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Sample records for resident assistants entitled

  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. Structural Analysis of the Resident Assistant Cultural Diversity Questionnaire

    Science.gov (United States)

    Johnson, Vanessa D.; Kang, Young-Shin; Thompson, George F.

    2011-01-01

    This study investigated the five-factor structure of the Resident Assistant Cultural Diversity (RACD) instrument, which assesses resident assistant (RA) confidence in addressing issues of cultural diversity in college and university residence halls. The instrument has five components that explore RA confidence: (1) belief in the need for cultural…

  3. Resident Transitions to Assisted Living: A Role for Social Workers

    Science.gov (United States)

    Fields, Noelle LeCrone; Koenig, Terry; Dabelko-Schoeny, Holly

    2012-01-01

    This study explored key aspects of resident transitions to assisted living (AL), including the frequency and importance of preadmission resident education and the potential role of social workers in this setting. To examine the factors that may help or hinder resident transitions to AL, a written survey was administered to a statewide,…

  4. Surgical Residents are Excluded From Robot-assisted Surgery

    DEFF Research Database (Denmark)

    Broholm, Malene; Rosenberg, Jacob

    2015-01-01

    PURPOSE: Implementation of a robotic system may influence surgical training. The aim was to report the charge of the operating surgeon and the bedside assistant at robot-assisted procedures in urology, gynecology, and colorectal surgery. MATERIALS AND METHODS: A review of hospital charts from...... performed. In 10 (1.3%) of these procedures, a resident attended as bedside assistant and never as operating surgeon in the console. CONCLUSIONS: Our results demonstrate a severe problem with surgical education. Robot-assisted surgery is increasingly used; however, robotic surgical training during residency...... surgical procedures during a 1-year period from October 2013 to October 2014. All robot-assisted urologic, gynecologic, and colorectal procedures were identified. Charge of both operating surgeon in the console and bedside assistant were registered. RESULTS: A total of 774 robot-assisted procedures were...

  5. Resident-to-resident relational aggression and subjective well-being in assisted living facilities

    NARCIS (Netherlands)

    Trompetter, H.R.; Trompetter, Hester; Scholte, Ron; Westerhof, Gerben Johan

    2011-01-01

    Purpose: Research in settings similar to assisted living facilities suggests that relational aggression, an indirect and mature form of aggression, might occur in assisted living facilities. This empirical study investigates the existence of relational aggression in a sample of residents and the

  6. Resident-to-resident relational aggression and subjective well-being in assisted living facilities.

    Science.gov (United States)

    Trompetter, Hester; Scholte, Ron; Westerhof, Gerben

    2011-01-01

    Research in settings similar to assisted living facilities suggests that relational aggression, an indirect and mature form of aggression, might occur in assisted living facilities. This empirical study investigates the existence of relational aggression in a sample of residents and the relationship between relational aggression and resident's subjective well-being. 121 residents from six assisted living facilities completed questionnaires assessing personal experiences as victims of relational aggression and subjective well-being. Also nurses reported on victimization of relational aggression for every participant. Linear regression models were used to examine the association between both reports of relational aggression and subjective well-being. Relational aggression was shown to exist in assisted living facilities according to both residents (prevalence: 19%) and nurses (prevalence: 41%). Chi-square testing revealed no association between ratings by nurses and residents. Self-reports of victimization of relational aggression were related to depression, anxiety, satisfaction with life and social loneliness, but not to emotional loneliness. Nurse-reports of victimization of relational aggression were not related to subjective well-being. Self-reports of relational aggression seem to be better predictors of resident's well-being than nurse-reports of relational aggression. Awareness of these findings and the discrepancy between nurse-reports and self-reports are important for practice and for future research regarding social dynamics and living arrangements in elderly care settings.

  7. Resident transitions to assisted living: a role for social workers.

    Science.gov (United States)

    Fields, Noelle LeCrone; Koenig, Terry; Dabelko-Schoeny, Holly

    2012-08-01

    This study explored key aspects of resident transitions to assisted living (AL), including the frequency and importance of preadmission resident education and the potential role of social workers in this setting. To examine the factors that may help or hinder resident transitions to AL, a written survey was administered to a statewide, geographically representative purposive sample of Medicaid Assisted Living Waiver providers (N = 28). Findings suggest a positive relationship between the availability of a social worker and the frequency and importance of resident preadmission education in several areas. Results also suggest a gap between what AL providers believe is important for resident transitions and what is actually happening in their facilities. Social workers may play a significant role in providing preadmission education and are well positioned to address the unmet psychosocial needs of residents and family members during the transition to AL. Future studies should specifically examine the contributing role of social workers during the period of adjustment to AL and the effect of social work services on the well-being of AL residents and families in AL settings.

  8. Social Support and Successful Aging in Assisted Living Residents

    Science.gov (United States)

    Howie, Laura Odell; Troutman-Jordan, Meredith; Newman, Ann M.

    2014-01-01

    Successful aging has been associated with adequate social support. However, impaired functionality, increased dependence, multiple comorbidities, and reduced social interactions place older assisted living community (ALC) residents at risk for poorer social support and less successful aging. This cross-sectional descriptive study used the revised…

  9. The Relationship between Stress, Job Performance, and Burnout in College Student Resident Assistants.

    Science.gov (United States)

    Nowak, Kenneth M.; Hanson, Alan L.

    1983-01-01

    Examined the relationship of stress, personality characteristics, and cognitive hardiness to job performance, burnout, and physical illness in resident assistants (N=37). Results indicated cognitive hardiness acts as a buffer against burnout and physical illness. Resident assistants rating themselves as Type A received poorer job performance…

  10. Peer-Assisted Analysis of Resident Feedback Improves Clinical Teaching: A Case Report.

    Science.gov (United States)

    Mai, Christine L; Baker, Keith

    2017-07-01

    Anesthesiologists play an important role in educating future clinicians. Yet few residency programs incorporate teaching skills into faculty development. Consequently, many anesthesiologists have limited training to supervise and educate residents. In turn, these attendings may receive negative feedback and poor evaluations from residents without a means to effectively improve. Peer-assisted teaching between faculty members may serve as a strategy to improve teaching skills. We report a case of peer-assisted analysis of resident feedback to identify specific areas of concern that were targeted for improvement. This approach resulted in improved teaching scores and feedback for the faculty member.

  11. Negotiating the Lack of Intimacy in Assisted Living: Resident Desires, Barriers, and Strategies.

    Science.gov (United States)

    Bender, Alexis A; Burgess, Elisabeth O; Barmon, Christina

    2017-12-01

    Despite continuity in the desire for sex and partnership, many older adults experience a lack of intimacy in late life. The use of assisted living is a complicating factor for understanding issues of partnership, sex, and intimacy for older adults. Using in-depth interviews with 23 assisted living residents and grounded theory methods, we examined how residents negotiate a lack of intimacy in assisted living. The process of negotiation entailed three factors: desire, barriers, and strategies. Although some residents continued to desire intimacy, there was a marked absence of dating or intimacy in our study sites. Findings highlight unique barriers to acting on desire and the strategies residents used as aligning actions between desire and barriers. This research expands previous studies of sexuality and older adults by examining the complex ways in which they balanced desire and barriers through the use of strategies within the assisted living environment.

  12. General surgery residents' perception of robot-assisted procedures during surgical training.

    Science.gov (United States)

    Farivar, Behzad S; Flannagan, Molly; Leitman, I Michael

    2015-01-01

    With the continued expansion of robotically assisted procedures, general surgery residents continue to receive more exposure to this new technology as part of their training. There are currently no guidelines or standardized training requirements for robot-assisted procedures during general surgical residency. The aim of this study was to assess the effect of this new technology on general surgery training from the residents' perspective. An anonymous, national, web-based survey was conducted on residents enrolled in general surgery training in 2013. The survey was sent to 240 Accreditation Council for Graduate Medical Education-approved general surgery training programs. Overall, 64% of the responding residents were men and had an average age of 29 years. Half of the responses were from postgraduate year 1 (PGY1) and PGY2 residents, and the remainder was from the PGY3 level and above. Overall, 50% of the responses were from university training programs, 32% from university-affiliated programs, and 18% from community-based programs. More than 96% of residents noted the availability of the surgical robot system at their training institution. Overall, 63% of residents indicated that they had participated in robotic surgical cases. Most responded that they had assisted in 10 or fewer robotic cases with the most frequent activities being assisting with robotic trocar placement and docking and undocking the robot. Only 18% reported experience with operating the robotic console. More senior residents (PGY3 and above) were involved in robotic cases compared with junior residents (78% vs 48%, p robotic case. Approximately 64% of residents reported that formal training in robotic surgery was important in residency training and 46% of residents indicated that robotic-assisted cases interfered with resident learning. Only 11% felt that robotic-assisted cases would replace conventional laparoscopic surgery in the future. This study illustrates that although the most residents

  13. Hope, Laughter, and Humor in Residents and Staff at an Assisted Living Facility.

    Science.gov (United States)

    Westburg, Nancy G.

    2003-01-01

    Assesses and compares hope levels and laughter and humor experiences of 24 elderly residents and 21 staff at an assisted living facility. Residents and staff reported numerous benefits from humor and laughing, but differences arose between the two groups about the source and frequency of humor and laughter. Implications for mental health…

  14. How Expectations Do Not Equate with Practice: The Gendered Reality of the Female Resident Assistant

    Science.gov (United States)

    Cousineau, Luc; Chambers, Lori

    2015-01-01

    Residence hall and house employees (resident assistants) at postsecondary institutions in Canada are an important part of the social and rules-based structure that allows these facilities to operate. These employees are challenged with varied situations that require the application of mediation, authoritarian, recognition, and referral skills. To…

  15. The physical environment influences neuropsychiatric symptoms and other outcomes in assisted living residents.

    Science.gov (United States)

    Bicket, Mark C; Samus, Quincy M; McNabney, Mathew; Onyike, Chiadi U; Mayer, Lawrence S; Brandt, Jason; Rabins, Peter; Lyketsos, Constantine; Rosenblatt, Adam

    2010-10-01

    Although the number of elderly residents living in assisted living (AL) facilities is rising, few studies have examined the AL physical environment and its impact on resident well-being. We sought to quantify the relationship of AL physical environment with resident outcomes including neuropsychiatric symptoms (NPS), quality of life (QOL), and fall risk, and to compare the effects for demented and non-demented residents. Prospective cohort study of a stratified random sample of 326 AL residents living in 21 AL facilities. Measures included the Therapeutic Environmental Screening Scale for Nursing Homes and Residential Care (TESS-NH/RC) to rate facilities and in-person assessment of residents for diagnosis (and assessment of treatment) of dementia, ratings on standardized clinical, cognitive, and QOL measures. Regression models compared environmental measures with outcomes. TESS-NH/RC is modified into a scale for rating the AL physical environment AL-EQS. The AL Environmental Quality Score (AL-EQS) was strongly negatively associated with Neuropsychiatric Inventory (NPI) total score (p environment of AL facilities likely affects NPS and QOL in AL residents, and the effect may be stronger for residents without dementia than for residents with dementia. Environmental manipulations that increase resident privacy, as well as implementing call buttons and telephones, may improve resident well-being. Copyright © 2010 John Wiley & Sons, Ltd.

  16. Dysphonia in nursing home and assisted living residents: prevalence and association with frailty.

    Science.gov (United States)

    G Nichols, Brent; Varadarajan, Varun; Bock, Jonathan M; Blumin, Joel H

    2015-01-01

    Previous studies of geriatric dysphonia prevalence have been limited to ambulatory outpatient and senior communities. Our goal was to identify prevalence of dysphonia in nursing home residents and assisted living residents and search for correlations between indices of dysphonia and indices of frailty. Prospective epidemiological survey. Residents of a vertically integrated senior care organization who were 65 or older and able to understand and complete the questionnaire were recruited to complete the voice handicap index 10 (VHI-10) to assess for dysphonia (VHI-10 > 10 = dysphonia) and Vulnerable Elders Survey 13 (VES-13), a validated instrument to assess for frailty (VES > 3 = frailty). A total of 119 residents were surveyed. Thirty-three percent of nursing home residents, and 25% of assisted living residents reported dysphonia with 29% of all respondents reporting dysphonia. The mean VHI-10 was 7.4, the median was 5, and the interquartile range was 2-12.5. There was a significant relationship between VHI-10 and VES-13 score (P = 0.029). There were no statistically significant relationships between frailty, age, or type of living and dysphonia or VHI-10. There is a high prevalence of voice dysfunction in assisted living and nursing home residents. The correlation between VHI-10 and VES-13 suggests that voice declines as frailty increases. Copyright © 2015 The Voice Foundation. All rights reserved.

  17. Auctioning payment entitlements

    DEFF Research Database (Denmark)

    Nielsen, Kurt

    2005-01-01

    Payment entitlements is a new commodity that arises from the new European common agricultural policy. The agricultural subsidies are decoupled from the actual production and replaced by the so-called payment entitlements. A payment entitlement has a farm specific value and may be freely traded. T...

  18. Community Participation in the Impact Aid Program. Special Impact Aid Provisions for Local Education Agencies That Claim Entitlements Based on the Number of Children Residing on Indian Lands, Public Law 81-874.

    Science.gov (United States)

    Office of Elementary and Secondary Education (ED), Washington, DC.

    Created in 1950, the Impact Aid program provides financial assistance to local education agencies (LEAs) in areas affected by federal activity. The program gives a direct general aid payment to LEAs that: (1) have lost local revenue as a result of land purchases by the federal government; (2) provide education to children who reside on federal…

  19. The relationship between weight status and the need for health care assistance in nursing home residents

    DEFF Research Database (Denmark)

    Beck, Anne Marie

    2012-01-01

    Objective: The purpose of this study was to evaluate the relationship between underweight status and weight loss events on the need for health care assistance among a sample of Danish nursing home residents over 12-months. Design: Longitudinal, repeated measures design with three data collection...... points at baseline (2004) and six and 12 months post baseline. Setting: 11 Danish nursing home facilities. Participants: 441 Danish nursing home residents over the age of 65. Measurements: Resident Assessment Instrument (RAI-NH) data were abstracted for each participant at each of three data collection...... of this study suggest that elderly nursing home residents with a low BMI or weight loss may add to the substantial and costly burden of nursing home care due to the associated need for higher levels of ADL assistance....

  20. Nursing home practices following resident death: the experience of Certified Nursing Assistants.

    Science.gov (United States)

    Barooah, Adrita; Boerner, Kathrin; van Riesenbeck, Isabelle; Burack, Orah R

    2015-01-01

    This study examined certified nursing assistants' (CNAs) experiences of nursing home practices following resident death. Participants were 140 CNAs who had experienced recent resident death. In semi-structured, in-person interviews, CNAs were asked about their experiences with the removal of the resident's body, filling the bed with a new resident, and how they were notified about the death. The facilities' practice of filling the bed quickly was most often experienced as negative. Responses to body removal and staff notification varied, but negative experiences were reported by a substantial minority. Being notified prior to returning to work was associated with a more positive experience. Learning about the death by walking into a room to find the bed empty or already filled was the most negative experience. Study findings suggest that more mindful approaches to the transitions related to resident deaths would be valued by CNAs and could improve their work experience. Copyright © 2015 Elsevier Inc. All rights reserved.

  1. The Impact of Gatekeeper Training for Suicide Prevention on University Resident Assistants

    Science.gov (United States)

    Taub, Deborah J.; Servaty-Seib, Heather L.; Miles, Nathan; Lee, Ji-Yeon; Wachter Morris, Carrie A.; Prieto-Welch, Susan L.; Werden, Donald

    2013-01-01

    Resident assistants (RAs) can serve as important suicide prevention gatekeepers. The purpose of the study was to determine if training improved RAs' crisis communications skills and suicide-related knowledge and to determine if the knowledge elements predicted crisis communications skills. New RAs showed significant improvement in all areas from…

  2. The Influence of Suicide Prevention Gatekeeper Training on Resident Assistants' Mental Health

    Science.gov (United States)

    Becker, Martin A. Swanbrow; Drum, David J.

    2015-01-01

    This study explored the mental health influence on resident assistants associated with their training in suicide prevention and their subsequent role as campus mental health gatekeepers. Despite considerable prior personal experience with their own suicidal thinking as well as with others who have thoughts of suicide, a multiple regression…

  3. Selecting Resident Assistants: The Relationship between Candidate Assessment and Job Performance

    Science.gov (United States)

    Berg, Stephen A.; Stoner, James C.

    2016-01-01

    Selecting resident assistants is integral to the success of housing operations on college and university campuses. Recruiting high-performing student staff is a priority in achieving departmental goals. Despite the importance of this process and the amount of time and resources expended during selection, there is scarce research investigating the…

  4. Validation of an integral conceptual model of frailty in older residents of assisted living facilities

    NARCIS (Netherlands)

    Gobbens, R.J.J.; Krans, A.; van Assen, M.A.L.M.

    2015-01-01

    Objective The aim of this cross-sectional study was to examine the validity of an integral model of the associations between life-course determinants, disease(s), frailty, and adverse outcomes in older persons who are resident in assisted living facilities. Methods Between June 2013 and May 2014

  5. Validation of an integral conceptual model of frailty in older residents of assisted living facilities

    NARCIS (Netherlands)

    Gobbens, Robbert J J; Krans, Anita; van Assen, Marcel A L M

    2015-01-01

    Objective: The aim of this cross-sectional study was to examine the validity of an integral model of the associations between life-course determinants, disease(s), frailty, and adverse outcomes in older persons who are resident in assisted living facilities. Methods: Between June 2013 and May 2014

  6. Black Women Resident Assistants: Seeking and Serving as Bridges, Mentors, Advisors, Filters, and Community Builders

    Science.gov (United States)

    Roland, Ericka; Agosto, Vonzell

    2017-01-01

    This article reports on a phenomenographic study of Black women undergraduates who were resident assistants in a predominantly White institution (PWI) of higher education. Critical race feminism, namely intersectionality, was used to explore how they navigated the responsibilities of their position and social identities. Findings are that…

  7. The Impact of Being a Resident Assistant on Intercultural Effectiveness and and Socially Responsible Leadership Development during College

    Science.gov (United States)

    Martin, Georgianna L.; Blechschmidt, Sally

    2014-01-01

    The developmental benefits of being a resident Assistant include several positive educational outcomes. This article explores the effects of being a resident assistant on intercultural effectiveness and socially responsible leadership over four years of college. This is a quantitative, longitudinal, multi-institutional exploration employing…

  8. Attitudes of young neurosurgeons and neurosurgical residents towards euthanasia and physician-assisted suicide.

    Science.gov (United States)

    Broekman, M L D; Verlooy, J S A

    2013-11-01

    Euthanasia and physician assisted suicide (PAS) are two controversial topics in neurosurgical practice. Personal attitudes and opinions on these important issues may vary between professionals, and may also depend on their location since current legislation differs between European countries. As these issues may have significant impact on clinical practice, the goal of the present study was to survey the opinions of neurosurgical residents and young neurosurgeons across Europe with respect to euthanasia and physician assisted suicide. We performed a survey among the participants of the European Association of Neurosurgical Societies (EANS) training courses (2011-2012), asking residents and young neurosurgeons nine questions on euthanasia and PAS. For the analysis of this survey, we divided all 295 participants into four European regions (North, South, East, West). We found that even though most residents are aware of regulations about euthanasia or PAS in their country or hospital, a substantial number were not aware of the regulations. We observed no significant differences in terms of their opinions on euthanasia and PAS among the four European regions. While most are actually in favor of euthanasia or PAS, if legally allowed, under appropriate circumstances, very few neurosurgeons would be willing to actively participate in these end-of-life practices. The results of this first survey on neurosurgical residents' attitudes towards euthanasia and PAS show that a significant number of residents is not familiar with national and/or local regulations regarding euthanasia and PAS. If legally allowed, most residents would be in favor of euthanasia and PAS, but only a minority would be willing to actively participate in these practices. We did not observe a difference in stances on euthanasia and PAS among residents from different regions in Europe.

