-mail: eric.ojerholm@uphs.upenn.edu [Department of Radiation Oncology, University of Pennsylvania, Philadelphia, Pennsylvania (United States)

    2016-11-15

    Purpose: To test the hypothesis that recent resident research productivity might be different than a decade ago, and to provide contemporary information about resident scholarly activity. Methods and Materials: We compiled a list of radiation oncology residents from the 2 most recent graduating classes (June 2014 and 2015) using the Association of Residents in Radiation Oncology annual directories. We queried the PubMed database for each resident's first-authored publications from postgraduate years (PGY) 2 through 5, plus a 3-month period after residency completion. We abstracted corresponding historical data for 2002 to 2007 from the benchmark publication by Morgan and colleagues (Int J Radiat Oncol Biol Phys 2009;74:1567-1572). We tested the null hypothesis that these 2 samples had the same distribution for number of publications using the Wilcoxon rank-sum test. We explored the association of demographic factors and publication number using multivariable zero-inflated Poisson regression. Results: There were 334 residents publishing 659 eligible first-author publications during residency (range 0-17; interquartile range 0-3; mean 2.0; median 1). The contemporary and historical distributions were significantly different (P<.001); contemporary publication rates were higher. Publications accrued late in residency (27% in PGY-4, 59% in PGY-5), and most were original research (75%). In the historical cohort, half of all articles were published in 3 journals; in contrast, the top half of contemporary publications were spread over 10 journals—most commonly International Journal of Radiation Oncology • Biology • Physics (17%), Practical Radiation Oncology (7%), and Radiation Oncology (4%). Male gender, non-PhD status, and larger residency size were associated with higher number of publications in the multivariable analysis. Conclusion: We observed an increase in first-author publications during training compared with historical data from the mid-2000s. These

  11. Elements of energy conversion

    CERN Document Server

    Russell, Charles R

    2013-01-01

    Elements of Energy Conversion brings together scattered information on the subject of energy conversion and presents it in terms of the fundamental thermodynamics that apply to energy conversion by any process. Emphasis is given to the development of the theory of heat engines because these are and will remain most important power sources. Descriptive material is then presented to provide elementary information on all important energy conversion devices. The book contains 10 chapters and opens with a discussion of forms of energy, energy sources and storage, and energy conversion. This is foll

  12. Iterated multidimensional wave conversion

    International Nuclear Information System (INIS)

    Brizard, A. J.; Tracy, E. R.; Johnston, D.; Kaufman, A. N.; Richardson, A. S.; Zobin, N.

    2011-01-01

    Mode conversion can occur repeatedly in a two-dimensional cavity (e.g., the poloidal cross section of an axisymmetric tokamak). We report on two novel concepts that allow for a complete and global visualization of the ray evolution under iterated conversions. First, iterated conversion is discussed in terms of ray-induced maps from the two-dimensional conversion surface to itself (which can be visualized in terms of three-dimensional rooms). Second, the two-dimensional conversion surface is shown to possess a symplectic structure derived from Dirac constraints associated with the two dispersion surfaces of the interacting waves.

  13. Changes in Personal Relationships During Residency and Their Effects on Resident Wellness: A Qualitative Study.

    Science.gov (United States)

    Law, Marcus; Lam, Michelle; Wu, Diana; Veinot, Paula; Mylopoulos, Maria

    2017-11-01

    Residency poses challenges for residents' personal relationships. Research suggests residents rely on family and friends for support during their training. The authors explored the impact of residency demands on residents' personal relationships and the effects changes in those relationships could have on their wellness. The authors used a constructivist grounded theory approach. In 2012-2014, they conducted semistructured interviews with a purposive and theoretical sample of 16 Canadian residents from various specialties and training levels. Data analysis occurred concurrently with data collection, allowing authors to use a constant comparative approach to explore emergent themes. Transcripts were coded; codes were organized into categories and then themes to develop a substantive theory. Residents perceived their relationships to be influenced by their evolving professional identity: Although personal relationships were important, being a doctor superseded them. Participants suggested they were forced to adapt their personal relationships, which resulted in the evolution of a hierarchy of relationships that was reinforced by the work-life imbalance imposed by their training. This poor work-life balance seemed to result in relationship issues and diminish residents' wellness. Participants applied coping mechanisms to manage the conflict arising from the adaptation and protect their relationships. To minimize the effects of identity dissonance, some gravitated toward relationships with others who shared their professional identity or sought social comparison as affirmation. Erosion of personal relationships could affect resident wellness and lead to burnout. Educators must consider how educational programs impact relationships and the subsequent effects on resident wellness.

  14. Curricula and Organization of Primary Care Residencies in Internal Medicine.

    Science.gov (United States)

    Eisenberg, John M.

    1980-01-01

    The organization and curricula of internal medicine residencies programs that emphasize primary care are described and compared with traditional residencies in internal medicine. It is noted that primary care residents spend more time in ambulatory care and are allowed more electives in specialties outside of internal medicine. Out-of-hospital…

  15. The Marketing of Residence Halls: A Question of Positioning.

    Science.gov (United States)

    Parker, R. Stephen; And Others

    1996-01-01

    A survey of 343 college residence hall directors revealed percentages of private and public institutions offering different amenities, main selling points in promotional brochures, and the most common resident complaints. Results were compared with those of a resident survey concerning the importance of various housing attributes. Implications for…

  16. The Effectiveness of Hypermedia Instructional Modules for Radiology Residents.

    Science.gov (United States)

    Shaw, Steven G.; And Others

    1995-01-01

    Details the development and field testing of hypermedia training materials for teaching radiology residents at the Montreal General Hospital (Canada). Compares results of randomly teaching 24 residents with either hypermedia or traditional classroom methods. Results indicate that residents who learned with hypermedia generally performed as well as…

  17. Residents in difficulty

    DEFF Research Database (Denmark)

    Christensen, Mette Krogh; O'Neill, Lotte; Hansen, Dorthe Høgh

    2016-01-01

    Background The majority of studies on prevalence and characteristics of residents in difficulty have been conducted in English-speaking countries and the existing literature may not reflect the prevalence and characteristics of residents in difficulty in other parts of the world such as the Scand...... in a healthcare system. From our perspective, further sociological and pedagogical investigations in educational cultures across settings and specialties could inform our understanding of and knowledge about pitfalls in residents’ and doctors’ socialization into the healthcare system....

  18. Analysis of internal conversion coefficients

    International Nuclear Information System (INIS)

    Coursol, N.; Gorozhankin, V.M.; Yakushev, E.A.; Briancon, C.; Vylov, Ts.

    2000-01-01

    An extensive database has been assembled that contains the three most widely used sets of calculated internal conversion coefficients (ICC): [Hager R.S., Seltzer E.C., 1968. Internal conversion tables. K-, L-, M-shell Conversion coefficients for Z=30 to Z=103, Nucl. Data Tables A4, 1-237; Band I.M., Trzhaskovskaya M.B., 1978. Tables of gamma-ray internal conversion coefficients for the K-, L- and M-shells, 10≤Z≤104, Special Report of Leningrad Nuclear Physics Institute; Roesel F., Fries H.M., Alder K., Pauli H.C., 1978. Internal conversion coefficients for all atomic shells, At. Data Nucl. Data Tables 21, 91-289] and also includes new Dirac-Fock calculations [Band I.M. and Trzhaskovskaya M.B., 1993. Internal conversion coefficients for low-energy nuclear transitions, At. Data Nucl. Data Tables 55, 43-61]. This database is linked to a computer program to plot ICCs and their combinations (sums and ratios) as a function of Z and energy, as well as relative deviations of ICC or their combinations for any pair of tabulated data. Examples of these analyses are presented for the K-shell and total ICCs of the gamma-ray standards [Hansen H.H., 1985. Evaluation of K-shell and total internal conversion coefficients for some selected nuclear transitions, Eur. Appl. Res. Rept. Nucl. Sci. Tech. 11.6 (4) 777-816] and for the K-shell and total ICCs of high multipolarity transitions (total, K-, L-, M-shells of E3 and M3 and K-shell of M4). Experimental data sets are also compared with the theoretical values of these specific calculations

  19. Operative time and cost of resident surgical experience: effect of instituting an otolaryngology residency program.

    Science.gov (United States)

    Pollei, Taylor R; Barrs, David M; Hinni, Michael L; Bansberg, Stephen F; Walter, Logan C

    2013-06-01

    Describe the procedure length difference between surgeries performed by an attending surgeon alone compared with the resident surgeon supervised by the same attending surgeon. Case series with chart review. Tertiary care center and residency program. Six common otolaryngologic procedures performed between August 1994 and May 2012 were divided into 2 cohorts: attending surgeon alone or resident surgeon. This division coincided with our July 2006 initiation of an otolaryngology-head and neck surgery residency program. Operative duration was compared between cohorts with confounding factors controlled. In addition, the direct result of increased surgical length on operating room cost was calculated and applied to departmental and published resident case log report data. Five of the 6 procedures evaluated showed a statistically significant increase in surgery length with resident involvement. Operative time increased 6.8 minutes for a cricopharyngeal myotomy (P = .0097), 11.3 minutes for a tonsillectomy (P operative time difference. Cost of increased surgical time was calculated per surgery and ranged from $286 (cricopharyngeal myotomy) to $2142 (mastoidectomy). When applied to reported national case log averages for graduating residents, this resulted in a significant increase of direct training-related costs. Resident participation in the operating room results in increased surgical length and additional system cost. Although residency is a necessary part of surgical training, associated costs need to be acknowledged.

  20. Translating Comparative Effectiveness Research Into Practice: Effects of Interventions on Lifestyle, Medication Adherence, and Self-care for Type 2 Diabetes, Hypertension, and Obesity Among Black, Hispanic, and Asian Residents of Chicago and Houston, 2010 to 2013.

    Science.gov (United States)

    Rashid, Jamila R; Leath, Brenda A; Truman, Benedict I; Atkinson, Donna Durant; Gary, Lisa C; Manian, Nanmathi

    In the United States, racial/ethnic minorities account for disproportionate disease and death from type 2 diabetes, hypertension, and obesity; however, interventions with measured efficacy in comparative effectiveness research are often not adopted or used widely in those communities. To assess implementation and effects of comparative effectiveness research-proven interventions translated for minority communities. Mixed-method assessment with pretest-posttest single-group evaluation design. US Department of Health and Human Services, Office of Minority Health, research contractor, and advisory board; health centers, including a federally qualified community health center in Chicago, Illinois; and public housing facilities for seniors in Houston, Texas. A total of 97 black, Hispanic, and Asian participants with any combination of health care provider-diagnosed type 2 diabetes, hypertension, or obesity. Virtual training institutes where intervention staff learned cultural competency methods of adapting effective interventions. Health educators delivered the Health Empowerment Lifestyle Program (HELP) in Chicago; community pharmacists delivered the MyRx Medication Adherence Program in Houston. Participation rates, satisfaction with interventions during January to April 2013, and pre- to postintervention changes in knowledge, diet, and clinical outcomes were analyzed through July 2013. In Chicago, 38 patients experienced statistically significant reductions in hemoglobin A1c and systolic blood pressure, increased knowledge of hypertension management, and improved dietary behaviors. In Houston, 38 subsidized housing residents had statistically nonsignificant improvements in knowledge of self-management and adherence to medication for diabetes and hypertension but high levels of participation in pharmacist home visits and group education classes. Adaptation, adoption, and implementation of HELP and MyRx demonstrated important postintervention changes among racial

  1. A Comparison Between the Level of Happiness Among the Elderly Living at Home and That of Senior Home Residents

    Directory of Open Access Journals (Sweden)

    2011-10-01

    Full Text Available Objectives: The present study was designed to compare the level of happiness among the elderly population living at home with that of senior home residents. Methods & Materials: This was a causative-comparative study. The statistical population consisted of all 60 plus men and women residing at home and senior homes in the city of Tabriz, from whom 100 samples were selected in two groups of 50 individuals (25 females and 25 males using an availability non-random sampling method. The oxford happiness questionnaire was used in order to collect data, which were then analyzed using an independent t-test. Results: Results showed that the level of happiness among the elderly living at home was significantly higher than that of senior home residents. Furthermore, among indicators of happiness, life satisfaction levels, psychological health, positive mood, and efficiency were significantly higher among the elderly living at home. However, there was no significant difference between the two in terms of self-esteem. Conclusion: Findings indicate that, due to better social and family support, the level of happiness among the elderly living at home is significantly higher than that of senior home residents. Conversely, residing at senior homes consequent to financial and family conditions, for those who would otherwise live with family, leads to depressed mood, dissatisfaction with life, and ultimately lack of happiness.

  2. Oral and maxillofacial surgery residents have poor understanding of biostatistics.

    Science.gov (United States)

    Best, Al M; Laskin, Daniel M

    2013-01-01

    The purpose of this study was to evaluate residents' understanding of biostatistics and interpretation of research results. A questionnaire previously used in internal medicine residents was modified to include oral and maxillofacial surgery (OMS) examples. The survey included sections to identify demographic and educational characteristics of residents, attitudes and confidence, and the primary outcome-knowledge of biostatistics. In 2009 an invitation to the Internet survey was sent to all 106 program directors in the United States, who were requested to forward it to their residents. One hundred twelve residents responded. The percentage of residents who had taken a course in epidemiology was 53%; biostatistics, 49%; and evidence-based dentistry, 65%. Conversely, 10% of OMS residents had taken none of these classes. Across the 6-item test of knowledge of statistical methods, the mean percentage of correct answers was 38% (SD, 22%). Nearly half of the residents (42%) could not correctly identify continuous, ordinal, or nominal variables. Only 21% correctly identified a case-control study, but 79% correctly identified that the purpose of blinding was to reduce bias. Only 46% correctly interpreted a clinically unimportant and statistically nonsignificant result. None of the demographic or experience factors of OMS residents were related to statistical knowledge. Overall, OMS resident knowledge was below that of internal medicine residents (Pbiostatistics and the interpretation of research and are thus unprepared to interpret the results of published clinical research. Residency programs should include effective biostatistical training in their curricula to prepare residents in evidence-based dentistry. Copyright © 2013 American Association of Oral and Maxillofacial Surgeons. Published by Elsevier Inc. All rights reserved.

  3. Burnout Syndrome During Residency.

    Science.gov (United States)

    Turgut, Namigar; Karacalar, Serap; Polat, Cengiz; Kıran, Özlem; Gültop, Fethi; Kalyon, Seray Türkmen; Sinoğlu, Betül; Zincirci, Mehmet; Kaya, Ender

    2016-10-01

    The aim of this study is identified the degree of Burnout Syndrome (BOS) and find out its correlation with years of recidency and sociodemograpfic chareacteristics, training, sleeping habits, such as smoking and alcohol consumption. After approval from the Hospital Ethics Committee and obtaining informed consent, First, second, third, fourth and fifth year of recidency staff (n=127) working in our hospital were involved in this study. The standardized Maslach Burnout Inventory (MBI) was used in this study. Fifty six male (44.1%) and seventy one female (55.9%) residents were enroled in this study (Coranbach Alfa(α)=0.873). 57% of the first year residents smokes cigaret and 54% of them use alcohol. 2% of them gets one day off after hospital night shift, 61% of them suffers from disturbed sleep. 60% of them had been stated that they willingly selected their profession. 61% of them prefers talking to friends and 32% of them prefers shopping to overcome stress. There were statistical difference acording to years of recidency in MBI, Emotional Burnout (EB) and desensitisation scale (DS) points. EB scale points of the second year of residency group was statisticaly higher than fourth year of residency group. DS points of second year of residency group was also statisticaly higher than the third and fourth year of residency group. There was no statistical difference between any groups in Personal Success. BOS is a frequent problem during residency in anaesthesia. Appropriate definition and awareness are the first important steps to prevent this syndrome. Further administrative approaches should be evaluated with regard to their effects.

  4. Evolution of the Pathology Residency Curriculum

    Directory of Open Access Journals (Sweden)

    Wesley Y. Naritoku MD, PhD

    2016-10-01

    Full Text Available The required medical knowledge and skill set for the pathologist of 2020 are different than in 2005. Pathology residency training curriculum must accordingly change to fulfill the needs of these ever-changing requirements. In order to make rational curricular adjustments, it is important for us to know the current trajectory of resident training in pathology—where we have been, what our actual current training curriculum is now—to understand how that might change in anticipation of meeting the needs of a changing patient and provider population and to fit within the evolving future biomedical and socioeconomic health-care setting. In 2013, there were 143 Accreditation Council for Graduate Medical Education-accredited pathology residency training programs in the United States, with approximately 2400 residents. There is diversity among residency training programs not only with respect to the number of residents but also in training venue(s. To characterize this diversity among pathology residency training programs, a curriculum survey was conducted of pathology residency program directors in 2013 and compared with a similar survey taken almost 9 years previously in 2005 to identify trends in pathology residency curriculum. Clinical pathology has not changed significantly in the number of rotations over 9 years; however, anatomic pathology has changed dramatically, with an increase in the number of surgical pathology rotations coupled with a decline in stand-alone autopsy rotations. With ever-expanding medical knowledge that the graduating pathology resident must know, it is necessary to (1 reflect upon what are the critical need subjects, (2 identify areas that have become of lesser importance, and then (3 prioritize training accordingly.

  5. Evolution of the Pathology Residency Curriculum

    Science.gov (United States)

    Powell, Suzanne Z.; Black-Schaffer, W. Stephen

    2016-01-01

    The required medical knowledge and skill set for the pathologist of 2020 are different than in 2005. Pathology residency training curriculum must accordingly change to fulfill the needs of these ever-changing requirements. In order to make rational curricular adjustments, it is important for us to know the current trajectory of resident training in pathology—where we have been, what our actual current training curriculum is now—to understand how that might change in anticipation of meeting the needs of a changing patient and provider population and to fit within the evolving future biomedical and socioeconomic health-care setting. In 2013, there were 143 Accreditation Council for Graduate Medical Education-accredited pathology residency training programs in the United States, with approximately 2400 residents. There is diversity among residency training programs not only with respect to the number of residents but also in training venue(s). To characterize this diversity among pathology residency training programs, a curriculum survey was conducted of pathology residency program directors in 2013 and compared with a similar survey taken almost 9 years previously in 2005 to identify trends in pathology residency curriculum. Clinical pathology has not changed significantly in the number of rotations over 9 years; however, anatomic pathology has changed dramatically, with an increase in the number of surgical pathology rotations coupled with a decline in stand-alone autopsy rotations. With ever-expanding medical knowledge that the graduating pathology resident must know, it is necessary to (1) reflect upon what are the critical need subjects, (2) identify areas that have become of lesser importance, and then (3) prioritize training accordingly. PMID:28725779

  6. Hypnotic susceptibility in patients with conversion disorder

    NARCIS (Netherlands)

    Roelofs, K.; Hoogduin, C.A.L.; Keijsers, G.P.J.; Näring, G.W.B.; Moene, F.C.; Sandijck, P.

    2002-01-01

    Conversion disorder has been associated with hypnotic susceptibility for over a century and is currently still believed to be a form of autohypnosis. There is, however. little empirical evidence for the relation between hypnotic susceptibility and conversion symptoms. The authors compared 50

  7. Identifying areas of weakness in thoracic surgery residency training: a comparison of the perceptions of residents and program directors.

    Science.gov (United States)

    Edwards, Janet P; Schofield, Adam; Paolucci, Elizabeth Oddone; Schieman, Colin; Kelly, Elizabeth; Servatyari, Ramin; Dixon, Elijah; Ball, Chad G; Grondin, Sean C

    2014-01-01

    To identify core thoracic surgery procedures that require increased emphasis during thoracic surgery residency for residents to achieve operative independence and to compare the perspectives of residents and program directors in this regard. A modified Delphi process was used to create a survey that was distributed electronically to all Canadian thoracic surgery residents (12) and program directors (8) addressing the residents' ability to perform 19 core thoracic surgery procedures independently after the completion of residency. Residents were also questioned about the adequacy of their operative exposure to these 19 procedures during their residency training. A descriptive summary including calculations of frequencies and proportions was conducted. The perceptions of the 2 groups were then compared using the Fisher exact test employing a Bonferroni correction. The relationship between residents' operative exposure and their perceived operative ability was explored in the same fashion. The response rate was 100% for residents and program directors. No statistical differences were found between residents' and program directors' perceptions of residents' ability to perform the 19 core procedures independently. Both groups identified lung transplantation, first rib resection, and extrapleural pneumonectomy as procedures for which residents were not adequately prepared to perform independently. Residents' subjective ratings of operative exposure were in good agreement with their reported operative ability for 13 of 19 procedures. This study provides new insight into the perceptions of thoracic surgery residents and their program directors regarding operative ability. This study points to good agreement between residents and program directors regarding residents' surgical capabilities. This study provides information regarding potential weaknesses in thoracic surgery training, which may warrant an examination of the curricula of existing programs as well as a

  8. Changes in medicine: residency

    Directory of Open Access Journals (Sweden)

    Robbins RA

    2011-07-01

    Full Text Available No abstract available. Article truncated at 150 words. The most important time in a physician’s educational development is residency, especially the first year. However, residency work and responsibility have come under the scrutiny of a host of agencies and bureaucracies, and therefore, is rapidly changing. Most important in the alphabet soup of regulatory agencies is the Accreditation Council for Graduate Medical Education (ACGME which accredits residencies and ultimately makes the governing rules.Resident work hours have received much attention and are clearly decreasing. However, the decline in work hours began in the 1970’s before the present political push to decrease work hours. The residency I entered in 1976 had every third night call during the first year resident’s 6-9 months on general medicine or wards. It had changed from every other night the year before. On wards, we normally were in the hospital for our 24 hours of call and followed this with a 10-12 hour day before …

  9. Computers and conversation

    CERN Document Server

    Luff, Paul; Gilbert, Nigel G

    1986-01-01

    In the past few years a branch of sociology, conversation analysis, has begun to have a significant impact on the design of human*b1computer interaction (HCI). The investigation of human*b1human dialogue has emerged as a fruitful foundation for interactive system design.****This book includes eleven original chapters by leading researchers who are applying conversation analysis to HCI. The fundamentals of conversation analysis are outlined, a number of systems are described, and a critical view of their value for HCI is offered.****Computers and Conversation will be of interest to all concerne

  10. Does resident ranking during recruitment accurately predict subsequent performance as a surgical resident?

    Science.gov (United States)

    Fryer, Jonathan P; Corcoran, Noreen; George, Brian; Wang, Ed; Darosa, Debra

    2012-01-01

    While the primary goal of ranking applicants for surgical residency training positions is to identify the candidates who will subsequently perform best as surgical residents, the effectiveness of the ranking process has not been adequately studied. We evaluated our general surgery resident recruitment process between 2001 and 2011 inclusive, to determine if our recruitment ranking parameters effectively predicted subsequent resident performance. We identified 3 candidate ranking parameters (United States Medical Licensing Examination [USMLE] Step 1 score, unadjusted ranking score [URS], and final adjusted ranking [FAR]), and 4 resident performance parameters (American Board of Surgery In-Training Examination [ABSITE] score, PGY1 resident evaluation grade [REG], overall REG, and independent faculty rating ranking [IFRR]), and assessed whether the former were predictive of the latter. Analyses utilized Spearman correlation coefficient. We found that the URS, which is based on objective and criterion based parameters, was a better predictor of subsequent performance than the FAR, which is a modification of the URS based on subsequent determinations of the resident selection committee. USMLE score was a reliable predictor of ABSITE scores only. However, when we compared our worst residence performances with the performances of the other residents in this evaluation, the data did not produce convincing evidence that poor resident performances could be reliably predicted by any of the recruitment ranking parameters. Finally, stratifying candidates based on their rank range did not effectively define a ranking cut-off beyond which resident performance would drop off. Based on these findings, we recommend surgery programs may be better served by utilizing a more structured resident ranking process and that subsequent adjustments to the rank list generated by this process should be undertaken with caution. Copyright © 2012 Association of Program Directors in Surgery

  11. Personal finances of residents at three Canadian universities.

    Science.gov (United States)

    Teichman, Joel M H; Matsumoto, Edward; Smart, Michael; Smith, Aspen E; Tongco, Wayne; Hosking, Denis E; MacNeily, Andrew E; Jewett, Michael A S

    2005-02-01

    To address 3 research questions (What financial choices do residents make? Are the financial choices of residents similar to those of the general public? Are the financial choices of surgical residents reasonable?), we examined financial data from Canadian residents. A written survey was administered to 338 residents (103 of them surgical residents) at 3 Canadian training institutions (University of Toronto, Queen's University and University of Manitoba). Resident household cash flows, assets and liabilities were characterized. Finances for residents were compared with those of the general public, by means of the Survey of Household Spending and Survey of Financial Security. Median resident income was 45,000 dollars annually (Can dollars throughout). With a working spouse, median household income was 87,500 dollars. Among residents, 62% had educational debt (median 37,500 dollars), 39% maintained unpaid credit-card balances (median 1750 dollars), 36% did not budget expenses, 25% maintained cash reserves card debts (39% v. 50%, respectively). Surgical residents had income expectations after graduation higher than current billings justified. Fewer surgical (69%) than anesthesiology residents (88%, p card debts. Surgical residents' expectations of future income may be unrealistic. Further study is warranted.

  12. Problem neurology residents: a national survey.

    Science.gov (United States)

    Tabby, David S; Majeed, Muhammed H; Schwartzman, Robert J

    2011-06-14

    Problem residents are found across most medical specialties at a prevalence of about 10%. This study was designed to explore the prevalence and causes of problem neurology residents and to compare neurology programs' responses and outcomes. Directors of 126 US neurology residency programs were sent an electronic survey. We collected data on demographics, first and all "identifiers" of problem residents, and year of training in which the problem was found. We asked about observable signs, etiology, and who performed remediation. We asked what resources were used and what outcomes occurred. Ninety-five program directors completed surveys (75% response rate). Almost all neurology programs have problem residents (81%). Age, sex, marital status, being a US native, or attending a US medical school had no effect on problem status. Being a parent carried a lower likelihood of problems (32%). Most commonly the problem is acted on during the first year of training. Faculty members without defined educational roles were the most frequent first identifiers. Program directors were the most common remediators. The most common remediation techniques were increasing supervision and assigning a faculty mentor. Graduate medical education office and psychiatric or psychological counseling services were most often used. Eleven percent of problem residents required a program for impaired physicians and 14% required a leave of absence. Sixteen percent were dismissed from their programs. The prevalence of problem residents in neurology is similar to other disciplines, and various resources are available to remediate them.

  13. Hydrothermal conversion of biomass

    NARCIS (Netherlands)

    Knezevic, D.

    2009-01-01

    This thesis presents research of hydrothermal conversion of biomass (HTC). In this process, hot compressed water (subcritical water) is used as the reaction medium. Therefore this technique is suitable for conversion of wet biomass/ waste streams. By working at high pressures, the evaporation of

  14. Conversations in African Philosophy

    African Journals Online (AJOL)

    JONATHAN

    Conversational philosophy is articulated by Jonathan O. Chimakonam as the new wave of philosophical practice both in “place” and in “space”. This journal adopts and promotes this approach to philosophizing for African philosophy. Readers are encouraged to submit their conversational piece (maximum of 2000 words) ...

  15. Microwave plasma mode conversion

    International Nuclear Information System (INIS)

    Torres, H.S.; Sakanaka, P.H.; Villarroel, C.H.

    1985-01-01

    The behavior of hot electrons during the process of laser-produced plasma is studied. The basic equations of mode conversion from electromagnetic waves to electrostatic waves are presented. It is shown by mode conversion, that, the resonant absorption and parametric instabilities appear simultaneously, but in different plasma regions. (M.C.K.) [pt

  16. Protected Time for Research During Orthopaedic Residency Correlates with an Increased Number of Resident Publications.

    Science.gov (United States)

    Williams, Benjamin R; Agel, Julie A; Van Heest, Ann E

    2017-07-05

    The Accreditation Council for Graduate Medical Education (ACGME) requires orthopaedic residency programs to promote scholarship and research, which manifest differently among programs. We assess the impact of protected research time during orthopaedic residency on the number of resident publications. Rotation schedules and resident names were collected from 125 ACGME-accredited U.S. orthopaedic residency programs. Protected research time was classified as 1 of 3 types: (1) block time, (2) longitudinal time, or (3) no dedicated time. In April 2016, we searched residents in postgraduate year (PGY)-3 to PGY-5 on pubmed.gov to generate all orthopaedic publications with a PubMed identifier published during residency. Each publication's 2015 Thomson Reuters Journal Citation Reports 5-Year Journal Impact Factor and resident first authorship were noted. The number of PubMed identifiers for each program was summed and was divided by the number of residents in PGY-3 to PGY-5, giving a mean number of publications per resident. The relationship between output and program research time was compared using t tests and analysis of variance (ANOVA). A total of 1,690 residents were included, with an overall mean number (and standard deviation) of 1.2 ± 2.4 publications per resident. Eighty-seven programs reported block time, 14 programs reported longitudinal time, and 24 programs reported no time. There was a significant difference (p = 0.02) in the mean number of publications per resident when compared between programs with protected time (1.1 ± 1.2 publications) and programs with no protected time (0.6 ± 0.5 publication). One-way ANOVA demonstrated a significant mean difference across the 3 groups (p publications than block time at 1.0 ± 1.0 publication or no time at 0.6 ± 0.5 publication, a difference that persisted when adjusted to include only impact factors of >0 and exclude case reports (p = 0.0015). Both the presence of and the type of dedicated research time correlate

  17. Political conversations on Facebook

    DEFF Research Database (Denmark)

    Sørensen, Mads P.

    2016-01-01

    Political conversations are according to theories on deliberative democracy essential to well-functioning democracies. Traditionally these conversations have taken place in face-to-face settings, in e.g. party meetings and town meetings. However, social media such as Facebook and Twitter offers new...... possibilities for online political conversations between citizens and politicians. This paper examines the presence on Facebook and Twitter of Members of the Danish national Parliament, the Folketing, and focusses on a quantitative mapping of the political conversation activities taking place in the threads...... following Facebook posts from Danish Members of Parliament (MPs). The paper shows that, in comparison with previous findings from other countries, Danish MPs have a relatively high degree of engagement in political conversations with citizens on Facebook – and that a large number of citizens follow MPs...

  18. Text messaging among residents and faculty in a university general surgery residency program: prevalence, purpose, and patient care.

    Science.gov (United States)

    Shah, Dhruvil R; Galante, Joseph M; Bold, Richard J; Canter, Robert J; Martinez, Steve R

    2013-01-01

    There is little information about the use of text messaging (texting) devices among resident and faculty physicians for patient-related care (PRC). To determine the prevalence, frequency, purpose, and concerns regarding texting among resident and attending surgeons and to identify factors associated with PRC texting. E-mail survey. University medical center and its affiliated hospitals. Surgery resident and attending staff. Prevalence, frequency, purpose, and concerns regarding patient-related care text messaging. Overall, 73 (65%) surveyed physicians responded, including 45 resident (66%) and 28 attending surgeons (62%). All respondents owned a texting device. Majority of surgery residents (88%) and attendings (71%) texted residents, whereas only 59% of residents and 65% of attendings texted other faculty. Most resident to resident text occurred at a frequency of 3-5 times/d (43%) compared with most attending to resident texts, which occurred 1-2 times/d (33%). Most resident to attending (25%) and attending to attending (30%) texts occurred 1-2 times/d. Among those that texted, PRC was the most frequently reported purpose for resident to resident (46%), resident to attending (64%), attending to resident (82%), and attending to other attending staff (60%) texting. Texting was the most preferred method to communicate about routine PRC (47% of residents vs 44% of attendings). Age (OR: 0.86, 95% CI: 0.79-0.95; p = 0.003), but not sex, specialty/clinical rotation, academic rank, or postgraduate year (PGY) level predicted PRC texting. Most resident and attending staff surveyed utilize texting, mostly for PRC. Texting was preferred for communicating routine PRC information. Our data may facilitate the development of guidelines for the appropriate use of PRC texting. Copyright © 2013 Association of Program Directors in Surgery. Published by Elsevier Inc. All rights reserved.

  19. Metylcyclohexane conversion to light olefins

    Directory of Open Access Journals (Sweden)

    SCOFIELD C.F.

    1998-01-01

    Full Text Available This study consists in the evaluation of the catalytic properties of zeolites with different structures in the conversion of methylcyclohexane to light olefins. Results obtained suggest that the steric constrictions of the catalysts used play an important role in hydrogen transfer reactions. Higher selectivities for light olefins (C3= and C4= were observed for zeolites having more closed structures, like MFI and ferrerite, when compared to those having more open ones, like beta, omega and faujasite.

  20. Metylcyclohexane conversion to light olefins

    OpenAIRE

    SCOFIELD, C.F.; BENAZZI, E.; CAUFFRIEZ, H.; MARCILLY, C.

    1998-01-01

    This study consists in the evaluation of the catalytic properties of zeolites with different structures in the conversion of methylcyclohexane to light olefins. Results obtained suggest that the steric constrictions of the catalysts used play an important role in hydrogen transfer reactions. Higher selectivities for light olefins (C3= and C4=) were observed for zeolites having more closed structures, like MFI and ferrerite, when compared to those having more open ones, like beta, omega and fa...

  1. Uranium conversion; Urankonvertering

    Energy Technology Data Exchange (ETDEWEB)

    Oliver, Lena; Peterson, Jenny; Wilhelmsen, Katarina [Swedish Defence Research Agency (FOI), Stockholm (Sweden)

    2006-03-15

    FOI, has performed a study on uranium conversion processes that are of importance in the production of different uranium compounds in the nuclear industry. The same conversion processes are of interest both when production of nuclear fuel and production of fissile material for nuclear weapons are considered. Countries that have nuclear weapons ambitions, with the intention to produce highly enriched uranium for weapons purposes, need some degree of uranium conversion capability depending on the uranium feed material available. This report describes the processes that are needed from uranium mining and milling to the different conversion processes for converting uranium ore concentrate to uranium hexafluoride. Uranium hexafluoride is the uranium compound used in most enrichment facilities. The processes needed to produce uranium dioxide for use in nuclear fuel and the processes needed to convert different uranium compounds to uranium metal - the form of uranium that is used in a nuclear weapon - are also presented. The production of uranium ore concentrate from uranium ore is included since uranium ore concentrate is the feed material required for a uranium conversion facility. Both the chemistry and principles or the different uranium conversion processes and the equipment needed in the processes are described. Since most of the equipment that is used in a uranium conversion facility is similar to that used in conventional chemical industry, it is difficult to determine if certain equipment is considered for uranium conversion or not. However, the chemical conversion processes where UF{sub 6} and UF{sub 4} are present require equipment that is made of corrosion resistant material.

  2. Solar energy conversion systems

    CERN Document Server

    Brownson, Jeffrey R S

    2013-01-01

    Solar energy conversion requires a different mind-set from traditional energy engineering in order to assess distribution, scales of use, systems design, predictive economic models for fluctuating solar resources, and planning to address transient cycles and social adoption. Solar Energy Conversion Systems examines solar energy conversion as an integrative design process, applying systems thinking methods to a solid knowledge base for creators of solar energy systems. This approach permits different levels of access for the emerging broad audience of scientists, engineers, architects, planners

  3. Energy conversion statics

    CERN Document Server

    Messerle, H K; Declaris, Nicholas

    2013-01-01

    Energy Conversion Statics deals with equilibrium situations and processes linking equilibrium states. A development of the basic theory of energy conversion statics and its applications is presented. In the applications the emphasis is on processes involving electrical energy. The text commences by introducing the general concept of energy with a survey of primary and secondary energy forms, their availability, and use. The second chapter presents the basic laws of energy conversion. Four postulates defining the overall range of applicability of the general theory are set out, demonstrating th

  4. Uranium Conversion & Enrichment

    Energy Technology Data Exchange (ETDEWEB)

    Karpius, Peter Joseph [Los Alamos National Lab. (LANL), Los Alamos, NM (United States)

    2017-02-06

    The isotopes of uranium that are found in nature, and hence in ‘fresh’ Yellowcake’, are not in relative proportions that are suitable for power or weapons applications. The goal of conversion then is to transform the U3O8 yellowcake into UF6. Conversion and enrichment of uranium is usually required to obtain material with enough 235U to be usable as fuel in a reactor or weapon. The cost, size, and complexity of practical conversion and enrichment facilities aid in nonproliferation by design.

  5. Postoperative conversion disorder.

    Science.gov (United States)

    Afolabi, Kola; Ali, Sameer; Gahtan, Vivian; Gorji, Reza; Li, Fenghua; Nussmeier, Nancy A

    2016-05-01

    Conversion disorder is a psychiatric disorder in which psychological stress causes neurologic deficits. A 28-year-old female surgical patient had uneventful general anesthesia and emergence but developed conversion disorder 1 hour postoperatively. She reported difficulty speaking, right-hand numbness and weakness, and right-leg paralysis. Neurologic examination and imaging revealed no neuronal damage, herniation, hemorrhage, or stroke. The patient mentioned failing examinations the day before surgery and discontinuing her prescribed antidepressant medication, leading us to diagnose conversion disorder, with eventual confirmation by neuroimaging and follow-up examinations. Copyright © 2016 Elsevier Inc. All rights reserved.

  6. Uranium conversion wastes

    International Nuclear Information System (INIS)

    Vicente, R.; Dellamano, J.C.

    1989-12-01

    A set of mathematical equations was developed and used to estimate the radiological significance of each radionuclide potentially present in the uranium refining industry effluents. The equations described the evolution in time of the radionuclides activities in the uranium fuel cycle, from mining and milling, through the yellowcake, till the conversion effluents. Some radionuclides that are not usually monitored in conversion effluents (e.g. Pa-231 and Ac-227) were found to be potentially relevant from the radiological point of view in conversion facilities, and are certainly relevant in mining and milling industry, at least in a few waste streams. (author) [pt

  7. Freely flowing conversations

    DEFF Research Database (Denmark)

    Aakjær, Marie Kirstejn; Andrade, David; Dexters, Peter

    and in regards to rehabilitation efforts. In the context of prisons UDI is inspired by the complexity approach (Stacey 2005). We seek to facilitate freely flowing conversations between inmates, staff and managers – pushing the boundaries of existing norms, roles and beliefs. In the end however we rely...... relations by changing conversations. Through the theoretical framework of the complexity approach, we discuss how this may lead to organizational change. Finally we suggest that inviting inmates to take part in conversations about core organizational development may be a fundamental strategy in trying...

  8. Can Medical School Performance Predict Residency Performance? Resident Selection and Predictors of Successful Performance in Obstetrics and Gynecology

    Science.gov (United States)

    Stohl, Hindi E.; Hueppchen, Nancy A.; Bienstock, Jessica L.

    2010-01-01

    Background During the evaluation process, Residency Admissions Committees typically gather data on objective and subjective measures of a medical student's performance through the Electronic Residency Application Service, including medical school grades, standardized test scores, research achievements, nonacademic accomplishments, letters of recommendation, the dean's letter, and personal statements. Using these data to identify which medical students are likely to become successful residents in an academic residency program in obstetrics and gynecology is difficult and to date, not well studied. Objective To determine whether objective information in medical students' applications can help predict resident success. Method We performed a retrospective cohort study of all residents who matched into the Johns Hopkins University residency program in obstetrics and gynecology between 1994 and 2004 and entered the program through the National Resident Matching Program as a postgraduate year-1 resident. Residents were independently evaluated by faculty and ranked in 4 groups according to perceived level of success. Applications from residents in the highest and lowest group were abstracted. Groups were compared using the Fisher exact test and the Student t test. Results Seventy-five residents met inclusion criteria and 29 residents were ranked in the highest and lowest quartiles (15 in highest, 14 in lowest). Univariate analysis identified no variables as consistent predictors of resident success. Conclusion In a program designed to train academic obstetrician-gynecologists, objective data from medical students' applications did not correlate with successful resident performance in our obstetrics-gynecology residency program. We need to continue our search for evaluation criteria that can accurately and reliably select the medical students that are best fit for our specialty. PMID:21976076

  9. Leadership Training in Otolaryngology Residency.

    Science.gov (United States)

    Bent, John P; Fried, Marvin P; Smith, Richard V; Hsueh, Wayne; Choi, Karen

    2017-06-01

    Although residency training offers numerous leadership opportunities, most residents are not exposed to scripted leadership instruction. To explore one program's attitudes about leadership training, a group of otolaryngology faculty (n = 14) and residents (n = 17) was polled about their attitudes. In terms of self-perception, more faculty (10 of 14, 71.4%) than residents (9 of 17, 52.9%; P = .461) considered themselves good leaders. The majority of faculty and residents (27 of 31) thought that adults could be taught leadership ability. Given attitudes about leadership ability and the potential for improvement through instruction, consideration should be given to including such training in otolaryngology residency.

  10. A Prospective, Multicenter Study to Compare a Disposable, High-fluid Capacity Underpad to Nonpermeable, Disposable, Reusable Containment Products on Incontinence-associated Dermatitis Rates Among Skilled Nursing Facility Residents.

    Science.gov (United States)

    Motta, Glenda; Milne, Catherine T

    2017-12-01

    Due to the high prevalence of incontinence among skilled nursing facility (SNF) residents, incontinence-associated derma- titis (IAD) is a common occurrence. In addition, facility staff may mistakenly identify IAD as a pressure injury. A prospective, descriptive, multicenter study was conducted in 3 Connecticut facilities to evaluate the effect of substituting a disposable, high- uid capacity underpad for nonpermeable disposable and reusable containment products on the rate of IADs. Residents with and without IAD but with high IAD risk scores who were bed- or chairbound or ambulatory and used disposable nonpermeable briefs and underpads or reusable, laundered containment products when in bed longer than 2 hours were randomly enrolled and observed for a 4-week period. Facility staff were trained on the importance of differentiating between IAD and pressure injury; they substituted the study product (a disposable, high- uid capacity underpad) for all previously used containment products. Patient risk for IAD and skin condition were assessed using the Perineal Assessment Tool (PAT) and the Skin Condition Assessment Tool (SAT), respectively, at 5 time points: baseline, week 1, week 2, week 3, and week 4. The PAT is a 4-item instrument based conceptually on the 4 determinants in perineal skin breakdown; subscales are rated from 1 (least risk) to 3 (most risk), with a total score range of 4 to 12. The SAT is used to evaluate IAD speci cally, generating a cumulative severity score ranging from 0 to 3 on area of skin affected, degree of redness, and depth of ero- sion. Final data analysis was conducted on 40 residents: 25 had IAD present at enrollment and 15 were deemed high risk for developing IAD. Mean SAT scores in the 25 participants with IAD decreased with signi cance at week 1 (P = .0016), week 2 (P = .0023), week 3 (P = .0005), and week 4 (P disposable, high- uid capacity underpad improved SAT scores over time. IAD rates increased in each facility, but pressure

  11. Ambulatory Care Skills: Do Residents Feel Prepared?

    Directory of Open Access Journals (Sweden)

    Denise Bonds

    2002-10-01

    Full Text Available Objective: To determine resident comfort and skill in performing ambulatory care skills. Methods: Descriptive survey of common ambulatory care skills administered to internal medicine faculty and residents at one academic medical center. Respondents were asked to rate their ability to perform 12 physical exam skills and 6 procedures, and their comfort in performing 7 types of counseling, and obtaining 6 types of patient history (4 point Likert scale for each. Self-rated ability or comfort was compared by gender, status (year of residency, faculty, and future predicted frequency of use of the skill. Results: Residents reported high ability levels for physical exam skills common to both the ambulatory and hospital setting. Fewer felt able to perform musculoskeletal, neurologic or eye exams easily alone. Procedures generally received low ability ratings. Similarly, residents’ comfort in performing common outpatient counseling was also low. More residents reported feeling very comfortable in obtaining history from patients. We found little variation by gender, year of training, or predicted frequency of use. Conclusion: Self-reported ability and comfort for many common ambulatory care skills is low. Further evaluation of this finding in other training programs is warranted.

  12. Liver-resident NK cells and their potential functions.

    Science.gov (United States)

    Peng, Hui; Sun, Rui

    2017-09-18

    Natural killer (NK) cells represent a heterogeneous population of innate lymphocytes with phenotypically and functionally distinct subsets. In particular, recent studies have identified a unique subset of NK cells residing within the liver that are maintained as tissue-resident cells, confer antigen-specific memory responses and exhibit different phenotypical and developmental characteristics compared with conventional NK (cNK) cells. These findings have encouraged researchers to uncover tissue-resident NK cells at other sites, and detailed analyses have revealed that these tissue-resident NK cells share many similarities with liver-resident NK cells and tissue-resident memory T cells. Here, we present a brief historical perspective on the discovery of liver-resident NK cells and discuss their relationship to cNK cells and other emerging NK cell subsets and their potential functions.Cellular &Molecular Immunology advance online publication, 18 September 2017; doi:10.1038/cmi.2017.72.

