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Sample records for reside explain variations

  1. Explaining variation in nascent entrepreneurship

    NARCIS (Netherlands)

    A.J. van Stel (André); A.R.M. Wennekers (Sander); P. Reynolds (Paul); A.R. Thurik (Roy)

    2004-01-01

    textabstractThis paper aims at explaining cross-country variation in nascent entrepreneurship. Regression analysis is applied using various explanatory variables derived from three different approaches. We make use of the Global Entrepreneurship Monitor database, including nascent entrepreneurship

  2. Explaining mutualism variation: a new evolutionary paradox?

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    Heath, Katy D; Stinchcombe, John R

    2014-02-01

    The paradox of mutualism is typically framed as the persistence of interspecific cooperation, despite the potential advantages of cheating. Thus, mutualism research has tended to focus on stabilizing mechanisms that prevent the invasion of low-quality partners. These mechanisms alone cannot explain the persistence of variation for partner quality observed in nature, leaving a large gap in our understanding of how mutualisms evolve. Studying partner quality variation is necessary for applying genetically explicit models to predict evolution in natural populations, a necessary step for understanding the origins of mutualisms as well as their ongoing dynamics. An evolutionary genetic approach, which is focused on naturally occurring mutualist variation, can potentially synthesize the currently disconnected fields of mutualism evolution and coevolutionary genetics. We outline explanations for the maintenance of genetic variation for mutualism and suggest approaches necessary to address them. © 2013 The Author(s). Evolution © 2013 The Society for the Study of Evolution.

  3. Explaining variation in Down's syndrome screening uptake

    DEFF Research Database (Denmark)

    Crombag, Neeltje M T H; Vellinga, Ynke E; Kluijfhout, Sandra A

    2014-01-01

    ), in an attempt to explain the observed variation in national uptake rates. METHODS: We used a mixed methods approach with an embedded design: a) documentary analysis and b) expert stakeholder analysis. National central statistical offices and legal documents were studied first to gain insight in demographic....... RESULTS: There were many similarities in the demographics, healthcare systems, government abortion legislation and Down's syndrome screening policy across the studied countries. However, the additional cost for Down's syndrome screening over and above standard antenatal care in the Netherlands...

  4. Explaining Direct Care Resource Use of Nursing Home Residents: Findings from Time Studies in Four States

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    Arling, Greg; Kane, Robert L; Mueller, Christine; Lewis, Teresa

    2007-01-01

    Objective To explain variation in direct care resource use (RU) of nursing home residents based on the Resource Utilization Groups III (RUG-III) classification system and other resident- and unit-level explanatory variables. Data Sources/Study Setting Primary data were collected on 5,314 nursing home residents in 156 nursing units in 105 facilities from four states (CO, IN, MN, MS) from 1998 to 2004. Study Design Nurses and other direct care staff recorded resident-specific and other time caring for all residents on sampled nursing units. Care time was linked to resident data from the Minimum Data Set assessment instrument. Major variables were: RUG-III group (34-group), other health and functional conditions, licensed and other professional minutes per day, unlicensed minutes per day, and direct care RU (wage-weighted minutes). Resident- and unit-level relationships were examined through hierarchical linear modeling. Data Collection/Extraction Methods Time study data were recorded with hand-held computers, verified for accuracy by project staff at the data collection sites and then merged into resident and unit-level data sets. Principal Findings Resident care time and RU varied between and within nursing units. RUG-III group was related to RU; variables such as length of stay and unit percentage of high acuity residents also were significantly related. Case-mix indices (CMIs) constructed from study data displayed much less variation across RUG-III groups than CMIs from earlier time studies. Conclusions Results from earlier time studies may not be representative of care patterns of Medicaid and private pay residents. New RUG-III CMIs should be developed to better reflect the relative costs of caring for these residents. PMID:17362220

  5. Thrive or Survive? Explaining Variation in Economic Outcomes for Refugees

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    Alexander Betts

    2017-11-01

    Full Text Available In the context of protracted refugee situations, there has been a revival in concern among policymakers to transcend the so-called humanitarian-development divide and create greater opportunities for self-reliance. Yet, these discussions too often neglect an analytical focus on refugees’ own economic lives, and their own interactions with markets.Despite a growing literature on the economic lives of refugees, much of that work has lacked theory or data. The work that has been quantitative has generally focused on the economic impact of refugees on host countries rather than explaining variation in economic outcomes for refugees.  In order to explain variation in economic outcomes for refugees, this paper asks three questions about the economic lives of refugees: 1 what makes the economic lives of refugees distinctive from other populations; 2 what explains variation in refugees’ income levels; and 3 what role does entrepreneurship play in shaping refugees’ economic outcomes?In order to answer these questions, the paper draws upon extensive qualitative and quantitative research conducted in Uganda by the Humanitarian Innovation Project at Oxford University. The quantitative data set is based on a survey of 2,213 refugees in three types of contexts: urban (Kampala, protracted camps (Nakivale and Kyangwali settlements, and emergency camps (Rwamwanja. It supplements this with qualitative research from other parts of Africa and the Middle East. The economic lives of refugees are argued to be distinctive not because refugees are any different qua human beings but because they often occupy a distinctive institutional space. Following new institutional economics, the paper argues that “refugee economies” represent a distinctive analytical space insofar as refugees face different formal and informal institutional barriers and distortions in their economic lives compared to nationals or other migrants. Even within the same country, refugees

  6. Four loci explain 83% of size variation in the horse.

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    Shokouh Makvandi-Nejad

    Full Text Available Horse body size varies greatly due to intense selection within each breed. American Miniatures are less than one meter tall at the withers while Shires and Percherons can exceed two meters. The genetic basis for this variation is not known. We hypothesize that the breed population structure of the horse should simplify efforts to identify genes controlling size. In support of this, here we show with genome-wide association scans (GWAS that genetic variation at just four loci can explain the great majority of horse size variation. Unlike humans, which are naturally reproducing and possess many genetic variants with weak effects on size, we show that horses, like other domestic mammals, carry just a small number of size loci with alleles of large effect. Furthermore, three of our horse size loci contain the LCORL, HMGA2 and ZFAT genes that have previously been found to control human height. The LCORL/NCAPG locus is also implicated in cattle growth and HMGA2 is associated with dog size. Extreme size diversification is a hallmark of domestication. Our results in the horse, complemented by the prior work in cattle and dog, serve to pinpoint those very few genes that have played major roles in the rapid evolution of size during domestication.

  7. Explaining the Learning Experiences of Clinical Procedures of the Internal Medicine Residents at Department of Gastroenterology

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    Mansoureh Taghavinia

    2012-07-01

    Full Text Available Introduction: the method and way of learning and teaching are effective in acquiring clinical skills, and identifying the shortcomings of learning and teaching will lead to better planning. The purpose of this study was to explain the experiences of the learning clinical procedures of the internal medicine residents in gastroenterology department. Methods: qualitative study using content thematic analysis was done. Six fourth-year residents were selected and interviewed considering purposive sampling. The data of the interviews were transcribed and analyzed after rereading. Results: the collected data are divided into three categories: learning and experience with the following four categories (learning time and experiencing, leaning and experiencing times, learning and experiencing opportunities, training and the lack of the training of some procedures. These categories are explained by using some quotes derived from the data. Conclusion: the results of this study suggest that the administrative management of internal residency is poor and should get seriously in implementation and application of intended instructions existing in the prepared program of Medical Education and Specialized Council of internal residency period. The attending physicians and residents must be aware of the content of education program at the beginning of the residency periods and the trainers must try to supervise the residents’ education.

  8. Nest predation risk explains variation in avian clutch size

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    Dillon, Kristen G.; Conway, Courtney J.

    2018-01-01

    Questions about the ecological drivers of, and mechanistic constraints on, productivity have driven research on life-history evolution for decades. Resource availability and offspring mortality are considered among the 2 most important influences on the number of offspring per reproductive attempt. We used a factorial experimental design to manipulate food abundance and perceived offspring predation risk in a wild avian population (red-faced warblers; Cardellina rubrifrons) to identify the mechanistic cause of variation in avian clutch size. Additionally, we tested whether female quality helped explain the extant variation in clutch size. We found no support for the Food Limitation or Female Quality Hypotheses, but we did find support for both predictions of the Nest Predation Risk Hypothesis. Females that experienced an experimentally heightened perception of offspring predation risk responded by laying a smaller clutch than females in the control group. Additionally, predation rates at artificial nests were highest where red-faced warbler clutch size was smallest (at high elevations). Life-history theory predicts that an individual should invest less in reproduction when high nest predation risk reduces the likely benefit from that nesting attempt and, indeed, we found that birds exhibit phenotypic plasticity in clutch size by laying fewer eggs in response to increasing nest predation risk.

  9. Explaining variation in the uptake of HPV vaccination in England

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    Whynes David K

    2011-03-01

    Full Text Available Abstract Background In England, two national programmes of HPV vaccination for girls have been instituted, a routine programme for 12- and 13-year-olds and a catch-up programme for 17- and 18-year-olds. Uptake rates across the country have been far from uniform, and this research sought to identify factors explaining the variation in uptake by locality. Methods An association between uptake, deprivation and ethnic background had been established in pilot research. The present analysis was conducted at an aggregate, Primary Care Trust (PCT, level for the first year of the programmes. Published measures of HPV vaccination uptake, material deprivation, ethnic composition of PCT populations, primary care quality, and uptake of cervical screening and of other childhood immunisations were collated. Strong evidence of collinearity amongst the explanatory variables required a factor analysis to be undertaken. This provided four independent factors, used thereafter in regression models to explain uptake by PCT. Results The factor analysis revealed that ethnic composition was associated with attitudes towards cervical screening and other childhood vaccinations, whilst material deprivation and quality of primary care were orthogonal. Ethnic composition, early childhood vaccination, cervical screening and primary care quality were found to be influential in predicting uptake in both the routine and the catch-up cohorts, although with a lower degree of confidence in the case of the last two independent variables. Lower primary care quality was significant in explaining a greater fall in vaccination uptake between the first two doses in the catch-up cohort. Greater deprivation was a significant explanatory factor for both uptake and the fall in uptake between doses for the catch-up cohort but not for uptake in the routine cohort. Conclusion These results for uptake of the first year of the national programme using aggregate data corroborate findings from

  10. Anatomic variation and orgasm: Could variations in anatomy explain differences in orgasmic success?

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    Emhardt, E; Siegel, J; Hoffman, L

    2016-07-01

    Though the public consciousness is typically focused on factors such as psychology, penis size, and the presence of the "G-spot," there are other anatomical and neuro-anatomic differences that could play an equal, or more important, role in the frequency and intensity of orgasms. Discovering these variations could direct further medical or procedural management to improve sexual satisfaction. The aim of this study is to review the available literature of anatomical sexual variation and to explain why this variation may predispose some patients toward a particular sexual experience. In this review, we explored the available literature on sexual anatomy and neuro-anatomy. We used PubMed and OVID Medline for search terms, including orgasm, penile size variation, clitoral variation, Grafenberg spot, and benefits of orgasm. First we review the basic anatomy and innervation of the reproductive organs. Then we describe several anatomical variations that likely play a superior role to popular known variation (penis size, presence of g-spot, etc). For males, the delicate play between the parasympathetic and sympathetic nervous systems is vital to achieve orgasm. For females, the autonomic component is more complex. The clitoris is the primary anatomical feature for female orgasm, including its migration toward the anterior vaginal wall. In conclusions, orgasms are complex phenomena involving psychological, physiological, and anatomic variation. While these variations predispose people to certain sexual function, future research should explore how to surgically or medically alter these. Clin. Anat. 29:665-672, 2016. © 2016 Wiley Periodicals, Inc. © 2016 Wiley Periodicals, Inc.

  11. Muscle characteristics only partially explain color variations in fresh hams.

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    Stufft, K; Elgin, J; Patterson, B; Matarneh, S K; Preisser, R; Shi, H; England, E M; Scheffler, T L; Mills, E W; Gerrard, D E

    2017-06-01

    Fresh hams display significant lean color variation that persists through further processing and contributes to a less desirable cured product. In an attempt to understand the underlying cause of this color disparity, we evaluated the differences in muscle characteristics and energy metabolites across semimembranosus (SM) muscles differing in color variation. The L* (lightness) and a* (redness) values were highest and lowest (Pham color variation but suggest other factors may mitigate or exacerbate these variances. Copyright © 2016 Elsevier Ltd. All rights reserved.

  12. Quantitative Social Dialectology : Explaining Linguistic Variation Geographically and Socially

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    Wieling, Martijn; Nerbonne, John; Baayen, R. Harald

    2011-01-01

    In this study we examine linguistic variation and its dependence on both social and geographic factors. We follow dialectometry in applying a quantitative methodology and focusing on dialect distances, and social dialectology in the choice of factors we examine in building a model to predict word

  13. Stress Redistribution Explains Anti-correlated Subglacial Pressure Variations

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    Pierre-Marie Lefeuvre

    2018-01-01

    Full Text Available We used a finite element model to interpret anti-correlated pressure variations at the base of a glacier to demonstrate the importance of stress redistribution in the basal ice. We first investigated two pairs of load cells installed 20 m apart at the base of the 210 m thick Engabreen glacier in Northern Norway. The load cell data for July 2003 showed that pressurisation of a subglacial channel located over one load cell pair led to anti-correlation in pressure between the two pairs. To investigate the cause of this anti-correlation, we used a full Stokes 3D model of a 210 m thick and 25–200 m wide glacier with a pressurised subglacial channel represented as a pressure boundary condition. The model reproduced the anti-correlated pressure response at the glacier bed and variations in pressure of the same order of magnitude as the load cell observations. The anti-correlation pattern was shown to depend on the bed/surface slope. On a flat bed with laterally constrained cross-section, the resulting bridging effect diverted some of the normal forces acting on the bed to the sides. The anti-correlated pressure variations were then reproduced at a distance >10–20 m from the channel. In contrast, when the bed was inclined, the channel support of the overlying ice was vertical only, causing a reduction of the normal stress on the bed. With a bed slope of 5 degrees, the anti-correlation occurred within 10 m of the channel. The model thus showed that the effect of stress redistribution can lead to an opposite response in pressure at the same distance from the channel and that anti-correlation in pressure is reproduced without invoking cavity expansion caused by sliding.

  14. Explaining brain size variation: from social to cultural brain.

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    van Schaik, Carel P; Isler, Karin; Burkart, Judith M

    2012-05-01

    Although the social brain hypothesis has found near-universal acceptance as the best explanation for the evolution of extensive variation in brain size among mammals, it faces two problems. First, it cannot account for grade shifts, where species or complete lineages have a very different brain size than expected based on their social organization. Second, it cannot account for the observation that species with high socio-cognitive abilities also excel in general cognition. These problems may be related. For birds and mammals, we propose to integrate the social brain hypothesis into a broader framework we call cultural intelligence, which stresses the importance of the high costs of brain tissue, general behavioral flexibility and the role of social learning in acquiring cognitive skills. Copyright © 2012 Elsevier Ltd. All rights reserved.

  15. Fluctuating survival selection explains variation in avian group size.

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    Brown, Charles R; Brown, Mary Bomberger; Roche, Erin A; O'Brien, Valerie A; Page, Catherine E

    2016-05-03

    Most animal groups vary extensively in size. Because individuals in certain sizes of groups often have higher apparent fitness than those in other groups, why wide group size variation persists in most populations remains unexplained. We used a 30-y mark-recapture study of colonially breeding cliff swallows (Petrochelidon pyrrhonota) to show that the survival advantages of different colony sizes fluctuated among years. Colony size was under both stabilizing and directional selection in different years, and reversals in the sign of directional selection regularly occurred. Directional selection was predicted in part by drought conditions: birds in larger colonies tended to be favored in cooler and wetter years, and birds in smaller colonies in hotter and drier years. Oscillating selection on colony size likely reflected annual differences in food availability and the consequent importance of information transfer, and/or the level of ectoparasitism, with the net benefit of sociality varying under these different conditions. Averaged across years, there was no net directional change in selection on colony size. The wide range in cliff swallow group size is probably maintained by fluctuating survival selection and represents the first case, to our knowledge, in which fitness advantages of different group sizes regularly oscillate over time in a natural vertebrate population.

  16. Variations in pollen counts largely explained by climate and weather

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    Jung, Stephan; Damialis, Athanasios; Estrella, Nicole; Jochner, Susanne; Menzel, Annette

    2017-04-01

    The interaction between climate and vegetation is well studied within phenology. Climatic / weather conditions affect e.g. flowering date, length of vegetation period, start and end of the season and the plant growth. Besides phenological stages also pollen counts can be used to investigate the interaction between climate and vegetation. Pollen emission and distribution is directly influenced by temperature, wind speed, wind direction and humidity/precipitation. The objective of this project is to study daily/sub daily variations in pollen counts of woody and herbaceous plant species along an altitudinal gradient with different climatic conditions during the vegetation period. Measurements of pollen were carried out with three volumetric pollen traps installed at the altitudes 450 m a.s.l (Freising), 700 m a.s.l (Garmisch-Partenkirchen), and 2700 m a.s.l (Schneefernerhaus near Zugspitze) representing gradient from north of Munich towards the highest mountain of Germany. Airborne pollen concentrations were recorded during the years 2014-2015. The altitudinal range of these three stations accompanied by different microclimates ("space for time approach") can be used as proxy for climate change and to assess its impact on pollen counts and thus allergenic risk for human health. For example the pollen season is shortened and pollen amount is reduced at higher sites. For detailed investigations pollen of the species Plantago, Quercus, Poaceae, Cupressaceae, Cyperacea, Betula and Platanus were chosen, because those are found in appropriate quantities. In general, pollen captured in the pollen traps to a certain extent has its origin from the immediate surrounding. Thus, it mirrors local species distribution. But furthermore the distance of pollen transport is also based on (micro-) climatic conditions, land cover and topography. The pollen trap shortly below the summit of Zugspitze (Schneefernerhaus) has an alpine environment without vegetation nearby. Therefore, this

  17. Swallowing disorders in nursing home residents: how can the problem be explained?

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    Nogueira D

    2013-02-01

    Full Text Available Dália Nogueira,1 Elizabeth Reis21Speech Therapy Department, Escola Superior de Saúde de Alcoitão, Estoril, Portugal; 2Department of Quantitative Methods, Lisbon University Institute ISCTE/IUL, Lisbon, PortugalBackground: The swallowing mechanism changes significantly as people age, even in the absence of chronic diseases. Presbyphagia, a term that refers to aging-related changes in the swallowing mechanism, may be linked to many health conditions and presents itself in distinct ways. Swallowing disorders are also identified as a major problem amongst the elderly population living in nursing homes.Methods: The study sought to determine the prevalence of swallowing disorders in nursing home residents, to identify the relationship between self-perceived swallowing disorders, cognitive functions, autonomy, and depression, and also to analyze which variables explain the score of the Dysphagia Self-Test (DST. For this purpose, the researchers chose to apply a survey conveying questions on demographic aspects, general health, eating and feeding, as well as instruments to assess functional performance and the 3 ounce Water Swallow Test.Results: The sample consisted of 272 elderly people living in eight nursing homes in Portugal. Six did not sign the informed consent form. Of the total, 29% were totally dependent, 33% were depressed, 45% had cognitive impairment, and 38% needed help with feeding. About 43% of the individuals reported having problems related to eating. Regarding the DST, 40% showed signs of dysphagia. With respect to the 3 ounce Water Swallow Test, 38% revealed at least one of the symptoms, wet voice being the most prevalent. Correlation measures showed that age had no linear association with the DST score although correlation with the Barthel Index and Mini Mental State Examination was found to be significant. A linear regression model was estimated with the DST score as the dependent variable and the MMSE and BI scores, gender, age

  18. Does geography or ecology best explain 'cultural' variation among chimpanzee communities?

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    Kamilar, Jason M; Marshack, Joshua L

    2012-02-01

    Much attention has been paid to geographic variation in chimpanzee behavior, but few studies have applied quantitative techniques to explain this variation. Here, we apply methods typically utilized in macroecology to explain variation in the putative cultural traits of chimpanzees. We analyzed published data containing 39 behavioral traits from nine chimpanzee communities. We used a canonical correspondence analysis to examine the relative importance of environmental characteristics and geography, which may be a proxy for inter-community gene flow and/or social transmission, for explaining geographic variation in chimpanzee behavior. We found that geography, and longitude in particular, was the best predictor of behavioral variation. Chimpanzee communities in close longitudinal proximity to each other exhibit similar behavioral repertoires, independent of local ecological factors. No ecological variables were significantly related to behavioral variation. These results support the idea that inter-community dispersal patterns have played a major role in structuring behavioral variation. We cannot be certain whether behavioral variation has a genetic basis, is the result of innovation and diffusion, or a combination of the two. Copyright © 2011 Elsevier Ltd. All rights reserved.

  19. Variation in the place of death among nursing home residents in France.

    Science.gov (United States)

    Morin, Lucas; Johnell, Kristina; Aubry, Régis

    2015-05-01

    recent studies have reported that hospitals have become a common place of death for nursing home residents. This study aimed to (i) measure variations in the proportion of in-hospital deaths across regions after adjustment for facility-level characteristics and (ii) identify environmental risk factors that might explain these variations in France. a cross-sectional retrospective survey was conducted in 2013. coordinating physicians in 3,705 nursing homes in France. a regression model was used to construct risk-adjusted rates of in-hospital deaths considering the facilities' characteristics. At the regional level, the outcome was defined as the difference between the observed rate of in-hospital deaths and the expected risk-adjusted rate. Values exceeding zero indicated rates that exceeded the national predicted rate of in-hospital deaths and thus highlighted regions in which the risk-adjusted probability for nursing home residents to die in a hospital was greater than average. among 70,119 nursing home decedents, 25.4% (n = 17,789) died in hospitals. The characteristics of the facilities had a significant influence on the proportion of in-hospital deaths among the nursing home decedents. However, after adjustment for these facility-level risk factors, the proportion of nursing homes that reported worse-than-average outcomes showed significant variation (range 26.0-79.6%). At the regional level, both the rate of acute hospital beds and the rate of general practitioners were found to be strongly correlated with the probability of reporting worse-than-average outcomes (P nursing home facilities. © The Author 2015. Published by Oxford University Press on behalf of the British Geriatrics Society. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

  20. Explaining growth variation over large spatial scales: Effects of temperature and food on walleye growth

    DEFF Research Database (Denmark)

    Mosgaard, Thomas; Venturelli, Paul; Lester, Nigel P.

    2012-01-01

    freshwater fish species in North America. We then use length at age data from yellow perch (Perca flavescens) to identify the mechanisms behind the remaining variation in the length at age – temperature relationship for walleye. A positive perch – walleye relationship indicates that the mechanism behind......Most fishes exhibit strong spatial variation in growth. Because fish growth and production are tightly linked, quantifying and explaining variation in growth can mean the difference between successful management and unforeseen collapse. However, disentangling the factors that are responsible...

  1. Variation in fistula use across dialysis facilities: is it explained by case-mix?

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    Tangri, Navdeep; Moorthi, Ranjani; Tighiouhart, Hocine; Meyer, Klemens B; Miskulin, Dana C

    2010-02-01

    Arteriovenous fistulas (AVFs) remain the preferred vascular access for hemodialysis patients. Dialysis facilities that fail to meet Centers for Medicare & Medicaid Services goals cite patient case-mix as a reason for low AVF prevalence. This study aimed to determine the magnitude of the variability in AVF usage across dialysis facilities and the extent to which patient case-mix explains it. The vascular access used in 10,112 patients dialyzed at 173 Dialysis Clinic Inc. facilities from October 1 to December 31, 2004, was evaluated. The access in use was considered to be an AVF if it was used for >70% of hemodialysis treatments. Mixed-effects models with a random intercept for dialysis facilities evaluated the effect of facilities on AVF usage. Sequentially adjusted multivariate models measured the extent to which patient factors (case-mix) explain variation across facilities in AVF rates. 3787 patients (38%) were dialyzed using AVFs. There was a significant facility effect: 7.6% of variation in AVF use was attributable to facility. This was reduced to 7.1% after case-mix adjustment. There were no identified specific facility-level factors that explained the interfacility variation. AVF usage varies across dialysis facilities, and patient case-mix did not reduce this variation. In this study, 92% of the total variation in AVF usage was due to patient factors, but most were not measurable. A combination of patient factors and process indicators should be considered in adjudicating facility performance for this quality indicator.

  2. Explaining regional variation in home care use by demand and supply variables.

    Science.gov (United States)

    van Noort, Olivier; Schotanus, Fredo; van de Klundert, Joris; Telgen, Jan

    2018-02-01

    In the Netherlands, home care services like district nursing and personal assistance are provided by private service provider organizations and covered by private health insurance companies which bear legal responsibility for purchasing these services. To improve value for money, their procurement increasingly replaces fee-for-service payments with population based budgets. Setting appropriate population budgets requires adaptation to the legitimate needs of the population, whereas historical costs are likely to be influenced by supply factors as well, not all of which are necessarily legitimate. Our purpose is to explain home care costs in terms of demand and supply factors. This allows for adjusting historical cost patterns when setting population based budgets. Using expenses claims of 60 Dutch municipalities, we analyze eight demand variables and five supply variables with a multiple regression model to explain variance in the number of clients per inhabitant, costs per client and costs per inhabitant. Our models explain 69% of variation in the number of clients per inhabitant, 28% of costs per client and 56% of costs per inhabitant using demand factors. Moreover, we find that supply factors explain an additional 17-23% of variation. Predictors of higher utilization are home care organizations that are integrated with intramural nursing homes, higher competition levels among home care organizations and the availability of complementary services. Copyright © 2017. Published by Elsevier B.V.

  3. Explaining reported puma-related behaviors and behavioral intentions among northern Arizona residents

    Science.gov (United States)

    Mattson, David J.; Ruther, Elizabeth J.

    2012-01-01

    Management of pumas in the American West is typified by conflict among stakeholders plausibly rooted in life experiences and worldviews. We used a mail questionnaire to assess demographics, nature-views, puma-related life experiences and behaviors, and support for puma-related policies among residents of northern Arizona. Data from the questionnaire (n = 693 respondents) were used to model behaviors and support for policies. Compared to models based on nature-views and life experiences, those based on demographics had virtually no support from the data. The Utilitarian/Dominionistic nature-view had the strongest effect of any variable in six of seven models, and was associated with firearms and opposition to policies that would limit killing pumas. The Humanistic/Moralistic nature-view was positively associated with non-lethal behaviors and policies in five models. Gender had the strongest effect of any demographic variable. Compared to demographics alone, our results suggest that worldviews provide a more meaningful explanation of reported human behaviors and behavioral intentions regarding pumas.

  4. Establishing a Set of Macroeconomic Factors Explaining Variation Over Time of Performance in Business Sectors

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    Audrius Dzikevičius

    2016-06-01

    Full Text Available With increasing competitiveness of companies and business sectors in the domestic markets of Lithuania, economic units are frequently confronted with the lack of methods for more detailed analysis of external factors explaining the variation over time of corporate financial indicators. The analysis or forecasting of financial indicators is usually linked with the development of a stock market or undertaken to estimate the probability of bankruptcy. However, there is a lack of studies aimed at identifying links between macroeconomic factors and financial performance indicators and explaining their variation over time. To serve that purpose, the factors of the macroeconomic environment that are most significant for certain economic activities have been identified and analysed to enable explaining the variation over time patterns of corporate financial indicators. The analysis covers economic performance, i.e. financial performance indicators and their links with macroeconomic factors, in 89 business sectors of Lithuania at a three-digit level of NACE 2 ed. The findings of the research indicate that the unemployment level in the country, the volume of export and import and the GDP are the most important macroeconomic factors that can be used to forecast different profitability, financial leverage, liquidity and other financial performance indicators of individual business sectors or companies. The research has not unfolded any significant differences between business sectors therefore the above factors are considered generic macroeconomic factors enabling to explain financial performance indicators of the 89 business sectors. Hence, special attention has to be paid to identifying and analysing specific factors and assessing the causal link. When established, the set of such factors provides a framework for building of a model to forecast business sector financial indicators.

  5. Explaining health care expenditure variation: large-sample evidence using linked survey and health administrative data.

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    Ellis, Randall P; Fiebig, Denzil G; Johar, Meliyanni; Jones, Glenn; Savage, Elizabeth

    2013-09-01

    Explaining individual, regional, and provider variation in health care spending is of enormous value to policymakers but is often hampered by the lack of individual level detail in universal public health systems because budgeted spending is often not attributable to specific individuals. Even rarer is self-reported survey information that helps explain this variation in large samples. In this paper, we link a cross-sectional survey of 267 188 Australians age 45 and over to a panel dataset of annual healthcare costs calculated from several years of hospital, medical and pharmaceutical records. We use this data to distinguish between cost variations due to health shocks and those that are intrinsic (fixed) to an individual over three years. We find that high fixed expenditures are positively associated with age, especially older males, poor health, obesity, smoking, cancer, stroke and heart conditions. Being foreign born, speaking a foreign language at home and low income are more strongly associated with higher time-varying expenditures, suggesting greater exposure to adverse health shocks. Copyright © 2013 John Wiley & Sons, Ltd.

  6. Can variation in risk of nest predation explain altitudinal migration in tropical birds?

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    Boyle, W Alice

    2008-03-01

    Migration is among the best studied of animal behaviors, yet few empirical studies have tested hypotheses explaining the ultimate causes of these cyclical annual movements. Fretwell's (1980) hypothesis predicts that if nest predation explains why many tropical birds migrate uphill to breed, then predation risk must be negatively associated with elevation. Data from 385 artificial nests spanning 2,740 m of elevation on the Atlantic slope of Costa Rica show an overall decline in predation with increasing elevation. However, nest predation risk was highest at intermediate elevations (500-650 m), not at lowest elevations. The proportion of nests depredated by different types of predators differed among elevations. These results imply that over half of the altitudinal migrant bird species in this region migrate to safer breeding areas than their non-breeding areas, suggesting that variation in nest predation risk could be an important benefit of uphill migrations of many species.

  7. Explained variation and predictive accuracy in general parametric statistical models: the role of model misspecification

    DEFF Research Database (Denmark)

    Rosthøj, Susanne; Keiding, Niels

    2004-01-01

    When studying a regression model measures of explained variation are used to assess the degree to which the covariates determine the outcome of interest. Measures of predictive accuracy are used to assess the accuracy of the predictions based on the covariates and the regression model. We give a ...... a detailed and general introduction to the two measures and the estimation procedures. The framework we set up allows for a study of the effect of misspecification on the quantities estimated. We also introduce a generalization to survival analysis....

  8. A marker of biological age explains individual variation in the strength of the adult stress response.

    Science.gov (United States)

    Andrews, Clare; Nettle, Daniel; Larriva, Maria; Gillespie, Robert; Reichert, Sophie; Brilot, Ben O; Bedford, Thomas; Monaghan, Pat; Spencer, Karen A; Bateson, Melissa

    2017-09-01

    The acute stress response functions to prioritize behavioural and physiological processes that maximize survival in the face of immediate threat. There is variation between individuals in the strength of the adult stress response that is of interest in both evolutionary biology and medicine. Age is an established source of this variation-stress responsiveness diminishes with increasing age in a range of species-but unexplained variation remains. Since individuals of the same chronological age may differ markedly in their pace of biological ageing, we asked whether biological age-measured here via erythrocyte telomere length-predicts variation in stress responsiveness in adult animals of the same chronological age. We studied two cohorts of European starlings in which we had previously manipulated the rate of biological ageing by experimentally altering the competition experienced by chicks in the fortnight following hatching. We predicted that individuals with greater developmental telomere attrition, and hence greater biological age, would show an attenuated corticosterone (CORT) response to an acute stressor when tested as adults. In both cohorts, we found that birds with greater developmental telomere attrition had lower peak CORT levels and a more negative change in CORT levels between 15 and 30 min following stress exposure. Our results, therefore, provide strong evidence that a measure of biological age explains individual variation in stress responsiveness: birds that were biologically older were less stress responsive. Our results provide a novel explanation for the phenomenon of developmental programming of the stress response: observed changes in stress physiology as a result of exposure to early-life adversity may reflect changes in ageing.

  9. Variations in body morphology explain sex differences in thermoeffector function during compensable heat stress.

    Science.gov (United States)

    Notley, Sean R; Park, Joonhee; Tagami, Kyoko; Ohnishi, Norikazu; Taylor, Nigel A S

    2017-05-01

    What is the central question of this study? Can sex-related differences in cutaneous vascular and sudomotor responses be explained primarily by variations in the ratio between body surface area and mass during compensable exercise that elicits equivalent heat-loss requirements and mean body temperature changes across participants? What is the main finding and its importance? Mass-specific surface area was a significant determinant of vasomotor and sudomotor responses in men and women, explaining 10-48% of the individual thermoeffector variance. Nonetheless, after accounting for changes in mean body temperature and morphological differences, sex explained only 5% of that inter-individual variability. It was concluded that sex differences in thermoeffector function are morphologically dependent, but not sex dependent. Sex is sometimes thought to be an independent modulator of cutaneous vasomotor and sudomotor function during heat exposure. Nevertheless, it was hypothesized that, when assessed during compensable exercise that evoked equal heat-loss requirements across participants, sex differences in those thermoeffectors would be explained by variations in the ratio between body surface area and mass (specific surface area). To evaluate that possibility, vasomotor and sudomotor functions were assessed in 60 individuals (36 men and 24 women) with widely varying (overlapping) specific surface areas (range, 232.3-292.7 and 241.2-303.1 cm 2  kg -1 , respectively). Subjects completed two trials in compensable conditions (28°C, 36% relative humidity) involving rest (20 min) and steady-state cycling (45 min) at fixed, area-specific metabolic heat-production rates (light, ∼135 W m -2 ; moderate, ∼200 W m -2 ). Equivalent heat-loss requirements and mean body temperature changes were evoked across participants. Forearm blood flow and vascular conductance were positively related to specific surface area during light work in men (r = 0.67 and r = 0

  10. Noticeable Variations in the Educational Exposure During Residency in Danish Orthopedic Departments

    DEFF Research Database (Denmark)

    Brand, Eske; Fridberg, Marie; Knudsen, Ulrik Kragegaard

    2016-01-01

    . CONCLUSIONS: A large variation in the educational exposure was found among the Danish orthopedic departments. Numbers indicate that Danish residents, compared with their US counterparts, operate considerably less during residency. Most residents work overtime and many of them work for free to participate......OBJECTIVE: The objective of the study was to examine the educational exposure during residency in Danish orthopedic departments. DESIGN: Questionnaire-based cross-sectional study. SETTING: Data were gathered from January 1, 2014 to April 30, 2014 through a nationwide web-based questionnaire...... procedures as primary surgeon was 16 (range: 8-35) per month. In all, 18 of 22 (81%) departments offered the possibility to participate in research facilitated by the department and 38 of 96 (40%) worked for free (an average of 10h a month [range: 3-60]) to increase the amount of surgical procedures...

  11. Can Simple Soil Parameters Explain Field-Scale Variations in Glyphosate-, Bromoxyniloctanoate-, Diflufenican-, and Bentazone Mineralization?

    DEFF Research Database (Denmark)

    Norgaard, Trine; de Jonge, Lis Wollesen; Møldrup, Per

    2015-01-01

    The large spatial heterogeneity in soil physico-chemical and microbial parameters challenges our ability to predict and model pesticide leaching from agricultural land. Microbial mineralization of pesticides is an important process with respect to pesticide leaching since mineralization...... is the major process for the complete degradation of pesticides without generation of metabolites. The aim of our study was to determine field-scale variation in the potential for mineralization of the herbicides glyphosate, bromoxyniloctanoate, diflufenican, and bentazone and to investigate whether....... The mineralization potentials for glyphosate and bentazone were compared with 9-years leaching data from two horizontal wells 3.5 m below the field. The field-scale leaching patterns, however, could not be explained by the pesticide mineralization data. Instead, field-scale pesticide leaching may have been governed...

  12. Canopy area of large trees explains aboveground biomass variations across neotropical forest landscapes

    Science.gov (United States)

    Meyer, Victoria; Saatchi, Sassan; Clark, David B.; Keller, Michael; Vincent, Grégoire; Ferraz, António; Espírito-Santo, Fernando; d'Oliveira, Marcus V. N.; Kaki, Dahlia; Chave, Jérôme

    2018-06-01

    Large tropical trees store significant amounts of carbon in woody components and their distribution plays an important role in forest carbon stocks and dynamics. Here, we explore the properties of a new lidar-derived index, the large tree canopy area (LCA) defined as the area occupied by canopy above a reference height. We hypothesize that this simple measure of forest structure representing the crown area of large canopy trees could consistently explain the landscape variations in forest volume and aboveground biomass (AGB) across a range of climate and edaphic conditions. To test this hypothesis, we assembled a unique dataset of high-resolution airborne light detection and ranging (lidar) and ground inventory data in nine undisturbed old-growth Neotropical forests, of which four had plots large enough (1 ha) to calibrate our model. We found that the LCA for trees greater than 27 m (˜ 25-30 m) in height and at least 100 m2 crown size in a unit area (1 ha), explains more than 75 % of total forest volume variations, irrespective of the forest biogeographic conditions. When weighted by average wood density of the stand, LCA can be used as an unbiased estimator of AGB across sites (R2 = 0.78, RMSE = 46.02 Mg ha-1, bias = -0.63 Mg ha-1). Unlike other lidar-derived metrics with complex nonlinear relations to biomass, the relationship between LCA and AGB is linear and remains unique across forest types. A comparison with tree inventories across the study sites indicates that LCA correlates best with the crown area (or basal area) of trees with diameter greater than 50 cm. The spatial invariance of the LCA-AGB relationship across the Neotropics suggests a remarkable regularity of forest structure across the landscape and a new technique for systematic monitoring of large trees for their contribution to AGB and changes associated with selective logging, tree mortality and other types of tropical forest disturbance and dynamics.

  13. Rib Geometry Explains Variation in Dynamic Structural Response: Potential Implications for Frontal Impact Fracture Risk.

    Science.gov (United States)

    Murach, Michelle M; Kang, Yun-Seok; Goldman, Samuel D; Schafman, Michelle A; Schlecht, Stephen H; Moorhouse, Kevin; Bolte, John H; Agnew, Amanda M

    2017-09-01

    The human thorax is commonly injured in motor vehicle crashes, and despite advancements in occupant safety rib fractures are highly prevalent. The objective of this study was to quantify the ability of gross and cross-sectional geometry, separately and in combination, to explain variation of human rib structural properties. One hundred and twenty-two whole mid-level ribs from 76 fresh post-mortem human subjects were tested in a dynamic frontal impact scenario. Structural properties (peak force and stiffness) were successfully predicted (p rib cross-sectional geometry obtained via direct histological imaging (total area, cortical area, and section modulus) and were improved further when utilizing a combination of cross-sectional and gross geometry (robusticity, whole bone strength index). Additionally, preliminary application of a novel, adaptive thresholding technique, allowed for total area and robusticity to be measured on a subsample of standard clinical CT scans with varied success. These results can be used to understand variation in individual rib response to frontal loading as well as identify important geometric parameters, which could ultimately improve injury criteria as well as the biofidelity of anthropomorphic test devices (ATDs) and finite element (FE) models of the human thorax.

  14. Genetic variation may explain why females are less susceptible to dental erosion.

    Science.gov (United States)

    Uhlen, Marte-Mari; Stenhagen, Kjersti R; Dizak, Piper M; Holme, Børge; Mulic, Aida; Tveit, Anne B; Vieira, Alexandre R

    2016-10-01

    Not all individuals at risk for dental erosion (DE) display erosive lesions. The prevalence of DE is higher among male subjects. The occurrence of DE may depend on more than just acidic challenge, with genetics possibly playing a role. The aim of this study was to investigate the association of enamel-formation genes with DE. One premolar and a saliva sample were collected from 90 individuals. Prepared teeth were immersed in 0.01 M HCl (pH 2.2), and enamel loss (μm) was measured using white light interferometry. DNA was extracted from saliva, and 15 single-nucleotide polymorphisms were analysed. Allele and genotype frequencies were related to the enamel loss of the specimens. Single-marker and haplotype analyses were performed using sex as a covariate. Mean enamel loss was higher for male donors than for female donors (P = 0.047). Significant associations were found between enamel loss and amelogenin, X-linked (AMELX), tuftelin 1 (TUFT1), and tuftelin-interacting protein 11 (TFIP11). Analyses showed significant associations between variation in enamel-formation genes and a lower susceptibility to DE in female subjects. The results indicate that susceptibility to DE is influenced by genetic variation, and may, in part, explain why some individuals are more susceptible than others to DE, including differences between female subjects and male subjects. © 2016 Eur J Oral Sci.

  15. Does mobility explain variation in colonisation and population recovery among stream fishes?

    Science.gov (United States)

    Angermeier, Paul L.; Albanese, Brett; Peterson, James T.

    2009-01-01

    1. Colonisation and population recovery are crucial to species persistence in environmentally variable ecosystems, but are poorly understood processes. After documenting movement rates for several species of stream fish, we predicted that this variable would influence colonisation rates more strongly than local abundance, per cent occupancy, body size and taxonomic family. We also predicted that populations of species with higher movement rates would recover more rapidly than species with lower movement rates and that assemblage structure would change accordingly. 2. To test these predictions, we removed fishes from a headwater and a mainstem creek in southwest Virginia and monitored colonisation over a 2-year period. Using an information–theoretic approach, we evaluated the relative plausibility of 15 alternative models containing different combinations of our predictor variables. Our best-supported model contained movement rate and abundance and was 41 times more likely to account for observed patterns in colonisation rates than the next-best model. Movement rate and abundance were both positively related to colonisation rates and explained 88% of the variation in colonisation rates among species. 3. Population recovery, measured as the per cent of initial abundance restored, was also positively associated with movement rate. One species recovered within 3 months, most recovered within 2 years, but two species still had not recovered after 2 years. Despite high variation in recovery, the removal had only a slight impact on assemblage structure because species that were abundant in pre-removal samples were also abundant in post-removal samples. 4. The significance of interspecific variation in colonisation and recovery rates has been underappreciated because of the widely documented recovery of stream fish assemblages following fish kills and small-scale experimental defaunations. Our results indicate that recovery of the overall assemblage does not imply

  16. Explaining regional variations in health care utilization between Swiss cantons using panel econometric models.

    Science.gov (United States)

    Camenzind, Paul A

    2012-03-13

    In spite of a detailed and nation-wide legislation frame, there exist large cantonal disparities in consumed quantities of health care services in Switzerland. In this study, the most important factors of influence causing these regional disparities are determined. The findings can also be productive for discussing the containment of health care consumption in other countries. Based on the literature, relevant factors that cause geographic disparities of quantities and costs in western health care systems are identified. Using a selected set of these factors, individual panel econometric models are calculated to explain the variation of the utilization in each of the six largest health care service groups (general practitioners, specialist doctors, hospital inpatient, hospital outpatient, medication, and nursing homes) in Swiss mandatory health insurance (MHI). The main data source is 'Datenpool santésuisse', a database of Swiss health insurers. For all six health care service groups, significant factors influencing the utilization frequency over time and across cantons are found. A greater supply of service providers tends to have strong interrelations with per capita consumption of MHI services. On the demand side, older populations and higher population densities represent the clearest driving factors. Strategies to contain consumption and costs in health care should include several elements. In the federalist Swiss system, the structure of regional health care supply seems to generate significant effects. However, the extent of driving factors on the demand side (e.g., social deprivation) or financing instruments (e.g., high deductibles) should also be considered.

  17. Large Variations in HIV-1 Viral Load Explained by Shifting-Mosaic Metapopulation Dynamics

    Science.gov (United States)

    Lythgoe, Katrina A.; Blanquart, François

    2016-01-01

    The viral population of HIV-1, like many pathogens that cause systemic infection, is structured and differentiated within the body. The dynamics of cellular immune trafficking through the blood and within compartments of the body has also received wide attention. Despite these advances, mathematical models, which are widely used to interpret and predict viral and immune dynamics in infection, typically treat the infected host as a well-mixed homogeneous environment. Here, we present mathematical, analytical, and computational results that demonstrate that consideration of the spatial structure of the viral population within the host radically alters predictions of previous models. We study the dynamics of virus replication and cytotoxic T lymphocytes (CTLs) within a metapopulation of spatially segregated patches, representing T cell areas connected by circulating blood and lymph. The dynamics of the system depend critically on the interaction between CTLs and infected cells at the within-patch level. We show that for a wide range of parameters, the system admits an unexpected outcome called the shifting-mosaic steady state. In this state, the whole body’s viral population is stable over time, but the equilibrium results from an underlying, highly dynamic process of local infection and clearance within T-cell centers. Notably, and in contrast to previous models, this new model can explain the large differences in set-point viral load (SPVL) observed between patients and their distribution, as well as the relatively low proportion of cells infected at any one time, and alters the predicted determinants of viral load variation. PMID:27706164

  18. Variations in automatically recorded rumination time as explained by variations in intake of dietary fractions and milk production, and between-cow variation.

    Science.gov (United States)

    Byskov, M V; Nadeau, E; Johansson, B E O; Nørgaard, P

    2015-06-01

    Individual recording of rumination time (RT) is now possible in commercial dairy herds, through development of a microphone-based sensor, which is able to record RT by the sound of rumination activity. The objectives of this study were to examine the relationship between daily RT and intakes of different dietary fractions, the relationship between RT in minutes per kilogram of dry matter intake (DMI) and milk production, and to examine the variation in RT within and between mid-lactating dairy cows. Data from 3 production trials were used in which a total of 27 different diets were fed. The data contained 761, 290, and 203 daily recordings of RT, milk yield, milk components, DMI, and intake of dietary fractions recorded on 29, 26, and 24 Holstein and Swedish Red cows from trials 1, 2, and 3, respectively. The dietary fractions included forage neutral detergent fiber (NDF), concentrate NDF, crude protein, sugar, starch, and the remaining fraction represented by organic matter--(forage NDF+concentrate NDF+crude protein+sugar+starch). The relationship between the dietary fractions and RT was analyzed in 2 steps. In step 1, the dietary fractions, which were significantly related to RT, were selected and simultaneously checked for multicollinearity between the dietary components; in step 2, a multivariate model, including the effect of repeated measurements, the main effect of the selected dietary fractions from step 1, random effects of cow(trial) and trial, and information on breed, days in milk, and parity was used to analyze the relationship between RT and the selected dietary fractions. Relationships between RT in minutes per kilogram of DMI and milk yield and milk components were analyzed, using the same multivariate model as in step 2. Approximately 32% of the variation in daily RT could be explained by variations in intakes of the dietary fractions, whereas 48% of the total variation in RT was accounted for by individual variations between cows. Intakes of

  19. Can Research Design Explain Variation in Head Start Research Results? A Meta-Analysis of Cognitive and Achievement Outcomes

    Science.gov (United States)

    Shager, Hilary M.; Schindler, Holly S.; Magnuson, Katherine A.; Duncan, Greg J.; Yoshikawa, Hirokazu; Hart, Cassandra M. D.

    2013-01-01

    This study explores the extent to which differences in research design explain variation in Head Start program impacts. We employ meta-analytic techniques to predict effect sizes for cognitive and achievement outcomes as a function of the type and rigor of research design, quality and type of outcome measure, activity level of control group, and…

  20. Explaining variation in work ethic in Europe. Religious heritage rather than modernisation, the welfare state and communism

    NARCIS (Netherlands)

    Stam, K.; Verbakel, C.M.C.; Graaf, P.M. de

    2013-01-01

    This paper presents unique descriptive and explanatory analyses of cross-national variation in work ethic in 44 European countries (European Values Study 2008). A strong work ethic is the conviction that people have a moral duty to work. To explain differences in the adherence of the work ethic

  1. Explaining variation in work ethic in Europe : Religious heritage rather than modernization, the welfare state and communism

    NARCIS (Netherlands)

    Stam, K.; Verbakel, C.M.C.; de Graaf, P.M.

    2013-01-01

    This paper presents unique descriptive and explanatory analyses of cross-national variation in work ethic in 44 European countries (European Values Study 2008). A strong work ethic is the conviction that people have a moral duty to work. To explain differences in the adherence of the work ethic

  2. Spatial variation in tuber depletion by swans explained by differences in net intake rates

    NARCIS (Netherlands)

    Nolet, BA; Langevoord, O; Bevan, RM; Engelaar, KR; Klaassen, M; Mulder, RJW

    We tested whether the spatial variation in resource depletion by Tundra Swans (Cygnus columbianus) foraging on belowground tubers of sage pondweed (Potnmogeton pectinatus) was caused by differences in net energy intake rates. The variation in giving up densities within the confines of one lake was

  3. Variations in hospitalization rates among nursing home residents: the role of discretionary hospitalizations.

    Science.gov (United States)

    Carter, Mary W

    2003-08-01

    To examine variations in hospitalization rates among nursing home residents associated with discretionary hospitalization practices. Quarterly Medicaid case-mix reimbursement data from the state of Massachusetts served as the core data source for this study, which was linked with data from the Medicare Provider Analysis and Review file (MEDPAR) to specify hospitalization status, nursing facility attribute data from the state of Massachusetts to specify facility-level organizational and structural attributes, and data from the Area Resource File (ARF) to specify area market-level attributes. Data spans three years (1991-1993) to produce a longitudinal analytical file containing 72,319 person-quarter-level observations. Two-step, multivariate logistic regression models were estimated for highly discretionary hospitalizations versus those containing less discretion, and low discretionary hospitalizations versus those containing greater amounts of physician discretion. Findings indicate that facility case-mix levels and area hospital bed supply levels contribute to variations in hospitalization rates among nursing home residents. Highly discretionary hospitalizations appear to be most sensitive to patient diagnoses best described as chronic, ambulatory care sensitive conditions. Findings suggest that defining hospitalizations simply in terms of whether an event occurs versus otherwise may obscure valuable information regarding the contribution of various risk factors to highly discretionary versus low discretionary hospitalization rates.

  4. Does dispersal from landlocked trout explain the coexistence of resident and migratory trout females in a small stream?

    DEFF Research Database (Denmark)

    Pettersson, J.C.E.; Hansen, Michael Møller; Bohlin, T.

    2001-01-01

    The hypothesis that stream-resident females of brown trout Salmo trutta occurring in sympatry with sea-migrant females in a small stream were immigrants from an up-stream allopatric landlocked population was rejected. Genetic differentiation was not detected between the sympatric forms whereas...

  5. Do sleep, stress, and illness explain daily variations in fatigue? A prospective study.

    Science.gov (United States)

    Akerstedt, Torbjörn; Axelsson, John; Lekander, Mats; Orsini, Nicola; Kecklund, Göran

    2014-04-01

    Fatigue is related to a number of serious diseases, as well as to general well-being. It is also a major cause of sickness absence and use of health facilities. Still, the determinants of variations in fatigue are little investigated. The purpose of present study was to investigate the relationships between the daily variations of fatigue with sleep during the previous night, stress or disease symptoms during the same day - across 42 consecutive days of normal life. 50 individuals participated and gave diary reports and used an actigraph across the 42days. The data was analyzed using a multilevel approach with mixed model regression. The analyses showed that the day-to-day variation in fatigue was related to (poor) sleep quality (pstress (pfatigue rating. Fatigue was also strongly related to poorer subjective health (pstress and illness are consistently connected to how fatigue is experienced during normal living conditions. Copyright © 2014 Elsevier Inc. All rights reserved.

  6. Is the diurnal pattern sufficient to explain the intraday variation in volatility? A nonparametric assessment

    DEFF Research Database (Denmark)

    Christensen, Kim; Hounyo, Ulrich; Podolskij, Mark

    In this paper, we propose a nonparametric way to test the hypothesis that time-variation in intraday volatility is caused solely by a deterministic and recurrent diurnal pattern. We assume that noisy high-frequency data from a discretely sampled jump-diffusion process are available. The test...... inference, we propose a new bootstrap approach, which leads to almost correctly sized tests of the null hypothesis. We apply the developed framework to a large cross-section of equity high-frequency data and find that the diurnal pattern accounts for a rather significant fraction of intraday variation...

  7. Diversity of fields and farmers : explaining yield variations in northern Cameroon

    NARCIS (Netherlands)

    Steenhuijsen Piters, de B.

    1995-01-01

    This research was inspired by the inability of agricultural research to deal adequately with phenomena of variation, diversity and heterogeneity in agriculture. Although these phenomena were observed as long ago as the beginning of this century, they are still causing concern. Until

  8. Explaining life history variation in a changing climate across a species' range

    DEFF Research Database (Denmark)

    Neuheimer, Anna B.; MacKenzie, Brian R.

    2014-01-01

    Timing of reproduction greatly influences offspring success and resulting population production. Explaining and predicting species' dynamics necessitates disentangling the intrinsic (genotypic) and extrinsic (climatic) factors controlling reproductive timing. Here we explore temporal and spatial...... changes in spawning time for 21 populations of Atlantic cod (Gadus morhua) across the species' range (40 degrees to 80 degrees N). We estimate spawning time using a physiologically relevant metric that includes information on fish thermal history (degree-days, DD). First, we estimate spawning DD among...... years (within populations) to show how recent changes in spawning time can be explained by local changes in temperature. Second, we employ spawning DD to identify temperature-independent trends in spawning time among populations that are consistent with parallel adaptive evolution and the evolutionary...

  9. Individual quality explains variation in reproductive success better than territory quality in a long-lived territorial raptor.

    Directory of Open Access Journals (Sweden)

    Jabi Zabala

    Full Text Available Evolution by natural selection depends on the relationship between individual traits and fitness. Variation in individual fitness can result from habitat (territory quality and individual variation. Individual quality and specialization can have a deep impact on fitness, yet in most studies on territorial species the quality of territory and individuals are confused. We aimed to determine if variation in breeding success is better explained by territories, individual quality or a combination of both. We analysed the number of fledglings and the breeding quality index (the difference between the number of fledglings of an individual/breeding pair and the average number of fledglings of the monitored territories in the same year as part of a long term (16 years peregrine falcon (Falco peregrinus monitoring program with identification of individuals. Using individual and territory identities as correlates of quality, we built Generalised Linear Models with Mixed effects, in which random factors depicted different hypotheses for sources of variation (territory/individual quality in the reproductive success of unique breeding pairs, males and females, and assessed their performance. Most evidence supported the hypothesis that variation in breeding success is explained by individual identity, particularly male identity, rather than territory. There is also some evidence for inter year variations in the breeding success of females and a territory effect in the case of males. We argue that, in territorial species, individual quality is a major source of variation in breeding success, often masked by territory. Future ecological and conservation studies on habitat use should consider and include the effect of individuals, in order to avoid misleading results.