  9. "Maintaining connections but wanting more": the continuity of familial relationships among assisted-living residents.

    Science.gov (United States)

    Tompkins, Catherine J; Ihara, Emily S; Cusick, Alison; Park, Nan Sook

    2012-01-01

    Social support is a key component of well-being for older adults, particularly for those who have moved from independent living to assisted living involving a transformation of roles, relationships, and responsibilities. Twenty-nine assisted-living facility residents were interviewed to understand the perceived continuity of relationships with family and friends. An inductive approach to thematic analysis revealed 1 main theme and 3 subthemes. The main theme that emerged was: maintaining connections but wanting more. Residents appreciated maintaining connections with family and friends, but often expressed feelings of discontentment with the continuity of former relationships. The subthemes included: appreciating family and friends, waiting for more, and losing control. Implications for research and practice are discussed.

  10. Understanding Sexual Freedom and Autonomy in Assisted Living: Discourse of Residents' Rights Among Staff and Administrators.

    Science.gov (United States)

    Barmon, Christina; Burgess, Elisabeth O; Bender, Alexis A; Moorhead, James R

    2017-05-01

    In contrast to nursing homes, assisted living (AL) facilities emphasize independence and autonomy as part of their mission. However, we do not know to what extent this extends to sexual freedom and autonomy. Using grounded theory methodology and symbolic interactionism, we examine how staff and administrators in AL facilities discuss residents' rights to sexual freedom and how this influences the environment of AL. Staff and administrators engage in a contradictory discourse of residents' rights that simultaneously affirms the philosophy of AL while behaving in ways that create an environment of surveillance and undermine those rights. A discourse of residents' rights masks a significant conflict between autonomy and protection in regards to sexual freedom in AL. © The Author 2016. Published by Oxford University Press on behalf of The Gerontological Society of America. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

  11. Validation of an integral conceptual model of frailty in older residents of assisted living facilities.

    Science.gov (United States)

    Gobbens, Robbert J J; Krans, Anita; van Assen, Marcel A L M

    2015-01-01

    The aim of this cross-sectional study was to examine the validity of an integral model of the associations between life-course determinants, disease(s), frailty, and adverse outcomes in older persons who are resident in assisted living facilities. Between June 2013 and May 2014 seven assisted living facilities were contacted. A total of 221 persons completed the questionnaire on life-course determinants, frailty (using the Tilburg Frailty Indicator), self-reported chronic diseases, and adverse outcomes disability, quality of life, health care utilization, and falls. Adverse outcomes were analyzed with sequential (logistic) regression analyses. The integral model is partially validated. Life-course determinants and disease(s) affected only physical frailty. All three frailty domains (physical, psychological, social) together affected disability, quality of life, visits to a general practitioner, and falls. Contrary to the model, disease(s) had no effect on adverse outcomes after controlling for frailty. Life-course determinants affected adverse outcomes, with unhealthy lifestyle having consistent negative effects, and women had more disability, scored lower on physical health, and received more personal and informal care after controlling for all other predictors. The integral model of frailty is less useful for predicting adverse outcomes of residents of assisted living facilities than for community-dwelling older persons, because these residents are much frailer and already have access to healthcare facilities. The present study showed that a multidimensional assessment of frailty, distinguishing three domains of frailty (physical, psychological, social), is beneficial with respect to predicting adverse outcomes in residents of assisted living facilities. Copyright © 2015. Published by Elsevier Ireland Ltd.

  12. The Impact of Training Residents on the Outcome of Robotic-Assisted Sacrocolpopexy

    Directory of Open Access Journals (Sweden)

    Mohamed A. Bedaiwy

    2012-01-01

    Full Text Available Objective. To evaluate the surgical outcomes of robotic-assisted sacrocolpopexy (RASCP before and after the incorporation of hands-on training for urology and gynecology residents. Study Design. Forty-one patients underwent RASCP between December 2008 and March 2010 with one surgeon. RASCP was performed in the context of surgical repair of complex pelvic organ prolapse and/or stress urinary incontinence. The first 20 cases (group I were performed exclusively by the attending surgeon. In the last 21 cases (group II, the urology resident performed a 50% or more of the RASCP while the gynecology resident performed the supracervical hysterectomy. The primary outcome measure was vaginal vault support at 24 weeks postoperatively based on pelvic organ prolapse quantification (POP-Q. Results. Mean ± SD operative time for the entire surgery including RASCP was 282.3±51.3 min and median EBL was 83.1±50.4 mL. Patient demographics and stage of disease did not differ between groups. Procedure time, PACU time, blood loss, and intraoperative complications were similar between groups. Follow-up POP-Q evaluations demonstrated significant correction of all points on vaginal examination for both groups (P<0.001. Conclusions. Incorporation of resident training during RASCP allows teaching of robotic surgery techniques in an effective manner without prolonging operative time or affecting the overall surgical outcome.

  13. Gender differences in the predictors of physical activity among assisted living residents.

    Science.gov (United States)

    Chen, Yuh-Min; Li, Yueh-Ping; Yen, Min-Ling

    2015-05-01

    To explore gender differences in the predictors of physical activity (PA) among assisted living residents. A cross-sectional design was adopted. A convenience sample of 304 older adults was recruited from four assisted living facilities in Taiwan. Two separate simultaneous multiple regression analyses were conducted to identify the predictors of PA for older men and women. Independent variables entered into the regression models were age, marital status, educational level, past regular exercise participation, number of chronic diseases, functional status, self-rated health, depression, and self-efficacy expectations. In older men, a junior high school or higher educational level, past regular exercise participation, better functional status, better self-rated health, and higher self-efficacy expectations predicted more PA, accounting for 61.3% of the total variance in PA. In older women, better self-rated health, lower depression, and higher self-efficacy expectations predicted more PA, accounting for 50% of the total variance in PA. Predictors of PA differed between the two genders. The results have crucial implications for developing gender-specific PA interventions. Through a clearer understanding of gender-specific predictors, healthcare providers can implement gender-sensitive PA-enhancing interventions to assist older residents in performing sufficient PA. © 2015 Sigma Theta Tau International.

  14. Animal assisted therapy and perception of loneliness in geriatric nursing home residents.

    Science.gov (United States)

    Vrbanac, Zoran; Zecević, Iva; Ljubić, Marijana; Belić, Maja; Stanin, Damir; Bottegaro, Nika Brkljaca; Jurkić, Gabrijela; Skrlin, Branimir; Bedrica, Ljiljana; Zubcić, Damir

    2013-09-01

    Use of animals for therapeutic purposes, animal assisted therapy or AAT is a method for improving quality of life for long-term inpatients. The object of this paper was to evaluate dog companionship as a form of AAT and its effects on perception of loneliness in geriatric nursing home residents. The participants were involved in a six-month program of dog companionship three times weekly for 90 minutes. There were 21 residents included in the program, with a mean age of 80 years. Loneliness was measured by the short version of the UCLA Scale of loneliness. Comparison of test results before and after participation in the program showed that dog companionship reduces the perception of loneliness.

  15. Euthanasia, assisted suicide and end-of-life care: attitudes of students, residents and attending physicians.

    Science.gov (United States)

    Ramírez-Rivera, José; Cruz, Juan; Jaume-Anselmi, Francisco

    2006-12-01

    Attitudes in regard to end-of life issues are evolving in Western societies. We have sought to trace this evolution in the relatively homogeneous cultural setting of Puerto Rico. One hundred fifty-two medical students, 62 medical residents and 84 members of three medical faculties were asked whether in terminally ill patients they: 1) would support a request for euthanasia(E); 2) if legalized, would engage in, would oppose or would not be opposed to others engaging physician-assisted suicide(PAS); 3) would consider ethical to prescribe full doses of drugs needed to alleviate pain, even if they knew it would hasten death; 4) would agree to limit certain resources for the terminally ill. Gender and religious affiliation were also requested. Twenty-eight percent of the students, 26% of the residents and 31% of the faculty supported E. Only 13% of the students, 18% of the residents and 11% of the faculty would engage in PAS. Men were more willing than women to acquiesce to a request for E or PAS. Religious affiliation or its absence did not influence the support or opposition to E and PAS. If it would hasten death, 86% of the residents, but only 65% of the faculty considered ethical to prescribe the dose of drugs needed to alleviate pain. More than 2/3 of the students, residents and faculty favored the limiting of certain resources for the terminally ill. In our cultural and medical environment, men are more willing than women to engage in E or PAS. The attitude towards E and PAS is not influenced by religious affiliation. If it hastens death, some still consider unethical to prescribe full doses of drugs needed to alleviate pain in the dying patient.

  16. 38 CFR 21.3045 - Entitlement charges.

    Science.gov (United States)

    2010-07-01

    ...) VOCATIONAL REHABILITATION AND EDUCATION Survivors' and Dependents' Educational Assistance Under 38 U.S.C...) Entitlement charges for elementary and secondary education. (1) When an eligible spouse or surviving spouse is... of the course or courses as a result of being— (A) Ordered, in connection with the Persian Gulf War...

  17. Certified nursing assistants' perspectives of nursing home residents' pain experience: communication patterns, cultural context, and the role of empathy.

    Science.gov (United States)

    Dobbs, Debra; Baker, Tamara; Carrion, Iraida V; Vongxaiburana, Elizabeth; Hyer, Kathryn

    2014-03-01

    This study explored the following issues related to pain management among nursing home (NH) residents: 1) communication patterns between NH residents and certified nursing assistants (CNAs) about pain; 2) how race and ethnicity influence NH residents' pain experiences; and 3) CNAs' personal experiences with pain that may affect their empathy toward the resident's pain experience. The study consisted of a convenience sample of four focus groups (n = 28) from a NH in central Florida. A content analysis approach was used. Data were analyzed with the use of Atlas.ti version 6.2. The content analysis identified four main themes: 1) attitudes as barriers to communication about resident pain care; 2) cultural, religious, and gender influences of resident pain care by CNAs; 3) the role of empathy in CNAs care of residents with pain; and 4) worker strategies to detect pain. Attitudes among CNAs about resident cognitive status and perceived resident burden need to be recognized as barriers to the detection and reporting of pain by CNAs and should be addressed. In addition, NHs should consider a person-centered approach to pain that is culturally competent given the cultural influences of both residents and staff. Finally, educational programs for CNAs that include empathy-inducing scenarios could potentially improve the care provided by CNAs when dealing with residents' pain. Copyright © 2014 American Society for Pain Management Nursing. Published by Elsevier Inc. All rights reserved.

  18. Implementation of personalized music listening for assisted living residents with dementia.

    Science.gov (United States)

    Murphy, Kelly; Liu, Winston W; Goltz, Daniel; Fixsen, Emma; Kirchner, Stephen; Hu, Janice; White, Heidi

    2018-05-03

    Personalized music listening (PML) has been touted as a safe and inexpensive means of improving the quality of life, mood, and behavior of persons with dementia. A PML program was implemented in an assisted living facility and evaluated across the five dimensions of the RE-AIM framework: reach, effectiveness, adoption, implementation, and maintenance. The first 17 residents invited to participate were enrolled and followed over eight months. Effectiveness was evident in staff-reported mood improvement in 62% of encounters. Adoption was evident in qualitative feedback collected from medication technicians. Implementation was facilitated by low costs, engagement of external volunteers, highlighting outcomes that are relevant to staff, and attention to playlists over time. Maintenance required continued engagement of volunteers, ongoing fundraising, attention to facility staff engagement, and iterative adjustments to the program framework as staffing changes occurred. PML was found to be a meaningful intervention that is possible at a reasonable cost. Copyright © 2018 Elsevier Inc. All rights reserved.

  19. Resident assistant training program for increasing alcohol, other drug, and mental health first-aid efforts.

    Science.gov (United States)

    Thombs, Dennis L; Gonzalez, Jennifer M Reingle; Osborn, Cynthia J; Rossheim, Matthew E; Suzuki, Sumihiro

    2015-05-01

    In college and university residence halls, resident assistants (RAs) are expected to serve as first-aid providers to students who may have alcohol, other drug, mental health, and academic problems. Despite this responsibility, evidence-based, first-aid programs have not been developed and tested for the RA workforce. The current study examined effects of an investigational first-aid program designed specifically for RAs. The online Peer Hero Training program is a novel approach to RA training in its use of interactive video dramatizations of incidents involving substance-using or distressed residents. A 9-month randomized trial conducted on eight US campuses compared RAs who participated in the Peer Hero Training program to RAs who received training-as-usual. Participation in the Peer Hero Training program significantly increased RA first-aid efforts for residential students who may have had alcohol, other drug, mental health, or academic problems 6 months after baseline. Compared with those in the training-as-usual condition, RAs in the Peer Hero Training program made more than 10 times as many first-aid efforts for possible alcohol problems, almost 14 times the number of first-aid efforts for possible drug use, almost 3 times the number of first-aid efforts for possible mental health problems, and 3 times the number of first-aid efforts for academic problems. There was no evidence that measured RA attitudes mediated the effects of the intervention. Results of this preliminary evaluation trial suggest that online training using interactive video dramatizations is a viable approach to strengthening RAs' ability to provide alcohol, other drugs, and mental health first-aid to undergraduates.

  20. Multimodal wireless sensor network-based ambient assisted living in real homes with multiple residents.

    Science.gov (United States)

    Tunca, Can; Alemdar, Hande; Ertan, Halil; Incel, Ozlem Durmaz; Ersoy, Cem

    2014-05-30

    Human activity recognition and behavior monitoring in a home setting using wireless sensor networks (WSNs) provide a great potential for ambient assisted living (AAL) applications, ranging from health and wellbeing monitoring to resource consumption monitoring. However, due to the limitations of the sensor devices, challenges in wireless communication and the challenges in processing large amounts of sensor data in order to recognize complex human activities, WSN-based AAL systems are not effectively integrated in the home environment. Additionally, given the variety of sensor types and activities, selecting the most suitable set of sensors in the deployment is an important task. In order to investigate and propose solutions to such challenges, we introduce a WSN-based multimodal AAL system compatible for homes with multiple residents. Particularly, we focus on the details of the system architecture, including the challenges of sensor selection, deployment, networking and data collection and provide guidelines for the design and deployment of an effective AAL system. We also present the details of the field study we conducted, using the systems deployed in two different real home environments with multiple residents. With these systems, we are able to collect ambient sensor data from multiple homes. This data can be used to assess the wellbeing of the residents and identify deviations from everyday routines, which may be indicators of health problems. Finally, in order to elaborate on the possible applications of the proposed AAL system and to exemplify directions for processing the collected data, we provide the results of several human activity inference experiments, along with examples on how such results could be interpreted. We believe that the experiences shared in this work will contribute towards accelerating the acceptance of WSN-based AAL systems in the home setting.

  1. How residents and interns utilise and perceive the personal digital assistant and UpToDate

    Directory of Open Access Journals (Sweden)

    Lim Tow

    2008-07-01

    Full Text Available Abstract Background In this era of evidence-based medicine, doctors are increasingly using information technology to acquire medical knowledge. This study evaluates how residents and interns utilise and perceive the personal digital assistant (PDA and the online resource UpToDate. Methods This is a questionnaire survey of all residents and interns in a tertiary teaching hospital. Results Out of 168 doctors, 134 (79.8% responded to the questionnaire. Only 54 doctors (40.3% owned a PDA. Although these owners perceived that the PDA was most useful for providing drug information, followed by medical references, scheduling and medical calculators, the majority of them did not actually have medical software applications downloaded on their PDAs. The greatest concerns highlighted for the PDA were the fear of loss and breakage, and the preference for working with desktop computers and paper. Meanwhile, only 76 doctors (56.7% used UpToDate, even though the hospital had an institutional subscription for it. Although 93.4% of these users would recommend UpToDate to a colleague, only 57.9% stated that the use of UpToDate had led to a change in their management of patients. Conclusion Although UpToDate and various PDA software applications were deemed useful by some of the residents and interns in our study, both digital tools were under-utilised. More should be done to facilitate the use of medical software applications on PDAs, to promote awareness of tools for evidence-based medicine such as UpToDate, and to facilitate the application of evidence-based medicine in daily clinical practice.

  2. Multimodal Wireless Sensor Network-Based Ambient Assisted Living in Real Homes with Multiple Residents

    Directory of Open Access Journals (Sweden)

    Can Tunca

    2014-05-01

    Full Text Available Human activity recognition and behavior monitoring in a home setting using wireless sensor networks (WSNs provide a great potential for ambient assisted living (AAL applications, ranging from health and wellbeing monitoring to resource consumption monitoring. However, due to the limitations of the sensor devices, challenges in wireless communication and the challenges in processing large amounts of sensor data in order to recognize complex human activities, WSN-based AAL systems are not effectively integrated in the home environment. Additionally, given the variety of sensor types and activities, selecting the most suitable set of sensors in the deployment is an important task. In order to investigate and propose solutions to such challenges, we introduce a WSN-based multimodal AAL system compatible for homes with multiple residents. Particularly, we focus on the details of the system architecture, including the challenges of sensor selection, deployment, networking and data collection and provide guidelines for the design and deployment of an effective AAL system. We also present the details of the field study we conducted, using the systems deployed in two different real home environments with multiple residents. With these systems, we are able to collect ambient sensor data from multiple homes. This data can be used to assess the wellbeing of the residents and identify deviations from everyday routines, which may be indicators of health problems. Finally, in order to elaborate on the possible applications of the proposed AAL system and to exemplify directions for processing the collected data, we provide the results of several human activity inference experiments, along with examples on how such results could be interpreted. We believe that the experiences shared in this work will contribute towards accelerating the acceptance of WSN-based AAL systems in the home setting.

  3. Resident-Assisted Montessori Programming (RAMP): training persons with dementia to serve as group activity leaders.

    Science.gov (United States)

    Camp, Cameron J; Skrajner, Michael J

    2004-06-01

    The purpose of this study was to determine the effects of an activity implemented by means of Resident-Assisted Montessori Programming (RAMP). Four persons with early-stage dementia were trained to serve as leaders for a small-group activity played by nine persons with more advanced dementia. Assessments of leaders' ability to learn the procedures of leading a group, as well as their satisfaction with this role, were taken, as were measures of players' engagement and affect during standard activities programming and RAMP activities. Leaders demonstrated the potential to fill the role of group activity leader effectively, and they expressed a high level of satisfaction with this role. Players' levels of positive engagement and pleasure during the RAMP activity were higher than during standard group activities. This study suggests that to the extent that procedural learning is available to persons with early-stage dementia, especially when they are assisted with external cueing, these individuals can successfully fill the role of volunteers when working with persons with more advanced dementia. This can provide a meaningful social role for leaders and increase access to high quality activities programming for large numbers of persons with dementia. Copyright 2004 The Gerontological Society of America

  4. Nursing Assistants' Job Commitment: Effect of Nursing Home Organizational Factors and Impact on Resident Well-Being

    Science.gov (United States)

    Bishop, Christine E.; Weinberg, Dana Beth; Leutz, Walter; Dossa, Almas; Pfefferle, Susan G.; Zincavage, Rebekah M.