  13. Cognitive learning during surgical residency. A model for curriculum evaluation.

    Science.gov (United States)

    Rhodes, R S; Wile, M Z; Persons, M L; Shuck, J M

    1987-02-01

    The program summary of the American Board of Surgery In-Service Training Exam (ABSITE) can be used to quantitate cognitive learning during a surgical residency and to identify areas of curricular weakness in a residency program. Knowledge on each question is categorized as high (known) or low (unknown) depending on the percentage of residents who answered correctly. Knowledge of Level 1 (entry) residents is then compared with Level 5 (exit) residents. Each ABSITE question can thus be categorized on entry versus exit as known-known, unknown-unknown, unknown-known, and known-unknown. Only about half of unknown knowledge on entry appears to become known on exit. Very little knowledge known on entry becomes unknown on exit. Weaknesses in specific subject areas can be readily identified by ranking questions according to the number of exiting residents who answer incorrectly. Use of this technique to quantitate cognitive learning in a residency program may allow objective assessment of changes in curriculum.

  14. The Relationship Between Academic Motivation and Lifelong Learning During Residency: A Study of Psychiatry Residents.

    Science.gov (United States)

    Sockalingam, Sanjeev; Wiljer, David; Yufe, Shira; Knox, Matthew K; Fefergrad, Mark; Silver, Ivan; Harris, Ilene; Tekian, Ara

    2016-10-01

    To examine the relationship between lifelong learning (LLL) and academic motivation for residents in a psychiatry residency program, trainee factors that influence LLL, and psychiatry residents' LLL practices. Between December 2014 and February 2015, 105 of 173 (61%) eligible psychiatry residents from the Department of Psychiatry, University of Toronto, completed a questionnaire with three study instruments: an LLL needs assessment survey, the Jefferson Scale of Physician Lifelong Learning (JeffSPLL), and the Academic Motivation Scale (AMS). The AMS included a relative autonomy motivation score (AMS-RAM) measuring the overall level of intrinsic motivation (IM). A significant correlation was observed between JeffSPLL and AMS-RAM scores (r = 0.39, P motivation identification domain (mean difference [M] = 0.38; 95% confidence interval [CI] [0.01, 0.75]; P = .045; d = 0.44) compared with senior residents. Clinician scientist stream (CSS) residents had significantly higher JeffSPLL scores compared with non-CSS residents (M = 3.15; 95% CI [0.52, 5.78]; P = .020; d = 0.57). The use of rigorous measures to study LLL and academic motivation confirmed prior research documenting the positive association between IM and LLL. The results suggest that postgraduate curricula aimed at enhancing IM, for example, through support for learning autonomously, could be beneficial to cultivating LLL in learners.

  15. Mining Conversational Social Video

    OpenAIRE

    Biel, Joan-Isaac

    2013-01-01

    The ubiquity of social media in our daily life, the intense user participation, and the explo- sion of multimedia content have generated an extraordinary interest from computer and social scientists to investigate the traces left by users to understand human behavior online. From this perspective, YouTube can be seen as the largest collection of audiovisual human behavioral data, among which conversational video blogs (vlogs) are one of the basic formats. Conversational vlogs have evolved fro...

  16. Persuasion detection in conversation

    OpenAIRE

    Gilbert, Henry T.

    2010-01-01

    Approved for public release; distribution is unlimited In this thesis, we present a system for annotating persuasion in conversation based on a social-psychological model. We augmented the social model developed by James Cialdini with some of our own categories for annotators to label. The conversations consisted of 37 hostage negotiation transcripts from private and public sources, with all personal information removed from the private source transcripts. We evaluated the level of agre...

  17. Perspective on direct conversion

    Energy Technology Data Exchange (ETDEWEB)

    Lewis, W B

    1963-10-15

    The objective of direct conversion is high electrical output for minimum total cost, and not always high conversion efficiency. The wide range of techniques embracing cryogenics and hot plasma derives from the special requirements of source, environment, and application. Sources include solar and other radiation, nuclear fission and fusion, chemical energy, and heat. Environments and applications range from space vehicles to submarines and from giant power networks to isolated buoys and pocket devices. (auth)

  18. Goals and Methodology for a Surgery Residency Program: A Committee Approach.

    Science.gov (United States)

    Knecht, Charles D.; And Others

    1979-01-01

    Written goals of a small animal residency program established by Purdue University are identified and an elaborate list of methodology for goals is provided. Tables include: summary of required activities of residents, checklist of residency progress, and comparable effort for surgery residency and masters program. (Author/MLW)

  19. evaluation of commercial FCC catalysts for hydrocarbon conversion. I. Physicochemical characterization and n-hexane conversion.

    NARCIS (Netherlands)

    Brait, A.; Brait, A.; Seshan, Kulathuiyer; Lercher, J.A.

    1998-01-01

    The physicochemical properties of six steam-stabilized, commercial FCC catalysts were compared in respect of their catalytic activity for n-hexane conversion. The conversion of n-hexane over these catalysts could be fully explained by three reaction pathways: protolytic cracking, protolytic

  20. Lawful Permanent Residents - Annual Report

    Data.gov (United States)

    Department of Homeland Security — A lawful permanent resident (LPR) or 'green card' recipient is defined by immigration law as a person who has been granted lawful permanent residence in the United...

  1. Have the 'black clouds' cleared with new residency programme regulations?

    Science.gov (United States)

    Schissler, A J; Einstein, A J

    2016-06-01

    For decades, residents believed to work harder have been referred to as having a 'black cloud'. Residency training programmes recently instituted changes to improve physician wellness and achieve comparable clinical workload. All Internal Medicine residents in the internship class of 2014 at Columbia were surveyed to assess for the ongoing presence of 'black cloud' trainees. While some residents are still thought to have this designation, they did not have a greater workload when compared to their peers. © 2016 Royal Australasian College of Physicians.

  2. Training Pediatric Residents to Provide Smoking Cessation Counseling to Parents

    Directory of Open Access Journals (Sweden)

    Rebecca L. Collins

    2005-01-01

    Full Text Available The objective was to assess the effectiveness of a smoking cessation educational program on pediatric residents' counseling. Residents were randomly selected to receive the intervention. Residents who were trained were compared to untrained residents. Self-reported surveys and patient chart reviews were used. Measures included changes in self-reported knowledge, attitudes and behaviors of residents, and differences in chart documentation and caretaker-reported physician counseling behaviors. The intervention was multidimensional including a didactic presentation, a problem-solving session, clinic reminders, and provision of patient education materials. Results showed that residents who were trained were more likely to ask about tobacco use in their patients' households. They were also more likely to advise caretakers to cut down on or to quit smoking, to help set a quit date, and to follow up on the advice given at a subsequent visit. Trained residents were more likely to record a history of passive tobacco exposure in the medical record. These residents also reported improved confidence in their counseling skills and documented that they had done such counseling more often than did untrained residents. Caretakers of pediatric patients who smoke seen by intervention residents were more likely to report that they had received tobacco counseling. Following this intervention, pediatric residents significantly improved their behaviors, attitudes, and confidence in providing smoking cessation counseling to parents of their pediatric patients.

  3. Neuroscience and humanistic psychiatry: a residency curriculum.

    Science.gov (United States)

    Griffith, James L

    2014-04-01

    Psychiatry residencies with a commitment to humanism commonly prioritize training in psychotherapy, cultural psychiatry, mental health policy, promotion of human rights, and similar areas reliant upon dialogue and collaborative therapeutic relationships. The advent of neuroscience as a defining paradigm for psychiatry has challenged residencies with a humanistic focus due to common perceptions that it would entail constriction of psychiatric practice to diagnostic and psychopharmacology roles. The author describes a neuroscience curriculum that has taught psychopharmacology effectively, while also advancing effectiveness of language-based and relationship-based therapeutics. In 2000, the George Washington University psychiatry residency initiated a neuroscience curriculum consisting of (1) a foundational postgraduate year 2 seminar teaching cognitive and social neuroscience and its integration into clinical psychopharmacology, (2) advanced seminars that utilized a neuroscience perspective in teaching specific psychotherapeutic skill sets, and (3) case-based teaching in outpatient clinical supervisions that incorporated a neuroscience perspective into traditional psychotherapy supervisions. Curricular assessment was conducted by (1) RRC reaccreditation site visit feedback, (2) examining career trajectories of residency graduates, (3) comparing PRITE exam Somatic Treatments subscale scores for 2010-2012 residents with pre-implementation residents, and (4) postresidency survey assessment by 2010-2012 graduates. The 2011 RRC site visit report recommended a "notable practice" citation for "innovative neurosciences curriculum." Three of twenty 2010-2012 graduates entered neuroscience research fellowships, as compared to none before the new curriculum. PRITE Somatic Treatments subscale scores improved from the 23rd percentile to the 62nd percentile in pre- to post-implementation of curriculum (p neuroscience curriculum for a residency committed to humanistic psychiatry

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

    Science.gov (United States)

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

    2013-01-01

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

  5. Development of a Comprehensive Communication Skills Curriculum for Pediatrics Residents.

    Science.gov (United States)

    Peterson, Eleanor B; Boland, Kimberly A; Bryant, Kristina A; McKinley, Tara F; Porter, Melissa B; Potter, Katherine E; Calhoun, Aaron W

    2016-12-01

    Effective communication is an essential element of medical care and a priority of medical education. Specific interventions to teach communication skills are at the discretion of individual residency programs. We developed the Resident Communication Skills Curriculum (RCSC), a formal curriculum designed to teach trainees the communication skills essential for high-quality practice. A multidisciplinary working group contributed to the development of the RCSC, guided by an institutional needs assessment, literature review, and the Accreditation Council for Graduate Medical Education core competencies. The result was a cohesive curriculum that incorporates didactic, role play, and real-life experiences over the course of the entire training period. Methods to assess curricular outcomes included self-reporting, surveys, and periodic faculty evaluations of the residents. Curricular components have been highly rated by residents (3.95-3.97 based on a 4-point Likert scale), and residents' self-reported communication skills demonstrated an improvement over the course of residency in the domains of requesting a consultation, providing effective handoffs, handling conflict, and having difficult conversations (intern median 3.0, graduate median 4.0 based on a 5-point Likert scale, P  ≤ .002). Faculty evaluations of residents have also demonstrated improvement over time (intern median 3.0, graduate median 4.5 based on a 5-point Likert scale, P  communication skills curriculum for pediatrics residents was implemented, with a multistep evaluative process showing improvement in skills over the course of the residency program. Positive resident evaluations and informal comments from faculty support its general acceptance. The use of existing resources makes this curriculum feasible.

  6. Biomass Thermochemical Conversion Program. 1984 annual report

    Energy Technology Data Exchange (ETDEWEB)

    Schiefelbein, G.F.; Stevens, D.J.; Gerber, M.A.

    1985-01-01

    The objective of the program is to generate scientific data and conversion process information that will lead to establishment of cost-effective process for converting biomass resources into clean fuels. The goal of the program is to develop the data base for biomass thermal conversion by investigating the fundamental aspects of conversion technologies and by exploring those parameters that are critical to the conversion processes. The research activities can be divided into: (1) gasification technology; (2) liquid fuels technology; (3) direct combustion technology; and (4) program support activities. These activities are described in detail in this report. Outstanding accomplishments during fiscal year 1984 include: (1) successful operation of 3-MW combustor/gas turbine system; (2) successful extended term operation of an indirectly heated, dual bed gasifier for producing medium-Btu gas; (3) determination that oxygen requirements for medium-Btu gasification of biomass in a pressurized, fluidized bed gasifier are low; (4) established interdependence of temperature and residence times on biomass pyrolysis oil yields; and (5) determination of preliminary technical feasibility of thermally gasifying high moisture biomass feedstocks. A bibliography of 1984 publications is included. 26 figs., 1 tab.

  7. Prevalence and management of pain, by race and dementia among nursing home residents: United States, 2004.

    Science.gov (United States)

    Sengupta, Manisha; Bercovitz, Anita; Harris-Kojetin, Lauren D

    2010-03-01

    Data from the National Nursing Home Survey, 2004. About one-quarter of all nursing home residents reported or showed signs of pain. Nonwhite residents and residents with dementia were less likely to report or show signs of pain compared with white residents and residents without dementia. Nonwhite residents with dementia were least likely, and white residents without dementia were most likely to report or show signs of pain. Forty-four percent of nursing home residents with pain received neither standing orders for pain medication nor special services for pain management (i.e., appropriate pain management). Among residents with dementia and pain, nonwhite residents were more likely than white residents to lack appropriate pain management.

  8. Mental health literacy as a function of remoteness of residence: an Australian national study.

    Science.gov (United States)

    Griffiths, Kathleen M; Christensen, Helen; Jorm, Anthony F

    2009-03-27

    Although there have been many population studies of mental health literacy, little is known about the mental health literacy of people who reside in rural areas. This study sought to determine the impact of remoteness on public knowledge of depression and schizophrenia. The mental health literacy of residents of major cities, inner regional, and outer-remote (including outer regional, remote, and very remote) regions were compared using data from a 2003-04 Australian national survey of the mental health literacy of 3998 adults. Measures included the perceived helpfulness of a range of professionals, non-professionals and interventions, and the causes, prognosis, and outcomes after treatment for four case vignettes describing depression, depression with suicidal ideation, early schizophrenia and chronic schizophrenia. Participant awareness of Australia's national depression initiative and depression in the media, their symptoms of depression and exposure to the conditions depicted in the vignettes were also compared. Mental health literacy was similar across remoteness categories. However, inner regional residents showed superior identification of the disorders depicted in the suicidal ideation and chronic schizophrenia vignettes. They were also more likely to report having heard of Australia's national depression health promotion campaign. Conversely, they were less likely than major city residents to rate the evidence-based treatment of psychotherapy helpful for depression. Both inner regional and outer-remote residents were less likely to rate psychologists as helpful for depression alone. The rural groups were more likely to rate the non-evidence based interventions of drinking and painkillers as helpful for a depression vignette. In addition, outer-remote residents were more likely to identify the evidence based treatment of antipsychotics as harmful for early schizophrenia and less likely to endorse psychiatrists, psychologists, social workers and general

  9. Mental health literacy as a function of remoteness of residence: an Australian national study

    Directory of Open Access Journals (Sweden)

    Jorm Anthony F

    2009-03-01

    Full Text Available Abstract Background Although there have been many population studies of mental health literacy, little is known about the mental health literacy of people who reside in rural areas. This study sought to determine the impact of remoteness on public knowledge of depression and schizophrenia. Methods The mental health literacy of residents of major cities, inner regional, and outer-remote (including outer regional, remote, and very remote regions were compared using data from a 2003–04 Australian national survey of the mental health literacy of 3998 adults. Measures included the perceived helpfulness of a range of professionals, non-professionals and interventions, and the causes, prognosis, and outcomes after treatment for four case vignettes describing depression, depression with suicidal ideation, early schizophrenia and chronic schizophrenia. Participant awareness of Australia's national depression initiative and depression in the media, their symptoms of depression and exposure to the conditions depicted in the vignettes were also compared. Results Mental health literacy was similar across remoteness categories. However, inner regional residents showed superior identification of the disorders depicted in the suicidal ideation and chronic schizophrenia vignettes. They were also more likely to report having heard of Australia's national depression health promotion campaign. Conversely, they were less likely than major city residents to rate the evidence-based treatment of psychotherapy helpful for depression. Both inner regional and outer-remote residents were less likely to rate psychologists as helpful for depression alone. The rural groups were more likely to rate the non-evidence based interventions of drinking and painkillers as helpful for a depression vignette. In addition, outer-remote residents were more likely to identify the evidence based treatment of antipsychotics as harmful for early schizophrenia and less likely to endorse

  10. Mental health literacy as a function of remoteness of residence: an Australian national study

    Science.gov (United States)

    Griffiths, Kathleen M; Christensen, Helen; Jorm, Anthony F

    2009-01-01

    Background Although there have been many population studies of mental health literacy, little is known about the mental health literacy of people who reside in rural areas. This study sought to determine the impact of remoteness on public knowledge of depression and schizophrenia. Methods The mental health literacy of residents of major cities, inner regional, and outer-remote (including outer regional, remote, and very remote) regions were compared using data from a 2003–04 Australian national survey of the mental health literacy of 3998 adults. Measures included the perceived helpfulness of a range of professionals, non-professionals and interventions, and the causes, prognosis, and outcomes after treatment for four case vignettes describing depression, depression with suicidal ideation, early schizophrenia and chronic schizophrenia. Participant awareness of Australia's national depression initiative and depression in the media, their symptoms of depression and exposure to the conditions depicted in the vignettes were also compared. Results Mental health literacy was similar across remoteness categories. However, inner regional residents showed superior identification of the disorders depicted in the suicidal ideation and chronic schizophrenia vignettes. They were also more likely to report having heard of Australia's national depression health promotion campaign. Conversely, they were less likely than major city residents to rate the evidence-based treatment of psychotherapy helpful for depression. Both inner regional and outer-remote residents were less likely to rate psychologists as helpful for depression alone. The rural groups were more likely to rate the non-evidence based interventions of drinking and painkillers as helpful for a depression vignette. In addition, outer-remote residents were more likely to identify the evidence based treatment of antipsychotics as harmful for early schizophrenia and less likely to endorse psychiatrists, psychologists

  11. Boiler conversions for biomass

    Energy Technology Data Exchange (ETDEWEB)

    Kinni, J [Tampella Power Inc., Tampere (Finland)

    1997-12-31

    Boiler conversions from grate- and oil-fired boilers to bubbling fluidized bed combustion have been most common in pulp and paper industry. Water treatment sludge combustion, need for additional capacity and tightened emission limits have been the driving forces for the conversion. To accomplish a boiler conversion for biofuel, the lower part of the boiler is replaced with a fluidized bed bottom and new fuel, ash and air systems are added. The Imatran Voima Rauhalahti pulverized-peat-fired boiler was converted to bubbling fluidized bed firing in 1993. In the conversion the boiler capacity was increased by 10 % to 295 MWth and NO{sub x} emissions dropped. In the Kymmene Kuusankoski boiler, the reason for conversion was the combustion of high chlorine content biosludge. The emissions have been under general European limits. During the next years, the emission limits will tighten and the boilers will be designed for most complete combustion and compounds, which can be removed from flue gases, will be taken care of after the boiler. (orig.) 3 refs.

  12. Boiler conversions for biomass

    Energy Technology Data Exchange (ETDEWEB)

    Kinni, J. [Tampella Power Inc., Tampere (Finland)

    1996-12-31

    Boiler conversions from grate- and oil-fired boilers to bubbling fluidized bed combustion have been most common in pulp and paper industry. Water treatment sludge combustion, need for additional capacity and tightened emission limits have been the driving forces for the conversion. To accomplish a boiler conversion for biofuel, the lower part of the boiler is replaced with a fluidized bed bottom and new fuel, ash and air systems are added. The Imatran Voima Rauhalahti pulverized-peat-fired boiler was converted to bubbling fluidized bed firing in 1993. In the conversion the boiler capacity was increased by 10 % to 295 MWth and NO{sub x} emissions dropped. In the Kymmene Kuusankoski boiler, the reason for conversion was the combustion of high chlorine content biosludge. The emissions have been under general European limits. During the next years, the emission limits will tighten and the boilers will be designed for most complete combustion and compounds, which can be removed from flue gases, will be taken care of after the boiler. (orig.) 3 refs.

  13. Automated medical resident rotation and shift scheduling to ensure quality resident education and patient care.

    Science.gov (United States)

    Smalley, Hannah K; Keskinocak, Pinar

    2016-03-01

    At academic teaching hospitals around the country, the majority of clinical care is provided by resident physicians. During their training, medical residents often rotate through various hospitals and/or medical services to maximize their education. Depending on the size of the training program, manually constructing such a rotation schedule can be cumbersome and time consuming. Further, rules governing allowable duty hours for residents have grown more restrictive in recent years (ACGME 2011), making day-to-day shift scheduling of residents more difficult (Connors et al., J Thorac Cardiovasc Surg 137:710-713, 2009; McCoy et al., May Clin Proc 86(3):192, 2011; Willis et al., J Surg Edu 66(4):216-221, 2009). These rules limit lengths of duty periods, allowable duty hours in a week, and rest periods, to name a few. In this paper, we present two integer programming models (IPs) with the goals of (1) creating feasible assignments of residents to rotations over a one-year period, and (2) constructing night and weekend call-shift schedules for the individual rotations. These models capture various duty-hour rules and constraints, provide the ability to test multiple what-if scenarios, and largely automate the process of schedule generation, solving these scheduling problems more effectively and efficiently compared to manual methods. Applying our models on data from a surgical residency program, we highlight the infeasibilities created by increased duty-hour restrictions placed on residents in conjunction with current scheduling paradigms.

  14. μ- conversion via doubly charged Higgs scalar

    International Nuclear Information System (INIS)

    Picciotto, C.E.; Zahir, M.S.

    1982-10-01

    A new mechanism is used to calculate μ - → e + conversion in nuclei, based on the existence of a doubly charged Higgs scalar. The scalar is part of a triplet which generates the spontaneous breakdown of B-L symmetry in an extension of the standard model, as proposed by Gelmini and Roncadelli. We find a limit for conversion rates which is comparable to those of earlier calculations

  15. Depression is associated with poor functioning in activities of daily living among nursing home residents without cognitive impairment.

    Science.gov (United States)

    Drageset, Jorunn; Eide, Geir E; Ranhoff, Anette H

    2011-11-01

    To explore depressive symptoms among nursing home residents without cognitive impairment and the relationship between their depressive symptoms and dependence on activities of daily living, comorbidity and sociodemographic variables. Depression has become a major health care concern among older people, but depression and its association with functioning in activities of daily living among nursing home residents without cognitive impairment has previously not been studied in Norway. A cross-sectional comparative design. The sample comprised older residents (age 65-102 years; n = 227) from 30 nursing homes with at least six months of residence. All nursing home residents had a Clinical Dementia Rating scale score ≤0·5 and were capable of conversation. Scores on the Geriatric Depression Scale (15 items) and demographic variables were collected during face-to-face interviews. The activities of daily living were assessed using the Katz Index based on nurses' observation, and medical diagnoses were obtained from the patient records. Pearson's chi-square test and ordinal logistic regression were used to identify possible associations between activities of daily living and depression. After adjustment for age, sex, marital status, length of stay per year and education, more dependence on activities of daily living was associated with depression [odds ratio (OR): 1·18; 95% confidence interval (CI): 1·04-1·37; p = 0·02]. Higher age was associated with less depression (OR: 0·64; 95% CI: 0·43-0·94; p = 0·02), that is, the odds of depression declined by 36% for each 10-year increase in age. Our results suggest that depression symptoms are a major health problem among nursing home residents without cognitive impairment and that younger residents are more prone to having depressive symptoms. Nursing home staff should communicate with and observe residents closely for signs of depression, especially younger residents with high dependence on activities of daily living

  16. Residents as teachers: psychiatry and family medicine residents' self-assessment of teaching knowledge, skills, and attitudes.

    Science.gov (United States)

    Brand, Michael W; Ekambaram, Vijayabharathi; Tucker, Phebe; Aggarwal, Ruchi

    2013-09-01

    Residents are one of the prime sources of information and education for medical students. As an initial step in supporting residents as teachers, a baseline self-assessment of residents' knowledge, skills, attitudes, and values related to teaching was conducted among psychiatry and family medicine residents to compare and improve their confidence and skills as teachers. Psychiatry residents (N=12) and family medicine residents (N=23) completed self-assessments of their knowledge, skills, attitudes, and values related to teaching. Residents also were asked to list steps used in the One-Minute Preceptor process and estimate the time each spent in teaching. Descriptive summary statistics were used for four main areas related to teaching; t-test and chi-square analyses were conducted to ascertain whether there was a significant difference in resident groups. In the current study, the perceived amount of time spent for teaching patients was significantly higher among family practice residents, whereas no group differences were found for time teaching medical students, peers, community members, non-physicians, or others. However, family medicine residents rated themselves higher than psychiatry residents in their understanding of their roles in teaching medical students and teaching patients. Also, family medicine residents' self-reported teaching skills were more advanced (82.4%) than psychiatry residents' (54.2%). They most likely applied at least two different teaching methods in inpatient and outpatient settings, as compared with psychiatry residents. No significant group differences were found in the other 15 items assessing teaching knowledge, skills, attitudes, and values. Results indicate that residents' knowledge, skills, attitudes, and values regarding teaching varies across institutions and training programs. The psychiatry residents in this study do not clearly understand their role as educators with patients and medical students; they have a less clear

  17. Evaluation of otolaryngology residency program websites.

    Science.gov (United States)

    Svider, Peter F; Gupta, Amar; Johnson, Andrew P; Zuliani, Giancarlo; Shkoukani, Mahdi A; Eloy, Jean Anderson; Folbe, Adam J

    2014-10-01

    %-49%). Sites for "large" programs (≥3 residents per year) were more comprehensive (49% vs 42%; P = .04). While further survey of prospective applicants would be invaluable in determining which factors are of greatest interest, many residency websites appear to be inadequately comprehensive. Despite the relative comprehensiveness of criteria relevant to clinical training when compared with other aspects of websites such as incentives, several crucial aspects of training are still not addressed in many sites.

  18. Photovoltaic solar energy conversion

    CERN Document Server

    Bauer, Gottfried H

    2015-01-01

    This concise primer on photovoltaic solar energy conversion invites readers to reflect on the conversion of solar light into energy at the most fundamental level and encourages newcomers to the field to help find meaningful answers on how photovoltaic solar energy conversion can work (better), eventually contributing to its ongoing advancement. The book is based on lectures given to graduate students in the Physics Department at the University of Oldenburg over the last two decades, yet also provides an easy-to-follow introduction for doctoral and postdoctoral students from related disciplines such as the materials sciences and electrical engineering. Inspired by classic textbooks in the field, it reflects the author’s own ideas on how to understand, visualize and eventually teach the microscopic physical mechanisms and effects, while keeping the text as concise as possible so as to introduce interested readers to the field and balancing essential knowledge with open questions.

  19. Catalytic Conversion of Carbohydrates

    DEFF Research Database (Denmark)

    Osmundsen, Christian Mårup

    a renewable route to aromatics. The conversion of biomass by high temperature processes is a desirable prospect due to the high volumetric production rates which can be achieved, and the ability of these types of processes to convert a wide range of substrates. Current processes however typically have rather...... with the production of commodity chemicals from the most abundantly available renewable source of carbon, carbohydrates. The production of alkyl lactates by the Lewis acid catalyzed conversion of hexoses is an interesting alternative to current fermentation based processes. A range of stannosilicates were...... to be an efficient initial conversion step in the utilization of biomass for chemicals production. The shift from an oil based chemical industry to one based on renewable resources is bound to happen sooner or later, however the environmental problems associated with the burning of fossil resources means...

  20. Sexy gene conversions: locating gene conversions on the X-chromosome.

    Science.gov (United States)

    Lawson, Mark J; Zhang, Liqing

    2009-08-01

    Gene conversion can have a profound impact on both the short- and long-term evolution of genes and genomes. Here, we examined the gene families that are located on the X-chromosomes of human (Homo sapiens), chimpanzee (Pan troglodytes), mouse (Mus musculus) and rat (Rattus norvegicus) for evidence of gene conversion. We identified seven gene families (WD repeat protein family, Ferritin Heavy Chain family, RAS-related Protein RAB-40 family, Diphosphoinositol polyphosphate phosphohydrolase family, Transcription Elongation Factor A family, LDOC1-related family, Zinc Finger Protein ZIC, and GLI family) that show evidence of gene conversion. Through phylogenetic analyses and synteny evidence, we show that gene conversion has played an important role in the evolution of these gene families and that gene conversion has occurred independently in both primates and rodents. Comparing the results with those of two gene conversion prediction programs (GENECONV and Partimatrix), we found that both GENECONV and Partimatrix have very high false negative rates (i.e. failed to predict gene conversions), which leads to many undetected gene conversions. The combination of phylogenetic analyses with physical synteny evidence exhibits high resolution in the detection of gene conversions.

  1. Description of a developmental criterion-referenced assessment for promoting competence in internal medicine residents.

    Science.gov (United States)

    Varney, Andrew; Todd, Christine; Hingle, Susan; Clark, Michael

    2009-09-01

    End-of- rotation global evaluations can be subjective, produce inflated grades, lack interrater reliability, and offer information that lacks value. This article outlines the generation of a unique developmental criterion-referenced assessment that applies adult learning theory and the learner, manager, teacher model, and represents an innovative application to the American Board of Internal Medicine (ABIM) 9-point scale. We describe the process used by Southern Illinois University School of Medicine to develop rotation-specific, criterion-based evaluation anchors that evolved into an effective faculty development exercise. The intervention gave faculty a clearer understanding of the 6 Accreditation Council for Graduate Medical Education competencies, each rotation's educational goals, and how rotation design affects meaningful work-based assessment. We also describe easily attainable successes in evaluation design and pitfalls that other institutions may be able to avoid. Shifting the evaluation emphasis on the residents' development of competence has made the expectations of rotation faculty more transparent, has facilitated conversations between program director and residents, and has improved the specificity of the tool for feedback. Our findings showed the new approach reduced grade inflation compared with the ABIM end-of-rotation global evaluation form. We offer the new developmental criterion-referenced assessment as a unique application of the competences to the ABIM 9-point scale as a transferable model for improving the validity and reliability of resident evaluations across graduate medical education programs.

  2. Predictability of Conversation Partners

    Science.gov (United States)

    Takaguchi, Taro; Nakamura, Mitsuhiro; Sato, Nobuo; Yano, Kazuo; Masuda, Naoki

    2011-08-01

    Recent developments in sensing technologies have enabled us to examine the nature of human social behavior in greater detail. By applying an information-theoretic method to the spatiotemporal data of cell-phone locations, [C. Song , ScienceSCIEAS0036-8075 327, 1018 (2010)] found that human mobility patterns are remarkably predictable. Inspired by their work, we address a similar predictability question in a different kind of human social activity: conversation events. The predictability in the sequence of one’s conversation partners is defined as the degree to which one’s next conversation partner can be predicted given the current partner. We quantify this predictability by using the mutual information. We examine the predictability of conversation events for each individual using the longitudinal data of face-to-face interactions collected from two company offices in Japan. Each subject wears a name tag equipped with an infrared sensor node, and conversation events are marked when signals are exchanged between sensor nodes in close proximity. We find that the conversation events are predictable to a certain extent; knowing the current partner decreases the uncertainty about the next partner by 28.4% on average. Much of the predictability is explained by long-tailed distributions of interevent intervals. However, a predictability also exists in the data, apart from the contribution of their long-tailed nature. In addition, an individual’s predictability is correlated with the position of the individual in the static social network derived from the data. Individuals confined in a community—in the sense of an abundance of surrounding triangles—tend to have low predictability, and those bridging different communities tend to have high predictability.

  3. Predictability of Conversation Partners

    Directory of Open Access Journals (Sweden)

    Taro Takaguchi

    2011-09-01

    Full Text Available Recent developments in sensing technologies have enabled us to examine the nature of human social behavior in greater detail. By applying an information-theoretic method to the spatiotemporal data of cell-phone locations, [C. Song et al., Science 327, 1018 (2010SCIEAS0036-8075] found that human mobility patterns are remarkably predictable. Inspired by their work, we address a similar predictability question in a different kind of human social activity: conversation events. The predictability in the sequence of one’s conversation partners is defined as the degree to which one’s next conversation partner can be predicted given the current partner. We quantify this predictability by using the mutual information. We examine the predictability of conversation events for each individual using the longitudinal data of face-to-face interactions collected from two company offices in Japan. Each subject wears a name tag equipped with an infrared sensor node, and conversation events are marked when signals are exchanged between sensor nodes in close proximity. We find that the conversation events are predictable to a certain extent; knowing the current partner decreases the uncertainty about the next partner by 28.4% on average. Much of the predictability is explained by long-tailed distributions of interevent intervals. However, a predictability also exists in the data, apart from the contribution of their long-tailed nature. In addition, an individual’s predictability is correlated with the position of the individual in the static social network derived from the data. Individuals confined in a community—in the sense of an abundance of surrounding triangles—tend to have low predictability, and those bridging different communities tend to have high predictability.

  4. Resident Peritoneal NK cells

    Science.gov (United States)

    Gonzaga, Rosemary; Matzinger, Polly; Perez-Diez, Ainhoa

    2011-01-01

    Here we describe a new population of NK cells that reside in the normal, un-inflamed peritoneal cavity. Phenotypically, they share some similarities with the small population of CD49b negative, CD27 positive immature splenic NK cells, and liver NK cells but differ in their expression of CD62L, TRAIL and EOMES. Functionally, the peritoneal NK cells resemble the immature splenic NK cells in their production of IFN-γ, GM-CSF and TNF-α and in the killing of YAC-1 target cells. We also found that the peritoneum induces different behavior in mature and immature splenic NK cells. When transferred intravenously into RAGγcKO mice, both populations undergo homeostatic proliferation in the spleen, but only the immature splenic NK cells, are able to reach the peritoneum. When transferred directly into the peritoneum, the mature NK cells survive but do not divide, while the immature NK cells proliferate profusely. These data suggest that the peritoneum is not only home to a new subset of tissue resident NK cells but that it differentially regulates the migration and homeostatic proliferation of immature versus mature NK cells. PMID:22079985

  5. Texting preferences in a Paediatric residency.

    Science.gov (United States)

    Draper, Lauren; Kuklinski, Cadence; Ladley, Amy; Adamson, Greg; Broom, Matthew

    2017-12-01

    Text messaging is ubiquitous among residents, but remains an underused educational tool. Though feasibility has been demonstrated, evidence of its ability to improve standardised test scores and provide insight on resident texting preferences is lacking. The authors set out to evaluate: (1) satisfaction with a hybrid question-and-answer (Q&A) texting format; and (2) pre-/post-paediatric in-training exam (ITE) performance. A prospective study with paediatrics and internal medicine-paediatrics residents. Residents were divided into subgroups: adolescent medicine (AM) and developmental medicine (DM). Messages were derived from ITE questions and sent Monday-Friday with a 20 per cent variance in messages specific to the sub-group. Residents completed surveys gauging perceptions of the programme, and pre- and post-programme ITE scores were analysed. Forty-one residents enrolled and 32 (78%) completed a post-programme survey. Of those, 21 (66%) preferred a Q&A format with an immediate text response versus information-only texts. The percentage change in ITE scores between 2013 and 2014 was significant. Comparing subgroups, there was no significant difference between the percentage change in ITE scores. Neither group performed significantly better on either the adolescent or developmental sections of the ITE. Text messaging… remains an underused educational tool CONCLUSIONS: Overall, participants improved their ITE scores, but no improvement was seen in the targeted subgroups on the exam. Although Q&A texts are preferred by residents, further assessment is required to assess the effect on educational outcomes. © 2017 John Wiley & Sons Ltd and The Association for the Study of Medical Education.

  6. Converse Barrier Certificate Theorem

    DEFF Research Database (Denmark)

    Wisniewski, Rafael; Sloth, Christoffer

    2013-01-01

    This paper presents a converse barrier certificate theorem for a generic dynamical system.We show that a barrier certificate exists for any safe dynamical system defined on a compact manifold. Other authors have developed a related result, by assuming that the dynamical system has no singular...... points in the considered subset of the state space. In this paper, we redefine the standard notion of safety to comply with generic dynamical systems with multiple singularities. Afterwards, we prove the converse barrier certificate theorem and illustrate the differences between ours and previous work...

  7. Dose conversion factors

    International Nuclear Information System (INIS)

    Kocher, D.C.; Eckerman, K.F.

    1992-01-01

    The following is discussed in this report: concepts and quantities used in calculating radiation dose from internal and external exposure. Tabulations of dose conversion factor for internal and external exposure to radionuclides. Dose conversion factors give dose per unit intake (internal) or dose per unit concentration in environment (external). Intakes of radionuclides for internal exposure and concentrations of radionuclides in environment for external exposure are assumed to be known. Intakes and concentrations are obtained, e.g., from analyses of environmental transport and exposure pathways. differences between dosimetry methods for radionuclides and hazardous chemicals are highlighted

  8. Ocean wave energy conversion

    CERN Document Server

    McCormick, Michael E

    2007-01-01

    This volume will prove of vital interest to those studying the use of renewable resources. Scientists, engineers, and inventors will find it a valuable review of ocean wave mechanics as well as an introduction to wave energy conversion. It presents physical and mathematical descriptions of the nine generic wave energy conversion techniques, along with their uses and performance characteristics.Author Michael E. McCormick is the Corbin A. McNeill Professor of Naval Engineering at the U.S. Naval Academy. In addition to his timely and significant coverage of possible environmental effects associa

  9. Magnetohydrodynamic energy conversion

    International Nuclear Information System (INIS)

    Rosa, R.J.

    1987-01-01

    The object of this book is to present a review of the basic principles and practical aspects of magnetohydrodynamic (MHD) energy conversion. The author has tried to give qualitative semiphysical arguments where possible for the benefit of the reader who is unfamiliar with plasma physics. The aim of MHD energy conversion is to apply to a specific practical goal a part of what has become a vast area of science called plasma physics. The author has attempted to note in the text where a broader view might be fruitful and to give appropriate references

  10. Optical analysis of down-conversion OLEDs

    Science.gov (United States)

    Krummacher, Benjamin; Klein, Markus; von Malm, Norwin; Winnacker, Albrecht

    2008-02-01

    Phosphor down-conversion of blue organic light-emitting diodes (OLEDs) is one approach to generate white light, which offers the possibility of easy color tuning, a simple device architecture and color stability over lifetime. In this article previous work on down-conversion devices in the field of organic solid state lighting is briefly reviewed. Further, bottom emitting down-conversion OLEDs are studied from an optical point of view. Therefore the physical processes occurring in the down-conversion layer are translated into a model which is implemented in a ray tracing simulation. By comparing its predictions to experimental results the model is confirmed. For the experiments a blue-emitting polymer OLED (PLED) panel optically coupled to a series of down-conversion layers is used. Based on results obtained from ray tracing simulation some of the implications of the model for the performance of down-conversion OLEDs are discussed. In particular it is analysed how the effective reflectance of the underlying blue OLED and the particle size distribution of the phosphor powder embedded in the matrix of the down-conversion layer influence extraction efficiency.

  11. Results of the 2013-2015 Association of Residents in Radiation Oncology Survey of Chief Residents in the United States

    Energy Technology Data Exchange (ETDEWEB)

    Nabavizadeh, Nima, E-mail: nabaviza@ohsu.edu [Department of Radiation Medicine, Oregon Health and Science University, Portland, Oregon (United States); Burt, Lindsay M. [Department of Radiation Oncology, University of Utah, Salt Lake City, Utah (United States); Mancini, Brandon R. [Department of Therapeutic Radiology, Yale University, New Haven, Connecticut (United States); Morris, Zachary S. [Department of Human Oncology, University of Wisconsin, Madison, Wisconsin (United States); Walker, Amanda J. [Department of Radiation Oncology and Molecular Radiation Sciences, Johns Hopkins University, Baltimore, Maryland (United States); Miller, Seth M. [Department of Radiation Oncology, University of North Carolina Chapel Hill, Chapel Hill, North Carolina (United States); Bhavsar, Shripal [Department of Radiation Oncology, Integris Cancer Institute, Oklahoma City, Oklahoma (United States); Mohindra, Pranshu [Department of Radiation Oncology, University of Maryland, Baltimore, Maryland (United States); Kim, Miranda B. [Harvard Radiation Oncology Program, Boston, Massachusetts (United States); Kharofa, Jordan [Department of Radiation Oncology, University of Cincinnati, Cincinnati, Ohio (United States)

    2016-02-01

    Purpose: The purpose of this project was to survey radiation oncology chief residents to define their residency experience and readiness for independent practice. Methods and Materials: During the academic years 2013 to 2014 and 2014 to 2015, the Association of Residents in Radiation Oncology (ARRO) conducted an electronic survey of post-graduate year-5 radiation oncology residents in the United States during the final 3 months of training. Descriptive statistics are reported. Results: Sixty-six chief residents completed the survey in 2013 to 2014 (53% response rate), and 69 completed the survey in 2014 to 2015 (64% response rate). Forty to 85% percent of residents reported inadequate exposure to high-dose rate and low-dose rate brachytherapy. Nearly all residents in both years (>90%) reported adequate clinical experience for the following disease sites: breast, central nervous system, gastrointestinal, genitourinary, head and neck, and lung. However, as few as 56% reported adequate experience in lymphoma or pediatric malignancies. More than 90% of residents had participated in retrospective research projects, with 20% conducting resident-led prospective clinical trials and 50% conducting basic science or translational projects. Most chief residents reported working 60 or fewer hours per week in the clinical/hospital setting and performing fewer than 15 hours per week tasks that were considered to have little or no educational value. There was more than 80% compliance with Accreditation Council for Graduate Medical Education (ACGME) work hour limits. Fifty-five percent of graduating residents intended to join an established private practice group, compared to 25% who headed for academia. Residents perceive the job market to be more competitive than previous years. Conclusions: This first update of the ARRO chief resident survey since the 2007 to 2008 academic year documents US radiation oncology residents' experiences and conditions over a 2-year period

  12. Results of the 2013-2015 Association of Residents in Radiation Oncology Survey of Chief Residents in the United States.

    Science.gov (United States)

    Nabavizadeh, Nima; Burt, Lindsay M; Mancini, Brandon R; Morris, Zachary S; Walker, Amanda J; Miller, Seth M; Bhavsar, Shripal; Mohindra, Pranshu; Kim, Miranda B; Kharofa, Jordan

    2016-02-01

    The purpose of this project was to survey radiation oncology chief residents to define their residency experience and readiness for independent practice. During the academic years 2013 to 2014 and 2014 to 2015, the Association of Residents in Radiation Oncology (ARRO) conducted an electronic survey of post-graduate year-5 radiation oncology residents in the United States during the final 3 months of training. Descriptive statistics are reported. Sixty-six chief residents completed the survey in 2013 to 2014 (53% response rate), and 69 completed the survey in 2014 to 2015 (64% response rate). Forty to 85% percent of residents reported inadequate exposure to high-dose rate and low-dose rate brachytherapy. Nearly all residents in both years (>90%) reported adequate clinical experience for the following disease sites: breast, central nervous system, gastrointestinal, genitourinary, head and neck, and lung. However, as few as 56% reported adequate experience in lymphoma or pediatric malignancies. More than 90% of residents had participated in retrospective research projects, with 20% conducting resident-led prospective clinical trials and 50% conducting basic science or translational projects. Most chief residents reported working 60 or fewer hours per week in the clinical/hospital setting and performing fewer than 15 hours per week tasks that were considered to have little or no educational value. There was more than 80% compliance with Accreditation Council for Graduate Medical Education (ACGME) work hour limits. Fifty-five percent of graduating residents intended to join an established private practice group, compared to 25% who headed for academia. Residents perceive the job market to be more competitive than previous years. This first update of the ARRO chief resident survey since the 2007 to 2008 academic year documents US radiation oncology residents' experiences and conditions over a 2-year period. This analysis may serve as a valuable tool for those seeking to

  13. Results of the 2013-2015 Association of Residents in Radiation Oncology Survey of Chief Residents in the United States

    International Nuclear Information System (INIS)

    Nabavizadeh, Nima; Burt, Lindsay M.; Mancini, Brandon R.; Morris, Zachary S.; Walker, Amanda J.; Miller, Seth M.; Bhavsar, Shripal; Mohindra, Pranshu; Kim, Miranda B.; Kharofa, Jordan

    2016-01-01

    Purpose: The purpose of this project was to survey radiation oncology chief residents to define their residency experience and readiness for independent practice. Methods and Materials: During the academic years 2013 to 2014 and 2014 to 2015, the Association of Residents in Radiation Oncology (ARRO) conducted an electronic survey of post-graduate year-5 radiation oncology residents in the United States during the final 3 months of training. Descriptive statistics are reported. Results: Sixty-six chief residents completed the survey in 2013 to 2014 (53% response rate), and 69 completed the survey in 2014 to 2015 (64% response rate). Forty to 85% percent of residents reported inadequate exposure to high-dose rate and low-dose rate brachytherapy. Nearly all residents in both years (>90%) reported adequate clinical experience for the following disease sites: breast, central nervous system, gastrointestinal, genitourinary, head and neck, and lung. However, as few as 56% reported adequate experience in lymphoma or pediatric malignancies. More than 90% of residents had participated in retrospective research projects, with 20% conducting resident-led prospective clinical trials and 50% conducting basic science or translational projects. Most chief residents reported working 60 or fewer hours per week in the clinical/hospital setting and performing fewer than 15 hours per week tasks that were considered to have little or no educational value. There was more than 80% compliance with Accreditation Council for Graduate Medical Education (ACGME) work hour limits. Fifty-five percent of graduating residents intended to join an established private practice group, compared to 25% who headed for academia. Residents perceive the job market to be more competitive than previous years. Conclusions: This first update of the ARRO chief resident survey since the 2007 to 2008 academic year documents US radiation oncology residents' experiences and conditions over a 2-year period. This

  14. Effectiveness of a Core-Competency-based Program on Residents' Learning and Experience.

    Science.gov (United States)

    Charles, Lesley; Triscott, Jean; Dobbs, Bonnie; Tian, Peter George; Babenko, Oksana

    2016-06-01

    The Care of the Elderly (COE) Diploma Program is a six-to-twelve-month enhanced skills program taken after two years of core residency training in Family Medicine. In 2010, we developed and implemented a core-competency-based COE Diploma program (CC), in lieu of one based on learning objectives (LO). This study assessed the effectiveness of the core-competency-based program on residents' learning and their training experience as compared to residents trained using learning objectives. The data from the 2007-2013 COE residents were used in the study, with nine and eight residents trained in the LO and CC programs, respectively. Residents' learning was measured using preceptors' evaluations of residents' skills/abilities throughout the program (118 evaluations in total). Residents' rating of training experience was measured using the Graduate's Questionnaire which residents completed after graduation. For residents' learning, overall, there was no significant difference between the two programs. However, when examined as a function of the four CanMEDS roles, there were significant increases in the CC residents' scores for two of the CanMEDS roles: Communicator/Collaborator/Manager and Scholar compared to residents in the LO program. With respect to residents' training experience, seven out of ten program components were rated by the CC residents higher than by the LO residents. The implementation of a COE CC program appears to facilitate resident learning and training experience.