  10. Hip Fractures in Long-Term Care: Is the Excess Explained by the Age and Gender Distribution of the Residents?

    Directory of Open Access Journals (Sweden)

    Richard G. Crilly

    2010-01-01

    Full Text Available Introduction. This study compares hip fracture rates in Long Term Care (LTC residents with those in the community to determine if their high rate of fracturing reflects the extreme age and predominantly female nature of that population. Methods. Hospital discharge data in London Ontario (population 350,000 and Statistics Canada data were used to correct the hip fracture rate in the LTC setting for age and gender. Results. The risk of hip fracture is 1.8 times greater in LTC than in the community for people of similar age and gender. The rate in women is 1.5 times higher whereas in men it is 4.3 times higher. In the oldest residents, the risk in men exceeds that of women in LTC. Conclusion. The high hip fracture rate in LTC is not just a reflection of the age and predominantly female nature of this population. The oldest men in LTC are a particularly high risk group, deserving more attention.

  11. Geographic variation in fee-for-service medicare beneficiaries' medical costs is largely explained by disease burden.

    Science.gov (United States)

    Reschovsky, James D; Hadley, Jack; Romano, Patrick S

    2013-10-01

    Control for area differences in population health (casemix adjustment) is necessary to measure geographic variations in medical spending. Studies use various casemix adjustment methods, resulting in very different geographic variation estimates. We study casemix adjustment methodological issues and evaluate alternative approaches using claims from 1.6 million Medicare beneficiaries in 60 representative communities. Two key casemix adjustment methods-controlling for patient conditions obtained from diagnoses on claims and expenditures of those at the end of life-were evaluated. We failed to find evidence of bias in the former approach attributable to area differences in physician diagnostic patterns, as others have found, and found that the assumption underpinning the latter approach-that persons close to death are equally sick across areas-cannot be supported. Diagnosis-based approaches are more appropriate when current rather than prior year diagnoses are used. Population health likely explains more than 75% to 85% of cost variations across fixed sets of areas.

  12. Leaf density explains variation in leaf mass per area in rice between cultivars and nitrogen treatments.

    Science.gov (United States)

    Xiong, Dongliang; Wang, Dan; Liu, Xi; Peng, Shaobing; Huang, Jianliang; Li, Yong

    2016-05-01

    Leaf mass per area (LMA) is an important leaf trait; however, correlations between LMA and leaf anatomical features and photosynthesis have not been fully investigated, especially in cereal crops. The objectives of this study were (a) to investigate the correlations between LMA and leaf anatomical traits; and (b) to clarify the response of LMA to nitrogen supply and its effect on photosynthetic nitrogen use efficiency (PNUE). In the present study, 11 rice varieties were pot grown under sufficient nitrogen (SN) conditions, and four selected rice cultivars were grown under low nitrogen (LN) conditions. Leaf anatomical traits, gas exchange and leaf N content were measured. There was large variation in LMA across selected rice varieties. Regression analysis showed that the variation in LMA was more closely related to leaf density (LD) than to leaf thickness (LT). LMA was positively related to the percentage of mesophyll tissue area (%mesophyll), negatively related to the percentage of epidermis tissue area (%epidermis) and unrelated to the percentage of vascular tissue area (%vascular). The response of LMA to N supplementation was dependent on the variety and was also mainly determined by the response of LD to N. Compared with SN, photosynthesis was significantly decreased under LN, while PNUE was increased. The increase in PNUE was more critical in rice cultivars with a higher LMA under SN supply. Leaf density is the major cause of the variation in LMA across rice varieties and N treatments, and an increase in LMA under high N conditions would aggravate the decrease in PNUE. © The Author 2016. Published by Oxford University Press on behalf of the Annals of Botany Company. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

  13. Climate and foraging mode explain interspecific variation in snake metabolic rates.

    Science.gov (United States)

    Dupoué, Andréaz; Brischoux, François; Lourdais, Olivier

    2017-11-29

    The energy cost of self-maintenance is a critical facet of life-history strategies. Clarifying the determinant of interspecific variation in metabolic rate (MR) at rest is important to understand and predict ecological patterns such as species distributions or responses to climatic changes. We examined variation of MR in snakes, a group characterized by a remarkable diversity of activity rates and a wide distribution. We collated previously published MR data ( n = 491 observations) measured in 90 snake species at different trial temperatures. We tested for the effects of metabolic state (standard MR (SMR) versus resting MR (RMR)), foraging mode (active versus ambush foragers) and climate (temperature and precipitation) while accounting for non-independence owing to phylogeny, body mass and thermal dependence. We found that RMR was 40% higher than SMR, and that active foragers have higher MR than species that ambush their prey. We found that MR was higher in cold environments, supporting the metabolic cold adaptation hypothesis. We also found an additive and positive effect of precipitation on MR suggesting that lower MR in arid environments may decrease dehydration and energetic costs. Altogether, our findings underline the complex influences of climate and foraging mode on MR and emphasize the relevance of these facets to understand the physiological impact of climate change. © 2017 The Author(s).

  14. Geographic variation in sexual behavior can explain geospatial heterogeneity in the severity of the HIV epidemic in Malawi.

    Science.gov (United States)

    Palk, Laurence; Blower, Sally

    2018-02-09

    In sub-Saharan Africa, where ~ 25 million individuals are infected with HIV and transmission is predominantly heterosexual, there is substantial geographic variation in the severity of epidemics. This variation has yet to be explained. Here, we propose that it is due to geographic variation in the size of the high-risk group (HRG): the group with a high number of sex partners. We test our hypothesis by conducting a geospatial analysis of data from Malawi, where ~ 13% of women and ~ 8% of men are infected with HIV. We used georeferenced HIV testing and behavioral data from ~ 14,000 participants of a nationally representative population-level survey: the 2010 Malawi Demographic and Health Survey (MDHS). We constructed gender-stratified epidemic surface prevalence (ESP) maps by spatially smoothing and interpolating the HIV testing data. We used the behavioral data to construct gender-stratified risk maps that reveal geographic variation in the size of the HRG. We tested our hypothesis by fitting gender-stratified spatial error regression (SER) models to the MDHS data. The ESP maps show considerable geographic variation in prevalence: 1-29% (women), 1-20% (men). Risk maps reveal substantial geographic variation in the size of the HRG: 0-40% (women), 16-58% (men). Prevalence and the size of the HRG are highest in urban centers. However, the majority of HIV-infected individuals (~75% of women, ~ 80% of men) live in rural areas, as does most of the HRG (~ 80% of women, ~ 85% of men). We identify a significant (P national average in districts where > 20% of women are in the HRG. Most importantly, the SER models show that geographic variation in the size of the HRG can explain a substantial proportion (73% for women, 67% for men) of the geographic variation in epidemic severity. Taken together, our results provide substantial support for our hypothesis. They provide a potential mechanistic explanation for the geographic variation in the severity

  15. Differences in the efficacy of climate forcings explained by variations in atmospheric boundary layer depth.

    Science.gov (United States)

    Davy, Richard; Esau, Igor

    2016-05-25

    The Earth has warmed in the last century and a large component of that warming has been attributed to increased anthropogenic greenhouse gases. There are also numerous processes that introduce strong, regionalized variations to the overall warming trend. However, the ability of a forcing to change the surface air temperature depends on its spatial and temporal distribution. Here we show that the efficacy of a forcing is determined by the effective heat capacity of the atmosphere, which in cold and dry climates is defined by the depth of the planetary boundary layer. This can vary by an order of magnitude on different temporal and spatial scales, and so we get a strongly amplified temperature response in shallow boundary layers. This must be accounted for to assess the efficacy of a climate forcing, and also implies that multiple climate forcings cannot be linearly combined to determine the temperature response.

  16. Explaining the Variation in Adoption Rates of the Information Content of Environmental Disclosure

    DEFF Research Database (Denmark)

    Fallan, Even

    2015-01-01

    of content, and whether innovation adoption theory might represent important factors of this decision-making process. Design/methodology/approach: - Actual adoption rates of 13 information content categories are computed using content analysis of annual reports for 62 listed companies. Each content category......Purpose: - Corporate management decides what types of environmental information content to disclose/adopt. It is explored whether internal context - decision-makers’ perception of characteristics of the information content - might predict the variation in adoption rates of different types...... is seen as an innovation the company decides to adopt or not. Interviews with management in several companies illustrate the decision process of disclosure, and help predict adoption rates. Predicted and actual adoption rates are compared. Findings: - Adoption rates vary considerably among the 13 types...

  17. Climate variables explain neutral and adaptive variation within salmonid metapopulations: The importance of replication in landscape genetics

    Science.gov (United States)

    Hand, Brian K.; Muhlfeld, Clint C.; Wade, Alisa A.; Kovach, Ryan; Whited, Diane C.; Narum, Shawn R.; Matala, Andrew P.; Ackerman, Michael W.; Garner, B. A.; Kimball, John S; Stanford, Jack A.; Luikart, Gordon

    2016-01-01

    Understanding how environmental variation influences population genetic structure is important for conservation management because it can reveal how human stressors influence population connectivity, genetic diversity and persistence. We used riverscape genetics modelling to assess whether climatic and habitat variables were related to neutral and adaptive patterns of genetic differentiation (population-specific and pairwise FST) within five metapopulations (79 populations, 4583 individuals) of steelhead trout (Oncorhynchus mykiss) in the Columbia River Basin, USA. Using 151 putatively neutral and 29 candidate adaptive SNP loci, we found that climate-related variables (winter precipitation, summer maximum temperature, winter highest 5% flow events and summer mean flow) best explained neutral and adaptive patterns of genetic differentiation within metapopulations, suggesting that climatic variation likely influences both demography (neutral variation) and local adaptation (adaptive variation). However, we did not observe consistent relationships between climate variables and FST across all metapopulations, underscoring the need for replication when extrapolating results from one scale to another (e.g. basin-wide to the metapopulation scale). Sensitivity analysis (leave-one-population-out) revealed consistent relationships between climate variables and FST within three metapopulations; however, these patterns were not consistent in two metapopulations likely due to small sample sizes (N = 10). These results provide correlative evidence that climatic variation has shaped the genetic structure of steelhead populations and highlight the need for replication and sensitivity analyses in land and riverscape genetics.

  18. Can changes in psychosocial factors and residency explain the decrease in physical activity during the transition from high school to college or university?

    Science.gov (United States)

    Van Dyck, Delfien; De Bourdeaudhuij, Ilse; Deliens, Tom; Deforche, Benedicte

    2015-04-01

    When students make the transition from high school to college or university, their physical activity (PA) levels decrease strongly. Consequently, it is of crucial importance to identify the determinants of this decline in PA. The study aims were to (1) examine changes in psychosocial factors in students during the transition from high school to college/university, (2) examine if changes in psychosocial factors and residency can predict changes in PA, and (3) investigate the moderating effects of residency on the relationship between changes in psychosocial factors and changes in PA. Between March 2008 and October 2010, 291 Flemish students participated in a longitudinal study, with baseline measurements during the final year of high school and follow-up measurements at the start of second year of college/university. At both time points, participants completed a questionnaire assessing demographics, active transportation, leisure-time sports, psychosocial variables, and residency. Repeated measures MANOVA analyses and multiple moderated hierarchic regression analyses were conducted. Modeling, self-efficacy, competition-related benefits, and health-related, external and social barriers decreased, while health-related benefits and time-related barriers increased from baseline to follow-up. Decreases in modeling and time-related barriers were associated with a decrease in active transportation (adjusted R(2) = 3.2%); residency, decreases in self-efficacy, competition-related benefits, and increases in health- and time-related barriers predicted a decrease in leisure-time sports (adjusted R(2) = 29.3%). Residency only moderated two associations between psychosocial factors and changes in PA. Residency and changes in psychosocial factors were mainly important to explain the decrease in leisure-time sports. Other factors such as distance to college/university are likely more important to explain the decrease in active transportation; these are worth exploring in

  19. Life span and reproductive cost explain interspecific variation in the optimal onset of reproduction.

    Science.gov (United States)

    Mourocq, Emeline; Bize, Pierre; Bouwhuis, Sandra; Bradley, Russell; Charmantier, Anne; de la Cruz, Carlos; Drobniak, Szymon M; Espie, Richard H M; Herényi, Márton; Hötker, Hermann; Krüger, Oliver; Marzluff, John; Møller, Anders P; Nakagawa, Shinichi; Phillips, Richard A; Radford, Andrew N; Roulin, Alexandre; Török, János; Valencia, Juliana; van de Pol, Martijn; Warkentin, Ian G; Winney, Isabel S; Wood, Andrew G; Griesser, Michael

    2016-02-01

    Fitness can be profoundly influenced by the age at first reproduction (AFR), but to date the AFR-fitness relationship only has been investigated intraspecifically. Here, we investigated the relationship between AFR and average lifetime reproductive success (LRS) across 34 bird species. We assessed differences in the deviation of the Optimal AFR (i.e., the species-specific AFR associated with the highest LRS) from the age at sexual maturity, considering potential effects of life history as well as social and ecological factors. Most individuals adopted the species-specific Optimal AFR and both the mean and Optimal AFR of species correlated positively with life span. Interspecific deviations of the Optimal AFR were associated with indices reflecting a change in LRS or survival as a function of AFR: a delayed AFR was beneficial in species where early AFR was associated with a decrease in subsequent survival or reproductive output. Overall, our results suggest that a delayed onset of reproduction beyond maturity is an optimal strategy explained by a long life span and costs of early reproduction. By providing the first empirical confirmations of key predictions of life-history theory across species, this study contributes to a better understanding of life-history evolution. © 2016 The Author(s). Evolution © 2016 The Society for the Study of Evolution.

  20. Beyond body size: muscle biochemistry and body shape explain ontogenetic variation of anti-predatory behaviour in the lizard Salvator merianae.

    Science.gov (United States)

    de Barros, Fábio Cury; de Carvalho, José Eduardo; Abe, Augusto Shinya; Kohlsdorf, Tiana

    2016-06-01

    Anti-predatory behaviour evolves under the strong action of natural selection because the success of individuals avoiding predation essentially defines their fitness. Choice of anti-predatory strategies is defined by prey characteristics as well as environmental temperature. An additional dimension often relegated in this multilevel equation is the ontogenetic component. In the tegu Salvator merianae, adults run away from predators at high temperatures but prefer fighting when it is cold, whereas juveniles exhibit the same flight strategy within a wide thermal range. Here, we integrate physiology and morphology to understand ontogenetic variation in the temperature-dependent shift of anti-predatory behaviour in these lizards. We compiled data for body shape and size, and quantified enzyme activity in hindlimb and head muscles, testing the hypothesis that morphophysiological models explain ontogenetic variation in behavioural associations. Our prediction is that juveniles exhibit body shape and muscle biochemistry that enhance flight strategies. We identified biochemical differences between muscles mainly in the LDH:CS ratio, whereby hindlimb muscles were more glycolytic than the jaw musculature. Juveniles, which often use evasive strategies to avoid predation, have more glycolytic hindlimb muscles and are much smaller when compared with adults 1-2 years old. Ontogenetic differences in body shape were identified but marginally contributed to behavioural variation between juvenile and adult tegus, and variation in anti-predatory behaviour in these lizards resides mainly in associations between body size and muscle biochemistry. Our results are discussed in the ecological context of predator avoidance by individuals differing in body size living at temperature-variable environments, where restrictions imposed by the cold could be compensated by specific phenotypes. © 2016. Published by The Company of Biologists Ltd.

  1. A statistical light use efficiency model explains 85% variations in global GPP

    Science.gov (United States)

    Jiang, C.; Ryu, Y.

    2016-12-01

    Photosynthesis is a complicated process whose modeling requires different levels of assumptions, simplification, and parameterization. Among models, light use efficiency (LUE) model is highly compact but powerful in monitoring gross primary production (GPP) from satellite data. Most of LUE models adopt a multiplicative from of maximum LUE, absorbed photosynthetically active radiation (APAR), and temperature and water stress functions. However, maximum LUE is a fitting parameter with large spatial variations, but most studies only use several biome dependent constants. In addition, stress functions are empirical and arbitrary in literatures. Moreover, meteorological data used are usually coarse-resolution, e.g., 1°, which could cause large errors. Finally, sunlit and shade canopy have completely different light responses but little considered. Targeting these issues, we derived a new statistical LUE model from a process-based and satellite-driven model, the Breathing Earth System Simulator (BESS). We have already derived a set of global radiation (5-km resolution), carbon and water fluxes (1-km resolution) products from 2000 to 2015 from BESS. By exploring these datasets, we found strong correlation between APAR and GPP for sunlit (R2=0.84) and shade (R2=0.96) canopy, respectively. A simple model, only driven by sunlit and shade APAR, was thus built based on linear relationships. The slopes of the linear function act as effective LUE of global ecosystem, with values of 0.0232 and 0.0128 umol C/umol quanta for sunlit and shade canopy, respectively. When compared with MPI-BGC GPP products, a global proxy of FLUXNET data, BESS-LUE achieved an overall accuracy of R2 = 0.85, whereas original BESS was R2 = 0.83 and MODIS GPP product was R2 = 0.76. We investigated spatiotemporal variations of the effective LUE. Spatially, the ratio of sunlit to shade values ranged from 0.1 (wet tropic) to 4.5 (dry inland). By using maps of sunlit and shade effective LUE the accuracy of

  2. Microbial properties explain temporal variation in soil respiration in a grassland subjected to nitrogen addition

    Science.gov (United States)

    Li, Yue; Liu, Yinghui; Wu, Shanmei; Niu, Lei; Tian, Yuqiang

    2015-01-01

    The role of soil microbial variables in shaping the temporal variability of soil respiration has been well acknowledged but is poorly understood, particularly under elevated nitrogen (N) deposition conditions. We measured soil respiration along with soil microbial properties during the early, middle, and late growing seasons in temperate grassland plots that had been treated with N additions of 0, 2, 4, 8, 16, or 32 g N m−2 yr−1 for 10 years. Representing the averages over three observation periods, total (Rs) and heterotrophic (Rh) respiration were highest with 4 g N m−2 yr−1, but autotrophic respiration (Ra) was highest with 8 to 16 g N m−2 yr−1. Also, the responses of Rh and Ra were unsynchronized considering the periods separately. N addition had no significant impact on the temperature sensitivity (Q10) for Rs but inhibited the Q10 for Rh. Significant interactions between observation period and N level occurred in soil respiration components, and the temporal variations in soil respiration components were mostly associated with changes in microbial biomass carbon (MBC) and phospholipid fatty acids (PLFAs). Further observation on soil organic carbon and root biomass is needed to reveal the long-term effect of N deposition on soil C sequestration. PMID:26678303

  3. Variation in adult stress resistance does not explain vulnerability to climate change in copper butterflies.

    Science.gov (United States)

    Klockmann, Michael; Wallmeyer, Leonard; Fischer, Klaus

    2017-03-15

    Ongoing climate change is a major threat to biodiversity. However, although many species clearly suffer from ongoing climate change, others benefit from it, for example, by showing range expansions. However, which specific features determine a species' vulnerability to climate change? Phenotypic plasticity, which has been described as the first line of defence against environmental change, may be of utmost importance here. Against this background, we here compare plasticity in stress tolerance in 3 copper butterfly species, which differ arguably in their vulnerability to climate change. Specifically, we investigated heat, cold and desiccation resistance after acclimatization to different temperatures in the adult stage. We demonstrate that acclimation at a higher temperature increased heat but decreased cold tolerance and desiccation resistance. Contrary to our predictions, species did not show pronounced variation in stress resistance, though plastic capacities in temperature stress resistance did vary across species. Overall, our results seemed to reflect population-rather than species-specific patterns. We conclude that the geographical origin of the populations used should be considered even in comparative studies. However, our results suggest that, in the 3 species studied here, vulnerability to climate change is not in the first place determined by stress resistance in the adult stage. As entomological studies focus all too often on adults only, we argue that more research effort should be dedicated to other developmental stages when trying to understand insect responses to environmental change. © 2017 Institute of Zoology, Chinese Academy of Sciences.

  4. Explaining variation in perceived team effectiveness: results from eleven quality improvement collaboratives.

    Science.gov (United States)

    Strating, Mathilde M H; Nieboer, Anna P

    2013-06-01

    Explore effectiveness of 11 collaboratives focusing on 11 different topics, as perceived by local improvement teams and to explore associations with collaborative-, organisational- and team-level factors. Evidence underlying the effectiveness of quality improvement collaboratives is inconclusive and few studies investigated determinants of implementation success. Moreover, most evaluation studies on quality improvement collaboratives are based on one specific topic or quality problem, making it hard to compare across collaboratives addressing different topics. A multiple-case cross-sectional study. Quality improvement teams in 11 quality improvement collaboratives focusing on 11 different topics. Team members received a postal questionnaire at the end of each collaborative. Of the 283 improvement teams, 151 project leaders and 362 team members returned the questionnaire. Analysis of variance revealed that teams varied widely on perceived effectiveness. Especially, members in the Prevention of Malnutrition and Prevention of Medication Errors collaboratives perceived a higher effectiveness than other groups. Multilevel regression analyses showed that educational level of professionals, innovation attributes, organisational support, innovative culture and commitment to change were all significant predictors of perceived effectiveness. In total, 27·9% of the individual-level variance, 57·6% of the team-level variance and 80% of the collaborative-level variance could be explained. The innovation's attributes, organisational support, an innovative team culture and professionals' commitment to change are instrumental to perceived effectiveness. The results support the notion that a layered approach is necessary to achieve improvements in quality of care and provides further insight in the determinants of success of quality improvement collaboratives. Understanding which factors enhance the impact of quality improvement initiatives can help professionals to achieve

  5. Borate protection of softwood from Coptotermes acinaciformis (Isoptera: Rhinotermitidae) damage: variation in protection thresholds explained.

    Science.gov (United States)

    Peters, Brenton C; Fitzgerald, Christopher J

    2006-10-01

    Laboratory and field data reported in the literature are confusing with regard to "adequate" protection thresholds for borate timber preservatives. The confusion is compounded by differences in termite species, timber species and test methodology. Laboratory data indicate a borate retention of 0.5% mass/mass (m/m) boric acid equivalent (BAE) would cause > 90% termite mortality and restrict mass loss in test specimens to 0.5% m/m BAE are required. We report two field experiments with varying amounts of untreated feeder material in which Coptotermes acinaciformis (Froggatt) (Isoptera: Rhinotermitidae) responses to borate-treated radiata (Monterey) pine, Pinus radiata D. Don, were measured. The apparently conflicting results between laboratory and field data are explained by the presence or absence of untreated feeder material in the test environment. In the absence of untreated feeder material, wood containing 0.5% BAE provided adequate protection from Coptotermes sp., whereas in the presence of untreated feeder material, increased retentions were required. Furthermore, the retentions required increased with increased amounts of susceptible material present. Some termites, Nasutitermes sp. and Mastotermes darwiniensis Froggatt, for example, are borate-tolerant and borate timber preservatives are not a viable management option with these species. The lack of uniform standards for termite test methodology and assessment criteria for efficacy across the world is recognized as a difficulty with research into the performance of timber preservatives with termites. The many variables in laboratory and field assays make "prescriptive" standards difficult to recommend. The use of "performance" standards to define efficacy criteria ("adequate" protection) is discussed.

  6. Social inequality in infant mortality: what explains variation across low and middle income countries?

    Science.gov (United States)

    Hajizadeh, Mohammad; Nandi, Arijit; Heymann, Jody

    2014-01-01

    Growing work demonstrates social gradients in infant mortality within countries. However, few studies have compared the magnitude of these inequalities cross-nationally. Even fewer have assessed the determinants of social inequalities in infant mortality across countries. This study provides a comprehensive and comparative analysis of social inequalities in infant mortality in 53 low-and-middle-income countries (LMICs). We used the most recent nationally representative household samples (n = 874,207) collected through the Demographic Health Surveys (DHS) to calculate rates of infant mortality. The relative and absolute concentration indices were used to quantify social inequalities in infant mortality. Additionally, we used meta-regression analyses to examine whether levels of inequality in proximate determinants of infant mortality were associated with social inequalities in infant mortality across countries. Estimates of both the relative and the absolute concentration indices showed a substantial variation in social inequalities in infant mortality among LMICs. Meta-regression analyses showed that, across countries, the relative concentration of teenage pregnancy among poorer households was positively associated with the relative concentration of infant mortality among these groups (beta = 0.333, 95% CI = 0.115 0.551). Our results demonstrate that the concentration of infant deaths among socioeconomically disadvantaged households in the majority of LMICs remains an important health and social policy concern. The findings suggest that policies designed to reduce the concentration of teenage pregnancy among mothers in lower socioeconomic groups may mitigate social inequalities in infant mortality. Copyright © 2013 Elsevier Ltd. All rights reserved.

  7. GABAergic synapse properties may explain genetic variation in hippocampal network oscillations in mice

    Directory of Open Access Journals (Sweden)

    Tim S Heistek

    2010-06-01

    Full Text Available Cognitive ability and the properties of brain oscillation are highly heritable in humans. Genetic variation underlying oscillatory activity might give rise to differences in cognition and behavior. How genetic diversity translates into altered properties of oscillations and synchronization of neuronal activity is unknown. To address this issue, we investigated cellular and synaptic mechanisms of hippocampal fast network oscillations in eight genetically distinct inbred mouse strains. The frequency of carbachol-induced oscillations differed substantially between mouse strains. Since GABAergic inhibition sets oscillation frequency, we studied the properties of inhibitory synaptic inputs (IPSCs received by CA3 and CA1 pyramidal cells of three mouse strains that showed the highest, lowest and intermediate frequencies of oscillations. In CA3 pyramidal cells, the frequency of rhythmic IPSC input showed the same strain differences as the frequency of field oscillations. Furthermore, IPSC decay times in both CA1 and CA3 pyramidal cells were faster in mouse strains with higher oscillation frequencies than in mouse strains with lower oscillation frequency, suggesting that differences in GABAA-receptor subunit composition exist between these strains. Indeed, gene expression of GABAA-receptor β2 (Gabrb2 and β3 (Gabrb2 subunits was higher in mouse strains with faster decay kinetics compared with mouse strains with slower decay kinetics. Hippocampal pyramidal neurons in mouse strains with higher oscillation frequencies and faster decay kinetics fired action potential at higher frequencies. These data indicate that differences in genetic background may result in different GABAA-receptor subunit expression, which affects the rhythm of pyramidal neuron firing and fast network activity through GABA synapse kinetics.

  8. Seasonal variations of aerosol residence time in the lower atmospheric boundary layer

    International Nuclear Information System (INIS)

    Ahmed, A.A.; Mohamed, A.; Ali, A.E.; Barakat, A.; Abd El-Hady, M.; El-Hussein, A.

    2004-01-01

    During a one year period, from Jan. 2002 up to Dec. 2002, approximately 130 air samples were analyzed to determine the atmospheric air activity concentrations of short- and long-lived ( 222 Rn) decay products 214 Pb and 210 Pb. The samples were taken by using a single-filter technique and γ-spectrometry was applied to determine the activity concentrations. A seasonal fluctuation in the concentration of 214 Pb and 210 Pb in surface air was observed. The activity concentrations of both radionuclides were observed to be relatively higher during the winter/autumn season than in spring/summer season. The mean activity concentration of 214 Pb and 210 Pb within the whole year was found to be 1.4±0.27 Bq m -3 and 1.2±0.15 mBq m -3 , respectively. Different 210 Pb: 214 Pb activity ratios during the year varied between 1.78x10 -4 and 1.6x10 -3 with a mean value of 8.9x10 -4 ±7.6x10 -5 . From the ratio between the activity concentrations of the radon decay products 214 Pb and 210 Pb a mean residence time (MRT) of aerosol particles in the atmosphere of about 10.5±0.91 d could be estimated. The seasonal variation pattern shows relatively higher values of MRT in spring/summer season than in winter/autumn season. The MRT data together with relative humidity (RH), air temperature (T) and wind speed (WS), were used for a comprehensive regression analysis of its seasonal variation in the atmospheric air

  9. Explaining quantitative variation in the rate of Optional Infinitive errors across languages: a comparison of MOSAIC and the Variational Learning Model.

    Science.gov (United States)

    Freudenthal, Daniel; Pine, Julian; Gobet, Fernand

    2010-06-01

    In this study, we use corpus analysis and computational modelling techniques to compare two recent accounts of the OI stage: Legate & Yang's (2007) Variational Learning Model and Freudenthal, Pine & Gobet's (2006) Model of Syntax Acquisition in Children. We first assess the extent to which each of these accounts can explain the level of OI errors across five different languages (English, Dutch, German, French and Spanish). We then differentiate between the two accounts by testing their predictions about the relation between children's OI errors and the distribution of infinitival verb forms in the input language. We conclude that, although both accounts fit the cross-linguistic patterning of OI errors reasonably well, only MOSAIC is able to explain why verbs that occur more frequently as infinitives than as finite verb forms in the input also occur more frequently as OI errors than as correct finite verb forms in the children's output.

  10. Regional variation in post-stroke multidisciplinary rehabilitation care among veteran residents in community nursing homes

    Directory of Open Access Journals (Sweden)

    Jia H

    2017-03-01

    Full Text Available Huanguang Jia,1 Qinglin Pei,1 Charles T Sullivan,1 Diane C Cowper Ripley,1 Samuel S Wu,1 W Bruce Vogel,1 Xinping Wang,1 Douglas E Bidelspach,2 Jennifer L Hale-Gallardo,1 Barbara E Bates3 1Center of Innovation on Disability and Rehabilitation Research, North Florida/South Georgia Veterans Health System, Gainesville, FL, 2Physical Medicine and Rehabilitation Service, Department of Veterans Affairs, Washington, DC, 3Aleda E. Lutz VA Medical Center, Saginaw, MI, USA Introduction: Effective post-acute multidisciplinary rehabilitation therapy improves stroke survivors’ functional recovery and daily living activities. The US Department of Veterans Affairs (VA places veterans needing post-acute institutional care in private community nursing homes (CNHs. These placements are made under the same rules and regulations across the VA health care system and through individual per diem contracts between local VA facilities and CNHs. However, there is limited information about utilization of these veterans’ health services as well as the geographic variation of the service utilization. Aim: The aims of this study were to determine rehabilitation therapy and restorative nursing care utilization by veterans with stroke in VA-contracted CNHs and to assess risk-adjusted regional variations in the utilization of rehabilitation therapy and restorative nursing care. Methods: This retrospective study included all veterans diagnosed with stroke residing in VA-contracted CNHs between 2006 and 2009. Minimum Dataset (a health status assessment tool for CNH residents for the study CNHs was linked with veterans’ inpatient and outpatient data within the VA health care system. CNHs were grouped into five VA-defined geographic regions: the North Atlantic, Southeast, Midwest, Continental, and Pacific regions. A two-part model was applied estimating risk-adjusted utilization probability and average weekly utilization days. Two dependent variables were rehabilitation

  11. Reform-based science teaching: A mixed-methods approach to explaining variation in secondary science teacher practice

    Science.gov (United States)

    Jetty, Lauren E.

    The purpose of this two-phase, sequential explanatory mixed-methods study was to understand and explain the variation seen in secondary science teachers' enactment of reform-based instructional practices. Utilizing teacher socialization theory, this mixed-methods analysis was conducted to determine the relative influence of secondary science teachers' characteristics, backgrounds and experiences across their teacher development to explain the range of teaching practices exhibited by graduates from three reform-oriented teacher preparation programs. Data for this study were obtained from the Investigating the Meaningfulness of Preservice Programs Across the Continuum of Teaching (IMPPACT) Project, a multi-university, longitudinal study funded by NSF. In the first quantitative phase of the study, data for the sample (N=120) were collected from three surveys from the IMPPACT Project database. Hierarchical multiple regression analysis was used to examine the separate as well as the combined influence of factors such as teachers' personal and professional background characteristics, beliefs about reform-based science teaching, feelings of preparedness to teach science, school context, school culture and climate of professional learning, and influences of the policy environment on the teachers' use of reform-based instructional practices. Findings indicate three blocks of variables, professional background, beliefs/efficacy, and local school context added significant contribution to explaining nearly 38% of the variation in secondary science teachers' use of reform-based instructional practices. The five variables that significantly contributed to explaining variation in teachers' use of reform-based instructional practices in the full model were, university of teacher preparation, sense of preparation for teaching science, the quality of professional development, science content focused professional, and the perceived level of professional autonomy. Using the results

  12. Alongshore Variation in the Depth of Activation: Implications of Oil Residence Time

    Science.gov (United States)

    Flores, P.; Houser, C.

    2016-12-01

    In 2010 the Deepwater Horizon Oil Spill released approximately 5 million barrels of oil into the Gulf of Mexico just as the nearshore and beach profile were recovering from winter storms. As a consequence, oil mats and tar balls were trapped at depth within the beach and nearshore profile. Excavation of this buried oil during subsequent storms creates the potential for the contamination of adjacent beaches and the degradation of marine ecosystems, which can in turn negatively impact local economies that depend on fisheries and tourism. The potential for oil burial and persistence is dependent on four things: the physio-chemical nature of the oil as it reaches the nearshore environment, the pre-existing morphology of the beach and nearshore, and the evolution of that morphology after the oil is deposited. The depth at which the oil is buried is also dependent on the beach profile during the time of the spill. The purpose of this study is to characterize the alongshore variation in depth of activation on a Deepwater Horizon impacted section of Pensacola Beach, Florida with regards to the implications of oil residence time. Ground- Penetrating Radar (GPR) surveys were conducted along two parallel 1-km transects adjacent to the swash zone and the dune. Additional cross- shore transects were completed every 150 m from the base of the dune to the top of the swash zone. Sediments cores were taken at the crossing points of the alongshore and cross-shore transects, to calibrate the GPR surveys and complete an elemental analysis for the identification of storm layers. The cores were also analyzed for the presence of buried oil.

  13. Seasonal variation of residence time in spring and groundwater evaluated by CFCs and numerical simulation in mountainous headwater catchment

    Science.gov (United States)

    Tsujimura, Maki; Watanabe, Yasuto; Ikeda, Koichi; Yano, Shinjiro; Abe, Yutaka

    2016-04-01

    Headwater catchments in mountainous region are the most important recharge area for surface and subsurface waters, additionally time information of the water is principal to understand hydrological processes in the catchments. However, there have been few researches to evaluate variation of residence time of subsurface water in time and space at the mountainous headwaters especially with steep slope. We investigated the temporal variation of the residence time of the spring and groundwater with tracing of hydrological flow processes in mountainous catchments underlain by granite, Yamanashi Prefecture, central Japan. We conducted intensive hydrological monitoring and water sampling of spring, stream and ground waters in high-flow and low-flow seasons from 2008 through 2013 in River Jingu Watershed underlain by granite, with an area of approximately 15 km2 and elevation ranging from 950 m to 2000 m. The CFCs, stable isotopic ratios of oxygen-18 and deuterium, inorganic solute constituent concentrations were determined on all water samples. Also, a numerical simulation was conducted to reproduce of the average residence times of the spring and groundwater. The residence time of the spring water estimated by the CFCs concentration ranged from 10 years to 60 years in space within the watershed, and it was higher (older) during the low flow season and lower (younger) during the high flow season. We tried to reproduce the seasonal change of the residence time in the spring water by numerical simulation, and the calculated residence time of the spring water and discharge of the stream agreed well with the observed values. The groundwater level was higher during the high flow season and the groundwater dominantly flowed through the weathered granite with higher permeability, whereas that was lower during the low flow season and that flowed dominantly through the fresh granite with lower permeability. This caused the seasonal variation of the residence time of the spring

  14. Environmental proxies of antigen exposure explain variation in immune investment better than indices of pace of life.

    Science.gov (United States)

    Horrocks, Nicholas P C; Hegemann, Arne; Ostrowski, Stéphane; Ndithia, Henry; Shobrak, Mohammed; Williams, Joseph B; Matson, Kevin D; Tieleman, B I

    2015-01-01

    Investment in immune defences is predicted to covary with a variety of ecologically and evolutionarily relevant axes, with pace of life and environmental antigen exposure being two examples. These axes may themselves covary directly or inversely, and such relationships can lead to conflicting predictions regarding immune investment. If pace of life shapes immune investment then, following life history theory, slow-living, arid zone and tropical species should invest more in immunity than fast-living temperate species. Alternatively, if antigen exposure drives immune investment, then species in antigen-rich tropical and temperate environments are predicted to exhibit higher immune indices than species from antigen-poor arid locations. To test these contrasting predictions we investigated how variation in pace of life and antigen exposure influence immune investment in related lark species (Alaudidae) with differing life histories and predicted risks of exposure to environmental microbes and parasites. We used clutch size and total number of eggs laid per year as indicators of pace of life, and aridity, and the climatic variables that influence aridity, as correlates of antigen abundance. We quantified immune investment by measuring four indices of innate immunity. Pace of life explained little of the variation in immune investment, and only one immune measure correlated significantly with pace of life, but not in the predicted direction. Conversely, aridity, our proxy for environmental antigen exposure, was predictive of immune investment, and larks in more mesic environments had higher immune indices than those living in arid, low-risk locations. Our study suggests that abiotic environmental variables with strong ties to environmental antigen exposure can be important correlates of immunological variation.

  15. Deterministic rather than stochastic factors explain most of the variation in the expression of skin telangiectasia after radiotherapy

    International Nuclear Information System (INIS)

    Safwat, Akmal; Bentzen, Soeren M.; Turesson, Ingela; Hendry, Jolyon H.

    2002-01-01

    90% (with 95% confidence limits 65% and 100%) of the variance in radioresponsiveness in the right-sided field was explained by the radioresponsiveness on the left-sided field. Through the linear regression analysis between the AUC and the ID2, it was estimated that patients with a reaction that is 1 SD from the population mean would require a dose modification of approximately 23 Gy (from the group mean of 56 Gy) to give them a level of reaction similar to the group average. Similarly, the WAUC was significantly correlated with the ID2, and 81% (with 95% confidence limits 49% and 100%) of the variance in radioresponsiveness in the right-sided field was explained by the radioresponsiveness on the left-sided field. Patients with a reaction that is 1 SD from the population mean would require a dose modification of approximately 21 Gy (from the group mean of 56 Gy) to give them a level of reaction similar to the group average. Conclusion: For a given fractionation schedule, patient-related factors explain 81-90% of the patient-to-patient variation in telangiectasia level seen after radiotherapy. The remaining 10-19% are explained by stochastic effects. This observation encourages further research into genetic or phenotypic assays of normal tissue radioresponsiveness

  16. To what extent does climate explain variations in reported malaria cases in early 20th century Uganda?

    Directory of Open Access Journals (Sweden)

    Adrian M. Tompkins

    2016-03-01

    Full Text Available Malaria case statistics were analysed for the period 1926 to 1960 to identify inter-annual variations in malaria cases for the Uganda Protectorate. The analysis shows the mid-to-late 1930s to be a period of increased reported cases. After World War II, malaria cases trend down to a relative minimum in the early 1950s, before increasing rapidly after 1953 to the end of the decade. Data for the Western Province confirm these national trends, which at the time were attributed to a wide range of causes, including land development and management schemes, population mobility, interventions and misdiagnosis. Climate was occasionally proposed as a contributor to enhanced case numbers, and unusual precipitation patterns were held responsible; temperature was rarely, if ever, considered. In this study, a dynamical malaria model was driven with available precipitation and temperature data from the period for five stations located across a range of environments in Uganda. In line with the historical data, the simulations produced relatively enhanced transmission in the 1930s, although there is considerable variability between locations. In all locations, malaria transmission was low in the late 1940s and early 1950s, steeply increasing after 1954. Results indicate that past climate variability explains some of the variations in numbers of reported malaria cases. The impact of multiannual variability in temperature, while only on the order of 0.5°C, was sufficient to drive some of the trends observed in the statistics and thus the role of climate was likely underestimated in the contemporary reports. As the elimination campaigns of the 1960s followed this partly climate-driven increase in malaria, this emphasises the need to account for climate when planning and evaluating intervention strategies.

  17. Diversity in plant hydraulic traits explains seasonal and inter-annual variations of vegetation dynamics in seasonally dry tropical forests.

    Science.gov (United States)

    Xu, Xiangtao; Medvigy, David; Powers, Jennifer S; Becknell, Justin M; Guan, Kaiyu

    2016-10-01

    We assessed whether diversity in plant hydraulic traits can explain the observed diversity in plant responses to water stress in seasonally dry tropical forests (SDTFs). The Ecosystem Demography model 2 (ED2) was updated with a trait-driven mechanistic plant hydraulic module, as well as novel drought-phenology and plant water stress schemes. Four plant functional types were parameterized on the basis of meta-analysis of plant hydraulic traits. Simulations from both the original and the updated ED2 were evaluated against 5 yr of field data from a Costa Rican SDTF site and remote-sensing data over Central America. The updated model generated realistic plant hydraulic dynamics, such as leaf water potential and stem sap flow. Compared with the original ED2, predictions from our novel trait-driven model matched better with observed growth, phenology and their variations among functional groups. Most notably, the original ED2 produced unrealistically small leaf area index (LAI) and underestimated cumulative leaf litter. Both of these biases were corrected by the updated model. The updated model was also better able to simulate spatial patterns of LAI dynamics in Central America. Plant hydraulic traits are intercorrelated in SDTFs. Mechanistic incorporation of plant hydraulic traits is necessary for the simulation of spatiotemporal patterns of vegetation dynamics in SDTFs in vegetation models. © 2016 The Authors. New Phytologist © 2016 New Phytologist Trust.

  18. Explaining variations in state foster care maintenance rates and the implications for implementing new evidence-based programs

    Science.gov (United States)

    Goldhaber-Fiebert, Jeremy D.; Babiarz, Kimberly S.; Garfield, Rachel L.; Wulczyn, Fred; Landsverk, John; Horwitz, Sarah M.

    2013-01-01

    declined $40 if a state's governorship and legislature became Republican, though significance was marginal. In analyses also examining state revenue, federal funding, and legal challenges, maintenance rates increased as the federal share of maximum TANF payments increased. However, >50% of variation in foster care maintenance rates was explained by unobserved state-level factors as measured by state fixed effects. These factors did not appear to be strongly related to 2008 Child Welfare outcomes like foster care placement stability and maltreatment which were also not correlated with foster care maintenance rates. Conclusions Despite being part of a social safety net, foster care maintenance rates have declined in real terms since 1991 in many states, and there is no strong evidence that they increase in response to harsher economic climates or to federal programs or legal reviews. State variation in maintenance rates was not related to Child Welfare outcomes, though further analysis of this important relationship is needed. Variability in state foster care maintenance rates appears highly idiosyncratic, an important contextual factor to consider when designing and disseminating evidence-based services. PMID:24659842

  19. Factors driving spatial and temporal variation in production and production/biomass ratio of stream-resident brown trout (Salmo trutta) in Cantabrian streams

    Science.gov (United States)

    Lobon-Cervia, J.; Gonzalez, G.; Budy, P.

    2011-01-01

    1.The objective was to identify the factors driving spatial and temporal variation in annual production (PA) and turnover (production/biomass) ratio (P/BA) of resident brown trout Salmo trutta in tributaries of the Rio Esva (Cantabrian Mountains, Asturias, north-western Spain). We examined annual production (total production of all age-classes over a year) (PA) and turnover (P/BA) ratios, in relation to year-class production (production over the entire life time of a year-class) (PT) and turnover (P/BT) ratio, over 14years at a total of 12 sites along the length of four contrasting tributaries. In addition, we explored whether the importance of recruitment and site depth for spatial and temporal variations in year-class production (PT), elucidated in previous studies, extends to annual production. 2.Large spatial (among sites) and temporal (among years) variation in annual production (range 1.9-40.3gm-2 per year) and P/BA ratio (range 0.76-2.4per year) typified these populations, values reported here including all the variation reported globally for salmonids streams inhabited by one or several species. 3.Despite substantial differences among streams and sites in all production attributes, when all data were pooled, annual (PA) and year-class production (PT) and annual (P/BA) and year-class P/BT ratios were tightly linked. Annual (PA) and year-class production (PT) were similar but not identical, i.e. PT=0.94 PA, whereas the P/BT ratios were 4+P/BA ratios. 4.Recruitment (Rc) and mean annual density (NA) were major density-dependent drivers of production and their relationships were described by simple mathematical models. While year-class production (PT) was determined (R2=70.1%) by recruitment (Rc), annual production (PA) was determined (R2=60.3%) by mean annual density (NA). In turn, variation in recruitment explained R2=55.2% of variation in year-class P/BT ratios, the latter attaining an asymptote at P/BT=6 at progressively higher levels of recruitment

  20. Diet of residents of Bryansk region western areas and it's variation resulted from the Chernobyl accident

    International Nuclear Information System (INIS)

    Travnikova, I.G.; Balonov, M.I.; Kaplun, I.S.

    1993-01-01

    The paper presents the results of the examination of 955 inhabitants of the Bryansk region areas affected greatly by the Chernobyl accident. The examination was carried out in August-September, 1987. The examination was conducted to estimate the efficiency of the protective measures taken to reduce the levels of population irradiation at the alimentary in take of radionuclides. The ratios characteristic for the urban and rural population and the variations of the rations resulted from the accident became one the objects of the investigation. Milk consumption by all groups of the population is determined to reduce abruptly thus affecting the usual structure of nutrition. Consumption of meat, of fish from local lakes and rivers, of mushrooms, of forest berries reduced, as well. The mentioned variations enabled to decrease the dose of internal irradiation of the population by several times, But protein, microelements and vitamin deficiency in combination with the stress may negative affet the health of the people

  1. A large-scale survey of genetic copy number variations among Han Chinese residing in Taiwan

    Directory of Open Access Journals (Sweden)

    Wu Jer-Yuarn

    2008-12-01

    Full Text Available Abstract Background Copy number variations (CNVs have recently been recognized as important structural variations in the human genome. CNVs can affect gene expression and thus may contribute to phenotypic differences. The copy number inferring tool (CNIT is an effective hidden Markov model-based algorithm for estimating allele-specific copy number and predicting chromosomal alterations from single nucleotide polymorphism microarrays. The CNIT algorithm, which was constructed using data from 270 HapMap multi-ethnic individuals, was applied to identify CNVs from 300 unrelated Han Chinese individuals in Taiwan. Results Using stringent selection criteria, 230 regions with variable copy numbers were identified in the Han Chinese population; 133 (57.83% had been reported previously, 64 displayed greater than 1% CNV allele frequency. The average size of the CNV regions was 322 kb (ranging from 1.48 kb to 5.68 Mb and covered a total of 2.47% of the human genome. A total of 196 of the CNV regions were simple deletions and 27 were simple amplifications. There were 449 genes and 5 microRNAs within these CNV regions; some of these genes are known to be associated with diseases. Conclusion The identified CNVs are characteristic of the Han Chinese population and should be considered when genetic studies are conducted. The CNV distribution in the human genome is still poorly characterized, and there is much diversity among different ethnic populations.

  2. Body size and geographic range do not explain long term variation in fish populations: a Bayesian phylogenetic approach to testing assembly processes in stream fish assemblages.

    Directory of Open Access Journals (Sweden)

    Stephen J Jacquemin

    Full Text Available We combine evolutionary biology and community ecology to test whether two species traits, body size and geographic range, explain long term variation in local scale freshwater stream fish assemblages. Body size and geographic range are expected to influence several aspects of fish ecology, via relationships with niche breadth, dispersal, and abundance. These traits are expected to scale inversely with niche breadth or current abundance, and to scale directly with dispersal potential. However, their utility to explain long term temporal patterns in local scale abundance is not known. Comparative methods employing an existing molecular phylogeny were used to incorporate evolutionary relatedness in a test for covariation of body size and geographic range with long term (1983 - 2010 local scale population variation of fishes in West Fork White River (Indiana, USA. The Bayesian model incorporating phylogenetic uncertainty and correlated predictors indicated that neither body size nor geographic range explained significant variation in population fluctuations over a 28 year period. Phylogenetic signal data indicated that body size and geographic range were less similar among taxa than expected if trait evolution followed a purely random walk. We interpret this as evidence that local scale population variation may be influenced less by species-level traits such as body size or geographic range, and instead may be influenced more strongly by a taxon's local scale habitat and biotic assemblages.

  3. Which plant trait explains the variations in relative growth rate and its response to elevated carbon dioxide concentration among Arabidopsis thaliana ecotypes derived from a variety of habitats?

    Science.gov (United States)

    Oguchi, Riichi; Ozaki, Hiroshi; Hanada, Kousuke; Hikosaka, Kouki

    2016-03-01

    Elevated atmospheric carbon dioxide (CO2) concentration ([CO2]) enhances plant growth, but this enhancement varies considerably. It is still uncertain which plant traits are quantitatively related to the variation in plant growth. To identify the traits responsible, we developed a growth analysis model that included primary parameters associated with morphology, nitrogen (N) use, and leaf and root activities. We analysed the vegetative growth of 44 ecotypes of Arabidopsis thaliana L. grown at ambient and elevated [CO2] (800 μmol mol(-1)). The 44 ecotypes were selected such that they were derived from various altitudes and latitudes. Relative growth rate (RGR; growth rate per unit plant mass) and its response to [CO2] varied by 1.5- and 1.7-fold among ecotypes, respectively. The variation in RGR at both [CO2]s was mainly explained by the variation in leaf N productivity (LNP; growth rate per leaf N),which was strongly related to photosynthetic N use efficiency (PNUE). The variation in the response of RGR to [CO2] was also explained by the variation in the response of LNP to [CO2]. Genomic analyses indicated that there was no phylogenetic constraint on inter-ecotype variation in the CO2 response of RGR or LNP. We conclude that the significant variation in plant growth and its response to [CO2] among ecotypes reflects the variation in N use for photosynthesis among ecotypes, and that the response of PNUE to CO2 is an important target for predicting and/or breeding plants that have high growth rates at elevated [CO2].

  4. Batch leachate treatment using stirred electrocoagulation reactor with variation of residence time and stirring rate

    Science.gov (United States)

    Sitorus, I. S.; Astono, W.; Iswanto, B.

    2018-01-01

    This study aims to reduce pollutant levels of the leachate by electrocoagulation method using a stirred electrocoagulation reactor as the electrochemical water treatment. The release of active coagulants as metallic ions took place in the anode, while in the cathode, the electrolysis reaction in the form of hydrogen gas dischargeoccurred. The source of wastewater is Waste Water Treatment Plant inlet III of Bantar Gebang, Bekasi. Some parameters were analyzed in this research, i.e., Chemical Oxygen Demand (COD), Biochemical Oxygen Demand (BOD), NH3, NO3 -, NO2 -, N-total, and organic substances as well as the microorganism growth before and after electrocoagulation, with variations of detention time (seconds) of 10, 20, 120, 600 and rapid mixing conditions (rpm) of 60, 100 and 200. The results show that the greater the rapid mixing speed and the detention time of electrolysis, the higher the removal of contaminants in liquid waste. The optimum condition of electrocoagulation was encountered at 200 rpm rapid mixing with 600 seconds of processing time. The removal efficiencies of electrocoagulation method for each parameter are TSS of 46.80%, BOD5 of 71.33%, COD of 73.77%, Pb of 62.5%,and NH3-N of 57.92%,whereas the pH value has been increased from 8.03 to 8.95. The electrocoagulation method can reduce levels of pollutants, complying with the environmental standards.

  5. Magnetic storms and variations in hormone levels among residents of North Polar area - Svalbard

    Science.gov (United States)

    Breus, Tamara; Zenchenko, Tatiana; Boiko, Evgeni

    It was previously shown that magnetic storms lead to an increase in the level of cortisol and noradrenalin in healthy and sick people with cardiovascular diseases [Breus Rapoport. 2003]. However, in the healthy group in the cited study was only 4 people and it seemed that these results need to be checked. In the present work the 4 examinations (January, March, June, October) of large groups of healthy inhabitants of high latitudes (Svalbard, the most northerly in the world year-round inhabited settlements) on the blood levels of adrenal hormones (cortisol) and thyroid hormones (triiodothyronine (T3 ) and thyroxine T4) have been done. The aim was to study the possible sensitivity of these biochemical parameters in three independent groups of people living in this region (men working underground (364 samples), the men working on the ground (274 samples) and women (280 samples)) to variations in external natural factors of high latitudes. For the analysis we used the following parameters of space and terrestrial weather :index of intensity of solar radio emission at a wavelength 10.7sm (RF10.7), planetary geomagnetic activity index - daily Kp index ( Kp) , the daily average Ap index ( Ap) , the maximum per every 3 -hour Kp index ) as well as the daily average indicators of flow rate of galactic cosmic rays neutron component (N), atmospheric pressure ( RATM ) and its rate of change ( the difference between the Ratm today and yesterday ) according to the geophysical station Oulu (Finland , http://cosmicrays.oulu.fi/). The obtained data indicate that the most expressed dependence of the level of studied three hormones is from the level of geomagnetic activity (GMA)-Kp, Ap, Kpmax - 3h. For two of the four seasons (June and October) with increasing levels of GMA a significant (p stress reaction in reply on GMA disturbance. 1. Breus T.K. and Rapoport S.I. Magnetic storms. Medico- biological aspects (in Russian), Publ.Co Soviet Sport,.Moscow, 2003, 271p.

  6. Polymorphisms of large effect explain the majority of the host genetic contribution to variation of HIV-1 virus load

    Science.gov (United States)

    Coulonges, Cedric; Bartha, István; Lenz, Tobias L.; Deutsch, Aaron J.; Bashirova, Arman; Buchbinder, Susan; Carrington, Mary N.; Cossarizza, Andrea; Dalmau, Judith; De Luca, Andrea; Goedert, James J.; Gurdasani, Deepti; Haas, David W.; Herbeck, Joshua T.; Johnson, Eric O.; Kirk, Gregory D.; Lambotte, Olivier; Luo, Ma; Mallal, Simon; van Manen, Daniëlle; Martinez-Picado, Javier; Meyer, Laurence; Miro, José M.; Mullins, James I.; Obel, Niels; Poli, Guido; Sandhu, Manjinder S.; Schuitemaker, Hanneke; Shea, Patrick R.; Theodorou, Ioannis; Walker, Bruce D.; Weintrob, Amy C.; Winkler, Cheryl A.; Wolinsky, Steven M.; Raychaudhuri, Soumya; Goldstein, David B.; Telenti, Amalio; de Bakker, Paul I. W.; Zagury, Jean-François; Fellay, Jacques

    2015-01-01

    Previous genome-wide association studies (GWAS) of HIV-1–infected populations have been underpowered to detect common variants with moderate impact on disease outcome and have not assessed the phenotypic variance explained by genome-wide additive effects. By combining the majority of available genome-wide genotyping data in HIV-infected populations, we tested for association between ∼8 million variants and viral load (HIV RNA copies per milliliter of plasma) in 6,315 individuals of European ancestry. The strongest signal of association was observed in the HLA class I region that was fully explained by independent effects mapping to five variable amino acid positions in the peptide binding grooves of the HLA-B and HLA-A proteins. We observed a second genome-wide significant association signal in the chemokine (C-C motif) receptor (CCR) gene cluster on chromosome 3. Conditional analysis showed that this signal could not be fully attributed to the known protective CCR5Δ32 allele and the risk P1 haplotype, suggesting further causal variants in this region. Heritability analysis demonstrated that common human genetic variation—mostly in the HLA and CCR5 regions—explains 25% of the variability in viral load. This study suggests that analyses in non-European populations and of variant classes not assessed by GWAS should be priorities for the field going forward. PMID:26553974

  7. Do countries matter? Explaining the variation in the use of numerical flexibility arrangements across European companies using a Multi-level model

    OpenAIRE

    Chung, Heejung

    2007-01-01

    Do countries matter, especially compared to other aspects that affect the flexibility behaviours of companies? Many studies on the labour market assume that there are country differences, cross-national variances, and that it is a crucial factor in explaining the actual practices of the labour market by individuals and companies. The supposition is that although there are variations across countries, the behaviour of actors within the country is rather homogeneous. Thus, due to country level ...