    2008-01-01

    Purpose: The purpose of this study was to investigate (a) whether certified nursing assistants (CNAs) are more committed to nursing home jobs when they perceive their jobs as enhanced (greater autonomy, use of knowledge, teamwork), and (b) whether CNA job commitment affects resident satisfaction. Design and Methods: A qualitative exploration of…

  5. Resident education in robotic-assisted vertical sleeve gastrectomy: outcomes and cost-analysis of 411 consecutive cases.

    Science.gov (United States)

    Ecker, Brett L; Maduka, Richard; Ramdon, Andre; Dempsey, Daniel T; Dumon, Kristoffel R; Williams, Noel N

    2016-02-01

    Robotic technology is increasingly prevalent in bariatric surgery, yet there are national deficiencies in exposure of surgical residents to robotic techniques. The purpose of this study is to accurately characterize the perioperative outcomes of a resident teaching model using the robotic-assisted sleeve gastrectomy. University Hospital. We identified 411 consecutive patients who underwent robotic sleeve gastrectomy at our institution from a prospectively maintained administrative database. Perioperative morbidity, operative time, and supply cost of the procedure were analyzed. Mean operative time was 96.4±24.9 minutes; mean robot usage time was 63.9 minutes (range 30.0-122.0 min). Ninety-day morbidities included reoperation (0.72%), major bleeding complications (0.48%), staple line leak (0.24%), stricture (0.97%), need for blood transfusion (3.86%), surgical site infection (1.69%), deep vein thrombosis (0.48%), and pulmonary embolism (0.48%). Mortality was nil. The resident cohort achieved operative time plateaus after five consecutive cases. Subset analysis for fiscal year 2014 demonstrated significantly increased supply cost for robotic sleeve gastrectomy compared with its laparoscopic equivalent. Robotic-assisted sleeve gastrectomy can be instituted as a model for resident robotic education with rates of morbidity and operative times equivalent to historical laparoscopic controls. The robot's enhanced ergonomics and its opportunity for resident education must be weighed against its increased supply cost. Copyright © 2016 American Society for Bariatric Surgery. Published by Elsevier Inc. All rights reserved.

  6. Exploring nursing assistants' roles in the process of pain management for cognitively impaired nursing home residents: a qualitative study.

    Science.gov (United States)

    Liu, Justina Y W

    2014-05-01

    To explore nursing assistants' roles during the actual process of pain management (assessment, reporting, implementation of pain-relieving interventions and re-assessment) for cognitively impaired home residents with pain. Nursing assistants provide most of the direct care to residents and represent the major taskforce in nursing homes. They may develop specialized knowledge of residents' pain experience that enables them to play both a pivotal role in pain assessment and possibly a supporting role in pain treatment. Currently, there is a lack of research into nursing assistants' functions in pain management. This is a descriptive, exploratory qualitative study. Forty-nine nursing assistants were recruited from 12 nursing homes, 12 of them participating in semi-structured individual interviews and 37 in 8 semi-structured focus groups. All interviews were carried out from May to September 2010. Data collected via both data collection methods were transcribed verbatim and analysed by content analysis. Nursing assistants were found to play four roles in the pain management process: (1) pain assessor; (2) reporter; (3) subordinate implementing prescribed medications; and (4) instigator implementing non-pharmacological interventions. This study highlights the importance of nursing assistants in successful pain assessment and identifies their possible supporting roles in other aspects of pain management. However, nursing assistants' scope of practice resulted in their functions in pain management being continually undervalued by other healthcare professionals. Continuous in-service training, the use of a standardized pain management protocol and strategies for building coherent work teams in nursing homes are suggested to improve this situation. © 2013 John Wiley & Sons Ltd.

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

    Directory of Open Access Journals (Sweden)

    Hogan David B

    2012-09-01

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

  8. Cohort differences in dementia recognition and treatment indicators among assisted living residents in Maryland: did a change in the resident assessment tool make a difference?

    Science.gov (United States)

    Samus, Quincy M; Vavilikolanu, Amrita; Mayer, Lawrence; McNabney, Matthew; Brandt, Jason; Lyketsos, Constantine G; Rosenblatt, Adam

    2013-12-01

    There is a lack of empirical evidence about the impact of regulations on dementia care quality in assisted living (AL). We examined cohort differences in dementia recognition and treatment indicators between two cohorts of AL residents with dementia, evaluated prior to and following a dementia-related policy modification to more adequately assess memory and behavioral problems. Cross-sectional comparison of two AL resident cohorts was done (Cohort 1 [evaluated 2001-2003] and Cohort 2 [evaluated 2004-2006]) from the Maryland Assisted Living studies. Initial in-person evaluations of residents with dementia (n = 248) were performed from a random sample of 28 AL facilities in Maryland (physician examination, clinical characteristics, and staff and family recognition of dementia included). Adequacy of dementia workup and treatment was rated by an expert consensus panel. Staff recognition of dementia was better in Cohort 1 than in Cohort 2 (77% vs. 63%, p = 0.011), with no significant differences in family recognition (86% vs. 85%, p = 0.680), or complete treatment ratings (52% vs. 64%, p = 0.060). In adjusted logistic regression, cognitive impairment and neuropsychiatric symptoms correlated with staff recognition; and cognitive impairment correlated with family recognition. Increased age and cognitive impairment reduced odds of having a complete dementia workup. Odds of having complete dementia treatment was reduced by age and having more depressive symptoms. Cohort was not predictive of dementia recognition or treatment indicators in adjusted models. We noted few cohort differences in dementia care indicators after accounting for covariates, and concluded that rates of dementia recognition and treatment did not appear to change much organically following the policy modifications.

  9. Using GoPro to Give Video-Assisted Operative Feedback for Surgery Residents: A Feasibility and Utility Assessment.

    Science.gov (United States)

    Moore, Maureen D; Abelson, Jonathan S; O'Mahoney, Paul; Bagautdinov, Iskander; Yeo, Heather; Watkins, Anthony C

    As an adjunct to simulation-based teaching, laparoscopic video-based surgical coaching has been an effective tool to augment surgical education. However, the wide use of video review in open surgery has been limited primarily due to technological and logistical challenges. The aims of our study were to (1) evaluate perceptions of general surgery (GS) residents on video-assisted operative instruction and (2) conduct a pilot study using a head-mounted GoPro in conjunction with the operative performance rating system to assess feasibility of providing video review to enhance operative feedback during open procedures. GS residents were anonymously surveyed to evaluate their perceptions of oral and written operative feedback and use of video-based operative resources. We then conducted a pilot study of 10 GS residents to assess the utility and feasibility of using a GoPro to record resident performance of an arteriovenous fistula creation with an attending surgeon. Categorical variables were analyzed using the chi-square test. Academic, tertiary medical center. GS residents and faculty. A total of 59 GS residents were anonymously surveyed (response rate = 65.5%). A total of 40% (n = 24) of residents reported that structured evaluations rarely or never provided meaningful feedback. When feedback was received, 55% (n = 32) residents reported that it was only rarely or sometimes in regard to their operative skills. There was no significant difference in surveyed responses among junior postgraduate year (PGY 1-2), senior (PGY 3-4), or chief residents (PGY-5). A total of 80% (n = 8) of residents found the use of GoPro video review very or extremely useful for education; they also deemed video review more useful for operative feedback than written or communicative feedback. An overwhelming majority (90%, n = 9) felt that video review would lead to improved technical skills, wanted to review the video with the attending surgeon for further feedback, and desired expansion of

  10. Academic entitlement in pharmacy education.

    Science.gov (United States)

    Cain, Jeff; Romanelli, Frank; Smith, Kelly M

    2012-12-12

    The constructs of academic entitlement and student consumerism refer to students' attitudes toward education as a commodity and the underlying belief that as consumers, they should be catered to and given the opportunity to participate in the education process according to their preferences. Most discussions regarding these attitudes are anecdotal, but the pervasiveness of these accounts and the troubling effects that ensue warrant attention. Grade inflation, student incivility, altered classroom practices, and decreased faculty morale are all potential aftereffects of teaching students who hold academic entitlement beliefs. Numerous factors are posited as attributing to academic entitlement including personal issues, societal pressures, and broad academic practices. This paper discusses these factors and offers faculty members and administrators recommendations regarding practices that may curb or alleviate issues associated with academically entitled students.

  11. Assessment of dementia in nursing home residents by nurses and assistants

    DEFF Research Database (Denmark)

    Sørensen, Lisbeth Uhrskov; Foldspang, Anders; Gulmann, Nils Christian

    2001-01-01

    Objectives To describe the criterion validity of nursing home staff's assessment of organic disorder compared with ICD-10 criteria, and to identify determinants of staff assessment of organic disorder. Method Two hundred and eighty-eight residents were diagnosed using the GMS-AGECAT. Nursing staff...... members were interviewed about the residents' activities of Daily Living, behavioural problems, orientation in surroundings and communication skills, and asked if the resident had an organic disorder. Multiple logistic regression was used to select the items that most strongly determined staff assessment...... as under-labelling of residents, a tendency that will affect communication with medical personnel and may lead to inadequate or wrong medical treatment and to negative performance as well as negative role expectations in everyday life in nursing homes....

  12. Exposing the Backstage: Critical Reflections on a Longitudinal Qualitative Study of Residents' Care Networks in Assisted Living.

    Science.gov (United States)

    Kemp, Candace L; Ball, Mary M; Morgan, Jennifer Craft; Doyle, Patrick J; Burgess, Elisabeth O; Dillard, Joy A; Barmon, Christina E; Fitzroy, Andrea F; Helmly, Victoria E; Avent, Elizabeth S; Perkins, Molly M

    2017-07-01

    In this article, we analyze the research experiences associated with a longitudinal qualitative study of residents' care networks in assisted living. Using data from researcher meetings, field notes, and memos, we critically examine our design and decision making and accompanying methodological implications. We focus on one complete wave of data collection involving 28 residents and 114 care network members in four diverse settings followed for 2 years. We identify study features that make our research innovative, but that also represent significant challenges. They include the focus and topic; settings and participants; scope and design complexity; nature, modes, frequency, and duration of data collection; and analytic approach. Each feature has methodological implications, including benefits and challenges pertaining to recruitment, retention, data collection, quality, and management, research team work, researcher roles, ethics, and dissemination. Our analysis demonstrates the value of our approach and of reflecting on and sharing methodological processes for cumulative knowledge building.

  13. Use of a Behavioral Contract with Resident Assistants: Prelude to a Health Fair.

    Science.gov (United States)

    Morgan, John D.; Hyner, Gerald C.

    1984-01-01

    Presents a conceptual model which focuses on goals of student government in residence halls. The model has two fundamental processes. One focuses on short term goals and activities catering to creation of environment. The second has long term effects referred to as lifelong personal development. (JAC)

  14. Solar assisted conditioning of residences with floor heating and ceiling cooling: review and simulation results

    OpenAIRE

    Egrican, Nilufer; Korkmaz, Adnan

    2015-01-01

    Solar or solar assisted heating and cooling systems are becoming widespread to reduce CO2 emissions. Efficient radiant space heating and cooling systems can be used to decrease the energy bills and improve occupant thermal comfort in buildings. This study uses the TRNSYS program, for the modeling and simulation of solar assisted radiant heating and cooling of a building with the domestic hot water supply, to examine the effects of various parameters on energy consumption. Calculations are per...

  15. The association of neuropsychiatric symptoms and environment with quality of life in assisted living residents with dementia.

    Science.gov (United States)

    Samus, Quincy M; Rosenblatt, Adam; Steele, Cynthia; Baker, Alva; Harper, Michael; Brandt, Jason; Mayer, Lawrence; Rabins, Peter V; Lyketsos, Constantine G

    2005-10-01

    We conducted this study to determine whether neuropsychiatric symptoms and environmental characteristics are associated with quality of life in assisted living residents with dementia. We used a cross-sectional study of 134 residents from 22 facilities and employed the Alzheimer's Disease-Related Quality of Life Scale and the Neuropsychiatric Inventory. A scale was developed to capture the homelike climate of each facility. Linear regression analyses were used to estimate the relationship of neuropsychiatric symptoms and homelike climate with quality of life, controlling for sociodemographics, cognition, functional dependence, and physical health. Exploratory analyses and graphical techniques were employed to test for environmental-level moderating effects. Agitation, depression, apathy, and irritability were significant predictors of quality of life, explaining 29% of the variance. Neither facility size nor homelike environment was significantly associated with quality of life in univariate analyses. Size of facility moderated the relationship between agitation and quality of life. Neuropsychiatric symptoms impair quality of life in residents with dementia. Further research should investigate the role of other environmental aspects.

  16. Prevalence of Horizontal Violence Among Emergency Attending Physicians, Residents, and Physician Assistants

    Directory of Open Access Journals (Sweden)

    Nico B. Volz

    2017-02-01

    Full Text Available Introduction: Horizontal violence (HV is malicious behavior perpetrated by healthcare workers against each other. These include bullying, verbal or physical threats, purposeful disruptive behavior, and other malicious behaviors. This pilot study investigates the prevalence of HV among emergency department (ED attending physicians, residents, and mid-level providers (MLPs. Methods: We sent an electronic survey to emergency medicine attending physicians (n=67, residents (n=25, and MLPs (n=24 in three unique EDs within a single multi-hospital medical system. The survey consisted of 18 questions that asked participants to indicate with what frequency (never, once, a few times, monthly, weekly, or daily they have witnessed or experienced a particular behavior in the previous 12 months. Seven additional questions aimed to elicit the impact of HV on the participant, the work environment, or the patient care. Results: Of the 122 survey invitations 91 were completed, yielding a response rate of 74.6%. Of the respondents 64.8% were male and 35.2% were female. Attending physicians represented 41.8%, residents 37.4%, and MLPs 19.8% of respondents. Prevalence of reported behaviors ranged from 1.1% (Q18: physical assault to 34.1% (Q4: been shouted at. Fourteen of these behaviors were most prevalent in the attending cohort, six were most prevalent in the MLP cohort, and three of the behaviors were most prevalent in the resident cohort. Conclusion: The HV behaviors investigated in this pilot study were similar to data previously published in nursing cohorts. Furthermore, nearly a quarter of participants (22.2% indicated that HV has affected care for their patients, suggesting further studies are warranted to assess prevalence and the impact HV has on staff and patients. [West J Emerg Med. 2017;18(2213-218.

  17. Antipsychotic Use and Hospitalization Among Older Assisted Living Residents: Does Risk Vary by Frailty Status?

    Science.gov (United States)

    Stock, Kathryn J; Hogan, David B; Lapane, Kate; Amuah, Joseph E; Tyas, Suzanne L; Bronskill, Susan E; Morris, Andrew M; Bell, Chaim M; Jeffs, Lianne; Maxwell, Colleen J

    2017-07-01

    To examine associations between baseline frailty measures, antipsychotic use, and hospitalization over 1 year and whether hospitalization risk associated with antipsychotic use varies by frailty level. In this prospective cohort study of 1,066 residents (mean age: 85 years; 77% women) from the Alberta Continuing Care Epidemiological Studies, trained research nurses conducted comprehensive resident assessments at baseline (2006-2007) for sociodemographic characteristics, health conditions, frailty status, behavioral problems, and all medications consumed during the past 3 days. Two separate measures of frailty were assessed, the Cardiovascular Health Study (CHS) phenotype and an 86-item Frailty Index (FI). Time to first hospitalization during follow-up was determined via linkage with the Alberta Inpatient Discharge Abstract Database. Baseline frailty status (both measures), but not antipsychotic use, was significantly associated with hospitalization over 1 year. When stratified by frailty, FI-defined frail residents using antipsychotics showed a significantly increased risk for hospitalization (adjusted HR: 1.54; 95% CI: 1.01-2.36) compared with frail nonusers. CHS-defined frail antipsychotic users versus frail nonusers also showed an elevated risk (adjusted HR: 1.67; 95% CI: 0.96-2.88). Nonfrail residents using antipsychotics were significantly less likely to be hospitalized compared with nonfrail nonusers whether defined by the FI (adjusted HR: 0.62; 95% CI: 0.39-0.99) or CHS criteria (adjusted HR: 0.62; 95% CI: 0.40-0.96). Frailty measures may be helpful in identifying those who are particularly vulnerable to adverse effects and those who may experience benefit with treatment. Copyright © 2017 American Association for Geriatric Psychiatry. Published by Elsevier Inc. All rights reserved.

  18. The effect of garden designs on mood and heart output in older adults residing in an assisted living facility.

    Science.gov (United States)

    Goto, Seiko; Park, Bum-Jin; Tsunetsugu, Yuko; Herrup, Karl; Miyazaki, Yoshifumi

    2013-01-01

    The objective of this study is to trace short-term changes in mood and heart function in elderly individuals in response to exposure to different landscaped spaces. Nineteen elderly but cognitively intact residents of an assisted living facility participated in the study. They were exposed to three landscaped spaces: a Japanese style garden, an herb garden, and a simple landscaped area planted with a single tree. To assess the effect of different landscaped spaces on older adults, individuals were monitored for mood and cardiac function in response to short exposures to spaces. Mood state was assessed using Profile of Mood States (POMS) before and after viewing the spaces. Cardiac output was assessed using a portable electrocardiograph monitor before and during the viewing. We found that the structured gardens evoked greater responses in all outcome measures. Scores on the POMS improved after observation of the two organized gardens compared to responses to the simple landscaped space with a single tree. During the observation period, heart rate was significantly lower in the Japanese garden than in the other environments, and sympathetic function was significantly lower as well. We conclude that exposure to organized gardens can affect both the mood and cardiac physiology of elderly individuals. Our data further suggest that these effects can differ depending on the types of landscape to which an individual is exposed. Elderly, Japanese garden, herb garden, heart rate, mood, healing environmentPreferred Citation: Goto, S., Park, B-J., Tsunetsugu, Y., Herrup, K., & Miyazaki, Y. (2013). The effect of garden designs on mood and heart output in older adults residing in an assisted living facility. Health Environments Research & Design Journal 6(2), pp 27-42.

  19. Animal-assisted therapy and agitation and depression in nursing home residents with dementia: a matched case-control trial.

    Science.gov (United States)

    Majić, Tomislav; Gutzmann, Hans; Heinz, Andreas; Lang, Undine E; Rapp, Michael A

    2013-11-01

    To investigate the efficacy of animal-assisted therapy (AAT) on symptoms of agitation/aggression and depression in nursing home residents with dementia in a randomized controlled trial. Previous studies have indicated that AAT has beneficial effects on neuropsychiatric symptoms in various psychiatric disorders but few studies have investigated the efficacy of AAT in patients suffering from dementia. Of 65 nursing home residents with dementia (mean [standard deviation] age: 81.8 [9.2] years; mean Mini-Mental State Examination score: 7.1 [0.7]), 27 matched pairs (N = 54) were randomly assigned to either treatment as usual or treatment as usual combined with AAT, administered over 10 weekly sessions. Blinded raters assessed cognitive impairment with the Mini-Mental State Examination, presence of agitation/aggression with the Cohen-Mansfield Agitation Inventory, and depression with the Dementia Mood Assessment Scale at baseline and during a period of 4 weeks after AAT intervention. In the control group, symptoms of agitation/aggression and depression significantly increased over 10 weeks; in the intervention group, patients receiving combined treatment displayed constant frequency and severity of symptoms of agitation/aggression (F1,48 = 6.43; p <0.05) and depression (F1,48 = 26.54; p <0.001). Symptom amelioration did not occur in either group. AAT is a promising option for the treatment of agitation/aggression and depression in patients with dementia. Our results suggest that AAT may delay progression of neuropsychiatric symptoms in demented nursing home residents. Further research is needed to determine its long-time effects. Copyright © 2013 American Association for Geriatric Psychiatry. Published by Elsevier Inc. All rights reserved.