  15. Introduction of laparoscopic low anterior resection for rectal cancer early during residency: a single institutional study on short-term outcomes.

    Science.gov (United States)

    Ogiso, Satoshi; Yamaguchi, Takashi; Hata, Hiroaki; Kuroyanagi, Hiroya; Sakai, Yoshiharu

    2010-11-01

    Laparoscopic surgery for rectal cancer is unpopular because it is technically challenging. Suitable training systems have not been widely studied or established despite the steep learning curve for this procedure. We developed a systematic training program that enables resident surgeons to perform laparoscopic low anterior resection (LLAR) for rectal cancer and evaluated the safety and feasibility of this training program. We analyzed prospectively gathered data on all LLARs for rectal cancer performed at a single center over a 7-year period. Patients were assessed for demographic characteristics, tumor characteristics, operative procedure, operative time, blood loss, conversion to open surgery, complications, time to bowel recovery, distal margin, and number of lymph nodes harvested. We compared the early surgical, oncological, and functional outcomes of LLARs performed by expert surgeons with those of LLARs performed by resident surgeons for both intraperitoneal and extraperitoneal rectal cancer. All analyses were performed on an intention-to-treat basis. A total of 137 patients met the inclusion criteria for this study. Of the 75 LLARs for intraperitoneal rectal cancer, 40 were performed by expert surgeons (I-E group) and 35 by resident surgeons (I-R group). Of the 62 LLARs for extraperitoneal rectal cancer, 51 were performed by expert surgeons (E-E group) and 11 by resident surgeons (E-R group). The operative time was longer in the E-R group than in the E-E group. The time to resumption of diet was longer in the I-E group than in the I-R group. The other early outcomes, including blood loss, anastomotic leakage, conversion to open surgery, and number of lymph nodes harvested, were similar in the I-E and I-R groups and in the E-E and E-R groups. Our systematic training program on LLAR for rectal cancer enables resident surgeons to perform this procedure safely early during residency, with acceptable short-term outcomes.

  16. Stress and burnout among Swiss dental residents.

    Science.gov (United States)

    Divaris, Kimon; Lai, Caroline S; Polychronopoulou, Argy; Eliades, Theodore; Katsaros, Christos

    2012-01-01

    Stress and burnout have been well-documented in graduate medical and undergraduate dental education, but studies among dental graduate students and residents are sparse. The purpose of this investigation was to examine perceived stressors and three dimensions of burnout among dental residents enrolled in the University of Bern, Switzerland. Thirty-six residents enrolled in five specialty programmes were administered the Graduate Dental Environment Stress (GDES30) questionnaire and the Maslach Burnout Inventory (MBI). Individual stress items and overall GDES30 scores were used to quantify perceived stress. To measure burnout, proportions of burnout "cases" and MBI subscale scores were computed in the domains of emotional exhaustion (EE), depersonalization (DP) and reduced personal accomplishment (PA). Analyses relied on descriptive and bi-variate methods. The mean GDES30 score was 2.1 (SD = 0.4). "Lack of leisure time", "meeting the research requirement of the programme" and "completing graduation requirements" emerged as the top three stressors. Thirty-six percent of respondents were burnout "cases" on the PA scale, while this proportion was 17% for EE and 8% for DP. Both stress and burnout levels increased according to year of study, whereas younger residents and females had consistently higher stress and burnout scores compared to older ones and males. Overall, low levels of perceived stress and burnout were found among this group of Swiss dental residents.

  17. First-Year Residents Outperform Third-Year Residents after Simulation-Based Education in Critical Care Medicine

    Science.gov (United States)

    Singer, Benjamin D.; Corbridge, Thomas C.; Schroedl, Clara J.; Wilcox, Jane E.; Cohen, Elaine R.; McGaghie, William C.; Wayne, Diane B.

    2012-01-01

    Introduction Prior research shows that gaps exist in internal medicine residents’ critical care knowledge and skills. The purpose of this study was to compare the bedside critical care competency of first-year residents who received a simulation-based educational intervention plus clinical training to third-year residents who received clinical training alone. Methods During their first three months of residency, a group of first-year residents completed a simulation-based educational intervention. A group of traditionally-trained third-year residents who did not receive simulation-based training served as a comparison group. Both groups were evaluated using a 20-item clinical skills assessment at the bedside of a patient receiving mechanical ventilation at the end of their medical intensive care unit rotation. Scores on the skills assessment were compared between groups. Results Simulator-trained first-year residents (n=40) scored significantly higher compared to traditionally-trained third-year residents (n=27) on the bedside assessment, 91.3% (95% CI 88.2% to 94.3%) vs. 80.9% (95% CI 76.8% to 85.0%), P = simulation-based educational intervention demonstrated higher clinical competency than third-year residents who did not undergo simulation training. Critical care competency cannot be assumed after clinical ICU rotations; simulation-based curricula can help ensure residents are proficient to care for critically ill patients. PMID:23222546

  18. A theory-informed, process-oriented Resident Scholarship Program.

    Science.gov (United States)

    Thammasitboon, Satid; Darby, John B; Hair, Amy B; Rose, Karen M; Ward, Mark A; Turner, Teri L; Balmer, Dorene F

    2016-01-01

    The Accreditation Council for Graduate Medical Education requires residency programs to provide curricula for residents to engage in scholarly activities but does not specify particular guidelines for instruction. We propose a Resident Scholarship Program that is framed by the self-determination theory (SDT) and emphasize the process of scholarly activity versus a scholarly product. The authors report on their longitudinal Resident Scholarship Program, which aimed to support psychological needs central to SDT: autonomy, competence, and relatedness. By addressing those needs in program aims and program components, the program may foster residents' intrinsic motivation to learn and to engage in scholarly activity. To this end, residents' engagement in scholarly processes, and changes in perceived autonomy, competence, and relatedness were assessed. Residents engaged in a range of scholarly projects and expressed positive regard for the program. Compared to before residency, residents felt more confident in the process of scholarly activity, as determined by changes in increased perceived autonomy, competence, and relatedness. Scholarly products were accomplished in return for a focus on scholarly process. Based on our experience, and in line with the SDT, supporting residents' autonomy, competence, and relatedness through a process-oriented scholarship program may foster the curiosity, inquisitiveness, and internal motivation to learn that drives scholarly activity and ultimately the production of scholarly products.

  19. Extremes in Otolaryngology Resident Surgical Case Numbers: An Update.

    Science.gov (United States)

    Baugh, Tiffany P; Franzese, Christine B

    2017-06-01

    Objectives The purpose of this study is to examine the effect of minimum case numbers on otolaryngology resident case log data and understand differences in minimum, mean, and maximum among certain procedures as a follow-up to a prior study. Study Design Cross-sectional survey using a national database. Setting Academic otolaryngology residency programs. Subjects and Methods Review of otolaryngology resident national data reports from the Accreditation Council for Graduate Medical Education (ACGME) resident case log system performed from 2004 to 2015. Minimum, mean, standard deviation, and maximum values for total number of supervisor and resident surgeon cases and for specific surgical procedures were compared. Results The mean total number of resident surgeon cases for residents graduating from 2011 to 2015 ranged from 1833.3 ± 484 in 2011 to 2072.3 ± 548 in 2014. The minimum total number of cases ranged from 826 in 2014 to 1004 in 2015. The maximum total number of cases increased from 3545 in 2011 to 4580 in 2015. Multiple key indicator procedures had less than the required minimum reported in 2015. Conclusion Despite the ACGME instituting required minimum numbers for key indicator procedures, residents have graduated without meeting these minimums. Furthermore, there continues to be large variations in the minimum, mean, and maximum numbers for many procedures. Variation among resident case numbers is likely multifactorial. Ensuring proper instruction on coding and case role as well as emphasizing frequent logging by residents will ensure programs have the most accurate data to evaluate their case volume.

  20. Catalytic Conversion of Biofuels

    DEFF Research Database (Denmark)

    Jørgensen, Betina

    This thesis describes the catalytic conversion of bioethanol into higher value chemicals. The motivation has been the unavoidable coming depletion of the fossil resources. The thesis is focused on two ways of utilising ethanol; the steam reforming of ethanol to form hydrogen and the partial oxida...

  1. Converse Barrier Certificate Theorems

    DEFF Research Database (Denmark)

    Wisniewski, Rafael; Sloth, Christoffer

    2016-01-01

    This paper shows that a barrier certificate exists for any safe dynamical system. Specifically, we prove converse barrier certificate theorems for a class of structurally stable dynamical systems. Other authors have developed a related result by assuming that the dynamical system has neither...

  2. Wavelength conversion devices

    DEFF Research Database (Denmark)

    Mikkelsen, Benny; Durhuus, Terji; Jørgensen, Carsten

    1996-01-01

    system requirements. The ideal wavelength converter should be transparent to the bit rate and signal format and provide an unchirped output signal with both a high extinction ratio and a large signal-to-noise ratio. It should allow conversion to both shorter and longer wavelengths with equal performance...

  3. Conversation and research

    NARCIS (Netherlands)

    Schuurman, Jan Gerrit; Veermans, K.H.

    2001-01-01

    Gordon Pask’s conversation theory was created in the 1970s. The theory encompasses a high-level framework for studying interactions between actors in artificial situations where people co-operate, have conflicts, follow rules, negotiate outcomes, invent new rules together, etc. Sadly, the theory is

  4. Catalyst for hydrocarbon conversion

    International Nuclear Information System (INIS)

    Duhaut, P.; Miquel, J.

    1975-01-01

    A description is given for a catalyst and process for hydrocarbon conversions, e.g., reforming. The catalyst contains an alumina carrier, platinum, iridium, at least one metal selected from uranium, vanadium, and gallium, and optionally halogen in the form of metal halide of one of the aforesaid components. (U.S.)

  5. Leadership is a conversation.

    Science.gov (United States)

    Groysberg, Boris; Slind, Michael

    2012-06-01

    Globalization and new technologies have sharply reduced the efficacy of command-and-control management and its accompanying forms of corporate communication. In the course of a recent research project, the authors concluded that by talking with employees, rather than simply issuing orders, leaders can promote operational flexibility, employee engagement, and tight strategic alignment. Groysberg and Slind have identified four elements of organizational conversation that reflect the essential attributes of interpersonal conversation: intimacy, interactivity, inclusion, and intentionality. Intimacy shifts the focus from a top-down distribution of information to a bottom-up exchange of ideas. Organizational conversation is less corporate in tone and more casual. And it's less about issuing and taking orders than about asking and answering questions. Interactivity entails shunning the simplicity of monologue and embracing the unpredictable vitality of dialogue. Traditional one-way media-print and broadcast, in particular-give way to social media buttressed by social thinking. Inclusion turns employees into full-fledged conversation partners, entitling them to provide their own ideas, often on company channels. They can create content and act as brand ambassadors, thought leaders, and storytellers. Intentionality enables leaders and employees to derive strategically relevant action from the push and pull of discussion and debate.

  6. Conversion tables. Appendix I

    International Nuclear Information System (INIS)

    McKerrell, H.

    1975-01-01

    Tables are presented for the conversion of standard (5568 year half-life) C-14 dates to calendar years. The major part of the data converts C-14 dates to tree-ring years: additional data are given, based on the Egyptian historical curve. (U.K.)

  7. Wavelength conversion technology

    DEFF Research Database (Denmark)

    Stubkjær, Kristian

    1998-01-01

    Optical wavelength conversion is currently attracting much interest. This is because it enables full flexibility and eases management of WDM fibre networks. The tutorial will review existing and potential application areas. Examples of node architectures and network demonstrators that use wavelen...

  8. Our Digital Conversion

    Science.gov (United States)

    Edwards, Mark

    2012-01-01

    In this article, the author describes their digital conversion initiative at Mooresville Graded School District. The project has placed a MacBook Air laptop in the hands of every 3rd through 12th grader and their teachers in the district over the past four years, with over 5,000 computers distributed. But they believe their academic successes have…

  9. Primary vs Conversion Total Hip Arthroplasty: A Cost Analysis

    Science.gov (United States)

    Chin, Garwin; Wright, David J.; Snir, Nimrod; Schwarzkopf, Ran

    2018-01-01

    Introduction Increasing hip fracture incidence in the United States is leading to higher occurrences of conversion total hip arthroplasty (THA) for failed surgical treatment of the hip. In spite of studies showing higher complication rates in conversion THA, the Centers for Medicare and Medicaid services currently bundles conversion and primary THA under the same diagnosis-related group. We examined the cost of treatment of conversion THA compared with primary THA. Our hypothesis is that conversion THA will have higher cost and resource use than primary THA. Methods Fifty-one consecutive conversion THA patients (Current Procedure Terminology code 27132) and 105 matched primary THA patients (Current Procedure Terminology code 27130) were included in this study. The natural log-transformed costs for conversion and primary THA were compared using regression analysis. Age, gender, body mass index, American Society of Anesthesiologist, Charlson comorbidity score, and smoker status were controlled in the analysis. Conversion THA subgroups formed based on etiology were compared using analysis of variance analysis. Results Conversion and primary THAs were determined to be significantly different (P conversion THA has significantly greater cost and resource use than primary THA. In order to prevent disincentives for treating these complex surgical patients, reclassification of conversion THA is needed, as they do not fit together with primary THA. PMID:26387923

  10. The Prevalence of Burnout Among US Neurosurgery Residents.

    Science.gov (United States)

    Shakir, Hakeem J; McPheeters, Matthew J; Shallwani, Hussain; Pittari, Joseph E; Reynolds, Renée M

    2017-10-27

    Burnout is a syndrome of emotional exhaustion, depersonalization, and reduced personal accomplishment. Its prevalence among US physicians exceeds 50% and is higher among residents/fellows. This is important to the practice of neurosurgery, as burnout is associated with adverse physical health, increased risk of substance abuse, and increased medical errors. To date, no study has specifically addressed the prevalence of burnout among neurosurgery residents. To determine and compare the prevalence of burnout among US neurosurgery residents with published rates for residents/fellows and practicing physicians from other specialties. We surveyed 106 US neurosurgery residency training programs to perform a descriptive analysis of the prevalence of burnout among residents. Data on burnout among control groups were used to perform a cross-sectional analysis. Nonparametric tests assessed differences in burnout scores among neurosurgery residents, and the 2-tailed Fisher's exact test assessed burnout between neurosurgery residents and control populations. Of approximately 1200 US neurosurgery residents, 255 (21.3%) responded. The prevalence of burnout was 36.5% (95% confidence interval: 30.6%-42.7%). There was no significant difference in median burnout scores between gender (P = .836), age (P = .183), or postgraduate year (P = .963) among neurosurgery residents. Neurosurgery residents had a significantly lower prevalence of burnout (36.5%) than other residents/fellows (60.0%; P burnout than other residents/fellows and practicing physicians. The underlying causes for these findings were not assessed and are likely multifactorial. Future studies should address possible causes of these findings. Copyright © 2017 by the Congress of Neurological Surgeons

  11. Burden and Stress among Psychiatry Residents and Psychiatric Healthcare Providers

    Science.gov (United States)

    Zuardi, Antonio Waldo; Ishara, Sergio; Bandeira, Marina

    2011-01-01

    Purpose: The authors compared the levels of job burden and stress in psychiatry residents with those of other healthcare professionals at inpatient and outpatient psychiatric hospitals in a medium-sized Brazilian city. Method: In this study, the levels of job burden and stress of 136 healthcare workers and 36 psychiatry residents from six various…

  12. Impact of adding additional providers to resident workload and the resident experience on a medical consultation rotation.

    Science.gov (United States)

    Fang, Michele; Linson, Eric; Suneja, Manish; Kuperman, Ethan F

    2017-02-22

    Excellence in Graduate Medical Education requires the right clinical environment with an appropriate workload where residents have enough patients to gain proficiency in medicine with optimal time for reflection. The Accreditation Council for Graduate Medical Education (ACGME) has focused more on work hours rather than workload; however, high resident workload has been associated with lower resident participation in education and fatigue-related errors. Recognizing the potential risks associated with high resident workload and being mindful of the costs of reducing resident workload, we sought to reduce residents' workload by adding an advanced practice provider (APP) to the surgical comanagement service (SCM) and study its effect on resident satisfaction and perceived educational value of the rotation. In Fiscal Year (FY) 2014 and 2015, an additional faculty member was added to the SCM rotation. In FY 2014, the faculty member was a staff physician, and in FY 2015, the faculty member was an APP.. Resident workload was assessed using billing data. We measured residents' perceptions of the rotation using an anonymous electronic survey tool. We compared FY2014-2015 data to the baseline FY2013. The number of patients seen per resident per day decreased from 8.0(SD 3.3) in FY2013 to 5.0(SD 1.9) in FY2014 (p value of the rotation (40.0%, 72.2%, 72.6% in FY2013, 2014, 2015 respectively, p perceived educational value and clinical experience of a medical consultation rotation.

  13. Life satisfaction of people with intellectual disability living in community residences: perceptions of the residents, their parents and staff members.

    Science.gov (United States)

    Schwartz, C; Rabinovitz, S

    2003-02-01

    Within the literature on quality of life (QoL), life satisfaction (LS) has emerged as a key variable by which to measure perceived well-being, which is referred to as subjective QoL. The LS self-reports of 93 residents with intellectual disability (ID) living in community-based residences were compared with reports about their LS completed by their staff and parents. The residents were interviewed on their LS by social workers who did not belong to the staff of the interviewee's residence. The instrument used was the Life Satisfaction Scale (LSS). Staff and parents completed the short version of the LSS. Residents and staff's LS reports were positively correlated. However, significant differences were found between these two groups of informants when the residents were characterized as high functioning, had a low score in challenging behaviour, worked in an integrative employment setting and lived in an apartment. As opposed to staff/resident discrepancies, no differences were found between parents' and residents' LS reports. If residents cannot to be interviewed about their LS, then the parent is the preferred person to respond on behalf of the resident. The current study highlights the importance of including both objective measures (e.g. functional assessment characteristics) and subjective measures (e.g. LS) in order to get a better understanding of the QoL of people with ID.

  14. Differences in health-related quality of life between older nursing home residents without cognitive impairment and the general population of Norway.

    Science.gov (United States)

    Drageset, Jorunn; Natvig, Gerd Karin; Eide, Geir Egil; Clipp, Elizabeth C; Bondevik, Margareth; Nortvedt, Monica W; Nygaard, Harald A

    2008-05-01

    To advance the understanding of health-related quality of life among older nursing home residents by assessing their health-related quality of life and comparing this with norms from the general population. The study used a two-group cross-sectional comparative design. The samples comprised 227 nursing home residents aged 65-102 years with at least six months' residence and a representative population sample of 1137 Norwegian citizens aged 65-102 years. All nursing home residents had a Clinical Dementia Rating Scale score > or =0.5 and were capable of conversing. The respondents provided demographic information and were surveyed using the SF-36 Health Survey. We used univariate and multivariate linear models to identify possible differences in health-related quality of life between the nursing home residents and the general population, controlled for age, sex, marital status and education. After adjustment for age, group, sex, marital status and education, the nursing home residents scored significantly higher on bodily pain and on physical and emotional role limitation and significantly lower on the other SF-36 subscales, except social functioning, with the largest differences for physical functioning (mean nursing home 23.2 and mean general population 62.9). The general population scores on all subscales generally increased with increasing education but not among the nursing home residents. The mean SF-36 scale scores differed markedly between the nursing home residents and the general population, with the nursing home residents generally scoring lower. The association with background variables known to be related to health-related quality of life differed between the groups. Healthcare professionals should increase attention to health-related quality of life among nursing home residents, periodically assess health-related quality of life and consider interventions that may improve health-related quality of life in older institutionalised populations. This study

  15. Vitamin D status among indigenous Mayan (Kekchi) and Afro-Caribe (Garifuna) adolescents from Guatemala: a comparative description between two ethnic groups residing on the Rio Dulce at the Caribbean coast in Izabal Province, Guatemala.

    Science.gov (United States)

    Naqvi, Ali; Solomons, Noel W; Campos, Raquel; Soto-Méndez, María José; Caplan, Emily; Armas, Laura; Bermudez, Odilia I

    2017-07-01

    To assess vitamin D status and the influence of risk factors such as skin pigmentation and time spent outdoors on hypovitaminosis D among Guatemalan Kekchi and Garifuna adolescents. Cross-sectional study, with convenient sampling design. Blood samples, anthropometric and behavioural data were all collected during the dry season. Serum 25-hydroxyvitamin D (25(OH)D) concentrations were measured by RIA. Communities of Rio Dulce and Livingston, Izabal Province, Caribbean coast of Guatemala, with latitude and longitude of 15°49'N and 88°45'W for Livingston and 15°46'N and 88°49'W for Rio Dulce, respectively. Eighty-six adolescents, divided evenly by sex and ethnicity, with mean age of 14 years. Mean (sd) 25(OH)D value was 27·8 (7·2) ng/ml for the total group, with 25·8 (5·9) and 29·8 (7·9) ng/ml, respectively, in Kekchis and Garifunas (P=0·01). Use of vitamin D supplementation, clothing practices and sun protection were not statistically different between groups. Skin area exposed on the day of data collection ranged from 20·0 % minimum to 49·4 % maximum, with mean (sd) exposure of 32·0 (8.5) %. With univariate regression analysis, age (P=0·034), sex (P=0·044), ethnicity (P=0·010), time spent outdoors (P=0·006) and percentage skin area exposed (P=0·001) were predictive. However, multivariate analysis indicated that only sex (P=0·034) and percentage skin area exposed (P=0·044) remained as predictors of 25(OH)D. Despite residing in an optimal geographic location for sunlight exposure, nearly 65 % of study adolescents were either insufficient or deficient in vitamin D. Correction and long-term prevention of this nutritional problem may be instrumental in avoiding adverse effects in adulthood attributed to low 25(OH)D during adolescence.

  16. Understanding the challenges to facilitating active learning in the resident conferences: a qualitative study of internal medicine faculty and resident perspectives.

    Science.gov (United States)

    Sawatsky, Adam P; Zickmund, Susan L; Berlacher, Kathryn; Lesky, Dan; Granieri, Rosanne

    2015-01-01

    In the Next Accreditation System, the Accreditation Council for Graduate Medical Education outlines milestones for medical knowledge and requires regular didactic sessions in residency training. There are many challenges to facilitating active learning in resident conferences, and we need to better understand resident learning preferences and faculty perspectives on facilitating active learning. The goal of this study was to identify challenges to facilitating active learning in resident conferences, both through identifying specific implementation barriers and identifying differences in perspective between faculty and residents on effective teaching and learning strategies. The investigators invited core residency faculty to participate in focus groups. The investigators used a semistructured guide to facilitate discussion about learning preferences and teaching perspectives in the conference setting and used an 'editing approach' within a grounded theory framework to qualitative analysis to code the transcripts and analyze the results. Data were compared to previously collected data from seven resident focus groups. Three focus groups with 20 core faculty were conducted. We identified three domains pertaining to facilitating active learning in resident conferences: barriers to facilitating active learning formats, similarities and differences in faculty and resident learning preferences, and divergence between faculty and resident opinions about effective teaching strategies. Faculty identified several setting, faculty, and resident barriers to facilitating active learning in resident conferences. When compared to residents, faculty expressed similar learning preferences; the main differences were in motivations for conference attendance and type of content. Resident preferences and faculty perspectives differed on the amount of information appropriate for lecture and the role of active participation in resident conferences. This study highlights several

  17. Exposing physicians to reduced residency work hours did not adversely affect patient outcomes after residency.

    Science.gov (United States)

    Jena, Anupam B; Schoemaker, Lena; Bhattacharya, Jay

    2014-10-01

    In 2003, work hours for physicians-in-training (residents) were capped by regulation at eighty hours per week, leading to the hotly debated but unexplored issue of whether physicians today are less well trained as a result of these work-hour reforms. Using a unique database of nearly all hospitalizations in Florida during 2000-09 that were linked to detailed information on the medical training history of the physician of record for each hospitalization, we studied whether hospital mortality and patients' length-of-stay varied according to the number of years a physician was exposed to the 2003 duty-hour regulations during his or her residency. We examined this database of practicing Florida physicians, using a difference-in-differences analysis that compared trends in outcomes of junior physicians (those with one-year post-residency experience) pre- and post-2003 to a control group of senior physicians (those with ten or more years of post-residency experience) who were not exposed to these reforms during their residency. We found that the duty-hour reforms did not adversely affect hospital mortality and length-of-stay of patients cared for by new attending physicians who were partly or fully exposed to reduced duty hours during their own residency. However, assessment of the impact of the duty-hour reforms on other clinical outcomes is needed. Project HOPE—The People-to-People Health Foundation, Inc.

  18. Resident Reactions to Person-Centered Communication by Long-Term Care Staff.

    Science.gov (United States)

    Savundranayagam, Marie Y; Sibalija, Jovana; Scotchmer, Emma

    2016-09-01

    Long-term care staff caregivers who are person centered incorporate the life history, preferences, and feelings of residents with dementia during care interactions. Communication is essential for person-centered care. However, little is known about residents' verbal reactions when staff use person-centered communication. Accordingly, this study investigated the impact of person-centered communication and missed opportunities for such communication by staff on resident reactions. Conversations (N = 46) between staff-resident dyads were audio-recorded during routine care tasks over 12 weeks. Staff utterances were coded for person-centered communication and missed opportunities. Resident utterances were coded for positive reactions, such as cooperation, and negative reactions, such as distress. Linear regression analyses revealed that the more staff used person-centered communication, the more likely that residents reacted positively. Additionally, the more missed opportunities in a conversation, the more likely that the residents reacted negatively. Conversation illustrations elaborate on the quantitative findings and implications for staff training are discussed. © The Author(s) 2016.

  19. Wind energy conversion system

    Science.gov (United States)

    Longrigg, Paul

    1987-01-01

    The wind energy conversion system includes a wind machine having a propeller connected to a generator of electric power, the propeller rotating the generator in response to force of an incident wind. The generator converts the power of the wind to electric power for use by an electric load. Circuitry for varying the duty factor of the generator output power is connected between the generator and the load to thereby alter a loading of the generator and the propeller by the electric load. Wind speed is sensed electro-optically to provide data of wind speed upwind of the propeller, to thereby permit tip speed ratio circuitry to operate the power control circuitry and thereby optimize the tip speed ratio by varying the loading of the propeller. Accordingly, the efficiency of the wind energy conversion system is maximized.

  20. Publication misrepresentation among anesthesiology residency applicants.

    Science.gov (United States)

    Neuman, Stephanie A; Long, Timothy R; Rose, Steven H

    2011-03-01

    Publication misrepresentation has been documented among applicants for residency positions in several specialties. However, these data are not available for anesthesiology applicants. Our purpose in this study was to document the prevalence of publication misrepresentation among applicants to a single anesthesiology residency, to compare anesthesiology publication misrepresentation data with similar data in other specialties, and to determine how often publication misrepresentation leads to an unfair competitive advantage in the application process. Applications to the Mayo School of Graduate Medical Education anesthesiology core residency in Rochester, Minnesota, were reviewed for publication misrepresentations using Medline and PubMed databases, Mayo Clinic library databases, and/or review by a qualified medical librarian. Misrepresented publications underwent further review to identify fraudulent publications and/or citation errors that provide an unfair competitive advantage. The authors found that 2.4% of the applications (13 of 532) included fraudulent publications, 6.6% of the applications with at least 1 publication (13 of 197) included ≥1 that was fraudulent, and 2.9% of all cited publications (15 of 522) were fraudulent. In addition, 0.9% of the applications (5 of 532) contained a citation error that, although not grossly fraudulent, could have favorably affected the applicant's competitiveness for a residency position. Misrepresented publications were fairly common among anesthesiology residency applicants. However, only a small percentage of applicants listed misrepresented publications that were clearly fraudulent or contained a citation error that conferred a competitive advantage. Identification of fraudulent publications on Electronic Residency Application Service applications is important to maintain the integrity of the application process.

  1. Clinical linguistics: conversational reflections.

    Science.gov (United States)

    Crystal, David

    2013-04-01

    This is a report of the main points I made in an informal "conversation" with Paul Fletcher and the audience at the 14th ICPLA conference in Cork. The observations arose randomly, as part of an unstructured 1-h Q&A, so they do not provide a systematic account of the subject, but simply reflect the issues which were raised by the conference participants during that time.

  2. Conversations with Miss Jane

    Directory of Open Access Journals (Sweden)

    Geneviève Fabre

    2006-05-01

    Full Text Available Considering the wide range of conversations in the autobiography, this essay will attempt to appraise the importance of these verbal exchanges in relation to the overall narrative structure of the book and to the prevalent oral tradition in Louisiana culture, as both an individual and communal expression. The variety of circumstances, the setting and staging, the interlocutors , and the complex intersection of time and place, of stories and History, will be examined; in these conversations with Miss Jane many actors participate, from  the interviewer-narrator, to most characters; even the reader becomes involved.Speaking, hearing, listening, keeping silent is an elaborate ritual that performs many functions; besides conveying news or rumors, it imparts information on the times and on the life of a “representative” woman whose existence - spanning a whole century- is both singular and emblematic. Most importantly this essay will analyse the resonance of an eventful and often dramatic era on her sensibility and conversely show how her evolving sensibility informs that history and draws attention to aspects that might have passed unnoticed or be forever silenced. Jane’s desire for liberty and justice is often challenged as she faces the possibilities of life or death.Conversations build up a complex, often contradictory, but compelling portrait: torn between silence and vehemence, between memories and the urge to meet the future, Jane summons body and mind to find her way through the maze of a fast changing world; self-willed and obstinate she claims her right to speak, to express with wit and wisdom her firm belief in the word, in the ability to express deep seated convictions and faith and a whole array of feelings and emotions.

  3. Blended Learning in Obstetrics and Gynecology Resident Education: Impact on Resident Clinical Performance.

    Science.gov (United States)

    Ghareeb, Allen; Han, Heeyoung; Delfino, Kristin; Taylor, Funminiyi

    2016-01-01

    Effects of residents' blended learning on their clinical performance have rarely been reported. A blended learning pilot program was instituted at Southern Illinois University School of Medicine's Obstetrics and Gynecology program. One of the modules was chronic hypertension in pregnancy. We sought to evaluate if the resident blended learning was transferred to their clinical performance six months after the module. A review of patient charts demonstrated inadequate documentation of history, evaluation, and counseling of patients with chronic hypertension at the first prenatal visit by Obstetrics and Gynecology (OB/GYN) residents. A blended learning module on chronic hypertension in pregnancy was then provided to the residents. A retrospective chart review was then performed to assess behavioral changes in the OB/GYN residents. This intervention was carried out at the Department of Obstetrics and Gynecology, Southern Illinois University. All 16 OB/GYN residents were enrolled in this module as part of their educational curriculum. A query of all prenatal patients diagnosed with chronic hypertension presenting to the OB/GYN resident clinics four months prior to the implementation of the blended learning module (March 2015-June 2015) and six months after (July 20, 2015-February 2016) was performed. Data were collected from outpatient charts utilizing the electronic medical record. Data were abstracted from resident documentation at the first prenatal visit. The residents thought that the blended learning module was applicable to performance improvement in the real-world setting. Patients evaluated before ( n = 10) and after ( n = 7) the intervention were compared. After the intervention, there was an increase in assessment of baseline liver enzymes, referral for electrocardiogram, and early assessment for diabetes in the obese patients. More patients were provided a blood pressure cuff after the module (71.4% vs. 20%). Data were provided to the residents in an

  4. Incorporating resident research into the dermatology residency program

    Science.gov (United States)

    Wagner, Richard F; Raimer, Sharon S; Kelly, Brent C

    2013-01-01

    Programmatic changes for the dermatology residency program at The University of Texas Medical Branch were first introduced in 2005, with the faculty goal incorporating formal dermatology research projects into the 3-year postgraduate training period. This curriculum initially developed as a recommendation for voluntary scholarly project activity by residents, but it evolved into a program requirement for all residents in 2009. Departmental support for this activity includes assignment of a faculty mentor with similar interest about the research topic, financial support from the department for needed supplies, materials, and statistical consultation with the Office of Biostatistics for study design and data analysis, a 2-week elective that provides protected time from clinical activities for the purpose of preparing research for publication and submission to a peer-reviewed medical journal, and a departmental award in recognition for the best resident scholarly project each year. Since the inception of this program, five classes have graduated a total of 16 residents. Ten residents submitted their research studies for peer review and published their scholarly projects in seven dermatology journals through the current academic year. These articles included three prospective investigations, three surveys, one article related to dermatology education, one retrospective chart review, one case series, and one article about dermatopathology. An additional article from a 2012 graduate about dermatology education has also been submitted to a journal. This new program for residents was adapted from our historically successful Dermatology Honors Research Program for medical students at The University of Texas Medical Branch. Our experience with this academic initiative to promote dermatology research by residents is outlined. It is recommended that additional residency programs should consider adopting similar research programs to enrich resident education. PMID:23901305

  5. Incorporating resident research into the dermatology residency program.

    Science.gov (United States)

    Wagner, Richard F; Raimer, Sharon S; Kelly, Brent C

    2013-01-01

    Programmatic changes for the dermatology residency program at The University of Texas Medical Branch were first introduced in 2005, with the faculty goal incorporating formal dermatology research projects into the 3-year postgraduate training period. This curriculum initially developed as a recommendation for voluntary scholarly project activity by residents, but it evolved into a program requirement for all residents in 2009. Departmental support for this activity includes assignment of a faculty mentor with similar interest about the research topic, financial support from the department for needed supplies, materials, and statistical consultation with the Office of Biostatistics for study design and data analysis, a 2-week elective that provides protected time from clinical activities for the purpose of preparing research for publication and submission to a peer-reviewed medical journal, and a departmental award in recognition for the best resident scholarly project each year. Since the inception of this program, five classes have graduated a total of 16 residents. Ten residents submitted their research studies for peer review and published their scholarly projects in seven dermatology journals through the current academic year. These articles included three prospective investigations, three surveys, one article related to dermatology education, one retrospective chart review, one case series, and one article about dermatopathology. An additional article from a 2012 graduate about dermatology education has also been submitted to a journal. This new program for residents was adapted from our historically successful Dermatology Honors Research Program for medical students at The University of Texas Medical Branch. Our experience with this academic initiative to promote dermatology research by residents is outlined. It is recommended that additional residency programs should consider adopting similar research programs to enrich resident education.

  6. Early learning effect of residents for laparoscopic sigmoid resection.

    Science.gov (United States)

    Bosker, Robbert; Groen, Henk; Hoff, Christiaan; Totte, Eric; Ploeg, Rutger; Pierie, Jean-Pierre

    2013-01-01

    To evaluate the effect of learning the laparoscopic sigmoid resection procedure on resident surgeons; establish a minimum number of cases before a resident surgeon could be expected to achieve proficiency with the procedure; and examine if an analysis could be used to measure and support the clinical evaluation of the surgeon's competence with the procedure. Retrospective analysis of data which was prospective entered in the database. From 2003 to 2007 all patients who underwent a laparoscopic sigmoid resection carried out by senior residents, who completed the procedure as the primary surgeon proctored by an experienced surgeon, were included in the study. A cumulative sum control chart (CUSUM) analysis was used evaluate performance. The procedure was defined as a failure if major intra-operative complications occurred such as intra abdominal organ injury, bleeding, or anastomotic leakage; if an inadequate number of lymph nodes (<12 nodes) were removed; or if conversion to an open surgical procedure was required. Thirteen residents performed 169 laparoscopic sigmoid resections in the period evaluated. A significant majority of the resident surgeons were able to consistently perform the procedure without failure after 11 cases and determined to be competent. One resident was not determined to be competent and the CUSUM score supported these findings. We concluded that at least 11 cases are required for most residents to obtain necessary competence with the laparoscopic sigmoid resection procedure. Evaluation with the CUSUM analysis can be used to measure and support the clinical evaluation of the resident surgeon's competence with the procedure. Copyright © 2013 Association of Program Directors in Surgery. Published by Elsevier Inc. All rights reserved.

  7. Association of General Surgery Resident Remediation and Program Director Attitudes With Resident Attrition.

    Science.gov (United States)

    Schwed, Alexander C; Lee, Steven L; Salcedo, Edgardo S; Reeves, Mark E; Inaba, Kenji; Sidwell, Richard A; Amersi, Farin; Are, Chandrakanth; Arnell, Tracey D; Damewood, Richard B; Dent, Daniel L; Donahue, Timothy; Gauvin, Jeffrey; Hartranft, Thomas; Jacobsen, Garth R; Jarman, Benjamin T; Melcher, Marc L; Mellinger, John D; Morris, Jon B; Nehler, Mark; Smith, Brian R; Wolfe, Mary; Kaji, Amy H; de Virgilio, Christian

    2017-12-01

    Previous studies of resident attrition have variably included preliminary residents and likely overestimated categorical resident attrition. Whether program director attitudes affect attrition has been unclear. To determine whether program director attitudes are associated with resident attrition and to measure the categorical resident attrition rate. This multicenter study surveyed 21 US program directors in general surgery about their opinions regarding resident education and attrition. Data on total resident complement, demographic information, and annual attrition were collected from the program directors for the study period of July 1, 2010, to June 30, 2015. The general surgery programs were chosen on the basis of their geographic location, previous collaboration with some coauthors, prior work in surgical education and research, or a program director willing to participate. Only categorical surgical residents were included in the study; thus, program directors were specifically instructed to exclude any preliminary residents in their responses. Five-year attrition rates (2010-2011 to 2014-2015 academic years) as well as first-time pass rates on the General Surgery Qualifying Examination and General Surgery Certifying Examination of the American Board of Surgery (ABS) were collected. High- and low-attrition programs were compared. The 21 programs represented different geographic locations and 12 university-based, 3 university-affiliated, and 6 independent program types. Programs had a median (interquartile range [IQR]) number of 30 (20-48) categorical residents, and few of those residents were women (median [IQR], 12 [5-17]). Overall, 85 of 966 residents (8.8%) left training during the study period: 15 (17.6%) left after postgraduate year 1, 34 (40.0%) after postgraduate year 2, and 36 (42.4%) after postgraduate year 3 or later. Forty-four residents (51.8%) left general surgery for another surgical discipline, 21 (24.7%) transferred to a different surgery

  8. Communication between residents and attending doctors on call after hours.

    Science.gov (United States)

    Novoselsky Persky, Michal A; Yinnon, Amos M; Freier-Dror, Yossi; Henshke-Bar-Meir, Ruth

    2013-12-01

    Off-hours medical care in hospitals is provided by residents, while attendings on call are available for assistance. This study evaluated the gap between residents' expectations and professional guidelines' requirements of attendings on call and what actually occurs during night shifts, while comparing surgical and medical specialties. Two questionnaires based on professional guidelines were filled by residents. The first queried about residents' expectations of attendings on call, and the second asked about communication with the attendings during actual night shifts. While 91 (100%) of residents expected the attending on call to be available by phone during the shift, only 44 (48%) expected the attending to initiate contact, and only 17 (19%) expected the attending to visit the ward or emergency department (ED) without being requested to do so. In 127 shifts (84%), some form of communication occurred. Residents called their attendings during 105 shifts (70%). However, attendings initiated contact with residents at the beginning or during the shift in only 67 (44%) and 62 (41%) shifts, respectively, and initiated a visit to the ward/ED during the shift in only 41 cases (27%). Surgical attendings initiated contact in these three ways significantly more frequently than medical attendings [21 (28%) versus 46 (61%), 20 (26%) versus 42 (56%) and 4 (5%) versus 37 (50%), respectively; P communication during night shifts between residents and attendings occurs in most shifts, attendings initiate far less contact with residents than is required by the guidelines. © 2013 John Wiley & Sons Ltd.

  9. Conversion of Questionnaire Data

    International Nuclear Information System (INIS)

    Powell, Danny H.; Elwood, Robert H. Jr.

    2011-01-01

    During the survey, respondents are asked to provide qualitative answers (well, adequate, needs improvement) on how well material control and accountability (MC and A) functions are being performed. These responses can be used to develop failure probabilities for basic events performed during routine operation of the MC and A systems. The failure frequencies for individual events may be used to estimate total system effectiveness using a fault tree in a probabilistic risk analysis (PRA). Numeric risk values are required for the PRA fault tree calculations that are performed to evaluate system effectiveness. So, the performance ratings in the questionnaire must be converted to relative risk values for all of the basic MC and A tasks performed in the facility. If a specific material protection, control, and accountability (MPC and A) task is being performed at the 'perfect' level, the task is considered to have a near zero risk of failure. If the task is performed at a less than perfect level, the deficiency in performance represents some risk of failure for the event. As the degree of deficiency in performance increases, the risk of failure increases. If a task that should be performed is not being performed, that task is in a state of failure. The failure probabilities of all basic events contribute to the total system risk. Conversion of questionnaire MPC and A system performance data to numeric values is a separate function from the process of completing the questionnaire. When specific questions in the questionnaire are answered, the focus is on correctly assessing and reporting, in an adjectival manner, the actual performance of the related MC and A function. Prior to conversion, consideration should not be given to the numeric value that will be assigned during the conversion process. In the conversion process, adjectival responses to questions on system performance are quantified based on a log normal scale typically used in human error analysis (see A

  10. Surgical residency: A tenant's view

    African Journals Online (AJOL)

    'To sleep: perchance to dream', is the frequent mantra of the surgical resident. However, unlike. Hamlet, there is no ensuing speculation as to what dreams may come as there are seldom any!! Surgical residency has been both vilified and immortalized, but the fact remains that it is one of the most challenging, provocative ...

  11. Burnout among Dutch medical residents

    NARCIS (Netherlands)

    Prins, J.T.; Hoekstra-Weebers, J.E.; Van De Wiel, H.B.; Gazendam-Donofrio, S.M.; Sprangers, F.; Jaspers, F.C.; van der Heijden, F.M.

    2007-01-01

    We examined levels of burnout and relationships between burnout, gender, age, years in training, and medical specialty in 158 medical residents working at the University Medical Center Groningen, the Netherlands. Thirteen percent of the residents met the criteria for burnout, with the highest

  12. Assessing work-related musculoskeletal symptoms among otolaryngology residents.

    Science.gov (United States)

    Wong, Kevin; Grundfast, Kenneth M; Levi, Jessica R

    Previous studies have suggested that musculoskeletal symptoms are common among practicing otolaryngologists. Early training can be the ideal time to foster knowledge of ergonomics and develop safe work habits, however, little data exists regarding musculoskeletal symptoms in residents. The purpose of this study was to identify and characterize musculoskeletal symptoms in a preliminary sample of otolaryngology residents. A cross-sectional survey incorporating the Nordic Musculoskeletal Questionnaire was sent to 30 Otolaryngology-Head and Neck Surgery residencies to examine musculoskeletal symptoms among residents. A two-sample test of proportions was performed to compare symptoms between male and female residents. In total, 141 respondents (response rate=34.7%) completed the survey. Fifty-five percent of survey respondents were male and 45% were female. Musculoskeletal symptoms were most frequently reported in the neck (82.3%), followed by the lower back (56%), upper back (40.4%), and shoulders (40.4%). The most common symptoms were stiffness in the neck (71.6%), pain in the neck (61.7%), and pain in the lower back (48.2%). In total, 6.4% of residents missed work and 16.3% of residents stopped during an operation at some point due to their symptoms. Most residents (88.3%) believed their musculoskeletal symptoms were attributed to their surgical training. Female residents were significantly more likely to experience neck (p<0.0001) and wrist/hand (p=0.019) discomfort compared to male residents. Musculoskeletal symptoms were common among residents, approaching rates similar to those previously identified in practicing otolaryngologists. Increased emphasis on surgical ergonomics is warranted to improve workplace safety and prevent future injury. Copyright © 2017. Published by Elsevier Inc.