  8. Explaining the Cross-National Time Series Variation in Life Expectancy: Income, Women’s Education, Shifts, and What Else?

    OpenAIRE

    Lant Pritchett; Martina Viarengo

    2010-01-01

    This paper examines the variation across countries and evolution over time of life expectancy. Using historical data going back to the beginning of the 20th century several basic facts about the relationship between national income and life expectancy are established. The paper shows that even by examining the augmented Preston curve there is no indication that the Preston curve is “breaking down” and no indication from over 100 years of data that a very strong relationship between national i...

  9. Emergency oil stocks in Southeastern and Eastern Europe: What explains variation in convergence towards the EU model?

    International Nuclear Information System (INIS)

    Tosun, Jale

    2012-01-01

    The accumulation and maintenance of emergency oil stocks in accordance with the requirements of the European Union involve changes in legislation, the strengthening of national stockholding institutions and the attraction of investment. Despite these challenges, almost all Southeastern and Eastern European countries have begun to align their oil stockholding arrangements with the European model, albeit there is variation in the actual degree of convergence. The greatest convergence is observed for Croatia and the Former Yugoslav Republic of Macedonia. In marked contrast, the oil stockholding system of Moldova continues to be different from the European model. This study provides an overview of the Southeastern and Eastern European countries’ progress in approximating the European requirements for emergency oil stocks and identifies the factors responsible for the cross-country variation. The differences observed stem from the extent to which the countries are legally obliged to comply with the European provisions, their membership aspirations, levels of energy-related investment from the European Union, and dependence on oil imports. - Highlights: ► Southeastern and Eastern European countries are approaching the European stockholding model. ► Croatia and Macedonia demonstrate the highest degree of convergence. ► Moldova displays the greatest distance to the European model. ► Variation in convergence is determined by legal obligation, membership aspiration, investment and dependence on oil.

  10. Variation in family physicians' recording of auscultation abnormalities in patients with acute cough is not explained by case mix. A study from 12 European networks.

    Science.gov (United States)

    Francis, Nick A; Melbye, Hasse; Kelly, Mark J; Cals, Jochen W L; Hopstaken, Rogier M; Coenen, Samuel; Butler, Christopher C

    2013-06-01

    Conflicting data on the diagnostic and prognostic value of auscultation abnormalities may be partly explained by inconsistent use of terminology. To describe general practitioners use of chest auscultation abnormality terms for patients presenting with acute cough across Europe, and to explore the influence of geographic location and case mix on use of these terms. Clinicians recorded whether 'diminished vesicular breathing', 'wheezes', 'crackles' and 'rhonchi' were present in an observational study of adults with acute cough in 13 networks in 12 European countries. We describe the use of these terms overall and by network, and used multilevel logistic regression to explore variation by network, controlling for patients' gender, age, comorbidities, smoking status and symptoms. 2345 patients were included. Wheeze was the auscultation abnormality most frequently recorded (20.6% overall) with wide variation by network (range: 8.3-30.8%). There was similar variation for other auscultation abnormalities. After controlling for patient characteristics, network was a significant predictor of auscultation abnormalities with odds ratios for location effects ranging from 0.37 to 4.46 for any recorded auscultation abnormality, and from 0.25 to 3.14 for rhonchi. There is important variation in recording chest auscultation abnormalities by general practitioners across Europe, which cannot be explained by differences in patient characteristics. There is a need and opportunity for standardization in the detection and classification of lung sounds.

  11. Subnational variation for care at birth in Tanzania: is this explained by place, people, money or drugs?

    Directory of Open Access Journals (Sweden)

    Corinne E. Armstrong

    2016-09-01

    Full Text Available Abstract Background Tanzania achieved the Millennium Development Goal for child survival, yet made insufficient progress for maternal and neonatal survival and stillbirths, due to low coverage and quality of services for care at birth, with rural women left behind. Our study aimed to evaluate Tanzania’s subnational (regional-level variations for rural care at birth outcomes, i.e., rural women giving birth in a facility and by Caesarean section (C-section, and associations with health systems inputs (financing, health workforce, facilities, and commodities, outputs (readiness and quality of care and context (education and GDP. Methods We undertook correlation analyses of subnational-level associations between health system inputs, outputs, context, and rural care at birth outcomes; and constructed implementation readiness barometers using benchmarks for each health system input indicator. We used geographical information system (GIS mapping to visualise subnational variations in care at birth for rural women, with a focus on service availability and readiness, and collected qualitative data to investigate financial flows from national to council level to understand variation in financing inputs. Results We found wide subnational variation for rural care at birth outcomes, health systems inputs, and contextual indicators. There was a positive association between rural women giving birth in a facility and by C-section; maternal education; workforce and facility density; and quality of care. There was a negative association between these outcomes and proportion of all births to rural women, total fertility rate, and availability of essential commodities at facilities. Per capita recurrent expenditure was positively associated with facility births (correlation coefficient = 0.43; p = 0.05 but not with C-section. Qualitative results showed that the health financing system is complex and insufficient for providing care at birth services

  12. Seasonal variation in marine C:N:P stoichiometry: can the composition of seston explain stable Redfield ratios?

    Directory of Open Access Journals (Sweden)

    H. Frigstad

    2011-10-01

    Full Text Available Seston is suspended particulate organic matter, comprising a mixture of autotrophic, heterotrophic and detrital material. Despite variable proportions of these components, marine seston often exhibits relatively small deviations from the Redfield ratio (C:N:P = 106:16:1. Two time-series from the Norwegian shelf in Skagerrak are used to identify drivers of the seasonal variation in seston elemental ratios. An ordination identified water mass characteristics and bloom dynamics as the most important drivers for determining C:N, while changes in nutrient concentrations and biomass were most important for the C:P and N:P relationships. There is no standardized method for determining the functional composition of seston and the fractions of POC, PON and PP associated with phytoplankton, therefore any such information has to be obtained by indirect means. In this study, a generalized linear model was used to differentiate between the live autotrophic and non-autotrophic sestonic fractions, and for both stations the non-autotrophic fractions dominated with respective annual means of 76 and 55%. This regression model approach builds on assumptions (e.g. constant POC:Chl-a ratio and the robustness of the estimates were explored with a bootstrap analysis. In addition the autotrophic percentage calculated from the statistical model was compared with estimated phytoplankton carbon, and the two independent estimates of autotrophic percentage were comparable with similar seasonal cycles. The estimated C:nutrient ratios of live autotrophs were, in general, lower than Redfield, while the non-autotrophic C:nutrient ratios were higher than the live autotrophic ratios and above, or close to, the Redfield ratio. This is due to preferential remineralization of nutrients, and the P content mainly governed the difference between the sestonic fractions. Despite the seasonal variability in seston composition and the generally low contribution of autotrophic

  13. The role of staff in health promotion in community residences for people with intellectual disabilities: variation in views among managers and caregivers.

    Science.gov (United States)

    Bergström, Helena; Wihlman, Ulla

    2011-09-01

    Managers and caregivers in community residences for people with intellectual disabilities are expected both to promote residents' health and to support their autonomy. The aim of this article was to explore variation in views among managers and caregivers on the role of staff in health promotion. A qualitative study was conducted using semi-structured interviews with six managers and six caregivers. The analysis used a phenomenographic approach to categorize variation in views. We identified five qualitatively different main categories of roles staff play in health promotion: the parent, the manipulator, the coach, the educator and the libertarian. In addition lifestyle-related risk factors for ill-health and barriers to a healthy lifestyle were analysed and described using qualitative content analysis. The results highlight the ethical conflict that faces staff trying to support a healthy lifestyle as well as the autonomy of the residents.

  14. A passive heat tracer experiment to determine the seasonal variation in residence times in a managed aquifer recharge system with DTS

    NARCIS (Netherlands)

    des Tombe, B.F.; Bakker, M.; Schaars, F; van der Made, KJ; Calje, R; Borst, L.

    2016-01-01

    Targeted provisional session N°8.01 The seasonal variation in residence times is determined in a managed aquifer recharge system using a passive heat tracer test. The managed aquifer recharge system consists of a sequence of alternating elongated recharge basins and rows of recovery wells. The

  15. A model explaining genotypic and ontogenetic variation of leaf photosynthetic rate in rice (Oryza sativa) based on leaf nitrogen content and stomatal conductance.

    Science.gov (United States)

    Ohsumi, Akihiro; Hamasaki, Akihiro; Nakagawa, Hiroshi; Yoshida, Hiroe; Shiraiwa, Tatsuhiko; Horie, Takeshi

    2007-02-01

    Identification of physiological traits associated with leaf photosynthetic rate (Pn) is important for improving potential productivity of rice (Oryza sativa). The objectives of this study were to develop a model which can explain genotypic variation and ontogenetic change of Pn in rice under optimal conditions as a function of leaf nitrogen content per unit area (N) and stomatal conductance (g(s)), and to quantify the effects of interaction between N and g(s) on the variation of Pn. Pn, N and g(s) were measured at different developmental stages for the topmost fully expanded leaves in ten rice genotypes with diverse backgrounds grown in pots (2002) and in the field (2001 and 2002). A model of Pn that accounts for carboxylation and CO diffusion processes, and assumes that the ratio of internal conductance to g(s) is constant, was constructed, and its goodness of fit was examined. Considerable genotypic differences in Pn were evident for rice throughout development in both the pot and field experiments. The genotypic variation of Pn was correlated with that of g(s) at a given stage, and the change of Pn with plant development was closely related to the change of N. The variation of g(s) among genotypes was independent of that of N. The model explained well the variation in Pn of the ten genotypes grown under different conditions at different developmental stages. Conclusions The response of Pn to increased N differs with g(s), and the increase in Pn of genotypes with low g(s) is smaller than that of genotypes with high g(s). Therefore, simultaneous improvements of these two traits are essential for an effective breeding of rice genotypes with increased Pn.

  16. The Role of Access to Finance in Explaining Cross-National Variation in Entrepreneurial Activity: A Panel Data Approach

    Directory of Open Access Journals (Sweden)

    Sorin Gabriel Anton

    2017-10-01

    Full Text Available The aim of the paper is to investigate to what extent access to finance explains differences in entrepreneurial activity across European Union (EU member countries. We use a dataset containing information across countries and time to investigate the determinants of entrepreneurial activity in twenty-five EU members over the period between 2007 and 2013. Our sample comprises both periods of difficult access to finance and periods of excessive liquidities. Employing a panel data model with fixed effects, we found a positive relationship between access to finance and entrepreneurial activities. Furthermore, we showed that this positive relationship is more important for the individuals who believe they have the required skills and knowledge to start a business. The results proved to be robust when we employed different measures of entrepreneurial activity and several proxies for access to finance. Our findings provide empirical evidence for the need of policy initiatives at national and EU level to facilitate the creation of sustainable new ventures.

  17. Explaining the variation in the shear force of lamb meat using sarcomere length, the rate of rigor onset and pH.

    Science.gov (United States)

    Hopkins, D L; Toohey, E S; Lamb, T A; Kerr, M J; van de Ven, R; Refshauge, G

    2011-08-01

    The temperature when the pH=6.0 (temp@pH6) impacts on the tenderness and eating quality of sheep meat. Due to the expense, sarcomere length is not routinely measured as a variable to explain variation in shear force, but whether measures such as temp@pH6 are as useful a parameter needs to be established. Measures of rigor onset in 261 carcases, including the temp@pH6, were evaluated in this study for their ability to explain some of the variation in shear force. The results show that for 1 day aged product combinations of the temp@pH6, the pH at 18 °C and the pH at 24 h provided a larger reduction (almost double) in total shear force variation than sarcomere length alone, with pH at 24 h being the single best measure. For 5 day aged product, pH at 18 °C was the single best measure. Inclusion of sarcomere length did represent some improvement, but the marginal increase would not be cost effective. Crown Copyright © 2011. Published by Elsevier Ltd. All rights reserved.

  18. Do diagnosis-related groups appropriately explain variations in costs and length of stay of hip replacement? A comparative assessment of DRG systems across 10 European countries.

    Science.gov (United States)

    Geissler, Alexander; Scheller-Kreinsen, David; Quentin, Wilm

    2012-08-01

    This paper assesses the variations in costs and length of stay for hip replacement cases in Austria, England, Estonia, Finland, France, Germany, Ireland, Poland, Spain and Sweden and examines the ability of national diagnosis-related group (DRG) systems to explain the variation in resource use against a set of patient characteristic and treatment specific variables. In total, 195,810 cases clustered in 712 hospitals were analyzed using OLS fixed effects models for cost data (n=125,698) and negative binominal models for length-of-stay data (n=70,112). The number of DRGs differs widely across the 10 European countries (range: 2-14). Underlying this wide range is a different use of classification variables, especially secondary diagnoses and treatment options are considered to a different extent. In six countries, a standard set of patient characteristics and treatment variables explain the variation in costs or length of stay better than the DRG variables. This raises questions about the adequacy of the countries' DRG system or the lack of specific criteria, which could be used as classification variables. Copyright © 2012 John Wiley & Sons, Ltd.

  19. Bias Correction Methods Explain Much of the Variation Seen in Breast Cancer Risks of BRCA1/2 Mutation Carriers.

    Science.gov (United States)

    Vos, Janet R; Hsu, Li; Brohet, Richard M; Mourits, Marian J E; de Vries, Jakob; Malone, Kathleen E; Oosterwijk, Jan C; de Bock, Geertruida H

    2015-08-10

    Recommendations for treating patients who carry a BRCA1/2 gene are mainly based on cumulative lifetime risks (CLTRs) of breast cancer determined from retrospective cohorts. These risks vary widely (27% to 88%), and it is important to understand why. We analyzed the effects of methods of risk estimation and bias correction and of population factors on CLTRs in this retrospective clinical cohort of BRCA1/2 carriers. The following methods to estimate the breast cancer risk of BRCA1/2 carriers were identified from the literature: Kaplan-Meier, frailty, and modified segregation analyses with bias correction consisting of including or excluding index patients combined with including or excluding first-degree relatives (FDRs) or different conditional likelihoods. These were applied to clinical data of BRCA1/2 families derived from our family cancer clinic for whom a simulation was also performed to evaluate the methods. CLTRs and 95% CIs were estimated and compared with the reference CLTRs. CLTRs ranged from 35% to 83% for BRCA1 and 41% to 86% for BRCA2 carriers at age 70 years width of 95% CIs: 10% to 35% and 13% to 46%, respectively). Relative bias varied from -38% to +16%. Bias correction with inclusion of index patients and untested FDRs gave the smallest bias: +2% (SD, 2%) in BRCA1 and +0.9% (SD, 3.6%) in BRCA2. Much of the variation in breast cancer CLTRs in retrospective clinical BRCA1/2 cohorts is due to the bias-correction method, whereas a smaller part is due to population differences. Kaplan-Meier analyses with bias correction that includes index patients and a proportion of untested FDRs provide suitable CLTRs for carriers counseled in the clinic. © 2015 by American Society of Clinical Oncology.

  20. ENSO, nest predation risk, food abundance, and male status fail to explain annual variations in the apparent survival rate of a migratory songbird.

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    Alizée Vernouillet

    Full Text Available Adult mortality can be a major driver of population decline in species whose productivity is relatively low. Yet, little is known about the factors influencing adult survival rates in migratory bird species, nor do we know much about the longer-term effects of habitat disturbance on the fitness of individuals. The Ovenbird (Seiurus aurocapilla is one of the vertebrate species most sensitive to forest management, yet it is still common and widespread. We monitored the fate of 330 colour-banded Ovenbird males in four pairs of 25-ha plots during 9 successive breeding seasons. One plot of each pair was treated through selection harvesting (30-40% basal area removed during the first winter. We tested the following hypotheses: (1 higher physiological costs in harvested plots as a result of lower food abundance will reduce apparent survival rate (ASR relative to controls; (2 lower ASR following years with low nest survival and higher probability of renesting; (3 fluctuations in ASR reflecting El Niño Southern Oscillation (ENSO; and (4 higher ASR in returning males than in recruits (unbanded immigrants owing to greater site familiarity in the former. We tested the relative importance of these hypotheses, or combinations thereof, by generating 23 models explaining variation in ASR. The year-dependent model received the most support, showing a 41% decrease in ASR from 2007 to 2014. The important year-to-year variation we observed in ASR (Σw(i = 0.99 was not explained by variation in nest predation risk nor by ENSO. There was also little evidence for an effect of selection harvesting on ASR of Ovenbird males, despite a slight reduction in lifespan relative to males from control plots (2.7 vs 2.9 years. An avenue worth exploring to explain this intriguing pattern would be to determine whether conditions at migratory stopover sites or in the wintering area of our focal population have gradually worsened over the past decade.

  1. Explaining individual- and country-level variations in unregistered employment using a multi-level model: evidence from 35 Eurasian countries

    Directory of Open Access Journals (Sweden)

    Krasniqi Besnik A.

    2017-12-01

    Full Text Available The aim of this paper is to evaluate the individual- and country-level variations in unregistered employment. To analyse whether it is marginalised groups who are more likely to engage in unregistered employment and explain the country-level variations, a 2010 Life in Transition Survey (LiTS involving 38,864 interviews in 35 Eurasian countries is reported. Multilevel logistic regression analysis reveals that younger age groups, the divorced, and those with fewer years in education, are more likely to be unregistered employed. On a country-level, meanwhile, the prevalence of unregistered employment is strongly associated with tax morale; the greater the asymmetry between informal and formal institutions, the greater is the prevalence of unregistered employment. It is also higher when GDP per capita as well as social distribution and state intervention (subsidies and transfers, social contribution expenditure, health expenditure are lower. The paper concludes by discussing the theoretical and policy implications.

  2. Foliar pH as a new plant trait: can it explain variation in foliar chemistry and carbon cycling processes among subarctic plant species and types?

    Science.gov (United States)

    Cornelissen, J H C; Quested, H M; van Logtestijn, R S P; Pérez-Harguindeguy, N; Gwynn-Jones, D; Díaz, S; Callaghan, T V; Press, M C; Aerts, R

    2006-03-01

    Plant traits have become popular as predictors of interspecific variation in important ecosystem properties and processes. Here we introduce foliar pH as a possible new plant trait, and tested whether (1) green leaf pH or leaf litter pH correlates with biochemical and structural foliar traits that are linked to biogeochemical cycling; (2) there is consistent variation in green leaf pH or leaf litter pH among plant types as defined by nutrient uptake mode and higher taxonomy; (3) green leaf pH can predict a significant proportion of variation in leaf digestibility among plant species and types; (4) leaf litter pH can predict a significant proportion of variation in leaf litter decomposability among plant species and types. We found some evidence in support of all four hypotheses for a wide range of species in a subarctic flora, although cryptogams (fern allies and a moss) tended to weaken the patterns by showing relatively poor leaf digestibility or litter decomposability at a given pH. Among seed plant species, green leaf pH itself explained only up to a third of the interspecific variation in leaf digestibility and leaf litter up to a quarter of the interspecific variation in leaf litter decomposability. However, foliar pH substantially improved the power of foliar lignin and/or cellulose concentrations as predictors of these processes when added to regression models as a second variable. When species were aggregated into plant types as defined by higher taxonomy and nutrient uptake mode, green-specific leaf area was a more powerful predictor of digestibility or decomposability than any of the biochemical traits including pH. The usefulness of foliar pH as a new predictive trait, whether or not in combination with other traits, remains to be tested across more plant species, types and biomes, and also in relation to other plant or ecosystem traits and processes.

  3. Which factors explain variation in intention to disclose a diagnosis of dementia? A theory-based survey of mental health professionals

    Directory of Open Access Journals (Sweden)

    Eccles Martin

    2007-09-01

    Full Text Available Abstract Background For people with dementia, patient-centred care should involve timely explanation of the diagnosis and its implications. However, this is not routine. Theoretical models of behaviour change offer a generalisable framework for understanding professional practice and identifying modifiable factors to target with an intervention. Theoretical models and empirical work indicate that behavioural intention represents a modifiable predictor of actual professional behaviour. We identified factors that predict the intentions of members of older people's mental health teams (MHTs to perform key behaviours involved in the disclosure of dementia. Design Postal questionnaire survey. Participants Professionals from MHTs in the English National Health Service. Methods We selected three behaviours: Determining what patients already know or suspect about their diagnosis; using explicit terminology when talking to patients; and exploring what the diagnosis means to patients. The questionnaire was based upon the Theory of Planned Behaviour (TPB, Social Cognitive Theory (SCT, and exploratory team variables. Main outcomes Behavioural intentions. Results Out of 1,269 professionals working in 85 MHTs, 399 (31.4% returned completed questionnaires. Overall, the TPB best explained behavioural intention. For determining what patients already know, the TPB variables of subjective norm, perceived behavioural control and attitude explained 29.4% of the variance in intention. For the use of explicit terminology, the same variables explained 53.7% of intention. For exploring what the diagnosis means to patients, subjective norm and perceived behavioural control explained 48.6% of intention. Conclusion These psychological models can explain up to half of the variation in intention to perform key disclosure behaviours. This provides an empirically-supported, theoretical basis for the design of interventions to improve disclosure practice by targeting relevant

  4. Natural selection in a population of Drosophila melanogaster explained by changes in gene expression caused by sequence variation in core promoter regions.

    Science.gov (United States)

    Sato, Mitsuhiko P; Makino, Takashi; Kawata, Masakado

    2016-02-09

    Understanding the evolutionary forces that influence variation in gene regulatory regions in natural populations is an important challenge for evolutionary biology because natural selection for such variations could promote adaptive phenotypic evolution. Recently, whole-genome sequence analyses have identified regulatory regions subject to natural selection. However, these studies could not identify the relationship between sequence variation in the detected regions and change in gene expression levels. We analyzed sequence variations in core promoter regions, which are critical regions for gene regulation in higher eukaryotes, in a natural population of Drosophila melanogaster, and identified core promoter sequence variations associated with differences in gene expression levels subjected to natural selection. Among the core promoter regions whose sequence variation could change transcription factor binding sites and explain differences in expression levels, three core promoter regions were detected as candidates associated with purifying selection or selective sweep and seven as candidates associated with balancing selection, excluding the possibility of linkage between these regions and core promoter regions. CHKov1, which confers resistance to the sigma virus and related insecticides, was identified as core promoter regions that has been subject to selective sweep, although it could not be denied that selection for variation in core promoter regions was due to linked single nucleotide polymorphisms in the regulatory region outside core promoter regions. Nucleotide changes in core promoter regions of CHKov1 caused the loss of two basal transcription factor binding sites and acquisition of one transcription factor binding site, resulting in decreased gene expression levels. Of nine core promoter regions regions associated with balancing selection, brat, and CG9044 are associated with neuromuscular junction development, and Nmda1 are associated with learning

  5. The role of organizational context and individual nurse characteristics in explaining variation in use of information technologies in evidence based practice

    Directory of Open Access Journals (Sweden)

    Doran Diane

    2012-12-01

    Full Text Available Abstract Background There is growing awareness of the role of information technology in evidence-based practice. The purpose of this study was to investigate the role of organizational context and nurse characteristics in explaining variation in nurses’ use of personal digital assistants (PDAs and mobile Tablet PCs for accessing evidence-based information. The Promoting Action on Research Implementation in Health Services (PARIHS model provided the framework for studying the impact of providing nurses with PDA-supported, evidence-based practice resources, and for studying the organizational, technological, and human resource variables that impact nurses’ use patterns. Methods A survey design was used, involving baseline and follow-up questionnaires. The setting included 24 organizations representing three sectors: hospitals, long-term care (LTC facilities, and community organizations (home care and public health. The sample consisted of 710 participants (response rate 58% at Time 1, and 469 for whom both Time 1 and Time 2 follow-up data were obtained (response rate 66%. A hierarchical regression model (HLM was used to evaluate the effect of predictors from all levels simultaneously. Results The Chi square result indicated PDA users reported using their device more frequently than Tablet PC users (p = 0.001. Frequency of device use was explained by ‘breadth of device functions’ and PDA versus Tablet PC. Frequency of Best Practice Guideline use was explained by ‘willingness to implement research,’ ‘structural and electronic resources,’ ‘organizational slack time,’ ‘breadth of device functions’ (positive effects, and ‘slack staff’ (negative effect. Frequency of Nursing Plus database use was explained by ‘culture,’ ‘structural and electronic resources,’ and ‘breadth of device functions’ (positive effects, and ‘slack staff’ (negative. ‘Organizational culture’ (positive, ‘breadth of device functions

  6. Can variation in hypothalamic-pituitary-adrenal (HPA-axis activity explain the relationship between depression and cognition in bipolar patients?

    Directory of Open Access Journals (Sweden)

    Marieke J van der Werf-Eldering

    Full Text Available Dysregulation of the hypothalamic-pituitary-adrenal (HPA axis is thought to be associated with more mood symptoms and worse cognitive functioning. This study examined whether variation in HPA axis activity underlies the association between mood symptoms and cognitive functioning.In 65 bipolar patients cognitive functioning was measured in domains of psychomotor speed, speed of information processing, attentional switching, verbal memory, visual memory, executive functioning and an overall mean score. Severity of depression was assessed by the Inventory of Depressive Symptomatology-self rating version. Saliva cortisol measurements were performed to calculate HPA axis indicators: cortisol awakening response, diurnal slope, the evening cortisol level and the cortisol suppression on the dexamethasone suppression test. Regression analyses of depressive symptoms and cognitive functioning on each HPA axis indicator were performed. In addition we calculated percentages explanation of the association between depressive symptoms and cognition by HPA axis indicators. Depressive symptoms were associated with dysfunction in psychomotor speed, attentional switching and the mean score, as well as with attenuation in diurnal slope value. No association was found between HPA axis activity and cognitive functioning and HPA axis activity did not explain the associations between depressive symptoms and cognition.As our study is the first one in this field specific for bipolar patients and changes in HPA-axis activity did not seem to explain the association between severity of depressive symptoms and cognitive functioning in bipolar patients, future studies are needed to evaluate other factors that might explain this relationship.

  7. Variations in the perception of trauma-related complications between attending surgeons, surgery residents, critical care nurses, and medical students.

    Science.gov (United States)

    Dissanaike, Sharmila; Berry, Matthew; Ginos, Jason; Paige, Robert; McNabb, Wendi; Griswold, John

    2009-06-01

    The morbidity and mortality conference (M&M) is a key component of the performance improvement process. The audience response system (ARS) has been shown to improve audience participation and promote more truthful responses in various settings. We implemented the ARS in our trauma M&M and evaluated the responses we received from different categories of participants. This was a prospective observational study undertaken between November 2006 and July 2007. Cases were graded based on the American College of Surgeons scoring system. We evaluated the responses of attending surgeons, residents, critical care nurses, and medical students using the ARS. We had 695 responses for complications and 936 responses for deaths. Residents consistently scored complications as more severe than other groups (P = .03). There was no difference in the scoring of deaths. Surgical residents assign higher severity to trauma-related complications than other groups when using an anonymous automated scoring system.

  8. Presence of sequence and SNP variation in the IRF6 gene in healthy residents of Guangdong Province

    Directory of Open Access Journals (Sweden)

    Wu Wenli

    2016-01-01

    Full Text Available This study was to investigate the single nucleotide polymorphism (SNP in the interferon regulatory factor 6 (IRF6 gene in healthy residents of Guangdong Province, China, for further analysis of their associations with the development of cleft lip with or without palate (CL/P.

  9. Variation in transnationalism among Eastern European migrants in Italy: the role of duration of residence and integration

    NARCIS (Netherlands)

    Cela, E.; Fokkema, T.; Ambrosetti, E.; King, Russell; Povrzanović Frykman, Maya; Vullnetari, Julie

    2017-01-01

    Transnationalism of first-generation migrants, usually considered as a core element of their migratory projects, is nowadays taken somewhat for granted. Our aim in this paper is to examine empirically the relations of transnationalism with duration of residence and integration of Eastern European

  10. Milk fat depression in dairy ewes fed fish oil: Might differences in rumen biohydrogenation, fermentation, or bacterial community explain the individual variation?

    Science.gov (United States)

    Frutos, P; Toral, P G; Belenguer, A; Hervás, G

    2018-07-01

    more abundant in RESPON+. Overall, the results suggest that individual variation in MFD severity in dairy ewes fed fish oil cannot be fully explained by differences in the processes of rumen biohydrogenation and fermentation or in the bacterial community, and further research would be necessary to elucidate the large variability in the responsiveness to MFD-inducing marine lipids. Copyright © 2018 American Dairy Science Association. Published by Elsevier Inc. All rights reserved.

  11. Variation in Older Adult Characteristics by Residence Type and Use of Home- and Community-Based Services

    Science.gov (United States)

    Ewen, Heidi H.; Washington, Tiffany R.; Emerson, Kerstin G.; Carswell, Andrew T.; Smith, Matthew Lee

    2017-01-01

    Background: The majority of older adults prefer to remain in their homes, or to “age-in-place.” To accomplish this goal, many older adults will rely upon home- and community-based services (HCBS) for support. However, the availability and accessibility of HCBS may differ based on whether the older adult lives in the community or in a senior housing apartment facility. Methods: This paper reports findings from the Pathways to Life Quality study of residential change and stability among seniors in upstate New York. Data were analyzed from 663 older adults living in one of three housing types: service-rich facilities, service-poor facilities, and community-dwelling in single-family homes. A multinomial logistic regression model was used to examine factors associated with residence type. A linear regression model was fitted to examine factors associated with HCBS utilization. Results: When compared to community-dwelling older adults, those residing in service-rich and service-poor facilities were more likely to be older, report more activity limitations, and provide less instrumental assistance to others. Those in service-poor facilities were more likely to have poorer mental health and lower perceived purpose in life. The three leading HCBS utilized were senior centers (20%), homemaker services (19%), and transportation services (18%). More HCBS utilization was associated with participants who resided in service-poor housing, were older, were female, and had more activity limitations. More HCBS utilization was also associated with those who received instrumental support, had higher perceived purpose in life, and poorer mental health. Conclusions: Findings suggest that older adults’ residential environment is associated with their health status and HCBS utilization. Building upon the Person–Environment Fit theories, dedicated efforts are needed to introduce and expand upon existing HCBS available to facility residents to address physical and mental health needs

  12. Variation in Older Adult Characteristics by Residence Type and Use of Home- and Community-Based Services

    Directory of Open Access Journals (Sweden)

    Heidi H. Ewen

    2017-03-01

    Full Text Available Background: The majority of older adults prefer to remain in their homes, or to “age-in-place.” To accomplish this goal, many older adults will rely upon home- and community-based services (HCBS for support. However, the availability and accessibility of HCBS may differ based on whether the older adult lives in the community or in a senior housing apartment facility. Methods: This paper reports findings from the Pathways to Life Quality study of residential change and stability among seniors in upstate New York. Data were analyzed from 663 older adults living in one of three housing types: service-rich facilities, service-poor facilities, and community-dwelling in single-family homes. A multinomial logistic regression model was used to examine factors associated with residence type. A linear regression model was fitted to examine factors associated with HCBS utilization. Results: When compared to community-dwelling older adults, those residing in service-rich and service-poor facilities were more likely to be older, report more activity limitations, and provide less instrumental assistance to others. Those in service-poor facilities were more likely to have poorer mental health and lower perceived purpose in life. The three leading HCBS utilized were senior centers (20%, homemaker services (19%, and transportation services (18%. More HCBS utilization was associated with participants who resided in service-poor housing, were older, were female, and had more activity limitations. More HCBS utilization was also associated with those who received instrumental support, had higher perceived purpose in life, and poorer mental health. Conclusions: Findings suggest that older adults’ residential environment is associated with their health status and HCBS utilization. Building upon the Person–Environment Fit theories, dedicated efforts are needed to introduce and expand upon existing HCBS available to facility residents to address physical and

  13. Specific infant feeding practices do not consistently explain variation in anthropometry at age 1 year in urban United States, Mexico, and China cohorts.

    Science.gov (United States)

    Woo, Jessica G; Guerrero, M Lourdes; Ruiz-Palacios, Guillermo M; Peng, Yong-mei; Herbers, Patricia M; Yao, Wen; Ortega, Hilda; Davidson, Barbara S; McMahon, Robert J; Morrow, Ardythe L

    2013-02-01

    Infant feeding practices generally influence infant growth, but it is unclear how introduction of specific foods affects growth across global populations. We studied 3 urban populations in the Global Exploration of Human Milk study to determine the association between infant feeding and anthropometry at 1 y of age. Three hundred sixty-five breastfeeding mother-infant pairs (120 US, 120 China, and 125 Mexico) were recruited soon after the infant's birth. Enrollment required agreement to breastfeed ≥75% for at least 3 mo. Weekly, 24-h, food frequency data were conducted on infants for 1 y and exclusive breastfeeding (EBF) duration and timing of specific complementary food introduction were calculated. Weight and length were measured at age 1 y and anthropometry Z-scores calculated using WHO standards. Cohorts in the 3 urban populations (Shanghai, China; Cincinnati, USA; and Mexico City, Mexico) differed by median EBF duration (5, 14, and 7 wk, respectively; P Mexico City infants (P < 0.001). Adjusting for nonfeeding covariates, the only feeding variable associated with anthropometry was EBF duration, which was modestly inversely associated with weight-for-age but not length-for-age or BMI Z-scores at 1 y. Although feeding variables differed by cohort, their impact on anthropometry differences was not consistent among cohorts. Overall, across these urban, international, breast-fed cohorts, differences in specific feeding practices did not explain the significant variation in anthropometry.

  14. Specific Infant Feeding Practices Do Not Consistently Explain Variation in Anthropometry at Age 1 Year in Urban United States, Mexico, and China Cohorts12

    Science.gov (United States)

    Woo, Jessica G.; Guerrero, M. Lourdes; Ruiz-Palacios, Guillermo M.; Peng, Yong-mei; Herbers, Patricia M.; Yao, Wen; Ortega, Hilda; Davidson, Barbara S.; McMahon, Robert J.; Morrow, Ardythe L.

    2013-01-01

    Infant feeding practices generally influence infant growth, but it is unclear how introduction of specific foods affects growth across global populations. We studied 3 urban populations in the Global Exploration of Human Milk study to determine the association between infant feeding and anthropometry at 1 y of age. Three hundred sixty-five breastfeeding mother-infant pairs (120 US, 120 China, and 125 Mexico) were recruited soon after the infant’s birth. Enrollment required agreement to breastfeed ≥75% for at least 3 mo. Weekly, 24-h, food frequency data were conducted on infants for 1 y and exclusive breastfeeding (EBF) duration and timing of specific complementary food introduction were calculated. Weight and length were measured at age 1 y and anthropometry Z-scores calculated using WHO standards. Cohorts in the 3 urban populations (Shanghai, China; Cincinnati, USA; and Mexico City, Mexico) differed by median EBF duration (5, 14, and 7 wk, respectively; P Mexico City infants (P < 0.001). Adjusting for nonfeeding covariates, the only feeding variable associated with anthropometry was EBF duration, which was modestly inversely associated with weight-for-age but not length-for-age or BMI Z-scores at 1 y. Although feeding variables differed by cohort, their impact on anthropometry differences was not consistent among cohorts. Overall, across these urban, international, breast-fed cohorts, differences in specific feeding practices did not explain the significant variation in anthropometry. PMID:23236024

  15. Effects of variations in cadmium and lead levels in river sediments on local foods and body burden of local residents in non-polluted areas in Japan.

    Science.gov (United States)

    Ikeda, Masayuki; Watanabe, Takao; Ohashi, Fumiko; Shimbo, Shinichiro

    2010-03-01

    This study was initiated to examine if variations in the concentrations of cadmium (Cd) and lead (Pb) in water environment may affect metal levels in local foods and body burden of local residents in non-polluted areas in Japan. Two nationwide databases have been made available on concentrations of Cd in locally harvested brown rice and of Cd and Pb in sediments in local river beds. These data were combined with published data on metal concentrations in polished rice, food duplicates, and blood and urine from the residents. Cd in river sediments correlated significantly with those in brown rice, food duplicates, blood, and urine. Cd in food duplicates correlated with Cd in rice. In contrast, Pb concentrations in the river sediments either did not correlate or correlated only weakly with Pb in biological materials or food duplicates. Possible implication of the different behavior between Cd and Pb regarding the intensity of correlation was discussed with reference to the different routes of exposure to the elements. In conclusions, the Cd body burden on local residents in Japan is significantly influenced by Cd levels in water in the general environment, whereas water-borne Pb did not show clear correlation with the Pb body burden.

  16. Age and Sex Variation In Prevalence Of Chronic Medical Conditions In Older Residents of U.S. Nursing Homes

    Science.gov (United States)

    Moore, Kelly L.; Boscardin, W. John; Steinman, Michael A.; Schwartz, Janice B.

    2012-01-01

    OBJECTIVES To investigate patterns in prevalences of chronic medical conditions over the agespan of long-term stay nursing home residents and between the sexes with data from the 2004 National Nursing Home Survey (NNHS). DESIGN Retrospective, cross-sectional study. SETTING U.S. nursing homes. PARTICIPANTS Nationally representative sample comprising 11,788 long-term stay residents (3003 (25%) men and 8785 women) aged 65 years or older. MEASUREMENTS Clinical Classifications Software (CCS) was used to group ICD-9 codes to identify the 20 most prevalent chronic medical conditions. SAS survey procedures were used to account for design effects of stratification and clustering to generate nationally representative estimates of prevalences of medical conditions. RESULTS Average age was 84 y, with women older than men (85 vs. 81, p=0.02) with 67% of women ages 80–95. Women required more ADL assistance. The most frequent chronic medical conditions were hypertension (53, 56%: men, women), dementia (45, 52%), depression (31, 37%), arthritis (26, 35%), diabetes mellitus (26, 23%), gastrointestinal reflux -GERD (23, 23%), atherosclerosis (24, 20%), congestive heart failure -CHF (18, 21%), cerebrovascular disease (24, 19%) and anemia (17, 20%). Sex differences in prevalences existed for all but constipation, GERD, and hypertension. Diabetes, cerebrovascular disease, and lipid disorders decreased with age in men and women. Atrial fibrillation, anemia, arthritis, CHF, and dementia, and thyroid disease increased with age in both men and women. Age-related patterns differed between the sexes for diabetes, hypertension, and Parkinson’s disease. CONCLUSION The profile of chronic medical conditions varies over the agespan of nursing home residents and differs between men and women. This knowledge should guide educational and care efforts in long-term care. PMID:22463062

  17. Explaining the spatiotemporal variation of fine particle number concentrations over Beijing and surrounding areas in an air quality model with aerosol microphysics

    International Nuclear Information System (INIS)

    Chen, Xueshun; Wang, Zifa; Li, Jie; Chen, Huansheng; Hu, Min; Yang, Wenyi; Wang, Zhe; Ge, Baozhu; Wang, Dawei

    2017-01-01

    In this study, a three-dimensional air quality model with detailed aerosol microphysics (NAQPMS + APM) was applied to simulate the fine particle number size distribution and to explain the spatiotemporal variation of fine particle number concentrations in different size ranges over Beijing and surrounding areas in the haze season (Jan 15 to Feb 13 in 2006). Comparison between observations and the simulation indicates that the model is able to reproduce the main features of the particle number size distribution. The high number concentration of total particles, up to 26600 cm −3 in observations and 39800 cm −3 in the simulation, indicates the severity of pollution in Beijing. We find that primary particles with secondary species coating and secondary particles together control the particle number size distribution. Secondary particles dominate particle number concentration in the nucleation mode. Primary and secondary particles together determine the temporal evolution and spatial pattern of particle number concentration in the Aitken mode. Primary particles dominate particle number concentration in the accumulation mode. Over Beijing and surrounding areas, secondary particles contribute at least 80% of particle number concentration in the nucleation mode but only 10–20% in the accumulation mode. Nucleation mode particles and accumulation mode particles are anti-phased with each other. Nucleation or primary emissions alone could not explain the formation of the particle number size distribution in Beijing. Nucleation has larger effects on ultrafine particles while primary particles emissions are efficient in producing large particles in the accumulation mode. Reduction in primary particle emissions does not always lead to a decrease in the number concentration of ultrafine particles. Measures to reduce fine particle pollution in terms of particle number concentration may be different from those addressing particle mass concentration. - Highlights:

  18. Using H/V Spectral Ratio Analysis to Map Sediment Thickness and to Explain Macroseismic Intensity Variation of a Low-Magnitude Seismic Swarm in Central Belgium

    Science.gov (United States)

    Van Noten, K.; Lecocq, T.; Camelbeeck, T.

    2013-12-01

    Between 2008 and 2010, the Royal Observatory of Belgium received numerous ';Did You Feel It'-reports related to a 2-year lasting earthquake swarm at Court-Saint-Etienne, a small town in a hilly area 20 km SE of Brussels, Belgium. These small-magnitude events (-0.7 ≤ ML ≤ 3.2, n = c. 300 events) were recorded both by the permanent seismometer network in Belgium and by a locally installed temporary seismic network deployed in the epicentral area. Relocation of the hypocenters revealed that the seismic swarm can be related to the reactivation of a NW-SE strike-slip fault at 3 to 6 km depth in the basement rocks of the Lower Palaeozoic London-Brabant Massif. This sequence caused a lot of emotion in the region because more than 60 events were felt by the local population. Given the small magnitudes of the seismic swarm, most events were more often heard than felt by the respondents, which is indicative of a local high-frequency earthquake source. At places where the bedrock is at the surface or where it is covered by thin alluvial sediments ( 30 m). In those river valleys that have a considerable alluvial sedimentary cover, macroseismic intensities are again lower. To explain this variation in macroseismic intensity we present a macroseismic analysis of all DYFI-reports related to the 2008-2010 seismic swarm and a pervasive H/V spectral ratio (HVSR) analysis of ambient noise measurements to model the thickness of sediments covering the London-Brabant Massif. The HVSR method is a very powerful tool to map the basement morphology, particularly in regions of unknown subsurface structure. By calculating the soil's fundamental frequency above boreholes, we calibrated the power-law relationship between the fundamental frequency, shear wave velocity and the thickness of sediments. This relationship is useful for places where the sediment thickness is unknown and where the fundamental frequency can be calculated by H/V spectral ratio analysis of ambient noise. In a

  19. Assessing the Relevance of Anomie Theory for Explaining Spatial Variation in Lethal Criminal Violence: An Aggregate-Level Analysis of Homicide within the United States

    Directory of Open Access Journals (Sweden)

    Eric P. Baumer

    2008-11-01

    Full Text Available One of the most influential statements in the anomie theory tradition has been Merton’s argument that the volume of instrumental property crime should be higher where there is a greater imbalance between the degree of commitment to monetary success goals and the degree of commitment to legitimate means of pursuing such goals. Contemporary anomie theories stimulated by Merton’s perspective, most notably Messner and Rosenfeld’s institutional anomie theory, have expanded the scope conditions by emphasizing lethal criminal violence as an outcome to which anomie theory is highly relevant, and virtually all contemporary empirical studies have focused on applying the perspective to explaining spatial variation in homicide rates. In the present paper, we argue that current explications of Merton’s theory and IAT have not adequately conveyed the relevance of the core features of the anomie perspective to lethal violence. We propose an expanded anomie model in which an unbalanced pecuniary value system – the core causal variable in Merton’s theory and IAT – translates into higher levels of homicide primarily in indirect ways by increasing levels of firearm prevalence, drug market activity, and property crime, and by enhancing the degree to which these factors stimulate lethal outcomes. Using aggregate-level data collected during the mid-to-late 1970s for a sample of relatively large social aggregates within the U.S., we find a significant effect on homicide rates of an interaction term reflecting high levels of commitment to monetary success goals and low levels of commitment to legitimate means. Virtually all of this effect is accounted for by higher levels of property crime and drug market activity that occur in areas with an unbalanced pecuniary value system. Our analysis also reveals that property crime is more apt to lead to homicide under conditions of high levels of structural disadvantage. These and other findings underscore the

  20. Single-nucleotide polymorphisms in LPA explain most of the ancestry-specific variation in Lp(a levels in African Americans.

    Directory of Open Access Journals (Sweden)

    Rahul C Deo

    2011-01-01

    Full Text Available Lipoprotein(a (Lp(a is an important causal cardiovascular risk factor, with serum Lp(a levels predicting atherosclerotic heart disease and genetic determinants of Lp(a levels showing association with myocardial infarction. Lp(a levels vary widely between populations, with African-derived populations having nearly 2-fold higher Lp(a levels than European Americans. We investigated the genetic basis of this difference in 4464 African Americans from the Jackson Heart Study (JHS using a panel of up to 1447 ancestry informative markers, allowing us to accurately estimate the African ancestry proportion of each individual at each position in the genome. In an unbiased genome-wide admixture scan for frequency-differentiated genetic determinants of Lp(a level, we found a convincing peak (LOD = 13.6 at 6q25.3, which spans the LPA locus. Dense fine-mapping of the LPA locus identified a number of strongly associated, common biallelic SNPs, a subset of which can account for up to 7% of the variation in Lp(a level, as well as >70% of the African-European population differences in Lp(a level. We replicated the association of the most strongly associated SNP, rs9457951 (p = 6 × 10(-22, 27% change in Lp(a per allele, ∼5% of Lp(a variance explained in JHS, in 1,726 African Americans from the Dallas Heart Study and found an even stronger association after adjustment for the kringle(IV repeat copy number. Despite the strong association with Lp(a levels, we find no association of any LPA SNP with incident coronary heart disease in 3,225 African Americans from the Atherosclerosis Risk in Communities Study.

  1. Preferences for (In)Formal Language: Correlations with Attitudes toward Linguistic Variation, Multilingualism, Tolerance of Ambiguity, and Residence Abroad

    Science.gov (United States)

    van Compernolle, Rémi A.

    2017-01-01

    Drawing on data collected via a web-based survey, the study investigates the relationship between preferences for (in)formal language and attitudes toward linguistic variation among a large group of monolingual and multilingual adults (n = 379). Also explored are the links between preferences for (in)formal language and several secondary…

  2. Complexity explained

    CERN Document Server

    Erdi, Peter

    2008-01-01

    This book explains why complex systems research is important in understanding the structure, function and dynamics of complex natural and social phenomena. Readers will learn the basic concepts and methods of complex system research.

  3. No Variation in Patient Care Outcomes After Implementation of Resident Shift Work Duty Hour Limitations and a Hospitalist Model System.

    Science.gov (United States)

    Hollier, John M; Wilson, Stephen D

    This study examines whether implementing a resident shift work schedule (RSWS) alone or combined with a hospitalist-led model system (HMS/RSWS) affects patient care outcomes or costs at a pediatric tertiary care teaching hospital. A retrospective sample compared pre- and postintervention groups for the most common primary discharge diagnoses, including asthma and cellulitis (RSWS intervention) and inflammatory bowel disease and diabetic ketoacidosis (HMS/RSWS intervention). Outcome variables included length of stay, number of subspecialty consultations, and hospitalization charges. For the RSWS intervention, the preintervention (n = 107) and postintervention (n = 92) groups showed no difference in any of the outcome variables. For the HMS/RSWS intervention, the preintervention (n = 98) and postintervention (n = 69) groups did not differ in demographics or length of stay. However, subspecialty consultations increased significantly during postintervention from 0.83 to 1.52 consults/hospitalization ( P care outcomes at a pediatric tertiary care teaching hospital.

  4. Evaluation of quantitative imaging methods for organ activity and residence time estimation using a population of phantoms having realistic variations in anatomy and uptake

    International Nuclear Information System (INIS)

    He Bin; Du Yong; Segars, W. Paul; Wahl, Richard L.; Sgouros, George; Jacene, Heather; Frey, Eric C.

    2009-01-01

    Estimating organ residence times is an essential part of patient-specific dosimetry for radioimmunotherapy (RIT). Quantitative imaging methods for RIT are often evaluated using a single physical or simulated phantom but are intended to be applied clinically where there is variability in patient anatomy, biodistribution, and biokinetics. To provide a more relevant evaluation, the authors have thus developed a population of phantoms with realistic variations in these factors and applied it to the evaluation of quantitative imaging methods both to find the best method and to demonstrate the effects of these variations. Using whole body scans and SPECT/CT images, organ shapes and time-activity curves of 111In ibritumomab tiuxetan were measured in dosimetrically important organs in seven patients undergoing a high dose therapy regimen. Based on these measurements, we created a 3D NURBS-based cardiac-torso (NCAT)-based phantom population. SPECT and planar data at realistic count levels were then simulated using previously validated Monte Carlo simulation tools. The projections from the population were used to evaluate the accuracy and variation in accuracy of residence time estimation methods that used a time series of SPECT and planar scans. Quantitative SPECT (QSPECT) reconstruction methods were used that compensated for attenuation, scatter, and the collimator-detector response. Planar images were processed with a conventional (CPlanar) method that used geometric mean attenuation and triple-energy window scatter compensation and a quantitative planar (QPlanar) processing method that used model-based compensation for image degrading effects. Residence times were estimated from activity estimates made at each of five time points. The authors also evaluated hybrid methods that used CPlanar or QPlanar time-activity curves rescaled to the activity estimated from a single QSPECT image. The methods were evaluated in terms of mean relative error and standard deviation of the

  5. Spatial and temporal variation of residence time and storage volume of subsurface water evaluated by multi-tracers approach in mountainous headwater catchments

    Science.gov (United States)

    Tsujimura, Maki; Yano, Shinjiro; Abe, Yutaka; Matsumoto, Takehiro; Yoshizawa, Ayumi; Watanabe, Ysuhito; Ikeda, Koichi

    2015-04-01

    Headwater catchments in mountainous region are the most important recharge area for surface and subsurface waters, additionally time and stock information of the water is principal to understand hydrological processes in the catchments. However, there have been few researches to evaluate variation of residence time and storage volume of subsurface water in time and space at the mountainous headwaters especially with steep slope. We performed an investigation on age dating and estimation of storage volume using simple water budget model in subsurface water with tracing of hydrological flow processes in mountainous catchments underlain by granite, Paleozoic and Tertiary, Yamanashi and Tsukuba, central Japan. We conducted hydrometric measurements and sampling of spring, stream and ground waters in high-flow and low-flow seasons from 2008 through 2012 in the catchments, and CFCs, stable isotopic ratios of oxygen-18 and deuterium, inorganic solute constituent concentrations were determined on all water samples. Residence time of subsurface water ranged from 11 to 60 years in the granite catchments, from 17 to 32 years in the Paleozoic catchments, from 13 to 26 years in the Tertiary catchments, and showed a younger age during the high-flow season, whereas it showed an older age in the low-flow season. Storage volume of subsurface water was estimated to be ranging from 10 ^ 4 to 10 ^ 6 m3 in the granite catchments, from 10 ^ 5 to 10 ^ 7 m3 in the Paleozoic catchments, from 10 ^ 4 to 10 ^ 6 m3 in the Tertiary catchments. In addition, seasonal change of storage volume in the granite catchments was the highest as compared with those of the Paleozoic and the Tertiary catchments. The results suggest that dynamic change of hydrological process seems to cause a larger variation of the residence time and storage volume of subsurface water in time and space in the granite catchments, whereas higher groundwater recharge rate due to frequent fissures or cracks seems to cause larger

  6. Variation in Spring Nearshore Resident Fish Species Composition and Life Histories in the Lower San Joaquin Watershed and Delta

    Directory of Open Access Journals (Sweden)

    Larry R. Brown

    2006-09-01

    Full Text Available Providing freshwater to human populations while protecting or rehabilitating ecosystem health is a significant challenge to water resource managers and requires accurate knowledge of aquatic resources. Previous studies of fish assemblages in the San Francisco Estuary and watershed have focused on specific habitat types, water bodies, or geographic subregions. In this study, we use seining data from two monitoring programs to provide an integrated view of spring nearshore resident fish species composition and life history characteristics in five regions: the San Joaquin River, the upper Sacramento River, the lower Sacramento River, the northern Sacramento-San Joaquin Delta (North Delta, and the Interior Delta. Data for the period March-May from 1994 to 2002, showed that spring species composition of the San Joaquin River was very different from the other four regions. Total catch in the San Joaquin River was dominated by small, short-lived batch spawning alien species (93%, particularly red shiner Cyprinella lutrensis (>75% of total catch. The upper and lower Sacramento River were very similar in species composition and life history characteristics and less dominated by alien fish (

  7. SPSS explained

    CERN Document Server

    Hinton, Perry R; Brownlow, Charlotte

    2014-01-01

    SPSS Explained provides the student with all that they need to undertake statistical analysis using SPSS. It combines a step-by-step approach to each procedure with easy to follow screenshots at each stage of the process. A number of other helpful features are provided: regular advice boxes with tips specific to each test explanations divided into 'essential' and 'advanced' sections to suit readers at different levels frequently asked questions at the end of each chapter. The first edition of this popular book has been fully updated for IBM SPSS version 21 and also includes: chapters that expl

  8. Variation in Women's Preferences Regarding Male Facial Masculinity Is Better Explained by Genetic Differences Than by Previously Identified Context-Dependent Effects.

    Science.gov (United States)

    Zietsch, Brendan P; Lee, Anthony J; Sherlock, James M; Jern, Patrick

    2015-09-01

    Women's preferences for masculine versus feminine male faces are highly variable. According to a dominant theory in evolutionary psychology, this variability results from adaptations that optimize preferences by calibrating them to certain contextual factors, including women's self-perceived attractiveness, short- versus long-term relationship orientation, pathogen disgust sensitivity, and stage of the menstrual cycle. The theory does not account for the possible contribution of genetic variation on women's facial masculinity preference. Using a large sample (N = 2,160) of identical and nonidentical female Finnish twins and their siblings, we showed that the proportion of variation in women's preferences regarding male facial masculinity that was attributable to genetic variation (38%) dwarfed the variation due to the combined effect of contextual factors (< 1%). These findings cast doubt on the importance of these context-dependent effects and may suggest a need for refocusing in the field toward understanding the wide genetic variation in these preferences and how this variation relates to the evolution of sexual dimorphism in faces. © The Author(s) 2015.