  20. "Fit and fabulous": mixed-methods research on processes, perceptions, and outcomes of a yearlong gym program with assisted-living residents.

    Science.gov (United States)

    Kluge, Mary Ann; LeCompte, Michelle; Ramel, Lisa

    2014-04-01

    This study's mixed-methods design sought to understand how to encourage assisted-living (AL) residents to initiate and continue exercise in a gym setting. Ten residents participated in this yearlong program. Processes developed and perceived benefits were understood through interviews and observations. Changes in active time, lower body strength, and workload were evaluated using direct measures. Findings indicated that AL residents regularly used exercise machines (mean participation = 53.8%) and increased active time and lower body strength (p = .02) when adequately prepared and supported. Participants prioritized gym time and developed pride and ownership in the program. They described themselves as exercisers and developed a sense of belonging to their new home. Friendships with one another, staff, and university partners were nurtured in the gym setting. When provided space, equipment, trained staff, and additional resource support, AL residents' quality of life and life satisfaction were enhanced in several domains.

  1. Changes in malnutrition and quality of nutritional care among aged residents in all nursing homes and assisted living facilities in Helsinki 2003-2011.

    Science.gov (United States)

    Saarela, Riitta K T; Muurinen, Seija; Suominen, Merja H; Savikko, Niina N; Soini, Helena; Pitkälä, Kaisu H

    2017-09-01

    While nutritional problems have been recognized as common in institutional settings for several decades, less is known about how nutritional care and nutrition has changed in these settings over time. To describe and compare the nutritional problems and nutritional care of residents in all nursing homes (NH) in 2003 and 2011 and residents in all assisted living facilities (ALF) in 2007 and 2011, in Helsinki, Finland. We combined four cross-sectional datasets of (1) residents from all NHs in 2003 (N=1987), (2) residents from all ALFs in 2007 (N=1377), (3) residents from all NHs in 2011 (N=1576) and (4) residents from all ALFs in 2011 (N=1585). All participants at each time point were assessed using identical methods, including the Mini Nutritional Assessment (MNA). The mean age of both samples from 2011 was higher and a larger proportion suffered from dementia, compared to earlier collected samples. A larger proportion of the residents in 2011 were assessed either malnourished or at-risk for malnutrition, according to the MNA, than in 2003 (NH: 93.5% vs. 88.9%, pimprovement. Copyright © 2017 Elsevier B.V. All rights reserved.

  2. The Volunteering-in-Place (VIP) Program: Providing meaningful volunteer activity to residents in assisted living with mild cognitive impairment.

    Science.gov (United States)

    Klinedinst, N Jennifer; Resnick, Barbara

    2016-01-01

    The Volunteering-in-Place (VIP) Program was developed to provide individualized meaningful volunteer activities matched to interests and capabilities for older adults with MCI in assisted living. The purposes of this single-site pre-test/post-test pilot study were to (1) establish feasibility of the VIP Program based on treatment fidelity (design, treatment, delivery, enactment); and (2) evaluate preliminary efficacy via improvement in psychological health (depressive symptoms, usefulness, purpose, resilience, and life satisfaction) and decreased sedentary activity (survey and Fitbit) at 3 and 6 months. Ten residents participated. The majority was white, female and educated, and on average 88 years old. The VIP Program was feasible and most participants continued to volunteer at 6 months. There were non-significant improvements in depressive symptoms, usefulness, purpose, resilience and recreational physical activity. The results of this study provide support for the feasibility of the VIP Program. Further study is necessary to examine efficacy. Copyright © 2016 Elsevier Inc. All rights reserved.

  3. Attitudes toward euthanasia, assisted suicide and termination of life-sustaining treatment of Puerto Rican medical students, medical residents, and faculty.

    Science.gov (United States)

    Ramirez Rivera, J; Rodríguez, R; Otero Igaravidez, Y

    2000-01-01

    To elicit the opinion of Puerto Rican medical students, residents and internal medicine faculty as to the appropriateness of euthanasia and physician-assisted suicide and end-of-life management. Survey using a 16-item questionnaire answered within a two-month period in the fall of 1996. Rounds or faculty meetings at teaching hospitals located in the north, south and southwest of the island of Puerto Rico. There were 424 participants. The questionnaires of 279 medical students, 75 medical residents, and 35 internal medicine faculty members were analyzed. Thirty-five questionnaires, which were incomplete or answered by non-Puerto Rican participants, were excluded. Frequency of support of active euthanasia, physician-assisted suicide, withholding or withdrawing life-sustaining treatment with informed consent was determined. Whether it was ethical to prescribe full doses of drugs needed to alleviate pain even if it would hasten death, or agree to limit or restrict resources for the terminally ill was also determined. Forty per cent of the students, 33% of the residents, and 20% of the faculty supported euthanasia. If physician-assisted suicide were legalized, 50 per cent of the students, 43 per cent of the residents and 45 percent of the faculty would not be opposed to it. Sixty-eight per cent of the students, 67 per cent of the residents and 88 per cent of the faculty would support withholding or withdrawing life-sustaining treatment for dying patients with informed consent. Seventy-nine per cent of residents, 80 per cent of the faculty but only 54 per cent of medical students would prescribe full doses of drugs needed to alleviate pain in dying patients even if they would hasten death. Thirty-six per cent of the residents and faculty would agree to limit the use of medical resources for the terminally ill but only sixteen per cent of medical students would do so. The acceptance of euthanasia was inversely proportional to the clinical experience of the respondents: 40

  4. How the perspectives of nursing assistants and frail elderly residents on their daily interaction in nursing homes affect their interaction: a qualitative study.

    Science.gov (United States)

    Lung, Chi-Chi; Liu, Justina Yat Wa

    2016-01-14

    Good support from and positive relations with institutional staff can enhance the psychosocial wellbeing of residents admitted to a nursing home. Nursing assistants (NAs) interact most frequently with residents and play an important role in developing good rapport with them. Most studies have described the daily interactions between NAs and residents as task oriented. Only few have attempted to explore the perspectives of NAs and residents on their daily interactions. Therefore, the aim of this study was to identify the types of daily interactions perceived by NAs and residents. We also investigated those intentions/beliefs held by NAs and residents that might direct their interactive behaviors. A descriptive, exploratory, qualitative approach was used to explore the perspectives of 18 NAs (mean age: 51) and 15 residents (mean age: 84.4) on their daily interactions. Unstructured in-depth interviews were used to collect data. All of the interviews were conducted from July to December 2013. The collected data were transcribed verbatim and analyzed by content analysis. Three types of interactions were found that described the NAs' and residents' perspectives on their daily interactions: (1) physiologically-oriented daily interactions; (2) cordial interactions intended to maintain a harmonious atmosphere; and (3) reciprocal social interactions intended to develop closer rapport. One or more themes reflecting the participants' intentions or beliefs were identified from each group to support each type of interaction. An over-emphasis on the formal caring relationship and over-concern about maintaining a harmonious atmosphere contributed to a superficial and distant relationship between the two parties. Building close rapport takes time and involves repeated reciprocal social interactions. The findings showed that with good intentions to establish closer rapport, both NAs and residents did favors for each other. All of those favors were easily integrated in the care

  5. 43 CFR 426.5 - Ownership entitlement.

    Science.gov (United States)

    2010-10-01

    ... nonexempt land; (ii) Married couples who hold equal interests are entitled to receive irrigation water on a... entitled to receive irrigation water on that land owned jointly in marriage up to a maximum of 320 acres of... tenant, provided each tenant holds an equal interest in the tenancy; (vi) Partnerships subject to prior...

  6. 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...

  7. Assisted living: a place to manage uncertainty. The ambiguity of assisted living is unavoidable because residents' needs are always changing. The Wheat Valley example is used to examine this concept.

    Science.gov (United States)

    Ekerdt, David J

    2005-01-01

    The assisted living environment lacks the satisfying clarity of the consumer model (a stay at the Holiday Inn) or the medical model (the hospital or nursing home). Yet the ambiguity of assisted living is unavoidable because it shelters individuals whose needs are changing, the model of care requires extensive negotiation with residents, and staff members must continually compromise as they implement the principles. Assisted living is a place where uncertainty is managed, not resolved. This indicates a need for the further pursuit of qualitative research, such as reported by these articles and others (e.g., Carder, 2002), to explore how participants construct, make sense of, and interpret their daily experience in assisted living.

  8. Feasibility of a computer-assisted social network motivational interviewing intervention for substance use and HIV risk behaviors for housing first residents.

    Science.gov (United States)

    Osilla, Karen Chan; Kennedy, David P; Hunter, Sarah B; Maksabedian, Ervant

    2016-09-07

    Social networks play positive and negative roles in the lives of homeless people influencing their alcohol and/or other drug (AOD) and HIV risk behaviors. We developed a four-session computer-assisted social network motivational interviewing intervention for homeless adults transitioning into housing. We examined the acceptability of the intervention among staff and residents at an organization that provides permanent supportive housing through iterative rounds of beta testing. Staff were 3 men and 3 women who were residential support staff (i.e., case managers and administrators). Residents were 8 men (7 African American, 1 Hispanic) and 3 women (2 African American, 1 Hispanic) who had histories of AOD and HIV risk behaviors. We conducted a focus group with staff who gave input on how to improve the delivery of the intervention to enhance understanding and receptivity among new residents. We conducted semi-structured qualitative interviews and collected self-report satisfaction data from residents. Three themes emerged over the course of the resident interviews. Residents reported that the intervention was helpful in discussing their social network, that seeing the visualizations was more impactful than just talking about their network, and that the intervention prompted thoughts about changing their AOD use and HIV risk networks. This study is the first of its kind that has developed, with input from Housing First staff and residents, a motivational interviewing intervention that targets both the structure and composition of one's social network. These results suggest that providing visual network feedback with a guided motivational interviewing discussion is a promising approach to supporting network change. ClinicalTrials.gov Identifier NCT02140359.

  9. Measurement of Psychological Entitlement in 28 Countries

    Czech Academy of Sciences Publication Activity Database

    Żemojtel-Piotrowska, M.; Piotrowski, J.; Cieciuch, J.; Calogero, R.M.; Van Hiel, A.; Argentero, P.; Baltatescu, S.; Baran, T.; Bardhwaj, G.; Bukowski, M.; Chargazia, M.; Clinton, A.; Halik, M.H.; Ilisko, D.; Khachatryan, N.; Klicperová-Baker, Martina; Košťál, Jaroslav; Kovacs, M.; Letovancova, E.; Liik, K.; Marganski, A.; Michałowski, J.; Nord, I.; Paspalanova, E.; de Leon, P.P.; Techera, J.; Rojas, M.; Różycka, J.; Sawicka, A.; Seibt, B.; Semkiv, I.; Tiliouine, H.; Truong, H.K.; Van den Bos, K.; Wills-Herrera, E.

    2017-01-01

    Roč. 33, č. 3 (2017), s. 207-217 ISSN 1015-5759 R&D Projects: GA ČR GA15-11062S Institutional support: RVO:68081740 Keywords : psychological entitlement * Entitlement Attitudes Questionnaire * cross-cultural research * measurement invariance Subject RIV: AN - Psychology OBOR OECD: Psychology (including human - machine relations) Impact factor: 2.328, year: 2016 http://econtent.hogrefe.com/doi/abs/10.1027/1015-5759/a000286

  10. Can a teaching assistant experience in a surgical anatomy course influence the learning curve for nontechnical skill development for surgical residents?

    Science.gov (United States)

    Heidenreich, Mark J; Musonza, Tashinga; Pawlina, Wojciech; Lachman, Nirusha

    2016-01-01

    The foundation upon which surgical residents are trained to work comprises more than just critical cognitive, clinical, and technical skill. In an environment where the synchronous application of expertise is vital to patient outcomes, the expectation for optimal functioning within a multidisciplinary team is extremely high. Studies have shown that for most residents, one of the most difficult milestones in the path to achieving professional expertise in a surgical career is overcoming the learning curve. This view point commentary provides a reflection from the two senior medical students who have participated in the Student-as-Teacher program developed by the Department of Anatomy at Mayo Clinic, designed to prepare students for their teaching assistant (TA) role in anatomy courses. Both students participated as TAs in a six week surgical anatomy course for surgical first assistant students offered by the School of Health Sciences at Mayo Clinic. Development of teaching skills, nontechnical leadership, communication, and assessment skills, are discussed in relation to their benefits in preparing senior medical students for surgical residency. © 2015 American Association of Anatomists.

  11. ?Sometimes I?ve gone home feeling that my voice hasn?t been heard?: a focus group study exploring the views and experiences of health care assistants when caring for dying residents

    OpenAIRE

    Fryer, Susan; Bellamy, Gary; Morgan, Tessa; Gott, Merryn

    2016-01-01

    Background In most developed countries, Health Care Assistants comprise a significant, and growing, proportion of the residential aged care workforce. Despite the fact that they provide the majority of direct care for residents, little is known about a?key care aspect of their work, namely their experience of caring for dying residents. Methods Twenty-six Health Care Assistants working in aged residential care facilities in Auckland, New Zealand participated in six focus group discussions. Fo...

  12. Academic Entitlement and Academic Performance in Graduating Pharmacy Students

    OpenAIRE

    Jeffres, Meghan N.; Barclay, Sean M.; Stolte, Scott K.

    2014-01-01

    Objectives. To determine a measurable definition of academic entitlement, measure academic entitlement in graduating doctor of pharmacy (PharmD) students, and compare the academic performance between students identified as more or less academically entitled.

  13. Between availability and entitlement: The Constitution, Grootboom ...

    African Journals Online (AJOL)

    Between availability and entitlement: The Constitution, Grootboom and the right to food. Danie Brand. Abstract. No Abstract. Full Text: EMAIL FREE FULL TEXT EMAIL FREE FULL TEXT · DOWNLOAD FULL TEXT DOWNLOAD FULL TEXT · AJOL African Journals Online. HOW TO USE AJOL... for Researchers · for Librarians ...

  14. "Sometimes I've gone home feeling that my voice hasn't been heard": a focus group study exploring the views and experiences of health care assistants when caring for dying residents.

    Science.gov (United States)

    Fryer, Susan; Bellamy, Gary; Morgan, Tessa; Gott, Merryn

    2016-08-19

    In most developed countries, Health Care Assistants comprise a significant, and growing, proportion of the residential aged care workforce. Despite the fact that they provide the majority of direct care for residents, little is known about a key care aspect of their work, namely their experience of caring for dying residents. Twenty-six Health Care Assistants working in aged residential care facilities in Auckland, New Zealand participated in six focus group discussions. Focus groups were designed to explore the experiences of Health Care Assistants caring for imminently dying residents in aged care facilities and to identify barriers and facilitators to their work in this area. The focus groups were digitally recorded, transcribed verbatim and analysed using a general inductive approach. Participants confirmed that Health Care Assistants provide the majority of hands on care to dying residents and believed they had a valuable role to play at this time due to their unique 'familial' relationship with residents and families. However, it was apparent that a number of barriers existed to them maximising their contribution to supporting dying residents, most notably the lack of value placed on their knowledge and experience by other members of the multidisciplinary team. Whilst a need for additional palliative and end of life care education was identified, a preference was identified for hands on education delivered by peers, rather than the didactic education they currently receive. Given ageing populations internationally coupled with a constrained health budget, the role of Health Care Assistants in most developed countries is likely to become even more significant in the short to medium term. This study makes a unique contribution to the international literature by identifying the barriers to caring for dying residents experienced by this valuable sector of the aged care workforce. These data have the potential to inform new, innovative, interventions to address

  15. Rights as entitlements and rights as claims

    Directory of Open Access Journals (Sweden)

    Azevedo, Marco Antônio Oliveira de

    2010-01-01

    Full Text Available Há pelo menos dois registros diferentes sobre o significado de “direitos”. Segundo um deles, os direitos são relações entre dois termos: uma pessoa e um bem; para o outro, os direitos são relações entre três termos: um indivíduo, uma pessoa e uma ação ou algo. Os registros são diferentes, mas não são totalmente incompatíveis. De acordo com a interpretação de direitos como entitlements, trata-se de direitos morais ou legais, ou seja, as relações de ordem moral ou jurídica das pessoas com bens (de benefícios concedidos a pessoas por uma lei humana, moral ou legal. Como uma espécie de direitos, os direitos humanos são vistos como direitos (entitlements das pessoas ou dos indivíduos a bens essenciais, dos quais podem-se inferir reivindicações (claims contra outras pessoas ou contra governos e representantes. Falamos sobre direitos humanos geralmente desta forma. Mas de acordo com o outro registro, os direitos em sentido próprio têm que ser interpretados como claims. Neste artigo, pretendo apresentar alguns argumentos em favor da vantagem de expor todos os enunciados significativos dos direitos como entitlements em termos explícitos de claims

  16. A computer-assisted motivational social network intervention to reduce alcohol, drug and HIV risk behaviors among Housing First residents.

    Science.gov (United States)

    Kennedy, David P; Hunter, Sarah B; Chan Osilla, Karen; Maksabedian, Ervant; Golinelli, Daniela; Tucker, Joan S

    2016-03-15

    Individuals transitioning from homelessness to housing face challenges to reducing alcohol, drug and HIV risk behaviors. To aid in this transition, this study developed and will test a computer-assisted intervention that delivers personalized social network feedback by an intervention facilitator trained in motivational interviewing (MI). The intervention goal is to enhance motivation to reduce high risk alcohol and other drug (AOD) use and reduce HIV risk behaviors. In this Stage 1b pilot trial, 60 individuals that are transitioning from homelessness to housing will be randomly assigned to the intervention or control condition. The intervention condition consists of four biweekly social network sessions conducted using MI. AOD use and HIV risk behaviors will be monitored prior to and immediately following the intervention and compared to control participants' behaviors to explore whether the intervention was associated with any systematic changes in AOD use or HIV risk behaviors. Social network health interventions are an innovative approach for reducing future AOD use and HIV risk problems, but little is known about their feasibility, acceptability, and efficacy. The current study develops and pilot-tests a computer-assisted intervention that incorporates social network visualizations and MI techniques to reduce high risk AOD use and HIV behaviors among the formerly homeless. CLINICALTRIALS. NCT02140359.

  17. Walker use, but not falls, is associated with lower physical functioning and health of residents in an assisted-living environment.

    Science.gov (United States)

    Andersen, Daniel A; Roos, Bernard A; Stanziano, Damian C; Gonzalez, Natasha M; Signorile, Joseph F

    2007-01-01

    The relationship between perceived health and walker use has seldom been addressed. Concerns over falls and falls risk are precursors to walker use. We compared the SF-36 scores of 26 women and 14 men, mean age 86.8 +/- 6.0 years based on walker use and faller status. An analysis of covariance (ANCOVA) with age as the covariate, compared groups for the SF-36 constructs and totals score. Significant differences were noted between walker users and nonusers in physical functioning, role limitations due to physical problems, general health, and the total SF-36 score. Pairwise comparisons favored nonusers, while no differences were seen due to faller status. Walker use is associated with lower self-perceptions of physical functioning, role limitations due to physical problems, and general health in assisted-living residents. Faller status is not associated with self-perceived health status. Although walker use aids mobility and lowers the probability of falls, further research is needed to determine if the prescription of assistive devices has a more negative impact on self-perceived health than does falling. This possibility could be explained, in part, by the greater activity levels of those individuals who do not depend on walkers.