  13. Early resident-to-resident physics education in diagnostic radiology.

    Science.gov (United States)

    Kansagra, Akash P

    2014-01-01

    The revised ABR board certification process has updated the method by which diagnostic radiology residents are evaluated for competency in clinical radiologic physics. In this work, the author reports the successful design and implementation of a resident-taught physics course consisting of 5 weekly, hour-long lectures intended for incoming first-year radiology residents in their first month of training. To the author's knowledge, this is the first description of a course designed to provide a very early framework for ongoing physics education throughout residency without increasing the didactic burden on faculty members. Twenty-six first-year residents spanning 2 academic years took the course and reported subjective improvement in their knowledge (90%) and interest (75%) in imaging physics and a high level of satisfaction with the use of senior residents as physics educators. Based on the success of this course and the minimal resources required for implementation, this work may serve as a blueprint for other radiology residency programs seeking to develop revised physics curricula. Copyright © 2014 American College of Radiology. Published by Elsevier Inc. All rights reserved.

  14. Nuclear spin conversion in formaldehyde

    OpenAIRE

    Chapovsky, Pavel L.

    2000-01-01

    Theoretical model of the nuclear spin conversion in formaldehyde (H2CO) has been developed. The conversion is governed by the intramolecular spin-rotation mixing of molecular ortho and para states. The rate of conversion has been found equal 1.4*10^{-4}~1/s*Torr. Temperature dependence of the spin conversion has been predicted to be weak in the wide temperature range T=200-900 K.

  15. Needs Assessment for Incoming PGY-1 Residents in Neurosurgical Residency.

    Science.gov (United States)

    Brandman, David M; Haji, Faizal A; Matte, Marie C; Clarke, David B

    2015-01-01

    Residents must develop a diverse range of skills in order to practice neurosurgery safely and effectively. The purpose of this study was to identify the foundational skills required for neurosurgical trainees as they transition from medical school to residency. Based on the CanMEDS competency framework, a web-based survey was distributed to all Canadian academic neurosurgical centers, targeting incoming and current PGY-1 neurosurgical residents as well as program directors. Using Likert scale and free-text responses, respondents rated the importance of various cognitive (e.g. management of raised intracranial pressure), technical (e.g. performing a lumbar puncture) and behavioral skills (e.g. obtaining informed consent) required for a PGY-1 neurosurgical resident. Of 52 individuals contacted, 38 responses were received. Of these, 10 were from program directors (71%), 11 from current PGY-1 residents (58%) and 17 from incoming PGY-1 residents (89%). Respondents emphasized operative skills such as proper sterile technique and patient positioning; clinical skills such as lesion localization and interpreting neuro-imaging; management skills for common scenarios such as raised intracranial pressure and status epilepticus; and technical skills such as lumbar puncture and external ventricular drain placement. Free text answers were concordant with the Likert scale results. We surveyed Canadian neurosurgical program directors and PGY-1 residents to identify areas perceived as foundational to neurosurgical residency education and training. This information is valuable for evaluating the appropriateness of a training program's goals and objectives, as well as for generating a national educational curriculum for incoming PGY-1 residents.

  16. Microbial Energy Conversion

    Energy Technology Data Exchange (ETDEWEB)

    Buckley, Merry [American Society for Microbiology (ASM), Washington, DC (United States); Wall, Judy D. [Univ. of Missouri, Columbia, MO (United States)

    2006-10-01

    The American Academy of Microbiology convened a colloquium March 10-12, 2006, in San Francisco, California, to discuss the production of energy fuels by microbial conversions. The status of research into various microbial energy technologies, the advantages and disadvantages of each of these approaches, research needs in the field, and education and training issues were examined, with the goal of identifying routes for producing biofuels that would both decrease the need for fossil fuels and reduce greenhouse gas emissions. Currently, the choices for providing energy are limited. Policy makers and the research community must begin to pursue a broader array of potential energy technologies. A diverse energy portfolio that includes an assortment of microbial energy choices will allow communities and consumers to select the best energy solution for their own particular needs. Funding agencies and governments alike need to prepare for future energy needs by investing both in the microbial energy technologies that work today and in the untested technologies that will serve the world’s needs tomorrow. More mature bioprocesses, such as ethanol production from starchy materials and methane from waste digestors, will find applications in the short term. However, innovative techniques for liquid fuel or biohydrogen production are among the longer term possibilities that should also be vigorously explored, starting now. Microorganisms can help meet human energy needs in any of a number of ways. In their most obvious role in energy conversion, microorganisms can generate fuels, including ethanol, hydrogen, methane, lipids, and butanol, which can be burned to produce energy. Alternatively, bacteria can be put to use in microbial fuel cells, where they carry out the direct conversion of biomass into electricity. Microorganisms may also be used some day to make oil and natural gas technologies more efficient by sequestering carbon or by assisting in the recovery of oil and

  17. Infrared up-conversion microscope

    DEFF Research Database (Denmark)

    2014-01-01

    There is presented an up-conversion infrared microscope (110) arranged for imaging an associated object (130), wherein the up-conversion infrared microscope (110) comprises a non-linear crystal (120) arranged for up-conversion of infrared electromagnetic radiation, and wherein an objective optical...

  18. Infrared up-conversion telescope

    DEFF Research Database (Denmark)

    2014-01-01

    There is presented to an up-conversion infrared telescope (110) arranged for imaging an associated scene (130), wherein the up-conversion infrared telescope (110) comprises a non-linear crystal (120) arranged for up-conversion of infrared electromagnetic radiation, and wherein a first optical...

  19. Psychiatry residents in a milieu participatory democracy: a resident's view.

    Science.gov (United States)

    Gersten, D

    1978-11-01

    Psychiatry residents respond with a variety of coping mechanisms to the lack of traditional structure in a milieu participatory democracy. To incorporate themselves into the system they must accept such democratic ideals as equality among staff and patients, group decision making, and free self-expression and give up some of their traditional ideas about staff and patient roles, treatment modalities, and the therapeutic environment. The author was a first-year resident in psychiatry on a university hospital inpatient therapeutic community; he discusses the conflicts between residents, who often adopt a "we-they" attitude, and the permanent staff, whose protectiveness of the ward community reflects their personal commitment to its ideals.

  20. Does Residency Selection Criteria Predict Performance in Orthopaedic Surgery Residency?

    Science.gov (United States)

    Raman, Tina; Alrabaa, Rami George; Sood, Amit; Maloof, Paul; Benevenia, Joseph; Berberian, Wayne

    2016-04-01

    More than 1000 candidates applied for orthopaedic residency positions in 2014, and the competition is intense; approximately one-third of the candidates failed to secure a position in the match. However, the criteria used in the selection process often are subjective and studies have differed in terms of which criteria predict either objective measures or subjective ratings of resident performance by faculty. Do preresidency selection factors serve as predictors of success in residency? Specifically, we asked which preresidency selection factors are associated or correlated with (1) objective measures of resident knowledge and performance; and (2) subjective ratings by faculty. Charts of 60 orthopaedic residents from our institution were reviewed. Preresidency selection criteria examined included United States Medical Licensing Examination (USMLE) Step 1 and Step 2 scores, Medical College Admission Test (MCAT) scores, number of clinical clerkship honors, number of letters of recommendation, number of away rotations, Alpha Omega Alpha (AOA) honor medical society membership, fourth-year subinternship at our institution, and number of publications. Resident performance was assessed using objective measures including American Board of Orthopaedic Surgery (ABOS) Part I scores and Orthopaedics In-Training Exam (OITE) scores and subjective ratings by faculty including global evaluation scores and faculty rankings of residents. We tested associations between preresidency criteria and the subsequent objective and subjective metrics using linear correlation analysis and Mann-Whitney tests when appropriate. Objective measures of resident performance namely, ABOS Part I scores, had a moderate linear correlation with the USMLE Step 2 scores (r = 0.55, p communication skills" subsection of the global evaluations. We found that USMLE Step 2, number of honors in medical school clerkships, and AOA membership demonstrated the strongest correlations with resident performance. Our

  1. Low severity conversion of activated coal

    Energy Technology Data Exchange (ETDEWEB)

    Hirschon, A.S.; Ross, D.S.

    1990-01-01

    The results suggest that coal contains regions with structural components significantly reactive under the hydrothermal environment. Although the specific mechanism for this process remains to be developed, this activity is reminiscent of findings in studies of accelerated maturation of oil shale, where hydrothermal treatment (hydrous pyrolysis) leads to the production of petroleum hydrocarbons. In line with what has been seen in the oil shale work, the pretreatment-generated hydrocarbons and phenols appear to represent a further or more complete maturation of some fraction of the organic material within the coal. These observations could have an impact in two areas. The first is in the area of coal structure, where immature, reactive regions have not been included in the structures considered at present. The second area of interest is the more practical one of conversions to coal liquids and pyrolytic tars. It seems clear that the hydrothermal pretreatment changes the coal in some manner that favorably affects the product quality substantially and, as in the CO/water liquefaction case, favorably affects the yields. The conversions of coals of lower rank, i.e., less mature coals, could particularly benefit in terms of both product quality and product quantity. The second portion of this project also shows important benefits to coal conversion technology. It deals with synthesizing catalysts designed to cleave the weak links in the coal structure and then linking these catalysts with the pretreatment methods in Task 2. The results show that highly dispersed catalysts can effectively be used to increase the yields of soluble material. An important aspect of highly dispersed catalysts are that they can effectively catalyze coal conversion even in poor liquefaction solvents, thus making them very attractive in processes such as coprocessing where inexpensive liquefaction media such as resids are used.

  2. 2009 Canadian Radiation Oncology Resident Survey

    Energy Technology Data Exchange (ETDEWEB)

    Debenham, Brock, E-mail: debenham@ualberta.net [Department of Radiation Oncology, Cross Cancer Institute, University of Alberta, Edmonton, Alberta (Canada); Banerjee, Robyn [Department of Radiation Oncology, Tom Baker Cancer Centre, University of Calgary, Calgary, Alberta (Canada); Fairchild, Alysa; Dundas, George [Department of Radiation Oncology, Cross Cancer Institute, University of Alberta, Edmonton, Alberta (Canada); Trotter, Theresa [Department of Radiation Oncology, Tom Baker Cancer Centre, University of Calgary, Calgary, Alberta (Canada); Yee, Don [Department of Radiation Oncology, Cross Cancer Institute, University of Alberta, Edmonton, Alberta (Canada)

    2012-03-15

    Purpose: Statistics from the Canadian post-MD education registry show that numbers of Canadian radiation oncology (RO) trainees have risen from 62 in 1999 to approximately 150 per year between 2003 and 2009, contributing to the current perceived downturn in employment opportunities for radiation oncologists in Canada. When last surveyed in 2003, Canadian RO residents identified job availability as their main concern. Our objective was to survey current Canadian RO residents on their training and career plans. Methods and Materials: Trainees from the 13 Canadian residency programs using the national matching service were sought. Potential respondents were identified through individual program directors or chief resident and were e-mailed a secure link to an online survey. Descriptive statistics were used to report responses. Results: The eligible response rate was 53% (83/156). Similar to the 2003 survey, respondents generally expressed high satisfaction with their programs and specialty. The most frequently expressed perceived weakness in their training differed from 2003, with 46.5% of current respondents feeling unprepared to enter the job market. 72% plan on pursuing a postresidency fellowship. Most respondents intend to practice in Canada. Fewer than 20% of respondents believe that there is a strong demand for radiation oncologists in Canada. Conclusions: Respondents to the current survey expressed significant satisfaction with their career choice and training program. However, differences exist compared with the 2003 survey, including the current perceived lack of demand for radiation oncologists in Canada.

  3. [Motivation and learning strategies in pediatric residents].

    Science.gov (United States)

    Sepúlveda-Vildósola, Ana Carolina; Carrada-Legaria, Sol; Reyes-Lagunes, Isabel

    2015-01-01

    Motivation is an internal mood that moves individuals to act, points them in certain directions, and maintains them in activities, playing a very important role in self-regulated learning and academic performance. Our objective was to evaluate motivation and self-regulation of knowledge in pediatric residents in a third-level hospital, and to determine if there are differences according to the type of specialty and sociodemographic variables. All residents who agreed to participate responded to the Motivated Strategies for Learning Questionnaire. Cronbach alpha was performed to determine reliability. The mean value of each subscale was compared with Student's t test or ANOVA, correlation of subscales with Pearson test. A value of p≤0.05 was considered significant. We included 118 residents. The questionnaire was highly reliable (α=0.939). There were no significant differences in motivation or learning strategies according to sex, marital status, or age. Those residents studying a second or third specialization had significantly higher scores in elaboration, critical thinking, and peer learning. There were significant correlations between intrinsic motivation and self-efficacy with the development of knowledge strategies such as elaboration, critical thinking, and metacognitive self-regulation. Our students present average-to-high scores of motivation and knowledge strategies, with a significant difference according to type of specialization. There is a high correlation between motivation and knowledge strategies.

  4. 2009 Canadian Radiation Oncology Resident Survey

    International Nuclear Information System (INIS)

    Debenham, Brock; Banerjee, Robyn; Fairchild, Alysa; Dundas, George; Trotter, Theresa; Yee, Don

    2012-01-01

    Purpose: Statistics from the Canadian post-MD education registry show that numbers of Canadian radiation oncology (RO) trainees have risen from 62 in 1999 to approximately 150 per year between 2003 and 2009, contributing to the current perceived downturn in employment opportunities for radiation oncologists in Canada. When last surveyed in 2003, Canadian RO residents identified job availability as their main concern. Our objective was to survey current Canadian RO residents on their training and career plans. Methods and Materials: Trainees from the 13 Canadian residency programs using the national matching service were sought. Potential respondents were identified through individual program directors or chief resident and were e-mailed a secure link to an online survey. Descriptive statistics were used to report responses. Results: The eligible response rate was 53% (83/156). Similar to the 2003 survey, respondents generally expressed high satisfaction with their programs and specialty. The most frequently expressed perceived weakness in their training differed from 2003, with 46.5% of current respondents feeling unprepared to enter the job market. 72% plan on pursuing a postresidency fellowship. Most respondents intend to practice in Canada. Fewer than 20% of respondents believe that there is a strong demand for radiation oncologists in Canada. Conclusions: Respondents to the current survey expressed significant satisfaction with their career choice and training program. However, differences exist compared with the 2003 survey, including the current perceived lack of demand for radiation oncologists in Canada.

  5. Applying Expectancy Theory to residency training: proposing opportunities to understand resident motivation and enhance residency training.

    Science.gov (United States)

    Shweiki, Ehyal; Martin, Niels D; Beekley, Alec C; Jenoff, Jay S; Koenig, George J; Kaulback, Kris R; Lindenbaum, Gary A; Patel, Pankaj H; Rosen, Matthew M; Weinstein, Michael S; Zubair, Muhammad H; Cohen, Murray J

    2015-01-01

    Medical resident education in the United States has been a matter of national priority for decades, exemplified initially through the Liaison Committee for Graduate Medical Education and then superseded by the Accreditation Council for Graduate Medical Education. A recent Special Report in the New England Journal of Medicine, however, has described resident educational programs to date as prescriptive, noting an absence of innovation in education. Current aims of contemporary medical resident education are thus being directed at ensuring quality in learning as well as in patient care. Achievement and work-motivation theories attempt to explain people's choice, performance, and persistence in tasks. Expectancy Theory as one such theory was reviewed in detail, appearing particularly applicable to surgical residency training. Correlations between Expectancy Theory as a work-motivation theory and residency education were explored. Understanding achievement and work-motivation theories affords an opportunity to gain insight into resident motivation in training. The application of Expectancy Theory in particular provides an innovative perspective into residency education. Afforded are opportunities to promote the development of programmatic methods facilitating surgical resident motivation in education.

  6. The FLIC conversion codes

    International Nuclear Information System (INIS)

    Basher, J.C.

    1965-05-01

    This report describes the FORTRAN programmes, FLIC 1 and FLIC 2. These programmes convert programmes coded in one dialect of FORTRAN to another dialect of the same language. FLIC 1 is a general pattern recognition and replacement programme whereas FLIC 2 contains extensions directed towards the conversion of FORTRAN II and S2 programmes to EGTRAN 1 - the dialect now in use on the Winfrith KDF9. FII or S2 statements are replaced where possible by their E1 equivalents; other statements which may need changing are flagged. (author)

  7. Zinc phosphate conversion coatings

    Science.gov (United States)

    Sugama, Toshifumi

    1997-01-01

    Zinc phosphate conversion coatings for producing metals which exhibit enhanced corrosion prevention characteristics are prepared by the addition of a transition-metal-compound promoter comprising a manganese, iron, cobalt, nickel, or copper compound and an electrolyte such as polyacrylic acid, polymethacrylic acid, polyitaconic acid and poly-L-glutamic acid to a phosphating solution. These coatings are further improved by the incorporation of Fe ions. Thermal treatment of zinc phosphate coatings to generate .alpha.-phase anhydrous zinc phosphate improves the corrosion prevention qualities of the resulting coated metal.

  8. The FLIC conversion codes

    Energy Technology Data Exchange (ETDEWEB)

    Basher, J C [General Reactor Physics Division, Atomic Energy Establishment, Winfrith, Dorchester, Dorset (United Kingdom)

    1965-05-15

    This report describes the FORTRAN programmes, FLIC 1 and FLIC 2. These programmes convert programmes coded in one dialect of FORTRAN to another dialect of the same language. FLIC 1 is a general pattern recognition and replacement programme whereas FLIC 2 contains extensions directed towards the conversion of FORTRAN II and S2 programmes to EGTRAN 1 - the dialect now in use on the Winfrith KDF9. FII or S2 statements are replaced where possible by their E1 equivalents; other statements which may need changing are flagged. (author)

  9. Moodle 20 Course Conversion

    CERN Document Server

    Wild, Ian

    2011-01-01

    With clear instructions and plenty of screenshots, this book provides all the support and guidance you will need as you begin to convert your teaching to Moodle. Step-by-step tutorials use real-world examples to show you how to convert to Moodle in the most efficient and effective ways possible. Moodle Course Conversion carefully illustrates how Moodle can be used to teach content and ideas and clearly demonstrates the advantages of doing so. This book is for teachers, tutors, and lecturers who already have a large body of teaching material and want to use Moodle to enhance their course, rathe

  10. Solar energy conversion

    CERN Document Server

    Likhtenshtein, Gertz I

    2012-01-01

    Finally filling a gap in the literature for a text that also adopts the chemist?s view of this hot topic, Prof Likhtenshtein, an experienced author and internationally renowned scientist, considers different physical and engineering aspects in solar energy conversion. From theory to real-life systems, he shows exactly which chemical reactions take place when converting light energy, providing an overview of the chemical perspective from fundamentals to molecular harvesting systems and solar cells. This essential guide will thus help researchers in academia and industry better understa

  11. Personal finances of urology residents in Canada.

    Science.gov (United States)

    Teichman, J M; Tongco, W; MacNeily, A E; Smart, M

    2000-12-01

    We examined how Urology residents in Canada manage their personal finances. A survey instrument was designed to elicit information on demographics, expenses, savings and incomes. The questionnaire was completed by 40 Urology residents attending the 2000 Queen's Urology Exam Skills Training (QUEST) program. Twenty-eight residents (70%) had educational debt (median debt $50 000). Seventeen residents (45%) paid credit card interest charges within the last year. Four residents (10%) maintained an unpaid credit card balance > $7500 at 17% annual interest rate. Twenty-six residents (67%) contributed to Registered Retirement Savings Program (RRSP) accounts. Seventeen residents (44%) contributed to non-RRSP retirement accounts. Nineteen residents (50%) budgeted expenses. Median resident income was $45 000. Thirteen residents (34%) had cash reserves < $250. Many residents save little, and incur substantial debt over and above educational loans. Many residents would benefit from instruction concerning prudent financial management. Residents should be informed of the consequences of low saving and high debt.

  12. Simulation-based education with mastery learning improves residents' lumbar puncture skills

    Science.gov (United States)

    Cohen, Elaine R.; Caprio, Timothy; McGaghie, William C.; Simuni, Tanya; Wayne, Diane B.

    2012-01-01

    Objective: To evaluate the effect of simulation-based mastery learning (SBML) on internal medicine residents' lumbar puncture (LP) skills, assess neurology residents' acquired LP skills from traditional clinical education, and compare the results of SBML to traditional clinical education. Methods: This study was a pretest-posttest design with a comparison group. Fifty-eight postgraduate year (PGY) 1 internal medicine residents received an SBML intervention in LP. Residents completed a baseline skill assessment (pretest) using a 21-item LP checklist. After a 3-hour session featuring deliberate practice and feedback, residents completed a posttest and were expected to meet or exceed a minimum passing score (MPS) set by an expert panel. Simulator-trained residents' pretest and posttest scores were compared to assess the impact of the intervention. Thirty-six PGY2, 3, and 4 neurology residents from 3 medical centers completed the same simulated LP assessment without SBML. SBML posttest scores were compared to neurology residents' baseline scores. Results: PGY1 internal medicine residents improved from a mean of 46.3% to 95.7% after SBML (p < 0.001) and all met the MPS at final posttest. The performance of traditionally trained neurology residents was significantly lower than simulator-trained residents (mean 65.4%, p < 0.001) and only 6% met the MPS. Conclusions: Residents who completed SBML showed significant improvement in LP procedural skills. Few neurology residents were competent to perform a simulated LP despite clinical experience with the procedure. PMID:22675080

  13. Market for natural uranium conversion. Commercial aspect

    International Nuclear Information System (INIS)

    Durret, L.F.

    1986-01-01

    The main activity of COMURHEX is the conversion into uranium hexafluoride of uranium concentrates from mines and owned by electricity producers. Capacities of the 5 uranium converters in the Western World are compared. About 50% of COMUREX turnover is exported. Evolution of the market and of stockpile are reviewed [fr

  14. Conversion program in Sweden

    Energy Technology Data Exchange (ETDEWEB)

    Jonsson, E.B. [Studsvik Nuclear AB, Nykoeping (Sweden)

    1997-08-01

    The conversion of the Swedish 50 MW R2 reactor from HEU to LEU fuel has been successfully accomplished over a 16 cycles long process. The conversion started in January 1991 with the introduction of 6 LEU assemblies in the 8*8 core. The first all LEU core was loaded in March 1993 and physics measurements were performed for the final licensing reports. A total of 142 LEU fuel assemblies have been irradiated up until September 1994 without any fuel incident. The operating licence for the R2 reactor was renewed in mid 1994 taking into account new fuel type. The Swedish Nuclear Inspectorate (SKI) pointed out one crucial problem with the LEU operation, that the back end of the LEU fuel cycle has not yet been solved. For the HEU fuel Sweden had the reprocessing alternative. The country is now relying heavily on the success of the USDOEs Off Site Fuels Policy to take back the spent fuel from the research reactors. They have in the meantime increased their intermediate storage facilities. There is, however, a limit both in time and space for storage of MTR-type of assemblies in water. The penalty of the lower thermal neutron flux in LEU cores has been reduced by improvements of the new irradiation rigs and by fine tuning the core calculations. The Studsvik code package, CASMO-SIMULATE, widely used for ICFM in LWRs has been modified to suit the compact MTR type of core.

  15. Microbial conversion technologies

    Energy Technology Data Exchange (ETDEWEB)

    Lau, P. [National Research Council of Canada, Ottawa, ON (Canada). Bioconversion and Sustainable Development

    2006-07-01

    Microbes are a biomass and an valuable resource. This presentation discussed microbial conversion technologies along with background information on microbial cells, their characteristics and microbial diversity. Untapped opportunities for microbial conversion were identified. Metagenomic and genome mining approaches were also discussed, as they can provide access to uncultivated or unculturable microorganisms in communal populations and are an unlimited resource for biocatalysts, novel genes and metabolites. Genome mining was seen as an economical approach. The presentation also emphasized that the development of microbial biorefineries would require significant insights into the relevant microorganisms and that biocatalysts were the ultimate in sustainability. In addition, the presentation discussed the natural fibres initiative for biochemicals and biomaterials. Anticipated outputs were identified and work in progress of a new enzyme-retting cocktail to provide diversity and/or consistency in fibre characteristics for various applications were also presented. It was concluded that it is necessary to leverage understanding of biological processes to produce bioproducts in a clean and sustainable manner. tabs., figs.

  16. Communal biomass conversion plants

    International Nuclear Information System (INIS)

    1991-06-01

    The Coordinating Committee set up by the Danish government in 1986 were given the responsibility of investigating the potentials for biomass conversion plants in Denmark, especially in relation to agricultural, environmental and energy aspects. The results of the Committee's plan of management for this project are presented. This main report covers 13 background reports which deal with special aspects in detail. The report describes the overall plan of management, the demonstration and follow-up programme and the individual biogas demonstration plants. Information gained from these investigations is presented. The current general status, (with emphasis on the technical and economical aspects) and the prospects for the future are discussed. The interest other countries have shown in Danish activities within the field of biogas production is described, and the possibilities for Danish export of technology and know-how in this relation are discussed. It is claimed that Denmark is the first country that has instigated a coordinated development programme for biomass conversion plants. (AB) 24 refs

  17. Attrition from surgical residency training: perspectives from those who left.

    Science.gov (United States)

    Bongiovanni, Tasce; Yeo, Heather; Sosa, Julie A; Yoo, Peter S; Long, Theodore; Rosenthal, Marjorie; Berg, David; Curry, Leslie; Nunez-Smith, Marcella

    2015-10-01

    High rates of attrition from general surgery residency may threaten the surgical workforce. We sought to gain further insight regarding resident motivations for leaving general surgery residency. We conducted in-depth interviews to generate rich narrative data that explored individual experiences. An interdisciplinary team used the constant comparative method to analyze the data. Four themes characterized experiences of our 19 interviewees who left their residency program. Participants (1) felt an informal contract was breached when clinical duties were prioritized over education, (2) characterized a culture in which there was no safe space to share personal and programmatic concerns, (3) expressed a scarcity of role models who demonstrated better work-life balance, and (4) reported negative interactions with authority resulting in a profound loss of commitment. As general surgery graduate education continues to evolve, our findings may inform interventions and policies regarding programmatic changes to boost retention in surgical residency. Copyright © 2015 Elsevier Inc. All rights reserved.

  18. The impact of local black residents' socioeconomic status on white residents' racial views.

    Science.gov (United States)

    Taylor, Marylee C; Reyes, Adriana M

    2014-01-01

    This paper extends the study of contextual influences on racial attitudes by asking how the SES of the local black community shapes the racial attitudes of local whites. Using responses to the 1998-2002 General Social Surveys merged with year 2000 census data, we compare the influences of black educational and economic composition on white residents' attitudes. Finally, the independence of these effects from the impact of white contextual SES is assessed. Across three dimensions of racial attitudes, white residents' views are more positive in localities where the black population contains more college graduates. However, such localities tend also to have highly educated white populations, as well as higher incomes among blacks and whites, and the multiple influences are inseparable. In contrast, many racial attitude measures show an independent effect of black economic composition, white residents reporting more negative views where the local African American community is poorer. Copyright © 2013 Elsevier Inc. All rights reserved.

  19. High conversion HTRs and their fuel cycle

    International Nuclear Information System (INIS)

    Gutmann, H.; Hansen, U.; Larsen, H.; Price, M.S.T.

    1975-01-01

    This report discusses the principles of the core design and the fuel cycle layout for High Conversion HTRs (HCHTRs). Though most of the principles apply equally to HTRs of the pebble-bed and the prismatic fuel element design types, the paper concentrates on the latter. Design and fuel cycle strategies for the full utilisation of the high conversion potential are compared with others that aim at easier reprocessing and the 'environmental' fuel cycle. The paper concludes by discussing operating and fuel cycle characteristics and economics of HCHTRs, and how the latter impinge on the allowable price for uranium ore and the available uranium resources. (orig./UA) [de

  20. Pediatric resident perceptions of shift work in ward rotations.

    Science.gov (United States)

    Nomura, Osamu; Mishina, Hiroki; Jasti, Harish; Sakai, Hirokazu; Ishiguro, Akira

    2017-10-01

    Although the long working hours of physicians are considered to be a social issue, no effective policies such as duty hour regulations have so far been proposed in Japan. We implemented an overnight call shift (OCS) system for ward rotations to improve the working environment for residents in a pediatric residency program. We later conducted a cross-sectional questionnaire asking the residents to compare this system with the traditional overnight call system. Forty-one pediatric residents participated in this survey. The residents felt that the quality of patient care improved (80.4% agreed). Most felt that there was less emphasis on education (26.8%) and more emphasis on service (31.7%). Overall, the residents reported that the OCS was beneficial (90.2%). In conclusion, the pediatric residents considered the OCS system during ward rotations as beneficial. Alternative solutions are vital to balance improvements in resident work conditions with the requirement for a high quality of education. © 2017 Japan Pediatric Society.

  1. Attitudes of Portuguese medical residents' towards clinical communication skills.

    Science.gov (United States)

    Loureiro, Elizabete; Severo, Milton; Ferreira, Maria Amélia

    2015-08-01

    To explore the attitudes and perceptions of Portuguese residents towards Clinical Communication Skills (CCS) and the need for complementary training. 78 medical residents responded to an on-line questionnaire which comprised demographic data, open-ended questions and a Portuguese version of the Communication Skills Attitude Scale (CSAS). Residents gave significantly higher scores (Pcommunication skills in general, compared to CSAS2 (attitudes towards the teaching/learning process of CCS). Residents doing their residency training in other parts of the country, other than the north, reveal a higher perception of insufficient training (72.7% vs. 38.7%, P=0.036). Residents showed more positive attitudes towards communication skills than towards the teaching/learning process. They admit to need more training in CCS in their residency year and highlight that the clinical cycle of undergraduate education should integrate these topics. Content analysis indicates that residents' perceptions are context-influenced. Integration of CCS in the undergraduate education, enhanced during post-graduate training. Training of clinical faculty and supervisors/tutors and the role that stakeholders have to play in order to promote continuous training in CCS; encourage patient-centeredness and reflective practice, as to facilitate transfer of acquired skills to clinical practice. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

  2. Can Emergency Medicine Residents Predict Cost of Diagnostic Testing?

    Directory of Open Access Journals (Sweden)

    Tainter, Christopher R

    2017-01-01

    Full Text Available Diagnostic testing represents a significant portion of healthcare spending, and cost should be considered when ordering such tests. Needless and excessive spending may occur without an appreciation of the impact on the larger healthcare system. Knowledge regarding the cost of diagnostic testing among emergency medicine (EM residents has not previously been studied. A survey was administered to 20 EM residents from a single ACGME-accredited three-year EM residency program, asking for an estimation of patient charges for 20 commonly ordered laboratory tests and seven radiological exams. We compared responses between residency classes to evaluate whether there was a difference based on level of training. The survey completion rate was 100% (20/20 residents. We noted significant discrepancies between the median resident estimates and actual charge to patient for both laboratory and radiological exams. Nearly all responses were an underestimate of the actual cost. The group median underestimation for laboratory testing was $114, for radiographs $57, and for computed tomography exams was $1,058. There was improvement in accuracy with increasing level of training. This pilot study demonstrates that EM residents have a poor understanding of the charges burdening patients and health insurance providers. In order to make balanced decisions with regard to diagnostic testing, providers must appreciate these factors. Education regarding the cost of providing emergency care is a potential area for improvement of EM residency curricula, and warrants further attention and investigation.

  3. Superhydrophobic nanofluidic channels for enhanced electrokinetic conversion

    Science.gov (United States)

    Checco, Antonio; Al Hossain, Aktaruzzaman; Rahmani, Amir; Black, Charles; Doerk, Gregory; Colosqui, Carlos

    2017-11-01

    We present current efforts in the development of novel slit nanofluidic channels with superhydrophobic nanostructured surfaces designed to enhance hydrodynamic conductivity and improve selective transport and electrokinetic energy conversion efficiencies (mechanical-electrical energy conversion). The nanochannels are fabricated on silicon wafers using UV lithography, and their internal surface is patterned with conical nanostructures (feature size and spacing 30 nm) defined by block copolymer self-assembly and plasma etching. These nanostructures are rendered superhydrophobic by passivation with a hydrophobic silane monolayer. We experimentally characterize hydrodynamic conductivity, effective zeta potentials, and eletrokinetic flows for the patterned nanochannels, comparing against control channels with bare surfaces. Experimental observations are rationalized using both continuum-based modeling and molecular dynamics simulations. Scientific and technical knowledge produced by this work is particularly relevant for sustainable energy conversion and storage, separation processes and water treatment using nanoporous materials. The ONR Contract # N000141613178 and NSF-CBET award# 1605809.

  4. Graphical comparison of calculated internal conversion coefficients

    International Nuclear Information System (INIS)

    Ewbank, W.B.

    1980-11-01

    Calculated values of the coefficients of internal conversion of gamma rays in the K shell and L 1 , L 2 , L 3 subshells from published tabulations by Band and Trzhaskovskaya and by Roesel et al. at Data Nucl. Data Tables, 21, 92-514(1978) are compared with values obtained by computer interpolation among tabulated values of Hager and Seltzer Nucl. Data, A4, 1-235(1968). In some cases, agreement among the three calculations is remarkably good, and differences are generally less than 5%. In a few cases, there are differences as large as 20 to 50%, corresponding to the threshold effect described by Roesel et al. The Z-dependent resonance minimum described by Roesel et al. is also observed in the comparison of E1-E4 conversion in the L 1 subshell. In several cases (notably M1-M4 conversion in the K shell and L 1 subshell), the Band and Roesel calculations show dramatically different dependence on gamma energy and atomic number. For Z = 100, the Band calculation for E4 conversion in the L 3 subshell shows irregular behavior at energies below the K-shell binding energy. A few high-quality measurements of internal conversion coefficients (+-5%) would help greatly to establish a basis for choice among the theoretical calculations. 32 figures

  5. Study on carbon dioxide conversion by radiation

    International Nuclear Information System (INIS)

    Cho, Young Hyun; Park, Geun Il; Cho, Il Hoon; Choi, Sang Do; Hong, Kwang Hee; Lee, Chang Woo

    1999-09-01

    This study was carried out to investigate the synergistic effects on the CO 2 conversion by the application of semiconductor in the field of gamma-ray. Gamma-ray irradiation was performed to examine the effects of semiconductor application on CO 2 conversion in water and the formation of organic material from carbonate solution. From experimental results it is clear that the supplication of semiconductor in the field of gamma-ray increases the efficiency for CO 2 conversion to organic matter. Based on the obtained experimental results it is obvious that the synergistic effects of semiconductor materials in the gamma-ray field leads to increase of the CO 2 conversion yield to organic matter up to 50 percent compared to the gamma-ray irradiation. The way of achieving higher activity is due to the catalytic action of semiconductor by gamma-ray irradiation. Zr-doped TiO 2 catalyst prepared by sol-gel method exhibits the higher efficiency for CO 2 conversion in aqueous solution and carbonate containing solution. This effect of Zr-doping can be explained by the formation of additional defects in surface of TiO 2 film. (author)

  6. Response inhibition in motor conversion disorder.

    Science.gov (United States)

    Voon, Valerie; Ekanayake, Vindhya; Wiggs, Edythe; Kranick, Sarah; Ameli, Rezvan; Harrison, Neil A; Hallett, Mark

    2013-05-01

    Conversion disorders (CDs) are unexplained neurological symptoms presumed to be related to a psychological issue. Studies focusing on conversion paralysis have suggested potential impairments in motor initiation or execution. Here we studied CD patients with aberrant or excessive motor movements and focused on motor response inhibition. We also assessed cognitive measures in multiple domains. We compared 30 CD patients and 30 age-, sex-, and education-matched healthy volunteers on a motor response inhibition task (go/no go), along with verbal motor response inhibition (color-word interference) and measures of attention, sustained attention, processing speed, language, memory, visuospatial processing, and executive function including planning and verbal fluency. CD patients had greater impairments in commission errors on the go/no go task (P conversion. Patients with nonepileptic seizures, a different form of conversion disorder, are commonly reported to have lower IQ and multiple cognitive deficits. Our results point toward potential differences between conversion disorder subgroups. © 2013 Movement Disorder Society. Copyright © 2013 Movement Disorder Society.

  7. Minimum Data Set Active Resident Information Report

    Data.gov (United States)

    U.S. Department of Health & Human Services — The MDS Active Resident Report summarizes information for residents currently in nursing homes. The source of these counts is the residents MDS assessment record....

  8. Selection criteria of residents for residency programs in Kuwait.

    Science.gov (United States)

    Marwan, Yousef; Ayed, Adel

    2013-01-19

    In Kuwait, 21 residency training programs were offered in the year 2011; however, no data is available regarding the criteria of selecting residents for these programs. This study aims to provide information about the importance of these criteria. A self-administered questionnaire was used to collect data from members (e.g. chairmen, directors, assistants …etc.) of residency programs in Kuwait. A total of 108 members were invited to participate. They were asked to rate the importance level (scale from 1 to 5) of criteria that may affect the acceptance of an applicant to their residency programs. Average scores were calculated for each criterion. Of the 108 members invited to participate, only 12 (11.1%) declined to participate. Interview performance was ranked as the most important criteria for selecting residents (average score: 4.63/5.00), followed by grade point average (average score: 3.78/5.00) and honors during medical school (average score: 3.67/5.00). On the other hand, receiving disciplinary action during medical school and failure in a required clerkship were considered as the most concerning among other criteria used to reject applicants (average scores: 3.83/5.00 and 3.54/5.00 respectively). Minor differences regarding the importance level of each criterion were noted across different programs. This study provided general information about the criteria that are used to accept/reject applicants to residency programs in Kuwait. Future studies should be conducted to investigate each criterion individually, and to assess if these criteria are related to residents' success during their training.

  9. Conversation with Meir Sternberg

    Directory of Open Access Journals (Sweden)

    Federico Pianzola

    2011-07-01

    Full Text Available Below are the videos of the interview recorded the 21st May 2011 in Fribourg (CH, in occasion of the first RRN conference. Conversation with Meir Sternberg. Part 1 of 8 - Narratology: classical and postclassical studies. Part 2 of 8 - The development of an original theoretical framework. Part 3 of 8 - Sternberg and Genette: different ways for the same problems. Part 4 of 8 - «There are no forms except in terms of functions». Part 5 of 8 - A life writing articles: so many papers and just four books. Part 6 of 8 - Two arguments against mimetical approaches to narrative. Part 7 of 8 - «Narrative is not given, it is a construct». Part 8 of 8 - The proteus principle. the many-to-many correspondence between forms and functions.

  10. Thermodynamics and energy conversion

    CERN Document Server

    Struchtrup, Henning

    2014-01-01

    This textbook gives a thorough treatment of engineering thermodynamics with applications to classical and modern energy conversion devices.   Some emphasis lies on the description of irreversible processes, such as friction, heat transfer and mixing, and the evaluation of the related work losses. Better use of resources requires high efficiencies, therefore the reduction of irreversible losses should be seen as one of the main goals of a thermal engineer. This book provides the necessary tools.   Topics include: car and aircraft engines,  including Otto, Diesel and Atkinson cycles, by-pass turbofan engines, ramjet and scramjet;  steam and gas power plants, including advanced regenerative systems, solar tower, and compressed air energy storage; mixing and separation, including reverse osmosis, osmotic powerplants, and carbon sequestration; phase equilibrium and chemical equilibrium, distillation, chemical reactors, combustion processes, and fuel cells; the microscopic definition of entropy.    The book i...

  11. Communal biomass conversion plants

    International Nuclear Information System (INIS)

    Holm-Nielsen, J.B.; Huntingford, S.; Halberg, N.

    1993-03-01

    The aim was to show the agricultural advantages of farmers being in connection with Communal Biogas Plant. Whether a more environmentally protectire distribution of plant nutrients from animal manure takes place through a biogas plants distribution system, whether the nitrogen in the digested slurry is better utilized and whether the connection results in slurry transportation-time reduction, are discussed. The average amount of nitrogen from animal manure used per hectare was reduced. The area of manure distribution was larger. The nitrogen efficiency was increased when using digested slurry and purchase of N mineral fertilizer decreased, resulting in considerable reduction in nitrogen leaching. The amount of slurry delivered to the local storage tanks was approximately 45 per cent of the total amount treated on the biogas plant. Conditions of manure transport improved greatly as this was now the responsibility of the communal biomass conversion plant administrators. (AB) (24 refs.)

  12. Power conversion technologies

    Energy Technology Data Exchange (ETDEWEB)

    Newton, M. A.

    1997-02-01

    The Power Conversion Technologies thrust area identifies and sponsors development activities that enhance the capabilities of engineering at Lawrence Livermore National Laboratory (LLNL) in the area of solid- state power electronics. Our primary objective is to be a resource to existing and emerging LLNL programs that require advanced solid-state power electronic technologies.. Our focus is on developing and integrating technologies that will significantly impact the capability, size, cost, and reliability of future power electronic systems. During FY-96, we concentrated our research efforts on the areas of (1) Micropower Impulse Radar (MIR); (2) novel solid-state opening switches; (3) advanced modulator technology for accelerators; (4) compact accelerators; and (5) compact pulse generators.

  13. The Role of Conversation Policy in Carrying Out Agent Conversations

    International Nuclear Information System (INIS)

    Link, Hamilton E.; Phillips, Laurence R.

    1999-01-01

    Structured conversation diagrams, or conversation specifications, allow agents to have predictable interactions and achieve predefined information-based goals, but they lack the flexibility needed to function robustly in an unpredictable environment. We propose a mechanism that combines a typical conversation structure with a separately established policy to generate an actual conversation. The word ''policy'' connotes a high-level direction external to a specific planned interaction with the environment. Policies, which describe acceptable procedures and influence decisions, can be applied to broad sets of activity. Based on their observation of issues related to a policy, agents may dynamically adjust their communication patterns. The policy object describes limitations, constraints, and requirements that may affect the conversation in certain circumstances. Using this new mechanism of interaction simplifies the description of individual conversations and allows domain-specific issues to be brought to bear more easily during agent communication. By following the behavior of the conversation specification when possible and deferring to the policy to derive behavior in exceptional circumstances, an agent is able to function predictably under normal situations and still act rationally in abnormal situations. Different conversation policies applied to a given conversation specification can change the nature of the interaction without changing the specification

  14. Predictive models for conversion of prediabetes to diabetes.

    Science.gov (United States)

    Yokota, N; Miyakoshi, T; Sato, Y; Nakasone, Y; Yamashita, K; Imai, T; Hirabayashi, K; Koike, H; Yamauchi, K; Aizawa, T

    2017-08-01

    To clarify the natural course of prediabetes and develop predictive models for conversion to diabetes. A retrospective longitudinal study of 2105 adults with prediabetes was carried out with a mean observation period of 4.7years. Models were developed using multivariate logistic regression analysis and verified by 10-fold cross-validation. The relationship between [final BMI minus baseline BMI] (δBMI) and incident diabetes was analyzed post hoc by comparing the diabetes conversion rate for low (Prediabetes conversion to diabetes could be predicted with accuracy, and weight reduction during the observation was associated with lowered conversion rate. Copyright © 2017 Elsevier Inc. All rights reserved.

  15. Applying Expectancy Theory to residency training: proposing opportunities to understand resident motivation and enhance residency training

    Directory of Open Access Journals (Sweden)

    Shweiki E

    2015-04-01

    Full Text Available Ehyal Shweiki,1 Niels D Martin,2 Alec C Beekley,1 Jay S Jenoff,1 George J Koenig,1 Kris R Kaulback,1 Gary A Lindenbaum,1 Pankaj H Patel,1 Matthew M Rosen,1 Michael S Weinstein,1 Muhammad H Zubair,2 Murray J Cohen1 1Department of Surgery, Thomas Jefferson University Hospital, Philadelphia, PA, USA; 2Department of Surgery, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, USA Abstract: Medical resident education in the United States has been a matter of national priority for decades, exemplified initially through the Liaison Committee for Graduate Medical Education and then superseded by the Accreditation Council for Graduate Medical Education. A recent Special Report in the New England Journal of Medicine, however, has described resident educational programs to date as prescriptive, noting an absence of innovation in education. Current aims of contemporary medical resident education are thus being directed at ensuring quality in learning as well as in patient care. Achievement and work-motivation theories attempt to explain people's choice, performance, and persistence in tasks. Expectancy Theory as one such theory was reviewed in detail, appearing particularly applicable to surgical residency training. Correlations between Expectancy Theory as a work-motivation theory and residency education were explored. Understanding achievement and work-motivation theories affords an opportunity to gain insight into resident motivation in training. The application of Expectancy Theory in particular provides an innovative perspective into residency education. Afforded are opportunities to promote the development of programmatic methods facilitating surgical resident motivation in education. Keywords: learning, education, achievement

  16. Paradoxical therapy in conversion disorder

    OpenAIRE

    ATAOĞLU, Ahmet

    1998-01-01

    Paradoxical therapy consists of suggesting that the patient intentionally engages in the unwanted behaviour, such as performing complusive ritual or bringing on a conversion attack. In this study paradoxical intention (PI) was used with to half of the patients with conversion disorders, while the other half were treated with diazepam in order to examine the efficiency of the PI versus diazepam in conversion disorder. Patients treated with PI appeared to have a greater improvement r...