  9. Astronomy Explained

    Science.gov (United States)

    North, Gerald

    Every year large numbers of people take up the study of astronomy, mostly at amateur level. There are plenty of elementary books on the market, full of colourful photographs, but lacking in proper explanations of how and why things are as they are. Many people eventually wish to go beyond the 'coffee-table book' stage and study this fascinating subject in greater depth. This book is written for them. In addition, many people sit for public examinations in this subject each year and this book is also intended to be of use to them. All the topics from the GCSE syllabus are covered here, with sample questions at the end of each chapter. Astronomy Explained provides a comprehensive treatment of the subject in more depth than is usually found in elementary works, and will be of interest to both amateur astronomers and students of astronomy.

  10. Foliar pH as a new plant trati: van it explain variation in foliar chemistry and carbon cycling processes among subarctiv plant species and types?

    NARCIS (Netherlands)

    Cornelissen, J.H.C.; Quested, H.M.; van Logtestijn, R.S.P; Perez-Harguindeguy, N.; Gwynn-Jones, D.; Diaz, S.; Callaghan, T.V.; Press, M.C.; Aerts, R.

    2006-01-01

    Plant traits have become popular as predictors of interspecific variation in important ecosystem properties and processes. Here we introduce foliar pH as a possible new plant trait, and tested whether (1) green leaf pH or leaf litter pH correlates with biochemical and structural foliar traits that

  11. WAP explained

    International Nuclear Information System (INIS)

    Kaiser, M.J.; Pulsipher, A.G.

    2004-01-01

    The Weatherization Assistance Program (WAP) is a federal block grant program administered by all 50 states and the District of Columbia through community action agencies, state energy offices, local government, and other nonprofit organizations to provide weatherization services to eligible households. The WAP was established in 1976 to increase the energy efficiency, reduce the energy expenditures, and improve the health and safety of low-income households, especially those households that are particularly vulnerable such as families with children, persons with disabilities, and the elderly. The manner in which WAP funds have been allocated to states, however, has been a contentious issue since the inception of the program. Southern states have argued that too much of the federal funding goes to cold-climate and rural states. Northern states disagree. In 1990, Congress amended the Energy Conservation and Production Act and required the Department of Energy to develop a new funding formula. The Department of Energy currently uses a three-factor formula developed in 1995 in conjunction with a two-factor formula developed in 1977 and a hold-harmless provision to allocate WAP funding. The purpose of this paper is to explain the WAP allocation mechanism and the assumptions associated with the 1977 and the 1995 funding formula. The factors that compose each funding formula are critically assessed and various implementation issues are reviewed, including the selection of the trigger point and program capacity levels. It is not possible to define the need for weatherization assistance objectively and in a unique manner, and this ambiguity is the main reason why the WAP allocation mechanism is expected to remain a lively topic of debate and contention

  12. Full-Scale Modeling Explaining Large Spatial Variations of Nitrous Oxide Fluxes in a Step-Feed Plug-Flow Wastewater Treatment Reactor.

    Science.gov (United States)

    Ni, Bing-Jie; Pan, Yuting; van den Akker, Ben; Ye, Liu; Yuan, Zhiguo

    2015-08-04

    Nitrous oxide (N2O) emission data collected from wastewater treatment plants (WWTPs) show huge variations between plants and within one plant (both spatially and temporarily). Such variations and the relative contributions of various N2O production pathways are not fully understood. This study applied a previously established N2O model incorporating two currently known N2O production pathways by ammonia-oxidizing bacteria (AOB) (namely the AOB denitrification and the hydroxylamine pathways) and the N2O production pathway by heterotrophic denitrifiers to describe and provide insights into the large spatial variations of N2O fluxes in a step-feed full-scale activated sludge plant. The model was calibrated and validated by comparing simulation results with 40 days of N2O emission monitoring data as well as other water quality parameters from the plant. The model demonstrated that the relatively high biomass specific nitrogen loading rate in the Second Step of the reactor was responsible for the much higher N2O fluxes from this section. The results further revealed the AOB denitrification pathway decreased and the NH2OH oxidation pathway increased along the path of both Steps due to the increasing dissolved oxygen concentration. The overall N2O emission from this step-feed WWTP would be largely mitigated if 30% of the returned sludge were returned to the Second Step to reduce its biomass nitrogen loading rate.

  13. Use of Co speciation and soil properties to explain variation in Co toxicity to root growth of barley (Hordeum vulgare L.) in different soils

    International Nuclear Information System (INIS)

    Mico, C.; Li, H.F.; Zhao, F.J.; McGrath, S.P.

    2008-01-01

    The influence of soil properties on the bioavailability and toxicity of Co to barley (Hordeum vulgare L.) root elongation was investigated. Ten soils varying widely in soil properties were amended with seven doses of CoCl 2 . Soil properties greatly influenced the expression of Co toxicity. The effective concentration of added Co causing 50% inhibition (EC 50 ) ranged from 45 to 863 mg kg -1 , representing almost 20-fold variation among soils. Furthermore, we investigated Co toxicity in relation to Co concentrations and free Co 2+ activity in soil solution. The EC 50 values showed variation among soils of 17- and 29-fold, based on the Co concentration in soil solution and free Co 2+ activity, respectively. Single regressions were carried out between Co toxicity threshold values and selected soil properties. Models obtained showed that soil effective cation exchange capacity (eCEC) and exchangeable calcium were the most consistent single predictors of the EC 50 values based on soil added Co. - Soil eCEC and exchangeable Ca were found to be the best predictors of the toxicity threshold values of Co to barley root growth on different soils

  14. Variation in mutation spectrum partly explains regional differences in the breast cancer risk of female BRCA mutation carriers in the Netherlands.

    Science.gov (United States)

    Vos, Janet R; Teixeira, Natalia; van der Kolk, Dorina M; Mourits, Marian J E; Rookus, Matti A; van Leeuwen, Flora E; Collée, Margriet; van Asperen, Christi J; Mensenkamp, Arjen R; Ausems, Margreet G E M; van Os, Theo A M; Meijers-Heijboer, Hanne E J; Gómez-Garcia, Encarna B; Vasen, Hans F; Brohet, Richard M; van der Hout, Annemarie H; Jansen, Liesbeth; Oosterwijk, Jan C; de Bock, Geertruida H

    2014-11-01

    We aimed to quantify previously observed relatively high cancer risks in BRCA2 mutation carriers (BRCA2 carriers) older than 60 in the Northern Netherlands, and to analyze whether these could be explained by mutation spectrum or population background risk. This consecutive cohort study included all known pathogenic BRCA1/2 carriers in the Northern Netherlands (N = 1,050). Carrier and general reference populations were: BRCA1/2 carriers in the rest of the Netherlands (N = 2,013) and the general population in both regions. Regional differences were assessed with HRs and ORs. HRs were adjusted for birth year and mutation spectrum. All BRCA1 carriers and BRCA2 carriers younger than 60 had a significantly lower breast cancer risk in the Northern Netherlands; HRs were 0.66 and 0.64, respectively. Above age 60, the breast cancer risk in BRCA2 carriers in the Northern Netherlands was higher than in the rest of the Netherlands [HR, 3.99; 95% confidence interval (CI), 1.11-14.35]. Adjustment for mutational spectrum changed the HRs for BRCA1, BRCA2 <60, and BRCA2 ≥60 years by -3%, +32%, and +11% to 0.75, 0.50, and 2.61, respectively. There was no difference in background breast cancer incidence between the two regions (OR, 1.03; 95% CI, 0.97-1.09). Differences in mutation spectrum only partly explain the regional differences in breast cancer risk in BRCA2 carriers, and for an even smaller part in BRCA1 carriers. The increased risk in BRCA2 carriers older than 60 may warrant extension of intensive breast screening beyond age 60. ©2014 American Association for Cancer Research.

  15. Explaining nascent entrepreneurship across countries

    NARCIS (Netherlands)

    A.R. Thurik (Roy); A.J. van Stel (André); A.R.M. Wennekers (Sander); P. Reynolds (Paul)

    2003-01-01

    textabstractThis paper aims at explaining cross-country variation in nascent entrepreneurship. Regression analysis is applied using various explanatory variables derived from three different approaches. We make use of the Global Entrepreneurship Monitor database, including nascent entrepreneurship

  16. Architecture of a minimal signaling pathway explains the T-cell response to a 1 million-fold variation in antigen affinity and dose

    Science.gov (United States)

    Lever, Melissa; Lim, Hong-Sheng; Kruger, Philipp; Nguyen, John; Trendel, Nicola; Abu-Shah, Enas; Maini, Philip Kumar; van der Merwe, Philip Anton

    2016-01-01

    T cells must respond differently to antigens of varying affinity presented at different doses. Previous attempts to map peptide MHC (pMHC) affinity onto T-cell responses have produced inconsistent patterns of responses, preventing formulations of canonical models of T-cell signaling. Here, a systematic analysis of T-cell responses to 1 million-fold variations in both pMHC affinity and dose produced bell-shaped dose–response curves and different optimal pMHC affinities at different pMHC doses. Using sequential model rejection/identification algorithms, we identified a unique, minimal model of cellular signaling incorporating kinetic proofreading with limited signaling coupled to an incoherent feed-forward loop (KPL-IFF) that reproduces these observations. We show that the KPL-IFF model correctly predicts the T-cell response to antigen copresentation. Our work offers a general approach for studying cellular signaling that does not require full details of biochemical pathways. PMID:27702900

  17. Primary health-care teams as adaptive organizations: exploring and explaining work variation using case studies in rural and urban Scotland.

    Science.gov (United States)

    Farmer, Jane; West, Christina; Whyte, Bruce; Maclean, Margaret

    2005-08-01

    It is acknowledged, internationally, that health-care practitioners' work differs between and urban areas. While several factors affect individual teams' activities, there is little understanding about how patterns of work evolve. Consideration of work in relation to local circumstances is important for training, devising contracts and redesigning services. Six case studies centred on Scottish rural and urban general practices were used to examine, in-depth, the activity of primary health-care teams. Quantitative workload data about patient contacts were collected over 24 months. Interviews and diaries revealed insightful qualitative data. Findings revealed that rural general practitioners and district nurses tended to conduct more consultations per practice patient compared with their urban counterparts. Conditions seen and work tasks varied between case study teams. Qualitative data suggested that the key reasons for variation were: local needs and circumstances; choices made about deployment of available time, team composition and the extent of access to other services. Primary care teams might be viewed as adaptive organization, with co-evolution of services produced by health professionals and local people. The study highlights limitations in the application of workload data and suggests that understanding the nature of work in relation to local circumstances is important in service redesign.

  18. The role of poverty in explaining health variations in 7-year-old children from different family structures: findings from the UK Millennium Cohort Study.

    Science.gov (United States)

    Pearce, Anna; Lewis, Hannah; Law, Catherine

    2013-02-01

    Despite rises in reconstituted and lone-parent families, relatively little is known about how the health of children in different family types varies, and the extent to which any differences might be explained by poverty. The authors examined this using cross-sectional data on 13 681 seven-year-olds from the Millennium Cohort Study. The authors estimated RRs and 95% CIs for having poor physical (general health, long-standing illness, injury, overweight, asthma, fits) and mental health (using strengths and difficulties scores) according to family structure using Poisson regression. The authors adjusted for confounders (aRR) and then investigated the role of poverty as a mediator by entering a poverty score (based on income, receipt of benefits, subjective poverty and material deprivation) into the main model. Children living in reconstituted and lone-parent families were at a slight increased risk of poor health compared with those living with two natural parents. Adjusting for poverty tended to remove the elevated risk of poor physical health in children living in lone-parent and reconstituted families. However, for the mental health outcomes, poverty tended to remove the elevated risk for lone parents but not for reconstituted families. For example, the aRR for borderline-abnormal total difficulties fell from 1.45 (1.22 to 1.72) to 1.34 (1.13 to 1.59) in children living in reconstituted families and from 1.29 (1.14 to 1.45) to 1.05 (0.92 to 1.19) in those living with lone parents. Poor physical and mental health was slightly more prevalent in children living in lone-parent or reconstituted families. Poverty reduction may help to reduce these differences, especially for children living with lone parents; however, alternative mechanisms should be also explored, particularly for children living in reconstituted families.

  19. The Heterogeneous Non-Resident Student Body: Measuring the Effect of Out-of-State Students' Home-State Wealth on Tuition and Fee Price Variations

    Science.gov (United States)

    González Canché, Manuel S.

    2017-01-01

    More than 40 years of research has found a positive relationship between increases in the proportion of non-resident students enrolling in an institution and increases in the tuition prices this institution charges to these same students. Notably, this line of research has consistently treated this non-resident student body as if they constitute a…

  20. Vegetation-zonation patterns across a temperate mountain cloud forest ecotone are not explained by variation in hydraulic functioning or water relations.

    Science.gov (United States)

    Berry, Z Carter; Johnson, Daniel M; Reinhardt, Keith

    2015-09-01

    Many studies have demonstrated linkages between the occurrence of fog and ecophysiological functioning in cloud forests, but few have investigated hydraulic functioning as a determining factor that explains sharp changes in vegetation. The objective of this study was to compare the plant water status during cloud-immersed and non-immersed conditions and hydraulic vulnerability in branches and roots of species across a temperate, mountain fog ecotone. Because cloud forests are often dark, cool and very moist, we expected cloud forest species to have less drought-tolerant characteristics (i.e., lower Pe and P50-the pressures required to induce a 12 and 50% loss in hydraulic conductivity, respectively) relative to non-cloud forest species in adjacent (lower elevation) forests. Additionally, due to the ability of cloud forest species to absorb cloud-fog water, we predicted greater improvements in hydraulic functioning during fog in cloud forest species relative to non-cloud forest species. Across the cloud forest ecotone, most species measured were very resistant to losses in conductivity with branch P50 values from -4.5 to -6.0 MPa, hydraulic safety margins (Ψmin - P50) >1.5 MPa and low calculated hydraulic conductivity losses. Roots had greater vulnerabilities, with P50 values ranging from -1.4 to -2.5 MPa, leading to greater predicted losses in conductivity (∼20%). Calculated values suggested strong losses of midday leaf hydraulic conductance in three of the four species, supporting the hydraulic segmentation hypothesis. In both cloud forest and hardwood species, Ψs were greater on foggy days than sunny days, demonstrating the importance of fog periods to plant water balance across fog regimes. Thus, frequent fog did not result in systemic changes in hydraulic functioning or vulnerability to embolism across our temperate cloud forest ecotone. Finally, roots functioned with lower hydraulic conductivity than branches, suggesting that they may serve as more

  1. The variation in the eating quality of beef from different sexes and breed classes cannot be completely explained by carcass measurements.

    Science.gov (United States)

    Bonny, S P F; Hocquette, J-F; Pethick, D W; Farmer, L J; Legrand, I; Wierzbicki, J; Allen, P; Polkinghorne, R J; Gardner, G E

    2016-06-01

    Delivering beef of consistent quality to the consumer is vital for consumer satisfaction and will help to ensure demand and therefore profitability within the beef industry. In Australia, this is being tackled with Meat Standards Australia (MSA), which uses carcass traits and processing factors to deliver an individual eating quality guarantee to the consumer for 135 different 'cut by cooking methods' from each carcass. The carcass traits used in the MSA model, such as ossification score, carcass weight and marbling explain the majority of the differences between breeds and sexes. Therefore, it was expected that the model would predict with eating quality of bulls and dairy breeds with good accuracy. In total, 8128 muscle samples from 482 carcasses from France, Poland, Ireland and Northern Ireland were MSA graded at slaughter then evaluated for tenderness, juiciness, flavour liking and overall liking by untrained consumers, according to MSA protocols. The scores were weighted (0.3, 0.1, 0.3, 0.3) and combined to form a global eating quality (meat quality (MQ4)) score. The carcasses were grouped into one of the three breed categories: beef breeds, dairy breeds and crosses. The difference between the actual and the MSA-predicted MQ4 scores were analysed using a linear mixed effects model including fixed effects for carcass hang method, cook type, muscle type, sex, country, breed category and postmortem ageing period, and random terms for animal identification, consumer country and kill group. Bulls had lower MQ4 scores than steers and females and were predicted less accurately by the MSA model. Beef breeds had lower eating quality scores than dairy breeds and crosses for five out of the 16 muscles tested. Beef breeds were also over predicted in comparison with the cross and dairy breeds for six out of the 16 muscles tested. Therefore, even after accounting for differences in carcass traits, bulls still differ in eating quality when compared with females and steers

  2. Explaining variation in adult Anopheles indoor resting abundance: the relative effects of larval habitat proximity and insecticide-treated bed net use.

    Science.gov (United States)

    McCann, Robert S; Messina, Joseph P; MacFarlane, David W; Bayoh, M Nabie; Gimnig, John E; Giorgi, Emanuele; Walker, Edward D

    2017-07-17

    , and house structure modulated Anopheles abundance, but the effect varied with Anopheles species and sex. Variation in the abundance of indoor-resting Anopheles in rural houses of western Kenya varies with clearly identifiable factors. Results suggest that LLIN use continues to function in reducing vector abundance, and that larval source management in this region could lead to further reductions in malaria risk by reducing the amount of an obligatory resource for mosquitoes near people's homes.

  3. Seasonal variation of infestation by ectoparasitic chigger mite larvae (Acarina: Trombiculidae) on resident and migratory birds in coffee agroecosystems of Chiapas, Mexico.

    Science.gov (United States)

    Dietsch, Thomas V

    2005-12-01

    Parasitism is not well documented for birds found in tropical habitats. Long-distance migratory birds may face additional risks to an already hazardous journey when infected. This study explores the ecology of an ectoparasite infestation in Chiapas, Mexico. During a mist-netting project in 2 different coffee management systems, chigger mites (Acarina: Trombiculidae), ectoparasitic during the larval stage, were found on both resident and migratory birds. Using a rapid assessment protocol, it was observed that 17 of 26 species of long-distance migrants and 33 of 71 resident species had at least 1 infested individual. Infestation prevalences were unexpectedly high on some long-distance migrants, as high as 0.73 for Swainson's thrush (Catharus ustulatus), a value on par with heavily infested resident species. Prevalence was highest during winter sampling: 0.18 overall, 0.16 of migrants, and 0.23 of residents. Prevalence was 0.14 for resident birds during the summer breeding season. Mean abundance and mean intensity of infestation are reported for 97 species captured and inspected during the course of this study. In this region, chigger mite larvae are relatively common on birds and their abundance varies seasonally. High prevalence for some migratory birds suggests that more research and monitoring of ectoparasites are needed, especially in light of emerging diseases.

  4. Much of the variation in breast pathology quality assurance data in the UK can be explained by the random order in which cases arrive at individual centres, but some true outliers do exist.

    Science.gov (United States)

    Cross, Simon S; Stephenson, Timothy J; Harrison, Robert F

    2011-10-01

    To investigate the role of random temporal order of patient arrival at screening centres in the variability seen in rates of node positivity and breast cancer grade between centres in the NHS Breast Screening Programme. Computer simulations were performed of the variation in node positivity and breast cancer grade with the random temporal arrival of patients at screening centres based on national UK audit data. Cumulative mean graphs of these data were plotted. Confidence intervals for the parameters were generated, using the binomial distribution. UK audit data were plotted on these control limit graphs. The results showed that much of the variability in the audit data could be accounted for by the effects of random order of arrival of cases at the screening centres. Confidence intervals of 99.7% identified true outliers in the data. Much of the variation in breast pathology quality assurance data in the UK can be explained by the random order in which cases arrive at individual centres. Control charts with confidence intervals of 99.7% plotted against the number of reported cases are useful tools for identification of true outliers. 2011 Blackwell Publishing Limited.

  5. Factors associated with primary care residents' satisfaction with their training.

    Science.gov (United States)

    Randall, C S; Bergus, G R; Schlechte, J A; McGuinness, G; Mueller, C W

    1997-01-01

    Satisfaction is known to impact work performance, learning, recruitment, and retention. This study identifies the factors associated with primary care residents' satisfaction with their training. We used a cross-sectional survey based on the Price-Mueller model of job satisfaction. The model included 14 job characteristics, four personal characteristics, and four demographic factors. Data were collected in February and March 1996 from residents in three primary care training programs (family practice, pediatrics, and internal medicine) at a large academic medical center. The same standardized, self-administered questionnaires were used in all three departments. Seventy-five percent (n = 119) of the residents returned questionnaires. Five job characteristics were positively associated with resident satisfaction: continuity of care, autonomy, collegiality, work that encourages professional growth, and work group loyalty. Role conflict, a sixth job characteristic, was negatively associated with satisfaction. The personal characteristic of having an optimistic outlook on life was also positively associated with satisfaction. The model explained 66% of the variation in self-reported satisfaction. The satisfaction of the residents was significantly associated with six job characteristics and one personal factor. Interventions based on these job characteristics may increase resident satisfaction and may lead to better patient outcomes, better work performance, greater patient satisfaction, and more success in recruiting top students into a residency.

  6. Journalism and Explaining News Content

    NARCIS (Netherlands)

    Albæk, E.; Skovsgaard, M.; de Vreese, C.H.; Nussbaum, J.F.

    Three models are presented to explain variation in news content. In the first model the explanation is based on the individual journalist, in the second model on the professional journalist, and in the third model on the organized journalist. The individual journalist model focuses on how the

  7. The human cerebral cortex is neither one nor many: Neuronal distribution reveals two quantitatively different zones in the grey matter, three in the white matter, and explains local variations in cortical folding

    Directory of Open Access Journals (Sweden)

    Pedro F. M. Ribeiro

    2013-09-01

    Full Text Available The human prefrontal cortex has been considered different in several aspects and relatively enlarged compared to the rest of the cortical areas. Here we determine whether the white and gray matter of the prefrontal portion of the human cerebral cortex have similar or different cellular compositions relative to the rest of the cortical regions by applying the Isotropic Fractionator to analyze the distribution of neurons along the entire anteroposterior axis of the cortex, and its relationship with the degree of gyrification, number of neurons under the cortical surface, and other parameters. The prefrontal region shares with the remainder of the cerebral cortex (except for occipital cortex the same relationship between cortical volume and number of neurons. In contrast, both occipital and prefrontal areas vary from other cortical areas in their connectivity through the white matter, with a systematic reduction of cortical connectivity through the white matter and an increase of the mean axon caliber along the anteroposterior axis. These two parameters explain local differences in the distribution of neurons underneath the cortical surface. We also show that local variations in cortical folding are neither a function of local numbers of neurons nor of cortical thickness, but correlate with properties of the white matter, and are best explained by the folding of the white matter surface. Our results suggest that the human cerebral cortex is divided in two zones (occipital and non-occipital that differ in how neurons distributed across their grey matter volume and in three zones (prefrontal, occipital, and non-occipital that differ in how neurons are connected through the white matter. Thus, the human prefrontal cortex has the largest fraction of neuronal connectivity through the white matter and the smallest average axonal caliber in the white matter within the cortex, although its neuronal composition fits the pattern found for other, non

  8. 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.

  9. 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

    program, and 18 (21.2%) exited graduate medical education altogether. Each program had an annual attrition rate ranging from 0.73% to 6.0% (median [IQR], 2.5% [1.5%-3.4%]). Low-attrition programs were more likely than high-attrition programs to use resident remediation (21.0% vs 6.8%; P < .001). Median (IQR) Qualifying Examination pass rates (93% [90%-98%] vs 92% [86%-100%]; P = .92) and Certifying Examination pass rates (83% [68%-84%] vs 81% [71%-86%]; P = .47) were similar. Program directors at high-attrition programs were more likely than their counterparts at low-attrition programs to agree with this statement: "I feel that it is my responsibility as a program director to redirect residents who should not be surgeons." The overall 5-year attrition rate of 8.8% was significantly lower than previously reported. Program directors at low-attrition programs were more likely to use resident remediation. Variations in attrition may be explained by program director attitudes, although larger studies are needed to further define program factors affecting attrition.

  10. Explaining Away Intuitions

    Directory of Open Access Journals (Sweden)

    Jonathan Ichikawa

    2009-12-01

    Full Text Available What is it to explain away an intuition? Philosophers regularly attempt to explain intuitions away, but it is often unclear what the success conditions for their project consist in. I attempt to articulate some of these conditions, taking philosophical case studies as guides, and arguing that many attempts to explain away intuitions underestimate the challenge the project of explaining away involves. I will conclude, therefore, that explaining away intuitions is a more difficult task than has sometimes been appreciated; I also suggest, however, that the importance of explaining away intuitions has often been exaggerated.

  11. Changes in breastfeeding and nutritional status of Nigerian children between 1990 and 2008, and variations by region, area of residence and maternal education and occupation.

    Science.gov (United States)

    Onubogu, Chinyere U; Onyeka, Ifeoma N; Esangbedo, Dorothy O; Ndiokwelu, Chika; Okolo, Selina N; Ngwu, Elizabeth K; Nwaru, Bright I

    2016-11-01

    Inadequate breastfeeding practices contribute to malnutrition in young children. This study examined changes in breastfeeding practices and the nutritional status of children (0-35 months, n = 37154) using data from the nationally-representative Nigerian Demographic and Health Surveys for 1990-2008. The study estimated the relative changes in the proportion of children meeting recommended breastfeeding practices and the anthropometric indices of the children during the study period, by region, place of residence, maternal education and maternal occupation. In each study year, over 97% of the children were ever breastfed. The proportion of infants breastfed within 1 hour and 1 day of birth increased from 34% to 45.8%, and from 63.8% to 82.3%, respectively. Overall, breastfeeding for ≥ 12 months changed from 88.9% to 95.2%, an increase of 7%; however, an increase of 14% was observed in the northern region (from 86.1% to 97.8%) while a decline of 7% was observed in the southern region (from 97.1% to 89.9%). Over the study period, the prevalence of all the assessed indicators of malnutrition (stunting, wasting and underweight) increased in the northern region while the southern region experienced a decline in all except severe wasting. In both urban and rural areas, stunting and wasting increased, while underweight declined. Children of non-formally educated and unemployed mothers were more malnourished in all the study years. Improvement in some breastfeeding practices did not result in improvement in the nutritional status of Nigerian children during 1990-2008, particularly in northern Nigeria and among socially disadvantaged mothers. Improving maternal education and employment, and integrating messages on techniques and benefits of optimal infant feeding with other maternal and child healthcare services could be beneficial.

  12. Temporal and Geographic variation in the validity and internal consistency of the Nursing Home Resident Assessment Minimum Data Set 2.0.

    Science.gov (United States)

    Mor, Vincent; Intrator, Orna; Unruh, Mark Aaron; Cai, Shubing

    2011-04-15

    The Minimum Data Set (MDS) for nursing home resident assessment has been required in all U.S. nursing homes since 1990 and has been universally computerized since 1998. Initially intended to structure clinical care planning, uses of the MDS expanded to include policy applications such as case-mix reimbursement, quality monitoring and research. The purpose of this paper is to summarize a series of analyses examining the internal consistency and predictive validity of the MDS data as used in the "real world" in all U.S. nursing homes between 1999 and 2007. We used person level linked MDS and Medicare denominator and all institutional claim files including inpatient (hospital and skilled nursing facilities) for all Medicare fee-for-service beneficiaries entering U.S. nursing homes during the period 1999 to 2007. We calculated the sensitivity and positive predictive value (PPV) of diagnoses taken from Medicare hospital claims and from the MDS among all new admissions from hospitals to nursing homes and the internal consistency (alpha reliability) of pairs of items within the MDS that logically should be related. We also tested the internal consistency of commonly used MDS based multi-item scales and examined the predictive validity of an MDS based severity measure viz. one year survival. Finally, we examined the correspondence of the MDS discharge record to hospitalizations and deaths seen in Medicare claims, and the completeness of MDS assessments upon skilled nursing facility (SNF) admission. Each year there were some 800,000 new admissions directly from hospital to US nursing homes and some 900,000 uninterrupted SNF stays. Comparing Medicare enrollment records and claims with MDS records revealed reasonably good correspondence that improved over time (by 2006 only 3% of deaths had no MDS discharge record, only 5% of SNF stays had no MDS, but over 20% of MDS discharges indicating hospitalization had no associated Medicare claim). The PPV and sensitivity levels of

  13. 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.

  14. Plagiarism explainer for students

    OpenAIRE

    Barba, Lorena A.

    2016-01-01

    A slide deck to serve as an explainer of plagiarism in academic settings, with a personal viewpoint. For my students.Also on SpeakerDeck:https://speakerdeck.com/labarba/plagiarism-explainer-for-students(The slide viewer on SpeakerDeck is much nicer.)

  15. Computer jargon explained

    CERN Document Server

    Enticknap, Nicholas

    2014-01-01

    Computer Jargon Explained is a feature in Computer Weekly publications that discusses 68 of the most commonly used technical computing terms. The book explains what the terms mean and why the terms are important to computer professionals. The text also discusses how the terms relate to the trends and developments that are driving the information technology industry. Computer jargon irritates non-computer people and in turn causes problems for computer people. The technology and the industry are changing so rapidly; it is very hard even for professionals to keep updated. Computer people do not

  16. The wireless internet explained

    CERN Document Server

    Rhoton, John

    2001-01-01

    The Wireless Internet Explained covers the full spectrum of wireless technologies from a wide range of vendors, including initiatives by Microsoft and Compaq. The Wireless Internet Explained takes a practical look at wireless technology. Rhoton explains the concepts behind the physics, and provides an overview that clarifies the convoluted set of standards heaped together under the umbrella of wireless. It then expands on these technical foundations to give a panorama of the increasingly crowded landscape of wireless product offerings. When it comes to actual implementation the book gives abundant down-to-earth advice on topics ranging from the selection and deployment of mobile devices to the extremely sensitive subject of security.Written by an expert on Internet messaging, the author of Digital Press''s successful Programmer''s Guide to Internet Mail and X.400 and SMTP: Battle of the E-mail Protocols, The Wireless Internet Explained describes and evaluates the current state of the fast-growing and crucial...

  17. Self-explaining roads

    NARCIS (Netherlands)

    Horst, A.R.A. van der; Kaptein, N.

    1999-01-01

    As a means to a sustainable safe traffic environment the concept of Self-Explaining Roads (SER) has been developed. The SER concept advocates a traffic environment that elicits safe driving behaviour simply by its design. In order to support safe driving behaviour and appropriate speed choice,

  18. 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...

  19. 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.

  20. 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

  1. MAGMADIM: Young Explainers Program

    International Nuclear Information System (INIS)

    Paltiel, Z.

    2005-01-01

    Full Text:Physics teachers and educators constantly face the problem of inspiring their students to major in physics. On the other hand, science museums are designed to provide a pleasant environment which will stimulate and encourage a science associated experience to the general public. Typically, there is no intention to teach science as such in science museums. One may, however, use the science museum to teach and inspire certain groups of students in a much deeper sense. In fact they may actually enthusiastically learn much of the school physics curriculum at the museum. This report discusses the Magmadim program through which 10th graders are trained to be young explainers at the Weizmann Institutes Clore Garden of Science. To this end they study the physics underlying its exhibits in an after-school course. The ultimate goal is for the 'magmadim' to become the best possible explainers and be able to face all sorts of museum visitors. Along with learning how to instruct visitors, they must learn the physics behind the exhibits to give a full explanation of the exhibit and be able to answer any question that may arise. Our 5 year experience with the program shows that its self-selected participants not only study a lot of science, but also like it and learn how to explain the content to other people. This program, along with similar programs at the Bloomfield Science Museum and the Madatzim (young physics tutors) program of Ort, help in promoting the interest in science in general and physics in particular among school students. Various ways to expand the programs will also be discussed

  2. Factors associated with physiotherapy provision in a population of elderly nursing home residents; a cross sectional study

    Directory of Open Access Journals (Sweden)

    Ribbe Miel W

    2007-04-01

    Full Text Available Abstract Background Although physiotherapy (PT plays an important role in improving activities of daily living (ADL functioning and discharge rates, it is unclear how many nursing home residents receive treatment. Furthermore, there is a lack of insight into the determinants that influence the decision for treatment. In this study, we investigated how many nursing home residents receive PT. In addition, we analysed the factors that contribute to the variation in the provision of PT both between nursing homes and between residents. Methods A random sample of 600 elderly residents was taken from a random sample of 15 nursing homes. Residents had to be admitted for rehabilitation or for long-term care. Data were collected through interviews with the nursing home physician and the physiotherapist. Multilevel analysis was used to define the variation in the provision of PT and the factors that are associated with the question whether a resident receives PT or not. Furthermore the amount of PT provided was analysed and the factors that are associated with this. Results On average 69% of the residents received PT. The percentage of patients receiving treatment differed significantly across nursing homes, and especially the number of physiotherapists available, explained this difference between nursing homes. Residents admitted to a somatic ward for rehabilitation, and male residents in general, were most likely to receive PT. Residents who were treated by a physiotherapist received on average 55 minutes (sd 41 treatment a week. Residents admitted for rehabilitation received more PT a week, as were residents with a status after a total hip replacement. Conclusion PT is most likely to be provided to residents on a somatic ward, recently admitted for rehabilitation to a nursing home, which has a relatively large number of physiotherapists. This suggests a potential under-use of PT for long-term residents with cognitive problems. It is recommended that

  3. Factors associated with physiotherapy provision in a population of elderly nursing home residents; a cross sectional study.

    Science.gov (United States)

    Leemrijse, Chantal J; de Boer, Marike E; van den Ende, Cornelia H M; Ribbe, Miel W; Dekker, Joost

    2007-04-04

    Although physiotherapy (PT) plays an important role in improving activities of daily living (ADL functioning) and discharge rates, it is unclear how many nursing home residents receive treatment. Furthermore, there is a lack of insight into the determinants that influence the decision for treatment. In this study, we investigated how many nursing home residents receive PT. In addition, we analysed the factors that contribute to the variation in the provision of PT both between nursing homes and between residents. A random sample of 600 elderly residents was taken from a random sample of 15 nursing homes. Residents had to be admitted for rehabilitation or for long-term care. Data were collected through interviews with the nursing home physician and the physiotherapist. Multilevel analysis was used to define the variation in the provision of PT and the factors that are associated with the question whether a resident receives PT or not. Furthermore the amount of PT provided was analysed and the factors that are associated with this. On average 69% of the residents received PT. The percentage of patients receiving treatment differed significantly across nursing homes, and especially the number of physiotherapists available, explained this difference between nursing homes. Residents admitted to a somatic ward for rehabilitation, and male residents in general, were most likely to receive PT. Residents who were treated by a physiotherapist received on average 55 minutes (sd 41) treatment a week. Residents admitted for rehabilitation received more PT a week, as were residents with a status after a total hip replacement. PT is most likely to be provided to residents on a somatic ward, recently admitted for rehabilitation to a nursing home, which has a relatively large number of physiotherapists. This suggests a potential under-use of PT for long-term residents with cognitive problems. It is recommended that physiotherapists reconsider which residents may benefit from

  4. Linear Algebra Thoroughly Explained

    CERN Document Server

    Vujičić, Milan

    2008-01-01

    Linear Algebra Thoroughly Explained provides a comprehensive introduction to the subject suitable for adoption as a self-contained text for courses at undergraduate and postgraduate level. The clear and comprehensive presentation of the basic theory is illustrated throughout with an abundance of worked examples. The book is written for teachers and students of linear algebra at all levels and across mathematics and the applied sciences, particularly physics and engineering. It will also be an invaluable addition to research libraries as a comprehensive resource book for the subject.

  5. Matlab for engineers explained

    CERN Document Server

    Gustafsson, Fredrik

    2003-01-01

    This book is written for students at bachelor and master programs and has four different purposes, which split the book into four parts: 1. To teach first or early year undergraduate engineering students basic knowledge in technical computations and programming using MATLAB. The first part starts from first principles and is therefore well suited both for readers with prior exposure to MATLAB but lacking a solid foundational knowledge of the capabilities of the system and readers not having any previous experience with MATLAB. The foundational knowledge gained from these interactive guided tours of the system will hopefully be sufficient for an effective utilization of MATLAB in the engineering profession, in education and in research. 2. To explain the foundations of more advanced use of MATLAB using the facilities added the last couple of years, such as extended data structures, object orientation and advanced graphics. 3. To give an introduction to the use of MATLAB in typical undergraduate courses in elec...

  6. 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.

  7. 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...

  8. Deepening Democracy: Explaining Variations in the Levels of Democracy

    Science.gov (United States)

    2010-06-01

    Federal Electoral Institute IMF International Monetary Fund INEGI Instituto Nacional de Estadistica, Geografia e Informatica xvi ISI Import...Geografia e Informatica (INEGI), 1999. Anuario de Estadísticas por Entidad Federativa 2009. Aguascalientes, Mexico: INEGI, 2009. Anuario

  9. Explaining Spatial Variation in Real Estate Development Activity in Turkey

    OpenAIRE

    Elif Alkay; Berna Keskin; Craig Watkins

    2015-01-01

    There is a strong policy discourse at local and national level in Turkey that ascribes considerable economic benefits to new construction activity. Critics, however, argue that this policy discourse has led to a mismatch between public policy and market fundamentals in many cities. It has been suggested that policy intentions might be driving construction levels above demand levels and could be contributing to uneven spatial development between regions. This paper seeks to shed light on this ...

  10. Explaining variations in co-worker assistance in organizations

    NARCIS (Netherlands)

    Frenkel, Stephen J.; Sanders, Karin

    2007-01-01

    In an age of flattened hierarchies and networked organizations, lateral processes in organizations take on added significance. Co-worker assistance refers to a key aspect of lateral relations: workers’ helping behaviour in relation to their immediate colleagues. Using data from a Dutch survey of

  11. Does residence time affect responses of alien species richness to environmental and spatial processes?

    Directory of Open Access Journals (Sweden)

    Matteo Dainese

    2012-08-01

    Full Text Available One of the most robust emerging generalisations in invasion biology is that the probability of invasion increases with the time since introduction (residence time. We analysed the spatial distribution of alien vascular plant species in a region of north-eastern Italy to understand the influence of residence time on patterns of alien species richness. Neophytes were grouped according to three periods of arrival in the study region (1500–1800, 1800–1900, and > 1900. We applied multiple regression (spatial and non-spatial with hierarchical partitioning to determine the influence of climate and human pressure on species richness within the groups. We also applied variation partitioning to evaluate the relative importance of environmental and spatial processes. Temperature mainly influenced groups with speciesa longer residence time, while human pressure influenced the more recently introduced species, although its influence remained significant in all groups. Partial regression analyses showed that most of the variation explained by the models is attributable to spatially structured environmental variation, while environment and space had small independent effects. However, effects independent of environment decreased, and spatially independent effects increased, from older to the more recent neophytes. Our data illustrate that the distribution of alien species richness for species that arrived recently is related to propagule pressure, availability of novel niches created by human activity, and neutral-based (dispersal limitation processes, while climate filtering plays a key role in the distribution of species that arrived earlier. This study highlights the importance of residence time, spatial structure, and environmental conditions in the patterns of alien species richness and for a better understanding of its geographical variation.

  12. Representation in the Care Planning Process for Nursing Home Residents With Dementia.

    Science.gov (United States)

    McCreedy, Ellen; Loomer, Lacey; Palmer, Jennifer A; Mitchell, Susan L; Volandes, Angelo; Mor, Vincent

    2018-05-01

    Federally mandated assessments of nursing home (NH) residents drive individualized care planning. Residents with cognitive impairment may not be able to meaningfully communicate their care needs and preferences during this process-a gap that may be partially addressed by involving surrogates. We describe the prevalence of family participation in the care planning process for long-stay NH residents with varying degrees of cognitive impairment. Retrospective study using administrative data made available as part of an ongoing pragmatic cluster randomized controlled trial. A total of 292 NHs from 1 large for-profit NH system. Long-stay NH residents in 2016. We identified all care planning assessments conducted in 2016 for long-stay NH residents. Cognitive functioning was defined using the Cognitive Function Scale. The Minimum Data Set was used to determine whether a resident, family member, and/or legal guardian participated in the assessment process. Certification and Survey Provider Enhance Reporting system data was used to identify facility-level correlates of family participation. Bivariate and multivariable hierarchical regression results are presented. The analytic sample included 18,552 long-stay NH residents. Family member/representative participation varied by degree of resident cognitive impairment; 8% of residents with no cognitive impairment had family or representative participation in care planning during 2016, compared with 26% of residents with severe impairment. NHs with more social workers had greater family participation in care planning. Available NH characteristics do not explain most of the variation in family participation between NHs (residual intraclass correlation = .57). Only a minority of family members and surrogates participate in NH care planning, even for residents with severe cognitive impairment. The association between social work staffing and participation suggests family involvement may be a measure of quality improvement

  13. Longitudinal variation in pressure injury incidence among long-term aged care facilities.

    Science.gov (United States)

    Jorgensen, Mikaela; Siette, Joyce; Georgiou, Andrew; Westbrook, Johanna I

    2018-05-04

    To examine variation in pressure injury (PI) incidence among long-term aged care facilities and identify resident- and facility-level factors that explain this variation. Longitudinal incidence study using routinely-collected electronic care management data. A large aged care service provider in New South Wales and the Australian Capital Territory, Australia. About 6556 people aged 65 years and older who were permanent residents in 60 long-term care facilities between December 2014 and November 2016. Risk-adjusted PI incidence rates over eight study quarters. Incidence density over the study period was 1.33 pressure injuries per 1000 resident days (95% confidence interval (CI) = 1.29-1.37). Funnel plots were used to identify variation among facilities. On average, 14% of facilities had risk-adjusted PI rates that were higher than expected in each quarter (above 95% funnel plot control limits). Ten percent of facilities had persistently high rates in any three or more consecutive quarters (n = 6). The variation between facilities was only partly explained by resident characteristics in multilevel regression models. Residents were more likely to have higher-pressure injury rates in facilities in regional areas compared with major city areas (adjusted incidence rate ratio = 1.25, 95% CI = 1.04-1.51), and facilities with persistently high rates were more likely to be located in areas with low socioeconomic status (P = 0.038). There is considerable variation among facilities in PI incidence. This study demonstrates the potential of routinely-collected care management data to monitor PI incidence and to identify facilities that may benefit from targeted intervention.

  14. [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.

  15. Explaining Physics – What Skills does a good Explainer Need?

    CERN Multimedia

    CERN. Geneva; Bartels, Hauke

    2018-01-01

    Explaining physics in a way that it is both scientifically correct and comprehensible is a highly demanding practice. But are explanations an effective way to teach physics? Under which circumstances should a physics teacher explain – and is there such a thing as a guideline for effective instructional explanations? Of course, explaining is more than just presenting content knowledge in clear language – but what more? In our talk, we want to discuss empirical studies on instructional explanations from science education and psychology to address these questions. Among other things, we will refer to results from a large study aiming to research whether teacher education contributes to the development of explaining skills. Besides, we will give insights into a project that seeks to measure explaining skills with an interactive online test instrument.

  16. Influence of temperature on patch residence time in parasitoids: physiological and behavioural mechanisms

    Science.gov (United States)

    Moiroux, Joffrey; Abram, Paul K.; Louâpre, Philippe; Barrette, Maryse; Brodeur, Jacques; Boivin, Guy

    2016-04-01

    Patch time allocation has received much attention in the context of optimal foraging theory, including the effect of environmental variables. We investigated the direct role of temperature on patch time allocation by parasitoids through physiological and behavioural mechanisms and its indirect role via changes in sex allocation and behavioural defences of the hosts. We compared the influence of foraging temperature on patch residence time between an egg parasitoid, Trichogramma euproctidis, and an aphid parasitoid, Aphidius ervi. The latter attacks hosts that are able to actively defend themselves, and may thus indirectly influence patch time allocation of the parasitoid. Patch residence time decreased with an increase in temperature in both species. The increased activity levels with warming, as evidenced by the increase in walking speed, partially explained these variations, but other mechanisms were involved. In T. euproctidis, the ability to externally discriminate parasitised hosts decreased at low temperature, resulting in a longer patch residence time. Changes in sex allocation with temperature did not explain changes in patch time allocation in this species. For A. ervi, we observed that aphids frequently escaped at intermediate temperature and defended themselves aggressively at high temperature, but displayed few defence mechanisms at low temperature. These defensive behaviours resulted in a decreased patch residence time for the parasitoid and partly explained the fact that A. ervi remained for a shorter time at the intermediate and high temperatures than at the lowest temperature. Our results suggest that global warming may affect host-parasitoid interactions through complex mechanisms including both direct and indirect effects on parasitoid patch time allocation.

  17. 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.

  18. Your Radiologist Explains Nuclear Medicine

    Medline Plus

    Full Text Available ... Disorders Video: The Basketball Game: An MRI Story Radiology and You Sponsored by Image/Video Gallery Your Radiologist Explains Nuclear Medicine Transcript Welcome to Radiology Info dot org Hello! I’m Dr. Ramji ...

  19. Your Radiologist Explains Nuclear Medicine

    Medline Plus

    Full Text Available ... by Image/Video Gallery Your Radiologist Explains Nuclear Medicine Transcript Welcome to Radiology Info dot org Hello! ... d like to talk to you about nuclear medicine. Nuclear medicine offers the potential to identify disease ...

  20. Your Radiologist Explains Nuclear Medicine

    Medline Plus

    Full Text Available ... An MRI Story Radiology and You Sponsored by Image/Video Gallery Your Radiologist Explains Nuclear Medicine Transcript ... by a special camera and computer to create images of the inside of your body. If you’ ...

  1. Your Radiologist Explains Nuclear Medicine

    Medline Plus

    Full Text Available ... Sponsored by Image/Video Gallery Your Radiologist Explains Nuclear Medicine Transcript Welcome to Radiology Info dot org ... I’d like to talk to you about nuclear medicine. Nuclear medicine offers the potential to identify ...

  2. 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.

  3. 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....

  4. 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.

  5. 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 …

  6. Teacher in Residence: Bringing Science to Students

    CERN Multimedia

    Daisy Yuhas

    CERN welcomes its first Teacher in Residence, Terrence Baine of the University of Oslo. Baine, who originally hails from Canada, will be concurrently completing his PhD in Physics Education during his time at CERN. Like CERN’s High School Teacher Programme (HST), of which Baine is an alumnus, the Teacher in Residence position is designed to help educators spread the science of CERN in a form that is accessible to students and can encourage them to pursue physics throughout their education.   Terrence Baine, first 'teacher in residence' at CERN Baine explains, “It’s very important to have a teacher present who can be that middle person between the young peoplecoming here, whom we are trying to enlighten, and the physicists who work at CERN. The Teacher in Residence can act as an on-site educational consultant.” As Teacher in Residence, Baine’s primary project will be to develop teaching modules, or a series of lesson plans, that can help high schoo...

  7. Can Marxism Explain America's Racism?

    Science.gov (United States)

    Willhelm, Sidney M.

    1980-01-01

    The Marxist interpretation of the Black experience in America has always had difficulty explaining various noneconomic aspects of racism. A perspective is needed that can blend racism as a variable in relationship with economic variables. To reach this perspective, the labor process within capitalism must be more fully understood. (Author/GC)

  8. Does market competition explain fairness?

    Science.gov (United States)

    Descioli, Peter

    2013-02-01

    The target article by Baumard et al. uses their previous model of bargaining with outside options to explain fairness and other features of human sociality. This theory implies that fairness judgments are determined by supply and demand but humans often perceive prices (divisions of surplus) in competitive markets to be unfair.

  9. Variation in the immune responses against Plasmodium falciparum merozoite surface protein-1 and apical membrane antigen-1 in children residing in the different epidemiological strata of malaria in Cameroon.

    Science.gov (United States)

    Kwenti, Tebit Emmanuel; Moye, Adzemye Linus; Wiylanyuy, Adzemye Basil; Njunda, Longdoh Anna; Nkuo-Akenji, Theresa

    2017-11-09

    Studies to assess the immune responses against malaria in Cameroonian children are limited. The purpose of this study was to assess the immune responses against Plasmodium falciparum merozoite surface protein-1 (MSP-1 19 ) and apical membrane antigen-1 (AMA-1) in children residing in the different epidemiological strata of malaria in Cameroon. In a cross-sectional survey performed between April and July 2015, 602 children between 2 and 15 years (mean ± SD = 5.7 ± 3.7), comprising 319 (53%) males were enrolled from five epidemiological strata of malaria in Cameroon including: the sudano-sahelian (SS) strata, the high inland plateau (HIP) strata, the south Cameroonian equatorial forest (SCEF) strata, the high western plateau (HWP) strata, and the coastal (C) strata. The children were screened for clinical malaria (defined by malaria parasitaemia ≥ 5000 parasites/µl plus axillary temperature ≥ 37.5 °C). Their antibody responses were measured against P. falciparum MSP-1 19 and AMA-1 vaccine candidate antigens using standard ELISA technique. A majority of the participants were IgG responders 72.1% (95% CI 68.3-75.6). The proportion of responders was higher in females (p = 0.002) and in children aged 10 years and above (p = 0.005). The proportion of responders was highest in Limbe (C strata) and lowest in Ngaoundere (HIP strata) (p malaria (p malaria parasites. The immune responses varied considerably across the different strata: the highest levels observed in the C strata and the lowest in the HIP strata. Furthermore, malaria transmission in Cameroon could be categorized into two major groups based on the serological reaction of the children: the southern (comprising C and SCEF strata) and northern (comprising HWP, HIP and SS strata) groups. These findings may have significant implications in the design of future trials for evaluating malaria vaccine candidates in Cameroon.

  10. Does Social Capital Explain Community-Level Differences in Organ Donor Designation?

    Science.gov (United States)

    Ladin, Keren; Wang, Rui; Fleishman, Aaron; Boger, Matthew; Rodrigue, James R

    2015-09-01

    mobility, violent-death rate), and religious characteristics. We used spatial modeling, including lagged variables to account for the effect of adjacent block groups, and multivariate regression analysis to examine the relationship of social capital and community-level characteristics with organ donor designation rates. Block groups with higher levels of social capital, racial homogeneity, income, workforce participation, owner-occupied housing, native-born residents, and white residents had higher rates of organ donor designation (p < 0.001). These factors remained significant in the multivariate model, which explained more than half the geographic variance in organ donor designation (R(2) = 0.52). The findings suggest that community-level factors, including social capital, predict more than half the variation in donor designation. Future interventions should target the community as the unit of intervention and should tailor messaging for areas with low social capital. © 2015 Milbank Memorial Fund.

  11. 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.

  12. 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.

  13. Explaining Disparities in Unemployment Dynamics

    OpenAIRE

    Karanassou, Marika; Snower, Dennis J.

    1993-01-01

    This paper attempts to explain disparities among the unemployment experiences of different OECD countries in terms of the `fragility' of the short-run unemployment equilibrium (the impact of labour market shocks on the short-run unemployment rate) and the lag structure of the employment determination, wage setting, and labour force participation decisions. The effects of this lag structure on unemployment dynamics are captured through two general measures of `unemployment persistence' (occurr...

  14. Explaining the Gender Wealth Gap

    Science.gov (United States)

    Ruel, Erin; Hauser, Robert M.

    2013-01-01

    To assess and explain the United States’ gender wealth gap, we use the Wisconsin Longitudinal Study to examine wealth accumulated by a single cohort over 50 years by gender, by marital status, and limited to the respondents who are their family’s best financial reporters. We find large gender wealth gaps between currently married men and women, and never-married men and women. The never-married accumulate less wealth than the currently married, and there is a marital disruption cost to wealth accumulation. The status-attainment model shows the most power in explaining gender wealth gaps between these groups explaining about one-third to one-half of the gap, followed by the human-capital explanation. In other words, a lifetime of lower earnings for women translates into greatly reduced wealth accumulation. A gender wealth gap remains between married men and women after controlling for the full model that we speculate may be related to gender differences in investment strategies and selection effects. PMID:23264038

  15. Modeling per capita state health expenditure variation: state-level characteristics matter.

    Science.gov (United States)

    Cuckler, Gigi; Sisko, Andrea

    2013-01-01

    In this paper, we describe the methods underlying the econometric model developed by the Office of the Actuary in the Centers for Medicare & Medicaid Services, to explain differences in per capita total personal health care spending by state, as described in Cuckler, et al. (2011). Additionally, we discuss many alternative model specifications to provide additional insights for valid interpretation of the model. We study per capita personal health care spending as measured by the State Health Expenditures, by State of Residence for 1991-2009, produced by the Centers for Medicare & Medicaid Services' Office of the Actuary. State-level demographic, health status, economic, and health economy characteristics were gathered from a variety of U.S. government sources, such as the Census Bureau, Bureau of Economic Analysis, the Centers for Disease Control, the American Hospital Association, and HealthLeaders-InterStudy. State-specific factors, such as income, health care capacity, and the share of elderly residents, are important factors in explaining the level of per capita personal health care spending variation among states over time. However, the slow-moving nature of health spending per capita and close relationships among state-level factors create inefficiencies in modeling this variation, likely resulting in incorrectly estimated standard errors. In addition, we find that both pooled and fixed effects models primarily capture cross-sectional variation rather than period-specific variation.

  16. Regional variation in short distance homogamy

    OpenAIRE

    Haandrikman, Karen; van Wissen, Leo

    2011-01-01

    A third of all Dutch cohabiters choose a partner from the same municipality, so-called short distance homogamy. This article analyses the regional variation in this phenomenon, and it explains this variation in terms of geographical, socioeconomic, demographic and cultural determinants. Population register data on all new cohabiters in 2004 were used. Regression methods were employed to explain spatial patterns. Regional variation in short distance homogamy is largely explained by geographica...

  17. Identifying county characteristics associated with resident well-being: A population based study.

    Science.gov (United States)

    Roy, Brita; Riley, Carley; Herrin, Jeph; Spatz, Erica S; Arora, Anita; Kell, Kenneth P; Welsh, John; Rula, Elizabeth Y; Krumholz, Harlan M

    2018-01-01

    Well-being is a positively-framed, holistic assessment of health and quality of life that is associated with longevity and better health outcomes. We aimed to identify county attributes that are independently associated with a comprehensive, multi-dimensional assessment of individual well-being. We performed a cross-sectional study examining associations between 77 pre-specified county attributes and a multi-dimensional assessment of individual US residents' well-being, captured by the Gallup-Sharecare Well-Being Index. Our cohort included 338,846 survey participants, randomly sampled from 3,118 US counties or county equivalents. We identified twelve county-level factors that were independently associated with individual well-being scores. Together, these twelve factors explained 91% of the variance in individual well-being scores, and they represent four conceptually distinct categories: demographic (% black); social and economic (child poverty, education level [divorced); clinical care (% eligible women obtaining mammography, preventable hospital stays per 100,000, number of federally qualified health centers); and physical environment (% commuting by bicycle and by public transit). Twelve factors across social and economic, clinical care, and physical environmental county-level factors explained the majority of variation in resident well-being.

  18. Identifying county characteristics associated with resident well-being: A population based study.

    Directory of Open Access Journals (Sweden)

    Brita Roy

    Full Text Available Well-being is a positively-framed, holistic assessment of health and quality of life that is associated with longevity and better health outcomes. We aimed to identify county attributes that are independently associated with a comprehensive, multi-dimensional assessment of individual well-being.We performed a cross-sectional study examining associations between 77 pre-specified county attributes and a multi-dimensional assessment of individual US residents' well-being, captured by the Gallup-Sharecare Well-Being Index. Our cohort included 338,846 survey participants, randomly sampled from 3,118 US counties or county equivalents.We identified twelve county-level factors that were independently associated with individual well-being scores. Together, these twelve factors explained 91% of the variance in individual well-being scores, and they represent four conceptually distinct categories: demographic (% black; social and economic (child poverty, education level [explained the majority of variation in resident well-being.