  18. Entitlement and organizational behaviors: the moderating role of narcissism

    Directory of Open Access Journals (Sweden)

    Agata Szalkowska

    2015-10-01

    Full Text Available Background The purpose of this study was to investigate the relationship between psychological entitlement (active, passive, and revenge, narcissism and two types of organizational behaviors in employees. Interactions between narcissism and psychological entitlement as predictors of organizational citizenship behaviors (OCB and counterproductive work behaviors (CWB were explored. Predictors were analyzed in an effort to determine whether psychological entitlement plays a more destructive role among narcissistic employees than among non-narcissistic ones and whether the effects of narcissism on OCB and CWB are mediated by entitlement. Participants and procedure Data were obtained from 100 employees (34% men aged 22 to 59 years (M = 37.00, SD = 9.30 from public and private companies. Participants were asked to complete the Organizational Citizenship Behavior Scale (OCBS, the Counterproductive Organizational Behaviors Scale (COBS, the Entitlement Questionnaire, and the Narcissistic Personality Inventory (NPI. Results Positive aspects of entitlement were positively associated with OCB only among narcissistic employees, and active entitlement mediated the effects of narcissism on CWB. Active entitlement was negatively related to CWB. Negative aspects of entitlement were negatively related to OCB and unrelated to CWB. Conclusions This study provides evidence for positive (healthy aspects of entitlement for organizations. The unexpected interaction between narcissism and entitlement in predicting higher levels of OCB suggests that among narcissistic employees, healthy aspects of entitlement are desirable and profitable for an organization. Psychological entitlement was observed to be an important predictor of organizational behaviors beyond narcissism itself.

  19. Perfil do médico residente atendido no Grupo de Assistência Psicológica ao Aluno (GRAPAL da Faculdade de Medicina da Universidade de São Paulo Profile of the resident physician attended by the Group of Psychological Assistance for Students at the São Paulo University School of Medicine

    Directory of Open Access Journals (Sweden)

    Emmanuel Nunes de Souza

    2009-01-01

    Full Text Available OBJETIVOS: Definir o perfil do médico residente atendido em um serviço de assistência à saúde mental a fim de contribuir para o conhecimento das necessidades deste grupo. MÉTODOS: Estudo observacional do tipo coorte retrospectivo. Os dados foram obtidos por meio de revisão de prontuários de uma série de residentes atendidos pelo Grupo de Assistência Psicológica ao Aluno (Grapal no período de 1998 a 2002 e pelo acesso ao registro geral de matrícula de residentes. Inclui a descrição da proporção de residentes atendidos segundo ano [cronológico], ano de residência, sexo, idade, especialidade, faculdade de origem e distância do núcleo familiar; e a análise das diferenças de proporções entre as categorias das variáveis investigadas. RESULTADOS: Durante o período estudado temos o registro de 2.131 residentes matriculados, totalizando 4.727 residentes-ano de seguimento. Neste conjunto, computando-se somente o primeiro atendimento, temos 104 residentes atendidos pelo Grapal (4,9% residentes atendidos, ou 2,2 atendidos para cada 100 residentes-ano de seguimento. Os dados revelam maior proporção de residentes atendidos com as seguintes características: primeiro ano de residência (4,5%, idade inferior a 26 anos (6,1%, sexo feminino (6,9%, egresso de outras escolas médicas (5,9% e residentes de especialidades cognitivas (6,7%. CONCLUSÃO: A assistência psiquiátrica mostrou-se associada ao gênero, a fatores ligados a crises adaptativas e a especialidades cognitivas. Não houve crescimento da proporção de residentes atendida pelo serviço durante o período analisado.OBJECTIVES: To define the profile of medical residents assisted by a mental health care service, aiming to contribute to the understanding of this group's needs. Methods: Observational study, retrospective cohort design. Data were collected from the medical records of a series of residents assisted by the group of psychological care for students of the Sao

  20. Reforming Equalization: Balancing Efficiency, Entitlement and Ownership

    Directory of Open Access Journals (Sweden)

    Bev Dahlby

    2014-08-01

    Full Text Available In this paper, we provide an overview of the equalization grant system in Canada and the issues that have been raised concerning the reform of the fiscal transfer system. Any reforms to the equalization grant system have to balance three concerns — “efficiency” effects that arise through federal financing of transfers, and the incentive effects on provincial fiscal policies, “entitlement” to reasonably comparable public services at reasonably comparable levels of taxation, and “ownership” of resources and independence of fiscal policies by provincial governments. Five proposals for reform of the equalization system are discussed. With regard to the inclusion rate for resource revenues in equalization formula, we argue that the rate should be reduced from 50 per cent to 25 per cent and that ceiling on total equalization payments should be eliminated. We argue against the proposal to exempt from the calculation of equalization entitlements that are deposited in provincial sovereign wealth funds because this would not reduce total equalization entitlements in present value terms, it would be complex to implement if it extended to all forms of savings by provinces (such as debt reduction, and it would not alter the resource rich provinces’ incentives to save more of their resource revenues. We argue against a proposal to reduce CHT and CST to provinces with above average fiscal capacities because this would reduce their incentive to develop and tax their resources, and it would be counter to the purpose of these block grants, which is to reduce the vertical fiscal imbalance between the federal and the provincial governments. We review the Gusen (2012a proto-type model for incorporating variations in costs and needs in the computation of the equalization entitlements and argue that this procedure seems feasible and merits further analysis.

  1. 42 CFR 31.11 - Persons entitled to treatment.

    Science.gov (United States)

    2010-10-01

    ... 42 Public Health 1 2010-10-01 2010-10-01 false Persons entitled to treatment. 31.11 Section 31.11... § 31.11 Persons entitled to treatment. To the extent and under the circumstances prescribed in this part, the following persons shall be entitled to medical, surgical, and dental treatment and...

  2. 20 CFR 725.219 - Duration of entitlement; child.

    Science.gov (United States)

    2010-04-01

    ... 20 Employees' Benefits 3 2010-04-01 2010-04-01 false Duration of entitlement; child. 725.219... of entitlement; child. (a) An individual is entitled to benefits as a child for each month beginning... month in which any one of the following events first occurs: (1) The child dies; (2) The child marries...

  3. 20 CFR 725.218 - Conditions of entitlement; child.

    Science.gov (United States)

    2010-04-01

    ... 20 Employees' Benefits 3 2010-04-01 2010-04-01 false Conditions of entitlement; child. 725.218... Conditions of entitlement; child. (a) An individual is entitled to benefits where he or she meets the... the child of a deceased miner who: (1) Was receiving benefits under section 415 or part C of title IV...

  4. 20 CFR 410.212 - Conditions of entitlement; child.

    Science.gov (United States)

    2010-04-01

    ... 20 Employees' Benefits 2 2010-04-01 2010-04-01 false Conditions of entitlement; child. 410.212...; Filing of Claims and Evidence § 410.212 Conditions of entitlement; child. (a) An individual is entitled to benefits if such individual: (1) Is the child or stepchild (see § 410.330) of (i) a deceased miner...

  5. 20 CFR 410.213 - Duration of entitlement; child.

    Science.gov (United States)

    2010-04-01

    ... 20 Employees' Benefits 2 2010-04-01 2010-04-01 false Duration of entitlement; child. 410.213...; Filing of Claims and Evidence § 410.213 Duration of entitlement; child. (a) An individual is entitled to benefits as a child for each month beginning with the first month in which all of the conditions of...

  6. The Appropriateness of Canine-Assisted Interventions (CAIs) on the Health and Social Care of Older People Residing in Long Term Care: A Systematic Review.

    Science.gov (United States)

    Stern, Cindy; Pearson, Alan; Chur-Hansen, Anna

    2011-01-01

    Background: Canine-assisted interventions are used frequently in long term care settings, even though their effectiveness has not been definitively proven. One concern commonly described in the literature is the risk of zoonotic infection or animal-related injury/allergy associated with this type of interaction. To date, no systematic review has been undertaken to determine the appropriateness of canine-assisted interventions in relation to these issues. The aim of the review was to synthesise the best available evidence on the appropriateness of canine-assisted interventions on the health and social care of the older population residing in long term care with regards to zoonotic infection or animal-related injury/allergy. A comprehensive search was undertaken on 32 electronic databases and two reputable websites from their inception to 2009. The search was restricted to English language and both published and unpublished studies and papers were considered. The review took an inclusive approach and considered quantitative and qualitative studies that focussed on zoonotic risk/exposure/infection or animal-related injury/allergy from canine-assisted interventions used in long term care settings. In the absence of research studies, text and opinion were also considered. Critical appraisal of papers was to be undertaken using the appropriate Joanna Briggs Institute critical appraisal instrument and data extraction was to be via the Joanna Briggs Institute data extraction forms, dependant on design. There were no studies located the met the inclusion requirements of this review. There were also no text and opinion pieces that were specific to long term care, older people and canines. There is currently no evidence available to determine the appropriateness of canine-assisted interventions used for older people in long term care in regards to zoonotic risk/exposure/infection or animal-related injuries/allergies. There is a small body of literature available that focuses

  7. Walker use, but not falls, is associated with lower physical functioning and health of residents in an assisted-living environment

    Directory of Open Access Journals (Sweden)

    Daniel A Andersen

    2007-04-01

    Full Text Available Daniel A Andersen1,5, Bernard A Roos1–4, Damian C Stanziano1,3, Natasha M Gonzalez3, Joseph F Signorile1–31Stein Gerontological Institute, Miami, FL; 2Geriatric Research, Education, and Clinical Center, Veterans Affairs Medical Center, Miami, FL; 3Department of Exercise and Sport Sciences, University of Miami, Coral Gables, FL; 4Departments of Medicine and Neurology, University of Miami Miller School of Medicine, Miami, FL; 5Department of Epidemiology and Public Health, University of Miami School of Medicine, Miami, FL, USAAbstract: The relationship between perceived health and walker use has seldom been addressed. Concerns over falls and falls risk are precursors to walker use. We compared the SF-36 scores of 26 women and 14 men, mean age 86.8 ± 6.0 years based on walker use and faller status. An analysis of covariance (ANCOVA with age as the covariate, compared groups for the SF-36 constructs and totals score. Significant differences were noted between walker users and nonusers in physical functioning, role limitations due to physical problems, general health, and the total SF-36 score. Pairwise comparisons favored nonusers, while no differences were seen due to faller status. Walker use is associated with lower self-perceptions of physical functioning, role limitations due to physical problems, and general health in assisted-living residents. Faller status is not associated with self-perceived health status. Although walker use aids mobility and lowers the probability of falls, further research is needed to determine if the prescription of assistive devices has a more negative impact on self-perceived health than does falling. This possibility could be explained, in part, by the greater activity levels of those individuals who do not depend on walkers.Keywords: physical function, threshold, walking aid, elderly, perceived health

  8. Effect of animal-assisted interventions on depression, agitation and quality of life in nursing home residents suffering from cognitive impairment or dementia: a cluster randomized controlled trial.

    Science.gov (United States)

    Olsen, Christine; Pedersen, Ingeborg; Bergland, Astrid; Enders-Slegers, Marie-José; Patil, Grete; Ihlebaek, Camilla

    2016-12-01

    The prevalence of neuropsychiatric symptoms in cognitively impaired nursing home residents is known to be very high, with depression and agitation being the most common symptoms. The possible effects of a 12-week intervention with animal-assisted activities (AAA) in nursing homes were studied. The primary outcomes related to depression, agitation and quality of life (QoL). A prospective, cluster randomized multicentre trial with a follow-up measurement 3 months after end of intervention was used. Inclusion criteria were men and women aged 65 years or older, with a diagnosis of dementia or having a cognitive deficit. Ten nursing homes were randomized to either AAA with a dog or a control group with treatment as usual. In total, 58 participants were recruited: 28 in the intervention group and 30 in the control group. The intervention consisted of a 30-min session with AAA twice weekly for 12 weeks in groups of three to six participants, led by a qualified dog handler. Norwegian versions of the Cornell Scale for Depression, the Brief Agitation Rating Scale and the Quality of Life in Late-stage Dementia scale were used. A significant effect on depression and QoL was found for participants with severe dementia at follow-up. For QoL, a significant effect of AAA was also found immediately after the intervention. No effects on agitation were found. Animal-assisted activities may have a positive effect on symptoms of depression and QoL in older people with dementia, especially those in a late stage. Copyright © 2016 John Wiley & Sons, Ltd. Copyright © 2016 John Wiley & Sons, Ltd.

  9. 38 CFR 21.7076 - Entitlement charges.

    Science.gov (United States)

    2010-07-01

    ...) VOCATIONAL REHABILITATION AND EDUCATION All Volunteer Force Educational Assistance Program (Montgomery GI... basic educational assistance otherwise applicable to him or her for full-time institutional training. If... to him or her for full-time institutional training. (Authority: 38 U.S.C. 3031(f)) (10) When a...

  10. Can a sense of entitlement increase stealing?

    DEFF Research Database (Denmark)

    Gravert, Christina Annette

    Are people more likely to steal when the payoff they deserve is determined randomly or when it depends on their performance in a difficult task? In this paper I investigate how the probability of stealing is affected by the way in which payoff is earned. After answering a short survey one group...... to take the (undeserved) maximum payoff than the participants in the random payment scheme. In contrast to previous findings in the cheating literature, stealing is an all-or-nothing decision rather than a trade-off between a slightly higher payoff and the desire to keep ones moral values intact....... The results support the theory that unethical behavior is increased by a sense of entitlement, which is more pronounced when wealth depends on performance than on the roll of a die....

  11. Testing the effectiveness of in-home behavioral economics strategies to increase vegetable intake, liking, and variety among children residing in households that receive food assistance.

    Science.gov (United States)

    Leak, Tashara M; Swenson, Alison; Vickers, Zata; Mann, Traci; Mykerezi, Elton; Redden, Joseph P; Rendahl, Aaron; Reicks, Marla

    2015-01-01

    To test the effectiveness of behavioral economics strategies for increasing vegetable intake, variety, and liking among children residing in homes receiving food assistance. A randomized controlled trial with data collected at baseline, once weekly for 6 weeks, and at study conclusion. Family homes. Families with a child (9-12 years) will be recruited through community organizations and randomly assigned to an intervention (n = 36) or control (n = 10) group. The intervention group will incorporate a new behavioral economics strategy during home dinner meal occasions each week for 6 weeks. Strategies are simple and low-cost. The primary dependent variable will be child's dinner meal vegetable consumption based on weekly reports by caregivers. Fixed independent variables will include the strategy and week of strategy implementation. Secondary dependent variables will include vegetable liking and variety of vegetables consumed based on data collected at baseline and study conclusion. Mean vegetable intake for each strategy across families will be compared using a mixed-model analysis of variance with a random effect for child. In additionally, overall mean changes in vegetable consumption, variety, and liking will be compared between intervention and control groups. Copyright © 2015 Society for Nutrition Education and Behavior. Published by Elsevier Inc. All rights reserved.

  12. Teaching Rational Entitlement and Responsibility: A Socratic Exercise

    Directory of Open Access Journals (Sweden)

    David Godden

    2014-02-01

    Full Text Available The paper reports on a Socratic exercise that introduces participants to the norm of rational entitlement, as distinct from political entitlement, and the attendant norm of rational responsibility. The exercise demonstrates that, because participants are not willing to exchange their own opinion at random for another differing opinion to which the owner is, by the participants’ own admission, entitled, they treat their entitlement to their own opinion differently, giving it a special status. This gives rise to rational obligations such as the obligation to provide reasons, and a willingness to risk those opinions to the force of the better reason.

  13. Prevalencia de las úlceras por presión en una residencia asistida de mayores Prevalence of pressure ulcers in an assisted residence for the elderly

    Directory of Open Access Journals (Sweden)

    J.M. Díaz Pizarro

    2007-09-01

    Full Text Available Se recogieron datos de 282 residentes distribuidos en las diferentes áreas asistenciales de una residencia asistida de mayores, con el objetivo de analizar la prevalencia de lesiones por presión y sus características, así como el estado funcional y psíquico de los usuarios para poder realizar un estudio descriptivo de su situación actual. Se observó una prevalencia del 13,47% de UPP con una mayor presencia en talones y una media de edad de 82,93 años. Además, se analizaron factores que aumentan el riesgo de aparición de UPP, con especial atención a la presencia de incontinencia, uso de suplementos nutricionales y a las medidas de prevención como cambios posturales y colchones antiescaras.We made a survey and collected data from 283 people distributed in the different welfare areas of an assisted residence for the elderly in order to analyse the prevalence of pressure ulcers as well as their functional and psychic conditions of the users to develop a descriptive report of their current situations. A prevalence percentage of 13,47 was found, the sores in their heels being the most spread ones and within people at the average age of 82,93. Besides, there were analyzed factors that increase the risk of PUs appearance with special attention to the presence of incontinence, use of nutritional supplements and the prevention measures as position changes and no injure mattresses.

  14. Academic Entitlement in the Context of Learning Styles

    Science.gov (United States)

    Andrey, Jean; Joakim, Erin; Schoner, Vivian; Hambly, Derrick; Silver, Amber; Jayasundera, Rohan; Nelson, Allen

    2012-01-01

    This study explores the linkages between students' sense of entitlement and their approaches to learning, based on survey research at a large public university in Canada. Through literature review and pilot testing, a questionnaire instrument was developed that measures four constructs: academic entitlement, deep learning, surface learning and…

  15. Entitlement Attitudes Predict Students' Poor Performance in Challenging Academic Conditions

    Science.gov (United States)

    Anderson, Donna; Halberstadt, Jamin; Aitken, Robert

    2013-01-01

    Excessive entitlement--an exaggerated or unrealistic belief about what one deserves--has been associated with a variety of maladaptive behaviors, including a decline in motivation and effort. In the context of tertiary education, we reasoned that if students expend less effort to obtain positive outcomes to which they feel entitled, this should…

  16. 42 CFR 31.2 - Persons entitled to treatment.

    Science.gov (United States)

    2010-10-01

    ... 42 Public Health 1 2010-10-01 2010-10-01 false Persons entitled to treatment. 31.2 Section 31.2... Public Health Service § 31.2 Persons entitled to treatment. To the extent and under the circumstances... treatment and hospitalization by the Service: (a) Coast Guard. (1) Commissioned officers, chief warrant...

  17. Personality, Self-Regulated Learning, and Academic Entitlement

    Science.gov (United States)

    McLellan, Chelsea K.; Jackson, Dennis L.

    2017-01-01

    The current study explored the relation between the Big-Five personality domains, self-regulated learning, and academic entitlement. Academic entitlement is defined as the tendency to possess expectations of unearned academic success, unearned/undeserved academic services, and/or the expectation of unrealistic accommodation (Chowning and Campbell…

  18. Academic Entitlement and Its Relationship with Perception of Cheating Ethics

    Science.gov (United States)

    Elias, Rafik Z.