  17. Preparing Future Leaders: An Integrated Quality Improvement Residency Curriculum.

    Science.gov (United States)

    Potts, Stacy; Shields, Sara; Upshur, Carole

    2016-06-01

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

  18. Investigation of current university research concerning energy conversion and conservation in small single-family dwellings

    Science.gov (United States)

    Grossman, G. R.; Roberts, A. S., Jr.

    1975-01-01

    An investigation was made of university research concerning energy conversion and conservation techniques which may be applied in small single-family residences. Information was accumulated through published papers, progress reports, telephone conversations, and personal interviews. A synopsis of each pertinent investigation is given. Finally, a discussion of the synopses is presented and recommendations are made concerning the applicability of concepts for the design and construction of NASA-Langley Research Center's proposed Technology Utilization House in Hampton, Virginia.

  19. Evaluating Dermatology Residency Program Websites.

    Science.gov (United States)

    Ashack, Kurt A; Burton, Kyle A; Soh, Jonathan M; Lanoue, Julien; Boyd, Anne H; Milford, Emily E; Dunnick, Cory; Dellavalle, Robert P

    2016-03-16

    Internet resources play an important role in how medical students access information related to residency programs.Evaluating program websites is necessary in order to provide accurate information for applicants and provide information regarding areas of website improvement for programs. To date, dermatology residency websites (D  WS) have not been evaluated.This paper evaluates dermatology residency websites based on availability of predefined measures. Using the FREIDA (Fellowship and Residency Electronic Interactive Database) Online database, authors searched forall accredited dermatology program websites. Eligible programs were identified through the FREIDA Online database and had a functioning website. Two authors independently extracted data with consensus or third researcher resolution of differences. This data was accessed and archived from July 15th to July 17th, 2015.Primary outcomes measured were presence of content on education, resident and faculty information, program environment, applicant recruitment, schedule, salary, and website quality evaluated using an online tool (WooRank.com). Out of 117 accredited dermatology residencies, 115 had functioning webpages. Of these, 76.5% (75) had direct links found on the FRIEDA Online database. Most programs contained information on education, faculty, program environment, and applicant recruitment. However, website quality and marketing effectiveness were highly variable; most programs were deemed to need improvements in the functioning of their webpages. Also, additional information on current residents and about potential away rotations were lacking from most websites with only 52.2% (60) and 41.7% (48) of programs providing this content, respectively. A majority of dermatology residency websites contained adequate information on many of the factors we evaluated. However, many were lacking in areas that matter to applicants. We hope this report will encourage dermatology residencyprograms

  20. Program Characteristics Influencing Allopathic Students' Residency Selection.

    Science.gov (United States)

    Stillman, Michael D; Miller, Karen Hughes; Ziegler, Craig H; Upadhyay, Ashish; Mitchell, Charlene K

    2016-04-01

    Medical students must consider many overt variables when entering the National Resident Matching Program. However, changes with the single graduate medical education accreditation system have caused a gap in knowledge about more subtle considerations, including what, if any, influence the presence of osteopathic physician (ie, DO) and international medical graduate (IMG) house officers has on allopathic students' residency program preferences. Program directors and selection committee members may assume students' implicit bias without substantiating evidence. To reexamine which program characteristics affect US-trained allopathic medical students' residency selection, and to determine whether the presence of DO and IMG house officers affects the program choices of allopathic medical students. Fourth-year medical students from 4 allopathic medical schools completed an online survey. The Pearson χ(2) statistic was used to compare demographic and program-specific traits that influence ranking decisions and to determine whether school type (private vs public), valuing a residency program's prestige, or interest in a competitive specialty dictated results. Qualitative data were analyzed using the Pandit variation of the Glaser and Strauss constant comparison. Surveys were completed by 323 of 577 students (56%). Students from private vs public institutions were more likely to value a program's prestige (160 [93%] vs 99 [72%]; P<.001) and research opportunities (114 [66%] vs 57 [42%]; P<.001), and they were less likely to consider their prospects of being accepted (98 [57%] vs 111 [81%]; P<.001). A total of 33 (10%) and 52 (16%) students reported that the presence of DO or IMG trainees, respectively, would influence their final residency selection, and these percentages were largely unchanged among students interested in programs' prestige or in entering a competitive specialty. Open-ended comments were generally optimistic about diversification of the physician

  1. Universal problems during residency: abuse and harassment.

    Science.gov (United States)

    Nagata-Kobayashi, Shizuko; Maeno, Tetsuhiro; Yoshizu, Misaki; Shimbo, Takuro

    2009-07-01

    Perceived abuse or harassment during residency has a negative impact on residents' health and well-being. This issue pertains not only to Western countries, but also to those in Asia. In order to launch strong international preventive measures against this problem, it is necessary to establish the generality and cultural specificity of this problem in different countries. Therefore, we investigated mistreatment among resident doctors in Japan. In 2007, a multi-institutional, cross-sectional survey was conducted at 37 hospitals. A total of 619 residents (409 men, 210 women) were recruited. Prevalence of mistreatment in six categories was evaluated: verbal abuse; physical abuse; academic abuse; sexual harassment; gender discrimination, and alcohol-associated harassment. In addition, alleged abusers, the emotional effects of abusive experiences, and reluctance to report the abuse to superiors were investigated. Male and female responses were statistically compared using chi-square analysis. A total of 355 respondents (228 men, 127 women) returned a completed questionnaire (response rate 57.4%). Mistreatment was reported by 84.8% of respondents (n = 301). Verbal abuse was the most frequently experienced form of mistreatment (n = 256, 72.1%), followed by alcohol-associated harassment (n = 184, 51.8%). Among women, sexual harassment was also often reported (n = 74, 58.3%). Doctors were most often reported as abusers (n = 124, 34.9%), followed by patients (n = 77, 21.7%) and nurses (n = 61, 17.2%). Abuse was reported to have occurred most frequently during surgical rotations (n = 98, 27.6%), followed by rotations in departments of internal medicine (n = 76, 21.4%), emergency medicine (n = 41, 11.5%) and anaesthesia (n = 40, 11.3%). Very few respondents reported their experiences of abuse to superiors (n = 36, 12.0%). The most frequent emotional response to experiences of abuse was anger (n = 84, 41.4%). Mistreatment during residency is a universal phenomenon. Deliberation

  2. Are All Competencies Equal in the Eyes of Residents? A Multicenter Study of Emergency Medicine Residents' Interest in Feedback.

    Science.gov (United States)

    Bentley, Suzanne; Hu, Kevin; Messman, Anne; Moadel, Tiffany; Khandelwal, Sorabh; Streich, Heather; Noelker, Joan

    2017-01-01

    Feedback, particularly real-time feedback, is critical to resident education. The emergency medicine (EM) milestones were developed in 2012 to enhance resident assessment, and many programs use them to provide focused resident feedback. The purpose of this study was to evaluate EM residents' level of interest in receiving real-time feedback on each of the 23 competencies/sub-competencies. This was a multicenter cross-sectional study of EM residents. We surveyed participants on their level of interest in receiving real-time on-shift feedback on each of the 23 competencies/sub-competencies. Anonymous paper or computerized surveys were distributed to residents at three four-year training programs and three three-year training programs with a total of 223 resident respondents. Residents rated their level of interest in each milestone on a six-point Likert-type response scale. We calculated average level of interest for each of the 23 sub-competencies, for all 223 respondents and separately by postgraduate year (PGY) levels of training. One-way analyses of variance were performed to determine if there were differences in ratings by level of training. The overall survey response rate across all institutions was 82%. Emergency stabilization had the highest mean rating (5.47/6), while technology had the lowest rating (3.24/6). However, we observed no differences between levels of training on any of the 23 competencies/sub-competencies. Residents seem to ascribe much more value in receiving feedback on domains involving high-risk, challenging procedural skills as compared to low-risk technical and communication skills. Further studies are necessary to determine whether residents' perceived importance of competencies/sub-competencies needs to be considered when developing an assessment or feedback program based on these 23 EM competencies/sub-competencies.

  3. Nanomaterials for photovoltaic conversion

    International Nuclear Information System (INIS)

    Davenas, J.; Ltaief, A.; Barlier, V.; Boiteux, G.; Bouazizi, A.

    2008-01-01

    A promising route for photovoltaic conversion has emerged from the combination of electroactive nanomaterials and small bandgap polymers. The formation of bulk heterojunctions resulting from the extended interfaces leads to efficient dissociation of the charge pairs generated under sunlight shown by the rapid extinction of the polymer photoluminescence for increasing contents of fullerenes or TiO 2 nanoparticles in MEH-PPV or PVK. Unconventional elaboration routes of the blends have been developed to increase the nanofiller dispersion and inhibit phase separation at high concentration. The size reduction of the acceptor domains led to a complete quenching of the radiative recombinations, obtained by specific solvent processing of MEH-PPV / C 60 nanocomposites or sol gel elaboration of TiO 2 nanoparticles in a PVK film. A simultaneous increase of the photocurrents could be achieved by the dispersion and size optimisation of the nanofillers. In situ generation of silver particles in MEH-PPV provides an example of enhanced charge separation induced by the plasmon resonance at the metal/polymer interface. The strong influence of the molecular morphology on the nanocomposite properties emphasizes the large improvements which can still be gained on the performances of organic solar cells

  4. Overview of fuel conversion

    International Nuclear Information System (INIS)

    Green, A.E.S.

    1991-01-01

    The conversion of solid fuels to cleaner-burning and more user-friendly solid liquid or gaseous fuels spans many technologies. In this paper, the authors consider coal, residual oil, oil shale, tar sends tires, municipal oil waste and biomass as feedstocks and examine the processes which can be used in the production of synthetic fuels for the transportation sector. The products of mechanical processing to potentially usable fuels include coal slurries, micronized coal, solvent refined coal, vegetable oil and powdered biomall. The thermochemical and biochemical processes considered include high temperature carbide production, liquefaction, gasification, pyrolysis, hydrolysis-fermentation and anaerobic digestion. The products include syngas, synthetic natural gas, methanol, ethanol and other hydrocarbon oxygenates synthetic gasoline and diesel and jet engine oils. The authors discuss technical and economic aspects of synthetic fuel production giving particular attention and literature references to technologies not discussed in the five chapters which follow. Finally the authors discuss economic energy, and environmental aspects of synthetic fuels and their relationship to the price of imported oil

  5. Geothermal energy conversion facility

    Energy Technology Data Exchange (ETDEWEB)

    Kutscher, C.F.

    1997-12-31

    With the termination of favorable electricity generation pricing policies, the geothermal industry is exploring ways to improve the efficiency of existing plants and make them more cost-competitive with natural gas. The Geothermal Energy Conversion Facility (GECF) at NREL will allow researchers to study various means for increasing the thermodynamic efficiency of binary cycle geothermal plants. This work has received considerable support from the US geothermal industry and will be done in collaboration with industry members and utilities. The GECF is being constructed on NREL property at the top of South Table Mountain in Golden, Colorado. As shown in Figure 1, it consists of an electrically heated hot water loop that provides heating to a heater/vaporizer in which the working fluid vaporizes at supercritical or subcritical pressures as high as 700 psia. Both an air-cooled and water-cooled condenser will be available for condensing the working fluid. In order to minimize construction costs, available equipment from the similar INEL Heat Cycle Research Facility is being utilized.

  6. Laughter annotations in conversational speech corpora - possibilities and limitations for phonetic analysis

    NARCIS (Netherlands)

    Truong, Khiet Phuong; Trouvain, Jürgen

    Existing laughter annotations provided with several publicly available conversational speech corpora (both multiparty and dyadic conversations) were investigated and compared. We discuss the possibilities and limitations of these rather coarse and shallow laughter annotations. There are definition

  7. Impact of Pregnancy and Gender on Internal Medicine Resident Evaluations: A Retrospective Cohort Study.

    Science.gov (United States)

    Krause, Megan L; Elrashidi, Muhamad Y; Halvorsen, Andrew J; McDonald, Furman S; Oxentenko, Amy S

    2017-06-01

    Pregnancy and its impact on graduate medical training are not well understood. To examine the effect of gender and pregnancy for Internal Medicine (IM) residents on evaluations by peers and faculty. This was a retrospective cohort study. All IM residents in training from July 1, 2004-June 30, 2014, were included. Female residents who experienced pregnancy and male residents whose partners experienced pregnancy during training were identified using an existing administrative database. Mean evaluation scores by faculty and peers were compared relative to pregnancy (before, during, and after), accounting for the gender of both the evaluator and resident in addition to other available demographic covariates. Potential associations were assessed using mixed linear models. Of 566 residents, 117 (20.7%) experienced pregnancy during IM residency training. Pregnancy was more common in partners of male residents (24.7%) than female residents (13.2%) (p = 0.002). In the post-partum period, female residents had lower peer evaluation scores on average than their male counterparts (p = 0.0099). A large number of residents experience pregnancy during residency. Mean peer evaluation scores were lower after pregnancy for female residents. Further study is needed to fully understand the mechanisms behind these findings, develop ways to optimize training throughout pregnancy, and explore any unconscious biases that may exist.

  8. Gout treatment: survey of Brazilian rheumatology residents.

    Science.gov (United States)

    Amorim, Rodrigo Balbino Chaves; Vargas-Santos, Ana Beatriz; Pereira, Leticia Rocha; Coutinho, Evandro Silva Freire; da Rocha Castelar-Pinheiro, Geraldo

    2017-05-01

    To assess the current practices in gout management among Brazilian rheumatology residents. We performed a cross-sectional online survey among all the rheumatology residents and those rheumatologists who had just completed their training (post-residency (PR)) regarding their approach to gout management. Results were compared with the 2012 American College of Rheumatology (ACR) gout guidelines and with the responses of a previous survey with a representative sample of practicing Brazilian rheumatologists (RHE). We received 224 responses (83%) from 271 subjects. Among all respondents, the first-choice treatment for gout flares was the combination of a nonsteroidal anti-inflammatory drug + colchicine for otherwise healthy patients. A target serum urate 75%. Less than 70% reported starting allopurinol at low doses (≤100 mg/day) for patients with normal renal function and gout guidelines, especially among PR. However, some important aspects of gout management need improvement. These results will guide the development of a physician education program to improve the management of gout patients in Brazil.

  9. Simulation Activity in Otolaryngology Residencies.

    Science.gov (United States)

    Deutsch, Ellen S; Wiet, Gregory J; Seidman, Michael; Hussey, Heather M; Malekzadeh, Sonya; Fried, Marvin P

    2015-08-01

    Simulation has become a valuable tool in medical education, and several specialties accept or require simulation as a resource for resident training or assessment as well as for board certification or maintenance of certification. This study investigates current simulation resources and activities in US otolaryngology residency programs and examines interest in advancing simulation training and assessment within the specialty. Web-based survey. US otolaryngology residency training programs. An electronic web-based survey was disseminated to all US otolaryngology program directors to determine their respective institutional and departmental simulation resources, existing simulation activities, and interest in further simulation initiatives. Descriptive results are reported. Responses were received from 43 of 104 (43%) residency programs. Simulation capabilities and resources are available in most respondents' institutions (78.6% report onsite resources; 73.8% report availability of models, manikins, and devices). Most respondents (61%) report limited simulation activity within otolaryngology. Areas of simulation are broad, addressing technical and nontechnical skills related to clinical training (94%). Simulation is infrequently used for research, credentialing, or systems improvement. The majority of respondents (83.8%) expressed interest in participating in multicenter trials of simulation initiatives. Most respondents from otolaryngology residency programs have incorporated some simulation into their curriculum. Interest among program directors to participate in future multicenter trials appears high. Future research efforts in this area should aim to determine optimal simulators and simulation activities for training and assessment as well as how to best incorporate simulation into otolaryngology residency training programs. © American Academy of Otolaryngology—Head and Neck Surgery Foundation 2015.

  10. The Value of a Resident Aesthetic Clinic: A 7-Year Institutional Review and Survey of the Chief Resident Experience.

    Science.gov (United States)

    Weissler, Jason M; Carney, Martin J; Yan, Chen; Percec, Ivona

    2017-10-16

    With the evolving plastic surgery training paradigm, there is an increasing emphasis on aesthetic surgery education during residency. In an effort to improve aesthetic education and to encourage preparation for independent practice, our institution has supported a resident-run aesthetic clinic for over two decades. To provide insight into the educational benefits of a resident-run cosmetic clinic through longitudinal resident follow up and institutional experiential review. A retrospective review was conducted to identify all clinic-based aesthetic operations performed between 2009 and 2016. To capture residents' perspectives on the cosmetic resident clinic, questionnaires were distributed to the cohort. Primary outcome measures included: volume and types of cases performed, impact of clinic experience on training, confidence level performing cosmetic procedures, and satisfaction with chief clinic. Unpaired t tests were calculated to compare case volume/type with level of confidence and degree of preparedness to perform cosmetic procedures independently. Overall, 264 operations performed by 18 graduated chief residents were reviewed. Surveys were distributed to 28 chief residents (71.4% completion rate). Performing twenty or more clinic-based procedures was associated with higher levels of preparedness to perform cosmetic procedures independently (P = 0.037). Residents reported the highest confidence when performing cosmetic breast procedures when compared to face/neck (P = 0.005), body/trunk procedures (P = 0.39), and noninvasive facial procedures (P = 0.85). The continued growth of aesthetic surgery highlights the need for comprehensive training and preparation for the new generation of plastic surgeons. Performing cosmetic procedures in clinic is a valuable adjunct to the traditional educational curriculum and increases preparedness and confidence for independent practice. © 2017 The American Society for Aesthetic Plastic Surgery, Inc. Reprints and permission

  11. Comparing the NPS MBA Resident and Distance Programs

    Science.gov (United States)

    2017-06-01

    at both the course and program levels . In particular students in the DL programs appear to be at a disadvantage in their math intensive courses...A student with a minimum grade of “C” in at least one upper- level Math course, including Linear Algebra, receives a “4.” A student with a minimum...grade of “C” in at least one lower level Calculus course, or a combined minimum “B” average in at least two college level Math courses also receives a

  12. Comparing tourists' and residents' motivations for travelling to ...

    African Journals Online (AJOL)

    This study analysed the motivations for visiting South Africa's Kruger National Park, with the aim of identifying similarities and differences between tourists' motives and those of people living near the Park. A factor analysis of the findings revealed five motives: education and learning, relaxation, photography, activities and ...

  13. Variability in Resident Operative Hand Experience by Specialty.

    Science.gov (United States)

    Silvestre, Jason; Lin, Ines C; Levin, L Scott; Chang, Benjamin

    2018-01-01

    Recent attention has sought to standardize hand surgery training in the United States. This study analyzes the variability in operative hand experience for orthopedic and general surgery residents. Case logs for orthopedic and general surgery residency graduates were obtained from the American Council of Graduate Medical Education (2006-2007 to 2014-2015). Plastic surgery case logs were not available for comparison. Hand surgery case volumes were compared between specialties with parametric tests. Intraspecialty variation in orthopedic surgery was assessed between the bottom and top 10th percentiles in procedure categories. Case logs for 9605 general surgery residents and 5911 orthopedic surgery residents were analyzed. Orthopedic surgery residents performed a greater number of hand surgery cases than general surgery residents ( P < .001). Mean total hand experience ranged from 2.5 ± 4 to 2.8 ± 5 procedures for general surgery residents with no reported cases of soft tissue repairs, vascular repairs, and replants. Significant intraspecialty variation existed in orthopedic surgery for all hand procedure categories (range, 3.3-15.0). As the model for hand surgery training evolves, general surgeons may represent an underutilized talent pool to meet the critical demand for hand surgeon specialists. Future research is needed to determine acceptable levels of training variability in hand surgery.

  14. Five Key Leadership Actions Needed to Redesign Family Medicine Residencies.

    Science.gov (United States)

    Kozakowski, Stanley M; Eiff, M Patrice; Green, Larry A; Pugno, Perry A; Waller, Elaine; Jones, Samuel M; Fetter, Gerald; Carney, Patricia A

    2015-06-01

    New skills are needed to properly prepare the next generation of physicians and health professionals to practice in medical homes. Transforming residency training to address these new skills requires strong leadership. We sought to increase the understanding of leadership skills useful in residency programs that plan to undertake meaningful change. The Preparing the Personal Physician for Practice (P4) project (2007-2014) was a comparative case study of 14 family medicine residencies that engaged in innovative training redesign, including altering the scope, content, sequence, length, and location of training to align resident education with requirements of the patient-centered medical home. In 2012, each P4 residency team submitted a final summary report of innovations implemented, overall insights, and dissemination activities during the study. Six investigators conducted independent narrative analyses of these reports. A consensus meeting held in September 2012 was used to identify key leadership actions associated with successful educational redesign. Five leadership actions were associated with successful implementation of innovations and residency transformation: (1) manage change; (2) develop financial acumen; (3) adapt best evidence educational strategies to the local environment; (4) create and sustain a vision that engages stakeholders; and (5) demonstrate courage and resilience. Residency programs are expected to change to better prepare their graduates for a changing delivery system. Insights about effective leadership skills can provide guidance for faculty to develop the skills needed to face practical realities while guiding transformation.

  15. A theory-informed, process-oriented Resident Scholarship Program

    Science.gov (United States)

    Thammasitboon, Satid; Darby, John B.; Hair, Amy B.; Rose, Karen M.; Ward, Mark A.; Turner, Teri L.; Balmer, Dorene F.

    2016-01-01

    Background The Accreditation Council for Graduate Medical Education requires residency programs to provide curricula for residents to engage in scholarly activities but does not specify particular guidelines for instruction. We propose a Resident Scholarship Program that is framed by the self-determination theory (SDT) and emphasize the process of scholarly activity versus a scholarly product. Methods The authors report on their longitudinal Resident Scholarship Program, which aimed to support psychological needs central to SDT: autonomy, competence, and relatedness. By addressing those needs in program aims and program components, the program may foster residents’ intrinsic motivation to learn and to engage in scholarly activity. To this end, residents’ engagement in scholarly processes, and changes in perceived autonomy, competence, and relatedness were assessed. Results Residents engaged in a range of scholarly projects and expressed positive regard for the program. Compared to before residency, residents felt more confident in the process of scholarly activity, as determined by changes in increased perceived autonomy, competence, and relatedness. Scholarly products were accomplished in return for a focus on scholarly process. Conclusions Based on our experience, and in line with the SDT, supporting residents’ autonomy, competence, and relatedness through a process-oriented scholarship program may foster the curiosity, inquisitiveness, and internal motivation to learn that drives scholarly activity and ultimately the production of scholarly products. PMID:27306995

  16. Occupational stress and related factors among surgical residents in Korea.

    Science.gov (United States)

    Kang, Sanghee; Jo, Hye Sung; Boo, Yoon Jung; Lee, Ji Sung; Kim, Chong Suk

    2015-11-01

    The application rate for surgical residents in Korea has continuously decreased over the past few years. The demanding workload and the occupational stress of surgical training are likely causes of this problem. The aim of this study was to investigate occupational stress and its related factors in Korean surgical residents. With the support of the Korean Surgical Society, we conducted an electronic survey of Korean surgical residents related to occupational stress. We used the Korean Occupational Stress Scale (KOSS) to measure occupational stress. We analyzed the data focused on the stress level and the factors associated with occupational stress. The mean KOSS score of the surgical residents was 55.39, which was significantly higher than that of practicing surgeons (48.16, P occupation rate and exercise were all significantly associated with KOSS score. Surgical residents have high occupational stress compared to practicing surgeons and other professionals. Their mean number of assigned patients, resident recruitment rate and exercise were all significantly associated with occupational stress for surgical residents.

  17. Tree value conversion standards revisited

    Science.gov (United States)

    Paul S. DeBald; Martin E. Dale; Martin E. Dale

    1991-01-01

    Updated tree value conversion standards (TVCS) are presented for 12 important hardwood species of the oak-hickory forest. These updated standards-developed for each species by butt-log grade, merchantable height, and diameter at breast height-reflect the changes in lumber prices and in conversion costs which have occurred since 1976 when the original TVCS were...

  18. Optimization theory for ballistic conversion

    NARCIS (Netherlands)

    Xie, Yanbo; Versluis, Michel; van den Berg, Albert; Eijkel, Jan C.T.

    2016-01-01

    The growing demand of renewable energy stimulates the exploration of new materials and methods for clean energy. We recently demonstrated a high efficiency and power density energy conversion mechanism by using jetted charged microdroplets, termed as ballistic energy conversion. Hereby, we model and

  19. Career conversations in vocational schools

    NARCIS (Netherlands)

    Mittendorff, K.M.; Brok, den P.J.; Beijaard, D.

    2010-01-01

    The purpose of this study was to examine career conversations between teachers and students in competence-based vocational education in the Netherlands. A total of 32 career conversations were observed and analysed with respect to four elements: content, teacher activities, student activities and

  20. [Neuropsychological assessment in conversion disorder].

    Science.gov (United States)

    Demır, Süleyman; Çelıkel, Feryal Çam; Taycan, Serap Erdoğan; Etıkan, İlker

    2013-01-01

    Conversion disorder is characterized by functional impairment in motor, sensory, or neurovegetative systems that cannot be explained by a general medical condition. Diagnostic systems emphasize the absence of an organic basis for the dysfunction observed in conversion disorder. Nevertheless, there is a growing body of data on the specific functional brain correlates of conversion symptoms, particularly those obtained via neuroimaging and neurophysiological assessment. The present study aimed to determine if there are differences in measures of cognitive functioning between patients with conversion disorder and healthy controls. The hypothesis of the study was that the patients with conversion disorder would have poorer neurocognitive performance than the controls. The patient group included 43 patients diagnosed as conversion disorder and other psychiatric comorbidities according to DSM-IV-TR. Control group 1 included 44 patients diagnosed with similar psychiatric comorbidities, but not conversion diosorder, and control group 2 included 43 healthy individuals. All participants completed a sociodemographic questionnaire and were administered the SCID-I and a neuropsychological test battery of 6 tests, including the Serial Digit Learning Test (SDLT), Auditory Verbal Learning Test (AVLT), Wechsler Memory Scale, Stroop Color Word Interference Test, Benton Judgment of Line Orientation Test (BJLOT), and Cancellation Test. The patient group had significantly poorer performance on the SDLT, AVLT, Stroop Color Word Interference Test, and BJLOT than both control groups. The present findings highlight the differences between the groups in learning and memory, executive and visuospatial functions, and attention, which seemed to be specific to conversion disorder.

  1. Mentorship in orthopaedic and trauma residency training ...

    African Journals Online (AJOL)

    Background: Mentorship is important in residency training as it is necessary for personal and professional development of the resident trainees. Objectives: This study documents mentorship in orthopaedic residency training programme in Nigeria by assessing the awareness of orthopaedic residents on the role of a mentor, ...

  2. The resident's view of residency training in Canada.

    Science.gov (United States)

    Fish, D G

    1966-04-09

    In the view of residents in their last year of specialty training, the Fellowship is now becoming the operative standard for obtaining hospital privileges in urban centres and they felt that this implied that the two standards, the Certificate and the Fellowship of the Royal College, were not achieving the purpose for which they were designed. Although 80% of the residents intended to write the Fellowship, few viewed a year in a basic science department or in research as of intrinsic value in terms of their future practice.The examinations of the Royal College were the subject of criticism, most residents feeling that the examinations did not test the knowledge and ability gained in training. Most expressed a desire for ongoing evaluation during the training period.Service responsibilities were generally regarded as too heavy.Despite the criticism of both training and examination, most residents felt that their training had provided them with the experience and background they needed to practise as specialists.

  3. Photon up-conversion increases biomass yield in Chlorella vulgaris.

    Science.gov (United States)

    Menon, Kavya R; Jose, Steffi; Suraishkumar, Gadi K

    2014-12-01

    Photon up-conversion, a process whereby lower energy radiations are converted to higher energy levels via the use of appropriate phosphor systems, was employed as a novel strategy for improving microalgal growth and lipid productivity. Photon up-conversion enables the utilization of regions of the solar spectrum, beyond the typical photosynthetically active radiation, that are usually wasted or are damaging to the algae. The effects of up-conversion of red light by two distinct sets of up-conversion phosphors were studied in the model microalgae Chlorella vulgaris. Up-conversion by set 1 phosphors led to a 2.85 fold increase in biomass concentration and a 3.2 fold increase in specific growth rate of the microalgae. While up-conversion by set 2 phosphors resulted in a 30% increase in biomass and 12% increase in specific intracellular neutral lipid, while the specific growth rates were comparable to that of the control. Furthermore, up-conversion resulted in higher levels of specific intracellular reactive oxygen species in C. vulgaris. Up-conversion of red light (654 nm) was shown to improve biomass yields in C. vulgaris. In principle, up-conversion can be used to increase the utilization range of the electromagnetic spectrum for improved cultivation of photosynthetic systems such as plants, algae, and microalgae. Copyright © 2014 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.

  4. Neurosurgical Resident Training in Germany.

    Science.gov (United States)

    Stienen, Martin N; Gempt, Jens; Gautschi, Oliver P; Demetriades, Andreas K; Netuka, David; Kuhlen, Dominique E; Schaller, Karl; Ringel, Florian

    2017-07-01

    Introduction  Efficient neurosurgical training is of paramount importance to provide continuing high-quality medical care to patients. In this era of law-enforced working hour restrictions, however, maintaining high-quality training can be a challenge and requires some restructuring. We evaluated the current status of resident training in Germany. Methods  An electronic survey was sent to European neurosurgical trainees between June 2014 and March 2015. The responses of German trainees were compared with those of trainees from other European countries. Logistic regression analysis was performed to assess the effect size of the relationship between a trainee being from Germany and the outcome (e.g., satisfaction, working time). Results  Of 532 responses, 95 were from German trainees (17.8%). In a multivariate analysis corrected for baseline group differences, German trainees were 29% as likely as non-German trainees to be satisfied with clinical lectures given at their teaching facility (odds ratio [OR]: 0.29; 95% confidence interval [CI]: 0.18-0.49; p  hours as requested from the European Working Time Directive 2003/88/EC, and in an international comparison, German trainees were twice as likely to work > 50 hours per week (OR: 2.13; 95% CI, 1.25-3.61; p  = 0.005). This working time, however, is less spent in the operating suite (OR: 0.26; 95% CI, 0.11-0.59; p  = 0.001) and more doing administrative work (OR: 1.83; 95% CI, 1.13-2.96; p  = 0.015). Conclusion  Some theoretical and practical aspects of neurosurgical training are superior, but a considerable proportion of relevant aspects are inferior in Germany compared with other European countries. The present analyses provide the opportunity for a critical review of the local conditions in German training facilities. Georg Thieme Verlag KG Stuttgart · New York.

  5. Impact of Generalist Physician Initiatives on Residency Selection

    Directory of Open Access Journals (Sweden)

    Michael H. Malloy

    2001-10-01

    Full Text Available Objective:To compare the residency selection choices of students who experienced courses resulting from generalist physician initiatives to choices made by students prior to the implementation of those courses and to describe the characteristics of students selecting primary care residencies. Background:In the fall of 1994 a first year Community Continuity Experience course was initiated and in the summer of 1995 a third year Multidisciplinary Ambulatory Clerkship was begun at the University of Texas Medical Branch in Galveston. These courses were inserted into the curriculum to enhance and promote primary care education. Design/Methods:We examined the residency selections of cohorts of graduating medical students before (1992-1996 and after (1997-1999 the implementation of the primary care courses. Survey information on career preferences at matriculation and in the fourth year of medical school were available for students graduating after the programs began. We compared the career preferences and characteristics of those students who selected a primary care residency to those who did not. Results:Prior to the implementation of the programs, 45%(425/950 of students graduating selected primary care residencies compared to 45% (210/465 of students participating in the programs (p=0.88. At matriculation, 45% of students had listed a primary care discipline as their first career choice. Among the students who had indicated this degree of primary care interest 61% ended up matching in a primary care discipline. At year 4, 31% of students indicated a primary care discipline as their first career choice and 92% of these students matched to a primary care residency. By univariate analysis, minority students (53% were more likely to select a primary care residency than non-minority students (40%; students in the two lowest grade point average quartiles (55% and 50% selected primary care residencies compared to 37% and 38% of students in the top 2

  6. Social worker assessment of bad news delivery by emergency medicine residents: a novel direct-observation milestone assessment.

    Science.gov (United States)

    Min, Alice Ann; Spear-Ellinwood, Karen; Berman, Melissa; Nisson, Peyton; Rhodes, Suzanne Michelle

    2016-09-01

    The skill of delivering bad news is difficult to teach and evaluate. Residents may practice in simulated settings; however, this may not translate to confidence or competence during real experiences. We investigated the acceptability and feasibility of social workers as evaluators of residents' delivery of bad news during patient encounters, and assessed the attitudes of both groups regarding this process. From August 2013 to June 2014, emergency medicine residents completed self-assessments after delivering bad news. Social workers completed evaluations after observing these conversations. The Assessment tools were designed by modifying the global Breaking Bad News Assessment Scale. Residents and social workers completed post-study surveys. 37 evaluations were received, 20 completed by social workers and 17 resident self-evaluations. Social workers reported discussing plans with residents prior to conversations 90 % of the time (18/20, 95 % CI 64.5, 97.8). Social workers who had previously observed the resident delivering bad news reported that the resident was more skilled on subsequent encounters 90 % of the time (95 % CI 42.2, 99). Both social workers and residents felt that prior training or experience was important. First-year residents valued advice from social workers less than advice from attending physicians, whereas more experienced residents perceived advice from social workers to be equivalent with that of attending physicians (40 versus 2.9 %, p = 0.002). Social worker assessment of residents' abilities to deliver bad news is feasible and acceptable to both groups. This formalized self-assessment and evaluation process highlights the importance of social workers' involvement in delivery of bad news, and the teaching of this skill. This method may also be used as direct-observation for resident milestone assessment.

  7. Improvement of skeleton conversion in ICRP reference phantom conversion project

    Energy Technology Data Exchange (ETDEWEB)

    Wang, Zhao Jun; Yeom, Yeon Soo; Thang, Nguyen Tat; Kim, Han Sung; Han, Min Cheol; Kim, Chan Hyeong [Dept. of Nuclear Engineering, Hanyang University, Seoul (Korea, Republic of); Kim, Seong Hoon [Dept. of Radiation Oncology, College of Medicine, Hanyang University, Seoul (Korea, Republic of)

    2014-11-15

    In the previous skeleton conversion, most bones were directly converted from the ICRP voxel phantoms by using the 3D rendering method whereas several complex-shape bones (cranium, ribs, spines, feet, and hands) were not able to be directly converted. We alternatively employed the corresponding well-defined polygonal models and attempted to adjust them to match the voxel models. However, this approach was unsatisfactory. The shapes of the alternative models were significantly different from those of the voxel models, making it virtually impossible to exactly match the voxel models as shown in Fig. 3 (left). In order to overcome the difficulty in the complex bone conversion, the present study developed a new conversion method and converted these complex bones voxel models of the ICRP male phantom to polygonal models. The present study developed the new conversion method and successfully improved polygonal models for cranium, ribs, and spines for the ICRP male phantom. The new conversion method will be also applied to the complex bone conversion for the ICRP female phantom as well as other complex organ conversion in the future.

  8. Improvement of skeleton conversion in ICRP reference phantom conversion project

    International Nuclear Information System (INIS)

    Wang, Zhao Jun; Yeom, Yeon Soo; Thang, Nguyen Tat; Kim, Han Sung; Han, Min Cheol; Kim, Chan Hyeong; Kim, Seong Hoon

    2014-01-01

    In the previous skeleton conversion, most bones were directly converted from the ICRP voxel phantoms by using the 3D rendering method whereas several complex-shape bones (cranium, ribs, spines, feet, and hands) were not able to be directly converted. We alternatively employed the corresponding well-defined polygonal models and attempted to adjust them to match the voxel models. However, this approach was unsatisfactory. The shapes of the alternative models were significantly different from those of the voxel models, making it virtually impossible to exactly match the voxel models as shown in Fig. 3 (left). In order to overcome the difficulty in the complex bone conversion, the present study developed a new conversion method and converted these complex bones voxel models of the ICRP male phantom to polygonal models. The present study developed the new conversion method and successfully improved polygonal models for cranium, ribs, and spines for the ICRP male phantom. The new conversion method will be also applied to the complex bone conversion for the ICRP female phantom as well as other complex organ conversion in the future

  9. Adaptive format conversion for scalable video coding

    Science.gov (United States)

    Wan, Wade K.; Lim, Jae S.

    2001-12-01

    The enhancement layer in many scalable coding algorithms is composed of residual coding information. There is another type of information that can be transmitted instead of (or in addition to) residual coding. Since the encoder has access to the original sequence, it can utilize adaptive format conversion (AFC) to generate the enhancement layer and transmit the different format conversion methods as enhancement data. This paper investigates the use of adaptive format conversion information as enhancement data in scalable video coding. Experimental results are shown for a wide range of base layer qualities and enhancement bitrates to determine when AFC can improve video scalability. Since the parameters needed for AFC are small compared to residual coding, AFC can provide video scalability at low enhancement layer bitrates that are not possible with residual coding. In addition, AFC can also be used in addition to residual coding to improve video scalability at higher enhancement layer bitrates. Adaptive format conversion has not been studied in detail, but many scalable applications may benefit from it. An example of an application that AFC is well-suited for is the migration path for digital television where AFC can provide immediate video scalability as well as assist future migrations.

  10. Surgical resident education in patient safety: where can we improve?

    Science.gov (United States)

    Putnam, Luke R; Levy, Shauna M; Kellagher, Caroline M; Etchegaray, Jason M; Thomas, Eric J; Kao, Lillian S; Lally, Kevin P; Tsao, KuoJen

    2015-12-01

    Effective communication and patient safety practices are paramount in health care. Surgical residents play an integral role in the perioperative team, yet their perceptions of patient safety remain unclear. We hypothesized that surgical residents perceive the perioperative environment as more unsafe than their faculty and operating room staff despite completing a required safety curriculum. Surgeons, anesthesiologists, and perioperative nurses in a large academic children's hospital participated in multifaceted, physician-led workshops aimed at enhancing communication and safety culture over a 3-y period. All general surgery residents from the same academic center completed a hospital-based online safety curriculum only. All groups subsequently completed the psychometrically validated safety attitudes questionnaire to evaluate three domains: safety culture, teamwork, and speaking up. Results reflect the percent of respondents who slightly or strongly agreed. Chi-square analysis was performed. Sixty-three of 84 perioperative personnel (75%) and 48 of 52 surgical residents (92%) completed the safety attitudes questionnaire. A higher percentage of perioperative personnel perceived a safer environment than the surgical residents in all three domains, which was significantly higher for safety culture (68% versus 46%, P = 0.03). When stratified into two groups, junior residents (postgraduate years 1-2) and senior residents (postgraduate years 3-5) had lower scores for all three domains, but the differences were not statistically significant. Surgical residents' perceptions of perioperative safety remain suboptimal. With an enhanced safety curriculum, perioperative staff demonstrated higher perceptions of safety compared with residents who participated in an online-only curriculum. Optimal surgical education on patient safety remains unknown but should require a dedicated, systematic approach. Copyright © 2015 Elsevier Inc. All rights reserved.

  11. Identifying nursing home residents at risk for falling.

    Science.gov (United States)

    Kiely, D K; Kiel, D P; Burrows, A B; Lipsitz, L A

    1998-05-01

    To develop a fall risk model that can be used to identify prospectively nursing home residents at risk for falling. The secondary objective was to determine whether the nursing home environment independently influenced the development of falls. A prospective study involving 1 year of follow-up. Two hundred seventy-two nursing homes in the state of Washington. A total of 18,855 residents who had a baseline assessment in 1991 and a follow-up assessment within the subsequent year. Baseline Minimum Data Set items that could be potential risk factors for falling were considered as independent variables. The dependent variable was whether the resident fell as reported at the follow-up assessment. We estimated the extrinsic risk attributable to particular nursing home environments by calculating the annual fall rate in each nursing home and grouping them into tertiles of fall risk according to these rates. Factors associated independently with falling were fall history, wandering behavior, use of a cane or walker, deterioration of activities of daily living performance, age greater than 87 years, unsteady gait, transfer independence, wheelchair independence, and male gender. Nursing home residents with a fall history were more than three times as likely to fall during the follow-up period than residents without a fall history. Residents in homes with the highest tertile of fall rates were more than twice as likely to fall compared with residents of homes in the lowest tertile, independent of resident-specific risk factors. Fall history was identified as the strongest risk factor associated with subsequent falls and accounted for the vast majority of the predictive strength of the model. We recommend that fall history be used as an initial screener for determining eligibility for fall intervention efforts. Studies are needed to determine the facility characteristics that contribute to fall risk, independent of resident-specific risk factors.

  12. From Residency to Lifelong Learning.

    Science.gov (United States)

    Brandt, Keith

    2015-11-01

    The residency training experience is the perfect environment for learning. The university/institution patient population provides a never-ending supply of patients with unique management challenges. Resources abound that allow the discovery of knowledge about similar situations. Senior teachers provide counseling and help direct appropriate care. Periodic testing and evaluations identify deficiencies, which can be corrected with future study. What happens, however, when the resident graduates? Do they possess all the knowledge they'll need for the rest of their career? Will medical discovery stand still limiting the need for future study? If initial certification establishes that the physician has the skills and knowledge to function as an independent physician and surgeon, how do we assure the public that plastic surgeons will practice lifelong learning and remain safe throughout their career? Enter Maintenance of Certification (MOC). In an ideal world, MOC would provide many of the same tools as residency training: identification of gaps in knowledge, resources to correct those deficiencies, overall assessment of knowledge, feedback about communication skills and professionalism, and methods to evaluate and improve one's practice. This article discusses the need; for education and self-assessment that extends beyond residency training and a commitment to lifelong learning. The American Board of Plastic Surgery MOC program is described to demonstrate how it helps the diplomate reach the goal of continuous practice improvement.

  13. Machiavelli and the Chief Resident.

    Science.gov (United States)

    Raviglione, Mario C.

    1990-01-01

    Precepts from Machiavelli's "The Prince" are used in giving advice to chief residents on how to balance their responsibilities in working for the welfare of both the housestaff and the institution. Subject discussions include the difficulties of introducing change, setting good examples, and supervising former colleagues and peers. (GLR)

  14. Elder abuse and neglect in institutional settings: the resident's perspective.

    Science.gov (United States)

    Charpentier, Michèle; Soulières, Maryse

    2013-01-01

    This article strives to share research findings concerning the rights and empowerment of the elderly living in various long-term care (LTC) or residential care facilities (public and private sectors) in Quebec, Canada. Inspired by the theories of constructivism, the research aims to understand the residents' perception of abuse, as well as the strategies they are developing to exercise their rights and liberties. Data from semistructured interviews with 20 residents, mostly very old women aged 80 to 98, are presented. Results show that residents' perception of abuse: (1) is conditioned by sensationalistic media coverage; (2) is limited to physical mistreatment; and (3) tends to legitimize day-to-day infringements of their rights, as these "minor" violations seem inoffensive when compared to the "real" acts of violence reported in the media. Tensions that can build up among residents, sometimes resulting in intimidation or even bullying, were addressed.

  15. Results of a Flipped Classroom Teaching Approach in Anesthesiology Residents.

    Science.gov (United States)

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

    2017-08-01

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

  16. General surgery training and robotics: Are residents improving their skills?

    Science.gov (United States)

    Finnerty, Brendan M; Afaneh, Cheguevara; Aronova, Anna; Fahey, Thomas J; Zarnegar, Rasa

    2016-02-01

    While robotic-assisted operations have become more prevalent, many general surgery residencies do not have a formal robotic training curriculum. We sought to ascertain how well current general surgery training permits acquisition of robotic skills by comparing robotic simulation performance across various training levels. Thirty-six participants were categorized by level of surgical training: eight medical students (MS), ten junior residents (JR), ten mid-level residents (MLR), and eight senior residents (SR). Participants performed three simulation tasks on the da Vinci (®) Skills Simulator (MatchBoard, EnergyDissection, SutureSponge). Each task's scores (0-100) and cumulative scores (0-300) were compared between groups. There were no differences in sex, hand dominance, video gaming history, or prior robotic experience between groups; however, SR was the oldest (p Robotic skillsets acquired during general surgery residency show minimal improvement during the course of training, although laparoscopic experience is correlated with advanced robotic task performance. Changes in residency curricula or pursuit of fellowship training may be warranted for surgeons seeking proficiency.