  19. 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.

  20. Explaining the Evolution of Poverty

    DEFF Research Database (Denmark)

    Arndt, Channing; Hussain, Azhar; Jones, Edward Samuel

    2012-01-01

    We provide a comprehensive approach for analyzing the evolution of poverty using Mozambique as a case study. Bringing together data from disparate sources, we develop a novel “back-casting” framework that links a dynamic computable general equilibrium model to a micro-simulation poverty module....... This framework provides a new approach to explaining and decomposing the evolution of poverty, as well as to examining rigorously the coherence between poverty, economic growth, and inequality outcomes. Finally, various simple but useful and rarely-applied approaches to considering regional changes in poverty...

  1. Seasonal Variation in Epidemiology

    Science.gov (United States)

    Marrero, Osvaldo

    2013-01-01

    Seasonality analyses are important in medical research. If the incidence of a disease shows a seasonal pattern, then an environmental factor must be considered in its etiology. We discuss a method for the simultaneous analysis of seasonal variation in multiple groups. The nuts and bolts are explained using simple trigonometry, an elementary…

  2. Disparities between resident and attending surgeon perceptions of intraoperative teaching.

    Science.gov (United States)

    Butvidas, Lynn D; Anderson, Cheryl I; Balogh, Daniel; Basson, Marc D

    2011-03-01

    This study aimed to assess attending surgeon and resident recall of good and poor intraoperative teaching experiences and how often these experiences occur at present. By web-based survey, we asked US surgeons and residents to describe their best and worst intraoperative teaching experiences during training and how often 26 common intraoperative teaching behaviors occur in their current environment. A total of 346 residents and 196 surgeons responded (51 programs; 26 states). Surgeons and residents consistently identified trainee autonomy, teacher confidence, and communication as positive, while recalling negatively contemptuous, arrogant, accusatory, or uncommunicative teachers. Residents described intraoperative teaching behaviors by faculty as substantially less frequent than faculty self-reports. Neither sex nor seniority explained these results, although women reported communicative behaviors more frequently than men. Although veteran surgeons and current trainees agree on what constitutes effective and ineffective teaching in the operating room, they disagree on how often these behaviors occur, leaving substantial room for improvement. Published by Elsevier Inc.

  3. Juvenile Delinquency Explained? A Test of Containment Theory.

    Science.gov (United States)

    Thompson, William E.; Dodder, Richard A.

    1983-01-01

    Examines the extent to which variation in self-reported delinquency is explained by the seven containment variables (favorable self-concept, goal orientation, frustration tolerance, retention of norms, internalization of rules, availability of meaningful roles, and group reinforcement), and focuses on racial and sex differences in self-reported…

  4. What Explains Patterns of Diversification and Richness among Animal Phyla?

    Science.gov (United States)

    Jezkova, Tereza; Wiens, John J

    2017-03-01

    Animal phyla vary dramatically in species richness (from one species to >1.2 million), but the causes of this variation remain largely unknown. Animals have also evolved striking variation in morphology and ecology, including sessile marine taxa lacking heads, eyes, limbs, and complex organs (e.g., sponges), parasitic worms (e.g., nematodes, platyhelminths), and taxa with eyes, skeletons, limbs, and complex organs that dominate terrestrial ecosystems (arthropods, chordates). Relating this remarkable variation in traits to the diversification and richness of animal phyla is a fundamental yet unresolved problem in biology. Here, we test the impacts of 18 traits (including morphology, ecology, reproduction, and development) on diversification and richness of extant animal phyla. Using phylogenetic multiple regression, the best-fitting model includes five traits that explain ∼74% of the variation in diversification rates (dioecy, parasitism, eyes/photoreceptors, a skeleton, nonmarine habitat). However, a model including just three (skeleton, parasitism, habitat) explains nearly as much variation (∼67%). Diversification rates then largely explain richness patterns. Our results also identify many striking traits that have surprisingly little impact on diversification (e.g., head, limbs, and complex circulatory and digestive systems). Overall, our results reveal the key factors that shape large-scale patterns of diversification and richness across >80% of all extant, described species.

  5. 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...

  6. Explaining the harmonic sequence paradox.

    Science.gov (United States)

    Schmidt, Ulrich; Zimper, Alexander

    2012-05-01

    According to the harmonic sequence paradox, an expected utility decision maker's willingness to pay for a gamble whose expected payoffs evolve according to the harmonic series is finite if and only if his marginal utility of additional income becomes zero for rather low payoff levels. Since the assumption of zero marginal utility is implausible for finite payoff levels, expected utility theory - as well as its standard generalizations such as cumulative prospect theory - are apparently unable to explain a finite willingness to pay. This paper presents first an experimental study of the harmonic sequence paradox. Additionally, it demonstrates that the theoretical argument of the harmonic sequence paradox only applies to time-patient decision makers, whereas the paradox is easily avoided if time-impatience is introduced. ©2011 The British Psychological Society.

  7. 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.

  8. 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.

  9. Inequality in healthcare costs between residing and non-residing patients: evidence from Vietnam.

    Science.gov (United States)

    Nguyen, Hieu M

    2017-05-12

    Place of residence has been shown to impact health. To date, however, previous studies have only focused on the variability in health outcomes and healthcare costs between urban and rural patients. This study takes a different approach and investigates cost inequality facing non-residing patients - patients who do not reside in the regions in which the hospitals are located. Understanding the sources for this inequality is important, as they are directly related to healthcare accessibility in developing countries. The causal impact of residency status on individual healthcare spending is documented with a quasi-experimental design. The propensity score matching method is applied to a unique patient-level dataset (n = 900) collected at public general and specialist hospitals across North Vietnam. Propensity score matching shows that Vietnamese patients who do not reside in the regions in which the hospitals are located are expected to pay about 15 million Vietnamese dongs (approximately 750 USD) more than those who do, a sizable gap, given the distribution of total healthcare costs for the overall sample. This estimate is robust to alternative matching specifications. The obtained discrepancy is empirically attributable to the differences in three potential contributors, namely spending on accompanying relatives, "courtesy funds," and days of hospitalization. The present study finds that there is significant inequality in healthcare spending between residing and non-residing patients at Vietnamese hospitals and that this discrepancy can be partially explained by both institutional and non-institutional factors. These factors signal practical channels through which policymakers can improve healthcare accessibility.

  10. 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

  11. The Preferred Learning Styles of Neurosurgeons, Neurosurgery Residents, and Neurology Residents: Implications in the Neurosurgical Field.

    Science.gov (United States)

    Lai, Hung-Yi; Lee, Ching-Yi; Chiu, Angela; Lee, Shih-Tseng

    2014-01-01

    To delineate the learning style that best defines a successful practitioner in the field of neurosurgery by using a validated learning style inventory. The Kolb Learning Style Inventory, a validated assessment tool, was administered to all practicing neurosurgeons, neurosurgical residents, and neurology residents employed at Chang Gung Memorial Hospital, an institution that provides primary and tertiary clinical care in 3 locations, Linkou, Kaohsiung, and Chiayi. There were 81 participants who entered the study, and all completed the study. Neurosurgeons preferred the assimilating learning style (52%), followed by the diverging learning style (39%). Neurosurgery residents were slightly more evenly distributed across the learning styles; however, they still favored assimilating (32%) and diverging (41%). Neurology residents had the most clearly defined preferred learning style with assimilating (76%) obtaining the large majority and diverging (12%) being a distant second. The assimilating and diverging learning styles are the preferred learning styles among neurosurgeons, neurosurgery residents, and neurology residents. The assimilating learning style typically is the primary learning style for neurosurgeons and neurology residents. Neurosurgical residents start off with a diverging learning style and progress toward an assimilating learning style as they work toward becoming practicing neurosurgeons. The field of neurosurgery has limited opportunities for active experimentation, which may explain why individuals who prefer reflective observation are more likely to succeed in this field. Copyright © 2014 Elsevier Inc. All rights reserved.

  12. Variational principles in physics

    CERN Document Server

    Basdevant, Jean-Louis

    2007-01-01

    Optimization under constraints is an essential part of everyday life. Indeed, we routinely solve problems by striking a balance between contradictory interests, individual desires and material contingencies. This notion of equilibrium was dear to thinkers of the enlightenment, as illustrated by Montesquieu’s famous formulation: "In all magistracies, the greatness of the power must be compensated by the brevity of the duration." Astonishingly, natural laws are guided by a similar principle. Variational principles have proven to be surprisingly fertile. For example, Fermat used variational methods to demonstrate that light follows the fastest route from one point to another, an idea which came to be known as Fermat’s principle, a cornerstone of geometrical optics. Variational Principles in Physics explains variational principles and charts their use throughout modern physics. The heart of the book is devoted to the analytical mechanics of Lagrange and Hamilton, the basic tools of any physicist. Prof. Basdev...

  13. Variations in levels of care between nursing home patients in a public health care system.

    Science.gov (United States)

    Døhl, Øystein; Garåsen, Helge; Kalseth, Jorid; Magnussen, Jon

    2014-03-05

    Within the setting of a public health service we analyse the distribution of resources between individuals in nursing homes funded by global budgets. Three questions are pursued. Firstly, whether there are systematic variations between nursing homes in the level of care given to patients. Secondly, whether such variations can be explained by nursing home characteristics. And thirdly, how individual need-related variables are associated with differences in the level of care given. The study included 1204 residents in 35 nursing homes and extra care sheltered housing facilities. Direct time spent with patients was recorded. In average each patient received 14.8 hours direct care each week. Multilevel regression analysis is used to analyse the relationship between individual characteristics, nursing home characteristics and time spent with patients in nursing homes. The study setting is the city of Trondheim, with a population of approximately 180 000. There are large variations between nursing homes in the total amount of individual care given to patients. As much as 24 percent of the variation of individual care between patients could be explained by variation between nursing homes. Adjusting for structural nursing home characteristics did not substantially reduce the variation between nursing homes. As expected a negative association was found between individual care and case-mix, implying that at nursing home level a more resource demanding case-mix is compensated by lowering the average amount of care. At individual level ADL-disability is the strongest predictor for use of resources in nursing homes. For the average user one point increase in ADL-disability increases the use of resources with 27 percent. In a financial reimbursement model for nursing homes with no adjustment for case-mix, the amount of care patients receive does not solely depend on the patients' own needs, but also on the needs of all the other residents.

  14. Explaining the judicial independence of international courts: a comparative analysis

    DEFF Research Database (Denmark)

    Beach, Derek

    What factors allow some international courts (ICs) to rule against the express preferences of powerful member states, whereas others routinely defer to governments? While judicial independence is not the only factor explaining the strength of a given international institution, it is a necessary...... condition. The paper first develops three sets of competing explanatory variables that potentially can explain variations in the judicial independence of ICs. The causal effects of these explanatory variables upon variance in judicial independence are investigated in a comparative analysis of the ACJ, ECJ...

  15. Splines and variational methods

    CERN Document Server

    Prenter, P M

    2008-01-01

    One of the clearest available introductions to variational methods, this text requires only a minimal background in calculus and linear algebra. Its self-contained treatment explains the application of theoretic notions to the kinds of physical problems that engineers regularly encounter. The text's first half concerns approximation theoretic notions, exploring the theory and computation of one- and two-dimensional polynomial and other spline functions. Later chapters examine variational methods in the solution of operator equations, focusing on boundary value problems in one and two dimension

  16. 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

  17. Defense styles explain psychiatric symptoms: an empirical study.

    Science.gov (United States)

    Holi, M M; Sammallahti, P R; Aalberg, V A

    1999-11-01

    To examine the relation between psychiatric symptoms and defense mechanisms, we administered two questionnaires, the Symptom Check-list 90 (SCL-90) and the Defense Style Questionnaire (DSQ) to 122 psychiatric out-patients and to a community sample of 337 subjects. Using regression analysis, we found that 51.8% of the variation in subject's Global Severity Index value could be explained by his defense style. Of the three defense styles, the immature style explained most of the variation in the symptoms. We found little overall evidence for specific connections between particular defenses and symptoms. Projection and dissociation were central in most of the symptom dimensions. We compared patients and controls with the same level of general symptom severity and found that patients used significantly more devaluation and splitting, and controls used significantly more altruism and idealization. Whether defenses predispose to certain symptomatology or are one of its aspects is discussed.

  18. 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

  19. [Fifty years of residency in Psychiatry at the University of Montreal: relevance and necessity of the Residents' Association].

    Science.gov (United States)

    Thibault, Alexis

    2015-01-01

    In the context of the fiftieth anniversary celebrations of the Département de psychiatrie de l'Université de Montréal, the present article offers to retrace the history of the Psychiatry Resident's Association (ARPUM). Since the Association's activities and demands reflected the concerns of the time, a depiction of the Residency Program and exploration of the historical and administrative context, in each key period, is also undertaken. Multiple psychiatrists from every decade, who were once active members of the Association, were interviewed and asked to describe the Residency Program at their time, with its positive and negative aspects, based on their own personal experience as a resident, but also as a member of the organization. The interviewees were also invited to share their recollections of the various Association's demands, representations, activities and functioning, depending on the issues and periods. Various private and public archives were also used, in order to contextualize the residents' experiences and the Association's work. A brief exploration of the historical and political context that led to the creation of the organization is explained. Training and working conditions of residents at that time are reported, enabling the understanding of the first demands when the group was born. Historical jumps are then proposed, from decades to decades, in order to depict key issues, whether they were academic, clinical or organizational, through which the Association worked, over the evolution of the Residency Program. The internal functioning and its occasional problems throughout the years are also described, as is the role in organizing social and educational events. The Residency Program is in constant mutation, and the Association has played its part in shaping the psychiatric training at the Université de Montréal. Multiple positive and tangible impacts were and are still made possible from the collaborative work between the Département de

  20. Validation of the visitor and resident framework in an e-book setting

    DEFF Research Database (Denmark)

    Engelsmann, Hazel C.; Greifeneder, Elke Susanne; Lauridsen, Nikoline D.

    2014-01-01

    Introduction. By applying the visitor and resident framework on e-book usage, the article explores whether the concepts of a resident and a visitor can help to explain e-book use, and can help to gain a better insight into users' motivations for e-book use. Method. A questionnaire and semi-struct...

  1. The resident-intruder paradigm : a standardized test for aggression, violence and social stress

    NARCIS (Netherlands)

    Koolhaas, Jacob; Coppens, Caroline M.; de Boer, Sietse F.; Buwalda, Bauke; Meerlo, Peter; Timmermans, Paul J. A.

    2013-01-01

    This video publication explains in detail the experimental protocol of the resident-intruder paradigm in rats. This test is a standardized method to measure offensive aggression and defensive behavior in a semi natural setting. The most important behavioral elements performed by the resident and the

  2. Residence Time Distributions in a Cold, Confined Swirl Flow

    DEFF Research Database (Denmark)

    Lans, Robert Pieter Van Der; Glarborg, Peter; Dam-Johansen, Kim

    1997-01-01

    Residence time distributions (RTD) in a confined, cold swirling flow have been measured with a fast-response probe and helium as a tracer. The test-rig represented a scaled down version of a burner. The effect of variation of flow velocities and swirl angle on the flow pattern in the near...

  3. 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

  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.

  5. Ensembl variation resources

    Directory of Open Access Journals (Sweden)

    Marin-Garcia Pablo

    2010-05-01

    Full Text Available Abstract Background The maturing field of genomics is rapidly increasing the number of sequenced genomes and producing more information from those previously sequenced. Much of this additional information is variation data derived from sampling multiple individuals of a given species with the goal of discovering new variants and characterising the population frequencies of the variants that are already known. These data have immense value for many studies, including those designed to understand evolution and connect genotype to phenotype. Maximising the utility of the data requires that it be stored in an accessible manner that facilitates the integration of variation data with other genome resources such as gene annotation and comparative genomics. Description The Ensembl project provides comprehensive and integrated variation resources for a wide variety of chordate genomes. This paper provides a detailed description of the sources of data and the methods for creating the Ensembl variation databases. It also explores the utility of the information by explaining the range of query options available, from using interactive web displays, to online data mining tools and connecting directly to the data servers programmatically. It gives a good overview of the variation resources and future plans for expanding the variation data within Ensembl. Conclusions Variation data is an important key to understanding the functional and phenotypic differences between individuals. The development of new sequencing and genotyping technologies is greatly increasing the amount of variation data known for almost all genomes. The Ensembl variation resources are integrated into the Ensembl genome browser and provide a comprehensive way to access this data in the context of a widely used genome bioinformatics system. All Ensembl data is freely available at http://www.ensembl.org and from the public MySQL database server at ensembldb.ensembl.org.

  6. Improving Reliability of a Residency Interview Process

    Science.gov (United States)

    Serres, Michelle L.; Gundrum, Todd E.

    2013-01-01

    Objective. To improve the reliability and discrimination of a pharmacy resident interview evaluation form, and thereby improve the reliability of the interview process. Methods. In phase 1 of the study, authors used a Many-Facet Rasch Measurement model to optimize an existing evaluation form for reliability and discrimination. In phase 2, interviewer pairs used the modified evaluation form within 4 separate interview stations. In phase 3, 8 interviewers individually-evaluated each candidate in one-on-one interviews. Results. In phase 1, the evaluation form had a reliability of 0.98 with person separation of 6.56; reproducibly, the form separated applicants into 6 distinct groups. Using that form in phase 2 and 3, our largest variation source was candidates, while content specificity was the next largest variation source. The phase 2 g-coefficient was 0.787, while confirmatory phase 3 was 0.922. Process reliability improved with more stations despite fewer interviewers per station—impact of content specificity was greatly reduced with more interview stations. Conclusion. A more reliable, discriminating evaluation form was developed to evaluate candidates during resident interviews, and a process was designed that reduced the impact from content specificity. PMID:24159209

  7. Improving reliability of a residency interview process.

    Science.gov (United States)

    Peeters, Michael J; Serres, Michelle L; Gundrum, Todd E

    2013-10-14

    To improve the reliability and discrimination of a pharmacy resident interview evaluation form, and thereby improve the reliability of the interview process. In phase 1 of the study, authors used a Many-Facet Rasch Measurement model to optimize an existing evaluation form for reliability and discrimination. In phase 2, interviewer pairs used the modified evaluation form within 4 separate interview stations. In phase 3, 8 interviewers individually-evaluated each candidate in one-on-one interviews. In phase 1, the evaluation form had a reliability of 0.98 with person separation of 6.56; reproducibly, the form separated applicants into 6 distinct groups. Using that form in phase 2 and 3, our largest variation source was candidates, while content specificity was the next largest variation source. The phase 2 g-coefficient was 0.787, while confirmatory phase 3 was 0.922. Process reliability improved with more stations despite fewer interviewers per station-impact of content specificity was greatly reduced with more interview stations. A more reliable, discriminating evaluation form was developed to evaluate candidates during resident interviews, and a process was designed that reduced the impact from content specificity.

  8. 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 ...

  9. 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

  10. Host-related factors explaining interindividual variability of carotenoid bioavailability and tissue concentrations in humans

    DEFF Research Database (Denmark)

    Bohn, Torsten; Desmarchelier, Charles; Dragsted, Lars Ove

    2017-01-01

    .g. smoking), gender and age, as well as genetic variations including single nucleotide polymorphisms that govern carotenoid metabolism. These are expected to explain interindividual differences that contribute to carotenoid uptake, distribution, metabolism and excretion, and therefore possibly also...

  11. 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

  12. 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.

  13. 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.

  14. Seasonality in cholera dynamics: A rainfall-driven model explains the wide range of patterns in endemic areas

    Science.gov (United States)

    Baracchini, Theo; King, Aaron A.; Bouma, Menno J.; Rodó, Xavier; Bertuzzo, Enrico; Pascual, Mercedes

    2017-10-01

    Seasonal patterns in cholera dynamics exhibit pronounced variability across geographical regions, showing single or multiple peaks at different times of the year. Although multiple hypotheses related to local climate variables have been proposed, an understanding of this seasonal variation remains incomplete. The historical Bengal region, which encompasses the full range of cholera's seasonality observed worldwide, provides a unique opportunity to gain insights on underlying environmental drivers. Here, we propose a mechanistic, rainfall-temperature driven, stochastic epidemiological model which explicitly accounts for the fluctuations of the aquatic reservoir, and analyze with this model the historical dataset of cholera mortality in the Bengal region. Parameters are inferred with a recently developed sequential Monte Carlo method for likelihood maximization in partially observed Markov processes. Results indicate that the hydrological regime is a major driver of the seasonal dynamics of cholera. Rainfall tends to buffer the propagation of the disease in wet regions due to the longer residence times of water in the environment and an associated dilution effect, whereas it enhances cholera resurgence in dry regions. Moreover, the dynamics of the environmental water reservoir determine whether the seasonality is unimodal or bimodal, as well as its phase relative to the monsoon. Thus, the full range of seasonal patterns can be explained based solely on the local variation of rainfall and temperature. Given the close connection between cholera seasonality and environmental conditions, a deeper understanding of the underlying mechanisms would allow the better management and planning of public health policies with respect to climate variability and climate change.

  15. 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.

  16. 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

  17. 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.

  18. Assessment and Management of Professionalism Issues in Pathology Residency Training

    Directory of Open Access Journals (Sweden)

    Ronald E. Domen MD

    2015-07-01

    Full Text Available Professionalism issues are common in residency training and can be very difficult to recognize and manage. Almost one-third of the milestones for pathology recently instituted by the Accreditation Council for Graduate Medical Education encompass aspects of professionalism. Program directors are often unsure of how and when to remediate residents for unprofessional behavior. We used a case-based educational approach in a workshop setting to assist program directors in the management of unprofessional behavior in residents. Eight case scenarios highlighting various aspects of unprofessional behavior by pathology residents were developed and presented in an open workshop forum at the annual pathology program director’s meeting. Prior to the workshop, 2 surveys were conducted: (1 to collect data on program directors’ experience with identifying, assessing, and managing unprofessional behavior in their residents and (2 to get feedback from workshop registrants on how they would manage each of the 8 case scenarios. A wide range of unprofessional behaviors have been observed by pathology program directors. Although there is occasionally general agreement on how to manage specific behaviors, there remains wide variation in how to manage many of the presented unprofessional behaviors. Remediation for unprofessional behavior in pathology residents remains a difficult and challenging process. Additional education and research in this area are warranted.

  19. 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....

  20. Explaining inequalities in women's mortality between U.S. States

    Directory of Open Access Journals (Sweden)

    Jennifer Karas Montez

    2016-12-01

    Full Text Available Inequalities in women's mortality between U.S. states are large and growing. It is unknown whether they reflect differences between states in their population characteristics, contextual characteristics, or both. This study systematically examines the large inequalities in women's mortality between U.S. states using a multilevel approach. It focuses on “fundamental” social determinants of mortality at the individual and state levels as potential explanations. We analyze data from the 2013 public-use National Longitudinal Mortality Study on women aged 45–89 years and estimate multilevel logistic regression models. The models include women's personal characteristics (age, race/ethnicity, education, employment, income, and marriage and states’ contextual characteristics (economic environment, social cohesion, sociopolitical orientation, physical infrastructure, and tobacco environment. We found that variation in women's mortality across states was significant (p<0.001. Adjusting for women's personal characteristics explained 30% of the variation. Additionally adjusting for states’ contextual characteristics explained 62% of the variation; the most important characteristics were social cohesion and economic conditions. No significant mortality differences between any two states remained after accounting for individual and contextual characteristics. Supplementary analyses of men indicate that state contexts have stronger and more pernicious consequences for women than men. Taken together, the findings underscore the importance of ‘bringing context back in’ and taking a multilevel approach when investigating geographic inequalities in U.S. mortality. Keywords: Mortality, Gender, Inequality, Social determinants, U.S. states, Multilevel

  1. An assessment of emergency medicine residents' ability to perform in a multitasking environment.

    Science.gov (United States)

    Ledrick, David; Fisher, Susan; Thompson, Justin; Sniadanko, Mark

    2009-09-01

    Multitasking (MT) is a term often applied to emergency medicine (EM), but it is still poorly understood. In an effort to facilitate MT research in EM, the authors conducted this pilot study to describe EM residents' scores on a Multi-Tasking Assessment Tool (MTAT) and compare these scores with the residents' work efficiency in the emergency department. The authors administered a previously developed test of MT ability to EM residents. They performed a multiple regression analysis to determine the effect of MT ability on resident work efficiency, defining efficiency as the number of relative value units billed per hour. They controlled the analysis for year of training and medical knowledge using as a standard the in-service exam administered by the American Board of Emergency Medicine. Complete data for 35 residents were available for analysis. Work efficiency was multivariately correlated with MTAT scores and year of training (P training explained the majority of the variance, a resident's MT ability accounted for a smaller but still significant portion. This pilot study further validates the MTAT and lays the groundwork for further research in MT in EM. Resident year of training and MTAT scores explain the variability in resident work efficiency significantly more than medical knowledge. Understanding MT ability may ultimately help in resident selection, education, and remediation as well as career counseling and improvement of practice systems in EM.

  2. 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.

  3. Interannual variability of net ecosystem productivity in forests is explained by carbon flux phenology in autumn

    DEFF Research Database (Denmark)

    Wu, Chaoyang; Chen, Xi Jing; Black, T. Andrew

    2013-01-01

    To investigate the importance of autumn phenology in controlling interannual variability of forest net ecosystem productivity (NEP) and to derive new phenological metrics to explain the interannual variability of NEP. North America and Europe. Flux data from nine deciduous broadleaf forests (DBF......, soil water content and precipitation, were also used to explain the phenological variations. We found that interannual variability of NEP can be largely explained by autumn phenology, i.e. the autumn lag. While variation in neither annual gross primary productivity (GPP) nor in annual ecosystem...

  4. Does place explain racial health disparities? Quantifying the contribution of residential context to the Black/white health gap in the United States.

    Science.gov (United States)

    Do, D Phuong; Finch, Brian Karl; Basurto-Davila, Ricardo; Bird, Chloe; Escarce, Jose; Lurie, Nicole

    2008-10-01

    The persistence of the black health disadvantage has been a puzzling component of health in the United States in spite of general declines in rates of morbidity and mortality over the past century. Studies that have focused on well-established individual-level determinants of health such as socio-economic status and health behaviors have been unable to fully explain these disparities. Recent research has begun to focus on other factors such as racism, discrimination, and segregation. Variation in neighborhood context-socio-demographic composition, social aspects, and built environment-has been postulated as an additional explanation for racial disparities, but few attempts have been made to quantify its overall contribution to the black/white health gap. This analysis is an attempt to generate an estimate of place effects on explaining health disparities by utilizing data from the U.S. National Health Interview Survey (NHIS) (1989-1994), combined with a methodology for identifying residents of the same blocks both within and across NHIS survey cross-sections. Our results indicate that controlling for a single point-in-time measure of residential context results in a roughly 15-76% reduction of the black/white disparities in self-rated health that were previously unaccounted for by individual-level controls. The contribution of residential context toward explaining the black/white self-rated health gap varies by both age and gender such that contextual explanations of disparities decline with age and appear to be smaller among females.

  5. Factors influencing variation in dentist service rates.

    Science.gov (United States)

    Grembowski, D; Milgrom, P; Fiset, L

    1990-01-01

    In the previous article, we calculated dentist service rates for 200 general dentists based on a homogeneous, well-educated, upper-middle-class population of patients. Wide variations in the rates were detected. In this analysis, factors influencing variation in the rates were identified. Variation in rates for categories of dental services was explained by practice characteristics, patient exposure to fluoridated water supplies, and non-price competition in the dental market. Rates were greatest in large, busy practices in markets with high fees. Older practices consistently had lower rates across services. As a whole, these variables explained between 5 and 30 percent of the variation in the rates.

  6. Variational principles

    CERN Document Server

    Moiseiwitsch, B L

    2004-01-01

    This graduate-level text's primary objective is to demonstrate the expression of the equations of the various branches of mathematical physics in the succinct and elegant form of variational principles (and thereby illuminate their interrelationship). Its related intentions are to show how variational principles may be employed to determine the discrete eigenvalues for stationary state problems and to illustrate how to find the values of quantities (such as the phase shifts) that arise in the theory of scattering. Chapter-by-chapter treatment consists of analytical dynamics; optics, wave mecha

  7. Urinary 1-hydroxypyrene in children living in city and rural residences in Denmark

    DEFF Research Database (Denmark)

    Hansen, Åse Marie; Raaschou-Nielsen, Ole; Knudsen, Lisbeth E.

    2006-01-01

    AIMS: The present study aims to assess the biological uptake in children of polycyclic aromatic hydrocarbons measured as 1-hydroxypyrene in urine from children living in city and rural residences. METHODS: 103 children living in Copenhagen and 101 children living in rural residences of Denmark......, the children excreted on average 0.07 [95% CI: 0.01-0.41] micromol urinary 1-hydroxypyrene per mol creatinine. Children living in urban residences excreted 0.02 [95% CI: 0.01-0.05] micromol more 1-hydroxypyrene than children living in rural residences. This was confirmed in the multiple regression analysis...... living in urban residences are more exposed to PAH than children living in rural residences. Time spent outdoors increased the excretion of 1-hydroxypyrene, which was most evident among urban children. Higher concentrations of ambient air pollution in urban areas may explain this finding. No influence...

  8. Explaining labor wedge trends: An equilibrium search approach

    Directory of Open Access Journals (Sweden)

    Coralia A. Quintero Rojas

    2016-06-01

    Full Text Available In this paper, we present a search and matching model of the labor market and use this as a device to explain the long-run variation in the aggregate hours worked in several OECD countries over the period 1980-2013. The model distinguishes between hours worked per employee (intensive margin and the employment rate (extensive margin and includes a tax/benefit system. This allows us to assess the impact of the observed time-varying heterogeneity of taxes, unemployment benefits, and workers’ bargaining power on the two margins. Our method is based on an accounting procedure. Once it has been calibrated, we find that, for the ten countries of the sample, our search economy is able to explain the patterns of the two margins of aggregate hours worked over the 1980-2013 period, when it includes the cross-country heterogeneity of the labor market institutions.

  9. Explaining human uniqueness: genome interactions with environment, behaviour and culture.

    Science.gov (United States)

    Varki, Ajit; Geschwind, Daniel H; Eichler, Evan E

    2008-10-01

    What makes us human? Specialists in each discipline respond through the lens of their own expertise. In fact, 'anthropogeny' (explaining the origin of humans) requires a transdisciplinary approach that eschews such barriers. Here we take a genomic and genetic perspective towards molecular variation, explore systems analysis of gene expression and discuss an organ-systems approach. Rejecting any 'genes versus environment' dichotomy, we then consider genome interactions with environment, behaviour and culture, finally speculating that aspects of human uniqueness arose because of a primate evolutionary trend towards increasing and irreversible dependence on learned behaviours and culture - perhaps relaxing allowable thresholds for large-scale genomic diversity.

  10. 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

  11. Killer whale morphology - Variation in morphology of killer whale ecotypes

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — We are using elliptic Fourier analysis to determine the patterns of variation in morphology of dorsal fin shape, saddle patch shape, and eye patch shape of resident,...

  12. A father effect explains sex-ratio bias.

    Science.gov (United States)

    Malo, Aurelio F; Martinez-Pastor, Felipe; Garcia-Gonzalez, Francisco; Garde, Julián; Ballou, Jonathan D; Lacy, Robert C

    2017-08-30

    Sex ratio allocation has important fitness consequences, and theory predicts that parents should adjust offspring sex ratio in cases where the fitness returns of producing male and female offspring vary. The ability of fathers to bias offspring sex ratios has traditionally been dismissed given the expectation of an equal proportion of X- and Y-chromosome-bearing sperm (CBS) in ejaculates due to segregation of sex chromosomes at meiosis. This expectation has been recently refuted. Here we used Peromyscus leucopus to demonstrate that sex ratio is explained by an exclusive effect of the father, and suggest a likely mechanism by which male-driven sex-ratio bias is attained. We identified a male sperm morphological marker that is associated with the mechanism leading to sex ratio bias; differences among males in the sperm nucleus area (a proxy for the sex chromosome that the sperm contains) explain 22% variation in litter sex ratio. We further show the role played by the sperm nucleus area as a mediator in the relationship between individual genetic variation and sex-ratio bias. Fathers with high levels of genetic variation had ejaculates with a higher proportion of sperm with small nuclei area. This, in turn, led to siring a higher proportion of sons (25% increase in sons per 0.1 decrease in the inbreeding coefficient). Our results reveal a plausible mechanism underlying unexplored male-driven sex-ratio biases. We also discuss why this pattern of paternal bias can be adaptive. This research puts to rest the idea that father contribution to sex ratio variation should be disregarded in vertebrates, and will stimulate research on evolutionary constraints to sex ratios-for example, whether fathers and mothers have divergent, coinciding, or neutral sex allocation interests. Finally, these results offer a potential explanation for those intriguing cases in which there are sex ratio biases, such as in humans. © 2017 The Author(s).

  13. Can neighborhoods explain racial/ethnic differences in adolescent inactivity?

    Science.gov (United States)

    Richmond, Tracy K; Field, Alison E; Rich, Michael

    2007-01-01

    To determine if neighborhoods and their attributes contribute to racial/ethnic disparities in adolescent inactivity. We undertook a cross-sectional analysis of the National Longitudinal Study of Adolescent Health (n = 17,007), a nationally representative school-based study in the United States. Stratifying by gender, we used multivariate linear regression and multi-level modeling to determine whether neighborhood of residence may partially explain racial/ethnic disparities in adolescent physical inactivity, defined as hours viewing television or videos/DVDs and/or playing computer/video games each week. Participants lived in largely segregated communities. Black and Hispanic adolescent girls reported higher levels of inactivity than White adolescent girls (21 vs. 15 vs. 13 hours/week, respectively, p violent crime in the neighborhood was associated with inactivity, despite the individual's perception of his/her neighborhood as safe not being predictive. Although inactivity varies by race/ethnicity and gender, only in Hispanic adolescent girls does neighborhood fully explain the differential use. Our findings suggest that approaches other than changing neighborhood characteristics are needed to eliminate racial/ethnic disparities in adolescent inactivity.

  14. Topology Explains Why Automobile Sunshades Fold Oddly

    Science.gov (United States)

    Feist, Curtis; Naimi, Ramin

    2009-01-01

    Automobile sunshades always fold into an "odd" number of loops. The explanation why involves elementary topology (braid theory and linking number, both explained in detail here with definitions and examples), and an elementary fact from algebra about symmetric group.

  15. Your Radiologist Explains Magnetic Resonance Angiography (MRA)

    Medline Plus

    Full Text Available ... Disorders Video: The Basketball Game: An MRI Story Radiology and You Sponsored by Image/Video Gallery Your ... Explains Magnetic Resonance Angiography (MRA) Transcript Welcome to Radiology Info dot org Hello, I’m Dr. Elliot ...

  16. Explorers Presentation: Explaining the Tides to Children

    OpenAIRE

    Institute, Marine

    2015-01-01

    Explaining the tides to children Presentation includes information about: Orbits of the Earth, Moon and Sun; Moon phases and the lunar cycle; Gravity; Gravity and the tide; Types of tides; The tides and me!; Tide tables; Extra insight

  17. Your Radiologist Explains Magnetic Resonance Angiography (MRA)

    Medline Plus

    Full Text Available ... An MRI Story Radiology and You Sponsored by Image/Video Gallery Your Radiologist Explains Magnetic Resonance Angiography ( ... posted: How to Obtain and Share Your Medical Images Movement Disorders Video: The Basketball Game: An MRI ...

  18. A model to explain human voice production

    Science.gov (United States)

    Vilas Bôas, C. S. N.; Gobara, S. T.

    2018-05-01

    This article presents a device constructed with low-cost material to demonstrate and explain voice production. It also provides a contextualized, interdisciplinary approach to introduce the study of sound waves.

  19. Using Expectancy Theory to Explain Performance Appraisal ...

    African Journals Online (AJOL)

    pc

    2018-03-05

    Mar 5, 2018 ... appraisal conducting style, the relation between the performance appraisal system and task ... the article first explains the theory model which is based expectancy theory. II. ... which in return lead to rewards. According to [12],.

  20. 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.

  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. 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.

  4. 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.

  5. 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.

  6. 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.

  7. 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)

  8. Regional variation in short distance homogamy

    NARCIS (Netherlands)

    Haandrikman, K.; van Wissen, L.J.G.

    2011-01-01

    A third of all Dutch cohabiters choose a partner from the same municipality, so-called short distance homogamy. This article analyses the regional variation in this phenomenon, and it explains this variation in terms of geographical, socioeconomic, demographic and cultural determinants. Population

  9. Metaleptic Variations

    OpenAIRE

    Pernot, Dominique

    2014-01-01

    Les derniers romans de Gabriel Josipovici offrent beaucoup de variété, allant de la parodie, de la fiction comique légère, dans Only Joking et Making Mistakes, à des sujets plus graves, plus personnels, ontologiques. Dans un court roman, Everything Passes, et dans un roman majeur, Goldberg: Variations, le lecteur est amené à se poser des questions sur la nature mystérieuse de la réalité, qui est, trop souvent, acceptée sans conteste par de nombreux roma...

  10. Moderation of Genetic Influences on Alcohol Involvement by Rural Residency among Adolescents: Results from the 1962 National Merit Twin Study.

    Science.gov (United States)

    Davis, Christal N; Natta, Shanaliz S; Slutske, Wendy S

    2017-11-01

    Adolescents in rural and urban areas may experience different levels of environmental restrictions on alcohol use, with those in rural areas experiencing greater monitoring and less access to alcohol. Such restrictions may limit expression of genetic vulnerability for alcohol use, resulting in a gene-environment interaction (G × E). This phenomenon has previously been reported in Finnish and Minnesota adolescents. The current study used data from 839 same-sex twin pairs from the 1962 National Merit Scholarship Qualifying Test to determine whether the G × E interaction would be evident in this earlier time period. We also assessed whether the G × E interaction would be moderated by sex, and whether family socioeconomic status (SES; income and parental education) may mediate the G × E interaction. Findings showed the expected interaction among females, with a weaker contribution of genes (2 vs. 44%) and greater contribution of shared environment (62 vs. 29%) to variation in alcohol involvement among rural as compared to urban residents. The G × E interaction was not observed among males, and operated independently from differences in family SES among rural and urban adolescents. This study represents a partial replication in a novel setting of the moderation of the genetic contribution to alcohol use by rural/urban residency, and suggests that SES differences may not explain this effect.

  11. Body size and pubertal development explain ethnic differences in structural geometry at the femur in Asian, Hispanic and white early adolescent girls living in the US

    Science.gov (United States)

    Variation in structural geometry is present in adulthood, but when this variation arises and what influences this variation prior to adulthood remains poorly understood. Ethnicity is commonly the focus of research of skeletal integrity and appears to explain some of the variation in quantification o...

  12. Change and predictors of change in social skills of nursing home residents with dementia.

    Science.gov (United States)

    Chappell, Neena L; Kadlec, Helena; Reid, Colin

    2014-02-01

    Social skills are of primary importance for those with dementia and their care providers, yet we know little about the extent to which basic social skills can be maintained over time and the predictors of change. A total of 18 nursing homes with 149 newly admitted residents with moderate to severe dementia, 195 direct care staff, and 135 family members, in British Columbia, Canada, contributed data on change in social skills from admission to 6 months and 1 year later. Three-quarters of residents maintained or improved their basic social skills during both the time periods. Decline was explained primarily by cognitive status at the time of admission, notably present orientation. However, staff-to-resident communication becomes more important over time. Social skills appear to present an opportunity to maintain interaction with these residents. The findings also suggest that a focus on the present orientation before and following admission and on staff-to-resident communication may be beneficial.

  13. Does a hostel's managing agency determine the access to psychiatric services of its residents?

    Science.gov (United States)

    Lucas, B; Audini, B; Chisholm, D; Knapp, M; Lelliott, P

    1998-10-01

    This study examines the effect of managing agency (local authority, private or voluntary) on the use of other health and social care services by residents in mental health hostels and group homes with different levels of staffing in England and Wales. The sample comprised 1323 residents in 275 facilities in eight districts. The measures of service use were number of days in hospital and number of other service contacts. There were highly significant differences between facilities with similar levels of staffing managed by different agencies. Residents in the voluntary sector used fewer community services overall; residents in low-staffed local authority facilities used more services than those in similar facilities managed by other agencies. These differences were not easily explained by differences in the social or clinical characteristics of residents. This suggests that there may be organisational factors, e.g. hostel staff, knowledge of services, which influence access to and use of community services.

  14. Do changes in connectivity explain desertification?

    Science.gov (United States)

    Desertification, broad-scale land degradation in drylands, is a major environmental hazard facing inhabitants of the world’s deserts as well as an important component of global change. There is no unifying framework that simply and effectively explains different forms of desertification. Here we arg...

  15. Can the inherence heuristic explain vitalistic reasoning?

    Science.gov (United States)

    Bastian, Brock

    2014-10-01

    Inherence is an important component of psychological essentialism. By drawing on vitalism as a way in which to explain this link, however, the authors appear to conflate causal explanations based on fixed features with those based on general causal forces. The disjuncture between these two types of explanatory principles highlights potential new avenues for the inherence heuristic.

  16. Explaining probalistic risk assessment in common language

    International Nuclear Information System (INIS)

    Wong, J.W.

    1994-01-01

    Probabilistic human health risk assessment is explained in ordinary language using a hypothetical example and the ingestion equation from EPA's Risk Assessment Guidance for Superfund. A section on understanding probabilities and probability distributions used in a Monte Carlo simulation is included as well as an appendix showing the computer run and the technical assumptions behind it

  17. Explaining Violence in Sierra Leone's Civil War

    African Journals Online (AJOL)

    Explaining the violence of civil war is never a simple task for the scholar. In the case of the Sierra Leone, paradoxically, the task has in some ways been rendered more difficult by the sheer variety of compelling scholarship on the question. This paper seeks to identify the most useful of the explanations offered thus far, and ...

  18. Measuring and explaining house price developments

    NARCIS (Netherlands)

    De Vries, P.

    2010-01-01

    This study discusses ways of measuring and explaining the development of house prices. The goal of the research underpinning this dissertation was to develop a methodological framework for studying these developments. This framework relates, first, to correcting for changes in the composition of

  19. Adaptive hatching hypotheses do not explain asynchronous ...

    African Journals Online (AJOL)

    At the core of the suite of adaptive hatching hypotheses advanced to explain asynchronous hatching in birds is the assumption that if food is not limited then all the hatchlings will develop normally to adulthood. In this study Brown-headed Parrot Poicephalus cryptoxanthus chicks were hand fed and weighed on a daily basis.

  20. Explaining convergence of oecd welfare states

    DEFF Research Database (Denmark)

    Schmitt, C.; Starke, Peter

    2011-01-01

    of conditional convergence helps to both better describe and explain the phenomenon. By applying error correction models, we examine conditional convergence of various types of social expenditure in 21 OECD countries between 1980 and 2005. Our empirical findings go beyond the existing literature in two respects...

  1. Explaining the VET Applied Research Developmental Framework

    Science.gov (United States)

    Simon, Linda; Beddie, Francesca M.

    2017-01-01

    This document explains the VET Applied Research Developmental Framework, created as part of a project that explored how the vocational education and training (VET) sector could broaden its engagement in Australia's research and development (R&D) and innovation systems. Achieving this engagement will rely significantly on building the…

  2. Explaining Teachers' Use of Textbooks

    Science.gov (United States)

    Reichenberg, Monica

    2016-01-01

    In educational systems without comprehensive systems for regulating textbooks, teachers can exert considerable influence on the use of textbooks. However, existing research has not yet identified the mechanisms of this use. Accordingly, the aim of this article is to examine and explain teachers' strategic use of textbooks. I administered a…

  3. Your Radiologist Explains Magnetic Resonance Angiography (MRA)

    Medline Plus

    Full Text Available ... Sponsored by Image/Video Gallery Your Radiologist Explains Magnetic Resonance Angiography (MRA) Transcript Welcome to Radiology Info dot ... I’d like to talk with you about magnetic resonance angiography, or as it’s commonly known, MRA. MRA ...

  4. 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.

  5. 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.

  6. Experiencing variation

    DEFF Research Database (Denmark)

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

    2017-01-01

    This study contributes towards a better understanding of learning dynamics in doctoral supervision by analysing how learning opportunities are created in the interaction between supervisors and PhD students, using the notion of experiencing variation as a key to learning. Empirically, we have based...... the study on four video-recorded sessions, with four different PhD students and their supervisors, all from life sciences. Our analysis revealed that learning opportunities in the supervision sessions concerned either the content matter of research (for instance, understanding soil structure......), or the research methods— more specifically how to produce valid results. Our results illustrate how supervisors and PhD students create a space of learning together in their particular discipline by varying critical aspects of their research in their discussions. Situations where more openended research issues...

  7. 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.

  8. [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.

  9. 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

  10. Continuity of care in dermatology residency programs in the United States.

    Science.gov (United States)

    Loh, Tiffany; Vazirnia, Aria; Afshar, Maryam; Dorschner, Robert; Paravar, Taraneh

    2017-05-15

    As established by the AccreditationCouncil for Graduate Medical Education (ACGME),dermatology residents in the United States must participate in continuity clinic. This requirement may be achieved through multiple means, allowing for program variation. To better assess continuity clinic's role in resident learning, more data on this component of graduate medical education is needed. An anonymous online survey was distributed via the American Board of Dermatology list serv to all U.S. dermatology residents. Continuity clinic organization, setting, frequency, and patient and preceptor characteristics were assessed; resident satisfaction and learning were compared. Of 231 responses, 7.8% reported continuity clinic daily, 77.1% weekly, 9.1% every other week, 3.0%monthly, 0.4% once every several months, and 2.2%only during certain blocks. Of the clinics reported,80.1% were "resident-run with attending" and 11.3%were attending-run. The rest were "resident-run with no attending" (0.9%), both resident and attending run(3.0%), or "other" (4.8%). Trainees in resident-run clinics (with attendings) reported greater continuity of care than those in attending-run clinics (p<0.001).Residents reported better teaching with attending presence during patient encounters than when attendings were present only if concerns were raised(p<0.01).

  11. Delegation of medical tasks in French radiation oncology departments: current situation and impact on residents' training.

    Science.gov (United States)

    Thureau, S; Challand, T; Bibault, J-E; Biau, J; Cervellera, M; Diaz, O; Faivre, J-C; Fumagalli, I; Leroy, T; Lescut, N; Martin, V; Pichon, B; Riou, O; Dubray, B; Giraud, P; Hennequin, C

    2013-10-01

    A national survey was conducted among the radiation oncology residents about their clinical activities and responsibilities. The aim was to evaluate the clinical workload and to assess how medical tasks are delegated and supervised. A first questionnaire was administered to radiation oncology residents during a national course. A second questionnaire was mailed to 59 heads of departments. The response rate was 62% for radiation oncology residents (99 questionnaires) and 51% for heads of department (30). Eighteen heads of department (64%) declared having written specifications describing the residents' clinical tasks and roles, while only 31 radiation oncology residents (34%) knew about such a document (P=0.009). A majority of residents were satisfied with the amount of medical tasks that were delegated to them. Older residents complained about insufficient exposure to new patient's consultation, treatment planning and portal images validation. The variations observed between departments may induce heterogeneous trainings and should be addressed specifically. National specifications are necessary to reduce heterogeneities in training, and to insure that the residents' training covers all the professional skills required to practice radiation oncology. A frame endorsed by academic and professional societies would also clarify the responsibilities of both residents and seniors. Copyright © 2013 Société française de radiothérapie oncologique (SFRO). Published by Elsevier SAS. All rights reserved.

  12. Neodymium isotopic variations in seawater

    Science.gov (United States)

    Piepgras, D. J.; Wasserburg, G. J.

    1980-01-01

    Direct measurement of the isotopic composition of Nd in the Atlantic agree with the Nd content in ferromanganese sediments and differ from the observed amounts in the Pacific samples. These data indicate the existence of distinctive differences in the isotopic composition of Nd in the waters of major oceans; the average values determined from seawater and ferromanganese sediments are considerably lower than in sources with oceanic mantle affinities showing that the REE in the oceans is dominated by continental sources. The Nd isotopic variations in seawater are applied to relate the residence time of Nd and mixing rates between the oceans.

  13. Consequences of contextual factors on clinical reasoning in resident physicians.

    Science.gov (United States)

    McBee, Elexis; Ratcliffe, Temple; Picho, Katherine; Artino, Anthony R; Schuwirth, Lambert; Kelly, William; Masel, Jennifer; van der Vleuten, Cees; Durning, Steven J

    2015-12-01

    Context specificity and the impact that contextual factors have on the complex process of clinical reasoning is poorly understood. Using situated cognition as the theoretical framework, our aim was to evaluate the verbalized clinical reasoning processes of resident physicians in order to describe what impact the presence of contextual factors have on their clinical reasoning. Participants viewed three video recorded clinical encounters portraying straightforward diagnoses in internal medicine with select patient contextual factors modified. After watching each video recording, participants completed a think-aloud protocol. Transcripts from the think-aloud protocols were analyzed using a constant comparative approach. After iterative coding, utterances were analyzed for emergent themes with utterances grouped into categories, themes and subthemes. Ten residents participated in the study with saturation reached during analysis. Participants universally acknowledged the presence of contextual factors in the video recordings. Four categories emerged as a consequence of the contextual factors: (1) emotional reactions (2) behavioral inferences (3) optimizing the doctor patient relationship and (4) difficulty with closure of the clinical encounter. The presence of contextual factors may impact clinical reasoning performance in resident physicians. When confronted with the presence of contextual factors in a clinical scenario, residents experienced difficulty with closure of the encounter, exhibited as diagnostic uncertainty. This finding raises important questions about the relationship between contextual factors and clinical reasoning activities and how this relationship might influence the cost effectiveness of care. This study also provides insight into how the phenomena of context specificity may be explained using situated cognition theory.

  14. Variational principle in quantum mechanics

    International Nuclear Information System (INIS)

    Popiez, L.

    1986-01-01

    The variational principle in a standard, path integral formulation of quantum mechanics (as proposed by Dirac and Feynman) appears only in the context of a classical limit n to 0 and manifests itself through the method of abstract stationary phase. Symbolically it means that a probability amplitude averaged over trajectories denotes a classical evolution operator for points in a configuration space. There exists, however, the formulation of quantum dynamics in which variational priniple is one of basic postulates. It is explained that the translation between stochastic and quantum mechanics in this case can be understood as in Nelson's stochastic mechanics

  15. Variability in working memory performance explained by epistasis vs polygenic scores in the ZNF804A pathway

    NARCIS (Netherlands)

    Nicodemus, Kristin K.; Hargreaves, April; Morris, Derek; Anney, Richard; Gill, Michael; Corvin, Aiden; Donohoe, Gary; Ripke, Stephan; Sanders, Alan R.; Kendler, Kenneth S.; Levinson, Douglas F.; Sklar, Pamela; Holmans, Peter A.; Lin, Dan-Yu; Duan, Jubao; Ophoff, Roel A.; Andreassen, Ole A.; Scolnick, Edward; Cichon, Sven; St Clair, David; Gurling, Hugh; Werge, Thomas; Rujescu, Dan; Blackwood, Douglas H. R.; Pato, Carlos N.; Malhotra, Anil K.; Purcell, Shaun; Dudbridge, Frank; Neale, Benjamin M.; Rossin, Lizzy; Visscher, Peter M.; Posthuma, Danielle; Ruderfer, Douglas M.; Fanous, Ayman; Stefansson, Hreinn; Steinberg, Stacy; Mowry, Bryan J.; Golimbet, Vera; de Hert, Marc; Jönsson, Erik G.; Bitter, István; Pietiläinen, Olli P. H.; Collier, David A.; Tosato, Sarah; Agartz, Ingrid; Albus, Margot; Alexander, Madeline; Amdur, Richard L.; de Haan, Lieuwe; Linszen, Don H.

    2014-01-01

    We investigated the variation in neuropsychological function explained by risk alleles at the psychosis susceptibility gene ZNF804A and its interacting partners using single nucleotide polymorphisms (SNPs), polygenic scores, and epistatic analyses. Of particular importance was the relative

  16. Variability in working memory performance explained by epistasis vs polygenic scores in the ZNF804A pathway.

    NARCIS (Netherlands)

    Nicodemus, K.K.; Hargreaves, A.; Morris, D.; Anney, R.; Gill, M.; Corvin, A.; Posthuma, D.; Donohoe, G.

    2014-01-01

    IMPORTANCE We investigated the variation in neuropsychological function explained by risk alleles at the psychosis susceptibility gene ZNF804A and its interacting partners using single nucleotide polymorphisms (SNPs), polygenic scores, and epistatic analyses. Of particular importance was the

  17. 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...

  18. 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...

  19. 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...

  20. 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...

  1. 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...

  2. 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...

  3. 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...

  4. Explaining money creation by commercial banks

    DEFF Research Database (Denmark)

    Ravn, Ib

    2015-01-01

    Educators and economists concerned with monetary reform face the extraordinary challenge of explaining to the public and its elected representatives not only what a reformed system would look like, but also how the current system works. Centrally, the point that in a modern economy money is largely...... created by commercial banks, as explained by the Bank of England recently (McLeay, Radia & Thomas, 2014b), is often met with incredulity: “What do you mean, created?” This paper introduces five easy-to-grasp analogies that educators and reformers may use to convey key money-creation concepts to a lay...... audience. The analogies offered include (1) money as patches in an expandable patchwork quilt that covers a nation’s real assets, (2) the money supply as water in a bathtub with a faucet and a drain, (3) money understood as debt in a model economy run by schoolchildren, (4) the misleading concept of a bank...

  5. HIV As Trojan Exosome: Immunological Paradox Explained?

    Science.gov (United States)

    Hildreth, James E K

    2017-01-01

    The HIV pandemic is still a major global challenge, despite the widespread availability of antiretroviral drugs. An effective vaccine would be the ideal approach to bringing the pandemic to an end. However, developing an effective HIV vaccine has proven to be an elusive goal. Three major human HIV vaccine trials revealed a strong trend toward greater risk of infection among vaccine recipients versus controls. A similar observation was made in a macaque SIV vaccine study. The mechanism explaining this phenomenon is not known. Here, a model is presented that may explain the troubling results of vaccine studies and an immunological paradox of HIV pathogenesis: preferential infection of HIV-specific T cells. The central hypothesis of this perspective is that as "Trojan exosomes" HIV particles can directly activate HIV-specific T cells enhancing their susceptibility to infection. Understanding the biology of HIV as an exosome may provide insights that enable novel approaches to vaccine development.