    2017-01-01

    Cheating is an epidemic in higher education. The author examined the psychological variable of academic entitlement and its relationship with the ethical perception of cheating using a sample of business students. Contrary to some previous research, the author found that millennials were only slightly more academically entitled than students from…

  19. Is computer-assisted instruction more effective than other educational methods in achieving ECG competence among medical students and residents? Protocol for a systematic review and meta-analysis.

    Science.gov (United States)

    Viljoen, Charle André; Scott Millar, Rob; Engel, Mark E; Shelton, Mary; Burch, Vanessa

    2017-12-26

    Although ECG interpretation is an essential skill in clinical medicine, medical students and residents often lack ECG competence. Novel teaching methods are increasingly being implemented and investigated to improve ECG training. Computer-assisted instruction is one such method under investigation; however, its efficacy in achieving better ECG competence among medical students and residents remains uncertain. This article describes the protocol for a systematic review and meta-analysis that will compare the effectiveness of computer-assisted instruction with other teaching methods used for the ECG training of medical students and residents. Only studies with a comparative research design will be considered. Articles will be searched for in electronic databases (PubMed, Scopus, Web of Science, Academic Search Premier, CINAHL, PsycINFO, Education Resources Information Center, Africa-Wide Information and Teacher Reference Center). In addition, we will review citation indexes and conduct a grey literature search. Data extraction will be done on articles that met the predefined eligibility criteria. A descriptive analysis of the different teaching modalities will be provided and their educational impact will be assessed in terms of effect size and the modified version of Kirkpatrick framework for the evaluation of educational interventions. This systematic review aims to provide evidence as to whether computer-assisted instruction is an effective teaching modality for ECG training. It is hoped that the information garnered from this systematic review will assist in future curricular development and improve ECG training. As this research is a systematic review of published literature, ethical approval is not required. The results will be reported according to the Preferred Reporting Items for Systematic Review and Meta-Analysis statement and will be submitted to a peer-reviewed journal. The protocol and systematic review will be included in a PhD dissertation. CRD

  20. Assisted Living

    Science.gov (United States)

    ... a resident's needs depends as much on the philosophy and services of the assisted living facility as it does on the quality of care. The Administration on Aging, a part of the U.S. Department of Health and Human Services (HHS), offers these suggestions to help you ...

  1. A REVIEW OF ENGLISH TEXTBOOK ENTITLED "SKILLFUL: READING AND WRITING, STUDENT'S BOOK 1" BY DAVID BOHLKE AND DOROTHY ZEMACH

    OpenAIRE

    Thunyalak Polsuk; Nutprapha K. Dennis, Ph.D

    2017-01-01

    This study aims to evaluate the usefulness of a commercial textbook entitle “Skillful: Reading & Writing, Student’s Book 1”, written by David Bohlke with Dorothy E. Zemach as a series consultant, published by Macmillan publisher. The study also explores the appropriateness for considering to teaching university EFL students. The result of this study assists English teachers in choosing textbooks which will be most appropriate to the learners at various level to develop their reading and writi...

  2. Social policy and entitlements : a proposal for reform

    NARCIS (Netherlands)

    Nentjes, Andries; Meijer, G; Heijman, WJM; VanOphem, JAC; Verstegen, BHJ

    2006-01-01

    Welfare states citizens have entitlements to a variety of social services provided for free or a price far below cost, such as education, health care, social security and housing. Every citizen benefits, but in their present organisation the social services also have major deficiencies: lack of

  3. Safe water: an enquiry into water entitlements and human rights

    NARCIS (Netherlands)

    Gaay Fortman, B. de

    2006-01-01

    Privatisation of water delivery is a human rights issue in two distinct ways. Firstly, it implies an institutional change that will tend to impinge on existing access to water. While basic water entitlements are supposed to be protected by human rights law, this is likely to influence

  4. Intellectual Freedom and Economic Sufficiency as Educational Entitlements.

    Science.gov (United States)

    Morse, Jane Fowler

    2001-01-01

    Using the theories of John Stuart Mill and Karl Marx, this article supports the educational entitlements of intellectual freedom and economic sufficiency. Explores these issues in reference to their implications for teaching, the teaching profession and its training. Concludes that ideas cannot be controlled by the interests of the dominant class.…

  5. 21 CFR 1.401 - Who is entitled to appeal?

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 1 2010-04-01 2010-04-01 false Who is entitled to appeal? 1.401 Section 1.401 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES GENERAL GENERAL ENFORCEMENT REGULATIONS Administrative Detention of Food for Human or Animal Consumption What Is the Appeal...

  6. Review Article: Revisiting the Entitlement Approach to Famine ...

    African Journals Online (AJOL)

    Sen's (1981b) entitlement approach conceptualises famine as the characteristics of some people not having enough food to eat but not of there being not enough food to eat. Famine from this perspective is one that occurs without a decline in the macro level supply of food and, hence, it is all about demand failure/shift in the ...

  7. 75 FR 52619 - Entitlement and Termination Requirements for Stepchildren

    Science.gov (United States)

    2010-08-27

    ... site, Social Security Online, at http://www.socialsecurity.gov . SUPPLEMENTARY INFORMATION: Electronic... SOCIAL SECURITY ADMINISTRATION 20 CFR Part 404 [Docket No. SSA-2006-0154] RIN 0960-AF78 Entitlement and Termination Requirements for Stepchildren AGENCY: Social Security Administration. ACTION...

  8. Cover Letter Dear Editor, Please find enclosed a paper entitled ...

    African Journals Online (AJOL)

    Ajamein

    Dear Editor,. Please find enclosed a paper entitled ' Intrinsic Kinetics of Fischer- Tropsch Synthesis Over a. Promoted Iron Catalyst '. I am submitting to your journal to be considered for publication as a research paper in Bulletin of the Chemical Society of Ethiopia. The manuscript has not been previously published, is not ...

  9. Robert Nozick's entitlement theory of justice: a critique | Nnajiofor ...

    African Journals Online (AJOL)

    The burden of this paper is to critique Robert Nozick's entitlement theory of justice which was drafted as an argument against traditional distribution theories. Nozick's theory of justice claims that whether a distribution is just or not depend entirely on how it came about. By contrast, justice according to equality, need, desert or ...

  10. 20 CFR 410.214 - Conditions of entitlement; parent, brother, or sister.

    Science.gov (United States)

    2010-04-01

    ... entitlement to brother's benefits may be established for any month before January 1973, based on a disability... 20 Employees' Benefits 2 2010-04-01 2010-04-01 false Conditions of entitlement; parent, brother...; Duration of Entitlement; Filing of Claims and Evidence § 410.214 Conditions of entitlement; parent, brother...

  11. An unexpected resident in the ileum detected during robot-assisted laparoscopic radical cystoprostatectomy and intracorporeal Studer pouch formation: Taenia saginata parasite.

    Science.gov (United States)

    Canda, Abdullah Erdem; Asil, Erem; Balbay, Mevlana Derya

    2011-02-01

    A case of moving ileal Taenia saginata parasites is presented with demonstrative images. We came across the parasites surprisingly while performing robot-assisted laparoscopic radical cystoprostatectomy with intracorporeal Studer pouch urinary diversion. We recommend stool sample evaluation in the preoperative period for possible presence of intestinal parasitic diseases, particularly in patients with bladder cancer who are admitted from areas with an increased incidence of intestinal parasitic diseases, before opening the bowel segments during surgery to perform radical cystectomy and urinary diversion.

  12. 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.

  13. Resident-Assisted Montessori Programming (RAMP): use of a small group reading activity run by persons with dementia in adult day health care and long-term care settings.

    Science.gov (United States)

    Skrajner, Michael J; Camp, Cameron J

    2007-01-01

    Six persons in the early to middle stages of dementia ("leaders") were trained in Resident-Assisted Montessori Programming (RAMP) to lead a reading activity for 22 persons with more advanced dementia ("participants") in an adult day health center (ADHC) and a special care unit (SCU) in a skilled nursing facility. Researchers assessed the leaders' abilities to learn and follow the procedures of leading a group, as well as their satisfaction with their roles. In addition, participants' engagement and affect were measured, both during standard activities programming and during client-led activities. Results of this study suggest that persons with dementia can indeed successfully lead small group activities, if several important prerequisites are met. Furthermore, the engagement and affect of participants was more positive in client-led activities than in standard activities programming.

  14. Wealth and the inflated self: class, entitlement, and narcissism.

    Science.gov (United States)

    Piff, Paul K

    2014-01-01

    Americans may be more narcissistic now than ever, but narcissism is not evenly distributed across social strata. Five studies demonstrated that higher social class is associated with increased entitlement and narcissism. Upper-class individuals reported greater psychological entitlement (Studies 1a, 1b, and 2) and narcissistic personality tendencies (Study 2), and they were more likely to behave in a narcissistic fashion by opting to look at themselves in a mirror (Study 3). Finally, inducing egalitarian values in upper-class participants decreased their narcissism to a level on par with their lower-class peers (Study 4). These findings offer novel evidence regarding the influence of social class on the self and highlight the importance of social stratification to understanding basic psychological processes.

  15. What Are Occupational Pension Plan Entitlements Worth in Britain?

    OpenAIRE

    Disney, Richard; Whitehouse, Edward

    1996-01-01

    The acquisition of rights by workers in private pension plans underpins retirement behavior, recruitment policy, and wage structure but there is controversy as to how these individual pension rights should be valued. The paper combines four data-sets to calculate pension entitlements for a sample of 3,000 British workers in 1987. Expected scheme tenure is a key variable in valuation; younger workers and women face greater initial uncertainty as to their pension outcomes, which is resolved as ...

  16. Resident Research Fundamentals Course Human Research Curves in the Road

    Science.gov (United States)

    2017-09-27

    MDW/SGVU SUBJECT: Professional Presentation Approval 27 JULY 2017 Your paper, entitled Resident Research Fundamentals Course - "Human Research ...Curves in the Road" (27 Sep 2017) presented at/published to Resident Research Fundamentals Course - JBSA Lackland, San Antonio, TX - 27 Sep 2017 in...are a Graduate Health Sciences Education student and your department has told you they cannot fund your publication, the 59th Clinical Research

  17. An immunity-triggering effector from the Barley smut fungus Ustilago hordei resides in an Ustilaginaceae-specific cluster bearing signs of transposable element-assisted evolution.

    Directory of Open Access Journals (Sweden)

    Shawkat Ali

    2014-07-01

    Full Text Available The basidiomycete smut fungus Ustilago hordei was previously shown to comprise isolates that are avirulent on various barley host cultivars. Through genetic crosses we had revealed that a dominant avirulence locus UhAvr1 which triggers immunity in barley cultivar Hannchen harboring resistance gene Ruh1, resided within an 80-kb region. DNA sequence analysis of this genetically delimited region uncovered the presence of 7 candidate secreted effector proteins. Sequence comparison of their coding sequences among virulent and avirulent parental and field isolates could not distinguish UhAvr1 candidates. Systematic deletion and complementation analyses revealed that UhAvr1 is UHOR_10022 which codes for a small effector protein of 171 amino acids with a predicted 19 amino acid signal peptide. Virulence in the parental isolate is caused by the insertion of a fragment of 5.5 kb with similarity to a common U. hordei transposable element (TE, interrupting the promoter of UhAvr1 and thereby changing expression and hence recognition of UhAVR1p. This rearrangement is likely caused by activities of TEs and variation is seen among isolates. Using GFP-chimeric constructs we show that UhAvr1 is induced only in mated dikaryotic hyphae upon sensing and infecting barley coleoptile cells. When infecting Hannchen, UhAVR1p causes local callose deposition and the production of reactive oxygen species and necrosis indicative of the immune response. UhAvr1 does not contribute significantly to overall virulence. UhAvr1 is located in a cluster of ten effectors with several paralogs and over 50% of TEs. This cluster is syntenous with clusters in closely-related U. maydis and Sporisorium reilianum. In these corn-infecting species, these clusters harbor however more and further diversified homologous effector families but very few TEs. This increased variability may have resulted from past selection pressure by resistance genes since U. maydis is not known to trigger immunity

  18. An Immunity-Triggering Effector from the Barley Smut Fungus Ustilago hordei Resides in an Ustilaginaceae-Specific Cluster Bearing Signs of Transposable Element-Assisted Evolution

    KAUST Repository

    Ali, Shawkat

    2014-07-03

    The basidiomycete smut fungus Ustilago hordei was previously shown to comprise isolates that are avirulent on various barley host cultivars. Through genetic crosses we had revealed that a dominant avirulence locus UhAvr1 which triggers immunity in barley cultivar Hannchen harboring resistance gene Ruh1, resided within an 80-kb region. DNA sequence analysis of this genetically delimited region uncovered the presence of 7 candidate secreted effector proteins. Sequence comparison of their coding sequences among virulent and avirulent parental and field isolates could not distinguish UhAvr1 candidates. Systematic deletion and complementation analyses revealed that UhAvr1 is UHOR_10022 which codes for a small effector protein of 171 amino acids with a predicted 19 amino acid signal peptide. Virulence in the parental isolate is caused by the insertion of a fragment of 5.5 kb with similarity to a common U. hordei transposable element (TE), interrupting the promoter of UhAvr1 and thereby changing expression and hence recognition of UhAVR1p. This rearrangement is likely caused by activities of TEs and variation is seen among isolates. Using GFP-chimeric constructs we show that UhAvr1 is induced only in mated dikaryotic hyphae upon sensing and infecting barley coleoptile cells. When infecting Hannchen, UhAVR1p causes local callose deposition and the production of reactive oxygen species and necrosis indicative of the immune response. UhAvr1 does not contribute significantly to overall virulence. UhAvr1 is located in a cluster of ten effectors with several paralogs and over 50% of TEs. This cluster is syntenous with clusters in closely-related U. maydis and Sporisorium reilianum. In these corn-infecting species, these clusters harbor however more and further diversified homologous effector families but very few TEs. This increased variability may have resulted from past selection pressure by resistance genes since U. maydis is not known to trigger immunity in its corn host.

  19. An Immunity-Triggering Effector from the Barley Smut Fungus Ustilago hordei Resides in an Ustilaginaceae-Specific Cluster Bearing Signs of Transposable Element-Assisted Evolution

    KAUST Repository

    Ali, Shawkat; Laurie, John D.; Linning, Rob; Cervantes-Chá vez, José Antonio; Gaudet, Denis; Bakkeren, Guus

    2014-01-01

    The basidiomycete smut fungus Ustilago hordei was previously shown to comprise isolates that are avirulent on various barley host cultivars. Through genetic crosses we had revealed that a dominant avirulence locus UhAvr1 which triggers immunity in barley cultivar Hannchen harboring resistance gene Ruh1, resided within an 80-kb region. DNA sequence analysis of this genetically delimited region uncovered the presence of 7 candidate secreted effector proteins. Sequence comparison of their coding sequences among virulent and avirulent parental and field isolates could not distinguish UhAvr1 candidates. Systematic deletion and complementation analyses revealed that UhAvr1 is UHOR_10022 which codes for a small effector protein of 171 amino acids with a predicted 19 amino acid signal peptide. Virulence in the parental isolate is caused by the insertion of a fragment of 5.5 kb with similarity to a common U. hordei transposable element (TE), interrupting the promoter of UhAvr1 and thereby changing expression and hence recognition of UhAVR1p. This rearrangement is likely caused by activities of TEs and variation is seen among isolates. Using GFP-chimeric constructs we show that UhAvr1 is induced only in mated dikaryotic hyphae upon sensing and infecting barley coleoptile cells. When infecting Hannchen, UhAVR1p causes local callose deposition and the production of reactive oxygen species and necrosis indicative of the immune response. UhAvr1 does not contribute significantly to overall virulence. UhAvr1 is located in a cluster of ten effectors with several paralogs and over 50% of TEs. This cluster is syntenous with clusters in closely-related U. maydis and Sporisorium reilianum. In these corn-infecting species, these clusters harbor however more and further diversified homologous effector families but very few TEs. This increased variability may have resulted from past selection pressure by resistance genes since U. maydis is not known to trigger immunity in its corn host.

  20. 75 FR 68035 - Proposed Information Collection (Evidence for Transfer of Entitlement of Education Benefits...

    Science.gov (United States)

    2010-11-04

    ... (Evidence for Transfer of Entitlement of Education Benefits) Activity: Comment Request AGENCY: Veterans Benefits Administration, Department of Veterans Affairs. ACTION: Notice. SUMMARY: The Veterans Benefits... receive education benefits under the transfer of entitlement provision of law. Affected Public...

  1. 78 FR 59772 - Proposed Information Collection (Evidence for Transfer of Entitlement of Education Benefits...

    Science.gov (United States)

    2013-09-27

    ... (Evidence for Transfer of Entitlement of Education Benefits) Activity: Comment Request AGENCY: Veterans Benefits Administration, Department of Veterans Affairs. ACTION: Notice. SUMMARY: The Veterans Benefits... receive education benefits under the transfer of entitlement provision of law. Affected Public...

  2. 78 FR 46418 - Proposed Information Collection (Obligation To Report Factors Affecting Entitlement) Activity...

    Science.gov (United States)

    2013-07-31

    ... (Obligation To Report Factors Affecting Entitlement) Activity; Comment Request AGENCY: Veterans Benefits... use of other forms of information technology. Title: Obligation to Report Factors Affecting... entitlement factors. Individual factors such as income, marital status, and the beneficiary's number of...

  3. Social Vulnerability to Climate Change and the Architecture of Entitlements

    International Nuclear Information System (INIS)

    Adger, W.N.; Kelly, P.M.

    1999-01-01

    The objective of this paper is to outline a conceptual model of vulnerability to climate change as the first step in appraising and understanding the social and economic processes which facilitate and constrain adaptation. Vulnerability as defined here pertains to individuals and social groups. It is the state of individuals, of groups, of communities defined in terms of their ability to cope with and adapt to any external stress placed on their livelihoods and well-being. This proposed approach puts the social and economic well-being of society at the centre of the analysis, thereby reversing the central focus of approaches to climate impact assessment based on impacts on and the adaptability of natural resources or ecosystems and which only subsequently address consequences for human well-being. The vulnerability or security of any group is determined by the availability of resources and, crucially, by the entitlement of individuals and groups to call on these resources. This perspective extends the concept of entitlements developed within neoclassical and institutional economics. Within this conceptual framework, vulnerability can be seen as a socially-constructed phenomenon influenced by institutional and economic dynamics. The study develops proxy indicators of vulnerability related to the structure of economic relations and the entitlements which govern them, and shows how these can be applied to a District in coastal lowland Vietnam. This paper outlines the lessons of such an approach to social vulnerability for the assessment of climate change at the global scale. We argue that the socio-economic and biophysical processes that determine vulnerability are manifest at the local, national, regional and global level but the state of vulnerability itself is associated with a specific population. Aggregation one level to another is therefore not appropriate and global-scale analysis is meaningful only in so far as it deals with the vulnerability of the global

  4. Assisted suicide and assisted voluntary euthanasia: Stransham-Ford ...

    African Journals Online (AJOL)

    The decision in Stransham-Ford v Minister of Justice and Correctional. Services and Others[1] by the North Gauteng High Court held that a terminally ill patient with intractable suffering was entitled to commit suicide with the assistance of his doctor, whose conduct would not be unlawful. The evidence was that the applicant ...

  5. 20 CFR 408.816 - When does SVB entitlement end due to death?