  17. Increasing Competitiveness for an Otolaryngology Residency: Where We Are and Concerns about the Future.

    Science.gov (United States)

    Kaplan, Alyson B; Riedy, Katherine N; Grundfast, Kenneth M

    2015-11-01

    For graduating medical students, securing a residency in otolaryngology-head and neck surgery has become exceedingly difficult. This commentary explores the ways that applicants and residency programs are reacting to the increasing competitiveness in applying to, interviewing for, and matching to an otolaryngology residency. The commonly held perceptions of applicants are compared to perspectives held by residency program directors and resident selection committees. Unintended consequences of the growing trend for medical students to add a research year to their curriculum are presented. Some cautions and suggestions about how to improve the application and selection process are offered. © American Academy of Otolaryngology—Head and Neck Surgery Foundation 2015.

  18. Effect of mixing on enzymatic hydrolysis of steam-pretreated spruce: a quantitative analysis of conversion and power consumption

    Directory of Open Access Journals (Sweden)

    Wiman Magnus

    2011-05-01

    Full Text Available Abstract Background When scaling up lignocellulose-based ethanol production, the desire to increase the final ethanol titer after fermentation can introduce problems. A high concentration of water-insoluble solids (WIS is needed in the enzymatic hydrolysis step, resulting in increased viscosity, which can cause mass and heat transfer problems because of poor mixing of the material. In the present study, the effects of mixing on the enzymatic hydrolysis of steam-pretreated spruce were investigated using a stirred tank reactor operated with different impeller speeds and enzyme loadings. In addition, the results were related to the power input needed to operate the impeller at different speeds, taking into account the changes in rheology throughout the process. Results A marked difference in hydrolysis rate at different impeller speeds was found. For example, the conversion was twice as high after 48 hours at 500 rpm compared with 25 rpm. This difference remained throughout the 96 hours of hydrolysis. Substantial amounts of energy were required to achieve only minor increases in conversion during the later stages of the process. Conclusions Impeller speed strongly affected both the hydrolysis rate of the pretreated spruce and needed power input. Similar conversions could be obtained at different energy input by altering the mixing (that is, energy input, enzyme load and residence time, an important issue to consider when designing large-scale plants.

  19. Investigating the Influence of Mesoporosity in Zeolite Beta on its Catalytic Performance for the Conversion of Methanol to Hydrocarbons

    KAUST Repository

    Liu, Zhaohui

    2015-08-26

    Hierarchically porous zeolite Beta (Beta-MS) synthesized by a soft-templating method contains remarkable intra-crystalline mesoporosity, which reduces the diffusion length in zeolite channels down to several nanometers and alters the distribution of Al among distinct crystallographic sites. When used as a catalyst for the conversion of methanol to hydrocarbons (MTH) at 330 oC, Beta-MS exhibited a 2.7-fold larger conversion capacity, a 2.0-fold faster reaction rate, and a remarkably longer lifetime than conventional zeolite Beta (Beta-C). The superior catalytic performance of Beta-MS is attributed to its hierarchical structure, which offers full accessibility to all catalytic active sites. In contrast, Beta-C was easily deactivated because a layer of coke quickly deposited on the outer surfaces of the catalyst crystals, impeding access to interior active sites. This difference is clearly demonstrated by using electron microscopy combined with electron energy loss spectroscopy to probe the distribution of coke in the deactivated catalysts. At both low and high conversions, ranging from 20% to 100%, Beta-MS gave higher selectivity towards higher aliphatics (C4-C7) but lower ethene selectivity compared to Beta-C. Therefore, we conclude that a hierarchical structure decreases the residence time of methylbenzenes in zeolite micropores, disfavoring the propagation of the aromatic-based catalytic cycle. This conclusion is consistent with a recent report on ZSM-5 and is also strongly supported by our analysis of soluble coke species residing in the catalysts. Moreover, we identified an oxygen-containing compound, 4-methyl-benzaldehyde, in the coke, which has not been observed in the MTH reaction before.  

  20. Investigating the Influence of Mesoporosity in Zeolite Beta on its Catalytic Performance for the Conversion of Methanol to Hydrocarbons

    KAUST Repository

    Liu, Zhaohui; Dong, Xinglong; Zhu, Yihan; Emwas, Abdul-Hamid M.; Zhang, Daliang; Tian, Qiwei; Han, Yu

    2015-01-01

    Hierarchically porous zeolite Beta (Beta-MS) synthesized by a soft-templating method contains remarkable intra-crystalline mesoporosity, which reduces the diffusion length in zeolite channels down to several nanometers and alters the distribution of Al among distinct crystallographic sites. When used as a catalyst for the conversion of methanol to hydrocarbons (MTH) at 330 oC, Beta-MS exhibited a 2.7-fold larger conversion capacity, a 2.0-fold faster reaction rate, and a remarkably longer lifetime than conventional zeolite Beta (Beta-C). The superior catalytic performance of Beta-MS is attributed to its hierarchical structure, which offers full accessibility to all catalytic active sites. In contrast, Beta-C was easily deactivated because a layer of coke quickly deposited on the outer surfaces of the catalyst crystals, impeding access to interior active sites. This difference is clearly demonstrated by using electron microscopy combined with electron energy loss spectroscopy to probe the distribution of coke in the deactivated catalysts. At both low and high conversions, ranging from 20% to 100%, Beta-MS gave higher selectivity towards higher aliphatics (C4-C7) but lower ethene selectivity compared to Beta-C. Therefore, we conclude that a hierarchical structure decreases the residence time of methylbenzenes in zeolite micropores, disfavoring the propagation of the aromatic-based catalytic cycle. This conclusion is consistent with a recent report on ZSM-5 and is also strongly supported by our analysis of soluble coke species residing in the catalysts. Moreover, we identified an oxygen-containing compound, 4-methyl-benzaldehyde, in the coke, which has not been observed in the MTH reaction before.  

  1. Energy Conversion Alternatives Study (ECAS)

    Science.gov (United States)

    1977-01-01

    ECAS compared various advanced energy conversion systems that can use coal or coal-derived fuels for baseload electric power generation. It was conducted in two phases. Phase 1 consisted of parametric studies. From these results, 11 concepts were selected for further study in Phase 2. For each of the Phase 2 systems and a common set of ground rules, performance, cost, environmental intrusion, and natural resource requirements were estimated. In addition, the contractors defined the state of the associated technology, identified the advances required, prepared preliminary research and development plans, and assessed other factors that would affect the implementation of each type of powerplant. The systems studied in Phase 2 include steam systems with atmospheric- and pressurized-fluidized-bed boilers; combined cycle gas turbine/steam systems with integrated gasifiers or fired by a semiclean, coal derived fuel; a potassium/steam system with a pressurized-fluidized-bed boiler; a closed-cycle gas turbine/organic system with a high-temperature, atmospheric-fluidized-bed furnace; a direct-coal-fired, open- cycle magnetohydrodynamic/steam system; and a molten-carbonate fuel cell/steam system with an integrated gasifier. The sensitivity of the results to changes in the ground rules and the impact of uncertainties in capital cost estimates were also examined.

  2. Tropospheric effects of energy conversion

    International Nuclear Information System (INIS)

    Derwent, R.G.

    1992-01-01

    The tropospheric concentrations of a number of trace gases are increasing due to man's activities. For some trace gases, their atmospheric life cycles are not fully understood and it is difficult to be certain about the role of man's activities. Emissions from the energy industries and energy conversion processes represent an important subset of source terms in these life cycles, along with agriculture, deforestation, cement manufacture, biomass burning, process industries and natural biospheric processes. Global Warming Potentials (GWPs) allow the tropospheric effects of a range of climate forcing trace gases to be assessed on a comparable basis. If a short term view of the commitment to global warming is adopted then the contribution from other trace gases may approach and exceed that of carbon dioxide, itself. Over longer time horizons, the long atmospheric lifetime of carbon dioxide shows through as a major influence and the contributions from the other trace gases appear to be much smaller, representing an additional 13-18% contribution on top of that from CO 2 itself

  3. Career goals and expectations of men and women pharmacy residents.

    Science.gov (United States)

    King, C M; Oliver, E J; Jeffrey, L P

    1982-11-01

    Personal and professional characteristics of men and women hospital pharmacy residents were studied to identify differences that could affect future hospital pharmacy practice. Residents in 111 ASHP-accredited pharmacy residency programs received a survey containing questions on demographic information, reasons for selecting a residency, areas of professional interest, postresidency career goals, responsibilities to home and family, and advantages and disadvantages associated with gender. Of 286 residents receiving questionnaires, 226 responded; the percentages of men and women responding corresponded to the ratio of men and women in hospital pharmacy residencies. While men and women expressed educational goals that were not significantly different, more men than women had earned or were in the process of earning advanced degrees. No significant differences were evident between men's and women's plans for marriage and children, but 73% of the women indicated that they would take time out from their practice to raise children, compared with only 9% of the men. The majority of residents did not think their gender affected them in their residency programs, but in professional interactions more men saw gender as an advantage and more women as a disadvantage. Significantly more than women aspired to be hospital pharmacy directors. The results suggest that men are obtaining advanced training closer to the time they graduate from pharmacy school and that in the future women competing for promotions may be older than men competing for comparable positions. Those planning pharmacy staffing should consider the needs of women, and men, who expect to take time out from their careers for family responsibilities and possibly seek part-time positions when they return to the work force.

  4. E-conferencing for delivery of residency didactics.

    Science.gov (United States)

    Markova, Tsveti; Roth, Linda M

    2002-07-01

    ease of use, cost-efficiency, and wide availability of equipment. Residents had the advantage of both geographic and temporal independence. Our e-conferences were interactive, and in addition to a PowerPoint presentation, faculty provided Web sites and hyperlinks for references. Initial problems included slow-speed connection, the requirement for digital materials, and the need for residents and faculty to adjust to a new learning method. There was also a need for increased coordination at the sites and reliance on electronic communication. To assess the effectiveness of the program, residents completed knowledge pre- and post-tests and a conference evaluation form. We also monitored conference attendance rates. Preliminary results indicated positive resident attitudes toward distance learning and significant increases in conference attendance. To objectively evaluate this instructional delivery method, we will compare residents' knowledge gains in the face-to-face instructor group with those of the group to which the lecture is broadcast. Ultimately, we are hoping to offer this educational opportunity to other family practice residency programs in the area, to medical students interested in family medicine, and to community family physicians for continuing medical education. We are considering the addition of streaming video to the presentations in the future, once the bandwidth of the Internet connections is sufficient.

  5. Atmospheric Residence Times of Continental Aerosols.

    Science.gov (United States)

    Balkanski, Yves Jacques

    The global atmospheric distributions of ^{222}Rn and ^{210 }Pb are simulated with a three-dimensional model of atmospheric transport based on the meteorology of the NASA GISS^1>=neral circulation model. The short-lived radioactive gas ^ {222}Rn (half-life = 3.8d) is emitted almost exclusively from land, at a relatively uniform rate; hence it is an excellent tracer of continental influences. Lead -210 is produced by decay of ^{222} Rn and immediately condenses to preexisting aerosol surfaces. It provides an excellent measure of aerosol residence times in the atmosphere because its source is accurately defined by the ^{222} Rn distribution. Results from the three-dimensional model are compared to measurements of ^ {222}Rn and ^{210 }Pb atmospheric concentrations to evaluate model's long-range transport over oceanic regions and to study the deposition mechanisms of atmospheric aerosols. Model results for ^{222} Rn are used to examine the long-range transport of continental air over two selected oceanic regions, the subantartic Indian Ocean and the North Pacific. It is shown that fast transport of air from southern Africa causes substantial continental pollution at southern mid-latitudes, a region usually regarded as pristine. Air over the North Pacific is heavily impacted by continental influences year round, but the altitude at which the transport occurs varies seasonally. Observations of aerosols at island sites, which are commonly used as diagnostics of continental influences, may be misleading because they do not account for influences at high altitude and because aerosols are efficiently scavenged by deposition during transport. The study of ^{210}Pb focuses on defining the residence times of submicron aerosols in the troposphere. Scavenging in wet convective updrafts is found to provide the dominant sink on a global scale. The globally averaged residence time for ^{210 }Pb-containing aerosols in the troposphere is 7 days. The average increase in residence time

  6. Direct conversion of fusion energy

    International Nuclear Information System (INIS)

    Johansson, Markus

    2003-03-01

    Deuterium and tritium are expected to be used as fuel in the first fusion reactors. Energy is released as kinetic energy of ions and neutrons, when deuterium reacts with tritium. One way to convert the kinetic energy to electrical energy, is to let the ions and neutrons hit the reactor wall and convert the heat that is caused by the particle bombardment to electrical energy with ordinary thermal conversion. If the kinetic energy of the ions instead is converted directly to electrical energy, a higher efficiency of the energy conversion is possible. The majority of the fusion energy is released as kinetic energy of neutrons, when deuterium reacts with tritium. Fusion reactions such as the D-D reactions, the D- 3 He reaction and the p- 11 B reaction, where a larger part of the fusion energy becomes kinetic energy of charged particles, appears therefore more suitable for direct conversion. Since they have lower reactivity than the D-T reaction, they need a larger βB 2 0 to give sufficiently high fusion power density. Because of this, the fusion configurations spherical torus (ST) and field-reversed configuration (FRC), where high β values are possible, appear interesting. Rosenbluth and Hinton come to the conclusion that efficient direct conversion isn't possible in closed field line systems and that open geometries, which facilitate direct conversion, provide inadequate confinement for D- 3 He. It is confirmed in this study that it doesn't seem possible to achieve as high direct conversion efficiency in closed systems as in open systems. ST and FRC fusion power plants that utilize direct conversion seem however interesting. Calculations with the help of Maple indicate that the reactor parameters needed for a D-D ST and a D 3 He ST hopefully are possible to achieve. The best energy conversion option for a D-D or D 3 He ST appears to be direct electrodynamic conversion (DEC) together with ordinary thermal conversion or liquid metal MHD conversion (LMMHD). For a D

  7. Conversion of Abbandoned Military Areas

    Directory of Open Access Journals (Sweden)

    Daiva Marcinkevičiūtė

    2011-03-01

    Full Text Available The article analyses the situation of abandoned military sites, their value and significance of their conservation. It also reviews their impact on their environment and their potential in tourism, environmental, economic and social spheres. Further the positive experiences in military sites' conversion are studied. The importance of society's involvement in the conversions is discussed. The situation of XIX-XX age's military object's, the significance of their conservation and their potential in tourism market is separately analysed. The results of two researches are introduced, one of which inquires about the Lithuanian military objects' potential in tourism sphere, another one explores the possibilities of conversion. Article in Lithuanian

  8. Direct conversion of fusion energy

    Energy Technology Data Exchange (ETDEWEB)

    Johansson, Markus

    2003-03-01

    Deuterium and tritium are expected to be used as fuel in the first fusion reactors. Energy is released as kinetic energy of ions and neutrons, when deuterium reacts with tritium. One way to convert the kinetic energy to electrical energy, is to let the ions and neutrons hit the reactor wall and convert the heat that is caused by the particle bombardment to electrical energy with ordinary thermal conversion. If the kinetic energy of the ions instead is converted directly to electrical energy, a higher efficiency of the energy conversion is possible. The majority of the fusion energy is released as kinetic energy of neutrons, when deuterium reacts with tritium. Fusion reactions such as the D-D reactions, the D-{sup 3}He reaction and the p-{sup 11}B reaction, where a larger part of the fusion energy becomes kinetic energy of charged particles, appears therefore more suitable for direct conversion. Since they have lower reactivity than the D-T reaction, they need a larger {beta}B{sup 2}{sub 0} to give sufficiently high fusion power density. Because of this, the fusion configurations spherical torus (ST) and field-reversed configuration (FRC), where high {beta} values are possible, appear interesting. Rosenbluth and Hinton come to the conclusion that efficient direct conversion isn't possible in closed field line systems and that open geometries, which facilitate direct conversion, provide inadequate confinement for D-{sup 3}He. It is confirmed in this study that it doesn't seem possible to achieve as high direct conversion efficiency in closed systems as in open systems. ST and FRC fusion power plants that utilize direct conversion seem however interesting. Calculations with the help of Maple indicate that the reactor parameters needed for a D-D ST and a D{sub 3} He ST hopefully are possible to achieve. The best energy conversion option for a D-D or D{sub 3} He ST appears to be direct electrodynamic conversion (DEC) together with ordinary thermal conversion

  9. Learning Through Experience: Influence of Formal and Informal Training on Medical Error Disclosure Skills in Residents.

    Science.gov (United States)

    Wong, Brian M; Coffey, Maitreya; Nousiainen, Markku T; Brydges, Ryan; McDonald-Blumer, Heather; Atkinson, Adelle; Levinson, Wendy; Stroud, Lynfa

    2017-02-01

    Residents' attitudes toward error disclosure have improved over time. It is unclear whether this has been accompanied by improvements in disclosure skills. To measure the disclosure skills of internal medicine (IM), paediatrics, and orthopaedic surgery residents, and to explore resident perceptions of formal versus informal training in preparing them for disclosure in real-world practice. We assessed residents' error disclosure skills using a structured role play with a standardized patient in 2012-2013. We compared disclosure skills across programs using analysis of variance. We conducted a multiple linear regression, including data from a historical cohort of IM residents from 2005, to investigate the influence of predictor variables on performance: training program, cohort year, and prior disclosure training and experience. We conducted a qualitative descriptive analysis of data from semistructured interviews with residents to explore resident perceptions of formal versus informal disclosure training. In a comparison of disclosure skills for 49 residents, there was no difference in overall performance across specialties (4.1 to 4.4 of 5, P  = .19). In regression analysis, only the current cohort was significantly associated with skill: current residents performed better than a historical cohort of 42 IM residents ( P  formal (workshops, morbidity and mortality rounds) and informal (role modeling, debriefing) activities in preparation for disclosure in real-world practice. Residents across specialties have similar skills in disclosure of errors. Residents identified role modeling and a strong local patient safety culture as key facilitators for disclosure.

  10. How Prospective Physical Medicine and Rehabilitation Trainees Rank Residency Training Programs.

    Science.gov (United States)

    Auriemma, Michael J; Whitehair, Curtis L

    2018-03-01

    Since the inception of the National Resident Matching Program, multiple studies have investigated the factors applicants consider important to ranking prospective residency programs. However, only 2 previous studies focused on prospective physical medicine and rehabilitation (PM&R) trainees, and the most recent of these studies was published in 1993. It is unknown whether these previous studies are reflective of current prospective PM&R residents. To assess various factors that contribute to prospective PM&R residents' decision making in choosing a residency program and compare these findings with previous studies. An anonymous, voluntary questionnaire. A single PM&R residency program. All applicants to a single PM&R residency program. All applicants to our PM&R residency program were invited to participate in a 44-item, 5-point Likert-based questionnaire. Applicants were asked to rate the importance of various factors as they related to constructing their residency rank list. Means and standard deviations were calculated for items included in the survey. A response rate of 26% was obtained, with the responses of 98 applicants (20%) ultimately analyzed. The highest rated factors included "perceived happiness of current residents," "opportunities for hands-on procedure training," "perceived camaraderie among current residents," "perceived camaraderie among faculty and current residents," "perceived quality of current residents," and "perceived work/life balance among current residents." Although male and female respondents demonstrated similar ranking preferences, an apparent difference was detected between how genders rated the importance of "whether the program projects a favorable environment for women" and "whether the program projects a favorable environment for minorities." As compared with previous PM&R applicants, current prospective trainees seem to place greater importance on skill acquisition over didactic teaching. Prospective PM&R residents highly value

  11. 5 CFR 317.302 - Conversion procedures.

    Science.gov (United States)

    2010-01-01

    ... conversion. (2) Pay. Upon conversion to the Senior Executive Service, an employee's SES rate will be... 5 Administrative Personnel 1 2010-01-01 2010-01-01 false Conversion procedures. 317.302 Section... IN THE SENIOR EXECUTIVE SERVICE Conversion to the Senior Executive Service § 317.302 Conversion...

  12. Alexithymia in patients with conversion disorder.

    Science.gov (United States)

    Gulpek, Demet; Kelemence Kaplan, Figen; Kesebir, Sermin; Bora, Ozlem

    2014-07-01

    In the recent years, it has been observed that alexithymia is not specified for the psychosomatic disorders. It is known that alexithymia is observed frequently in various psychiatric disorders especially in the somatoform disorders. The aim of this study is to evaluate alexithymia in the patients with the conversion disorder. The study was performed in the Psychiatry Outpatients Clinics of the Izmir Atatürk Training and Research Hospital and Erenköy Psychiatry Education and Research Hospital. A total of 93 cases-47 outpatients who were diagnosed with conversion disorder according to the DSM-IV criteria and 46 age, gender and educational level matched healthy controls-were included in the study. All the cases were assessed by a Structured Clinical Interview for DSM-IV and were evaluated with a questionnaire (which included demographics and clinical data), the Toronto Alexithymia Scale and the Somatosensory Amplification Scale. When the two groups were compared, the Toronto Alexithymia Scale scores (except "externally oriented thinking" subscale) and the Somatosensory Amplification Scale score of the conversion disorder group were statistically significantly higher than the control group. The number of the alexithymic cases of the patient group was significantly higher than the control group's. The level of alexithymia in conversion disorder patients, without any other psychiatric disorder, is higher than that of the healthy controls. During the evaluation of the psychological state of patients with conversion disorder, it could be useful to keep in mind the probability of them having alexithymia to determine the type of suitable therapy.

  13. The physical environment influences neuropsychiatric symptoms and other outcomes in assisted living residents.

    Science.gov (United States)

    Bicket, Mark C; Samus, Quincy M; McNabney, Mathew; Onyike, Chiadi U; Mayer, Lawrence S; Brandt, Jason; Rabins, Peter; Lyketsos, Constantine; Rosenblatt, Adam

    2010-10-01

    Although the number of elderly residents living in assisted living (AL) facilities is rising, few studies have examined the AL physical environment and its impact on resident well-being. We sought to quantify the relationship of AL physical environment with resident outcomes including neuropsychiatric symptoms (NPS), quality of life (QOL), and fall risk, and to compare the effects for demented and non-demented residents. Prospective cohort study of a stratified random sample of 326 AL residents living in 21 AL facilities. Measures included the Therapeutic Environmental Screening Scale for Nursing Homes and Residential Care (TESS-NH/RC) to rate facilities and in-person assessment of residents for diagnosis (and assessment of treatment) of dementia, ratings on standardized clinical, cognitive, and QOL measures. Regression models compared environmental measures with outcomes. TESS-NH/RC is modified into a scale for rating the AL physical environment AL-EQS. The AL Environmental Quality Score (AL-EQS) was strongly negatively associated with Neuropsychiatric Inventory (NPI) total score (p environment of AL facilities likely affects NPS and QOL in AL residents, and the effect may be stronger for residents without dementia than for residents with dementia. Environmental manipulations that increase resident privacy, as well as implementing call buttons and telephones, may improve resident well-being. Copyright © 2010 John Wiley & Sons, Ltd.

  14. Space use and habitat selection of migrant and resident American Avocets in San Francisco Bay

    Science.gov (United States)

    Demers, Scott A.; Takekawa, John Y.; Ackerman, Joshua T.; Warnock, N.; Athearn, N.D.

    2010-01-01

    San Francisco Bay is a wintering area for shorebirds, including American Avocets (Recurvirostra americana). Recently, a new resident population of avocets has emerged, presumably because of the development of tidal marshes into salt-evaporation ponds. In habitat restoration now underway, as many as 90% of salt ponds will be restored to tidal marsh. However, it is unknown if wintering and resident avocets coexist and if their requirements for space and habitat differ, necessitating different management for their populations to be maintained during restoration. We captured and radio-marked wintering avocets at a salt pond and a tidal flat to determine their population status (migrant or resident) and examine their space use and habitat selection. Of the radio-marked avocets, 79% were migrants and 21% were residents. At the salt pond, residents' fidelity to their location of capture was higher, and residents moved less than did migrants from the same site. Conversely, on the tidal flat, fidelity of residents to their site of capture was lower, and residents' home ranges were larger than those of migrants from the same site. Habitat selection of migrants and residents differed little; however, capture site influenced habitat selection far more than the birds' status as migrants or residents. Our study suggests that individual avocets have high site fidelity while wintering in San Francisco Bay, although the avocet as a species is plastic in its space use and habitat selection. This plasticity may allow wintering migrant and resident avocets to adapt to habitat change in San Francisco Bay. ?? The Cooper Ornithological Society 2010.

  15. Conversational evidence in therapeutic dialogue.

    Science.gov (United States)

    Strong, Tom; Busch, Robbie; Couture, Shari

    2008-07-01

    Family therapists' participation in therapeutic dialogue with clients is typically informed by evidence of how such dialogue is developing. In this article, we propose that conversational evidence, the kind that can be empirically analyzed using discourse analyses, be considered a contribution to widening psychotherapy's evidence base. After some preliminaries about what we mean by conversational evidence, we provide a genealogy of evaluative practice in psychotherapy, and examine qualitative evaluation methods for their theoretical compatibilities with social constructionist approaches to family therapy. We then move on to examine the notion of accomplishment in therapeutic dialogue given how such accomplishments can be evaluated using conversation analysis. We conclude by considering a number of research and pedagogical implications we associate with conversational evidence.

  16. HYDROKINETIC ENERGY CONVERSION SYSTEMS: PROSPECTS ...

    African Journals Online (AJOL)

    eobe

    Hydrokinetic energy conversion systems utilize the kinetic energy of flowing water bodies with little or no head to generate ... generator. ... Its principle of operation is analogous to that of wind ..... Crisis-solar and wind power systems, 2009,.

  17. Conversion electrons in the SDC

    International Nuclear Information System (INIS)

    Wicklund, A.B.

    1991-01-01

    We summarize a preliminary analysis of the rates for conversion electrons in the SDC detector, relative to other interesting sources of prompt electrons. We have used Papageno V3.30, and other available NLO calculations to estimate inclusive rates in the central region (η less than 2.0), and we have cross checked these using CDF data at 1.8 TeV. We have considered three sources of ''isolated'' electrons, namely inclusive W/Z production; top quark (Mt=140); and QCD prompt photon production, followed by conversion in 10% XO. This value approximates the inner silicon detector at SDC. Additional conversions will occur in the outer tracking chamber, but the trigger and track reconstruction efficiency will be lower. We have also considered ''nonisolated'' leptons coming from inclusive bottom production, photon conversions resulting from π 0 ,η production in jets, and high pt hadrons faking electrons

  18. Energy conversion at dipolarization fronts

    Science.gov (United States)

    Khotyaintsev, Yu. V.; Divin, A.; Vaivads, A.; André, M.; Markidis, S.

    2017-02-01

    We use multispacecraft observations by Cluster in the Earth's magnetotail and 3-D particle-in-cell simulations to investigate conversion of electromagnetic energy at the front of a fast plasma jet. We find that the major energy conversion is happening in the Earth (laboratory) frame, where the electromagnetic energy is being transferred from the electromagnetic field to particles. This process operates in a region with size of the order several ion inertial lengths across the jet front, and the primary contribution to E·j is coming from the motional electric field and the ion current. In the frame of the front we find fluctuating energy conversion with localized loads and generators at sub-ion scales which are primarily related to the lower hybrid drift instability excited at the front; however, these provide relatively small net energy conversion.

  19. Ocean energy conversion - A reality

    Digital Repository Service at National Institute of Oceanography (India)

    Sarkar, A.

    -depth analysis of application and achievements of OTEC, tidal energy, impact of astronomical forces on tide, prospects of tidal power plants, wave energy conversion and its mathematical approach for both linear and non-linear waves, economic viability, problems...

  20. Enzymes for improved biomass conversion

    Science.gov (United States)

    Brunecky, Roman; Himmel, Michael E.

    2016-02-02

    Disclosed herein are enzymes and combinations of the enzymes useful for the hydrolysis of cellulose and the conversion of biomass. Methods of degrading cellulose and biomass using enzymes and cocktails of enzymes are also disclosed.

  1. Hydrogen photoproduction by photoelectrochemical conversion

    International Nuclear Information System (INIS)

    Anon.

    1989-01-01

    The water-splitting reaction by photoelectrochemical processes has gained much more attention than any of many reactions proposed for solar generation of energy-rich molecules (fuels). The conversion efficiency of the photosystem is the key factor. The higher the efficiency, the more economically feasible will be the conversion scheme. The conversion efficiency is a function of the semiconductor properties, light intensity, spectral quality, properties of the electrolyte, counterelectrode, cell configuration, etc. The semiconductor parameters include band gap, absorption coefficient and diffusion length. The area and material used for a counterelectrode are important when considering polarization losses in a two-electrode system. Besides, the stability problem is also a very important one to meet the requirement for practical applications. This paper reviews some important issues on photoelectrochemical generation of hydrogen by water splitting. It includes energy conversion efficiency, market assessment and cost goal, state of the technology, and future directions for research

  2. Effective communication during difficult conversations.

    Science.gov (United States)

    Polito, Jacquelyn M

    2013-06-01

    A strong interest and need exist in the workplace today to master the skills of conducting difficult conversations. Theories and strategies abound, yet none seem to have found the magic formula with universal appeal and success. If it is such an uncomfortable skill to master is it better to avoid or initiate such conversations with employees? Best practices and evidence-based management guide us to the decision that quality improvement dictates effective communication, even when difficult. This brief paper will offer some suggestions for strategies to manage difficult conversations with employees. Mastering the skills of conducting difficult conversations is clearly important to keeping lines of communication open and productive. Successful communication skills may actually help to avert confrontation through employee engagement, commitment and appropriate corresponding behavior

  3. Electron spectrometers with internal conversion

    International Nuclear Information System (INIS)

    Suita, J.C.; Lemos Junior, O.F.; Auler, L.T.; Silva, A.G. da

    1981-01-01

    The efforts that the Department of Physics (DEFI) of Institute of Nuclear Engineering (IEN) are being made aiming at adjusting the electron spectrometers with internal conversion to its necessity, are shown. (E.G.) [pt

  4. A Conversation Well Worth Remembering

    Science.gov (United States)

    Woolven-Allen, John

    2009-01-01

    To mark the 200th anniversary of Charles Darwin's birth, a special event was held at Oxford, which included a "Conversation" between Professor Richard Dawkins and Bishop Richard Harries. Here we present a personal reminiscence of the event.

  5. Kinetic modeling of ethane pyrolysis at high conversion.

    Science.gov (United States)

    Xu, Chen; Al Shoaibi, Ahmed Sultan; Wang, Chenguang; Carstensen, Hans-Heinrich; Dean, Anthony M

    2011-09-29

    The primary objective of this study is to develop an improved first-principle-based mechanism that describes the molecular weight growth kinetics observed during ethane pyrolysis. A proper characterization of the kinetics of ethane pyrolysis is a prerequisite for any analysis of hydrocarbon pyrolysis and oxidation. Flow reactor experiments were performed with ~50/50 ethane/nitrogen mixtures with temperatures ranging from 550 to 850 °C at an absolute pressure of ~0.8 atm and a residence time of ~5 s. These conditions result in ethane conversions ranging from virtually no reaction to ~90%. Comparisons of predictions using our original mechanism to these data yielded very satisfactory results in terms of the temperature dependence of ethane conversion and prediction of the major products ethylene and hydrogen. However, there were discrepancies in some of the minor species concentrations that are involved in the molecular weight growth kinetics. We performed a series of CBS-QB3 analyses for the C(3)H(7), C(4)H(7), and C(4)H(9) potential energy surfaces to better characterize the radical addition reactions that lead to molecular weight growth. We also extended a published C(6)H(9) PES to include addition of vinyl to butadiene. The results were then used to calculate pressure-dependent rate constants for the multiple reaction pathways of these addition reactions. Inclusion of the unadjusted rate constants resulting from these analyses in the mechanism significantly improved the description of several of the species involved in molecular weight growth kinetics. We compare the predictions of this improved model to those obtained with a consensus model recently published as well as to ethane steam cracking data. We find that a particularly important reaction is that of vinyl addition to butadiene. Another important observation is that several radical addition reactions are partially equilibrated. Not only does this mean that reliable thermodynamic parameters are essential

  6. Computer code conversion using HISTORIAN

    International Nuclear Information System (INIS)

    Matsumoto, Kiyoshi; Kumakura, Toshimasa.

    1990-09-01

    When a computer program written for a computer A is converted for a computer B, in general, the A version source program is rewritten for B version. However, in this way of program conversion, the following inconvenient problems arise. 1) The original statements to be rewritten for B version are lost. 2) If the original statements of the A version rewritten for B version would remain as comment lines, the B version source program becomes quite large. 3) When update directives of the program are mailed from the organization which developed the program or when some modifications are needed for the program, it is difficult to point out the part to be updated or modified in the B version source program. To solve these problems, the conversion method using the general-purpose software management aid system, HISTORIAN, has been introduced. This conversion method makes a large computer code a easy-to-use program for use to update, modify or improve after the conversion. This report describes the planning and procedures of the conversion method and the MELPROG-PWR/MOD1 code conversion from the CRAY version to the JAERI FACOM version as an example. This report would provide useful information for those who develop or introduce large programs. (author)

  7. Frequency conversion of structured light.

    Science.gov (United States)

    Steinlechner, Fabian; Hermosa, Nathaniel; Pruneri, Valerio; Torres, Juan P

    2016-02-15

    Coherent frequency conversion of structured light, i.e. the ability to manipulate the carrier frequency of a wave front without distorting its spatial phase and intensity profile, provides the opportunity for numerous novel applications in photonic technology and fundamental science. In particular, frequency conversion of spatial modes carrying orbital angular momentum can be exploited in sub-wavelength resolution nano-optics and coherent imaging at a wavelength different from that used to illuminate an object. Moreover, coherent frequency conversion will be crucial for interfacing information stored in the high-dimensional spatial structure of single and entangled photons with various constituents of quantum networks. In this work, we demonstrate frequency conversion of structured light from the near infrared (803 nm) to the visible (527 nm). The conversion scheme is based on sum-frequency generation in a periodically poled lithium niobate crystal pumped with a 1540-nm Gaussian beam. We observe frequency-converted fields that exhibit a high degree of similarity with the input field and verify the coherence of the frequency-conversion process via mode projection measurements with a phase mask and a single-mode fiber. Our results demonstrate the suitability of exploiting the technique for applications in quantum information processing and coherent imaging.

  8. Conversion factors and oil statistics

    International Nuclear Information System (INIS)

    Karbuz, Sohbet

    2004-01-01

    World oil statistics, in scope and accuracy, are often far from perfect. They can easily lead to misguided conclusions regarding the state of market fundamentals. Without proper attention directed at statistic caveats, the ensuing interpretation of oil market data opens the door to unnecessary volatility, and can distort perception of market fundamentals. Among the numerous caveats associated with the compilation of oil statistics, conversion factors, used to produce aggregated data, play a significant role. Interestingly enough, little attention is paid to conversion factors, i.e. to the relation between different units of measurement for oil. Additionally, the underlying information regarding the choice of a specific factor when trying to produce measurements of aggregated data remains scant. The aim of this paper is to shed some light on the impact of conversion factors for two commonly encountered issues, mass to volume equivalencies (barrels to tonnes) and for broad energy measures encountered in world oil statistics. This paper will seek to demonstrate how inappropriate and misused conversion factors can yield wildly varying results and ultimately distort oil statistics. Examples will show that while discrepancies in commonly used conversion factors may seem trivial, their impact on the assessment of a world oil balance is far from negligible. A unified and harmonised convention for conversion factors is necessary to achieve accurate comparisons and aggregate oil statistics for the benefit of both end-users and policy makers

  9. Resident and program director gender distribution by specialty.

    Science.gov (United States)

    Long, Timothy R; Elliott, Beth A; Warner, Mary Ellen; Brown, Michael J; Rose, Steven H

    2011-12-01

    Although enrollment of women in U.S. medical schools has increased, women remain less likely to achieve senior academic rank, lead academic departments, or be appointed to national leadership positions. The purpose of this paper is to compare the gender distribution of residency program directors (PDs) with residents and faculty in the 10 largest specialties. The gender distribution of residents training in the 10 specialties with the largest enrollment was obtained from the annual education issue of Journal of the American Medical Association. The gender distribution of the residents was compared with the gender distribution of PDs and medical school faculty. The number of programs and the names of the PDs were identified by accessing the Accreditation Council for Graduate Medical Education web site. Gender was confirmed through electronic search of state medical board data, program web sites, or by using internet search engines. The gender distribution of medical school faculty was determined using the Association of American Medical Colleges faculty roster database (accessed June 15, 2011). The correlation between female residents and PDs was assessed using Pearson's product-moment correlation. The gender distribution of female PDs appointed June 1, 2006, through June 1, 2010, was compared with the distribution appointed before June 1, 2006, using chi square analysis. Specialties with higher percentages of female PDs had a higher percentage of female residents enrolled (r=0.81, p=0.005). The number of female PDs appointed from July 1, 2006, through June 30, 2010, was greater than the number appointed before July 1, 2006, in emergency medicine (pWomen remain underrepresented in PD appointments relative to the proportion of female medical school faculty and female residents. Mechanisms to address gender-based barriers to advancement should be considered.

  10. Diversity in Dermatology Residency Programs.

    Science.gov (United States)

    Van Voorhees, Abby S; Enos, Clinton W

    2017-10-01

    Given the change in our population to one that is more racially and ethnically diverse, the topic of diversity in dermatology residency programs has gained attention. In a field that has become highly competitive, diversity is lagging behind. What are the reasons for this? The existing diversity among medical school matriculants is reflective of the applicant pool, and although modest, there has been an increase in applications and acceptances from minority populations. However, these proportions do not carry through to the population applying to dermatology residency. Making sense of this and planning how to recruit a more diverse applicant pool will improve the quality and cultural competency of future dermatologists. Copyright © 2017 The Authors. Published by Elsevier Inc. All rights reserved.

  11. Redesigning journal club in residency.

    Science.gov (United States)

    Al Achkar, Morhaf

    2016-01-01

    The gap between production and implementation of knowledge is the main reason for the suboptimal quality of health care. To eliminate this gap and improve the quality of patient care, journal club (JC) in graduate medical education provides an opportunity for learning the skills of evidence-based medicine. JC, however, continues to face many challenges mainly due to poorly defined goals, inadequate preparation, and lack of interest. This article presents an innovative model to prepare and present JC based on three pillars: dialogical learning through group discussion, mentored residents as peer teachers, and including JC as part of a structured curriculum to learn evidence-based medicine. This engaging model has the potential to transform JC from a moribund session that is daunting for residents into a lively discussion to redefine clinical practice using the most current evidence.

  12. Variability of Arthroscopy Case Volume in Orthopaedic Surgery Residency.

    Science.gov (United States)

    Gil, Joseph A; Waryasz, Gregory R; Owens, Brett D; Daniels, Alan H

    2016-05-01

    To examine orthopaedic surgery case logs for arthroscopy case volume during residency training and to evaluate trends in case volume and variability over time. Publicly available Accreditation Council for Graduate Medical Education surgical case logs from 2007 to 2013 for orthopaedic surgery residency were assessed for variability and case volume trends in shoulder, elbow, wrist, hip, knee, and ankle arthroscopy. The national average number of procedures performed in each arthroscopy category reported was directly compared from 2009 to 2013. The 10th and 90th percentile arthroscopy case volume was compared between 2007 and 2013 for shoulder and knee arthroscopy procedures. Subsequently, the difference between the 10th and 90th percentile arthroscopy case volume in each category in 2007 was compared with the difference between the 10th and 90th percentile arthroscopy case volume in each category in 2013. From 2007 to 2013, shoulder arthroscopy procedures performed per resident increased by 43.1% (P = .0001); elbow arthroscopy procedures increased by 28.0% (P = .00612); wrist arthroscopy procedures increased by 8.6% (P = .05); hip arthroscopy procedures, which were first reported in 2012, increased by 588.9%; knee arthroscopy procedures increased by 8.5% (P = .0435); ankle arthroscopy increased by 27.6% (P = .00149). The difference in knee and shoulder arthroscopy volume between residents in the 10th and 90th percentile in 2007 and residents in the 10th and 90th percentile in 2013 was not significant (P > .05). There was a 3.66-fold difference in knee arthroscopy volume between residents in the 10th and 90th percentile in 2007, whereas the difference was 3.36-fold in 2013 (P = .70). There was a 5.86-fold difference in shoulder arthroscopy case volume between residents in the 10th and 90th percentile in 2007, whereas the difference was 4.96-fold in 2013 (P = .29). The volume of arthroscopy cases performed by graduating orthopaedic surgery residents has

  13. Perspective of ophthalmology residents in the United States about residency programs and competency in relation to the International Council of Ophthalmology guidelines.

    Science.gov (United States)

    Abdelfattah, Nizar Saleh; Radwan, Ahmed E; Sadda, Srinivas R

    2016-09-01

    To evaluate the perspective of ophthalmology residents in the US about their residency programs and compare the competency of residency programs to international competency levels set by the International Council of Ophthalmology (ICO). A cross-sectional web-based survey extracted from the ICO published competency standards was sent to program directors of ophthalmology residency programs in the US to forward it to current PGY-3, 4 residents, and residency graduates from 2011 to 2014. Eighty-seven responses were received, comprising 61 residents and 26 graduates. Most respondents were highly satisfied with their programs (93.6%). Clinic-based training was rated satisfactorily. Insufficient exposure to low-vision rehabilitation (38.5%), refraction and contact lenses prescription (38.5%), and vitreo-retinal surgeries (38.5%) was reported. Respondents were satisfied with their overall surgical experiences, with the vast majority (>83%) rating case volume, complexity, and variety as satisfactory or better. A significant group stated they had insufficient exposure to extra-capsular cataract extraction (26.3%), refractive surgery (19.7%), and orbital surgery (64.5%). All graduates surveyed passed their Ophthalmic Knowledge Assessment Program (OKAP) examinations, and 72% felt their residency programs adequately prepared them for the examinations. All respondents reported insufficient training in certain nonclinical areas, such as practice management, staffing, and administration skills. Ophthalmology residents in the US express high levels of satisfaction with their residency training programs. While most programs adequately address most ICO core objectives, certain curriculum modifications should be considered.

  14. Economic and socio-cultural impacts of Mainland Chinese tourists on Hong Kong residents

    Directory of Open Access Journals (Sweden)

    Manisa Piuchan

    2018-01-01

    Full Text Available The aim of this study was to investigate the economic and socio-cultural impacts from the burgeoning mainland Chinese tourists on Hong Kong residents. Ten individual, semi-structured interviews were conducted to collect Hong Kong residents' views. Content analysis was employed to analyze the data. The results showed that the socio-cultural aspects were reported negatively with regard to culture, shopping and dining, and transportation but conversely, it had a positive impact on education and infrastructure. The economic aspect showed that residents accepted and appreciated the economic benefits brought by the inflow of mainland Chinese tourists. The Hong Kong government should consider these impacts, and then provide better solutions for residents' lives and plans to cope with the upcoming scenario which might arise regarding Hong Kong's economic boom and more tourists traveling to Hong Kong. Recommendations are also suggested in this study for further development. Keywords: Chinese tourists, economic impacts, socio-cultural impacts, tourism impacts

  15. Residents' Perspectives on Careers in Academic Medicine: Obstacles and Opportunities.

    Science.gov (United States)

    Lin, Steven; Nguyen, Cathina; Walters, Emily; Gordon, Paul

    2018-03-01

    Worsening faculty shortages in medical schools and residency programs are threatening the US medical education infrastructure. Little is known about the factors that influence the decision of family medicine residents to choose or not choose academic careers. Our study objective was to answer the following question among family medicine residents: "What is your greatest concern or fear about pursuing a career in academic family medicine?" Participants were family medicine residents who attended the Faculty for Tomorrow Workshop at the Society of Teachers of Family Medicine Annual Spring Conference in 2016 and 2017. Free responses to the aforementioned prompt were analyzed using a constant comparative method and grounded theory approach. A total of 156 participants registered for the workshops and 95 (61%) answered the free response question. Eight distinct themes emerged from the analysis. The most frequently recurring theme was "lack of readiness or mentorship," which accounted for nearly one-third (31%) of the codes. Other themes included work-life balance and burnout (17%), job availability and logistics (15%), lack of autonomy or flexibility (11%), competing pressures/roles (10%), lower financial rewards (4%), politics and bureaucracy (4%), and research (3%). To our knowledge, this is the first study to identify barriers and disincentives to pursuing a career in academic medicine from the perspective of family medicine residents. There may be at least eight major obstacles, for which we summarize and consider potential interventions. More research is needed to understand why residents choose, or don't choose, academic careers.