  6. Children's Theories and the Drive to Explain

    Science.gov (United States)

    Schwitzgebel, Eric

    Debate has been growing in developmental psychology over how much the cognitive development of children is like theory change in science. Useful debate on this topic requires a clear understanding of what it would be for a child to have a theory. I argue that existing accounts of theories within philosophy of science and developmental psychology either are less precise than is ideal for the task or cannot capture everyday theorizing of the sort that children, if they theorize, must do. I then propose an account of theories that ties theories and explanation very closely together, treating theories primarily as products of a drive to explain. I clarify some of the positions people have taken regarding the theory theory of development, and I conclude by proposing that psychologists interested in the ''theory theory'' look for patterns of affect and arousal in development that would accompany the existence of a drive to explain.

  7. Explaining the Allocation of Regional Structural Funds

    DEFF Research Database (Denmark)

    Charron, Nicholas

    2016-01-01

    What regional factors can explain the heterogeneity in Structural Funds distribution to European Union regions? Past studies have shown that aside from the level of economic development and rates of unemployment, other political, and economic factors systematically explain why certain European...... Union regions receive greater funding than others, in particular where there is room for bargaining. In this article, a novel theory is posited which argues that the determination of Structural Funds is based on an interaction between a region’s formal institutions (the level of a regional autonomy......) and informal institutions (its level of quality of government). In cases of low regional autonomy, member states and European Union level actors prefer to allocate greater levels of Funds to regions with lower quality of government in order to increase cohesion. Yet in cases of high regional autonomy, risks...

  8. Tourist Activity of Senior Citizens (60+ Residing in Urban and Rural Areas

    Directory of Open Access Journals (Sweden)

    Omelan Aneta

    2016-12-01

    Full Text Available The objective of this study was to analyze the influence of place of permanent residence (urban or rural on the tourist activity of senior citizens (60+ of different socioeconomic statuses. The study involved 380 senior citizens (305 female and 75 male aged 60 years and older who were permanent residents of the region of Warmia and Mazury, Poland. In this group, 244 subjects resided in urban areas and 136 participants were rural dwellers. The respondents were asked to complete a questionnaire regarding their socioeconomic status (place of permanent residence, age, gender, educational attainment, financial status, membership in senior organizations, marital status, and professional activity and tourist activity. A significance test of two structure coefficients (α=0.05 was applied. Factors such as gender, professional activity, and marital status were not related with the travel propensity of seniors from different groups (urban and rural, but were significant when rural residents were compared with urban dwellers. Seniors residing in urban areas of Warmia and Mazury, Poland, were significantly more likely to travel for leisure than those residing in rural areas. The tourist activity of seniors decreased significantly (p<0.05 with the age (60-74 years and financial status of rural residents. The travel propensity of elderly people increased significantly (p<0.05 with educational attainment and membership in senior organizations. The study revealed considerable differences in the socioeconomic status and social characteristics of seniors residing in rural and urban areas, and those variations significantly influenced their propensity for travel: urban residents traveled more frequently than rural residents. It can be concluded that place of residence was a crucial factor determining the tourist behavior of senior citizens, and urban dwellers were more likely to travel.

  9. IEE wiring regulations explained and illustrated

    CERN Document Server

    Scaddan, Brian

    2013-01-01

    The IEE Wiring Regulations Explained and Illustrated, Second Edition discusses the recommendations of the IEE Regulations for the Electrical Equipment of Buildings for the safe selection or erection of wiring installations. The book emphasizes earthing, bonding, protection, and circuit design of electrical wirings. The text reviews the fundamental requirements for safety, earthing systems, the earth fault loop impedance, and supplementary bonding. The book also describes the different types of protection, such as protection against mechanical damage, overcurrent, under voltage (which prevents

  10. A More Practical Method for Explaining Equilibrium

    OpenAIRE

    Yi-Jang Yu

    2014-01-01

    The aim of this study is to suggest a more practical method for explaining market equilibrium in a two-dimensional risk-return world. Its main difference from textbook contents is to define, in both qualitative and quantitative ways, the environment or the system factor and treat it as an endogenous variable. Once the two-dimensional framework that is capable of managing uncertainty and environmental relationship can be reasonably established, a greater number of economic issues can be effect...

  11. "Explaining the Gender Wage Gap in Georgia"

    OpenAIRE

    Tamar Khitarishvili

    2009-01-01

    This paper evaluates gender wage differentials in Georgia between 2000 and 2004. Using ordinary least squares, we find that the gender wage gap in Georgia is substantially higher than in other transition countries. Correcting for sample selection bias using the Heckman approach further increases the gender wage gap. The Blinder Oaxaca decomposition results suggest that most of the wage gap remains unexplained. The explained portion of the gap is almost entirely attributed to industrial variab...

  12. Explaining seeing? Disentangling qualia from perceptual organization.

    Science.gov (United States)

    Ibáñez, Agustin; Bekinschtein, Tristan

    2010-09-01

    Abstract Visual perception and integration seem to play an essential role in our conscious phenomenology. Relatively local neural processing of reentrant nature may explain several visual integration processes (feature binding or figure-ground segregation, object recognition, inference, competition), even without attention or cognitive control. Based on the above statements, should the neural signatures of visual integration (via reentrant process) be non-reportable phenomenological qualia? We argue that qualia are not required to understand this perceptual organization.

  13. 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

  14. 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

  15. 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...

  16. 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...

  17. 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...

  18. 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…

  19. The teaching of physics and related courses to residents in radiation oncology

    International Nuclear Information System (INIS)

    Dunscombe, P.

    1989-01-01

    A survey of physics and related teaching to radiation oncology residents in 21 Canadian cancer centres was undertaken in December 1987 and January 1988. This survey illustrates a very considerable variation in the formal teaching of physics to aspiring radiation oncologists with, for example, the number of hours offered ranging from 40 to 160 in those 10 centres that have a training program. It would appear to be of benefit to radiation oncology residents, those charged with teaching them, and the radiation oncology community as a whole, to develop specific guidelines for this aspect of resident education. (8 refs., tab.)

  20. Explaining fruit and vegetable intake using a consumer marketing tool.

    Science.gov (United States)

    Della, Lindsay J; Dejoy, David M; Lance, Charles E

    2009-10-01

    In response to calls to reinvent the 5 A Day fruit and vegetable campaign, this study assesses the utility of VALS, a consumer-based audience segmentation tool that divides the U.S. population into groups leading similar lifestyles. The study examines whether the impact of theory of planned behavior (TPB) constructs varies across VALS groups in a cross-sectional sample of 1,588 U.S. adults. In a multigroup structural equation model, the VALS audience group variable moderated latent TPB relationships. Attitudes, subjective norms, and perceived behavioral control explained 57% to 70% of the variation in intention to eat fruit and vegetables across 5 different VALS groups. Perceived behavioral control and intention also predicted self-reported consumption behavior (R2 = 20% to 71% across VALS groups). Bivariate z tests were calculated to determine statistical differences in parameter estimates across groups. Nine of the bivariate z tests were statistically significant (p audiences for fruit and vegetable consumption messaging.

  1. Can Nomenclature for the Body be Explained by Embodiment Theories?

    Science.gov (United States)

    Majid, Asifa; van Staden, Miriam

    2015-10-01

    According to widespread opinion, the meaning of body part terms is determined by salient discontinuities in the visual image; such that hands, feet, arms, and legs, are natural parts. If so, one would expect these parts to have distinct names which correspond in meaning across languages. To test this proposal, we compared three unrelated languages-Dutch, Japanese, and Indonesian-and found both naming systems and boundaries of even basic body part terms display variation across languages. Bottom-up cues alone cannot explain natural language semantic systems; there simply is not a one-to-one mapping of the body semantic system to the body structural description. Although body parts are flexibly construed across languages, body parts semantics are, nevertheless, constrained by non-linguistic representations in the body structural description, suggesting these are necessary, although not sufficient, in accounting for aspects of the body lexicon. Copyright © 2015 Cognitive Science Society, Inc.

  2. The "Nursing Home Compare" measure of urinary/fecal incontinence: cross-sectional variation, stability over time, and the impact of case mix.

    Science.gov (United States)

    Li, Yue; Schnelle, John; Spector, William D; Glance, Laurent G; Mukamel, Dana B

    2010-02-01

    To assess the impact of facility case mix on cross-sectional variations and short-term stability of the "Nursing Home Compare" incontinence quality measure (QM) and to determine whether multivariate risk adjustment can minimize such impacts. Retrospective analyses of the 2005 national minimum data set (MDS) that included approximately 600,000 long-term care residents in over 10,000 facilities in each quarterly sample. Mixed logistic regression was used to construct the risk-adjusted QM (nonshrinkage estimator). Facility-level ordinary least-squares models and adjusted R(2) were used to estimate the impact of case mix on cross-sectional and short-term longitudinal variations of currently published and risk-adjusted QMs. At least 50 percent of the cross-sectional variation and 25 percent of the short-term longitudinal variation of the published QM are explained by facility case mix. In contrast, the cross-sectional and short-term longitudinal variations of the risk-adjusted QM are much less susceptible to case-mix variations (adjusted R(2)case-mix variations across facilities and over time, and therefore it may be biased. This issue can be largely addressed by multivariate risk adjustment using risk factors available in the MDS.

  3. 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

  4. 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.

  5. 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.

  6. Attitudes toward the use of gender-inclusive language among residency trainees

    Science.gov (United States)

    Guyatt, G H; Cook, D J; Griffith, L; Walter, S D; Risdon, C; Liutkus, J

    1997-01-01

    OBJECTIVE: To explore postgraduate medical trainees' attitudes toward the use of gender-inclusive language. DESIGN: Self-administered questionnaire. SETTING: Seven residency training programs at McMaster University, Hamilton, Ont., from July 1993 to June 1994. PARTICIPANTS: Of 225 residents in the programs, 186 responded to the survey, for a response rate of 82.7%. Men and women were equally represented among the respondents. OUTCOME MEASURES: Categorization of attitudes about the use of language as gender-inclusive or gender-exclusive; characteristics predicting a gender-inclusive attitude. RESULTS: Factor analysis and Cronbach's alpha (0.90) supported the existence of a construct related to attitudes about language use, the poles of which were categorized as gender-inclusive and gender-exclusive. The authors classified residents with respect to their attitudes to language use from their responses to the questionnaire. In univariate analyses, sex, residency program and country of graduation significantly predicted a gender-inclusive attitude (p < 0.01). Only the first 2 variables were significant in a multivariate model; residency program explained 18% of the variance and sex 3%. Residents in obstetrics and gynecology and psychiatry had the most gender-inclusive attitudes, whereas residents in surgery and anesthesia had the most gender-exclusive attitudes. CONCLUSIONS: Residents' values are reflected in the language they choose to use. Language use may provide an index of underlying attitudes that may create hostile environments for female trainees. PMID:9145055

  7. Does neuroticism explain variations in care service use for mental health problems in the general population?

    NARCIS (Netherlands)

    ten Have, M; Oldehinkel, A; Vollebergh, W; Ormel, J

    Little is known about the role of personality characteristics in service utilisation for mental health problems. We investigate whether neuroticism: 1) predicts the use of primary and specialised care services for mental health problems, independently of whether a person has an emotional disorder;

  8. Motives underlying healthy eating: using the Food Choice Questionnaire to explain variation in dietary intake.

    Science.gov (United States)

    Pollard, T M; Steptoe, A; Wardle, J

    1998-04-01

    The Food Choice Questionnaire (FCQ), which measures the reported importance to a given individual of nine factors underlying food choice, and a food frequency questionnaire, were administered to 241 participants, who were also required to classify their diet as either 'standard', 'low in red meat' or 'vegetarian'. Respondents describing their diet as low in red meat attributed greater importance to health, natural content, weight control and ethical concern in their food choice than did those who described their diets as standard, whereas vegetarians differed significantly from those with a standard diet only on the score for ethical concern. Differences between men and women and between students and non-students in the frequency of consumption of a number of foods were shown to be mediated by differences in the importance attached to FCQ factors. Thus the generally healthier diets of women compared to men appeared to be accounted for by the greater importance attributed by women to weight control, natural content and ethical concerns.

  9. Explaining individual variation in patterns of mass loss in breeding birds

    Directory of Open Access Journals (Sweden)

    Cuthill Innes C

    2006-05-01

    Full Text Available Abstract Background Studies of birds have a disproportionate representation in the literature on life-history evolution, because of the (apparent ease with which the costs and benefits can be quantified and manipulated. During reproduction, birds frequently show a highly conserved pattern of mass change and changes in mass loss during breeding have been widely considered to be a valid short-term measure of the costs of reproduction. Experimental manipulations of the breeding attempts of birds usually argue that the presence of a response shows that a cost of reproduction exists, but there is little consensus as to how the size of these costs can be measured. Results We model this mass loss by considering how a parent can maximise its lifetime reproductive success, using a theoretical framework that is particularly suited to modelling parental care in altricial birds. If lifetime reproductive success is taken to be the sum of a parent's current and future reproductive success, we show that the exact forms of these components will influence the optimal amount of mass a parent should lose. In particular, we demonstrate that the shape of the relationship between parental investment and chick survival will lead to differing degrees of investment between parents of different initial qualities: parents with initially high levels of energy reserves could conceivably invested a lesser, similar or greater amount of resources than parents with initially low reserves, and these initially 'heavy' parents could potentially end up being lighter than the initially 'lighter' individuals. Conclusion We argue that it is difficult to make predictions about the dependence of a parent's final mass on its initial mass, and therefore mass loss should only be used as a short-term measure of the costs of reproduction with caution. The model demonstrates that we require a better understanding of the relationship between mass loss and both current and future reproductive success of the parent, before predictions about mass loss can be made and tested. We discuss steps that could be taken to increase the accuracy of our predictions.

  10. Explaining Variation in the Apprehension of Mexican Drug Trafficking Cartel Leaders

    Science.gov (United States)

    2010-06-01

    modelo democratico de seguridad cuidadana: entre la justicia civica y el sistema penal,” in Transnational Crime and Public Security: Challenges to...be unlikely to fabricate for purposes of promoting itself. A review of the DEA’s Web site for press releases and histories for information regarding...Camarena, has continued to the present, as illustrated by the following excerpt drawn from the DEA’s web -site in April 2010: The DEA has

  11. The Politics of Process Implementation: Explaining Variations Across Units in a High-Tech Firm

    DEFF Research Database (Denmark)

    Müller, Sune Dueholm

    political strategies for adopting consensus or conflict based leadership styles and management practices to process implementation depending on the actors' response patterns. The developed concepts and propositions contribute to the streams of literature on process innovation and Software Process...

  12. Explaining technical inefficiency and the variation in income from apple adoption in highland Ethiopia

    NARCIS (Netherlands)

    Alemu, Sintayehu Hailu; Kempen, van Luuk; Ruben, Ruerd

    2017-01-01

    This paper considers the performance and quality of apple fruits and seedlings production in Chencha district of southern Ethiopia. The estimated, three-factor (labour, land and capital) production frontier reveals that the technical inefficiency is 60% and 48% for fruits and seedlings

  13. Explaining variation in perceived team effectiveness: Results from eleven quality improvement collaboratives

    NARCIS (Netherlands)

    M.M.H. Strating (Mathilde); A.P. Nieboer (Anna)

    2013-01-01

    textabstractAims and objectives. Explore effectiveness of 11 collaboratives focusing on 11 different topics, as perceived by local improvement teams and to explore associations with collaborative-, organisational- and team-level factors. Background. Evidence underlying the effectiveness of quality

  14. The importance of adult life-span perspective in explaining variations in political ideology.

    Science.gov (United States)

    Sedek, Grzegorz; Kossowska, Malgorzata; Rydzewska, Klara

    2014-06-01

    As a comment on Hibbing et al.'s paper, we discuss the evolution of political and social views from more liberal to more conservative over the span of adulthood. We show that Hibbing et al.'s theoretical model creates a false prediction from this developmental perspective, as increased conservatism in the adult life-span trajectory is accompanied by the avoidance of negative bias.

  15. Influences on Tobacco Control Funding Decisions: Explaining State Variation in Appropriations

    Science.gov (United States)

    2003-01-01

    18 and older) in all states was 23.3%, far short of the national goal of reducing adult smoking prevalence to 15% (CDC, 2002; Mendez & Warner, 2000...Multiple levels, multiple agendas. Quorum Books: Westport CT, 1995. Mendez D, Warner K. Smoking prevalence in 2010: Why the healthy people goal is...1998. Siegel M, Carol J, Jordan J, Hobart R, Schoenmarklin S, DuMelle F, Fisher P. Preemption in tobacco control: Review of an emerging public health

  16. The interplay between mouth and mind : explaining variation in taste-related brain activation

    NARCIS (Netherlands)

    Rijn, van Inge

    2016-01-01

    Food does not always ‘taste’ the same. During hunger, for example, food may be tastier compared to during satiety. Many other internal and external factors affect the way we experience our food and make it a dynamic process. Our brain is responsible for weighing and integrating these factors and

  17. Nest attentiveness and egg temperature do not explain the variation in incubation periods in tropical birds

    NARCIS (Netherlands)

    Tieleman, Bernadine; Ricklefs, R.E.; Williams, J.B.

    2004-01-01

    The wide range in incubation periods among bird species has puzzled biologists for decades, because an extended egg-phase increases time-dependent mortality of the eggs. We investigated a recently proposed mechanistic explanation inspired by life-history theory, suggesting that adults may increase

  18. Explaining cross-national variation in the relationship between priority congruence and satisfaction with democracy

    DEFF Research Database (Denmark)

    Reher, Stefanie

    2015-01-01

    Previous research has shown that citizens tend to be more satisfied with the functioning of democracy when their ideological positions are more proximate to representatives’.This article argues that congruence in policy priorities between citizens and political elites should have a similar effect...

  19. CAN GALACTIC CHEMICAL EVOLUTION EXPLAIN THE OXYGEN ISOTOPIC VARIATIONS IN THE SOLAR SYSTEM?

    International Nuclear Information System (INIS)

    Lugaro, Maria; Liffman, Kurt; Ireland, Trevor R.; Maddison, Sarah T.

    2012-01-01

    A number of objects in primitive meteorites have oxygen isotopic compositions that place them on a distinct, mass-independent fractionation line with a slope of one on a three-isotope plot. The most popular model for describing how this fractionation arose assumes that CO self-shielding produced 16 O-rich CO and 16 O-poor H 2 O, where the H 2 O subsequently combined with interstellar dust to form relatively 16 O-poor solids within the solar nebula. Another model for creating the different reservoirs of 16 O-rich gas and 16 O-poor solids suggests that these reservoirs were produced by Galactic chemical evolution (GCE) if the solar system dust component was somewhat younger than the gas component and both components were lying on the line of slope one in the O three-isotope plot. We argue that GCE is not the cause of mass-independent fractionation of the oxygen isotopes in the solar system. The GCE scenario is in contradiction with observations of the 18 O/ 17 O ratios in nearby molecular clouds and young stellar objects. It is very unlikely for GCE to produce a line of slope one when considering the effect of incomplete mixing of stellar ejecta in the interstellar medium. Furthermore, the assumption that the solar system dust was younger than the gas requires unusual timescales or the existence of an important stardust component that is not theoretically expected to occur nor has been identified to date.

  20. Explaining regional variation in home care use by demand and supply variables

    NARCIS (Netherlands)

    van Noort, Leendert Olivier; Schotanus, Fredo; van der Klundert, Joris; Telgen, Jan

    In the Netherlands, home care services like district nursing and personal assistance are provided by private service provider organizations and covered by private health insurance companies which bear legal responsibility for purchasing these services. To improve value for money, their procurement

  1. Natural Diversity in Pentose Fermentation Is Explained by Variations in Histone Deacetylases

    Directory of Open Access Journals (Sweden)

    Zvi Tamari

    2016-01-01

    Full Text Available The extent to which carbon flux is directed toward fermentation versus respiration differs between cell types and environmental conditions. Understanding the basic cellular processes governing carbon flux is challenged by the complexity of the metabolic and regulatory networks. To reveal the genetic basis for natural diversity in channeling carbon flux, we applied quantitative trait loci analysis by phenotyping and genotyping hundreds of individual F2 segregants of budding yeast that differ in their capacity to ferment the pentose sugar xylulose. Causal alleles were mapped to the RXT3 and PHO23 genes, two components of the large Rpd3 histone deacetylation complex. We show that these allelic variants modulate the expression of SNF1/AMPK-dependent respiratory genes. Our results suggest that over close evolutionary distances, diversification of carbon flow is driven by changes in global regulators, rather than adaptation of specific metabolic nodes. Such regulators may improve the ability to direct metabolic fluxes for biotechnological applications.

  2. Table for two : Explaining variations in the evaluation of authenticity by restaurant critics

    NARCIS (Netherlands)

    Lomi, Alessandro; Giachanou, Anastasia; Crestani, Fabio; Angelopoulos, Spyros

    2018-01-01

    In this paper, we present the preliminary results of a study on the relationship between organizational identity, multiple categorical affiliation and evaluation. More specifically, we are interested in understanding how food critics’ evaluation of restaurants and their judgments of authenticity of

  3. To what extent does IQ 'explain' socio-economic variations in function?

    Directory of Open Access Journals (Sweden)

    van Eijk Jacques

    2007-07-01

    Full Text Available Abstract Background The aims of this study were to examine the extent to which higher intellectual abilities protect higher socio-economic groups from functional decline and to examine whether the contribution of intellectual abilities is independent of childhood deprivation and low birth weight and other socio-economic and developmental factors in early life. Methods The Maastricht Aging Study (MAAS is a prospective cohort study based upon participants in a registration network of general practices in The Netherlands. Information was available on 1211 men and women, 24 – 81 years old, who were without cognitive impairment at baseline (1993 – 1995, who ever had a paid job, and who participated in the six-year follow-up. Main outcomes were longitudinal decline in important components of quality of life and successful aging, i.e., self-reported physical, affective, and cognitive functioning. Results Persons with a low occupational level at baseline showed more functional decline than persons with a high occupational level. Socio-economic and developmental factors from early life hardly contributed to the adult socio-economic differences in functional decline. Intellectual abilities, however, took into account more than one third of the association between adult socio-economic status and functional decline. The contribution of the intellectual abilities was independent of the early life factors. Conclusion Rather than developmental and socio-economic characteristics of early life, the findings substantiate the importance of intellectual abilities for functional decline and their contribution – as potential, but neglected confounders – to socio-economic differences in functioning, successful aging, and quality of life. The higher intellectual abilities in the higher socio-economic status groups may also underlie the higher prevalences of mastery, self-efficacy and efficient coping styles in these groups.

  4. Optimization of Occupancy Based Demand Controlled Ventilation in Residences

    DEFF Research Database (Denmark)

    Mortensen, Dorthe Kragsig; Walker, Iain; Sherman, Max

    2011-01-01

    Although it has been used for many years in commercial buildings, the application of demand controlled ventilation in residences is limited. In this study we used occupant exposure to pollutants integrated over time (referred to as "dose") as the metric to evaluate the effectiveness and air quality...... implications of demand controlled ventilation in residences. We looked at air quality for two situations. The first is that typically used in ventilation standards: the exposure over a long term. The second is to look at peak exposures that are associated with time variations in ventilation rates and pollutant...... when occupied. We used analytical solutions to the continuity equation to determine the ventilation effectiveness and the long-term chronic dose and peak acute exposure for a representative range of occupancy periods, pollutant generation rates and airflow rates. The results of the study showed that we...

  5. Comparison of radiology residency programs in ten countries

    International Nuclear Information System (INIS)

    Willatt, J.M.G.; Mason, A.C.

    2006-01-01

    The purpose of our study was to compare various aspects of radiology training schemes in ten countries. A questionnaire was sent to senior residents in the UK, USA, Canada, Australia, New Zealand, Italy, Egypt, India, Malaysia and Greece. The questions concerned length of training, required pre-training experience, the organization of the training scheme, teaching, resources, stages at which residents can independently perform and report examinations, fellowships, and progression to jobs. A wide variety of training, ranging from highly scheduled programs with detailed aims and objectives, to self-learning occurs across the world. Examinations and assessments are also variable. There are lessons to be learned from varying practices; more exchanges of ideas should be encouraged. In view of the ''internationalization'' of radiology services and the variation in training styles an international qualification for quality assurance purposes may be desirable. (orig.)

  6. 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.

  7. 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

  8. 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.

  9. Effect of viscosity on tear drainage and ocular residence time.

    Science.gov (United States)

    Zhu, Heng; Chauhan, Anuj

    2008-08-01

    An increase in residence time of dry eye medications including artificial tears will likely enhance therapeutic benefits. The drainage rates and the residence time of eye drops depend on the viscosity of the instilled fluids. However, a quantitative understanding of the dependence of drainage rates and the residence time on viscosity is lacking. The current study aims to develop a mathematical model for the drainage of Newtonian fluids and also for power-law non-Newtonian fluids of different viscosities. This study is an extension of our previous study on the mathematical model of tear drainage. The tear drainage model is modified to describe the drainage of Newtonian fluids with viscosities higher than the tear viscosity and power-law non-Newtonian fluids with rheological parameters obtained from fitting experimental data in literature. The drainage rate through canaliculi was derived from the modified drainage model and was incorporated into a tear mass balance to calculate the transients of total solute quantity in ocular fluids and the bioavailability of instilled drugs. For Newtonian fluids, increasing the viscosity does not affect the drainage rate unless the viscosity exceeds a critical value of about 4.4 cp. The viscosity has a maximum impact on drainage rate around a value of about 100 cp. The trends are similar for shear thinning power law fluids. The transients of total solute quantity, and the residence time agrees at least qualitatively with experimental studies. A mathematical model has been developed for the drainage of Newtonian fluids and power-law fluids through canaliculi. The model can quantitatively explain different experimental observations on the effect of viscosity on the residence of instilled fluids on the ocular surface. The current study is helpful for understanding the mechanism of fluid drainage from the ocular surface and for improving the design of dry eye treatments.

  10. 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.

  11. SOME THEORETICAL MODELS EXPLAINING ADVERTISING EFFECTS

    Directory of Open Access Journals (Sweden)

    Vasilica Magdalena SOMEŞFĂLEAN

    2014-06-01

    Full Text Available Persuade clients is still the main focus of the companies, using a set of methods and techniques designed to influence their behavior, in order to obtain better results (profits over a longer period of time. Since the late nineteenth - early twentieth century, the american E.St.Elmo Lewis, considered a pioneer in advertising and sales, developed the first theory, AIDA model, later used by marketers and advertisers to develop a marketing communications strategy. Later studies have developed other models that are the main subject of this research, which explains how and why persuasive communication works, to understand why some approaches are effective and others are not.

  12. Weaker dental enamel explains dental decay.

    Science.gov (United States)

    Vieira, Alexandre R; Gibson, Carolyn W; Deeley, Kathleen; Xue, Hui; Li, Yong

    2015-01-01

    Dental caries continues to be the most prevalent bacteria-mediated non-contagious disease of humankind. Dental professionals assert the disease can be explained by poor oral hygiene and a diet rich in sugars but this does not account for caries free individuals exposed to the same risk factors. In order to test the hypothesis that amount of amelogenin during enamel development can influence caries susceptibility, we generated multiple strains of mice with varying levels of available amelogenin during dental development. Mechanical tests showed that dental enamel developed with less amelogenin is "weaker" while the dental enamel of animals over-expressing amelogenin appears to be more resistant to acid dissolution.

  13. A matching-allele model explains host resistance to parasites.

    Science.gov (United States)

    Luijckx, Pepijn; Fienberg, Harris; Duneau, David; Ebert, Dieter

    2013-06-17

    The maintenance of genetic variation and sex despite its costs has long puzzled biologists. A popular idea, the Red Queen Theory, is that under rapid antagonistic coevolution between hosts and their parasites, the formation of new rare host genotypes through sex can be advantageous as it creates host genotypes to which the prevailing parasite is not adapted. For host-parasite coevolution to lead to an ongoing advantage for rare genotypes, parasites should infect specific host genotypes and hosts should resist specific parasite genotypes. The most prominent genetics capturing such specificity are matching-allele models (MAMs), which have the key feature that resistance for two parasite genotypes can reverse by switching one allele at one host locus. Despite the lack of empirical support, MAMs have played a central role in the theoretical development of antagonistic coevolution, local adaptation, speciation, and sexual selection. Using genetic crosses, we show that resistance of the crustacean Daphnia magna against the parasitic bacterium Pasteuria ramosa follows a MAM. Simulation results show that the observed genetics can explain the maintenance of genetic variation and contribute to the maintenance of sex in the facultatively sexual host as predicted by the Red Queen Theory. Copyright © 2013 Elsevier Ltd. All rights reserved.

  14. A Conceptual Characterization of Online Videos Explaining Natural Selection

    Science.gov (United States)

    Bohlin, Gustav; Göransson, Andreas; Höst, Gunnar E.; Tibell, Lena A. E.

    2017-11-01

    Educational videos on the Internet comprise a vast and highly diverse source of information. Online search engines facilitate access to numerous videos claiming to explain natural selection, but little is known about the degree to which the video content match key evolutionary content identified as important in evolution education research. In this study, we therefore analyzed the content of 60 videos accessed through the Internet, using a criteria catalog with 38 operationalized variables derived from research literature. The variables were sorted into four categories: (a) key concepts (e.g. limited resources and inherited variation), (b) threshold concepts (abstract concepts with a transforming and integrative function), (c) misconceptions (e.g. that evolution is driven by need), and (d) organismal context (e.g. animal or plant). The results indicate that some concepts are frequently communicated, and certain taxa are commonly used to illustrate concepts, while others are seldom included. In addition, evolutionary phenomena at small temporal and spatial scales, such as subcellular processes, are rarely covered. Rather, the focus is on population-level events over time scales spanning years or longer. This is consistent with an observed lack of explanations regarding how randomly occurring mutations provide the basis for variation (and thus natural selection). The findings imply, among other things, that some components of natural selection warrant far more attention in biology teaching and science education research.

  15. Buzz Factor or Innovation Potential: What Explains Cryptocurrencies’ Returns?

    Science.gov (United States)

    Wang, Sha

    2017-01-01

    Cryptocurrencies have become increasingly popular since the introduction of bitcoin in 2009. In this paper, we identify factors associated with variations in cryptocurrencies’ market values. In the past, researchers argued that the “buzz” surrounding cryptocurrencies in online media explained their price variations. But this observation obfuscates the notion that cryptocurrencies, unlike fiat currencies, are technologies entailing a true innovation potential. By using, for the first time, a unique measure of innovation potential, we find that the latter is in fact the most important factor associated with increases in cryptocurrency returns. By contrast, we find that the buzz surrounding cryptocurrencies is negatively associated with returns after controlling for a variety of factors, such as supply growth and liquidity. Also interesting is our finding that a cryptocurrency’s association with fraudulent activity is not negatively associated with weekly returns—a result that further qualifies the media’s influence on cryptocurrencies. Finally, we find that an increase in supply is positively associated with weekly returns. Taken together, our findings show that cryptocurrencies do not behave like traditional currencies or commodities—unlike what most prior research has assumed—and depict an industry that is much more mature, and much less speculative, than has been implied by previous accounts. PMID:28085906

  16. Buzz Factor or Innovation Potential: What Explains Cryptocurrencies' Returns?

    Science.gov (United States)

    Wang, Sha; Vergne, Jean-Philippe

    2017-01-01

    Cryptocurrencies have become increasingly popular since the introduction of bitcoin in 2009. In this paper, we identify factors associated with variations in cryptocurrencies' market values. In the past, researchers argued that the "buzz" surrounding cryptocurrencies in online media explained their price variations. But this observation obfuscates the notion that cryptocurrencies, unlike fiat currencies, are technologies entailing a true innovation potential. By using, for the first time, a unique measure of innovation potential, we find that the latter is in fact the most important factor associated with increases in cryptocurrency returns. By contrast, we find that the buzz surrounding cryptocurrencies is negatively associated with returns after controlling for a variety of factors, such as supply growth and liquidity. Also interesting is our finding that a cryptocurrency's association with fraudulent activity is not negatively associated with weekly returns-a result that further qualifies the media's influence on cryptocurrencies. Finally, we find that an increase in supply is positively associated with weekly returns. Taken together, our findings show that cryptocurrencies do not behave like traditional currencies or commodities-unlike what most prior research has assumed-and depict an industry that is much more mature, and much less speculative, than has been implied by previous accounts.

  17. Buzz Factor or Innovation Potential: What Explains Cryptocurrencies' Returns?

    Directory of Open Access Journals (Sweden)

    Sha Wang

    Full Text Available Cryptocurrencies have become increasingly popular since the introduction of bitcoin in 2009. In this paper, we identify factors associated with variations in cryptocurrencies' market values. In the past, researchers argued that the "buzz" surrounding cryptocurrencies in online media explained their price variations. But this observation obfuscates the notion that cryptocurrencies, unlike fiat currencies, are technologies entailing a true innovation potential. By using, for the first time, a unique measure of innovation potential, we find that the latter is in fact the most important factor associated with increases in cryptocurrency returns. By contrast, we find that the buzz surrounding cryptocurrencies is negatively associated with returns after controlling for a variety of factors, such as supply growth and liquidity. Also interesting is our finding that a cryptocurrency's association with fraudulent activity is not negatively associated with weekly returns-a result that further qualifies the media's influence on cryptocurrencies. Finally, we find that an increase in supply is positively associated with weekly returns. Taken together, our findings show that cryptocurrencies do not behave like traditional currencies or commodities-unlike what most prior research has assumed-and depict an industry that is much more mature, and much less speculative, than has been implied by previous accounts.

  18. Can we explain the observed methane variability after the Mount Pinatubo eruption?

    NARCIS (Netherlands)

    Banda, Narcisa; Krol, M.; Van Weele, M.; Van Noije, T.; Le Sager, P.; Röckmann, T.

    2016-01-01

    The CH4 growth rate in the atmosphere showed large variations after the Pinatubo eruption in June 1991. A decrease of more than 10 ppb yr-1 in the growth rate over the course of 1992 was reported, and a partial recovery in the following year. Although several reasons have been proposed to explain

  19. Beyond dichotomous explanations: Explaining constitutional control of the executieve with fuzzy-sets.

    NARCIS (Netherlands)

    Pennings, P.J.M.

    2003-01-01

    What are the main variations in the constitutional control of the executive in 45 parliamentary democracies and how can these differences be accounted for? Four competing hypotheses, based on dichotomies, explain the degree of this control by means of contrasting institutional settings: consensus

  20. Beyond dichotomous explanations: explaining constitutional control of the executive with fuzzy-sets

    NARCIS (Netherlands)

    Pennings, P.J.M.

    2003-01-01

    What are the main variations in the constitutional control of the executive in 45 parliamentary democracies and how can these differences be accounted for? Four competing hypotheses, based on dichotomies, explain the degree of this control by means of contrasting institutional settings: consensus

  1. [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

  2. Communication skills in pediatric training program: National-based survey of residents' perspectives in Saudi Arabia.

    Science.gov (United States)

    Alofisan, Tariq; Al-Alaiyan, Saleh; Al-Abdulsalam, Moath; Siddiqui, Khawar; Hussain, Ibrahim Bin; Al-Qahtani, Mohammad H

    2016-01-01

    Good communication skills and rapport building are considered the cardinal tools for developing a patient-doctor relationship. A positive, healthy competition among different health care organizations in Saudi Arabia underlines an ever increasing emphasis on effective patient-doctor relationship. Despite the numerous guidelines provided and programs available, there is a significant variation in the acceptance and approach to the use of this important tool among pediatric residents in this part of the world. To determine pediatric residents' attitude toward communication skills, their perception of important communication skills, and their confidence in the use of their communication skills in the performance of their primary duties. A cross-sectional study was conducted among all pediatrics trainee residents working in 13 different hospitals in Saudi Arabia. A standardized self-administered questionnaire developed by the Harvard Medical School was used. A total of 297 residents out of all trainees in these centers participated in the data collection. The 283 (95%) residents considered learning communication skills a priority in establishing a good patient-doctor relationship. Thirty four percent reported being very confident with regard to their communication skills. Few residents had the skills, and the confidence to communicate with children with serious diseases, discuss end-of-life issues, and deal with difficult patients and parents. Pediatric residents perceive the importance of communication skills and competencies as crucial components in their training. A proper comprehensive communication skills training should be incorporated into the pediatric resident training curriculum.

  3. EXPLAINING THE ASSOCIATION BETWEEN INCARCERATION AND DIVORCE*

    Science.gov (United States)

    Siennick, Sonja E.; Stewart, Eric A.; Staff, Jeremy

    2014-01-01

    Recent studies have suggested that incarceration dramatically increases the odds of divorce, but we know little about the mechanisms that explain the association. This study uses prospective longitudinal data from a subset of married young adults in the National Longitudinal Study of Adolescent Health (N = 1,919) to examine whether incarceration is associated with divorce indirectly via low marital love, economic strain, relationship violence, and extramarital sex. The findings confirmed that incarcerations occurring during, but not before, a marriage were associated with an increased hazard of divorce. Incarcerations occurring during marriage also were associated with less marital love, more relationship violence, more economic strain, and greater odds of extramarital sex. Above-average levels of economic strain were visible among respondents observed preincarceration, but only respondents observed postincarceration showed less marital love, more relationship violence, and higher odds of extramarital sex than did respondents who were not incarcerated during marriage. These relationship problems explained approximately 40 percent of the association between incarceration and marital dissolution. These findings are consistent with theoretical predictions that a spouse’s incarceration alters the rewards and costs of the marriage and the relative attractiveness of alternative partners. PMID:25598544

  4. Explaining mastitis incidence in Dutch dairy farming: the influence of farmers' attitudes and behaviour.

    Science.gov (United States)

    Jansen, J; van den Borne, B H P; Renes, R J; van Schaik, G; Lam, T J G M; Leeuwis, C

    2009-11-15

    When mastitis incidence increases, either infection pressure has increased or cows' resistance has decreased. This usually indicates that farm management is not optimal. Numerous quantitative studies have demonstrated the effect of management practices on mastitis. In most of these studies, the identified risk factors could explain only part of the variance in mastitis incidence on farms. Several studies suggest that the unexplained variance is caused by farmers' attitudes towards different aspects of mastitis treatment and preventive behaviour. This study aims to determine, to quantify and to specify the extent to which farmers' attitudes, over and above farmers' behaviour, are factors that explain the variation in mastitis incidence, measured in terms of the quantifiable effect of management factors. An extensive survey on self-reported attitudes, behaviour and mastitis incidence was conducted on 336 Dutch dairy farms. Results of multiple linear regression analyses show that farmers' self-reported behaviour and attitudes together explain 48%, 31% and 23% of the variation within, respectively, the average farm bulk milk somatic cell count (BMSCC), the clinical mastitis incidence and the combined clinical and subclinical mastitis incidence. Both behaviour and attitudes explain part of the variance. However, most of the variance in all three dependant measures is explained solely by the attitude variables. The variation in BMSCC value is best explained by (1) farmers' normative frame of reference about mastitis, (2) farmers' perceptions about the control of mastitis and (3) the perceived effect of a BMSCC penalty level. The variation in clinical mastitis is best explained by farmers' perceptions about mastitis control. The variation in the combined clinical and subclinical mastitis incidence rate is best explained by the perceived effect of a BMSCC penalty level and the frequency of contact with others. The results of this study show that farmers' attitudes are a

  5. 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

  6. Intracultural variation of knowledge about wild plant uses in the Biosphere Reserve Grosses Walsertal (Austria

    Directory of Open Access Journals (Sweden)

    Schunko Christoph

    2012-07-01

    Full Text Available Abstract Background Leading scholars in ethnobiology and ethnomedicine continuously stress the need for moving beyond the bare description of local knowledge and to additionally analyse and theorise about the characteristics and dynamics of human interactions with plants and related local knowledge. Analyses of the variation of local knowledge are thereby perceived as minimal standard. In this study we investigate the distribution and variation of wild plant knowledge in five domains: food, drinks, human medicine, veterinary medicine and customs. We assess relations between the wild plant knowledge of informants and their socio-demographic as well as geographic background. Method Research was conducted in the Biosphere Reserve Grosses Walsertal, Austria. Structured questionnaires were used to inquire wild plant knowledge from 433 informants with varying socio-demographic and geographic background. Children assisted in the data collection. Data was analysed using descriptive statistics and generalized linear models. Results and discussion A majority of respondents is familiar with wild plant uses, however to varying degrees. Knowledge variations depend on the socio-demographic and geographic background of the informants as well as on the domains of knowledge under investigation: women, older informants and homegardeners report more human medicinal applications and applications in drinks than men, younger informants and non-homegardeners; farmers know a greater variety of veterinary medicinal applications than non-farmers; the place of residence relates significantly to food and veterinary uses. Customs are difficult to investigate in standardized matrices. The household-related distribution of work and the general socio-cultural context are especially helpful in order to explain intracultural variation of knowledge in the Grosses Walsertal. Conclusions Research on the intracultural variation of local knowledge exposes cultural characteristics and

  7. The Effectiveness of Computer-Based Hypermedia Teaching Modules for Radiology Residents.

    Science.gov (United States)

    Azevedo, Roger; And Others

    This paper explains the rationale for utilizing computer-based, hypermedia tutorials for radiology education and presents the results of a field test of this educational technique. It discusses the development of the hypermedia tutorials at Montreal General Hospital (Quebec, Canada) in 1991-92 and their use in the radiology residency program. The…

  8. Generic Skills Development and Satisfaction with Groupwork among Business Students: Effect of Country of Permanent Residency

    Science.gov (United States)

    Teo, Stephen T. T.; Segal, Naomi; Morgan, Adam C.; Kandlbinder, Peter; Wang, Karen Y.; Hingorani, Anurag

    2012-01-01

    Purpose: The purpose of this study is to examine variables explaining students' positive and negative experiences of groupwork and connect country of residence with the perception of generic skills development and self-reported satisfaction with groupwork. It also aims to examine the effect of prior training in groups from the perspective of…

  9. Living environment matters: relationships between neighborhood characteristics and health of the residents in a Dutch municipality

    NARCIS (Netherlands)

    Putrik, Polina; de Vries, Nanne K.; Mujakovic, Suhreta; van Amelsvoort, Ludovic; Kant, Ijmert; Kunst, Anton E.; van Oers, Hans; Jansen, Maria

    2015-01-01

    Characteristics of an individual alone cannot exhaustively explain all the causes of poor health, and neighborhood of residence have been suggested to be one of the factors that contribute to health. However, knowledge about aspects of the neighborhood that are most important to health is limited.

  10. Living environment matters : Relationships between neighborhood characteristics and health of the residents in a Dutch municipality

    NARCIS (Netherlands)

    Putrik, P.; de Vries, N.K.; Mujakovic, S.; van Amelsvoort, L.; Kant, IJ.; Kunst, A.E.; van Oers, J.A.M.; Jansen, M.

    2015-01-01

    Characteristics of an individual alone cannot exhaustively explain all the causes of poor health, and neighborhood of residence have been suggested to be one of the factors that contribute to health. However, knowledge about aspects of the neighborhood that are most important to health is limited.

  11. Neurocritical care education during neurology residency

    Science.gov (United States)

    Drogan, O.; Manno, E.; Geocadin, R.G.; Ziai, W.

    2012-01-01

    Objective: Limited information is available regarding the current state of neurocritical care education for neurology residents. The goal of our survey was to assess the need and current state of neurocritical care training for neurology residents. Methods: A survey instrument was developed and, with the support of the American Academy of Neurology, distributed to residency program directors of 132 accredited neurology programs in the United States in 2011. Results: A response rate of 74% (98 of 132) was achieved. A dedicated neuroscience intensive care unit (neuro-ICU) existed in 64%. Fifty-six percent of residency programs offer a dedicated rotation in the neuro-ICU, lasting 4 weeks on average. Where available, the neuro-ICU rotation was required in the vast majority (91%) of programs. Neurology residents' exposure to the fundamental principles of neurocritical care was obtained through a variety of mechanisms. Of program directors, 37% indicated that residents would be interested in performing away rotations in a neuro-ICU. From 2005 to 2010, the number of programs sending at least one resident into a neuro-ICU fellowship increased from 14% to 35%. Conclusions: Despite the expansion of neurocritical care, large proportions of US neurology residents have limited exposure to a neuro-ICU and neurointensivists. Formal training in the principles of neurocritical care may be highly variable. The results of this survey suggest a charge to address the variability of resident education and to develop standardized curricula in neurocritical care for neurology residents. PMID:22573636

  12. Geographic Variations of Colorectal and Breast Cancer Late-Stage Diagnosis and the Effects of Neighborhood-Level Factors.

    Science.gov (United States)

    Lin, Yan; Wimberly, Michael C

    2017-04-01

    The purpose of this study was to examine the geographic variations of late-stage diagnosis in colorectal cancer (CRC) and breast cancer as well as to investigate the effects of 3 neighborhood-level factors-socioeconomic deprivation, urban/rural residence, and spatial accessibility to health care-on the late-stage risks. This study used population-based South Dakota cancer registry data from 2001 to 2012. A total of 4,878 CRC cases and 6,418 breast cancer cases were included in the analyses. Two-level logistic regression models were used to analyze the risk of late-stage CRC and breast cancer. For CRC, there was a small geographic variation across census tracts in late-stage diagnosis, and residing in isolated small rural areas was significantly associated with late-stage risk. However, this association became nonsignificant after adjusting for census-tract level socioeconomic deprivation. Socioeconomic deprivation was an independent predictor of CRC late-stage risk, and it explained the elevated risk among American Indians. No relationship was found between spatial accessibility and CRC late-stage risk. For breast cancer, no geographic variation in the late-stage diagnosis was observed across census tracts, and none of the 3 neighborhood-level factors was significantly associated with late-stage risk. Results suggested that socioeconomic deprivation, rather than spatial accessibility, contributed to CRC late-stage risks in South Dakota as a rural state. CRC intervention programs could be developed to target isolated small rural areas, socioeconomically disadvantaged areas, as well as American Indians residing in these areas. © 2016 National Rural Health Association.

  13. Explaining the democratic anchorage of governance networks

    DEFF Research Database (Denmark)

    Skelcher, Chris; Klijn, Erik-Hans; Kübler, Daniel

    2011-01-01

    Advances in understanding the democratic anchorage of governance networks require carefully designed and contextually grounded empirical analysis that take into account contextual factors. The article uses a conjectural framework to study the impact of the national democratic milieu...... on the relationship between network governance and representative institutions in four European countries: the United Kingdom, Switzerland, the Netherlands, and Denmark. The article shows that the distinction between majoritarian and consensus democracy as well as the varying strength of voluntary associations...... are important contextual factors that help explain cross-national differences in the relationship between governance networks and representative institutions. We conclude that a context of weak associationalism in majoritarian democracies facilitates the instrumentalization of networks by government actors...

  14. Explaining CMS lepton excesses with supersymmetry

    CERN Multimedia

    CERN. Geneva; Prof. Allanach, Benjamin

    2014-01-01

    1) Kostas Theofilatos will give an introduction to CMS result 2) Ben Allanach: Several CMS analyses involving di-leptons have recently reported small 2.4-2.8 sigma local excesses: nothing to get too excited about, but worth keeping an eye on nonetheless. In particular, a search in the $lljj p_T$(miss) channel, a search for $W_R$ in the $lljj$ channel and a di-leptoquark search in the $lljj$ channel and $ljj p_T$(miss) channel have all yielded small excesses. We interpret the first excess in the MSSM, showing that the interpretation is viable in terms of other constraints, despite only having squark masses of around 1 TeV. We can explain the last three excesses with a single R-parity violating coupling that predicts a non-zero contribution to the neutrinoless double beta decay rate.

  15. Explaining the moral of the story.

    Science.gov (United States)

    Walker, Caren M; Lombrozo, Tania

    2017-10-01

    Although storybooks are often used as pedagogical tools for conveying moral lessons to children, the ability to spontaneously extract "the moral" of a story develops relatively late. Instead, children tend to represent stories at a concrete level - one that highlights surface features and understates more abstract themes. Here we examine the role of explanation in 5- and 6-year-old children's developing ability to learn the moral of a story. Two experiments demonstrate that, relative to a control condition, prompts to explain aspects of a story facilitate children's ability to override salient surface features, abstract the underlying moral, and generalize that moral to novel contexts. In some cases, generating an explanation is more effective than being explicitly told the moral of the story, as in a more traditional pedagogical exchange. These findings have implications for moral comprehension, the role of explanation in learning, and the development of abstract reasoning in early childhood. Copyright © 2016 Elsevier B.V. All rights reserved.

  16. Explaining NDVI trends in northern Burkina Faso

    DEFF Research Database (Denmark)

    Rasmussen, Kjeld; Fensholt, Rasmus; Fog, Bjarne

    2014-01-01

    by a distinct spatial pattern and strongly dominated by negative trends in Normalized Difference Vegetation Index (NDVI). The aim of the paper is to explain this distinct pattern. When studied over the period 2000–2012, using NDVI data from the MODIS sensor the spatial pattern of NDVI trends indicates that non......-climatic factors are involved. By relating NDVI trends to landscape elements and land use change we demonstrate that NDVI trends in the north-western parts of the study area are mostly related to landscape elements, while this is not the case in the south-eastern parts, where rapidly changing land use, including....... expansion of irrigation, plays a major role. It is inferred that a process of increased redistribution of fine soil material, water and vegetation from plateaus and slopes to valleys, possibly related to higher grazing pressure, may provide an explanation of the observed pattern of NDVI trends. Further work...

  17. Can molecular cell biology explain chromosome motions?

    Directory of Open Access Journals (Sweden)

    Gagliardi L

    2011-05-01

    Full Text Available Abstract Background Mitotic chromosome motions have recently been correlated with electrostatic forces, but a lingering "molecular cell biology" paradigm persists, proposing binding and release proteins or molecular geometries for force generation. Results Pole-facing kinetochore plates manifest positive charges and interact with negatively charged microtubule ends providing the motive force for poleward chromosome motions by classical electrostatics. This conceptual scheme explains dynamic tracking/coupling of kinetochores to microtubules and the simultaneous depolymerization of kinetochore microtubules as poleward force is generated. Conclusion We question here why cells would prefer complex molecular mechanisms to move chromosomes when direct electrostatic interactions between known bound charge distributions can accomplish the same task much more simply.

  18. Explaining fast radio bursts through Dicke's superradiance

    Science.gov (United States)

    Houde, Martin; Mathews, Abhilash; Rajabi, Fereshteh

    2018-03-01

    Fast radio bursts (FRBs), characterized by strong bursts of radiation intensity at radio wavelengths lasting on the order of a millisecond, have yet to be firmly associated with a family, or families, of astronomical sources. It follows that despite the large number of proposed models, no well-defined physical process has been identified to explain this phenomenon. In this paper, we demonstrate how Dicke's superradiance, for which evidence has recently been found in the interstellar medium, can account for the characteristics associated with FRBs. Our analysis and modelling of previously detected FRBs suggest they could originate from regions in many ways similar to those known to harbour masers or megamasers, and result from the coherent radiation emanating from populations of molecules associated with large-scale entangled quantum mechanical states. We estimate this entanglement to involve as many as ˜1030 to ˜1032 molecules over distances spanning 100-1000 au.

  19. Explaining excess morbidity amongst homeless shelter users

    DEFF Research Database (Denmark)

    Benjaminsen, Lars; Birkelund, Jesper Fels

    2018-01-01

    AIMS: This article analyses excess morbidity amongst homeless shelter users compared to the general Danish population. The study provides an extensive control for confounding and investigates to what extent excess morbidity is explained by homelessness or other risk factors. METHODS: Data set...... includes administrative micro-data for 4,068,926 Danes who were 23 years or older on 1 January 2007. Nationwide data on shelter use identified 14,730 individuals as shelter users from 2002 to 2006. Somatic diseases were measured from 2007 to 2011 through diagnosis data from hospital discharges. The risk...... of somatic diseases amongst shelter users was analysed through a multivariate model that decomposed the total effect into a direct effect and indirect effects mediated by other risk factors. RESULTS: The excess morbidity associated with shelter use is substantially lower than in studies that did not include...

  20. Geographic variation and effect of area-level poverty rate on colorectal cancer screening.

    Science.gov (United States)

    Lian, Min; Schootman, Mario; Yun, Shumei

    2008-10-16

    With a secular trend of increasing colorectal cancer (CRC) screening, concerns about disparities in CRC screening also have been rising. It is unclear if CRC screening varies geographically, if area-level poverty rate affects CRC screening, and if individual-level characteristics mediate the area-level effects on CRC screening. Using 2006 Missouri Behavioral Risk Factor Surveillance System (BRFSS) data, a multilevel study was conducted to examine geographic variation and the effect of area-level poverty rate on CRC screening use among persons age 50 or older. Individuals were nested within ZIP codes (ZIP5 areas), which in turn, were nested within aggregations of ZIP codes (ZIP3 areas). Six groups of individual-level covariates were considered as potential mediators. An estimated 51.8% of Missourians aged 50 or older adhered to CRC screening recommendations. Nearly 15% of the total variation in CRC screening lay between ZIP5 areas. Persons residing in ZIP5 areas with > or = 10% of poverty rate had lower odds of CRC screening use than those residing in ZIP5 areas with poverty rate (unadjusted odds ratio [OR], 0.69; 95% confidence interval [95% CI], 0.58-0.81; adjusted OR, 0.81; 95% CI, 0.67-0.98). Persons who resided in ZIP3 areas with > or = 20% poverty rate also had lower odds of following CRC screening guidelines than those residing in ZIP3 areas with poverty rate (unadjusted OR, 0.66; 95% CI, 0.52-0.83; adjusted OR, 0.64; 95% CI, 0.50-0.83). Obesity, history of depression/anxiety and access to care were associated with CRC screening, but did not mediate the effect of area-level poverty on CRC screening. Large geographic variation of CRC screening exists in Missouri. Area-level poverty rate, independent of individual-level characteristics, is a significant predictor of CRC screening, but it only explains a small portion of the geographic heterogeneity of CRC screening. Individual-level factors we examined do not mediate the effect of the area-level poverty rate on

  1. PNEUMONIA IN NURSING HOME RESIDENTS

    Directory of Open Access Journals (Sweden)

    Renato Eržen

    2002-10-01

    Full Text Available Background. Pneumonia remains one of the leading causes of morbidity and mortality worldwide, especially in advanced age. Prognosis of the disease depends on premorbid condition and immune competence of the patient, severity of the disease and causative microorganism. In our analysis we wanted to establish clinical, x-ray and microbiological characteristics of pneumonia in nursing home residents, estimate suitability of therapeutic measures and find out risk factors for adverse outcome in this group of patients.Material and methods. This retrospective study includes all nursing home residents hospitalised due to CAP in Hospital Golnik in 2000. Clinical data was/were evaluated according to case history. Microbiological data and laboratory results were gathered from the patients files. Chi-square test was used for statistical analysis.Results. 30 patients, 17 women were included, aged 82.5 ± 11.7 years. 60% of patients had at least 2 accompanying diseases, most frequently cardiovascular and neurologic diseases. At admittance 83% of patients presented with severe form of the disease. Dispnea (93%, tachypnea, cough (67% and confusion (47% dominate clinical picture. Patients rarely expectorate, are frequently hypoxemic (93%, have leucocytosis (63%, electrolyte disturbances and elevated urea (67%. According to the microbiologic results most frequent causative agents are Enterobacteriae, S. pneumoniae, H. influenzae and also some multiresistant bacteria. Amoxycillin with clavulanic acid was the most frequently used antibiotic, followed by macrolides and 3rd generation cephalosporines.9 patients died, mortality rate was 30%. Their average age was 83,4 years, 67% of them had more than 2 accompanying diseases, all of them severe form of the disease, 89% severe respiratory insufficiency and 22% positive hemoculture.Conclusions. Patients are characterised with numerous comorbidities and advanced age. Clinical presentation is unspecific. Mortality is high

  2. Case-Logging Practices in Otolaryngology Residency Training: National Survey of Residents and Program Directors.

    Science.gov (United States)

    Dermody, Sarah M; Gao, William; McGinn, Johnathan D; Malekzadeh, Sonya

    2017-06-01

    Objective (1) Evaluate the consistency and manner in which otolaryngology residents log surgical cases. (2) Assess the extent of instruction and guidance provided by program directors on case-logging practices. Study Design Cross-sectional national survey. Setting Accreditation Council for Graduate Medical Education otolaryngology residency programs in the United States. Subjects and Methods US otolaryngology residents, postgraduate year 2 through graduating chiefs as of July 2016, were recruited to respond to an anonymous questionnaire designed to characterize surgical case-logging practices. Program directors of US otolaryngology residency programs were recruited to respond to an anonymous questionnaire to elucidate how residents are instructed to log cases. Results A total of 272 residents and 53 program directors completed the survey, yielding response rates of 40.6% and 49.5%, respectively. Perceived accuracy of case logs is low among residents and program directors. Nearly 40% of residents purposely choose not to log certain cases, and 65.1% of residents underreport cases performed. More than 80% of program directors advise residents to log procedures performed outside the operating room, yet only 16% of residents consistently log such cases. Conclusion Variability in surgical case-logging behaviors and differences in provided instruction highlight the need for methods to improve consistency of logging practices. It is imperative to standardize practices across otolaryngology residency programs for case logs to serve as an accurate measure of surgical competency. This study provides a foundation for reform efforts within residency programs and for the Resident Case Log System.