    Science.gov (United States)

    2010-04-01

    ... 20 Employees' Benefits 2 2010-04-01 2010-04-01 false When does SVB entitlement end due to death? 408.816 Section 408.816 Employees' Benefits SOCIAL SECURITY ADMINISTRATION SPECIAL BENEFITS FOR CERTAIN WORLD WAR II VETERANS Suspensions and Terminations Termination § 408.816 When does SVB entitlement end due to death? Your SVB entitlement ends wit...

  6. Academic Entitlement: Relations to Perceptions of Parental Warmth and Psychological Control

    Science.gov (United States)

    Turner, Lisa A.; McCormick, Wesley H.

    2018-01-01

    Academic entitlement characterises students who expect positive academic outcomes without personal effort. The current study examined the relations of perceived parental warmth and parental psychological control with two dimensions of academic entitlement (i.e., entitled expectations and externalised responsibility) among college students.…

  7. Pediatric Residents and Interns in an Italian Hospital Perform Improved Bibliographic. A Review of: Gardois, P., Calabrese, R., Colombi, N., Lingua, C., Longo, F., Villanacci, M., Miniero, R., & Piga, A. (2011. Effectiveness of bibliographic searches performed by paediatric residents and interns assisted by librarian. A randomised controlled trial. Health Information and Libraries Journal, 28(4, 273-284. doi: 10.1111/j.1471-1842.2011.00957.x

    Directory of Open Access Journals (Sweden)

    Mathew Stone

    2013-03-01

    Full Text Available Objective – To establish whether the assistance of an experienced biomedical librarian delivers an improvement in the searching of bibliographic databases as performed by medical residents and interns.Design – Randomized controlled trial.Setting – The pediatrics department of a large Italian teaching hospital.Subjects – 18 pediatric residents and interns.Methods – 23 residents and interns from the pediatrics department of a large Italian teaching hospital were invited to participate inthis study, of which 18 agreed. Subjects were then randomized into two groups and asked to spend between 30 and 90 minutes searching bibliographic databases for evidence to answer a real-life clinical question which was randomly allocated to them. Each member ofthe intervention group was provided with an experienced biomedical librarian to provide assistance throughout the search session. The control group received no assistance. The outcome of the search was then measured using an assessment tool adapted for the purpose of this study from the Fresno test of competence in evidence based medicine. This adapted assessment tool rated the “global success” of the search and included criteria such as appropriate question formulation, number of PICO terms translated into search terms, use of Boolean logic, use of subject headings, use of filters, use of limits, and the percentage of citations retrieved that matched a gold standard set of citations found in a prior search by two librarians (who were not involved in assisting the subjects together with an expert clinician. Main Results – The intervention group scored a median average of 73.6 points out of a possible 100, compared with the control group which scored 50.4. The difference of 23.2 points in favour of the librarian assisted group was a statistically significant result (p value = 0.013 with a 95% confidence interval of between 4.8 and 33.2.Conclusion – This study presents credible evidence that

  8. Employee entitlements during pregnancy and maternal psychological well-being.

    Science.gov (United States)

    Cooklin, Amanda R; Rowe, Heather J; Fisher, Jane R W

    2007-12-01

    Antenatal psychological well-being is multifactorially determined, including by social circumstances. Evidence suggests that workplace conditions are salient determinants of mental health, but it is not known whether employment conditions influence antenatal psychological well-being. To investigate the relationship between employment conditions and antenatal psychological well-being in Australian women. A sociodemographically diverse consecutive cohort of employed nulliparous women was recruited in late pregnancy. Data were collected by a structured interview assessing sociodemographic characteristics, employment arrangements, experience of pregnancy-related discrimination, and access to maternity leave entitlements. Participants completed two standardised psychometric measures of maternal mood: the Edinburgh Depression Scale (EDS) and the Profile of Mood States (PoMS). Comparisons of self-reported mood were made between women by experience of workplace adversity, using a composite measure of workplace events. Of 205 eligible women, 165 agreed to participate. Of these, 114 of 165 (69%) reported at least one form of workplace adversity during pregnancy. More women without private health insurance (78%) reported workplace adversity than those who were privately insured (57%) (chi2(1)=6.95, P=0.008). Women experiencing workplace adversity had significantly worse psychological well-being as indicated by the EDS score (7.7+/-5.1) than those who were experiencing no workplace adversity (5.5+/-3.4), mean difference (95% CI)=-2.2 (-3.7 to -0.8), P=0.003. Similar results were reported for the PoMS. Workplace adversity during pregnancy is associated with poorer maternal psychological well-being. Workplace conditions and entitlements are salient factors for consideration in assessments of antenatal psychosocial well-being.

  9. 38 CFR 21.8020 - Entitlement to vocational training and employment assistance.

    Science.gov (United States)

    2010-07-01

    ... been determined by VA to have limitations affecting employability arising from the effects of the... case manager finds the child has attained sufficient skills to be employable; or (3) VA determines during evaluation that the child already has the skills necessary for suitable employment and does not...

  10. Computer assisted radiology

    International Nuclear Information System (INIS)

    Lemke, H.U.; Jaffe, C.C.; Felix, R.

    1993-01-01

    The proceedings of the CAR'93 symposium present the 126 oral papers and the 58 posters contributed to the four Technical Sessions entitled: (1) Image Management, (2) Medical Workstations, (3) Digital Image Generation - DIG, and (4) Application Systems - AS. Topics discussed in Session (1) are: picture archiving and communication systems, teleradiology, hospital information systems and radiological information systems, technology assessment and implications, standards, and data bases. Session (2) deals with computer vision, computer graphics, design and application, man computer interaction. Session (3) goes into the details of the diagnostic examination methods such as digital radiography, MRI, CT, nuclear medicine, ultrasound, digital angiography, and multimodality imaging. Session (4) is devoted to computer-assisted techniques, as there are: computer assisted radiological diagnosis, knowledge based systems, computer assisted radiation therapy and computer assisted surgical planning. (UWA). 266 figs [de

  11. Original article Entitlement and subjective well-being: a three-nations study

    Directory of Open Access Journals (Sweden)

    Magdalena Żemojtel-Piotrowska

    2015-03-01

    Full Text Available Background The current study investigated the role of three facets of entitlement (active, passive and revenge in various forms of subjective well-being (SWB: hedonistic and two facets of eudaimonic well-being (social and psychological. Social well-being was based on Keyes’ model (1998 and psychological well-being on Ryff’s model (1989. Participants and procedure The study was performed in three nations (Poland, Puerto Rico and Vietnam on student samples (Poland, n = 245, Vietnam, n = 115, and Puerto Rico, n = 300. To assess entitlement level the Entitlement Questionnaire was used. The level of hedonistic well-being was measured with the Satisfaction with Life Scale (SWLS and the Positive and Negative Affect Schedule (PANAS, and eudaimonic well-being by the Mental Health Continuum–Short Form (MHC-SF. Results Active entitlement was positively related to all aspects of SWB. Revenge entitlement was negatively related to hedonistic and psychological SWB in all samples and negatively related to social well-being only in Poland. Passive entitlement was unrelated to SWB. Conclusions The current study shows cross-cultural similarities in relationships of entitlement with hedonistic and psychological well-being and cross-cultural differences in the relationship of entitlement with social well-being. Additionally, the study indicates positive meaning of healthy aspects of entitlement for subjective well-being and negative meaning of dysfunctional aspects of entitlement for subjective well-being.

  12. Identifying Two Groups of Entitled Individuals: Cluster Analysis Reveals Emotional Stability and Self-Esteem Distinction.

    Science.gov (United States)

    Crowe, Michael L; LoPilato, Alexander C; Campbell, W Keith; Miller, Joshua D

    2016-12-01

    The present study hypothesized that there exist two distinct groups of entitled individuals: grandiose-entitled, and vulnerable-entitled. Self-report scores of entitlement were collected for 916 individuals using an online platform. Model-based cluster analyses were conducted on the individuals with scores one standard deviation above mean (n = 159) using the five-factor model dimensions as clustering variables. The results support the existence of two groups of entitled individuals categorized as emotionally stable and emotionally vulnerable. The emotionally stable cluster reported emotional stability, high self-esteem, more positive affect, and antisocial behavior. The emotionally vulnerable cluster reported low self-esteem and high levels of neuroticism, disinhibition, conventionality, psychopathy, negative affect, childhood abuse, intrusive parenting, and attachment difficulties. Compared to the control group, both clusters reported being more antagonistic, extraverted, Machiavellian, and narcissistic. These results suggest important differences are missed when simply examining the linear relationships between entitlement and various aspects of its nomological network.

  13. 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.

  14. 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.

  15. 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.

  16. 20 CFR 408.228 - When do we consider you to be residing outside the United States?

    Science.gov (United States)

    2010-04-01

    ... outside the United States? 408.228 Section 408.228 Employees' Benefits SOCIAL SECURITY ADMINISTRATION SPECIAL BENEFITS FOR CERTAIN WORLD WAR II VETERANS SVB Qualification and Entitlement Residence Outside the United States § 408.228 When do we consider you to be residing outside the United States? (a) Effect of...

  17. 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...

  18. [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

  19. Three Paradigms of Social Assistance

    Directory of Open Access Journals (Sweden)

    Pierre-Marc Daigneault

    2014-11-01

    Full Text Available “Ideas,” which are defined as the normative and cognitive beliefs of actors, are fundamental to a full understanding of the welfare state and, in particular, of social assistance. However, policy ideas have been neglected in most typologies of social assistance regimes. Based on a selective review of the literature, this article proposes a brief but systematic analysis of policy paradigms in the field of social assistance. Three ideal types that emphasize the ideational dimension of social assistance are analyzed, namely, the entitlement, workfare, and activation paradigms. The value of the typology lies in its utility for characterizing the ideational orientation of social assistance regimes. Specifically, the typology provides a yardstick for measuring the ideas of policy actors with respect to social assistance and can facilitate the conduct of case studies, comparative research, and causal analyses on this policy sector.

  20. FORUM: Instructional Communication and Millennial Students: Millennial Students in the College Classroom: Adjusting to Academic Entitlement

    Science.gov (United States)

    Goldman, Zachary W.; Martin, Matthew M.

    2016-01-01

    Academic entitlement (AE) refers to the expectation of educational success despite the input of personal effort needed to earn it (Boswell, 2012). Entitled students feel that learning should require minimal work and that difficulties encountered during the learning process should be attributed to instructors, rather than themselves. AE has become…

  1. The Effects of Reducing the Entitlement Period to Unemployment Insurance Benefits

    NARCIS (Netherlands)

    de Groot, N.; van der Klaauw, B.

    This paper exploits a substantial reform of the Dutch UI law to study the effect of the entitlement period on job finding and subsequent labor market outcomes. Using detailed administrative data covering the full population we find that reducing the entitlement period increases the job finding rate,

  2. 76 FR 2758 - Agency Information Collection (Evidence for Transfer of Entitlement of Education Benefits (CFR 21...

    Science.gov (United States)

    2011-01-14

    ... for Transfer of Entitlement of Education Benefits (CFR 21.7080)) Activity Under OMB Review AGENCY... INFORMATION: Title: Evidence for Transfer of Entitlement of Education Benefits (CFR 21.7080). OMB Control... DOD Form 2366-1 to determine whether the dependent qualifies to receive education benefits under the...

  3. Gender Differences in Pay Histories and Views on Pay Entitlement among University Students.

    Science.gov (United States)

    Desmarais, Serge; Curtis, James

    1997-01-01

    Examines whether gender differences in recent pay experience influence entitlement views by providing different standards for female and male students' judgments of their entitlements. Responses from 309 undergraduate students reveal that income gaps in the full-time working world extended to their own recent work experiences and that these past…

  4. 76 FR 28789 - Draft Alert Entitled “Preventing Occupational Respiratory Disease From Dampness in Office...

    Science.gov (United States)

    2011-05-18

    ... NIOSH-238] Draft Alert Entitled ``Preventing Occupational Respiratory Disease From Dampness in Office... Institute for Occupational Safety and Health (NIOSH) of the Centers for Disease Control and Prevention (CDC), announces the availability of a draft Alert entitled ``Preventing Occupational Respiratory Disease from...

  5. 24 CFR 81.93 - Creation of Participant's Security Entitlement; security interests.

    Science.gov (United States)

    2010-04-01

    ... 24 Housing and Urban Development 1 2010-04-01 2010-04-01 false Creation of Participant's Security... Procedures § 81.93 Creation of Participant's Security Entitlement; security interests. (a) A Participant's... Entitlement of a Participant in favor of the United States to secure deposits of public money, including...

  6. 18 CFR 1314.5 - Creation of Participant's Security Entitlement; security interests.

    Science.gov (United States)

    2010-04-01

    ... 18 Conservation of Power and Water Resources 2 2010-04-01 2010-04-01 false Creation of Participant... FEDERAL RESERVE BANKS § 1314.5 Creation of Participant's Security Entitlement; security interests. (a) A... Security Entitlement of a Participant in favor of the United States to secure deposits of public money...

  7. 12 CFR 615.5454 - Creation of participant's security entitlement; security interests.

    Science.gov (United States)

    2010-01-01

    ... 12 Banks and Banking 6 2010-01-01 2010-01-01 false Creation of participant's security entitlement... Procedures for Farm Credit Securities § 615.5454 Creation of participant's security entitlement; security... public money, including without limitation deposits to the Treasury tax and loan accounts, or other...

  8. 12 CFR 1511.4 - Creation of Participant's Security Entitlement; security interests.

    Science.gov (United States)

    2010-01-01

    ... 12 Banks and Banking 7 2010-01-01 2010-01-01 false Creation of Participant's Security Entitlement... CORPORATION BOOK-ENTRY PROCEDURE § 1511.4 Creation of Participant's Security Entitlement; security interests... to secure deposits of public money, including without limitation deposits to the Treasury tax and...

  9. Permissive Parenting and Mental Health in College Students: Mediating Effects of Academic Entitlement

    Science.gov (United States)

    Barton, Alison L.; Hirsch, Jameson K.

    2016-01-01

    Objective: Student mental health may suffer due to unreasonable expectations associated with academic entitlement; permissive parenting may be one source of these expectations. The authors examined the role of academic entitlement as a mediator of the relationship between permissive parenting and psychological functioning. Participants:…

  10. Entitlement attitude in the workplace and its relationship to job satisfaction and organizational commitment

    Directory of Open Access Journals (Sweden)

    Sonya Asenova Dragova-Koleva

    2017-05-01

    Full Text Available Background This article is focused on the entitlement attitude in an organizational context. Its purpose was to examine the relationship of entitlement and its 3 components (active, passive and revengefulness with job satisfaction and organizational commitment. Participants and procedure Two independent studies were conducted to examine the discussed relationships. In study 1 and study 2 there participated respectively 110 and 95 full-time employees from both genders working in public and private organizations. The 30-item Bulgarian version of the Entitlement Questionnaire was used. Job satisfaction measurement included employees’ affective response to their overall job and to various aspects of their job. The three aspects of organizational commitment (affective, instrumental and normative were measured. Results Active entitlement had a positive effect on satisfaction with results, satisfaction with supervisor, pay satisfaction and overall job satisfaction. It was not related to organizational commitment. Passive entitlement had a positive effect on satisfaction with tasks, but it correlated negatively with pay satisfaction. Higher level of passive entitlement predicted instrumental commitment. Revengefulness was negatively related to task satisfaction, satisfaction with supervisor and overall satisfaction, and had a negative effect on affective commitment. Conclusions Different forms of entitlement have a diverse influence on the various aspects of job satisfaction and components of organizational commitment. Active and passive types of entitlement are more adaptive, whereas revengefulness is a maladaptive and dysfunctional attitude.

  11. 7 CFR 272.11 - Systematic Alien Verification for Entitlements (SAVE) Program.

    Science.gov (United States)

    2010-01-01

    ... 7 Agriculture 4 2010-01-01 2010-01-01 false Systematic Alien Verification for Entitlements (SAVE... FOR PARTICIPATING STATE AGENCIES § 272.11 Systematic Alien Verification for Entitlements (SAVE... and Naturalization Service (INS), in order to verify the validity of documents provided by aliens...

  12. Permissive parenting and mental health in college students: Mediating effects of academic entitlement.

    Science.gov (United States)

    Barton, Alison L; Hirsch, Jameson K

    2016-01-01

    Student mental health may suffer due to unreasonable expectations associated with academic entitlement; permissive parenting may be one source of these expectations. The authors examined the role of academic entitlement as a mediator of the relationship between permissive parenting and psychological functioning. Participants were 524 undergraduate students at a single institution (52% female; age range = 18-22). Data collection was completed in May 2011. Cross-sectional design. Participants completed online self-report measures of parenting styles, academic entitlement, stress, depressive symptoms, and well-being. Permissive parenting was associated with greater academic entitlement and, in turn, to more perceived stress and poorer mental health. Mother/father differences were found in some cases. Academic entitlement may partially explain why permissive parenting is detrimentally related to mental health for college students. Implications for academic affairs and counseling include helping students develop an appreciation of the role of self-regulation in college success.

  13. 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.)

  14. 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

  15. Can we make a new deal? Entitlement reform sounds alluring, but the reality is stark.

    Science.gov (United States)

    Wagner, L

    1995-01-20

    After simmering for more than a decade, the Great Entitlement Debate promises to dominate the 1995 congressional agenda. But lost amid a tangle of conflicting parochial interests, voter confusion and searing partisan rhetoric are some harsh truths about our options.

  16. Resident Preferences for Program Director Role in Wellness Management.

    Science.gov (United States)

    Kolarik, Russ C; O'Neal, Richard L; Ewing, Joseph A

    2018-05-01

    Burnout and depression are prevalent among resident physicians, though the supportive role of the program director (PD) is not well defined. To understand the residents' view of the residency program director's role in assessing and promoting resident wellness. A single institution survey of all house staff was conducted in 2017. Rates of burnout and depression were identified via the 2-item Maslach Burnout Inventory (MBI) and the Patient Health Questionaire-2 (PHQ-2), respectively. Residents then qualified their preferences for various assistance services and for the role of their program directors in assisting them. One-hundred sixty-one of 202 (79.7%) residents completed the survey. The rate of depression was 28%. Rates of emotional exhaustion and depersonalization (2-item MBI) were 44 and 62%, respectively. Only 4% of respondents had used the Employee Assistance Program (EAP) in the prior 12 months. Eighty-two percent of residents were in favor of PDs inquiring about wellness regardless of their job performance and only 1% of residents stated the PD should not inquire about wellness at all. Thirty-three percent of residents reported that they would be likely to contact EAP on their own if they felt unwell. Significantly more residents (62%) reported being more likely to contact EAP if recommended by their PD (33 vs 62%, p assistance were lack of time (65%), lack of knowledge of how to contact EAP (41%), and concerns about appearing weak (35%). Despite a high prevalence of burnout and depression, residents are unlikely to seek help on their own. Program directors have an important role in assessing and promoting the wellness of their residents. The majority of residents wants their PD to inquire about wellness and may be more likely to seek and receive help if recommended and facilitated by their PD.