  16. Trends in violence education in family medicine residency curricula.

    Science.gov (United States)

    Cronholm, Peter F; Singh, Vijay; Fogarty, Colleen T; Ambuel, Bruce

    2014-09-01

    Violence is a significant public health issue with far-reaching implications for the health of individuals and their communities. Our objective was to describe trends in violence-related training in family medicine residency programs since the last national survey was conducted in 1997. Surveys were sent to 337 US family medicine residency programs with the program director having active Society of Teachers of Family Medicine (STFM) membership. Measures included residency setting and characteristics, violence-related curricular content, teaching techniques and personnel, timing of content, and impact of changes in Residency Review Committee (RRC) and Accreditation Council for Graduate Medical Education (ACGME) requirements. Descriptive statistics and bivariate analyses comparing measures across time were used. A total of 201 (60%) surveys were completed. The most common violence curricula was child (83%) and elder abuse (76%), and the most common teachers of violence-related content were family physicians, psychologists, and social workers. The most common teaching methods were clinical precepting (94%), lectures (90%), case vignettes (71%), and intimate partner violence (IPV) shelter experiences (67%). ACGME and RRC changes were not reflected in self-reported measures of curricular emphasis or time. Violence curricular content and number of hours has been constant in family medicine residencies over time. An increase in the reported use of active learning strategies was identified as a trend across surveys. Next steps for violence curricula involve assessment of residents' competency to identify and intervene in violence.

  17. Hospitalist career decisions among internal medicine residents.

    Science.gov (United States)

    Ratelle, John T; Dupras, Denise M; Alguire, Patrick; Masters, Philip; Weissman, Arlene; West, Colin P

    2014-07-01

    Hospital medicine is a rapidly growing field of internal medicine. However, little is known about internal medicine residents' decisions to pursue careers in hospital medicine (HM). To identify which internal medicine residents choose a career in HM, and describe changes in this career choice over the course of their residency education. Observational cohort using data collected from the annual Internal Medicine In-Training Examination (IM-ITE) survey. 16,781 postgraduate year 3 (PGY-3) North American internal medicine residents who completed the annual IM-ITE survey in 2009-2011, 9,501 of whom completed the survey in all 3 years of residency. Self-reported career plans for individual residents during their postgraduate year 1 (PGY-1), postgraduate year 2 (PGY-2) and PGY-3. Of the 16,781 graduating PGY-3 residents, 1,552 (9.3 %) reported HM as their ultimate career choice. Of the 951 PGY-3 residents planning a HM career among the 9,501 residents responding in all 3 years, 128 (13.5 %) originally made this decision in PGY-1, 192 (20.2 %) in PGY-2, and 631 (66.4 %) in PGY-3. Only 87 (9.1 %) of these 951 residents maintained a career decision of HM during all three years of residency education. Hospital medicine is a reported career choice for an important proportion of graduating internal medicine residents. However, the majority of residents do not finalize this decision until their final year.

  18. Performance of Bedside Lung Ultrasound by a Pediatric Resident

    DEFF Research Database (Denmark)

    Zhan, Chen; Grundtvig, Natalia; Klug, Bent Helmuth

    2017-01-01

    OBJECTIVES: Recent studies suggest that lung ultrasound is a good, radiation-free alternative to chest radiography in children with pneumonia. We investigated how bedside lung ultrasound performed by a pediatric resident compared with chest radiography in children with suspected pneumonia. METHODS......: This was a prospective study comparing bedside lung ultrasound to chest radiography as the reference standard. Children aged 0 to 15 years with suspected pneumonia at a pediatric emergency department were included and underwent chest radiography and lung ultrasound. A pediatric resident with minimal practical ultrasound...

  19. The management and conversion of light

    DEFF Research Database (Denmark)

    Jensen, Jacob

    methods. A key challenge in device fabrication is the development of a suitable electrolyte system, and two electrolyte systems are compared in fully printable and laminated devices on flexible substrates. Devices of various sizes are presented and the transmission contrast, when switched between...... the fully bleached and fully colored state, are found to be 43 % at Absmax with a response time of less than 10 seconds. To show possible applications, an electrochromic display powered by a printed organic photovoltaic device are demonstrated, that can switch between the two redox states during solar......; carbon dioxide reduction and water splitting. Practical solutions are presented, and the use of flexible substrates as carrier foils is explored. A key challenge in these conversion systems is the necessary precautions that must be taken when evaluating conversion and this is most convincingly done...

  20. Energy conversion in natural and artificial photosynthesis.

    Science.gov (United States)

    McConnell, Iain; Li, Gonghu; Brudvig, Gary W

    2010-05-28

    Modern civilization is dependent upon fossil fuels, a nonrenewable energy source originally provided by the storage of solar energy. Fossil-fuel dependence has severe consequences, including energy security issues and greenhouse gas emissions. The consequences of fossil-fuel dependence could be avoided by fuel-producing artificial systems that mimic natural photosynthesis, directly converting solar energy to fuel. This review describes the three key components of solar energy conversion in photosynthesis: light harvesting, charge separation, and catalysis. These processes are compared in natural and in artificial systems. Such a comparison can assist in understanding the general principles of photosynthesis and in developing working devices, including photoelectrochemical cells, for solar energy conversion. 2010 Elsevier Ltd. All rights reserved.

  1. Air Turbines for Wave Energy Conversion

    Directory of Open Access Journals (Sweden)

    Manabu Takao

    2012-01-01

    Full Text Available This paper describes the present status of the art on air turbines, which could be used for wave energy conversion. The air turbines included in the paper are as follows: Wells type turbines, impulse turbines, radial turbines, cross-flow turbine, and Savonius turbine. The overall performances of the turbines under irregular wave conditions, which typically occur in the sea, have been compared by numerical simulation and sea trial. As a result, under irregular wave conditions it is found that the running and starting characteristics of the impulse type turbines could be superior to those of the Wells turbine. Moreover, as the current challenge on turbine technology, the authors explain a twin-impulse turbine topology for wave energy conversion.

  2. [Medical ethics in residency training].

    Science.gov (United States)

    Civaner, Murat; Sarikaya, Ozlem; Balcioğlu, Harun

    2009-04-01

    Medical ethics education in residency training is one of the hot topics of continuous medical education debates. Its importance and necessity is constantly stressed in declarations and statements on national and international level. Parallel to the major structural changes in the organization and the finance model of health care system, patient-physician relationship, identity of physicianship, social perception and status of profession are changing. Besides, scientific developments and technological advancements create possibilities that never exists before, and bring new ethical dilemmas along with. To be able to transplant human organs has created two major problems for instance; procurement of organs in sufficient numbers, and allocating them to the patients in need by using some prioritizing criteria. All those new and challenging questions force the health care workers to find authentic and justifiable solutions while keeping the basic professional values. In that sense, proper medical ethics education in undergraduate and postgraduate term that would make physician-to-be's and student-physicians acquire the core professional values and skill to notice, analyze and develop justifiable solutions to ethical problems is paramount. This article aims to express the importance of medical ethics education in residency training, and to propose major topics and educational methods to be implemented into. To this aim, first, undergraduate medical education, physician's working conditions, the exam of selection for residency training, and educational environment were revised, and then, some topics and educational methods, which are oriented to educate physicians regarding the professional values that they should have, were proposed.

  3. Redesigning journal club in residency

    Directory of Open Access Journals (Sweden)

    Al Achkar M

    2016-05-01

    Full Text Available Morhaf Al Achkar Department of Family Medicine, Indiana University, Indianapolis, IN, USA Abstract: The gap between production and implementation of knowledge is the main reason for the suboptimal quality of health care. To eliminate this gap and improve the quality of patient care, journal club (JC in graduate medical education provides an opportunity for learning the skills of evidence-based medicine. JC, however, continues to face many challenges mainly due to poorly defined goals, inadequate preparation, and lack of interest. This article presents an innovative model to prepare and present JC based on three pillars: dialogical learning through group discussion, mentored residents as peer teachers, and including JC as part of a structured curriculum to learn evidence-based medicine. This engaging model has the potential to transform JC from a moribund session that is daunting for residents into a lively discussion to redefine clinical practice using the most current evidence. Keywords: journal club, residents, peer teaching, evidence-based medicine, dialogical learning

  4. Assessment of sleep quality in post-graduate residents in a tertiary hospital and teaching institute

    Directory of Open Access Journals (Sweden)

    Vasantmeghna Srinivasa Murthy

    2014-01-01

    Full Text Available Objectives: To evaluate subjective sleep quality, day-time sleepiness, prevalence of substance use, satisfaction with life among residents at our institute. To evaluate association of sleep qualitywith satisfaction with life and day-time sleepiness. To compare the findings between residents in clinical and para-clinical departments. Materials and Methods: Eighty-four residents filled questionnaires to obtain socio-demographic information and use of substance (s. Pittsburgh Sleep Quality Index (PSQI, Epworth Sleepiness Scale (ESS, and Satisfaction With Life scale (SWLS were also used. Association between sleep quality and sleepiness and satisfaction with life was evaluated. From the data collected, comparisons were made between the clinical and para-clinical department residents. Results: A significant number of residents belonging to the clinical faculty were poorsleepers; reported high levels of abnormal day-time sleepiness and less satisfaction with life compared to residents in para-clinical faculties. The differences in correlation between sleepiness and satisfaction with life with sleep quality among the two groups were not found to be significant. A larger percentage of clinical residents reported use of at least one substance during the residency period compared to the para-clinical residents. Conclusions: Poor sleep quality is perceived greatly by the resident doctors in our public hospital, especially among clinical faculties. Interventions are thus necessary in order to ensure adequate sleep among them.

  5. Emergency medicine resident well-being: stress and satisfaction.

    Science.gov (United States)

    Hoonpongsimanont, W; Murphy, M; Kim, C H; Nasir, D; Compton, S

    2014-01-01

    Emergency medicine (EM) residents are exposed to many work-related stressors, which affect them both physically and emotionally. It is unknown, however, how EM residents perceive the effect of these stressors on their well-being and how often they use unhealthy coping mechanisms to manage stress. To evaluate EM residents' perceptions of stressors related to their overall well-being and the prevalence of various coping mechanisms. An online survey instrument was developed to gauge resident stress, satisfaction with current lifestyle, stress coping mechanisms and demographics. A stratified random sample of EM residents from three postgraduate years (PGY-I, PGY-II and PGY-III) was obtained. Descriptive statistics and one-way analysis of variance were used to compare residents across PGY level. There were 120 potential participants in each of the three PGYs. The overall response rate was 30% (109) with mean age of 30 and 61% were male. On a 0-4 scale (0 = completely dissatisfied), respondents in PGY-I reported significantly less satisfaction with lifestyle than those in PGY-II and III (mean rating: 1.29, 1.66 and 1.70, respectively; P stress categories: work relationships (1.37), work environment (1.10) and response to patients (1.08). Residents reported exercise (94%), hobbies (89%) and use of alcohol (71%) as coping methods. Residents reported low satisfaction with current lifestyle. This dissatisfaction was unrelated to perceived work-related stress. Some undesirable coping methods were prevalent, suggesting that training programs could focus on promotion of healthy group activities.

  6. Number needed to eat: pizza and resident conference attendance.

    Science.gov (United States)

    Cosimini, Michael J; Mackintosh, Liza; Chang, Todd P

    2016-12-01

    The didactic conference is a common part of the resident education curriculum. Given the demands of clinical responsibilities and restrictions on duty hours, maximising education is a challenge faced by all residency programmes. To date, little research exists with respect to how the provision of complimentary food affects physician and resident conference attendance. The objective of this study was to determine whether complimentary food improves resident arrival times and attendance at educational conferences and, furthermore, to test whether this provision is a potentially cost-effective tool for improving education. A retrospective review of 36 resident educational Friday noon conferences, including 1043 resident arrivals, was performed. Data were analysed for total attendance, arrival times, number needed to eat (NNE) and the percentage of residents arriving on time, and compared between days on which food was and was not provided. Median attendance was 3.7% higher (p = 0.04) on days on which food was provided, at a cost of US$46 for each additional resident in attendance. Arrival times were also statistically significantly improved when food was provided, with a median improvement of 0.7 minutes (p = 0.02) and an 11.0% increase in on-time arrivals (p < 0.001). The NNE was 10.6. Complimentary food improves both attendance and arrival times by a small, but statistically significant, degree. The provision of complimentary food can be considered as an incentive for attendance and on-time arrival at didactic educational sessions, although more cost-effective modalities may exist. © 2016 John Wiley & Sons Ltd and The Association for the Study of Medical Education.

  7. Information for Consumers about Alternative Fuel Conversions

    Science.gov (United States)

    Here are some factors to be aware of if you are considering fuel conversion, including background information on fuel conversion, instructions for demonstrating compliance, and other related information.

  8. Lawful Permanent Residents Fiscal Year 2014 Country

    Data.gov (United States)

    Department of Homeland Security — Lawful permanent residents (LPRs) are foreign nationals who have been granted the right to reside permanently in the United States. LPRs are also known as 'permanent...

  9. Lawful Permanent Residents Fiscal Year 2011 State

    Data.gov (United States)

    Department of Homeland Security — Lawful permanent residents (LPRs) are foreign nationals who have been granted the right to reside permanently in the United States. LPRs are also known as 'permanent...

  10. Lawful Permanent Residents Fiscal Year 2015 Country

    Data.gov (United States)

    Department of Homeland Security — Lawful permanent residents (LPRs) are foreign nationals who have been granted the right to reside permanently in the United States. LPRs are also known as 'permanent...

  11. Lawful Permanent Residents Fiscal Year 2011 Country

    Data.gov (United States)

    Department of Homeland Security — Lawful permanet residents (LPRs) are foreign nationals who have been gratned the right to reside permanently in the United States. LPRs are also known as 'permanent...

  12. Lawful Permanent Residents Fiscal Year 2016 State

    Data.gov (United States)

    Department of Homeland Security — Lawful permanent residents (LPRs) are foreign nationals who have been granted the right to reside permanently in the United States. LPRs are also known as 'permanent...

  13. Lawful Permanent Residents Fiscal Year 2014 State

    Data.gov (United States)

    Department of Homeland Security — Lawful permanent residents (LPRs) are foreign nationals who have been granted the right to reside permanently in the United States. LPRs are also known as 'permanent...

  14. Lawful Permanent Residents Fiscal Year 2015 State

    Data.gov (United States)

    Department of Homeland Security — Lawful permanent residents (LPRs) are foreign nationals who have been granted the right to reside permanently in the United States. LPRs are also known as 'permanent...

  15. The diagnosis of depression and use of antidepressants in nursing home residents with and without dementia.

    Science.gov (United States)

    van Asch, Iris F M; Nuyen, Jasper; Veerbeek, Marjolein A; Frijters, Dinnus H M; Achterberg, Wilco P; Pot, Anne Margriet

    2013-03-01

    To compare the prevalence of diagnosed depressive disorders, depressive symptoms and use of antidepressant medication between nursing home residents with and without dementia. This cross-sectional study used Minimal Data Set of the Resident Assessment Instrument 2.1 data collected in seven nursing homes located in an urbanized region in the Netherlands. Trained nurse assistants recorded all medical diagnoses made by a medical specialist, including dementia and depressive disorder, and medication use. Depressive symptoms were measured with the Depression Rating Scale. Multivariate logistic regression analysis was used to compare data between residents with and without dementia. Included in the study were 1885 nursing home residents (aged 65 years or older), of which 837 had dementia. There was no significant difference in the prevalence of diagnosed depressive disorder between residents with (9.6%) and without dementia (9.8%). Residents with dementia (46.4%) had more depressive symptoms than residents without dementia (22.6%). Among those with depressive symptoms, residents with dementia had the same likelihood of being diagnosed with a depressive disorder as residents without dementia. Among residents with a diagnosed depressive disorder, antidepressant use did not differ significantly between residents with dementia (58.8%) and without dementia (57.3%). The same holds true for residents with depressive symptoms, where antidepressant use was 25.3% in residents with dementia and 24.6% in residents without dementia. Regarding the prevalence rates of diagnosed depressive disorder and antidepressant use found in this study, our findings demonstrate that there is room for improvement not only for the detection of depression but also with regard to its treatment. Copyright © 2012 John Wiley & Sons, Ltd.

  16. The association of departmental leadership gender with that of faculty and residents in radiology.

    Science.gov (United States)

    Shah, Anand; Braga, Larissa; Braga-Baiak, Andresa; Jacobs, Danny O; Pietrobon, Ricardo

    2007-08-01

    Although the number of women graduating from medical school continues to increase, their representation in radiology residency programs has not increased over the past 10 years. We examined whether the gender of radiology faculty and residents differed according to the gender of the departmental leadership. We issued an anonymous Web-based survey via e-mail to all 188 radiology residency program directors listed in the Fellowship and Residency Electronic Interactive Database (FREIDA Online). Data regarding the gender of the department chairperson, residency program director, faculty, and residents were collected. The institutional review board granted a waiver for this study, and all subjects provided informed consent. Of the 84 program directors who responded, 9 (10.7%) were chaired by females and 75 (89.3%) by males; residency program director positions were held by 36 (42.9%) females and 48 (57.1%) males. More programs were located in the northeastern United States (n = 31, 36.9%) than in any other region, and more were self-described as academic (n = 36, 42.9%) than any other practice type. Programs that were led by a male chairperson had a similar proportion of female faculty (25.2% versus 27.3%; P = .322) and residents (26.2% versus 27.4%; P = .065) compared with those led by a female. Similarly, radiology departments with a male residency program director had a similar proportion of female residents (24.8% versus 28.7%; P = .055) compared with programs with a female residency program director. The gender composition of radiology faculty and residents does not differ significantly according to the gender of the departmental chairperson or residency program director. Nevertheless, there continues to be a disparity in the representation of women among radiology faculty and residents.

  17. Gallbladder Nonvisualization in Cholecystectomy: A Factor for Conversion.

    Science.gov (United States)

    Slack, Daniel R; Grisby, Shaunda; Dike, Uzoamaka Kimberly; Kohli, Harjeet

    2018-01-01

    Many risk factors have been identified in minimally invasive cholecystectomies that lead to higher complications and conversion rates. No study that we encountered looked at nonvisualization of the gallbladder (GB) during surgery as a risk factor. We hypothesized that nonvisualization was associated with an increased risk of complications and could be an early intraoperative identifier of a higher risk procedure. Recognizing this could allow surgeons to be aware of potential risks and to be more likely to convert to open for the safety of the patient. We looked at minimally invasive cholecystectomies performed at our institution from January 2015 through April 2016 and had the performing resident fill out a survey after the surgery. Outcomes were conversion rates, intraoperative complications, and blood loss and were analyzed via Pearson χ 2 test or Mann-Whitney U test. The primary outcome showed a conversion rate of 37% in nonvisualized GBs versus 0% in visualized ( P = .001). Secondary outcomes showed significant differences in GB perforations (74% vs 13%, P = .001), omental vessel bleeding (16% vs. 0%, P = .005), and EBL (46 mL vs 29 mL, P = .001). Intraoperative nonvisualization of the GB after adequate positioning caused significantly increased risk of intraoperative complications and conversion. This knowledge could be useful during intraoperative assessment, to decide whether a case should be continued as a minimally invasive procedure or converted early to help reduce risk to the patient. Further randomized controlled studies should be performed to further demonstrate the value of this assessment.

  18. Mechanisms of Ectopic Gene Conversion

    Directory of Open Access Journals (Sweden)

    P.J. Hastings

    2010-11-01

    Full Text Available Gene conversion (conversion, the unidirectional transfer of DNA sequence information, occurs as a byproduct of recombinational repair of broken or damaged DNA molecules. Whereas excision repair processes replace damaged DNA by copying the complementary sequence from the undamaged strand of duplex DNA, recombinational mechanisms copy similar sequence, usually in another molecule, to replace the damaged sequence. In mitotic cells the other molecule is usually a sister chromatid, and the repair does not lead to genetic change. Less often a homologous chromosome or homologous sequence in an ectopic position is used. Conversion results from repair in two ways. First, if there was a double-strand gap at the site of a break, homologous sequence will be used as the template for synthesis to fill the gap, thus transferring sequence information in both strands. Second, recombinational repair uses complementary base pairing, and the heteroduplex molecule so formed is a source of conversion, both as heteroduplex and when donor (undamaged template information is retained after correction of mismatched bases in heteroduplex. There are mechanisms that favour the use of sister molecules that must fail before ectopic homology can be used. Meiotic recombination events lead to the formation of crossovers required in meiosis for orderly segregation of pairs of homologous chromosomes. These events result from recombinational repair of programmed double-strand breaks, but in contrast with mitotic recombination, meiotic recombinational events occur predominantly between homologous chromosomes, so that transfer of sequence differences by conversion is very frequent. Transient recombination events that do not form crossovers form both between homologous chromosomes and between regions of ectopic homology, and leave their mark in the occurrence of frequent non-crossover conversion, including ectopic conversion.

  19. Pediatric Integrative Medicine in Residency Program: Relationship between Lifestyle Behaviors and Burnout and Wellbeing Measures in First-Year Residents.

    Science.gov (United States)

    McClafferty, Hilary; Brooks, Audrey J; Chen, Mei-Kuang; Brenner, Michelle; Brown, Melanie; Esparham, Anna; Gerstbacher, Dana; Golianu, Brenda; Mark, John; Weydert, Joy; Yeh, Ann Ming; Maizes, Victoria

    2018-04-23

    It is widely recognized that burnout is prevalent in medical culture and begins early in training. Studies show pediatricians and pediatric trainees experience burnout rates comparable to other specialties. Newly developed Accreditation Council for Graduate Medical Education (ACGME) core competencies in professionalism and personal development recognize the unacceptably high resident burnout rates and present an important opportunity for programs to improve residents experience throughout training. These competencies encourage healthy lifestyle practices and cultivation of self-awareness, self-regulation, empathy, mindfulness, and compassion—a paradigm shift from traditional medical training underpinned by a culture of unrealistic endurance and self-sacrifice. To date, few successful and sustainable programs in resident burnout prevention and wellness promotion have been described. The University of Arizona Center for Integrative Medicine Pediatric Integrative Medicine in Residency (PIMR) curriculum, developed in 2011, was designed in part to help pediatric programs meet new resident wellbeing requirements. The purpose of this paper is to detail levels of lifestyle behaviors, burnout, and wellbeing for the PIMR program’s first-year residents ( N = 203), and to examine the impact of lifestyle behaviors on burnout and wellbeing. The potential of the PIMR to provide interventions addressing gaps in lifestyle behaviors with recognized association to burnout is discussed.

  20. Pediatric Integrative Medicine in Residency Program: Relationship between Lifestyle Behaviors and Burnout and Wellbeing Measures in First-Year Residents

    Directory of Open Access Journals (Sweden)

    Hilary McClafferty

    2018-04-01

    Full Text Available It is widely recognized that burnout is prevalent in medical culture and begins early in training. Studies show pediatricians and pediatric trainees experience burnout rates comparable to other specialties. Newly developed Accreditation Council for Graduate Medical Education (ACGME core competencies in professionalism and personal development recognize the unacceptably high resident burnout rates and present an important opportunity for programs to improve residents experience throughout training. These competencies encourage healthy lifestyle practices and cultivation of self-awareness, self-regulation, empathy, mindfulness, and compassion—a paradigm shift from traditional medical training underpinned by a culture of unrealistic endurance and self-sacrifice. To date, few successful and sustainable programs in resident burnout prevention and wellness promotion have been described. The University of Arizona Center for Integrative Medicine Pediatric Integrative Medicine in Residency (PIMR curriculum, developed in 2011, was designed in part to help pediatric programs meet new resident wellbeing requirements. The purpose of this paper is to detail levels of lifestyle behaviors, burnout, and wellbeing for the PIMR program’s first-year residents (N = 203, and to examine the impact of lifestyle behaviors on burnout and wellbeing. The potential of the PIMR to provide interventions addressing gaps in lifestyle behaviors with recognized association to burnout is discussed.

  1. Systems-Based Aspects in the Training of IMG or Previously Trained Residents: Comparison of Psychiatry Residency Training in the United States, Canada, the United Kingdom, India, and Nigeria

    Science.gov (United States)

    Jain, Gaurav; Mazhar, Mir Nadeem; Uga, Aghaegbulam; Punwani, Manisha; Broquet, Karen E.

    2012-01-01

    Objectives: International medical graduates (IMGs) account for a significant proportion of residents in psychiatric training in the United States. Many IMGs may have previously completed psychiatry residency training in other countries. Their experiences may improve our system. Authors compared and contrasted psychiatry residency training in the…

  2. Role of Pharmacy Residency Training in Career Planning: A Student's Perspective.

    Science.gov (United States)

    McElhaney, Ashley; Weber, Robert J

    2014-12-01

    Pharmacy students typically become more focused on career planning and assessment in the final year of their PharmD training. Weighing career options in the advanced pharmacy practice experience year can be both exciting and stressful. The goal of this article is to provide a primer on how pharmacy students can assess how a residency can fit into career planning. This article will describe the various career paths available to graduating students, highlight ways in which a residency can complement career choices, review the current state of the job market for pharmacists, discuss the current and future plans for residency programs, and present thoughts from some current and former residents on why they chose to complete a residency. Most career paths require some additional training, and a residency provides appropriate experience very quickly compared to on-the-job training. Alternative plans to residency training must also be considered, as there are not enough residency positions for candidates. Directors of pharmacy must consider several factors when giving career advice on pharmacy residency training to pharmacy students; they should provide the students with an honest assessment of their work skills and their abilities to successfully complete a residency. This assessment will help the students to set a plan for improvement and give them a better chance at being matched to a pharmacy residency.

  3. Changes in the number of resident publications after inception of the 80-hour work week.

    Science.gov (United States)

    Namdari, Surena; Baldwin, Keith D; Weinraub, Barbara; Mehta, Samir

    2010-08-01

    Since the inception of resident work-hour regulations, there has been considerable concern regarding the influence of decreased work hours on graduate medical education. In particular, it is unclear whether implementation of work-hour restrictions has influenced resident academic performance as defined by quantity of peer-reviewed publications while participating in graduate medical education. We determined the impact of work-hour changes on resident involvement in the number of published clinical studies, laboratory research, case reports, and review articles. We conducted a PubMed literature search of 139 consecutive orthopaedic surgery residents (789 total resident-years) at one institution from academic years 1995-1996 to 2008-2009. This represented a continuous timeline before and after implementation of work-hour restrictions. The number of resident publications before and after implementation of work-hour changes was compared. There was a greater probability of peer review authorship in any given resident-year after work-hour changes than before. Average publications per resident-year increased for total articles, clinical articles, case reports, and reviews. There was an increased rate of publications in which the resident was the first author. Since implementation of work-hour changes, total resident publications and publications per resident-year have increased.

  4. Suicidal Thoughts Among Medical Residents with Burnout

    NARCIS (Netherlands)

    van der Heijden, Frank; Dillingh, Gea; Bakker, Arnold; Prins, Jelle

    2008-01-01

    Objectives: Recent research showed that medical residents have a high risk for developing burnout. The present study investigates the prevalence of burnout and its relationship with suicidal thoughts among medical residents. Methods: All Dutch medical residents (n = 5126) received a self-report

  5. Pioneering partnerships: Resident involvement from multiple perspectives

    NARCIS (Netherlands)

    Baur, V.E.; Abma, T.A.; Boelsma, F.; Woelders, S.

    2013-01-01

    Resident involvement in residential care homes is a challenge due to shortcomings of consumerist and formal approaches such as resident councils. The PARTNER approach aims to involve residents through collective action to improve their community life and wellbeing. The purpose of this article is to

  6. 45 CFR 233.40 - Residence.

    Science.gov (United States)

    2010-10-01

    .... For purposes of this section: (1) A resident of a State is one: (i) Who is living in the State... resident of the State in which he or she is living other than on a temporary basis. Residence may not depend upon the reason for which the individual entered the State, except insofar as it may bear upon...

  7. 24 CFR 964.140 - Resident training.

    Science.gov (United States)

    2010-04-01

    ... TENANT PARTICIPATION AND TENANT OPPORTUNITIES IN PUBLIC HOUSING Tenant Participation § 964.140 Resident... Resident Management Corporations and duly elected Resident Councils; (3) Public housing policies, programs... colleges, vocational schools; and (4) HUD and other Federal agencies and other local public, private and...

  8. 38 CFR 51.110 - Resident assessment.

    Science.gov (United States)

    2010-07-01

    ...) PER DIEM FOR NURSING HOME CARE OF VETERANS IN STATE HOMES Standards § 51.110 Resident assessment. The... physician orders for the resident's immediate care and a medical assessment, including a medical history and...) Review of assessments. The nursing facility management must examine each resident no less than once every...

  9. Sexual Health Education: A Psychiatric Resident's Perspective

    Science.gov (United States)

    Waineo, Eva; Arfken, Cynthia L.; Morreale, Mary K.

    2010-01-01

    Objective: This report discusses psychiatric residents' perceptions of sexual health education and their opinions regarding curricular improvements. Methods: An anonymous, web-based survey was sent to residents in one general psychiatry program (N = 33). The response rate was 69.7%. Results: Residents reported inadequate experience in multiple…

  10. [Conversation analysis for improving nursing communication].

    Science.gov (United States)

    Yi, Myungsun

    2007-08-01

    Nursing communication has become more important than ever before because quality of nursing services largely depends on the quality of communication in a very competitive health care environment. This article was to introduce ways to improve nursing communication using conversation analysis. This was a review study on conversation analysis, critically examining previous studies in nursing communication and interpersonal relationships. This study provided theoretical backgrounds and basic assumptions of conversation analysis which was influenced by ethnomethodology, phenomenology, and sociolinguistic. In addition, the characteristics and analysis methods of conversation analysis were illustrated in detail. Lastly, how conversation analysis could help improve communication was shown, by examining researches using conversation analysis not only for ordinary conversations but also for extraordinary or difficult conversations such as conversations between patients with dementia and their professional nurses. Conversation analysis can help in improving nursing communication by providing various structures and patterns as well as prototypes of conversation, and by suggesting specific problems and problem-solving strategies in communication.

  11. Association of the 2011 ACGME resident duty hour reform with general surgery patient outcomes and with resident examination performance.

    Science.gov (United States)

    Rajaram, Ravi; Chung, Jeanette W; Jones, Andrew T; Cohen, Mark E; Dahlke, Allison R; Ko, Clifford Y; Tarpley, John L; Lewis, Frank R; Hoyt, David B; Bilimoria, Karl Y

    2014-12-10

    In 2011, the Accreditation Council for Graduate Medical Education (ACGME) restricted resident duty hour requirements beyond those established in 2003, leading to concerns about the effects on patient care and resident training. To determine if the 2011 ACGME duty hour reform was associated with a change in general surgery patient outcomes or in resident examination performance. Quasi-experimental study of general surgery patient outcomes 2 years before (academic years 2009-2010) and after (academic years 2012-2013) the 2011 duty hour reform. Teaching and nonteaching hospitals were compared using a difference-in-differences approach adjusted for procedural mix, patient comorbidities, and time trends. Teaching hospitals were defined based on the proportion of cases at which residents were present intraoperatively. Patients were those undergoing surgery at hospitals participating in the American College of Surgeons National Surgical Quality Improvement Program (ACS NSQIP). General surgery resident performance on the annual in-training, written board, and oral board examinations was assessed for this same period. National implementation of revised resident duty hour requirements on July 1, 2011, in all ACGME accredited residency programs. Primary outcome was a composite of death or serious morbidity; secondary outcomes were other postoperative complications and resident examination performance. In the main analysis, 204,641 patients were identified from 23 teaching (n = 102,525) and 31 nonteaching (n = 102,116) hospitals. The unadjusted rate of death or serious morbidity improved during the study period in both teaching (11.6% [95% CI, 11.3%-12.0%] to 9.4% [95% CI, 9.1%-9.8%], P adverse outcome. Mean (SD) in-training examination scores did not significantly change from 2010 to 2013 for first-year residents (499.7 [ 85.2] to 500.5 [84.2], P = .99), for residents from other postgraduate years, or for first-time examinees taking the written or oral board

  12. Resident physician's knowledge and attitudes toward biostatistics and research methods concepts.

    Science.gov (United States)

    Alzahrani, Sami H; Aba Al-Khail, Bahaa A

    2015-10-01

    To assess the knowledge and attitudes of resident physicians toward biostatistics and research methodology concepts. We conducted a cross-sectional study between November 2014 and October 2014 at King Abdulaziz University Hospital, Jeddah, Kingdom of Saudi Arabia. A self-administered questionnaire was distributed to all participants. The response rate was 90%. One hundred sixty-two resident completed the questionnaire. Most residents were well-informed in basic concepts, such as, "P" values, study power, and case control studies; more than half had confidence in interpreting the results of scientific papers. Conversely, more than 67% of the residents were not knowledgeable on more sophisticated terms in biostatistics. Residents with previous training in evidence-based medicine (EBM) (p=0.05) and non-specialist residents (p=0.003) were more likely to have better knowledge scores. Females (p=0.003), and those with previous training in biostatistics and epidemiology had positive attitude toward biostatistics (p less than 0.001 in both cases). Residents who read medical journals scored lower than those who never read journals (p=0.001). Prior courses in EBM, as well as male gender were associated with knowledge scores. Reinforcing training after graduation from medical school with special focus on integrating biostatistics with epidemiology and research methods is needed.

  13. Intelligent Online Marketing : Predicting Conversion Rate Of New Keywords

    OpenAIRE

    Engström, Tommy

    2013-01-01

    This thesis looks at the problem of predicting conversion rate of keywords in Google Adwords where little or no data for the keyword is available. Several methods are investigated and tested on data belonging to three different real world clients. The methods try to predict the conversion rate only given the keyword text. All methods are compared, using two different evaluation methods, with results showing good potential. Finally further improvements are suggested that could have a big impac...

  14. TEMPERAMENT CHARACTERISTICS OF CHILDREN WITH CONDUCT AND CONVERSION DISORDERS

    OpenAIRE

    Malhotra, Savita

    1989-01-01

    SUMMARY In a comparative study of temperament profiles of groups of 30 children each diagnosed as conduct disorders, conversion disorder, emotional disorders (according to DSM-III) and normal control, it was found that the children diagnosed as conduct disorders showed high activity and intensity of emotional response as well as negative mood, those diagnosed as conversion disorder exhibited low distractibility. The significance of various temperament variables in differing clinical outcomes ...

  15. Effectiveness of mammography boot camp for radiology residents

    International Nuclear Information System (INIS)

    Kim, Keum Won; Kim, Young Joong; Seo, Jae Young

    2017-01-01

    To evaluate an educational effect of the mammography boot camp (MBC) for radiology residents and analyze affecting factors. Between December 2014 and February 2015, radiology residents in 16 institutions performed the MBC program. We compared the educational effect (score difference between pre- and post-camp test) using 25 case series and analyzed the affecting factors including institution, grades of residents, training periods, presence of sub-specialized breast staff, breast density, and types of cases. The mean scores of 92 residents were 52.80 ± 18.10 and 72.50 ± 12.91 in the pre- and post-camp test, respectively (p = 0.001). There was no significant difference of educational effect according to institution (19.70 ± 16.31), grade, or training period. Although the educational effect of non-trainees was superior to that of trainees (28.10 ± 17.55 vs. 15.90 ± 14.22; p = 0.001), the scores of trainees were higher than those of non-trainees. The diagnostic accuracy showed more improvement in a fatty breast and cases with microcalcifications than compared with others. The MBC showed an effective educational result for radiology residents when interpretating a mammography. It was helpful even for non-trainees. The institution, grades training period, and presence of sub-specialized breast staff did not affect the educational effect

  16. Effectiveness of mammography boot camp for radiology residents

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Keum Won; Kim, Young Joong; Seo, Jae Young [Dept. of Radiology, Konyang University Hospital, Daejeon (Korea, Republic of); and others

    2017-01-15

    To evaluate an educational effect of the mammography boot camp (MBC) for radiology residents and analyze affecting factors. Between December 2014 and February 2015, radiology residents in 16 institutions performed the MBC program. We compared the educational effect (score difference between pre- and post-camp test) using 25 case series and analyzed the affecting factors including institution, grades of residents, training periods, presence of sub-specialized breast staff, breast density, and types of cases. The mean scores of 92 residents were 52.80 ± 18.10 and 72.50 ± 12.91 in the pre- and post-camp test, respectively (p = 0.001). There was no significant difference of educational effect according to institution (19.70 ± 16.31), grade, or training period. Although the educational effect of non-trainees was superior to that of trainees (28.10 ± 17.55 vs. 15.90 ± 14.22; p = 0.001), the scores of trainees were higher than those of non-trainees. The diagnostic accuracy showed more improvement in a fatty breast and cases with microcalcifications than compared with others. The MBC showed an effective educational result for radiology residents when interpretating a mammography. It was helpful even for non-trainees. The institution, grades training period, and presence of sub-specialized breast staff did not affect the educational effect.

  17. Residents' response to bleeding during a simulated robotic surgery task.

    Science.gov (United States)

    Walker, Jessica L; Nathwani, Jay N; Mohamadipanah, Hossein; Laufer, Shlomi; Jocewicz, Frank F; Gwillim, Eran; Pugh, Carla M

    2017-12-01

    The aim of this study was to assess performance measurement validity of our newly developed robotic surgery task trainer. We hypothesized that residents would exhibit wide variations in their intercohort performance as well as a measurable difference compared to surgeons in fellowship training. Our laboratory synthesized a model of a pelvic tumor that simulates unexpected bleeding. Surgical residents and fellows of varying specialties completed a demographic survey and were allowed 20 minutes to resect the tumor using the da Vinci robot and achieve hemostasis. At a standardized event in the simulation, venous bleeding began, and participants attempted hemostasis using suture ligation. A motion tracking system, using electromagnetic sensors, recorded participants' hand movements. A postparticipation Likert scale survey evaluated participants' assessment of the model's realism and usefulness. Three of the seven residents (postgraduate year 2-5), and the fellow successfully resected the tumor in the allotted time. Residents showed high variability in performance and blood loss (125-700 mL) both within their cohort and compared to the fellow (150 mL blood). All participants rated the model as having high realism and utility for trainees. The results support that our bleeding pelvic tumor simulator has the ability to discriminate resident performance in robotic surgery. The combination of motion, decision-making, and blood loss metrics offers a multilevel performance assessment, analyzing both technical and decision-making abilities. Copyright © 2017 Elsevier Inc. All rights reserved.

  18. Problem-based learning in laboratory medicine resident education: a satisfaction survey.

    Science.gov (United States)

    Lepiller, Quentin; Solis, Morgane; Velay, Aurélie; Gantner, Pierre; Sueur, Charlotte; Stoll-Keller, Françoise; Barth, Heidi; Fafi-Kremer, Samira

    2017-04-01

    Theoretical knowledge in biology and medicine plays a substantial role in laboratory medicine resident education. In this study, we assessed the contribution of problem-based learning (PBL) to improve the training of laboratory medicine residents during their internship in the department of virology, Strasbourg University Hospital, France. We compared the residents' satisfaction regarding an educational program based on PBL and a program based on lectures and presentations. PBL induced a high level of satisfaction (100%) among residents compared to lectures and presentations (53%). The main advantages of this technique were to create a situational interest regarding virological problems, to boost the residents' motivation and to help them identify the most relevant learning objectives in virology. However, it appears pertinent to educate the residents in appropriate bibliographic research techniques prior to PBL use and to monitor their learning by regular formative assessment sessions.

  19. Psychotherapy Training: Residents' Perceptions and Experiences.

    Science.gov (United States)

    Kovach, Jessica G; Dubin, William R; Combs, Christopher J

    2015-10-01

    This survey examined actual training hours in psychotherapy modalities as reported by residents, residents' perceptions of training needs, and residents' perceptions of the importance of different aspects of psychotherapy training. A brief, voluntary, anonymous, Internet-based survey was developed. All 14 program directors for Accreditation Council for Graduate Medical Education accredited programs in Pennsylvania, New Jersey, and Delaware provided email addresses for current categorical residents. The survey inquired about hours of time spent in various aspects of training, value assigned to aspects of training, residents' involvement in their own psychotherapy, and overall resident wellness. The survey was e-mailed to 328 residents. Of the 328 residents contacted, 133 (40.5%) responded. Median reported number of PGY 3 and 4 performed versus perceived ideal hours of supportive therapy, cognitive behavioral therapy (CBT), and psychodynamic therapy did not differ. Answers for clinical time utilizing these modalities ranged from "none or less than 1 h" per month to 20+ h per month. PGY 3 and 4 residents reported a median of "none or less than 1 h" per month performed of interpersonal, dialectical behavior therapy, couples/family/group, and child therapies but preferred more time using these therapies. Residents in all years of training preferred more hours of didactic instruction for all psychotherapies and for medication management. Residents ranked teaching modalities in the following order of importance: supervision, hours of psychotherapy performed, personal psychotherapy, readings, and didactic instruction. Residents engaged in their own psychotherapy were significantly more likely to rank the experiential aspects of psychotherapy training (personal psychotherapy, supervision, and hours performed) higher than residents not in psychotherapy. Current psychotherapy training for psychiatry residents is highly variable, but overall, residents want more

  20. Derivation of dose conversion factors for tritium

    Energy Technology Data Exchange (ETDEWEB)

    Killough, G. G.

    1982-03-01

    For a given intake mode (ingestion, inhalation, absorption through the skin), a dose conversion factor (DCF) is the committed dose equivalent to a specified organ of an individual per unit intake of a radionuclide. One also may consider the effective dose commitment per unit intake, which is a weighted average of organ-specific DCFs, with weights proportional to risks associated with stochastic radiation-induced fatal health effects, as defined by Publication 26 of the International Commission on Radiological Protection (ICRP). This report derives and tabulates organ-specific dose conversion factors and the effective dose commitment per unit intake of tritium. These factors are based on a steady-state model of hydrogen in the tissues of ICRP's Reference Man (ICRP Publication 23) and equilibrium of specific activities between body water and other tissues. The results differ by 27 to 33% from the estimate on which ICRP Publication 30 recommendations are based. The report also examines a dynamic model of tritium retention in body water, mineral bone, and two compartments representing organically-bound hydrogen. This model is compared with data from human subjects who were observed for extended periods. The manner of combining the dose conversion factors with measured or model-predicted levels of contamination in man's exposure media (air, drinking water, soil moisture) to estimate dose rate to an individual is briefly discussed.

  1. Derivation of dose conversion factors for tritium

    International Nuclear Information System (INIS)

    Killough, G.G.

    1982-03-01

    For a given intake mode (ingestion, inhalation, absorption through the skin), a dose conversion factor (DCF) is the committed dose equivalent to a specified organ of an individual per unit intake of a radionuclide. One also may consider the effective dose commitment per unit intake, which is a weighted average of organ-specific DCFs, with weights proportional to risks associated with stochastic radiation-induced fatal health effects, as defined by Publication 26 of the International Commission on Radiological Protection (ICRP). This report derives and tabulates organ-specific dose conversion factors and the effective dose commitment per unit intake of tritium. These factors are based on a steady-state model of hydrogen in the tissues of ICRP's Reference Man (ICRP Publication 23) and equilibrium of specific activities between body water and other tissues. The results differ by 27 to 33% from the estimate on which ICRP Publication 30 recommendations are based. The report also examines a dynamic model of tritium retention in body water, mineral bone, and two compartments representing organically-bound hydrogen. This model is compared with data from human subjects who were observed for extended periods. The manner of combining the dose conversion factors with measured or model-predicted levels of contamination in man's exposure media (air, drinking water, soil moisture) to estimate dose rate to an individual is briefly discussed

  2. Energy conversion and utilization technologies

    International Nuclear Information System (INIS)

    1988-01-01

    The DOE Energy Conversion and Utilization Technologies (ECUT) Program continues its efforts to expand the generic knowledge base in emerging technological areas that support energy conservation initiatives by both the DOE end-use sector programs and US private industry. ECUT addresses specific problems associated with the efficiency limits and capabilities to use alternative fuels in energy conversion and end-use. Research is aimed at understanding and improving techniques, processes, and materials that push the thermodynamic efficiency of energy conversion and usage beyond the state of the art. Research programs cover the following areas: combustion, thermal sciences, materials, catalysis and biocatalysis, and tribology. Six sections describe the status of direct contact heat exchange; the ECUT biocatalysis project; a computerized tribology information system; ceramic surface modification; simulation of internal combustion engine processes; and materials-by-design. These six sections have been indexed separately for inclusion on the database. (CK)

  3. Environmental effects of energy conversion

    International Nuclear Information System (INIS)

    Hansmeyer, K.H.; Fortak, H.; Knoepp, H.; Lindackers, K.H.; Schafhausen, F.; Schoedel, J.P.