  3. Feasibility of an innovative third-year chief resident system: an internal medicine residency leadership study

    Directory of Open Access Journals (Sweden)

    Victor O. Kolade

    2014-07-01

    Full Text Available Introduction: The role of the internal medicine chief resident includes various administrative, academic, social, and educational responsibilities, fulfillment of which prepares residents for further leadership tasks. However, the chief resident position has historically only been held by a few residents. As fourth-year chief residents are becoming less common, we considered a new model for rotating third-year residents as the chief resident. Methods: Online surveys were given to all 29 internal medicine residents in a single university-based program after implementation of a leadership curriculum and specific job description for the third-year chief resident. Chief residents evaluated themselves on various aspects of leadership. Participation was voluntary. Descriptive statistics were generated using SPSS version 21. Results: Thirteen junior (first- or second-year resident responses reported that the chief residents elicited input from others (mean rating 6.8, were committed to the team (6.8, resolved conflict (6.7, ensured efficiency, organization and productivity of the team (6.7, participated actively (7.0, and managed resources (6.6. Responses from senior residents averaged 1 point higher for each item; this pattern repeated itself in teaching evaluations. Chief resident self-evaluators were more comfortable running a morning report (8.4 than with being chief resident (5.8. Conclusion: The feasibility of preparing internal medicine residents for leadership roles through a rotating PGY-3 (postgraduate year chief residency curriculum was explored at a small internal medicine residency, and we suggest extending the study to include other programs.

  4. Women residents, women physicians and medicine's future.

    Science.gov (United States)

    Serrano, Karen

    2007-08-01

    The number of women in medicine has increased dramatically in the last few decades, and women now represent half of all incoming medical students. Yet residency training still resembles the historical model when there were few women in medicine. This article reviews the issues facing women in residency today. Data suggest that the experience of female residents is more negative than that of males. Unique challenges facing female residents include the existence of gender bias and sexual harassment, a scarcity of female mentors in leadership positions, and work/family conflicts. Further research is needed to understand the experience of female residents and to identify barriers that hinder their optimal professional and personal development. Structural and cultural changes to residency programs are needed to better accommodate the needs of female trainees.

  5. Racial differences in dementia care among nursing home residents.

    Science.gov (United States)

    Sengupta, Manisha; Decker, Sandra L; Harris-Kojetin, Lauren; Jones, Adrienne

    2012-06-01

    This article aims to describe potential racial differences in dementia care among nursing home residents with dementia. Using data from the 2004 National Nursing Home Survey (NNHS) in regression models, the authors examine whether non-Whites are less likely than Whites to receive special dementia care--defined as receiving special dementia care services or being in a dementia special care unit (SCU)--and whether this difference derives from differences in resident or facility characteristics. The authors find that non-Whites are 4.3 percentage points less likely than Whites to receive special dementia care. The fact that non-Whites are more likely to rely on Medicaid and less likely to pay out of pocket for nursing home care explains part but not all of the difference. Most of the difference is due to the fact that non-Whites reside in facilities that are less likely to have special dementia care services or dementia care units, particularly for-profit facilities and those in the South.

  6. Motherhood during residency training: challenges and strategies.

    Science.gov (United States)

    Walsh, Allyn; Gold, Michelle; Jensen, Phyllis; Jedrzkiewicz, Michelle

    2005-07-01

    To determine what factors enable or impede women in a Canadian family medicine residency program from combining motherhood with residency training. To determine how policies can support these women, given that in recent decades the number of female family medicine residents has increased. Qualitative study using in-person interviews. McMaster University Family Medicine Residency Program. Twenty-one of 27 family medicine residents taking maternity leave between 1994 and 1999. Semistructured interviews. The research team reviewed transcripts of audiotaped interviews for emerging themes; consensus was reached on content and meaning. NVIVO software was used for data analysis. Long hours, unpredictable work demands, guilt because absences from work increase workload for colleagues, and residents' high expectations of themselves cause pregnant residents severe stress. This stress continues upon return to work; finding adequate child care is an added stress. Residents report receiving less support from colleagues and supervisors upon return to work; they associate this with no longer being visibly pregnant. Physically demanding training rotations put additional strain on pregnant residents and those newly returned to work. Flexibility in scheduling rotations can help accommodate needs at home. Providing breaks, privacy, and refrigerators at work can help maintain breastfeeding. Allowing residents to remain involved in academic and clinical work during maternity leave helps maintain clinical skills, build new knowledge, and promote peer support. Pregnancy during residency training is common and becoming more common. Training programs can successfully enhance the experience of motherhood during residency by providing flexibility at work to facilitate a healthy balance among the competing demands of family, work, and student life.

  7. Stress and burnout among Swiss dental residents

    OpenAIRE

    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...

  8. Geographic variation and effect of area-level poverty rate on colorectal cancer screening

    Directory of Open Access Journals (Sweden)

    Schootman Mario

    2008-10-01

    Full Text Available Abstract Background With a secular trend of increasing colorectal cancer (CRC screening, concerns about disparities in CRC screening also have been rising. It is unclear if CRC screening varies geographically, if area-level poverty rate affects CRC screening, and if individual-level characteristics mediate the area-level effects on CRC screening. Methods Using 2006 Missouri Behavioral Risk Factor Surveillance System (BRFSS data, a multilevel study was conducted to examine geographic variation and the effect of area-level poverty rate on CRC screening use among persons age 50 or older. Individuals were nested within ZIP codes (ZIP5 areas, which in turn, were nested within aggregations of ZIP codes (ZIP3 areas. Six groups of individual-level covariates were considered as potential mediators. Results An estimated 51.8% of Missourians aged 50 or older adhered to CRC screening recommendations. Nearly 15% of the total variation in CRC screening lay between ZIP5 areas. Persons residing in ZIP5 areas with ≥ 10% of poverty rate had lower odds of CRC screening use than those residing in ZIP5 areas with Conclusion Large geographic variation of CRC screening exists in Missouri. Area-level poverty rate, independent of individual-level characteristics, is a significant predictor of CRC screening, but it only explains a small portion of the geographic heterogeneity of CRC screening. Individual-level factors we examined do not mediate the effect of the area-level poverty rate on CRC screening. Future studies should identify other area- and individual-level characteristics associated with CRC screening in Missouri.

  9. Evaluation of residents in professionalism and communication skills in south China

    International Nuclear Information System (INIS)

    Bo Qu; Yuhong Zhao; Baozhi Sun

    2010-01-01

    To evaluate the resident doctors' competency in professionalism and communication skills in south China.We conducted this cross-sectional study in 8 hospitals, in 4 provinces of southern China from October to December 2007. The evaluation included 148 resident doctors. A 360-degree instrument from Education Outcomes Service Group (EOS group) of the Arizona Medical Education Consortium was developed and used by the attending physicians, residents, and their peers, nurses, patients, and office staff in this study. All data were entered into a computerized database and analyzed using the Statistical Package for Social Sciences version 13.0( SPSS Inc., Chicago, IL, USA) for Windows. Our results indicated that the instruments are internally consistent (Cronbach's alpha >0.90). The principal components analysis with varimax rotation for the attending-, resident self-evaluation, nurse-, patient-, office staff- and resident peer-rated questionnaires explained 70.68%, 76.13%, 77.02%, 76.37%, 75.51%, and 72.05% of the total variance. Significant differences (p<0.05) were found among different evaluators. The 360-degree instrument appears to be reliable in evaluating a residents' competency in professionalism and communication skills. Information from the assessment may provide feedback to residents (Author).

  10. Managing Cultural Variation in Software Process Improvement

    DEFF Research Database (Denmark)

    Müller, Sune Dueholm; Kræmmergaard, Pernille; Mathiassen, Lars

    The scale and complexity of change in software process improvement (SPI) are considerable and managerial attention to organizational culture during SPI can therefore potentially contribute to successful outcomes. However, we know little about the impact of variations in organizational subculture...... CMMI level 2 as planned, ASY struggled to implement even modest improvements. To explain these differences, we analyzed the underlying organizational culture within ISY and ASY using two different methods for subculture assessment. The study demonstrates how variations in culture across software...

  11. Radiology residents' experience with intussusception reduction

    International Nuclear Information System (INIS)

    Bateni, Cyrus; Stein-Wexler, Rebecca; Wootton-Gorges, Sandra L.; Li, Chin-Shang

    2011-01-01

    Residents should be exposed to adequate procedural volume to act independently upon completion of training. Informal inquiry led us to question whether residents encounter enough intussusception reductions to become comfortable with the procedure. We sought to determine radiology residents' exposure to intussusception reductions, and whether their experiences vary by region or institution. U.S. radiology residency program directors were asked to encourage their residents to complete a 12-question online survey describing characteristics of their pediatric radiology department, experiences with intussusception reduction, and confidence in their own ability to perform the procedure. Six hundred sixty-four residents responded during the study period. Of those, 308 (46.4%) had not experienced an intussusception reduction, and 228 (34%) had experienced only one or two. Twenty-two percent of fourth-year residents had never experienced an intussusception reduction, and 21% had experienced only one. Among second- through fourth-year residents, only 99 (18.3%) felt confident that they could competently reduce an intussusception (P < 0.0001), and 336 (62.2%) thought they would benefit from a computer-assisted training model simulating intussusception reduction (P < 0.0001). Radiology residents have limited opportunity to learn intussusception reduction and therefore lack confidence. Most think they would benefit from additional training with a computer-simulation model. (orig.)

  12. Ophthalmology resident surgical competency: a national survey.

    Science.gov (United States)

    Binenbaum, Gil; Volpe, Nicholas J

    2006-07-01

    To describe the prevalence, management, and career outcomes of ophthalmology residents who struggle with surgical competency and to explore related educational issues. Fourteen-question written survey. Fifty-eight program directors at Accreditation Council on Graduate Medical Education-accredited, United States ophthalmology residency programs, representing a total of 2179 resident graduates, between 1991 and 2000. Study participants completed a mailed, anonymous survey whose format combined multiple choice and free comment questions. Number of surgically challenged residents, types of problems identified, types of remediation, final departmental decision at the end of residency, known career outcomes, and residency program use of microsurgical skills laboratories and applicant screening tests. One hundred ninety-nine residents (9% overall; 10% mean per program) were labeled as having trouble mastering surgical skills. All of the programs except 2 had encountered such residents. The most frequently cited problems were poor hand-eye coordination (24%) and poor intraoperative judgment (22%). Most programs were supportive and used educational rather than punitive measures, the most common being extra practice-laboratory time (32%), scheduling cases with the best teaching surgeon (23%), and counseling (21%). Nearly one third (31%) of residents were believed to have overcome their difficulties before graduation. Other residents were encouraged to pursue medical ophthalmology (22%) or to obtain further surgical training through a fellowship (21%) or a supervised practice setting (12%); these residents were granted a departmental statement of satisfactory completion of residency for Board eligibility. Twelve percent were asked to leave residency. Of reported career outcomes, 92% of residents were practicing ophthalmology, 65% as surgical and 27% as medical ophthalmologists. Ninety-eight percent of residency programs had microsurgical practice facilities, 64% had a formal

  13. Explaining evolution via constrained persistent perfect phylogeny

    Science.gov (United States)

    2014-01-01

    Background The perfect phylogeny is an often used model in phylogenetics since it provides an efficient basic procedure for representing the evolution of genomic binary characters in several frameworks, such as for example in haplotype inference. The model, which is conceptually the simplest, is based on the infinite sites assumption, that is no character can mutate more than once in the whole tree. A main open problem regarding the model is finding generalizations that retain the computational tractability of the original model but are more flexible in modeling biological data when the infinite site assumption is violated because of e.g. back mutations. A special case of back mutations that has been considered in the study of the evolution of protein domains (where a domain is acquired and then lost) is persistency, that is the fact that a character is allowed to return back to the ancestral state. In this model characters can be gained and lost at most once. In this paper we consider the computational problem of explaining binary data by the Persistent Perfect Phylogeny model (referred as PPP) and for this purpose we investigate the problem of reconstructing an evolution where some constraints are imposed on the paths of the tree. Results We define a natural generalization of the PPP problem obtained by requiring that for some pairs (character, species), neither the species nor any of its ancestors can have the character. In other words, some characters cannot be persistent for some species. This new problem is called Constrained PPP (CPPP). Based on a graph formulation of the CPPP problem, we are able to provide a polynomial time solution for the CPPP problem for matrices whose conflict graph has no edges. Using this result, we develop a parameterized algorithm for solving the CPPP problem where the parameter is the number of characters. Conclusions A preliminary experimental analysis shows that the constrained persistent perfect phylogeny model allows to

  14. Use of social media by residency program directors for resident selection.

    Science.gov (United States)

    Cain, Jeff; Scott, Doneka R; Smith, Kelly

    2010-10-01

    Pharmacy residency program directors' attitudes and opinions regarding the use of social media in residency recruitment and selection were studied. A 24-item questionnaire was developed, pilot tested, revised, and sent to 996 residency program directors via SurveyMonkey.com. Demographic, social media usage, and opinions on social media data were collected and analyzed. A total of 454 residency program directors completed the study (response rate, 46.4%). The majority of respondents were women (58.8%), were members of Generation X (75.4%), and worked in a hospital or health system (80%). Most respondents (73%) rated themselves as either nonusers or novice users of social media. Twenty percent indicated that they had viewed a pharmacy residency applicant's social media information. More than half (52%) had encountered e-professionalism issues, including questionable photos and posts revealing unprofessional attitudes, and 89% strongly agreed or agreed that information voluntarily published online was fair game for judgments on character, attitudes, and professionalism. Only 4% of respondents had reviewed applicants' profiles for residency selection decisions. Of those respondents, 52% indicated that the content had no effect on resident selection. Over half of residency program directors were unsure whether they will use social media information for future residency selection decisions. Residency program directors from different generations had different views regarding social media information and its use in residency applicant selections. Residency program directors anticipated using social media information to aid in future decisions for resident selection and hiring.

  15. Brand Name Statin Prescribing in a Resident Ambulatory Practice: Implications for Teaching Cost-Conscious Medicine.

    Science.gov (United States)

    Ryskina, Kira L; Pesko, Michael F; Gossey, J Travis; Caesar, Erica Phillips; Bishop, Tara F

    2014-09-01

    Several national initiatives aim to teach high-value care to residents. While there is a growing body of literature on cost impact of physicians' therapeutic decisions, few studies have assessed factors that influence residents' prescribing practices. We studied factors associated with intensive health care utilization among internal medicine residents, using brand name statin prescribing as a proxy for higher-cost care. We conducted a retrospective, cross-sectional analysis of statin prescriptions by residents at an urban academic internal medicine program, using electronic health record data between July 1, 2010, and June 30, 2011. For 319 encounters by 90 residents, patients were given a brand name statin in 50% of cases. When categorized into quintiles, the bottom quintile of residents prescribed brand name statins in 2% of encounters, while the top quintile prescribed brand name statins in 98% of encounters. After adjusting for potential confounders, including patient characteristics and supervising attending, being in the primary care track was associated with lower odds (odds ratio [OR], 0.38; P  =  .02; 95% confidence interval [CI], 0.16-0.86), and graduating from a medical school with an above-average hospital care intensity index was associated with higher odds of prescribing brand name statins (OR, 1.70; P  =  .049; 95% CI, 1.003-2.88). We found considerable variation in brand name statin prescribing by residents. Medical school attended and residency program type were associated with resident prescribing behavior. Future interventions should raise awareness of these patterns in an effort to teach high-value, cost-conscious care to all residents.

  16. Dark matter "transporting" mechanism explaining positron excesses

    Science.gov (United States)

    Kim, Doojin; Park, Jong-Chul; Shin, Seodong

    2018-04-01

    We propose a novel mechanism to explain the positron excesses, which are observed by satellite-based telescopes including PAMELA and AMS-02, in dark matter (DM) scenarios. The novelty behind the proposal is that it makes direct use of DM around the Galactic Center where DM populates most densely, allowing us to avoid tensions from cosmological and astrophysical measurements. The key ingredients of this mechanism include DM annihilation into unstable states with a very long laboratory-frame life time and their "retarded" decay near the Earth to electron-positron pair(s) possibly with other (in)visible particles. We argue that this sort of explanation is not in conflict with relevant constraints from big bang nucleosynthesis and cosmic microwave background. Regarding the resultant positron spectrum, we provide a generalized source term in the associated diffusion equation, which can be readily applicable to any type of two-"stage" DM scenarios wherein production of Standard Model particles occurs at completely different places from those of DM annihilation. We then conduct a data analysis with the recent AMS-02 data to validate our proposal.

  17. Explaining Global Secularity: Existential Security or Education?

    Directory of Open Access Journals (Sweden)

    Claude M. J. Braun

    2012-11-01

    Full Text Available At the time of data analysis for this report there were 193 countries in the world. Various institutions – the United Nations, the World Health Organization, the CIA, the World Values Survey, Gallup, and many others – have performed sophisticated statistical analyses on cross-national data. The present investigation demonstrates that valid and reliable data concerning religiosity and secularity exist for most countries and that these data are comparable. Cross-national data relating to social, political, economic and cultural aspects of life were tested for correlation with religiosity/secularity. In contrast to the most widely accepted general account of secularity, the Existential Security Framework (ESF; Norris & Inglehart, 2004, secularity was not most highly related to material security, though these were highly related. Rather, secularity was most strongly related to the degree of formal education attained. Material security explained no significant variance beyond education. Thus, religion’s primary function in the world today is being replaced, not so much by the pseudo-materialistic supplication for better living conditions as posited by the ESF, but by contemporary education – extensive knowledge of contemporary cultures, philosophy, modes of thought or processes of reasoning.

  18. Explaining Polarization Reversals in STEREO Wave Data

    Science.gov (United States)

    Breneman, A.; Cattell, C.; Wygant, J.; Kersten, K.; Wilson, L, B., III; Dai, L.; Colpitts, C.; Kellogg, P. J.; Goetz, K.; Paradise, A.

    2012-01-01

    Recently Breneman et al. reported observations of large amplitude lightning and transmitter whistler mode waves from two STEREO passes through the inner radiation belt (Lpaper. We show, with a combination of observations and simulated wave superposition, that these polarization reversals are due to the beating of an incident electromagnetic whistler mode wave at 21.4 kHz and linearly polarized, symmetric lower hybrid sidebands Doppler-shifted from the incident wave by +/-200 Hz. The existence of the lower hybrid waves is consistent with the parametric decay mechanism of Lee and Kuo whereby an incident whistler mode wave decays into symmetric, short wavelength lower hybrid waves and a purely growing (zero-frequency) mode. Like the lower hybrid waves, the purely growing mode is Doppler-shifted by 200 Hz as observed on STEREO. This decay mechanism in the upper ionosphere has been previously reported at equatorial latitudes and is thought to have a direct connection with explosive spread F enhancements. As such it may represent another dissipation mechanism of VLF wave energy in the ionosphere and may help to explain a deficit of observed lightning and transmitter energy in the inner radiation belts as reported by Starks et al.

  19. Psychosocial Training in U.S. Internal Medicine and Family Practice Residency Programs.

    Science.gov (United States)

    Gaufberg, Elizabeth H.; Joseph, Robert C.; Pels, Richard J.; Wyshak, Grace; Wieman, Dow; Nadelson, Carol C.

    2001-01-01

    Surveyed directors of internal medicine (IM) and family practice (FP) residency programs regarding the format, content, and quantity of psychosocial training in their programs, their opinions on topics related to such training, and program demographics. Found considerable variation in content and time devoted to psychosocial training within and…

  20. 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

  1. 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

  2. Lawful Permanent Residents Fiscal Year 2015 Core Based Statistical Area (CBSA) of Residence

    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...

  3. Lawful Permanent Residents Fiscal Year 2016 Core Based Statistical Area (CBSA) of Residence

    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...

  4. Lawful Permanent Residents Fiscal Year 2011 Core Based Statistical Area (CBSA) of Residence

    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...

  5. Lawful Permanent Residents Fiscal Year 2014 Core Based Statistical Area (CBSA) of Residence

    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...

  6. Residents' experiences of abuse, discrimination and sexual harassment during residency training. McMaster University Residency Training Programs.

    Science.gov (United States)

    Cook, D J; Liutkus, J F; Risdon, C L; Griffith, L E; Guyatt, G H; Walter, S D

    1996-06-01

    To assess the prevalence of psychological abuse, physical assault, and discrimination on the basis of gender and sexual orientation, and to examine the prevalence and impact of sexual harassment in residency training programs. Self-administered questionnaire. McMaster University, Hamilton, Ont. Residents in seven residency training programs during the academic year from July 1993 to June 1994. Of 225 residents 186 (82.7%) returned a completed questionnaire, and 50% of the respondents were women. Prevalence of psychological abuse, physical assault and discrimination on the basis of gender and sexual orientation experienced by residents during medical training, prevalence and residents' perceived frequency of sexual harassment. Psychological abuse was reported by 50% of the residents. Some of the respondents reported physical assault, mostly by patients and their family members (14.7% reported assaults by male patients and family members, 9.8% reported assaults by female patients and family members), 5.4% of the female respondents reported assault by male supervising physicians. Discrimination on the basis of gender was reported to be common and was experienced significantly more often by female residents than by male residents (p sexual orientation. Most of the respondents experienced sexual harassment, especially in the form of sexist jokes, flirtation and unwanted compliments on their dress or figure. On average, 40% of the respondents, especially women (p sexual harassment to someone (p sexual harassment were embarassment (reported by 24.0%), anger (by 23.4%) and frustration (20.8%). Psychological abuse, discrimination on the basis of gender and sexual harassment are commonly experienced by residents in training programs. A direct, progressive, multidisciplinary approach is needed to label and address these problems.

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

    Science.gov (United States)

    Falcone, John L; Middleton, Donald B

    2013-01-01

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

  8. Explaining stasis: microevolutionary studies in natural populations.

    Science.gov (United States)

    Merilä, J; Sheldon, B C; Kruuk, L E

    2001-01-01

    Microevolution, defined as a change in the genetic constitution of a population over time, is considered to be of commonplace occurrence in nature. Its ubiquity can be inferred from the observation that quantitative genetic divergence among populations usually exceeds that to be expected due to genetic drift alone, and from numerous observations and experiments consistent with local adaptation. Experimental manipulations in natural populations have provided evidence that rapid evolutionary responses may occur in the wild. However, there are remarkably few cases where direct observations of natural populations have revealed microevolutionary changes occurring, despite the frequent demonstration of additive genetic variation and strong directional selection for particular traits. Those few cases where responses congruent with expectation have been demonstrated are restricted to changes over one generation. In this article we focus on possible explanations as to why heritable traits under apparently strong directional selection often fail to show the expected evolutionary response. To date, few of these explanations for apparent stasis have been amenable to empirical testing. We describe new methods, derived from procedures developed by animal breeding scientists, which can be used to address these explanations, and illustrate the approach with examples from long-term studies of collared flycatchers (Ficedula albicollis) and red deer (Cervus elaphus). Understanding why most intensively studied natural populations do not appear to be evolving is an important challenge for evolutionary biology.

  9. Explaining clinical behaviors using multiple theoretical models

    Directory of Open Access Journals (Sweden)

    Eccles Martin P

    2012-10-01

    Full Text Available Abstract Background In the field of implementation research, there is an increased interest in use of theory when designing implementation research studies involving behavior change. In 2003, we initiated a series of five studies to establish a scientific rationale for interventions to translate research findings into clinical practice by exploring the performance of a number of different, commonly used, overlapping behavioral theories and models. We reflect on the strengths and weaknesses of the methods, the performance of the theories, and consider where these methods sit alongside the range of methods for studying healthcare professional behavior change. Methods These were five studies of the theory-based cognitions and clinical behaviors (taking dental radiographs, performing dental restorations, placing fissure sealants, managing upper respiratory tract infections without prescribing antibiotics, managing low back pain without ordering lumbar spine x-rays of random samples of primary care dentists and physicians. Measures were derived for the explanatory theoretical constructs in the Theory of Planned Behavior (TPB, Social Cognitive Theory (SCT, and Illness Representations specified by the Common Sense Self Regulation Model (CSSRM. We constructed self-report measures of two constructs from Learning Theory (LT, a measure of Implementation Intentions (II, and the Precaution Adoption Process. We collected data on theory-based cognitions (explanatory measures and two interim outcome measures (stated behavioral intention and simulated behavior by postal questionnaire survey during the 12-month period to which objective measures of behavior (collected from routine administrative sources were related. Planned analyses explored the predictive value of theories in explaining variance in intention, behavioral simulation and behavior. Results Response rates across the five surveys ranged from 21% to 48%; we achieved the target sample size for three of

  10. Explaining clinical behaviors using multiple theoretical models.

    Science.gov (United States)

    Eccles, Martin P; Grimshaw, Jeremy M; MacLennan, Graeme; Bonetti, Debbie; Glidewell, Liz; Pitts, Nigel B; Steen, Nick; Thomas, Ruth; Walker, Anne; Johnston, Marie

    2012-10-17

    In the field of implementation research, there is an increased interest in use of theory when designing implementation research studies involving behavior change. In 2003, we initiated a series of five studies to establish a scientific rationale for interventions to translate research findings into clinical practice by exploring the performance of a number of different, commonly used, overlapping behavioral theories and models. We reflect on the strengths and weaknesses of the methods, the performance of the theories, and consider where these methods sit alongside the range of methods for studying healthcare professional behavior change. These were five studies of the theory-based cognitions and clinical behaviors (taking dental radiographs, performing dental restorations, placing fissure sealants, managing upper respiratory tract infections without prescribing antibiotics, managing low back pain without ordering lumbar spine x-rays) of random samples of primary care dentists and physicians. Measures were derived for the explanatory theoretical constructs in the Theory of Planned Behavior (TPB), Social Cognitive Theory (SCT), and Illness Representations specified by the Common Sense Self Regulation Model (CSSRM). We constructed self-report measures of two constructs from Learning Theory (LT), a measure of Implementation Intentions (II), and the Precaution Adoption Process. We collected data on theory-based cognitions (explanatory measures) and two interim outcome measures (stated behavioral intention and simulated behavior) by postal questionnaire survey during the 12-month period to which objective measures of behavior (collected from routine administrative sources) were related. Planned analyses explored the predictive value of theories in explaining variance in intention, behavioral simulation and behavior. Response rates across the five surveys ranged from 21% to 48%; we achieved the target sample size for three of the five surveys. For the predictor variables

  11. Explaining Counterfeit Alcohol Purchases in Russia.

    Science.gov (United States)

    Kotelnikova, Zoya

    2017-04-01

    of surrogate alcohol (i.e., nonbeverage) are more influential in explaining why people purchase counterfeit alcohol. Further research on these 2 factors is needed to more fully understand the purchase and consumption of counterfeit alcoholic beverages. Copyright © 2017 by the Research Society on Alcoholism.

  12. Explaining the entropy concept and entropy components

    Directory of Open Access Journals (Sweden)

    Marko Popovic

    2018-04-01

    Full Text Available Total entropy of a thermodynamic system consists of two components: thermal entropy due to energy, and residual entropy due to molecular orientation. In this article, a three-step method for explaining entropy is suggested. Step one is to use a classical method to introduce thermal entropy STM as a function of temperature T and heat capacity at constant pressure Cp: STM = ∫(Cp/T dT. Thermal entropy is the entropy due to uncertainty in motion of molecules and vanishes at absolute zero (zero-point energy state. It is also the measure of useless thermal energy that cannot be converted into useful work. The next step is to introduce residual entropy S0 as a function of the number of molecules N and the number of distinct orientations available to them in a crystal m: S0 = N kB ln m, where kB is the Boltzmann constant. Residual entropy quantifies the uncertainty in molecular orientation. Residual entropy, unlike thermal entropy, is independent of temperature and remains present at absolute zero. The third step is to show that thermal entropy and residual entropy add up to the total entropy of a thermodynamic system S: S = S0 + STM. This method of explanation should result in a better comprehension of residual entropy and thermal entropy, as well as of their similarities and differences. The new method was tested in teaching at Faculty of Chemistry University of Belgrade, Serbia. The results of the test show that the new method has a potential to improve the quality of teaching.

  13. Characteristics explaining performance in downhill mountain biking.

    Science.gov (United States)

    Chidley, Joel B; MacGregor, Alexandra L; Martin, Caoimhe; Arthur, Calum A; Macdonald, Jamie H

    2015-03-01

    To identify physiological, psychological, and skill characteristics that explain performance in downhill (DH) mountain-bike racing. Four studies were used to (1) identify factors potentially contributing to DH performance (using an expert focus group), (2) develop and validate a measure of rider skill (using video analysis and expert judge evaluation), (3) evaluate whether physiological, psychological, and skill variables contribute to performance at a DH competition, and (4) test the specific contribution of aerobic capacity to DH performance. STUDY 1 identified aerobic capacity, handgrip endurance, anaerobic power, rider skill, and self-confidence as potentially important for DH. In study 2 the rider-skill measure displayed good interrater reliability. Study 3 found that rider skill and handgrip endurance were significantly related to DH ride time (β=-0.76 and -0.14, respectively; R2=.73), with exploratory analyses suggesting that DH ride time may also be influenced by self-confidence and aerobic capacity. Study 4 confirmed aerobic capacity as an important variable influencing DH performance (for a DH ride, mean oxygen uptake was 49±5 mL·kg(-1)·min(-1), and 90% of the ride was completed above the 1st ventilatory threshold). In order of importance, rider skill, handgrip endurance, self-confidence, and aerobic capacity were identified as variables influencing DH performance. Practically, this study provides a novel assessment of rider skill that could be used by coaches to monitor training and identify talent. Novel intervention targets to enhance DH performance were also identified, including self-confidence and aerobic capacity.

  14. Explaining the gender gap in sickness absence.

    Science.gov (United States)

    Østby, K A; Mykletun, A; Nilsen, W

    2018-04-17

    In many western countries, women have a much higher rate of sickness absence than men. To what degree the gender differences in sickness absence are caused by gender differences in health is largely unknown. To assess to what degree the gender gap in sickness absence can be explained by health factors and work- and family-related stressors. Norwegian parents participating in the Tracking Opportunities and Problems (TOPP) study were asked about sickness absence and a range of factors possibly contributing to gender differences in sickness absence, including somatic and mental health, sleep problems, job control/demands, work-home conflicts, parent-child conflicts and stressful life events. Using a cross-sectional design, we did linear regression analyses, to assess the relative contribution from health and stressors. There were 557 study participants. Adjusting for health factors reduced the gender difference in sickness absence by 24%, while adjusting for stressors in the family and at work reduced the difference by 22%. A simultaneous adjustment for health factors and stressors reduced the difference in sickness absence by about 28%. Despite adjusting for a large number of factors, including both previously well-studied factors (e.g. health, job control/demands) and lesser-studied factors (parent-child conflict and sexual assault), this study found that most of the gender gap in sickness absence remains unexplained. Gender differences in health and stressors account for only part of the differences in sickness absence. Other factors must, therefore, exist outside the domains of health, work and family stressors.

  15. Explaining G20 and BRICS Compliance

    Directory of Open Access Journals (Sweden)

    Marina Larionova

    2016-11-01

    Full Text Available This article explores the internal and external factors influencing the compliance performance of the Group of 20 (G20 and the BRICS. The authors start with an overview of the G20 and BRICS compliance patterns using comparative data onthe number of commitments made by the two institutions, the level of institutional compliance, and distribution of commitments and compliance across issue areas. G20 compliance is traced since the leaders’ first 2008 summit in Washington. The BRICS compliance performance record includes data since the third stand alone summit in Sanya in 2011.The study then takes stock of compliance catalysts embedded in the summits’ discourse: priority placements, numerical targets, timelines, self-accountability pledges and mandates to implement and/or monitor implementation. The authors review trends in the use of catalysts in different years and issue areas and identify commonalities and differences.The analysis then turns to external causes of compliance and focuses on demand for collective actions and members’ collective power to respond and deliver on their pledges. Here the study explores whether the self-accountability mechanisms created by the institutions in response to the demand for effectiveness and legitimacy facilitate compliance.The article concludes by highlighting catalysts, causes of compliance and their combinations with the greatest power to encourage implementation, explaining trends in G20 and BRICS compliance performance. The data sets on G20 and BRICS differ in terms of scale. The G20 data set contains 1,511 commitments of which 114 have been monitored, and the BRICS data set contains 231 commitments of which 23 have been monitored.

  16. Regional variations in cancer survival: Impact of tumour stage, socioeconomic status, comorbidity and type of treatment in Norway.

    Science.gov (United States)

    Skyrud, Katrine Damgaard; Bray, Freddie; Eriksen, Morten Tandberg; Nilssen, Yngvar; Møller, Bjørn

    2016-05-01

    Cancer survival varies by place of residence, but it remains uncertain whether this reflects differences in tumour, patient and treatment characteristics (including tumour stage, indicators of socioeconomic status (SES), comorbidity and information on received surgery and radiotherapy) or possibly regional differences in the quality of delivered health care. National population-based data from the Cancer Registry of Norway were used to identify cancer patients diagnosed in 2002-2011 (n = 258,675). We investigated survival from any type of cancer (all cancer sites combined), as well as for the six most common cancers. The effect of adjusting for prognostic factors on regional variations in cancer survival was examined by calculating the mean deviation, defined by the mean absolute deviation of the relative excess risks across health services regions. For prostate cancer, the mean deviation across regions was 1.78 when adjusting for age and sex only, but decreased to 1.27 after further adjustment for tumour stage. For breast cancer, the corresponding mean deviations were 1.34 and 1.27. Additional adjustment for other prognostic factors did not materially change the regional variation in any of the other sites. Adjustment for tumour stage explained most of the regional variations in prostate cancer survival, but had little impact for other sites. Unexplained regional variations after adjusting for tumour stage, SES indicators, comorbidity and type of treatment in Norway may be related to regional inequalities in the quality of cancer care. © 2015 UICC.

  17. Adult neurology training during child neurology residency.

    Science.gov (United States)

    Schor, Nina F

    2012-08-21

    As it is currently configured, completion of child neurology residency requires performance of 12 months of training in adult neurology. Exploration of whether or not this duration of training in adult neurology is appropriate for what child neurology is today must take into account the initial reasons for this requirement and the goals of adult neurology training during child neurology residency.

  18. 42 CFR 483.10 - Resident rights.

    Science.gov (United States)

    2010-10-01

    ... Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED...-determination, and communication with and access to persons and services inside and outside the facility. A... resident both orally and in writing in a language that the resident understands of his or her rights and...

  19. Emotional intelligence in orthopedic surgery residents.

    Science.gov (United States)

    Chan, Kevin; Petrisor, Brad; Bhandari, Mohit

    2014-04-01

    Emotional intelligence (EI) is the ability to understand and manage emotions in oneself and others. It was originally popularized in the business literature as a key attribute for success that was distinct from cognitive intelligence. Increasing focus is being placed on EI in medicine to improve clinical and academic performance. Despite the proposed benefits, to our knowledge, there have been no previous studies on the role of EI in orthopedic surgery. We evaluated baseline data on EI in a cohort of orthopedic surgery residents. We asked all orthopedic surgery residents at a single institution to complete an electronic version of the Mayer-Salovey-Caruso Emotional Intelligence Test (MSCEIT). We used completed questionnaires to calculate total EI scores and 4 branch scores. Data were analyzed according to a priori cutoff values to determine the proportion of residents who were considered competent on the test. Data were also analyzed for possible associations with age, sex, race and level of training. Thirty-nine residents (100%) completed the MSCEIT. The mean total EI score was 86 (maximum score 145). Only 4 (10%) respondents demonstrated competence in EI. Junior residents (p = 0.026), Caucasian residents (p = 0.009) and those younger than 30 years (p = 0.008) had significantly higher EI scores. Our findings suggest that orthopedic residents score low on EI based on the MSCEIT. Optimizing resident competency in noncognitive skills may be enhanced by dedicated EI education, training and testing.

  20. Medication Refusal: Resident Rights, Administration Dilemma.

    Science.gov (United States)

    Haskins, Danielle R; Wick, Jeannette Y

    2017-12-01

    Occasionally, residents actively or passively refuse to take medications. Residents may refuse medication for a number of reasons, including religious beliefs, dietary restrictions, misunderstandings, cognitive impairment, desire to self-harm, or simple inconvenience. This action creates a unique situation for pharmacists and long-term facility staff, especially if patients have dementia. Residents have the legal right to refuse medications, and long-term care facilities need to employ a process to resolve disagreement between the health care team that recommends the medication and the resident who refuses it. In some cases, simple interventions like selecting a different medication or scheduling medications in a different time can address and resolve the resident's objection. If the medical team and the resident cannot resolve their disagreement, often an ethics consultation is helpful. Documenting the resident's refusal to take any or all medications, the health care team's actions and any other outcomes are important. Residents' beliefs may change over time, and the health care team needs to be prepared to revisit the issue as necessary.

  1. Tax treaty entitlement issues concerning dual residents

    NARCIS (Netherlands)

    Sanghavi, D.

    2014-01-01

    The question whether a dual resident taxpayer is entitled to tax treaties concluded by each residence state with a third state has been controversial. Since 2008, the Organisation for Economic Co-operation and Development (OECD) Commentary on Article 4(1) of the OECD Model states that such a

  2. Displacing Media: LCD LAB Artistic Residency

    Directory of Open Access Journals (Sweden)

    Filipe Pais

    2012-12-01

    Full Text Available This review refers to an artistic residency which took place at LCD LAB -  CAAA at Guimarães, in March, exploring a strategy for media art called Media Displacement. The text introduces the strategy very briefly and describes the residency's organization, structure, processses and the results produced.

  3. 42 CFR 436.403 - State residence.

    Science.gov (United States)

    2010-10-01

    ...) Definition. For purposes of this section—Institution has the same meaning as Institution and Medical... intention to remain there permanently or for an indefinite period. (2) For any individual not residing in an... of residence is the State where the individual is— (i) Living with the intention to remain there...

  4. 42 CFR 435.403 - State residence.

    Science.gov (United States)

    2010-10-01

    ... set forth in § 431.52 of this chapter. (b) Definition. For purposes of this section—Institution has... intent, the State of residence is the State where the individual is living with the intention to remain...), the State of residence is the State where the individual is— (i) Living with the intention to remain...

  5. Teaching Forensic Psychiatry to General Psychiatry Residents

    Science.gov (United States)

    Lewis, Catherine F.

    2004-01-01

    Objective: The Accreditation Council on Graduate Medical Education (ACGME) requires that general psychiatry residency training programs provide trainees with exposure to forensic psychiatry. Limited information is available on how to develop a core curriculum in forensic psychiatry for general psychiatry residents and few articles have been…

  6. 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.

  7. Explaining CO2 fluctuations observed in snowpacks

    Science.gov (United States)

    Graham, Laura; Risk, David

    2018-02-01

    Winter soil carbon dioxide (CO2) respiration is a significant and understudied component of the global carbon (C) cycle. Winter soil CO2 fluxes can be surprisingly variable, owing to physical factors such as snowpack properties and wind. This study aimed to quantify the effects of advective transport of CO2 in soil-snow systems on the subdiurnal to diurnal (hours to days) timescale, use an enhanced diffusion model to replicate the effects of CO2 concentration depletions from persistent winds, and use a model-measure pairing to effectively explore what is happening in the field. We took continuous measurements of CO2 concentration gradients and meteorological data at a site in the Cape Breton Highlands of Nova Scotia, Canada, to determine the relationship between wind speeds and CO2 levels in snowpacks. We adapted a soil CO2 diffusion model for the soil-snow system and simulated stepwise changes in transport rate over a broad range of plausible synthetic cases. The goal was to mimic the changes we observed in CO2 snowpack concentration to help elucidate the mechanisms (diffusion, advection) responsible for observed variations. On subdiurnal to diurnal timescales with varying winds and constant snow levels, a strong negative relationship between wind speed and CO2 concentration within the snowpack was often identified. Modelling clearly demonstrated that diffusion alone was unable to replicate the high-frequency CO2 fluctuations, but simulations using above-atmospheric snowpack diffusivities (simulating advective transport within the snowpack) reproduced snow CO2 changes of the observed magnitude and speed. This confirmed that wind-induced ventilation contributed to episodic pulsed emissions from the snow surface and to suppressed snowpack concentrations. This study improves our understanding of winter CO2 dynamics to aid in continued quantification of the annual global C cycle and demonstrates a preference for continuous wintertime CO2 flux measurement systems.

  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. Why do some women refuse to allow male residents to perform pelvic exams?

    Science.gov (United States)

    Rifkin, Julie I; Shapiro, Howard; Regensteiner, Judith G; Stotler, Jeanne K; Schmidt, Betty

    2002-10-01

    Many women who receive medical care in residency training clinics refuse to allow male residents to perform their pelvic exams. This study was conducted to identify which women were most likely to refuse and to learn their reasons for refusing. From January to March 1997, a questionnaire was given to all women entering a Tri-County Health office and a Planned Parenthood clinic, both in the Denver, Colorado, metropolitan area, who consented to participate in the study. Data from the questionnaire were analyzed using a statistical software package. A total of 1,437 women entered the clinics during the study period. Of these patients, 1,078 consented to complete the questionnaire. Seven of these 1,078 women did not complete the questionnaire. Women who did not know the training level of the resident performing the pelvic exam were more likely to refuse than were women who knew the training level of the resident (p =.001), but many women preferred a female physician regardless of the physician's training level. Fifty-eight percent said they would allow a male resident to observe a female attending physician perform the exam, compared with 36% who said they would allow a male resident to observe if the attending physician was a man. Common statements from those who would refuse were: "I am just more comfortable with a female," "Women do not want men to examine their private body parts," and "Women explain things better." A woman's knowledge of the resident's training level correlates with her willingness to have a pelvic exam performed by a male resident. Women who said they would refuse a pelvic exam performed by a male resident gave specific reasons for their decision.

  10. Attitudes and behaviour of residents within the framework of energy efficiency

    Energy Technology Data Exchange (ETDEWEB)

    Valkila, N.

    2013-11-01

    The goal of this study was to determine how Finnish energy policies are realised and the attitudes of consumers regarding energy issues. Further research was done to study if the attitudes of residents and their behaviour regarding energy issues are inter-related. A goal was also to study if place of residence affects attitudes and behaviour. Are residents willing to improve their efficiency in terms of energy consumption? The range of applied research methods was diverse. A literature review was performed and experts operating in the energy industry were interviewed. Ordinary energy consumers, i.e. residents, were studied using interviews and measurements and by forming consumer panels. Content analysis and statistical methods were used for analysing the results. Based on this study, Finland should strive to utilise more diverse energy sources and engage in closer co-operation with different stakeholders. Resident attitudes on energy matters must be influenced. The most effective influencing methods are peer groups, communication, media, training and education, perceptions and visions. Age and the location of residence influence people's attitudes and behaviour with respect to energy issues, whereas their life satisfaction level does not. For example, research subjects that reside in a more densely populated suburban area are more concerned with climate change and more willing to give up driving than research subjects that live in more scarcely populated residential areas. Residents are willing to improve their energy behaviour, although young and elderly people are more willing to make environmentally friendly choices than the middle-aged demographic. There is a gap that needs to be bridged between attitudes and behaviour. If the attitudes of residents were to become more active and positive towards energy, they could lead to the desired energy-efficient behaviour. This study does not aim to make generalisations regarding Finns. Instead, it wishes to explain

  11. Variations in automatically recorded rumination time as explained by variations in intake of dietary fractions and milk production, and between-cow variation

    DEFF Research Database (Denmark)

    Byskov, Malene Vesterager; Nadeau, E.; Johansson, B. E. O.

    2015-01-01

    selected and simultaneously checked for multicollinearity between the dietary components; in step 2, a multivariate model, including the effect of repeated measurements, the main effect of the selected dietary fractions from step 1, random effects of cow(trial) and trial, and information on breed, days...

  12. Climate and terrain factors explaining streamflow response and recession in Australian catchments

    Directory of Open Access Journals (Sweden)

    A. I. J. M. van Dijk

    2010-01-01

    Full Text Available Daily streamflow data were analysed to assess which climate and terrain factors best explain streamflow response in 183 Australian catchments. Assessed descriptors of catchment response included the parameters of fitted baseflow models, and baseflow index (BFI, average quick flow and average baseflow derived by baseflow separation. The variation in response between catchments was compared with indicators of catchment climate, morphology, geology, soils and land use. Spatial coherence in the residual unexplained variation was investigated using semi-variogram techniques. A linear reservoir model (one parameter; recession coefficient produced baseflow estimates as good as those obtained using a non-linear reservoir (two parameters and for practical purposes was therefore considered an appropriate balance between simplicity and explanatory performance. About a third (27–34% of the spatial variation in recession coefficients and BFI was explained by catchment climate indicators, with another 53% of variation being spatially correlated over distances of 100–150 km, probably indicative of substrate characteristics not captured by the available soil and geology data. The shortest recession half-times occurred in the driest catchments and were attributed to intermittent occurrence of fast-draining (possibly perched groundwater. Most (70–84% of the variation in average baseflow and quick flow was explained by rainfall and climate characteristics; another 20% of variation was spatially correlated over distances of 300–700 km, possibly reflecting a combination of terrain and climate factors. It is concluded that catchment streamflow response can be predicted quite well on the basis of catchment climate alone. The prediction of baseflow recession response should be improved further if relevant substrate properties were identified and measured.

  13. 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.

  14. Pregnancy and the Plastic Surgery Resident.

    Science.gov (United States)

    Garza, Rebecca M; Weston, Jane S; Furnas, Heather J

    2017-01-01

    Combining pregnancy with plastic surgery residency has historically been difficult. Two decades ago, 36 percent of plastic surgery program directors surveyed actively discouraged pregnancy among residents, and 33 percent of women plastic surgeons suffered from infertility. Most alarmingly, 26 percent of plastic surgery trainees had had an elective abortion during residency. With increasing numbers of women training in plastic surgery, this historical lack of support for pregnancy deserves further attention. To explore the current accommodations made for the pregnant plastic surgery resident, an electronic survey was sent to 88 plastic surgery program directors in the United States. Fifty-four responded, for a response rate of 61.36 percent. On average, a director trained a total of 7.91 women among 17.28 residents trained over 8.19 years. Of the women residents, 1.43 were pregnant during a director's tenure, with 1.35 of those residents taking maternity leave. An average 1.75 male residents took paternity leave. Approximately one-third of programs had a formal maternity/paternity leave policy (36.54 percent) which, in most cases, was limited to defining allowed weeks of leave, time required to fulfill program requirements, and remuneration during leave. This survey of plastic surgery directors is a first step in defining the challenges training programs face in supporting the pregnant resident. Directors provided comments describing their challenges accommodating an absent resident in a small program and complying with the American Board of Plastic Surgery's required weeks of training per year. A discussion of these challenges is followed by suggested solutions.

  15. 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

  16. Assessment of medical resident's attention to the health literacy level of newly admitted patients

    Directory of Open Access Journals (Sweden)

    Cecile Karsenty

    2013-12-01

    Full Text Available Objectives: The objective of this study was to assess communication at the bedside in the emergency room between residents and their patients in order to identify common communication gaps. We also intended to evaluate whether residents for whom English is a second language (ESL residents communicate less effectively. Methods: A scorable checklist was developed in order to assess and identify communication gaps between the residents and their patients. Medical students observed the internal medicine and family medicine residents while they admitted patients to the medical service in the Emergency Room. Before this, medical students were trained for two weeks with a senior internist. The role of the medical student was not revealed; rather they were self-described as observers of the admission process. Results: Over an 8 week period, 71 observations were made of 27 medicine residents. 71 patient intakes were observed, evaluating 27 residents. In 52.1% of these interactions, the residents used medical acronyms when communicating with the patients. During 66.2% of interactions, technical medical terms or expressions were used during the history taking and in only 27.6% of those cases were the terms explained at least partially. Teach back technique was not observed in any of the interactions evaluated. Data was also analyzed based on whether the doctors were ESL residents or native English speakers. ESL residents tended to use significantly more technical language than the native English speakers, but the native English speakers tended to use more acronyms. Conclusions: How much patients understand of what their doctor says is called “health literacy.” Resident physicians often overestimate their patients’ health literacy, and this leads to communication gaps which have the potential to result in poorer health outcomes for the patients. The checklist developed for this pilot study assessed how well residents tailor their communication to

  17. A case-mix classification system for explaining healthcare costs using administrative data in Italy.

    Science.gov (United States)

    Corti, Maria Chiara; Avossa, Francesco; Schievano, Elena; Gallina, Pietro; Ferroni, Eliana; Alba, Natalia; Dotto, Matilde; Basso, Cristina; Netti, Silvia Tiozzo; Fedeli, Ugo; Mantoan, Domenico

    2018-03-04

    The Italian National Health Service (NHS) provides universal coverage to all citizens, granting primary and hospital care with a copayment system for outpatient and drug services. Financing of Local Health Trusts (LHTs) is based on a capitation system adjusted only for age, gender and area of residence. We applied a risk-adjustment system (Johns Hopkins Adjusted Clinical Groups System, ACG® System) in order to explain health care costs using routinely collected administrative data in the Veneto Region (North-eastern Italy). All residents in the Veneto Region were included in the study. The ACG system was applied to classify the regional population based on the following information sources for the year 2015: Hospital Discharges, Emergency Room visits, Chronic disease registry for copayment exemptions, ambulatory visits, medications, the Home care database, and drug prescriptions. Simple linear regressions were used to contrast an age-gender model to models incorporating more comprehensive risk measures aimed at predicting health care costs. A simple age-gender model explained only 8% of the variance of 2015 total costs. Adding diagnoses-related variables provided a 23% increase, while pharmacy based variables provided an additional 17% increase in explained variance. The adjusted R-squared of the comprehensive model was 6 times that of the simple age-gender model. ACG System provides substantial improvement in predicting health care costs when compared to simple age-gender adjustments. Aging itself is not the main determinant of the increase of health care costs, which is better explained by the accumulation of chronic conditions and the resulting multimorbidity. Copyright © 2018. Published by Elsevier B.V.

  18. Classifying and explaining democracy in the Muslim world

    Directory of Open Access Journals (Sweden)

    Rohaizan Baharuddin

    2012-12-01

    Full Text Available The purpose of this study is to classify and explain democracies in the 47 Muslim countries between the years 1998 and 2008 by using liberties and elections as independent variables. Specifically focusing on the context of the Muslim world, this study examines the performance of civil liberties and elections, variation of democracy practised the most, the elections, civil liberties and democratic transitions and patterns that followed. Based on the quantitative data primarily collected from Freedom House, this study demonstrates the following aggregate findings: first, the “not free not fair” elections, the “limited” civil liberties and the “Illiberal Partial Democracy” were the dominant feature of elections, civil liberties and democracy practised in the Muslim world; second, a total of 413 Muslim regimes out of 470 (47 regimes x 10 years remained the same as their democratic origin points, without any transitions to a better or worse level of democracy, throughout these 10 years; and third, a slow, yet steady positive transition of both elections and civil liberties occurred in the Muslim world with changes in the nature of elections becoming much more progressive compared to the civil liberties’ transitions.

  19. Surprisingly rational: probability theory plus noise explains biases in judgment.

    Science.gov (United States)

    Costello, Fintan; Watts, Paul

    2014-07-01

    The systematic biases seen in people's probability judgments are typically taken as evidence that people do not use the rules of probability theory when reasoning about probability but instead use heuristics, which sometimes yield reasonable judgments and sometimes yield systematic biases. This view has had a major impact in economics, law, medicine, and other fields; indeed, the idea that people cannot reason with probabilities has become a truism. We present a simple alternative to this view, where people reason about probability according to probability theory but are subject to random variation or noise in the reasoning process. In this account the effect of noise is canceled for some probabilistic expressions. Analyzing data from 2 experiments, we find that, for these expressions, people's probability judgments are strikingly close to those required by probability theory. For other expressions, this account produces systematic deviations in probability estimates. These deviations explain 4 reliable biases in human probabilistic reasoning (conservatism, subadditivity, conjunction, and disjunction fallacies). These results suggest that people's probability judgments embody the rules of probability theory and that biases in those judgments are due to the effects of random noise. (c) 2014 APA, all rights reserved.

  20. Laboratory simulations of cumulus cloud flows explain the entrainment anomaly

    Science.gov (United States)

    Narasimha, Roddam; Diwan, Sourabh S.; Subrahmanyam, Duvvuri; Sreenivas, K. R.; Bhat, G. S.

    2010-11-01

    In the present laboratory experiments, cumulus cloud flows are simulated by starting plumes and jets subjected to off-source heat addition in amounts that are dynamically similar to latent heat release due to condensation in real clouds. The setup permits incorporation of features like atmospheric inversion layers and the active control of off-source heat addition. Herein we report, for the first time, simulation of five different cumulus cloud types (and many shapes), including three genera and three species (WMO Atlas 1987), which show striking resemblance to real clouds. It is known that the rate of entrainment in cumulus cloud flows is much less than that in classical plumes - the main reason for the failure of early entrainment models. Some of the previous studies on steady-state jets and plumes (done in a similar setup) have attributed this anomaly to the disruption of the large-scale turbulent structures upon the addition of off-source heat. We present estimates of entrainment coefficients from these measurements which show a qualitatively consistent variation with height. We propose that this explains the observed entrainment anomaly in cumulus clouds; further experiments are planned to address this question in the context of starting jets and plumes.

  1. Enhancing teamwork between chief residents and residency program directors: description and outcomes of an experiential workshop.

    Science.gov (United States)

    McPhillips, Heather A; Frohna, John G; Murad, M Hassan; Batra, Maneesh; Panda, Mukta; Miller, Marsha A; Brigham, Timothy P; Doughty, Robert A

    2011-12-01

    An effective working relationship between chief residents and residency program directors is critical to a residency program's success. Despite the importance of this relationship, few studies have explored the characteristics of an effective program director-chief resident partnership or how to facilitate collaboration between the 2 roles, which collectively are important to program quality and resident satisfaction. We describe the development and impact of a novel workshop that paired program directors with their incoming chief residents to facilitate improved partnerships. The Accreditation Council for Graduate Medical Education sponsored a full-day workshop for residency program directors and their incoming chief residents. Sessions focused on increased understanding of personality styles, using experiential learning, and open communication between chief residents and program directors, related to feedback and expectations of each other. Participants completed an anonymous survey immediately after the workshop and again 8 months later to assess its long-term impact. Participants found the workshop to be a valuable experience, with comments revealing common themes. Program directors and chief residents expect each other to act as a role model for the residents, be approachable and available, and to be transparent and fair in their decision-making processes; both groups wanted feedback on performance and clear expectations from each other for roles and responsibilities; and both groups identified the need to be innovative and supportive of changes in the program. Respondents to the follow-up survey reported that workshop participation improved their relationships with their co-chiefs and program directors. Participation in this experiential workshop improved the working relationships between chief residents and program directors. The themes that were identified can be used to foster communication between incoming chief residents and residency directors and to

  2. Selective Pressures Explain Differences in Flower Color among Gentiana lutea Populations.

    Directory of Open Access Journals (Sweden)

    Mar Sobral

    Full Text Available Flower color variation among plant populations might reflect adaptation to local conditions such as the interacting animal community. In the northwest Iberian Peninsula, flower color of Gentiana lutea varies longitudinally among populations, ranging from orange to yellow. We explored whether flower color is locally adapted and the role of pollinators and seed predators as agents of selection by analyzing the influence of flower color on (i pollinator visitation rate and (ii escape from seed predation and (iii by testing whether differences in pollinator communities correlate with flower color variation across populations. Finally, (iv we investigated whether variation in selective pressures explains flower color variation among 12 G. lutea populations. Flower color influenced pollinator visits and differences in flower color among populations were related to variation in pollinator communities. Selective pressures on flower color vary among populations and explain part of flower color differences among populations of G. lutea. We conclude that flower color in G. lutea is locally adapted and that pollinators play a role in this adaptation.

  3. Selective Pressures Explain Differences in Flower Color among Gentiana lutea Populations.

    Science.gov (United States)

    Sobral, Mar; Veiga, Tania; Domínguez, Paula; Guitián, Javier A; Guitián, Pablo; Guitián, José M

    2015-01-01

    Flower color variation among plant populations might reflect adaptation to local conditions such as the interacting animal community. In the northwest Iberian Peninsula, flower color of Gentiana lutea varies longitudinally among populations, ranging from orange to yellow. We explored whether flower color is locally adapted and the role of pollinators and seed predators as agents of selection by analyzing the influence of flower color on (i) pollinator visitation rate and (ii) escape from seed predation and (iii) by testing whether differences in pollinator communities correlate with flower color variation across populations. Finally, (iv) we investigated whether variation in selective pressures explains flower color variation among 12 G. lutea populations. Flower color influenced pollinator visits and differences in flower color among populations were related to variation in pollinator communities. Selective pressures on flower color vary among populations and explain part of flower color differences among populations of G. lutea. We conclude that flower color in G. lutea is locally adapted and that pollinators play a role in this adaptation.

  4. Causes and significance of variation in mammalian basal metabolism.

    Science.gov (United States)

    Raichlen, David A; Gordon, Adam D; Muchlinski, Magdalena N; Snodgrass, J Josh

    2010-02-01

    Mammalian basal metabolic rates (BMR) increase with body mass, whichs explains approximately 95% of the variation in BMR. However, at a given mass, there remains a large amount of variation in BMR. While many researchers suggest that the overall scaling of BMR with body mass is due to physiological constraints, variation at a given body mass may provide clues as to how selection acts on BMR. Here, we examine this variation in BMR in a broad sample of mammals and we test the hypothesis that, across mammals, body composition explains differences in BMR at a given body mass. Variation in BMR is strongly correlated with variation in muscle mass, and both of these variables are correlated with latitude and ambient temperature. These results suggest that selection alters BMR in response to thermoregulatory pressures, and that selection uses muscle mass as a means to generate this variation.

  5. 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

  6. Identification of basin characteristics influencing spatial variation of river flows

    NARCIS (Netherlands)

    Mazvimavi, D.; Burgers, S.L.G.E.; Stein, A.

    2006-01-01

    The selection of basin characteristics that explain spatial variation of river flows is important for hydrological regionalization as this enables estimation of flow statistics of ungauged basins. A direct gradient analysis method, redundancy analysis, is used to identify basin characteristics,

  7. Problematizing the multidisciplinary residency in oncology: a practical teaching protocol from the perspective of nurse residents

    Directory of Open Access Journals (Sweden)

    Myllena Cândida de Melo

    2014-08-01

    Full Text Available Objective: To investigate practical teaching of nurse residents in a multidisciplinary residency in oncology. Method: A qualitative descriptive study grounded in the problematization methodology and its steps, represented by the Maguerez Arch. Data were analyzed using content analysis. Results: Potentiating and limiting elements of the residency guided the design of a practical teaching protocol from the perspective of residents, structured in three stages: Welcoming and ambience; Nursing care for problem situations; and, Evaluation process. Conclusion: Systematization of practical teaching promoted the autonomy of individuals and the approximation of teaching to reality, making residency less strenuous, stressful and distressing.

  8. Variational principles for locally variational forms

    International Nuclear Information System (INIS)

    Brajercik, J.; Krupka, D.

    2005-01-01

    We present the theory of higher order local variational principles in fibered manifolds, in which the fundamental global concept is a locally variational dynamical form. Any two Lepage forms, defining a local variational principle for this form, differ on intersection of their domains, by a variationally trivial form. In this sense, but in a different geometric setting, the local variational principles satisfy analogous properties as the variational functionals of the Chern-Simons type. The resulting theory of extremals and symmetries extends the first order theories of the Lagrange-Souriau form, presented by Grigore and Popp, and closed equivalents of the first order Euler-Lagrange forms of Hakova and Krupkova. Conceptually, our approach differs from Prieto, who uses the Poincare-Cartan forms, which do not have higher order global analogues

  9. Pediatric dermatology training during residency: a survey of the 2014 graduating residents.

    Science.gov (United States)

    Akhavan, Alaleh; Murphy-Chutorian, Blair; Friedman, Adam

    2015-01-01

    Knowledge of pediatric dermatology is considered a core competency of dermatology training and should be expected of all practicing dermatologists. While the numbers of both pediatric dermatology fellowships and board certified pediatric dermatologists in the workforce have increased over the years, recent reports suggest that there is a gap in pediatric dermatology education during dermatology residency. The goal of this study is to assess the current state of pediatric education during residency, as well as the clinical experience, satisfaction and expectations of graduating dermatology residents. A 31-question self-report survey was distributed electronically to 294 third-year dermatology residents with questions pertaining to demographics, didactic education, resident experience in pediatric dermatology training, satisfaction with pediatric training and future plans. One hundred and twenty-three residents responded (41.8% response rate) representing approximately 29.1% of the total number of graduating residents. 69 (56.1%) residents reported academic time specifically devoted to pediatric dermatology, the majority (79.7%) of which was led by pediatric dermatologists. 82% of residents reported dedicated pediatric dermatology clinics at their program. 86.8% of respondents felt that their training in pediatric dermatology will allow them to confidently see pediatric dermatology patients in practice. This survey highlights a promising state of pediatric dermatology training among current graduating dermatology residents. The majority of current graduating dermatology residents are satisfied with their pediatric dermatology education, feel confident treating pediatric patients, and plan to see pediatric patients in clinical practice. © 2015 Wiley Periodicals, Inc.

  10. Women in leadership positions within obstetrics and gynecology: does the past explain the present?

    Science.gov (United States)

    Baecher-Lind, Laura

    2012-12-01

    To determine whether the proportion of leadership positions in obstetrics and gynecology held by women is consistent with expectations based on the proportion of women entering residency at the time of current leaders. Leadership positions were considered as department chairs affiliated with the Council of University Chairs of Obstetrics and Gynecology, editors of the 20 obstetrics and gynecology journals with the highest impact factors [corrected],and presidents of influential professional societies. Publically available data were accessed to determine sex and the year of medical school graduation for each individual holding each leadership position, as well as to determine the number of men and women entering residency in obstetrics and gynecology per year. Actual and expected proportions of leadership positions held by women were compared using χ² tests. Women should hold 71 of the total 194 leadership positions based on the proportion of women entering residency during the mean graduation year among leaders. Women actually hold 41 of these leadership positions (21.1%; Pwomen should hold 28 of these 74 leadership positions. Women actually hold 20 of the leadership positions from this subset (27.0%; P=.05). Women are underrepresented in leadership positions in obstetrics and gynecology, and this cannot be explained by historical sex imbalances among physicians entering our specialty.

  11. Association of Group Prenatal Care in US Family Medicine Residencies With Maternity Care Practice: A CERA Secondary Data Analysis.

    Science.gov (United States)

    Barr, Wendy B; Tong, Sebastian T; LeFevre, Nicholas M

    2017-03-01

    Group prenatal care has been shown to improve both maternal and neonatal outcomes. With increasing adaption of group prenatal care by family medicine residencies, this model may serve as a potential method to increase exposure to and interest in maternity care among trainees. This study aims to describe the penetration, regional and program variations, and potential impacts on future maternity care practice of group prenatal care in US family medicine residencies. The CAFM Educational Research Alliance (CERA) conducted a survey of all US family medicine residency program directors in 2013 containing questions about maternity care training. A secondary data analysis was completed to examine relevant data on group prenatal care in US family medicine residencies and maternity care practice patterns. 23.1% of family medicine residency programs report provision of group prenatal care. Programs with group prenatal care reported increased number of vaginal deliveries per resident. Controlling for average number of vaginal deliveries per resident, programs with group prenatal care had a 2.35 higher odds of having more than 10% of graduates practice obstetrics and a 2.93 higher odds of having at least one graduate in the past 5 years enter an obstetrics fellowship. Residency programs with group prenatal care models report more graduates entering OB fellowships and practicing maternity care. Implementing group prenatal care in residency training can be one method in a multifaceted approach to increasing maternity care practice among US family physicians.

  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. Do otolaryngology residency applicants relocate for training?

    Science.gov (United States)

    Gebhard, Grant M; Hauser, Leah J; Dally, Miranda J; Weitzenkamp, David A; Cabrera-Muffly, Cristina

    2016-04-01

    To determine whether there is an association between the geographic location of an applicant's undergraduate school, medical school, and residency program among matched otolaryngology residency applicants. Observational. Otolaryngology residency program applications to our institution from 2009 to 2013 were analyzed. The geographic location of each applicant's undergraduate education and medical education were collected. Online public records were queried to determine the residency program location of matched applicants. Applicants who did not match or who attended medical school outside the United States were excluded. Metro area, state, and region were determined according to US Census Bureau definitions. From 2009 to 2013, 1,089 (78%) of 1,405 applicants who matched into otolaryngology residency applied to our institution. The number of subjects who attended medical school and residency in the same geographic region was 241 (22%) for metropolitan area, 305 (28%) for state, and 436 (40%) for region. There was no difference in geographic location retention by gender or couples match status of the subject. United States Medical Licensing Exam step 1 scores correlated with an increased likelihood of subjects staying within the same geographic region (P = .03). Most otolaryngology applicants leave their previous geographic area to attend residency. Based on these data, the authors recommend against giving weight to geography as a factor when inviting applicants to interview. NA. © 2015 The American Laryngological, Rhinological and Otological Society, Inc.

  14. Canadian residents' perceived manager training needs.

    Science.gov (United States)

    Stergiopoulos, Vicky; Lieff, Susan; Razack, Saleem; Lee, A Curtis; Maniate, Jerry M; Hyde, Stacey; Taber, Sarah; Frank, Jason R

    2010-01-01

    Despite widespread endorsement for administrative training during residency, teaching and learning in this area remains intermittent and limited in most programmes. To inform the development of a Manager Train-the-Trainer program for faculty, the Royal College of Physicians and Surgeons of Canada undertook a survey of perceived Manager training needs among postgraduate trainees. A representative sample of Canadian specialty residents received a web-based questionnaire in 2009 assessing their perceived deficiencies in 13 Manager knowledge and 11 Manager skill domains, as determined by gap scores (GSs). GSs were defined as the difference between residents' perceived current and desired level of knowledge or skill in selected Manager domains. Residents' educational preferences for furthering their Manager knowledge and skills were also elicited. Among the 549 residents who were emailed the survey, 199 (36.2%) responded. Residents reported significant gaps in most knowledge and skills domains examined. Residents' preferred educational methods for learning Manager knowledge and skills included workshops, web-based formats and interactive small groups. The results of this national survey, highlighting significant perceived gaps in multiple Manager knowledge and skills domains, may inform the development of Manager curricula and faculty development activities to address deficiencies in training in this important area.

  15. Variation and Mathematics Pedagogy

    Science.gov (United States)

    Leung, Allen

    2012-01-01

    This discussion paper put forwards variation as a theme to structure mathematical experience and mathematics pedagogy. Patterns of variation from Marton's Theory of Variation are understood and developed as types of variation interaction that enhance mathematical understanding. An idea of a discernment unit comprising mutually supporting variation…

  16. Program for developing leadership in pharmacy residents.

    Science.gov (United States)

    Fuller, Patrick D

    2012-07-15

    An innovative, structured approach to incorporating leadership development activities into pharmacy residency training is described. The American Society of Health-System Pharmacists (ASHP) has called for increased efforts to make leadership development an integral component of the training of pharmacy students and new practitioners. In 2007, The Nebraska Medical Center (TNMC) took action to systematize leadership training in its pharmacy residency programs by launching a new Leadership Development Series. Throughout the residency year, trainees at TNMC participate in a variety of activities: (1) focused group discussions of selected articles on leadership concepts written by noted leaders of the past and present, (2) a two-day offsite retreat featuring trust-building exercises and physical challenges, (3) a self-assessment designed to help residents identify and use their untapped personal strengths, (4) training on the effective application of different styles of communication and conflict resolution, and (5) education on the history and evolution of health-system pharmacy, including a review and discussion of lectures by recipients of ASHP's Harvey A. K. Whitney Award. Feedback from residents who have completed the series has been positive, with many residents indicating that it has stimulated their professional growth and helped prepared them for leadership roles. A structured Leadership Development Series exposes pharmacy residents to various leadership philosophies and principles and, through the study of Harvey A. K. Whitney Award lectures, to the thoughts of past and present pharmacy leaders. Residents develop an increased self-awareness through a resident fall retreat, a StrengthsFinder assessment, and communication and conflict-mode assessment tools.

  17. Calculus of variations

    CERN Document Server

    Elsgolc, L E; Stark, M

    1961-01-01

    Calculus of Variations aims to provide an understanding of the basic notions and standard methods of the calculus of variations, including the direct methods of solution of the variational problems. The wide variety of applications of variational methods to different fields of mechanics and technology has made it essential for engineers to learn the fundamentals of the calculus of variations. The book begins with a discussion of the method of variation in problems with fixed boundaries. Subsequent chapters cover variational problems with movable boundaries and some other problems; sufficiency

  18. Lunar nitrogen: Secular variation or mixing?

    International Nuclear Information System (INIS)

    Norris, S.J.; Wright, I.P.; Pillinger, C.T.

    1986-01-01

    The two current models to explain the nearly 40% variation of the lunar nitrogen isotopic composition are: (1) secular variation of solar wind nitrogen; and (2) a two component mixing model having a constant, heavy solar wind admixed with varying amounts of indigenous light lunar N (LLN). Both models are needed to explain the step pyrolysis extraction profile. The secular variation model proposes that the low temperature release is modern day solar wind implanted into grain surfaces, the 900 C to 1100 C release is from grain surfaces which were once exposed to the ancient solar wind but which are now trapped inside agglutinates, and the >1100 C release as spallogenic N produced by cosmic rays. The mixing model ascribes the components to solar wind, indigenous lunar N and spallogenic N respectively. An extension of either interpretation is that the light N seen in lunar breccias or deep drill cores represent conditions when more N-14 was available to the lunar surface

  19. 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.

  20. 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.

  1. 26 CFR 25.2702-5 - Personal residence trusts.

    Science.gov (United States)

    2010-04-01

    ... a portion of the residence is used in an activity meeting the requirements of section 280A(c) (1) or... provision of lodging (e.g. a hotel or a bed and breakfast). A residence is not a personal residence if... portion of their interests in the residence) to the same personal residence trust, provided that the...

  2. Negotiations of Acknowledgement among Middle Class Residents

    DEFF Research Database (Denmark)

    Andersen, Nina Blom

    2013-01-01

    The article presents an analysis of communication processes between residents, between residents and people in the broader societal context as well as of media coverage of a fireworks disaster in a Danish suburb. It demonstrates how residents (all members of the Danish middle class) were able......, ethnicity, class or other social categories normally recognized as influential in case of disastrous events. Since the population in the area was very homogenous, the axis of differentiation was instead linked to the social category of affectedness, and a hierarchy of affectedness was identified within...

  3. Continuous Certification Within Residency: An Educational Model.

    Science.gov (United States)

    Rachlin, Susan; Schonberger, Alison; Nocera, Nicole; Acharya, Jay; Shah, Nidhi; Henkel, Jacqueline

    2015-10-01

    Given that maintaining compliance with Maintenance of Certification is necessary for maintaining licensure to practice as a radiologist and provide quality patient care, it is important for radiology residents to practice fulfilling each part of the program during their training not only to prepare for success after graduation but also to adequately learn best practices from the beginning of their professional careers. This article discusses ways to implement continuous certification (called Continuous Residency Certification) as an educational model within the residency training program. Copyright © 2015 AUR. Published by Elsevier Inc. All rights reserved.

  4. Consequences for established design practice from geographical variation of historical rainfall data

    DEFF Research Database (Denmark)

    Mikkelsen, P.S.; Arnbjerg-Nielsen, K.; Harremoës, P.

    1997-01-01

    variation and variation due to (correlated) sampling errors. Further analyses indicate that the observed variation can be explained only partially by correlation with regional climatological variables and that a significant residual variation remains, especially for large return periods. The new perceptions...

  5. Explaining Cross-Country Differences in Attitudes Towards Immigration in the EU-15

    DEFF Research Database (Denmark)

    Malchow-Møller, Nikolaj; Munch, Jakob Roland; Schroll, Sanne

    2009-01-01

    In this paper, we use data from the first two rounds of the European Social Survey to analyze the extent to which differences in average attitudes towards immigration across the EU-15 countries may be explained by differences in socioeconomic characteristics and individually perceived consequences...... of immigration, using an extension of a decomposition technique developed by Fairlie (2005). We find that despite the significant effects of socioeconomic characteristics on attitudes, differences in the distributions of these characteristics can only explain a modest share of the cross-country variation...... in average attitudes. A larger part can be explained by differences in perceived consequences of immigration, but the main part is still left unexplained. Apart from providing useful input for policy makers working in the area of immigration policy, this raises a number of questions for further research...

  6. Explaining Cross-Country Differences in Attitudes towards Immigration in the EU-15

    DEFF Research Database (Denmark)

    Malchow-Møller, Nikolaj; Munch, Jakob Roland; Schroll, Sanne

    2007-01-01

    In this paper, we use data from the first two rounds of the European Social Survey to analyze the extent to which differences in average attitudes towards immigration across the EU-15 countries may be explained by differences in socioeconomic characteristics and individually perceived consequences...... of immigration, using an extension of a decomposition technique developed by Fairlie (2005). We find that despite the significant effects of socioeconomic characteristics on attitudes, differences in the distributions of these characteristics can only explain a modest share of the cross-country variation...... in average attitudes. A larger part can be explained by differences in perceived consequences of immigration, but the main part is still left unexplained. Apart from providing useful input for policy makers working in the area of immigration policy, this raises a number of questions for further research...

  7. Explaining Cross-Country Differences in Attitudes Towards Immigration in the EU-15

    DEFF Research Database (Denmark)

    Malchow-Møller, Nikolaj; Munch, Jakob Roland; Skaksen, Jan Rose

    In this paper, we use data from the first two rounds of the European Social Survey to analyse the extent to which differences in average attitudes towards immigration across the EU-15 countries may be explained by differences in socioeconomic characteristics and individually perceived consequences...... of immigration, using an extension of a decomposition technique developed by Fairlie (2005). We find that despite the significant effects of socioeconomic characteristics on attitudes, differences in the distributions of these characteristics can only explain a modest share of the cross-country variation...... in average attitudes. A larger part can be explained by differences in perceived consequences of immigration, but the main part is still left unexplained. Apart from providing useful input for policy makers working in the area of immigration policy, this raises a number of questions for further research...

  8. Resident and attending physician perception of maladaptive response to stress in residents

    Directory of Open Access Journals (Sweden)

    Lee Ann Riesenberg

    2014-11-01

    Full Text Available Background: Residency stress has been shown to interfere with resident well-being and patient safety. We developed a survey research study designed to explore factors that may affect perception of a maladaptive response to stress. Methods: A 16-item survey with 12 Likert-type perception items was designed to determine how often respondents agreed or disagreed with statements regarding the resident on the trigger tape. A total of 438 respondents from multiple institutions completed surveys. Results: Attending physicians were more likely than residents to agree that the resident on the trigger tape was impaired, p<0.0001; needed to seek professional counseling, p=0.0003; should be removed from the service, p=0.002; was not receiving adequate support from the attending physician, p=0.007; and was a risk to patient safety, p=0.02. Attending physicians were also less likely to agree that the resident was a good role model, p=0.001, and that the resident should be able to resolve these issues herself/himself, p<0.0001. Conclusion: Our data suggest that resident physicians may not be able to adequately detect maladaptive responses to stress and that attending physicians may be more adept at recognizing this problem. More innovative faculty and resident development workshops should be created to teach and encourage physicians to better observe and detect residents who are displaying maladaptive responses to stress.

  9. 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.

  10. Resident Wellness and Social Support: Development and Cognitive Validation of a Resident Social Capital Assessment Tool.

    Science.gov (United States)

    Kaplan, Stephen J; Seabott, Heather M; Cunningham, Erika B; Helman, James D; Calderon, Alvin; Thirlby, Richard C; Schenarts, Kimberly D

    The purpose of this study is to develop and generate validity evidence for an instrument to measure social capital in residents. Mixed-methods, phased approach utilizing a modified Delphi technique, focus groups, and cognitive interviews. Four residency training institutions in Washington state between February 2016 and March 2017. General surgery, anesthesia, and internal medicine residents ranging from PGY-1 to PGY-6. The initial resident-focused instrument underwent revision via Delphi process with 6 experts; 100% expert consensus was achieved after 4 cycles. Three focus groups were conducted with 19 total residents. Focus groups identified 6 of 11 instrument items with mean quality ratings ≤4.0 on a 1-5 scale. The composite instrument rating of the draft version was 4.1 ± 0.5. After refining the instrument, cognitive interviews with the final version were completed with 22 residents. All items in the final version had quality ratings >4.0; the composite instrument rating was 4.8 ± 0.1. Social capital may be an important factor in resident wellness as residents rely upon each other and external social support to withstand fatigue, burnout, and other negative sequelae of rigorous training. This instrument for assessment of social capital in residents may provide an avenue for data collection and potentially, identification of residents at-risk for wellness degradation. Copyright © 2018 Association of Program Directors in Surgery. Published by Elsevier Inc. All rights reserved.

  11. Perspectives of Residents of Mashhad School of Dentistry about the Curriculum of Residency Program

    Directory of Open Access Journals (Sweden)

    Javad Sarabadani

    2015-09-01

    Full Text Available Introduction: This study was carried out to analyze the viewpoint of the residents of school of dentistry about the curriculum presented in the residency program to students of Mashhad School of Dentistry. Methods: To evaluate the perspectives of residents of dental school about the curriculum and regulations of residency program, a questionnaire was designed whose validity and reliability were confirmed by the authorities of School of Dentistry and test-retest reliability, respectively. The questionnaire was distributed among 100 residents and 80 of them completed the questionnaires. The data were analyzed by SPSS software (version 11.5. Results: A total of 43% of residents were informed of the curriculum (e.g. academic leave, transfer, removal of semester, etc.. As for the ability to write research proposal, 42.7% of residents were reported to have a favorable status, i.e. they were able to write more than 80% of their proposal. From among the residents, 30.4% had specialized English language certificate. Most of them (77% were satisfied with the professional staff, faculty members, of the faculty. Many students liked to participate in the teaching method courses of the residency program. Conclusion: Residents maintained that the curriculum in such domains as educational and research issues and special capabilities had some weak points. Thus, appropriate strategies are recommended to be applied to revise the curriculum using the residents’ views on these programs.

  12. Confidence, knowledge, and skills at the beginning of residency. A survey of pathology residents.

    Science.gov (United States)

    Hsieh, Cindy M; Nolan, Norris J

    2015-01-01

    To document the pathology learning experiences of pathology residents prior to residency and to determine how confident they were in their knowledge and technical skills. An online survey was distributed to all pathology residency program directors in the United States, who were requested to forward the survey link to their residents. Data were obtained on pathology electives, grossing experience, and frozen section experience. Likert scale questions assessed confidence level in knowledge and skills. In total, 201 pathology residents responded (8% of residents in the United States). Prior to starting residency, most respondents had exposure to anatomic pathology through elective rotations. Few respondents had work-related experience. Most did not feel confident in their pathology-related knowledge or skills, and many did not understand what pathology resident duties entail. Respondents gained exposure to pathology primarily through elective rotations, and most felt the elective experience prepared them for pathology residency. However, elective time may be enhanced by providing opportunities for students to increase hands-on experience and understanding of resident duties. Copyright© by the American Society for Clinical Pathology.

  13. 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

  14. Identifying Gaps and Launching Resident Wellness Initiatives: The 2017 Resident Wellness Consensus Summit.

    Science.gov (United States)

    Zaver, Fareen; Battaglioli, Nicole; Denq, William; Messman, Anne; Chung, Arlene; Lin, Michelle; Liu, Emberlynn L

    2018-03-01

    Burnout, depression, and suicidality among residents of all specialties have become a critical focus for the medical education community, especially among learners in graduate medical education. In 2017 the Accreditation Council for Graduate Medical Education (ACGME) updated the Common Program Requirements to focus more on resident wellbeing. To address this issue, one working group from the 2017 Resident Wellness Consensus Summit (RWCS) focused on wellness program innovations and initiatives in emergency medicine (EM) residency programs. Over a seven-month period leading up to the RWCS event, the Programmatic Initiatives workgroup convened virtually in the Wellness Think Tank, an online, resident community consisting of 142 residents from 100 EM residencies in North America. A 15-person subgroup (13 residents, two faculty facilitators) met at the RWCS to develop a public, central repository of initiatives for programs, as well as tools to assist programs in identifying gaps in their overarching wellness programs. An online submission form and central database of wellness initiatives were created and accessible to the public. Wellness Think Tank members collected an initial 36 submissions for the database by the time of the RWCS event. Based on general workplace, needs-assessment tools on employee wellbeing and Kern's model for curriculum development, a resident-based needs-assessment survey and an implementation worksheet were created to assist residency programs in wellness program development. The Programmatic Initiatives workgroup from the resident-driven RWCS event created tools to assist EM residency programs in identifying existing initiatives and gaps in their wellness programs to meet the ACGME's expanded focus on resident wellbeing.

  15. Identifying Gaps and Launching Resident Wellness Initiatives: The 2017 Resident Wellness Consensus Summit

    Directory of Open Access Journals (Sweden)

    Nicole Battaglioli

    2018-02-01

    Full Text Available Introduction: Burnout, depression, and suicidality among residents of all specialties have become a critical focus for the medical education community, especially among learners in graduate medical education. In 2017 the Accreditation Council for Graduate Medical Education (ACGME updated the Common Program Requirements to focus more on resident wellbeing. To address this issue, one working group from the 2017 Resident Wellness Consensus Summit (RWCS focused on wellness program innovations and initiatives in emergency medicine (EM residency programs. Methods: Over a seven-month period leading up to the RWCS event, the Programmatic Initiatives workgroup convened virtually in the Wellness Think Tank, an online, resident community consisting of 142 residents from 100 EM residencies in North America. A 15-person subgroup (13 residents, two faculty facilitators met at the RWCS to develop a public, central repository of initiatives for programs, as well as tools to assist programs in identifying gaps in their overarching wellness programs. Results: An online submission form and central database of wellness initiatives were created and accessible to the public. Wellness Think Tank members collected an initial 36 submissions for the database by the time of the RWCS event. Based on general workplace, needs-assessment tools on employee wellbeing and Kern’s model for curriculum development, a resident-based needs-assessment survey and an implementation worksheet were created to assist residency programs in wellness program development. Conclusion: The Programmatic Initiatives workgroup from the resident-driven RWCS event created tools to assist EM residency programs in identifying existing initiatives and gaps in their wellness programs to meet the ACGME’s expanded focus on resident wellbeing.

  16. Microhabitat and Climatic Niche Change Explain Patterns of Diversification among Frog Families.

    Science.gov (United States)

    Moen, Daniel S; Wiens, John J

    2017-07-01

    A major goal of ecology and evolutionary biology is to explain patterns of species richness among clades. Differences in rates of net diversification (speciation minus extinction over time) may often explain these patterns, but the factors that drive variation in diversification rates remain uncertain. Three important candidates are climatic niche position (e.g., whether clades are primarily temperate or tropical), rates of climatic niche change among species within clades, and microhabitat (e.g., aquatic, terrestrial, arboreal). The first two factors have been tested separately in several studies, but the relative importance of all three is largely unknown. Here we explore the correlates of diversification among families of frogs, which collectively represent ∼88% of amphibian species. We assemble and analyze data on phylogeny, climate, and microhabitat for thousands of species. We find that the best-fitting phylogenetic multiple regression model includes all three types of variables: microhabitat, rates of climatic niche change, and climatic niche position. This model explains 67% of the variation in diversification rates among frog families, with arboreal microhabitat explaining ∼31%, niche rates ∼25%, and climatic niche position ∼11%. Surprisingly, we show that microhabitat can have a much stronger influence on diversification than climatic niche position or rates of climatic niche change.

  17. Do Slow and Steady Residents Win the Race? Modeling the Effects of Peak and Overall Resident Productivity in the Emergency Department.

    Science.gov (United States)

    Joseph, Joshua W; Novack, Victor; Wong, Matthew L; Nathanson, Larry A; Sanchez, Leon D

    2017-08-01

    Emergency medicine residents need to be staffed in a way that balances operational needs with their educational experience. Key to developing an optimal schedule is knowing a resident's expected productivity, a poorly understood metric. We sought to measure how a resident's busiest (peak) workload affects their overall productivity for the shift. We conducted a retrospective, observational study of resident productivity at an urban, tertiary care center with a 3-year Accreditation Council for Graduate Medical Education-approved emergency medicine training program, with 55,000 visits annually. We abstracted resident productivity data from a database of patient assignments from July 1, 2010 to June 20, 2015, utilizing a generalized estimation equation method to evaluate physician shifts. Our primary outcome measure was the total number of patients seen by a resident over a shift. The secondary outcome was the number of patients seen excluding those in the peak hour. A total of 14,361 shifts were evaluated. Multivariate analysis showed that the total number of patients seen was significantly associated with the number of patients seen during the peak hour, level of training, the timing of the shift, but most prominently, lower variance in patients seen per hour (coefficient of variation productivity can be a strong predictor of their overall productivity, but the substantial negative effect of variability favors a steadier pace. This suggests that resident staffing and patient assignments should generally be oriented toward a more consistent workload, an effect that should be further investigated with attending physicians. Copyright © 2017 Elsevier Inc. All rights reserved.

  18. Challenges of pediatric residency training in Taiwan.

    Science.gov (United States)

    Tsai, Tsuen-Chiuan; Harasym, Peter H

    2006-01-01

    A crisis in pediatric residency training today has raised serious concerns about the healthcare quality for children in Taiwan. The purpose of this study was to document the problems and to propose possible solutions for improvement. The problems include: 1) manpower shortage due to the difficulty of recruiting pediatric residents; 2) heavy workload that hinders learning; 3) lack of assessment and poor program planning; and 4) inadequate institutional and financial support. As a result, physicians' competencies are not guaranteed at the end of residency training, even with the pediatric board certification. Possible solutions may include: 1) conducting research on physician manpower statistics, work hours and environment; 2) establishing a Residency Program Review Committee and provision of standards for accreditation; 3) defining the competencies mandated as a general pediatrician and developing a set of measurable qualitative standards; 4) encouraging new programs with flexibility (e.g., primary care); and 5) pursuing adequate institutional and financial supports.

  19. Resident Station Contact Information for Application Developers

    Data.gov (United States)

    Social Security Administration — SSA provides a web service and downloadable file for SSA Resident Station locations, telephone numbers, and hours of operation. (Note: If you think an office might...

  20. Thermal discharge residence by Lake Michigan Salmonids

    International Nuclear Information System (INIS)

    Romberg, G.P.; Prepejchal, W.

    1975-01-01

    Lake Michigan salmon and trout were tagged with a thermoluminescent dosimeter (TLD) temperature tag to estimate their thermal exposure and residence time at a warm water discharge. Fish were collected, tagged, and released at the Point Beach Nuclear Plant, Two Rivers, Wisconsin, in the fall of 1973 and 1974. Tags were recovered during the same season, primarily from fish recaptured at Point Beach. Average uniform temperature exposure and maximum possible discharge residence time were determined. Appropriate hourly intake and discharge temperatures were averaged to calculate mean temperature exposure for the case of maximum discharge residence. Lowest discharge temperature not included within the period of maximum residence was identified to serve as a possible indicator of avoidance temperature. Mean values for the above parameters were calculated for fish species for each tagging year and are reported with the accompanying range of intake and discharge temperatures

  1. Knowledge and Utilization of Electrocardiogram among Resident ...

    African Journals Online (AJOL)

    2017-10-26

    Oct 26, 2017 ... knowledge and utilization of ECG among family medicine residents in Nigeria. Materials and ... doctors regarding their ECG requests, preferred source of interpretation, most common ECG ..... There are no conflicts of interest.

  2. Introducing "optimal challenges" in resident training

    DEFF Research Database (Denmark)

    Sørensen, Anette Bagger; Christensen, Mette Krogh

    Background: Residents are often caught between two interests: the resident’s desire to participate in challenging learning situations and the department’s work planning. However, these interests may clash if they are not coordinated by the senior doctors, and challenging learning situations risk...... that the residents benefit from the intervention because they experienced more optimal challenges than before the intervention. However, the matching of resident and case seems to work against the established culture in the department: The daily work has for many years been organized so that senior doctors have...... their “own” patients and they do not “share” patients with residents. Thus the patients were accustomed to have their “own” specialist doctor. Conclusion: The intervention generated optimal challenges, but revealed the need for more team-based organization of senior doctors and residents’ working...

  3. Request by the Resident Representative of Iraq

    International Nuclear Information System (INIS)

    1990-01-01

    The attached clarification by a spokesman of the Iraqi Ministry of Foreign Affairs is being circulated for the information of Member States pursuant to a request made by the Resident Representative of Iraq

  4. General Surgery Resident Satisfaction on Cardiothoracic Rotations.

    Science.gov (United States)

    Lussiez, Alisha; Bevins, Jack; Plaska, Andrew; Rosin, Vadim; Reddy, Rishindra M

    2016-01-01

    General surgery residents' exposure to cardiothoracic (CT) surgery rotations has decreased, which may affect resident satisfaction. We surveyed general surgery graduates to assess the relationships among rotation satisfaction, CT disease exposure, rotation length, mentorship, and mistreatment. A survey assessing CT curriculum, exposure, mentorship, and satisfaction was forwarded to general surgery graduates from 17 residency programs. A Wilcoxon rank-sum test was used to assess statistical significance of ordinal level data. Statistical significance was defined as p surgery residency programs who graduated between the years of 1999 to 2014. A total of 94 responses were completed and received. Receiving adequate exposure to CT procedures and disease management was significantly associated with higher satisfaction ratings for all procedures, particularly thoracotomy incisions (p Surgery. Published by Elsevier Inc. All rights reserved.

  5. Do you get it? User-evaluated explainable BDI agents

    NARCIS (Netherlands)

    Broekens, J.; Harbers, M.; Hindriks, K.; Bosch, K. van den; Jonker, C.; Meyer, J.J.C.

    2010-01-01

    In this paper we focus on explaining to humans the behavior of autonomous agents, i.e., explainable agents. Explainable agents are useful for many reasons including scenario-based training (e.g. disaster training), tutor and pedagogical systems, agent development and debugging, gaming, and

  6. Mobile technology in radiology resident education.

    Science.gov (United States)

    Korbage, Aiham C; Bedi, Harprit S

    2012-06-01

    The authors hypothesized that ownership of a mobile electronic device would result in more time spent learning radiology. Current trends in radiology residents' studying habits, their use of electronic and printed radiology learning resources, and how much of the funds allotted to them are being used toward printed vs electronic education tools were assessed in this study. A survey study was conducted among radiology residents across the United States from June 13 to July 5, 2011. Program directors listed in the Association of Program Directors in Radiology e-mail list server received an e-mail asking for residents to participate in an online survey. The questionnaire consisted of 12 questions and assessed the type of institution, the levels of training of the respondents, and book funds allocated to residents. It also assessed the residents' study habits, access to portable devices, and use of printed and electronic radiology resources. Radiology residents are adopters of new technologies, with 74% owning smart phones and 37% owning tablet devices. Respondents spend nearly an equal amount of time learning radiology from printed textbooks as they do from electronic resources. Eighty-one percent of respondents believe that they would spend more time learning radiology if provided with tablet devices. There is considerable use of online and electronic resources and mobile devices among the current generation of radiology residents. Benefits, such as more study time, may be obtained by radiology programs that incorporate tablet devices into the education of their residents. Copyright © 2012 American College of Radiology. Published by Elsevier Inc. All rights reserved.

  7. Emergency Medicine Resident Perceptions of Medical Professionalism.

    Science.gov (United States)

    Jauregui, Joshua; Gatewood, Medley O; Ilgen, Jonathan S; Schaninger, Caitlin; Strote, Jared

    2016-05-01

    Medical professionalism is a core competency for emergency medicine (EM) trainees; but defining professionalism remains challenging, leading to difficulties creating objectives and performing assessment. Because professionalism is dynamic, culture-specific, and often taught by modeling, an exploration of trainees' perceptions can highlight their educational baseline and elucidate the importance they place on general conventional professionalism domains. To this end, our objective was to assess the relative value EM residents place on traditional components of professionalism. We performed a cross-sectional, multi-institutional survey of incoming and graduating EM residents at four programs. The survey was developed using the American Board of Internal Medicine's "Project Professionalism" and the Accreditation Council of Graduate Medical Education definition of professionalism competency. We identified 27 attributes within seven domains: clinical excellence, humanism, accountability, altruism, duty and service, honor and integrity, and respect for others. Residents were asked to rate each attribute on a 10-point scale. We analyzed data to assess variance across attributes as well as differences between residents at different training levels or different institutions. Of the 114 residents eligible, 100 (88%) completed the survey. The relative value assigned to different professional attributes varied considerably, with those in the altruism domain valued significantly lower and those in the "respect for others" and "honor and integrity" valued significantly higher (p<0.001). Significant differences were found between interns and seniors for five attributes primarily in the "duty and service" domain (p<0.05). Among different residencies, significant differences were found with attributes within the "altruism" and "duty and service" domains (p<0.05). Residents perceive differences in the relative importance of traditionally defined professional attributes and this may

  8. The urology residency matching program in practice.

    Science.gov (United States)

    Teichman, J M; Anderson, K D; Dorough, M M; Stein, C R; Optenberg, S A; Thompson, I M

    2000-06-01

    We evaluate behaviors and attitudes among resident applicants and program directors related to the American Urological Association (AUA) residency matching program and recommend changes to improve the match. Written questionnaires were mailed to 519 resident applicants and 112 program directors after the 1999 American Urological Association match. Subjects were asked about their observations, behaviors and opinions towards the match. Questionnaires were returned by 230 resident applicants and 94 program directors (44% and 83% response rates, respectively.) Of the resident applicants 75% spent $1,001 to $5,000 for interviewing. Of the program directors 47% recalled that applicants asked how programs would rank the applicant and 61% of applicants recalled that program directors asked applicants how they would rank programs. Dishonesty was acknowledged by 31% of program directors and 44% of resident applicants. Of program directors 82% thought applicants "lied", while 67% of applicants thought that programs "lied" (quotations indicate questionnaire language). Participants characterized their own dishonesty as "just playing the game" or they "did not feel badly." Of program directors 81% and of applicants 61% were "skeptical" or "did not believe" when informed they were a "high" or "number 1" selection. Being asked about marital status was recalled by 91% of male and 100% of female (p = 0. 02), if they had children by 53% of male and 67% of female, (p = 0. 03), and intent to have children by 25% of male and 62% of female (p match code rules frequently. Program directors and resident applicants are skeptical of each other. Patterns of faculty behavior differ based on applicant gender. Interviews are costly for applicants. We recommend that 1) programs adopt policies to enhance fairness, 2) applications be filed electronically, 3) programs assist resident applicants with interview accommodation to reduce financial burden and 4) a post-interview code of limited or

  9. Informatics and Technology in Resident Education.

    Science.gov (United States)

    Niehaus, William

    2017-05-01

    Biomedical or clinical informatics is the transdisciplinary field that studies and develops effective uses of biomedical data, information technology innovations, and medical knowledge for scientific inquiry, problem solving, and decision making, with an emphasis on improving human health. Given the ongoing advances in information technology, the field of informatics is becoming important to clinical practice and to residency education. This article will discuss how informatics is specifically relevant to residency education and the different ways to incorporate informatics into residency education, and will highlight applications of current technology in the context of residency education. How informatics can optimize communication for residents, promote information technology use, refine documentation techniques, reduce medical errors, and improve clinical decision making will be reviewed. It is hoped that this article will increase faculty and trainees' knowledge of the field of informatics, awareness of available technology, and will assist practitioners to maximize their ability to provide quality care to their patients. This article will also introduce the idea of incorporating informatics specialists into residency programs to help practitioners deliver more evidenced-based care and to further improve their efficiency. Copyright © 2017 American Academy of Physical Medicine and Rehabilitation. Published by Elsevier Inc. All rights reserved.

  10. Thoracic surgical resident education: a costly endeavor.

    Science.gov (United States)

    Calhoon, John H; Baisden, Clint; Holler, Ben; Hicks, George L; Bove, Ed L; Wright, Cameron D; Merrill, Walter H; Fullerton, Dave A

    2014-12-01

    We sought to define an accurate measure of thoracic surgical education costs. Program directors from six distinct and differently sized and geographically located thoracic surgical training programs used a common template to provide estimates of resident educational costs. These data were reviewed, clarifying questions or discrepancies when noted and using best estimates when exact data were unavailable. Subsequently, a composite of previously published cost-estimation products was used to capture accurate cost data. Data were then compiled and averaged to provide an accurate picture of all costs associated with thoracic surgical education. Before formal accounting was performed, the estimated average for all programs was approximately $250,000 per year per resident. However, when formal evaluations by the six programs were performed, the annual cost of resident education ranged from $330,000 to $667,000 per year per resident. The average cost of $483,000 per year was almost double the initial estimates. Variability was noted by region and size of program. Faculty teaching costs varied from $208,000 to $346,000 per year. Simulation costs ranged from $0 to $80,000 per year. Resident savings to program ranged from $0 to $135,000 per year and averaged $37,000 per year per resident. Thoracic surgical education costs are considerably higher than initial estimates from program directors and probably represent an unappreciated source of financial burden for cardiothoracic surgical educational programs. Copyright © 2014 The Society of Thoracic Surgeons. Published by Elsevier Inc. All rights reserved.

  11. seasonal variation and prevalence of tuberculosis among health

    African Journals Online (AJOL)

    Damary

    2006-11-11

    Nov 11, 2006 ... effects of seasonal variation on the incidence of TB in the study area and to use sentinel analysis to predict areas of ... One third of the world's population is exposed to TB ... residence and ethnic origin) were collected from all.

  12. On the Total Variation Distance of Semi-Markov Chains

    DEFF Research Database (Denmark)

    Bacci, Giorgio; Bacci, Giovanni; Larsen, Kim Guldstrand

    2015-01-01

    Semi-Markov chains (SMCs) are continuous-time probabilistic transition systems where the residence time on states is governed by generic distributions on the positive real line. This paper shows the tight relation between the total variation distance on SMCs and their model checking problem over...

  13. Calculus of variations

    CERN Document Server

    Elsgolc, Lev D

    2007-01-01

    This concise text offers both professionals and students an introduction to the fundamentals and standard methods of the calculus of variations. In addition to surveys of problems with fixed and movable boundaries, it explores highly practical direct methods for the solution of variational problems.Topics include the method of variation in problems with fixed boundaries; variational problems with movable boundaries and other problems; sufficiency conditions for an extremum; variational problems of constrained extrema; and direct methods of solving variational problems. Each chapter features nu

  14. Genetic factors explain half of all variance in serum eosinophil cationic protein

    DEFF Research Database (Denmark)

    Elmose, Camilla; Sverrild, Asger; van der Sluis, Sophie

    2014-01-01

    with variation in serum ECP and to determine the relative proportion of the variation in ECP due to genetic and non-genetic factors, in an adult twin sample. METHODS: A sample of 575 twins, selected through a proband with self-reported asthma, had serum ECP, lung function, airway responsiveness to methacholine......, exhaled nitric oxide, and skin test reactivity, measured. Linear regression analysis and variance component models were used to study factors associated with variation in ECP and the relative genetic influence on ECP levels. RESULTS: Sex (regression coefficient = -0.107, P ... was statistically non-significant (r = -0.11, P = 0.50). CONCLUSION: Around half of all variance in serum ECP is explained by genetic factors. Serum ECP is influenced by sex, BMI, and airway responsiveness. Serum ECP and airway responsiveness seem not to share genetic variance....

  15. Slum residence and child health in developing countries.

    Science.gov (United States)

    Fink, Günther; Günther, Isabel; Hill, Kenneth

    2014-08-01

    Continued population growth and increasing urbanization have led to the formation of large informal urban settlements in many developing countries in recent decades. The high prevalence of poverty, overcrowding, and poor sanitation observed in these settlements-commonly referred to as "slums"-suggests that slum residence constitutes a major health risk for children. In this article, we use data from 191 Demographic and Health Surveys (DHS) across 73 developing countries to investigate this concern empirically. Our results indicate that children in slums have better health outcomes than children living in rural areas yet fare worse than children in better-off neighborhoods of the same urban settlements. A large fraction of the observed health differences appears to be explained by pronounced differences in maternal education, household wealth, and access to health services across residential areas. After we control for these characteristics, children growing up in the slums and better-off neighborhoods of towns show levels of morbidity and mortality that are not statistically different from those of children living in rural areas. Compared with rural children, children living in cities (irrespective of slum or formal residence) fare better with respect to mortality and stunting but not with respect to recent illness episodes.

  16. Documentation and billing for services provided by midwives teaching obstetrics and gynecology residents and medical students.

    Science.gov (United States)

    Wilson-Liverman, Angela; Slager, Joan; Wage, Deborah

    2009-01-01

    Certified nurse-midwives are teaching obstetrics and gynecology residents and medical students in major academic institutions across the United States. In these instances, the ability to appropriately document services rendered to support a billable service is paramount. This article explains the difference in requirements for midwives' documentation when working with residents compared with documentation required of an attending obstetrician-gynecologist. It also reviews the teaching physician guidelines developed by the Centers for Medicare and Medicaid Services (CMS) as well as current evaluation and management documentation requirements. Several examples of documentation are provided, as are suggestions for enhancement and simplification of the guidelines to include midwives. An important point to remember is that the CMS rules do not prohibit a certified nurse-midwife from teaching a resident.

  17. Agricultural management explains historic changes in regional soil carbon stocks

    Science.gov (United States)

    van Wesemael, Bas; Paustian, Keith; Meersmans, Jeroen; Goidts, Esther; Barancikova, Gabriela; Easter, Mark

    2010-01-01

    Agriculture is considered to be among the economic sectors having the greatest greenhouse gas mitigation potential, largely via soil organic carbon (SOC) sequestration. However, it remains a challenge to accurately quantify SOC stock changes at regional to national scales. SOC stock changes resulting from SOC inventory systems are only available for a few countries and the trends vary widely between studies. Process-based models can provide insight in the drivers of SOC changes, but accurate input data are currently not available at these spatial scales. Here we use measurements from a soil inventory dating from the 1960s and resampled in 2006 covering the major soil types and agricultural regions in Belgium together with region-specific land use and management data and a process-based model. The largest decreases in SOC stocks occurred in poorly drained grassland soils (clays and floodplain soils), consistent with drainage improvements since 1960. Large increases in SOC in well drained grassland soils appear to be a legacy effect of widespread conversion of cropland to grassland before 1960. SOC in cropland increased only in sandy lowland soils, driven by increasing manure additions. Modeled land use and management impacts accounted for more than 70% of the variation in observed SOC changes, and no bias could be demonstrated. There was no significant effect of climate trends since 1960 on observed SOC changes. SOC monitoring networks are being established in many countries. Our results demonstrate that detailed and long-term land management data are crucial to explain the observed SOC changes for such networks. PMID:20679194

  18. Life history dependent morphometric variation in stream-dwelling Atlantic salmon

    Science.gov (United States)

    Letcher, B.H.

    2003-01-01

    The time course of morphometric variation among life histories for stream-dwelling Atlantic salmon (Salmo salar L.) parr (age-0+ to age-2+) was analyzed. Possible life histories were combinations of parr maturity status in the autumn (mature or immature) and age at outmigration (smolt at age-2+ or later age). Actual life histories expressed with enough fish for analysis in the 1997 cohort were immature/age-2+ smolt, mature/age-2 +smolt, and mature/age-2+ non-smolt. Tagged fish were assigned to one of the three life histories and digital pictures from the field were analyzed using landmark-based geometric morphometrics. Results indicated that successful grouping of fish according to life history varied with fish age, but that fish could be grouped before the actual expression of the life histories. By March (age-1+), fish were successfully grouped using a descriptive discriminant function and successful assignment ranged from 84 to 97% for the remainder of stream residence. A jackknife of the discriminant function revealed an average life history prediction success of 67% from age-1+ summer to smolting. Low sample numbers for one of the life histories may have limited prediction success. A MANOVA on the shape descriptors (relative warps) also indicated significant differences in shape among life histories from age-1+ summer through to smolting. Across all samples, shape varied significantly with size. Within samples, shape did not vary significantly with size for samples from December (age-0+) to May (age-1+). During the age-1+ summer however, shape varied significantly with size, but the relationship between shape and size was not different among life histories. In the autumn (age-1+) and winter (age-2+), life history differences explained a significant portion of the change in shape with size. Life history dependent morphometric variation may be useful to indicate the timing of early expressions of life history variation and as a tool to explore temporal and

  19. Geographic Variation in Maternal Smoking during Pregnancy in the Missouri Adolescent Female Twin Study (MOAFTS)

    Science.gov (United States)

    Lian, Min; Madden, Pamela A.; Lynskey, Michael T.; Colditz, Graham A.; Lessov-Schlaggar, Christina N.; Schootman, Mario; Heath, Andrew C.

    2016-01-01

    Objective Despite well-known adverse health effects of maternal smoking during pregnancy (MSP), it is still unclear if MSP varies geographically and if neighborhood socioeconomic deprivation (SED) plays an important role in MSP. This study aims to investigate small-area geographic variation in MSP and examine the association of SED with MSP. Methods The Missouri Adolescent Female Twin Study (MOAFTS) is a cohort study of female like-sex twins born in Missouri to Missouri-resident parents during 1975–1985. Biological mothers completed a baseline interview in 1995–1998 and reported MSP with the twins. Residential address of the mother at birth was geocoded. We developed a census tract-level SED index using a common factor approach based on 21 area-level socioeconomic variables from the 1980 Census data. Multilevel logistic regressions estimated geographic heterogeneity (random effect) in MSP and the odds ratios (ORs, fixed effects) of neighborhood SED associated with MSP. Results Of 1658 MOAFTS mothers, 35.2% reported any MSP and 21.9% reported MSP beyond the first trimester. Neighborhood SED was associated with any MSP (the highest vs. the lowest quartile: OR = 1.90, 95% confidence interval [CI] = 1.40–2.57, Ptrendalcohol use, and parents’ cohabitation), neighborhood SED was not associated with MSP, but geographic variation still persisted in MSP (variance = 0.41, P = 0.003) and in MSP beyond the first trimester (variance = 0.82, P<0.001). Conclusions Neighborhood SED was associated with MSP in unadjusted analyses but this association could be explained by individual socioeconomic conditions. Nonetheless, significant geographic variation in MSP persisted and was not accounted for by differences in neighborhood SED. To develop effective interventions to reduce MSP, further studies are necessary to explore underlying reasons for its geographic variation. PMID:27100091

  20. The Resident Academic Project Program: A Structured Approach to Inspiring Academic Development During Residency Training.

    Science.gov (United States)

    Eckert, Jill; Vaida, Sonia J; Bezinover, Dmitri; McCloskey, Diane E; Mets, Berend

    2016-02-15

    We report the successful implementation of structured resident academic projects in our Department of Anesthesiology at the Penn State Hershey Medical Center. Beginning with the graduating class of 2010, we adopted an expectation that each resident complete a project that results in a manuscript of publishable quality. Defining a clear timeline for all steps in the project and providing research education, as well as the necessary infrastructure and ongoing support, has helped grow the academic productivity of our anesthesia residents.