    1984-01-01

    The article presents an analysis of energy conversion systems by the ''Council of Environmental Experts'' in order to correct the erroneous assumption that small energy conversion systems will also be small-scale and negligible emitters of pollutants. The additional pollution caused by Neurath power plant is considered to be low, at least in its immediate vicinity, owing to the implementation of the most recent technical developments. The environmental effects of energy conversion processes are discussed, including the waste heat problem and processes for water-cooling of power plants. General aspects of a new concept of energy taxation are discussed which is to reduce energy consumption. The problem of radioactive waste is discussed from spent fuel storage and reprocessing to the decommissioning of older power plants. The author points out that also new fossil-fuel technologies will pollute the environment. (orig.) [de

  4. Blind-date Conversation Joining

    Directory of Open Access Journals (Sweden)

    Luca Cesari

    2013-07-01

    Full Text Available We focus on a form of joining conversations among multiple parties in service-oriented applications where a client may asynchronously join an existing conversation without need to know in advance any information about it. More specifically, we show how the correlation mechanism provided by orchestration languages enables a form of conversation joining that is completely transparent to clients and that we call 'blind-date joining'. We provide an implementation of this strategy by using the standard orchestration language WS-BPEL. We then present its formal semantics by resorting to COWS, a process calculus specifically designed for modelling service-oriented applications. We illustrate our approach by means of a simple, but realistic, case study from the online games domain.

  5. Empathy, Sense of Power, and Personality: Do They Change During Pediatric Residency?

    Science.gov (United States)

    Greenberg, Larrie; Agrawal, Dewesh; Toto, Regina; Blatt, Benjamin

    2015-08-01

    Empathy is a critical competency in medicine. Prior studies demonstrate a longitudinal decrease in empathy during residency; however, they have not included pediatric residents. The relations among the expression of empathy, sense of power (ability to influence other's behavior), and personality traits in residents also have not been addressed. Lastly, there are no data on how residents compare with the general nonmedical population in their expression of empathy. The purposes of our study were to assess whether empathy, sense of power, and personality type were statistically correlated; if resident empathy declines over time; and how resident empathy compares with that of nonmedical peers. In 2010, a cohort of individuals entering pediatric residency were given three validated survey instruments at the beginning of their first and third years of training to explore longitudinal changes in empathy, sense of power, and major personality traits. We found no decrease in resident empathy in 2 years of pediatric training, no changes in their sense of power, and no statistically significant correlation between empathetic tendencies and sense of power. When compared with the general nonmedical population, pediatric residents rated themselves higher in empathy. As expected, the two components of empathy (empathic concern and perspective taking) were moderately correlated. Of the major personality traits, only agreeableness showed significant correlation with empathy. Pediatric resident empathy did not decrease longitudinally, unlike studies in other residents. There was no inverse relation between self-perceptions of sense of power and empathy as is present in the business literature. Finally, pediatric resident empathy was significantly higher when compared with a general nonmedical population.

  6. [Hydroxylamine conversion by anammox enrichment].

    Science.gov (United States)

    Hu, Anhui; Zheng, Ping; Lu, Huifeng; Ding, Shuang; Wang, Caihua

    2010-04-01

    Hydroxylamine is an important intermediate product of anammox. This study was focused on the characteristics of hydroxylamine and nitrite conversions by anammox enrichment. The changes of nitrogenous substrates and related products with time were measured using batch tests with anammox enrichment as inoculum. Since hydroxylamine didn't react with nitrite in uninoculated control culture, these two compounds were chemically stable. Both of them decreased with time in anammox enrichment inoculated cultures, in which ammonia as intermediate product would be produced and converted with the maximum concentration being 0.338 mg/L. The total nitrogen concentration decreased from 4.694 mmol/L to 0.812 mmol/L with conversion rate 82.7% in the end. When hydroxylamine and nitrite concentrations were about 2.5 mmol/L respectively, the maximum specific sludge conversion rates of hydroxylamine was 0.535 mmol/(gVSS.h), which was 1.81 times bigger than that of ammonia in ammonia reaction system; the maximum specific sludge rate of total nitrogen was slightly higher than that in ammonia reaction system. When hydroxylamine concentration increased to 5.0 mmol/L, the hydroxylamine and nitrite conversion rates promoted by 26.7% and 120.7% respectively; and the maximum ammonia accumulated was 1.810 mmol/L. When nitrite concentration increased to 5.0 mmol/L, the hydroxylamine and nitrite conversion rates promoted by 6.9% and 9.0% respectively; and the maximum ammonia accumulated was 0.795 mmol/L. Anammox enrichment was capable of converting hydroxylamine and nitrite simultaneously and had the higher conversion rate of hydroxylamine than ammonia conversion rate. Hydroxylamine and nitrite conversion rates were less affected by increase in nitrite concentration, but more significantly influenced by increase in hydroxylamine. The maximum ammonia concentration accumulated would rise as the result of increasing both hydroxylamine and nitrite. The result of experiment was consistent with pathway

  7. Wavelength conversion techniques and devices

    DEFF Research Database (Denmark)

    Danielsen, Søren Lykke; Mikkelsen, Benny; Hansen, Peter Bukhave

    1997-01-01

    Taking into account the requirements to the converters e.g., bit rate transparency (at least up to 10 Gbit/s), polarisation independence, wavelength independence, moderate input power levels, high signal-to-noise ratio and high extinction ratio interferometric wavelength convertors are very...... interesting for use in WDM optical fibre networks. However, the perfect converter has probably not yet been fabricated and new techniques such as conversion relying on cross-absorption modulation in electro-absorption modulators might also be considered in pursue of effective conversion devices...

  8. Solar energy conversion. Chemical aspects

    Energy Technology Data Exchange (ETDEWEB)

    Likhtenshtein, Gertz [Ben-Gurion Univ. of the Negev, Beersheba (Israel). Dept. of Chemistry

    2012-07-01

    Finally filling a gap in the literature for a text that also adopts the chemist's view of this hot topic, Professor Likhtenshtein, an experienced author and internationally renowned scientist, considers different physical and engineering aspects in solar energy conversion. From theory to real-life systems, he shows exactly which chemical reactions take place when converting light energy, providing an overview of the chemical perspective from fundamentals to molecular harvesting systems and solar cells. This essential guide will thus help researchers in academia and industry better understand solar energy conversion, and so ultimately help this promising, multibillion euro/dollar field to expand. (orig.)

  9. A perspective on direct conversion

    Energy Technology Data Exchange (ETDEWEB)

    Lewis, W. B.

    1963-10-15

    As flowing energy, electricity is sought for its versatility. Its generation from some other flow or release of energy without mechanical power, or even sometimes heat, as intermediary is called direct conversion. The objective is high electrical output for minimum total cost and not always high conversion efficiency. The wide range of techniques embracing cryogenics and hot plasma derives from the special requirements of source, environment and application. Sources include solar and other radiation, nuclear fission and fusion, chemical energy and heat. Environments and applications range from space vehicles to submarines and from giant power networks to isolated buoys and pocket devices. (author)

  10. A perspective on direct conversion

    International Nuclear Information System (INIS)

    Lewis, W.B.

    1963-10-01

    As flowing energy, electricity is sought for its versatility. Its generation from some other flow or release of energy without mechanical power, or even sometimes heat, as intermediary is called direct conversion. The objective is high electrical output for minimum total cost and not always high conversion efficiency. The wide range of techniques embracing cryogenics and hot plasma derives from the special requirements of source, environment and application. Sources include solar and other radiation, nuclear fission and fusion, chemical energy and heat. Environments and applications range from space vehicles to submarines and from giant power networks to isolated buoys and pocket devices. (author)

  11. Operative Landscape at Canadian Neurosurgery Residency Programs.

    Science.gov (United States)

    Tso, Michael K; Dakson, Ayoub; Ahmed, Syed Uzair; Bigder, Mark; Elliott, Cameron; Guha, Daipayan; Iorio-Morin, Christian; Kameda-Smith, Michelle; Lavergne, Pascal; Makarenko, Serge; Taccone, Michael S; Wang, Bill; Winkler-Schwartz, Alexander; Sankar, Tejas; Christie, Sean D

    2017-07-01

    Background Currently, the literature lacks reliable data regarding operative case volumes at Canadian neurosurgery residency programs. Our objective was to provide a snapshot of the operative landscape in Canadian neurosurgical training using the trainee-led Canadian Neurosurgery Research Collaborative. Anonymized administrative operative data were gathered from each neurosurgery residency program from January 1, 2014, to December 31, 2014. Procedures were broadly classified into cranial, spine, peripheral nerve, and miscellaneous procedures. A number of prespecified subspecialty procedures were recorded. We defined the resident case index as the ratio of the total number of operations to the total number of neurosurgery residents in that program. Resident number included both Canadian medical and international medical graduates, and included residents on the neurosurgery service, off-service, or on leave for research or other personal reasons. Overall, there was an average of 1845 operative cases per neurosurgery residency program. The mean numbers of cranial, spine, peripheral nerve, and miscellaneous procedures were 725, 466, 48, and 193, respectively. The nationwide mean resident case indices for cranial, spine, peripheral nerve, and total procedures were 90, 58, 5, and 196, respectively. There was some variation in the resident case indices for specific subspecialty procedures, with some training programs not performing carotid endarterectomy or endoscopic transsphenoidal procedures. This study presents the breadth of neurosurgical training within Canadian neurosurgery residency programs. These results may help inform the implementation of neurosurgery training as the Royal College of Physicians and Surgeons residency training transitions to a competence-by-design curriculum.

  12. 2003 survey of Canadian radiation oncology residents

    International Nuclear Information System (INIS)

    Yee, Don; Fairchild, Alysa; Keyes, Mira; Butler, Jim; Dundas, George

    2005-01-01

    Purpose: Radiation oncology's popularity as a career in Canada has surged in the past 5 years. Consequently, resident numbers in Canadian radiation oncology residencies are at all-time highs. This study aimed to survey Canadian radiation oncology residents about their opinions of their specialty and training experiences. Methods and Materials: Residents of Canadian radiation oncology residencies that enroll trainees through the Canadian Resident Matching Service were identified from a national database. Residents were mailed an anonymous survey. Results: Eight of 101 (7.9%) potential respondents were foreign funded. Fifty-two of 101 (51.5%) residents responded. A strong record of graduating its residents was the most important factor residents considered when choosing programs. Satisfaction with their program was expressed by 92.3% of respondents, and 94.3% expressed satisfaction with their specialty. Respondents planning to practice in Canada totaled 80.8%, and 76.9% plan to have academic careers. Respondents identified job availability and receiving adequate teaching from preceptors during residency as their most important concerns. Conclusions: Though most respondents are satisfied with their programs and specialty, job availability and adequate teaching are concerns. In the future, limited time and resources and the continued popularity of radiation oncology as a career will magnify the challenge of training competent radiation oncologists in Canada

  13. Current perspectives on chief residents in psychiatry.

    Science.gov (United States)

    Warner, Christopher H; Rachal, James; Breitbach, Jill; Higgins, Michael; Warner, Carolynn; Bobo, William

    2007-01-01

    The authors examine qualitative data from outgoing chief residents in psychiatry from the 2004-2005 academic year to 1) determine common characteristics between programs, 2) examine the residents' perspectives on their experiences, and 3) determine their common leadership qualities. The authors sent out self-report surveys via e-mail to 89 outgoing chief residents who attended the APA/Lilly Chief Resident Executive Leadership Program. Fifty-three (60%) chief residents responded. Although most chief residents are senior residents, over 20% are in their third postgraduate year. Two-thirds of programs have more than one chief resident each year. Most chief residents believe that their "participating" leadership style, existing leadership skills, and interpersonal skills contributed to their overall positive experiences. Successfully performing duties as a chief resident entails functioning in a variety of roles and demands attention to leadership qualities of the individual. Developing existing leadership skills, clarifying expectations, and providing mentorship to chief residents will ensure successful transition into practice, and the advancement of the field of psychiatry.

  14. Stress and coping among orthopaedic surgery residents and faculty.

    Science.gov (United States)

    Sargent, M Catherine; Sotile, Wayne; Sotile, Mary O; Rubash, Harry; Barrack, Robert L

    2004-07-01

    Evaluations of physicians and residents have revealed concerning levels of psychosocial dysfunction. The purposes of this study were to determine the quality of life of orthopaedic residents and faculty and to identify the risk factors for decompensation. Twenty-one orthopaedic residents and twenty-five full-time orthopaedic faculty completed a 102-question voluntary, anonymous survey. The survey consisted of three validated instruments, i.e., the Maslach Burnout Inventory, the General Health Questionnaire-12, and the Revised Dyadic Adjustment Scale; and three novel question sets addressing background and demographic information, stress reaction and management, and the balance between work and home life. Descriptive statistics, pairwise correlations, simple t tests, and Pearson and nonparametric Spearman correlations were calculated. The simple correlation coefficient was used to assess bivariate relationships. The mean overall quality-of-life score, on a scale of 0 to 4 points, was 2.5 points for residents compared with 3.6 points for faculty members. Residents reported considerable burnout, showing a high level of emotional exhaustion and depersonalization and an average level of personal achievement, whereas faculty reported minimal burnout, showing a low level of emotional exhaustion (p burnout and psychiatric morbidity correlated with weekly work hours; conflict between the commitments of work and home life; discord with faculty, nursing staff, and senior residents; debt load; and work-related stress. Protective factors included being a parent, spending time with a spouse, having a physician father, and deriving satisfaction from discussing concerns with colleagues, friends, and family. In pursuit of our goal of determining the quality of life of orthopaedic residents and faculty, we identified a large disparity between the two groups. The resident group reported much greater levels of dysfunction particularly with regard to burnout and psychiatric morbidity

  15. Administrative organization in diagnostic radiology residency program leadership.

    Science.gov (United States)

    Webber, Grant R; Mullins, Mark E; Chen, Zhengjia; Meltzer, Carolyn C

    2012-04-01

    The aim of this study was to document the current state of administrative structure in US diagnostic radiology (DR) residency program leadership. A secondary objective was to assess for correlation(s), if any, with DR residency programs that equipped positions such as assistant, associate, and emeritus program director (PD) with respect to residency size and region of the country. The Fellowship and Residency Electronic Interactive Database, as well as direct communication and programmatic Web site searches, were used to gather data regarding current US DR residency leadership. Data collected included the presence of additional leadership titles, including assistant PD, associate PD, and PD emeritus, and how many faculty members currently held each position. Programs were excluded if results could not be identified. Analysis of variance and t tests were used to estimate the correlations of the size of a residency with having additional or shared PD positions and the types of positions, respectively. Chi-square tests were used to assess for any regional differences. As of the time of this project, the Fellowship and Residency Electronic Interactive Database defined 186 US DR residency programs. A total of 173 programs (93%) were included in the analysis; the remainder were excluded because of unavailability of relevant data. Seventy-two percent (124 of 173) of programs had additional DR leadership positions. Of these, 30 programs (17%) had more than one such position. There were no significant differences in the sizes of the programs that used these additional positions (mean, 25 ± 12; range, 6-72) compared with those that did not (mean, 24 ± 12; range, 7-51). There were no significant differences between programs that had additional positions with respect to region of the country. The majority of US DR residency programs used some form of additional DR leadership position. In the majority of cases, this was in the form of an assistant or associate PD. Nearly one

  16. Creating a Culture of Wellness in Residency.

    Science.gov (United States)

    Edmondson, Emma K; Kumar, Anupam A; Smith, Stephanie M

    2018-04-17

    Despite increased awareness and recognition of the prevalence of physician burnout and the associated risks of depression and suicide, there is a paucity of actionable guidelines for residency programs to mitigate these risks for their residents. In this Invited Commentary, the authors acknowledge that, although there are inherent barriers to resident wellness, there are numerous modifiable barriers that present opportunities for programs to enable culture change and improve resident wellbeing. The authors frame the discussion with a personal narrative written by a resident in their internal medicine program who experienced burnout, depression, and suicidality during his intern year. They aim to inspire residency programs and hospital leadership to identify and intervene upon the modifiable barriers to wellness for residents in their programs in order to shape meaningful cultural change.

  17. The Effect of Gender on Resident Autonomy in the Operating room.

    Science.gov (United States)

    Meyerson, Shari L; Sternbach, Joel M; Zwischenberger, Joseph B; Bender, Edward M

    Discrimination against women training in medicine and surgery has been subjectively described for decades. This study objectively documents gender differences in the degree of autonomy given to thoracic surgery trainees in the operating room. Thoracic surgery residents and faculty underwent frame of reference training on the use of the 4-point Zwisch scale to measure operative autonomy. Residents and faculty then submitted evaluations of their perception of autonomy granted for individual operations as well as operative difficulty on a real-time basis using the "Zwisch Me!!" mobile application. Differences in autonomy given to male and female residents were elucidated using chi-square analysis and ordered logistic regression. Seven academic medical centers with thoracic surgery training programs. Volunteer thoracic surgery residents in both integrated and traditional training pathways and their affiliated cardiothoracic faculty. Residents (n = 33, female 18%) submitted a total of 596 evaluations to faculty (n = 48, female 12%). Faculty gave less autonomy to female residents with only 56 of 184 evaluations (30.3%) showing meaningful autonomy (passive help or supervision only) compared to 107 of 292 evaluations (36.7%) at those levels for male residents (p = 0.02). Resident perceptions of autonomy showed even more pronounced differences with female residents receiving only 38 of 197 evaluations (19.3%) with meaningful autonomy compared to 133 of 399 evaluations (33.3%) for male residents (p autonomy granted to residents. Evaluations of operative autonomy reveal a significant bias against female residents. Faculty education is needed to encourage allowing female residents more operative autonomy. Copyright © 2017 Association of Program Directors in Surgery. Published by Elsevier Inc. All rights reserved.

  18. Open knot-tying skills: residents skills assessed

    NARCIS (Netherlands)

    van Empel, P.J.; Verdam, M.G.E.; Huirne, J.A.; Bonjer, H.J.; Meijerink, W.J.; Scheele, F.

    2013-01-01

    Aim: Open knot-tying and suturing skills are fundamental surgical skills, founding many alternative knot-tying techniques. It is therefore mandatory for residents to possess adequate basic open knot-tying skills. The aim of this study was to compare an objective assessment of open knot-tying skills

  19. Gene conversion in the rice genome

    DEFF Research Database (Denmark)

    Xu, Shuqing; Clark, Terry; Zheng, Hongkun

    2008-01-01

    -chromosomal conversions distributed between chromosome 1 and 5, 2 and 6, and 3 and 5 are more frequent than genome average (Z-test, P ... is not tightly linked to natural selection in the rice genome. To assess the contribution of segmental duplication on gene conversion statistics, we determined locations of conversion partners with respect to inter-chromosomal segment duplication. The number of conversions associated with segmentation is less...... involved in conversion events. CONCLUSION: The evolution of gene families in the rice genome may have been accelerated by conversion with pseudogenes. Our analysis suggests a possible role for gene conversion in the evolution of pathogen-response genes....

  20. [Part-time residency training in Israel].

    Science.gov (United States)

    Fishbain, Dana; Levi, Baruch; Borow, Malke; Ashkenazi, Shai; Lindner, Arie

    2012-08-01

    Full-time work has long been perceived as a cornerstone of medical residency, the consensus being that a resident must apply the bulk of his time and attention to his professional training. Demographic and cultural changes that have taken place over the last several years, specifically the rise in the number of female doctors and the importance of leisure time to the younger generation, have intensified the need to find new and innovative ways to deal with the plight of the resident population. One idea, already in effect in many Western countries, is the institution of part-time residency programs. The possibility of fulfilling residency requirements on a part-time basis is intended to assist medical residents in integrating their professional development with their personal and family life, without compromising the quality of their training. A number of research studies conducted over the last several years in countries that allow part-time residency, among them the United States, England and Switzerland, aimed to examine the quality of part-time training. The various studies evinced a high level of satisfaction from the program both by the residents themselves and their supervisors, and in many aspects those doing residency part-time received higher appraisals than their full-time colleagues. Some of the residents polled noted that they would have totally foregone the practice of medicine had there not been an option to complete residency part-time. In light of the experience throughout the world and the changing landscape in Israel, the Scientific Council of the Israeli Medical Association decided to examine the issue and its various aspects, and weighed all the considerations in favor and against part-time residency. Recently, the Scientific Council approved the launch of a pilot program to allow part-time residency in several fields that were carefully selected according to specific criteria. Once the Ministry of Health completes the LegisLation process, part

  1. Measuring Error Identification and Recovery Skills in Surgical Residents.

    Science.gov (United States)

    Sternbach, Joel M; Wang, Kevin; El Khoury, Rym; Teitelbaum, Ezra N; Meyerson, Shari L

    2017-02-01

    Although error identification and recovery skills are essential for the safe practice of surgery, they have not traditionally been taught or evaluated in residency training. This study validates a method for assessing error identification and recovery skills in surgical residents using a thoracoscopic lobectomy simulator. We developed a 5-station, simulator-based examination containing the most commonly encountered cognitive and technical errors occurring during division of the superior pulmonary vein for left upper lobectomy. Successful completion of each station requires identification and correction of these errors. Examinations were video recorded and scored in a blinded fashion using an examination-specific rating instrument evaluating task performance as well as error identification and recovery skills. Evidence of validity was collected in the categories of content, response process, internal structure, and relationship to other variables. Fifteen general surgical residents (9 interns and 6 third-year residents) completed the examination. Interrater reliability was high, with an intraclass correlation coefficient of 0.78 between 4 trained raters. Station scores ranged from 64% to 84% correct. All stations adequately discriminated between high- and low-performing residents, with discrimination ranging from 0.35 to 0.65. The overall examination score was significantly higher for intermediate residents than for interns (mean, 74 versus 64 of 90 possible; p = 0.03). The described simulator-based examination with embedded errors and its accompanying assessment tool can be used to measure error identification and recovery skills in surgical residents. This examination provides a valid method for comparing teaching strategies designed to improve error recognition and recovery to enhance patient safety. Copyright © 2017 The Society of Thoracic Surgeons. Published by Elsevier Inc. All rights reserved.

  2. Choosing academia versus private practice: factors affecting oral maxillofacial surgery residents' career choices.

    Science.gov (United States)

    Lanzon, Jesse; Edwards, Sean P; Inglehart, Marita R

    2012-07-01

    This study explored how residents who intend to enter private practice versus academic careers differ in their background and educational characteristics, engagement in different professional activities, professional values, and satisfaction. Survey data were collected from 257 residents in oral and maxillofacial surgery programs in the United States. The responses of the respondents who planned a career in private practice (65%) and who considered academia (35%) were compared with χ(2) and independent-sample t tests. Residents who considered academia were more likely to be women (29% vs 8%; P career compared with residents interested in private practice. Future clinicians placed a higher value on having manageable hours and more time performing outpatient procedures than future educators. These findings showed, first, that the characteristics at the beginning of residency programs that are likely to indicate an increased interest in academic careers are being a woman, from a non-European American background, and having an interest in research. Second, once residents are admitted, different types of surgeries and different types of professional activities tend to appeal to residents who want to practice in private practice settings versus work in academia. Third, residents interested in academia have a relatively lower level of satisfaction compared with residents interested in practicing outside of academia. Copyright © 2012 American Association of Oral and Maxillofacial Surgeons. Published by Elsevier Inc. All rights reserved.

  3. Oral health educational interventions for nursing home staff and residents.

    Science.gov (United States)

    Albrecht, Martina; Kupfer, Ramona; Reissmann, Daniel R; Mühlhauser, Ingrid; Köpke, Sascha

    2016-09-30

    Associations between nursing home residents' oral health status and quality of life, respiratory tract infections, and nutritional status have been reported. Educational interventions for nurses or residents, or both, focusing on knowledge and skills related to oral health management may have the potential to improve residents' oral health. To assess the effects of oral health educational interventions for nursing home staff or residents, or both, to maintain or improve the oral health of nursing home residents. We searched the Cochrane Oral Health Trials Register (to 18 January 2016), the Cochrane Central Register of Controlled Trials (CENTRAL) (the Cochrane Library, 2015, Issue 12), MEDLINE Ovid (1946 to 18 January 2016), Embase Ovid (1980 to 18 January 2016), CINAHL EBSCO (1937 to 18 January 2016), and Web of Science Conference Proceedings (1990 to 18 January 2016). We searched ClinicalTrials.gov and the World Health Organization International Clinical Trials Registry Platform for ongoing trials to 18 January 2016. In addition, we searched reference lists of identified articles and contacted experts in the field. We placed no restrictions on language or date of publication when searching the electronic databases. Randomised controlled trials (RCTs) and cluster-RCTs comparing oral health educational programmes for nursing staff or residents, or both with usual care or any other oral healthcare intervention. Two review authors independently screened articles retrieved from the searches for relevance, extracted data from included studies, assessed risk of bias for each included study, and evaluated the overall quality of the evidence. We retrieved data about the development and evaluation processes of complex interventions on the basis of the Criteria for Reporting the Development and Evaluation of Complex Interventions in healthcare: revised guideline (CReDECI 2). We contacted authors of relevant studies for additional information. We included nine RCTs involving

  4. Comparison of stress and burnout among anesthesia and surgical residents in a tertiary care teaching hospital in North India.

    Science.gov (United States)

    Gandhi, K; Sahni, N; Padhy, S K; Mathew, P J

    2017-10-23

    The residents undergoing training at hospitals in our country face challenges in terms of infrastructure and high workload with undefined working hours. The aim of the study was to compare the stress and burnout levels in trainee doctors doing residency in surgical fields and anesthesia at a tertiary care academic center in North India. A comparative, observational study was conducted in a tertiary care teaching hospital in North India. After Ethics Committee approval, 200 residents (100 each from surgical branches and anesthesia) were required to fill a questionnaire with information about age, sex, year of residency, marital status, and the Perceived Stress Scale-10, and Burnout Clinical Subtype Questionnaire-12. Burnout and perceived stress were compared between residents of anesthesia and surgical specialties. Residents of both surgical and anesthesia branches scored high in perceived stress, namely 21 and 18, respectively. The score was significantly higher in surgical residents (P = 0.03) and increased progressively with the year of residency. The majority of residents (90% surgical, 80% anesthesia) felt that they were being overloaded with work. However, only 20%-30% of respondents felt that there was lack of development of individual skills and still fewer (<10%) reported giving up in view of difficulties. There is high level of stress and overload dimension of burnout among the residents of anesthesia and surgical branches at our tertiary care academic institution and the surgical residents score marginally higher than anesthesia residents.

  5. External doses of residents near semipalatinsk nuclear test site

    International Nuclear Information System (INIS)

    Takada, Jun; Hoshi, Masaharu; Nagatomo, Tsuneto

    1999-01-01

    Accumulated external radiation doses of residents near the Semipalatinsk nuclear test site of the former USSR are presented as a results of study by the thermoluminescence technique for bricks sampled at several settlements in 1995 and 1996. The external doses that we evaluated from exposed bricks were up to about 100 cGy for resident. The external doses at several points in the center of Semipalatinsk City ranged from a background level to 60 cGy, which was remarkably high compared with the previously reported values based on military data. (author)

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

    Science.gov (United States)

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

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

  7. Analog to digital conversion for nuclear spectrometry

    International Nuclear Information System (INIS)

    Carvalho, P.V.R. de.

    1982-04-01

    A study of the analog to digital conversion techniques for nuclear spectrometry is presented and the main design philosophies of nuclear ADC's are compared. Among them, the most suitable for the current Brazilian conditions, concerning the specifications and components avaiability is the one that employs a statistical correction of successive approximation converters. This technique is described in full detail. A prototype has been developed an tested for the practical demonstration of the theoretical conclusions. These tests was carried on nuclear spectrometry data aquisition system whose implementation is also described. (Author) [pt

  8. Evolution of energy conversion plants

    International Nuclear Information System (INIS)

    Osnaghi, C.

    2001-01-01

    The paper concerns the evolution and the future development of energy conversion plants and puts into evidence the great importance of the scientific and technological improvement in machines design, in order to optimize the use of energy resources and to improve ambient compatibility [it

  9. Direct digital conversion detector technology

    Science.gov (United States)

    Mandl, William J.; Fedors, Richard

    1995-06-01

    Future imaging sensors for the aerospace and commercial video markets will depend on low cost, high speed analog-to-digital (A/D) conversion to efficiently process optical detector signals. Current A/D methods place a heavy burden on system resources, increase noise, and limit the throughput. This paper describes a unique method for incorporating A/D conversion right on the focal plane array. This concept is based on Sigma-Delta sampling, and makes optimum use of the active detector real estate. Combined with modern digital signal processors, such devices will significantly increase data rates off the focal plane. Early conversion to digital format will also decrease the signal susceptibility to noise, lowering the communications bit error rate. Computer modeling of this concept is described, along with results from several simulation runs. A potential application for direct digital conversion is also reviewed. Future uses for this technology could range from scientific instruments to remote sensors, telecommunications gear, medical diagnostic tools, and consumer products.

  10. Restarts in Conversation and Literature.

    Science.gov (United States)

    Person, Raymond F., Jr.

    1996-01-01

    Analyzes restarts, a common feature of conversation, in literary discourse. The term "restart" refers to the repetition of a word or words within an utterance by the same speaker. Restarts in literary discourse are of two types: (1) those produced by the characters in their "real" narrative world and (2) those produced by the narrators themselves.…

  11. Direct Energy Conversion Literature Abstracts

    Science.gov (United States)

    1962-12-01

    TMMOELECTRIC 6 CONVERSION SYSTEMS. compiled by Edda 7p.. Aug.1960. (Spec. Bibl. 430) Barber. 48p., Mar. 1962. (Lit. Search 392) (Contract NAS 7-100) Covers...2865 BaranskiiP.I ............... 2905, 2945 Brogan, T.R. .............. 3322 Barber, Edda ................. . 2866 Brooklyn Polytechnic

  12. Photovoltaic conversion of laser energy

    Science.gov (United States)

    Stirn, R. J.

    1976-01-01

    The Schottky barrier photovoltaic converter is suggested as an alternative to the p/n junction photovoltaic devices for the conversion of laser energy to electrical energy. The structure, current, output, and voltage output of the Schottky device are summarized. The more advanced concepts of the multilayer Schottky barrier cell and the AMOS solar cell are briefly considered.

  13. Conversations to Transform Geometry Class

    Science.gov (United States)

    Szydlik, Jennifer Earles; Parrott, Amy; Belnap, Jason Knight

    2016-01-01

    Classroom culture is negotiated and established through both conversations and practices. Traditionally, teachers and researchers have focused primarily on the individual and social construction of mathematical content--that is, students' conceptual understanding and procedural skills--through mathematical actions and practices. This article…

  14. Conversation Analysis and Applied Linguistics.

    Science.gov (United States)

    Schegloff, Emanuel A.; Koshik, Irene; Jacoby, Sally; Olsher, David

    2002-01-01

    Offers biographical guidance on several major areas of conversation-analytic work--turn-taking, repair, and word selection--and indicates past or potential points of contact with applied linguistics. Also discusses areas of applied linguistic work. (Author/VWL)

  15. Facilitating Conversations about Managerial Identities

    DEFF Research Database (Denmark)

    Madsen, Mona Toft

    -based organization in the engineering consulting sector b) a reflection meeting, where the same three managers were gathered, and conversations were facilitated based on identity work in the context of earlier interviews. More specifically, three themes were discussed; flat organizational structure, tensions between...

  16. Humor and Embodied Conversational Agents

    NARCIS (Netherlands)

    Nijholt, Antinus

    This report surveys the role of humor in human-to-human interaction and the possible role of humor in human-computer interaction. The aim is to see whether it is useful for embodied conversational agents to integrate humor capabilities in their internal model of intelligence, emotions and

  17. Energy Conversion and Storage Program

    Energy Technology Data Exchange (ETDEWEB)

    Cairns, E.J.

    1992-03-01

    The Energy Conversion and Storage Program applies chemistry and materials science principles to solve problems in (1) production of new synthetic fuels, (2) development of high-performance rechargeable batteries and fuel cells, (3) development of advanced thermochemical processes for energy conversion, (4) characterization of complex chemical processes, and (5) application of novel materials for energy conversion and transmission. Projects focus on transport-process principles, chemical kinetics, thermodynamics, separation processes, organic and physical chemistry, novel materials, and advanced methods of analysis. Electrochemistry research aims to develop advanced power systems for electric vehicle and stationary energy storage applications. Topics include identification of new electrochemical couples for advanced rechargeable batteries, improvements in battery and fuel-cell materials, and the establishment of engineering principles applicable to electrochemical energy storage and conversion. Chemical Applications research includes topics such as separations, catalysis, fuels, and chemical analyses. Included in this program area are projects to develop improved, energy-efficient methods for processing waste streams from synfuel plants and coal gasifiers. Other research projects seek to identify and characterize the constituents of liquid fuel-system streams and to devise energy-efficient means for their separation. Materials Applications research includes the evaluation of the properties of advanced materials, as well as the development of novel preparation techniques. For example, the use of advanced techniques, such as sputtering and laser ablation, are being used to produce high-temperature superconducting films.

  18. Automated data mining: an innovative and efficient web-based approach to maintaining resident case logs.

    Science.gov (United States)

    Bhattacharya, Pratik; Van Stavern, Renee; Madhavan, Ramesh

    2010-12-01

    Use of resident case logs has been considered by the Residency Review Committee for Neurology of the Accreditation Council for Graduate Medical Education (ACGME). This study explores the effectiveness of a data-mining program for creating resident logs and compares the results to a manual data-entry system. Other potential applications of data mining to enhancing resident education are also explored. Patient notes dictated by residents were extracted from the Hospital Information System and analyzed using an unstructured mining program. History, examination and ICD codes were obtained and compared to the existing manual log. The automated data History, examination, and ICD codes were gathered for a 30-day period and compared to manual case logs. The automated method extracted all resident dictations with the dates of encounter and transcription. The automated data-miner processed information from all 19 residents, while only 4 residents logged manually. The manual method identified only broad categories of diseases; the major categories were stroke or vascular disorder 53 (27.6%), epilepsy 28 (14.7%), and pain syndromes 26 (13.5%). In the automated method, epilepsy 114 (21.1%), cerebral atherosclerosis 114 (21.1%), and headache 105 (19.4%) were the most frequent primary diagnoses, and headache 89 (16.5%), seizures 94 (17.4%), and low back pain 47 (9%) were the most common chief complaints. More detailed patient information such as tobacco use 227 (42%), alcohol use 205 (38%), and drug use 38 (7%) were extracted by the data-mining method. Manual case logs are time-consuming, provide limited information, and may be unpopular with residents. Data mining is a time-effective tool that may aid in the assessment of resident experience or the ACGME core competencies or in resident clinical research. More study of this method in larger numbers of residency programs is needed.

  19. The professionalism curriculum as a cultural change agent in surgical residency education.

    Science.gov (United States)

    Hochberg, Mark S; Berman, Russell S; Kalet, Adina L; Zabar, Sondra R; Gillespie, Colleen; Pachter, H Leon

    2012-01-01

    Teaching professionalism effectively to fully engaged residents is a significant challenge. A key question is whether the integration of professionalism into residency education leads to a change in resident culture. The goal of this study was to assess whether professionalism has taken root in the surgical resident culture 3 years after implementing our professionalism curriculum. Evidence was derived from 3 studies: (1) annual self-assessments of the residents' perceived professionalism abilities to perform 20 defined tasks representing core Accrediting Council on Graduate Medical Education professionalism domains, (2) objective metrics of their demonstrated professionalism skills as rated by standardized patients annually using the objective structure clinical examination tool, and (3) a national survey of the Surgical Professionalism and Interpersonal Communications Education Study Group. Study 1: aggregate perceived professionalism among surgical residents shows a statistically significant positive trend over time (P = .016). Improvements were seen in all 6 domains: accountability, ethics, altruism, excellence, patient sensitivity, and respect. Study 2: the cohort of residents followed up over 3 years showed a marked improvement in their professionalism skills as rated by standardized patients using the objective structure clinical examination tool. Study 3: 41 members of the national Surgical Professionalism and Interpersonal Communications Education Study Group rated their residents' skills in admitting mistakes, delivering bad news, communication, interdisciplinary respect, cultural competence, and handling stress. Twenty-nine of the 41 responses rated their residents as "slightly better" or "much better" compared with 5 years ago (P = .001). Thirty-four of the 41 programs characterized their department's leadership view toward professionalism as "much better" compared with 5 years ago. All 3 assessment methods suggest that residents feel increasingly

  20. Radiology Residents' Performance in Screening Mammography Interpretation

    International Nuclear Information System (INIS)

    Lee, Eun Hye; Lyou, Chae Yeon

    2013-01-01

    To evaluate radiology residents' performance in screening mammography interpretation and to analyze the factors affecting performance. We enrolled 203 residents from 21 institutions and performed mammography interpretation tests. Between the trainee and non-trainee groups, we compared the interpretation score, recall rate, sensitivity, positive predictive value (PPV) and false-positive rate (FPR). We estimated the training effect using the score differences between trainee and non-trainee groups. We analyzed the factors affecting performance between training-effective and non-effective groups. Trainees were superior to non-trainees regarding interpretation score (43.1 vs. 37.1), recall rate (11.0 vs. 15.5%), sensitivity (83.6 vs. 72.0%), PPV (53.0 vs. 32.4%) and FPR (13.5 vs. 25.5). The longer the training period, the better were the interpretation score, recall rate, sensitivity, PPV and FPR (rho = 0.486, -0.375, 0.343, 0.504, -0.446, respectively). The training affected an increase by an average of 6 points; however, 31.6% of institutions showed no effect. A difference was noted in the volume of mammography interpretation during a month (594.0 vs. 476.9) and dedication of breast staff (61.5 vs. 0%) between training-effective and non-effective groups. Trainees showed better performance in mammography interpretation compared to non-trainees. Moreover, performance was correlated with the training period. The factors affecting performance were the volume of mammography interpretation and the dedication of the breast staff.

  1. Full-spectrum volumetric solar thermal conversion via photonic nanofluids.

    Science.gov (United States)

    Liu, Xianglei; Xuan, Yimin

    2017-10-12

    Volumetric solar thermal conversion is an emerging technique for a plethora of applications such as solar thermal power generation, desalination, and solar water splitting. However, achieving broadband solar thermal absorption via dilute nanofluids is still a daunting challenge. In this work, full-spectrum volumetric solar thermal conversion is demonstrated over a thin layer of the proposed 'photonic nanofluids'. The underlying mechanism is found to be the photonic superposition of core resonances, shell plasmons, and core-shell resonances at different wavelengths, whose coexistence is enabled by the broken symmetry of specially designed composite nanoparticles, i.e., Janus nanoparticles. The solar thermal conversion efficiency can be improved by 10.8% compared with core-shell nanofluids. The extinction coefficient of Janus dimers with various configurations is also investigated to unveil the effects of particle couplings. This work provides the possibility to achieve full-spectrum volumetric solar thermal conversion, and may have potential applications in efficient solar energy harvesting and utilization.

  2. Semiconductor nanowires for photovoltaic and photoelectrochemical energy conversion

    Energy Technology Data Exchange (ETDEWEB)

    Dasgupta, Neil; Yang, Peidong

    2013-01-23

    Semiconductor nanowires (NW) possess several beneficial properties for efficient conversion of solar energy into electricity and chemical energy. Due to their efficient absorption of light, short distances for minority carriers to travel, high surface-to-volume ratios, and the availability of scalable synthesis methods, they provide a pathway to address the low cost-to-power requirements for wide-scale adaptation of solar energy conversion technologies. Here we highlight recent progress in our group towards implementation of NW components as photovoltaic and photoelectrochemical energy conversion devices. An emphasis is placed on the unique properties of these one-dimensional (1D) structures, which enable the use of abundant, low-cost materials and improved energy conversion efficiency compared to bulk devices.

  3. Taxonomy of instructions given to residents in laparoscopic cholecystectomy.

    Science.gov (United States)

    Feng, Yuanyuan; Wong, Christopher; Park, Adrian; Mentis, Helena

    2016-03-01

    Although simulation-based training allows residents to become proficient in surgical skills outside the OR, residents still depend on senior surgeons' guidance in transferring skills accumulated from simulators into the operating room. This study aimed to identify and classify explicit instructions made by attending surgeons to their residents during laparoscopic surgery. Through these instructions, we examined the role gaze guidance plays in OR-based training. A total of ten laparoscopic cholecystectomy cases being performed by PGY4 residents were analyzed. The explicit directional instructions given by the mentoring attending surgeons to their residents were identified and classified into four categories based on their locations in the coordinate system. These categories were further combined into two classes, based on the target of instructions. The frequencies of instructions in the two classes were compared, and effect size was calculated. There were 1984 instructions identified in the ten cases. The instructions were categorized into instrument guidance (38.51%) and gaze guidance (61.49%). The instrument guidance focused on moving the instruments to perform surgical tasks, including directions to targets, instrument manipulation, and instrument interaction. The gaze guidance focused on achieving common ground during the operation, including target identification and target fixation. The frequency of gaze guidance is significantly higher than instrument guidance in a laparoscopic cholecystectomy (p guidance has become the main focus of OR-based training. The results show a tight connection between adopting expert gaze and performing surgical tasks and suggest that gaze training should be integrated into the simulation training.

  4. Autonomy and social functioning of recently admitted nursing home residents.

    Science.gov (United States)

    Paque, Kristel; Goossens, Katrien; Elseviers, Monique; Van Bogaert, Peter; Dilles, Tinne

    2017-09-01

    This paper examines recently admitted nursing home residents' practical autonomy, their remaining social environment and their social functioning. In a cross-sectional design, 391 newly admitted residents of 67 nursing homes participated. All respondents were ≥65 years old, had mini-mental state examination ≥18 and were living in the nursing home for at least 1 month. Data were collected using a structured questionnaire and validated measuring tools. The mean age was 84, 64% were female, 23% had a partner, 80% children, 75% grandchildren and 59% siblings. The mean social functioning score was 3/9 (or 33%) and the autonomy and importance of autonomy score 6/9 (or 67%). More autonomy was observed when residents could perform activities of daily living more independently, and cognitive functioning, quality of life and social functioning were high. Residents with depressive feelings scored lower on autonomy and social functioning compared to those without depressive feelings. Having siblings and the frequency of visits positively correlated with social functioning. In turn, social functioning correlated positively with quality of life. Moreover, a higher score on social functioning lowered the probability of depression. Autonomy or self-determination and maintaining remaining social relationships were considered to be important by the new residents. The remaining social environment, social functioning, quality of life, autonomy and depressive feelings influenced each other, but the cause--effect relation was not clear.

  5. Burnout and interventions in pediatric residency: A literature review

    Directory of Open Access Journals (Sweden)

    Tara F. McKinley

    2017-09-01

    Full Text Available Despite an increase in interest in issues related to burnout in medical education and mandates from the national residency accrediting body, available literature is sparse in pediatrics, a medical discipline that requires special empathy and compassion, as well as enhanced communication skills to effectively care for children and their families. Burnout prevalence ranges from 17 to 67.8% of pediatric residents in recent studies. There is little that details the pathogenesis of burnout in these residents and little that compares them with those in other medical disciplines. This comprehensive literature review describes all that is published on burnout and burnout interventions since 2005 in pediatrics and other primary care oriented specialty residents, as well as key papers from pre-2005. This review, with its focus on the available information and evidence-based intervention strategies, identifies four areas for focus for future interventions and directions. It should serve as a useful resource to program directors, medical educators and graduate medical education leadership who are committed to preventing and/or treating burnout in their residents and molding these young physicians to be able to maintain resilience through their careers. This review should also be useful to investigators exploring burnout in other health care professionals.

  6. Factors Associated with Medical Knowledge Acquisition During Internal Medicine Residency

    Science.gov (United States)

    Zeger, Scott L.; Kolars, Joseph C.

    2007-01-01

    BACKGROUND Knowledge acquisition is a goal of residency and is measurable by in-training exams. Little is known about factors associated with medical knowledge acquisition. OBJECTIVE To examine associations of learning habits on medical knowledge acquisition. DESIGN, PARTICIPANTS Cohort study of all 195 residents who took the Internal Medicine In-Training Examination (IM-ITE) 421 times over 4 years while enrolled in the Internal Medicine Residency, Mayo Clinic, Rochester, MN. MEASUREMENTS Score (percent questions correct) on the IM-ITE adjusted for variables known or hypothesized to be associated with score using a random effects model. RESULTS When adjusting for demographic, training, and prior achievement variables, yearly advancement within residency was associated with an IM-ITE score increase of 5.1% per year (95%CI 4.1%, 6.2%; p international medical school graduation, −3.4% (95%CI −6.5%, −0.36%; p = .03). CONCLUSIONS Conference attendance and self-directed reading of an electronic knowledge resource had statistically and educationally significant independent associations with knowledge acquisition that were comparable to the benefit of a year in residency training. PMID:17468889

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

    Science.gov (United States)

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

    2012-10-01

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

  8. Obesity and intensive staffing needs of nursing home residents.

    Science.gov (United States)

    Harris, John Alexander; Engberg, John; Castle, Nicholas George

    2018-06-05

    The objective of this study is to examine how increasing body mass index (BMI) among nursing home residents affects the amount of staffing assistance needed for activities of daily living (ADL). We analyzed 1,627,141 US nursing home residents reported in the 2013 Minimum Data Set in seven BMI categories, from underweight (B