  17. Improving applicant selection: identifying qualities of the unsuccessful otolaryngology resident.

    Science.gov (United States)

    Badran, Karam W; Kelley, Kanwar; Conderman, Christian; Mahboubi, Hossein; Armstrong, William B; Bhandarkar, Naveen D

    2015-04-01

    To identify the prevalence and management of problematic residents. Additionally, we hope to identify the factors associated with successful remediation of unsuccessful otolaryngology residents. Self-reported Internet and paper-based survey. An anonymous survey was distributed to 152 current and former program directors (PDs) in 2012. The factors associated with unsuccessful otolaryngology residents and those associated with the successful remediation of problematic residents were investigated. An unsuccessful resident is defined as one who quit or was removed from the program for any reason, or one whose actions resulted in criminal action or citation against their medical license after graduation from residency. Remediation is defined as an individualized program implemented to correct documented weaknesses. The overall response rate was 26% (40 PDs). Seventy-three unsuccessful or problematic residents were identified. Sixty-six problematic or unsuccessful residents were identified during residency, with 58 of 66 (88%) undergoing remediation. Thirty-one (47%) residents did not graduate. The most commonly identified factors of an unsuccessful resident were: change in specialty (21.5%), interpersonal and communication skills with health professionals (13.9%), and clinical judgment (10.1%). Characteristics of those residents who underwent successful remediation include: poor performance on in-training examination (17%, P otolaryngology PDs in this sample identified at least one unsuccessful resident. Improved methods of applicant screening may assist in optimizing otolaryngology resident selection. © 2014 The American Laryngological, Rhinological and Otological Society, Inc.

  18. Association Between the Nursing Home Minimum Data Set for Vision and Vision-Targeted Health-Related Quality of Life in Nursing Home Residents as Assessed by Certified Nursing Assistants

    Directory of Open Access Journals (Sweden)

    Mark W. Swanson

    2009-01-01

    Conclusions: Ratings by CNAs on the vision-targeted quality of life of nursing home residents under their care is in general agreement with the MDS category assigned by the nurse coordinator. However, CNA ratings are largely homogeneous in the adequate vision to moderately impaired categories.

  19. 20 CFR 404.337 - When does my entitlement to widow's and widower's benefits start and end?

    Science.gov (United States)

    2010-04-01

    ... 20 Employees' Benefits 2 2010-04-01 2010-04-01 false When does my entitlement to widow's and widower's benefits start and end? 404.337 Section 404.337 Employees' Benefits SOCIAL SECURITY... does my entitlement to widow's and widower's benefits start and end? (a) We will find you entitled to...

  20. 20 CFR 725.228 - Effect of conviction of felonious and intentional homicide on entitlement to benefits.

    Science.gov (United States)

    2010-04-01

    ... intentional homicide on entitlement to benefits. 725.228 Section 725.228 Employees' Benefits EMPLOYMENT... intentional homicide on entitlement to benefits. An individual who has been convicted of the felonious and intentional homicide of a miner or other beneficiary shall not be entitled to receive any benefits payable...

  1. Residents Living in Residential Care Facilities: United States, 2010

    Science.gov (United States)

    ... analyses, the 12% of residents chair-ridden or bedridden were defined as receiving assistance in the transferring ... MD: National Center for Health Statistics. 2011. Mollica R, Sims-Kastelein K, O'Keeffe J. Residential care ...

  2. Online database for documenting clinical pathology resident education.

    Science.gov (United States)

    Hoofnagle, Andrew N; Chou, David; Astion, Michael L

    2007-01-01

    Training of clinical pathologists is evolving and must now address the 6 core competencies described by the Accreditation Council for Graduate Medical Education (ACGME), which include patient care. A substantial portion of the patient care performed by the clinical pathology resident takes place while the resident is on call for the laboratory, a practice that provides the resident with clinical experience and assists the laboratory in providing quality service to clinicians in the hospital and surrounding community. Documenting the educational value of these on-call experiences and providing evidence of competence is difficult for residency directors. An online database of these calls, entered by residents and reviewed by faculty, would provide a mechanism for documenting and improving the education of clinical pathology residents. With Microsoft Access we developed an online database that uses active server pages and secure sockets layer encryption to document calls to the clinical pathology resident. Using the data collected, we evaluated the efficacy of 3 interventions aimed at improving resident education. The database facilitated the documentation of more than 4 700 calls in the first 21 months it was online, provided archived resident-generated data to assist in serving clients, and demonstrated that 2 interventions aimed at improving resident education were successful. We have developed a secure online database, accessible from any computer with Internet access, that can be used to easily document clinical pathology resident education and competency.

  3. Parental leave for residents and pediatric training programs.

    Science.gov (United States)

    2013-02-01

    The American Academy of Pediatrics (AAP) is committed to the development of rational, equitable, and effective parental leave policies that are sensitive to the needs of pediatric residents, families, and developing infants and that enable parents to spend adequate and good-quality time with their young children. It is important for each residency program to have a policy for parental leave that is written, that is accessible to residents, and that clearly delineates program practices regarding parental leave. At a minimum, a parental leave policy for residents and fellows should conform legally with the Family Medical Leave Act as well as with respective state laws and should meet institutional requirements of the Accreditation Council for Graduate Medical Education for accredited programs. Policies should be well formulated and communicated in a culturally sensitive manner. The AAP advocates for extension of benefits consistent with the Family Medical Leave Act to all residents and interns beginning at the time that pediatric residency training begins. The AAP recommends that regardless of gender, residents who become parents should be guaranteed 6 to 8 weeks, at a minimum, of parental leave with pay after the infant's birth. In addition, in conformance with federal law, the resident should be allowed to extend the leave time when necessary by using paid vacation time or leave without pay. Coparenting, adopting, or fostering of a child should entitle the resident, regardless of gender, to the same amount of paid leave (6-8 weeks) as a person who takes maternity/paternity leave. Flexibility, creativity, and advanced planning are necessary to arrange schedules that optimize resident education and experience, cultivate equity in sharing workloads, and protect pregnant residents from overly strenuous work experiences at critical times of their pregnancies.

  4. 77 FR 39498 - Guidances for Industry and Food and Drug Administration Staff: Computer-Assisted Detection...

    Science.gov (United States)

    2012-07-03

    ...] Guidances for Industry and Food and Drug Administration Staff: Computer-Assisted Detection Devices Applied... Clinical Performance Assessment: Considerations for Computer-Assisted Detection Devices Applied to... guidance, entitled ``Computer-Assisted Detection Devices Applied to Radiology Images and Radiology Device...

  5. Research Experience in Psychiatry Residency Programs Across Canada: Current Status

    Science.gov (United States)

    Shanmugalingam, Arany; Ferreria, Sharon G; Norman, Ross M G; Vasudev, Kamini

    2014-01-01

    Objective: To determine the current status of research experience in psychiatry residency programs across Canada. Method: Coordinators of Psychiatric Education (COPE) resident representatives from all 17 psychiatry residency programs in Canada were asked to complete a survey regarding research training requirements in their programs. Results: Among the 17 COPE representatives, 15 completed the survey, representing 88% of the Canadian medical schools that have a psychiatry residency program. Among the 15 programs, 11 (73%) require residents to conduct a scholarly activity to complete residency. Some of these programs incorporated such a requirement in the past 5 years. Ten respondents (67%) reported availability of official policy and (or) guidelines on resident research requirements. Among the 11 programs that have a research requirement, 10 (91%) require residents to complete 1 scholarly activity; 1 requires completion of 2 scholarly activities. Eight (53%) residency programs reported having a separate research track. All of the programs have a research coordinator and 14 (93%) programs provide protected time to residents for conducting research. The 3 most common types of scholarly activities that qualify for the mandatory research requirement are a full independent project (10 programs), a quality improvement project (8 programs), and assisting in a faculty project (8 programs). Six programs expect their residents to present their final work in a departmental forum. None of the residency programs require publication of residents’ final work. Conclusions: The current status of the research experience during psychiatry residency in Canada is encouraging but there is heterogeneity across the programs. PMID:25565474

  6. Visão do paciente quanto à participação do residente no exame proctológico em ambulatório Patient view about the proctological exam assisted by the resident in outpatient clinics

    Directory of Open Access Journals (Sweden)

    Isabela Pessoa Elias

    2006-12-01

    Full Text Available OBJETIVOS: O acompanhamento ambulatorial de pacientes e a participação no exame proctológico são essenciais ao aprendizado do residente de coloproctologia. Entretanto pode haver relutância por parte dos pacientes em relação à presença do residente durante sua consulta e exame físico. Este estudo visa avaliar a visão do paciente quanto a este aspecto do aprendizado prático do residente de coloproctologia. MÉTODOS: Cem pacientes consecutivos responderam , de forma voluntária e anônima a um questionário após a realização de exame proctológico com a aprticipação de residentes em coloproctologia em ambulatório de instituição privada. Foram investigados, sexo, idade, cor, estado civil e nível educacional e sócio-econômico, assim como a visão do paciente em relação à presença de residentes durante o exame proctológico, procurando-se identificar razões para a sua aceitação ou recusa durante a consulta. As respostas foram analisadas usando-se teste do qui-quadrado e o teste t de Student. RESULTADOS: Observou-se que 87% dos pacientes aceitaram bem a participação do residente no exame proctológico, enquanto 1% respondeu que recusaria sua presença. Onze por cento se mostraram indiferentes em relação à presença do residente e um paciente não respondeu. Não houve diferença significativa em relação às variáveis estudadas no que diz respeito à presença do residente durante o exame proctológico, exceto para estado civil, uma vez que uma taxa maior de pacientes casados aceitou o residente. A principal razão para a aceitação foi contribuir para a formação médica, enquanto que a recusa esteve relacionado à perda da privacidade. CONCLUSÃO: De um modo geral, os residentes são bem aceitos no ambulatório de coloproctologia em uma instituição privada. O conhecimento das razões para sua aceitação ou recusa podem favorecer posturas que facilitem a aceitação e minimizem a recusa.Residents exposure to

  7. Dementia prevalence and care in assisted living.

    Science.gov (United States)

    Zimmerman, Sheryl; Sloane, Philip D; Reed, David

    2014-04-01

    Assisted living residences have become prominent sites of long-term residential care for older adults with dementia. Estimates derived from national data indicate that seven out of ten residents in these residences have some form of cognitive impairment, with 29 percent having mild impairment, 23 percent moderate impairment, and 19 percent severe impairment. More than one-third of residents display behavioral symptoms, and of these, 57 percent have a medication prescribed for their symptoms. Only a minority of cognitively impaired residents reside in a dementia special care unit, where admission and discharge policies are more supportive of their needs. Policy-relevant recommendations from our study include the need to examine the use of psychotropic medications and cultures related to prescribing, better train assisted living staff to handle medications and provide nonpharmacological treatments, use best practices in caring for people with dementia, and promote consumer education regarding policies and practices in assisted living.

  8. [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.

  9. Entitlement to vote in the Canton of Geneva and entitlement to vote and eligibility for election in the Canton of Vaud

    CERN Multimedia

    DG Unit

    2009-01-01

    You are reminded that, at commune level, certain international civil servants and their family members: are entitled to vote in the Canton of Geneva are entitled to vote and are eligible for election in the Canton of Vaud. For further information, in particular regarding the special procedure to be followed to apply to exercise these entitlements, you are invited to consult the information published, in French only, on the Swiss Mission’s website: for the Canton of Genevafor the Canton of VaudThe dates of the forthcoming ballots are available on the official websites of the cantonal administrative authorities: for Geneva: referendum and forthcoming ballots ; for Vaud: forthcoming ballots In this context, please note, especially with regard to eligibility for election, that: in accordance with Articles S I 3.05 and I 3.06 of the Staff Rules "Members of the personnel wishing to take part in the public and political life of a State shall comply with the relevant legislat...

  10. Entitlement to vote in the Canton of Geneva and entitlement to vote and eligibility for election in the Canton of Vaud

    CERN Multimedia

    DG Unit

    2011-01-01

    You are reminded that, at commune level, certain international civil servants and their family members: are entitled to vote in the Canton of Geneva are entitled to vote and are eligible for election in the Canton of Vaud. For further information, in particular regarding the special procedure to be followed to apply to exercise these entitlements, you are invited to consult the information published, in French only, on the Swiss Mission’s website (topic « Privileges and immunities (Manual) » : http://www.eda.admin.ch/eda/fr/home/topics/intorg/un/unge/gepri/manvot/manvt1.html (for the Canton of Geneva), http://www.eda.admin.ch/eda/fr/home/topics/intorg/un/unge/gepri/manvot/manvt2.html (for the Canton of Vaud). The dates of the forthcoming ballots are available on the official websites of the cantonal administrative authorities : for Geneva: http://www.ge.ch/votations-elections/prochains-scrutins/; for Vaud: http://www.vd.ch/fr/themes/etat-droit-financ...

  11. Approaching Corporate Social Responsibility through Kenneth Burke's Notions of Terministic Screens and Entitlement

    DEFF Research Database (Denmark)

    Kampf, Constance

    summarizes Burke's essay, "Antinomies of Definition," from a Grammar of Motives as demonstrating that 'the intrinsic and the extrinsic can change places' "such that to define is always to contextualize and to uncover the absence of a solid ground for a claim to knowledge."2   So if the intrinsic...... allow for user agency, whereas entitlement appears to be focused more at the cultural level, with the agency shared by the 'tribe,' the language itself, and the context of situation.1 In other words, "terministic screens" appear to be extrinsic, while "entitlement" appears to be intrinsic.  Carmichael...... and extrinsic can change places, the interpretive process of "terministic screens" and the constitutive process of "entitlement" may well be reciprocal.  The implications of this reciprocity can be used as a basis for understanding the linguistic and cultural components of Corporate Social Responsibility...

  12. Restricted health care entitlements for child migrants in Europe and Australia

    DEFF Research Database (Denmark)

    Østergaard, Liv Stubbe; Norredam, Marie; Mock-Munoz de Luna, Claire

    2017-01-01

    Background: More than 300 000 asylum seeking children were registered in Europe alone during 2015. In this study, we examined entitlements for health care for these and other migrant children in Europe and Australia in a framework based on United Nations Convention of the Rights of the Child (UNCRC......). Methods: Survey to child health professionals, NGO's and European Ombudspersons for Children in 30 EU/EEA countries and Australia, supplemented by desktop research of official documents. Migrant children were categorised as asylum seekers and irregular/undocumented migrants. Results: Five countries....... Twelve European countries have limited entitlements to health care for asylum seeking children, including Germany that stands out as the country with the most restrictive health care policy for migrant children. In Australia entitlements for health care are restricted for asylum seeking children...

  13. Supporting Regional Aged Care Nursing Staff to Manage Residents' Behavioural and Psychological Symptoms of Dementia, in Real Time, Using the Nurses' Behavioural Assistant (NBA): A Pilot Site 'End-User Attitudes' Trial.

    Science.gov (United States)

    Klein, Britt; Clinnick, Lisa; Chesler, Jessica; Stranieri, Andrew; Bignold, Adam; Dazeley, Richard; McLaren, Suzanne; Lauder, Sue; Balasubramanian, Venki

    2018-01-01

    This regional pilot site 'end-user attitudes' study explored nurses' experiences and impressions of using the Nurses' Behavioural Assistant (NBA) (a knowledge-based, interactive ehealth system) to assist them to better respond to behavioural and psychological symptoms of dementia (BPSD) and will be reported here. Focus groups were conducted, followed by a four-week pilot site 'end-user attitudes' trial of the NBA at a regional aged care residential facility (ACRF). Brief interviews were conducted with consenting nursing staff. Focus group feedback (N = 10) required only minor cosmetic changes to the NBA prototype. Post pilot site end-user interview data (N = 10) indicated that the regional ACRF nurses were positive and enthusiastic about the NBA, however several issues were also identified. Overall the results supported the utility of the NBA to promote a person centred care approach to managing BPSD. Slight modifications may be required to maximise its uptake across all ACRF nursing staff.

  14. 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.

  15. A Comparison of the Number of Men Who Have Sex with Men among Rural-To-Urban Migrants with Non-Migrant Rural and Urban Residents in Wuhan, China: A GIS/GPS-Assisted Random Sample Survey Study

    Science.gov (United States)

    Chen, Xinguang; Yu, Bin; Zhou, Dunjin; Zhou, Wang; Gong, Jie; Li, Shiyue; Stanton, Bonita

    2015-01-01

    Background Mobile populations and men who have sex with men (MSM) play an increasing role in the current HIV epidemic in China and across the globe. While considerable research has addressed both of these at-risk populations, more effective HIV control requires accurate data on the number of MSM at the population level, particularly MSM among migrant populations. Methods Survey data from a random sample of male rural-to-urban migrants (aged 18-45, n=572) in Wuhan, China were analyzed and compared with those of randomly selected non-migrant urban (n=566) and rural counterparts (580). The GIS/GPS technologies were used for sampling and the survey estimation method was used for data analysis. Results HIV-related risk behaviors among rural-to-urban migrants were similar to those among the two comparison groups. The estimated proportion of MSM among migrants [95% CI] was 5.8% [4.7, 6.8], higher than 2.8% [1.2, 4.5] for rural residents and 1.0% [0.0, 2.4] for urban residents, respectively. Among these migrants, the MSM were more likely than non-MSM to be older in age, married, and migrated to more cities. They were also more likely to co-habit with others in rental properties located in new town and neighborhoods with fewer old acquaintances and more entertainment establishments. In addition, they were more likely to engage in commercial sex and less likely to consistently use condoms. Conclusion Findings of this study indicate that compared to rural and urban populations, the migrant population in Wuhan consists of a higher proportion of MSM who also exhibit higher levels of HIV-related risk behaviors. More effective interventions should target this population with a focus on neighborhood factors, social capital and collective efficacy for risk reduction. PMID:26241900

  16. 24 CFR 982.602 - SRO: Who may reside in an SRO?

    Science.gov (United States)

    2010-04-01

    ... 24 Housing and Urban Development 4 2010-04-01 2010-04-01 false SRO: Who may reside in an SRO? 982... URBAN DEVELOPMENT SECTION 8 TENANT BASED ASSISTANCE: HOUSING CHOICE VOUCHER PROGRAM Special Housing Types Single Room Occupancy (sro) § 982.602 SRO: Who may reside in an SRO? A single person may reside in...

  17. Learning Based on the Project Entitled "Design and Construction of a Wooden Bridge"

    Science.gov (United States)

    Barris, Cristina; Torres, Lluís; Simon, Enric

    2016-01-01

    This article presents the results of a case involving the application of project-based learning carried out with students in the Mechanical Engineering degree program at the University of Girona. The project, entitled "Design and construction of a wooden bridge", was conducted at the Polytechnic School in the third-year Structures…

  18. The Impact of Active Labor Market Programs and Benefit Entitlement Rules on the Duration of Unemployment

    NARCIS (Netherlands)

    Lalive, R.; van Ours, J.C.; Zweimüller, J.

    2000-01-01

    Swiss policy makers created a unique link between unemployment benefits and active labor market programs (ALMPs) by making benefit payments conditional on program attendance after 7 months of unemployment duration. We evaluate the effect of ALMPs and benefit entitlement on the duration of

  19. 75 FR 69521 - Evidence for Transfer of Entitlement of Education Benefits; Correction

    Science.gov (United States)

    2010-11-12

    ... DEPARTMENT OF VETERANS AFFAIRS [OMB Control No. 2900-0708] Evidence for Transfer of Entitlement of Education Benefits; Correction AGENCY: Veterans Benefits Administration, Department of Veterans Affairs. ACTION: Notice; correction. SUMMARY: The Department of Veterans Affairs (VA) published a collection of...

  20. The Relationship between Academic Entitlement, Academic Performance, and Satisfaction with Life in a College Student Population

    Science.gov (United States)

    Reysen, Rebekah H.

    2013-01-01

    Although academic entitlement (AE) has become a popular topic of discussion in the media, it has received very little scholarly focus in the higher education literature to date. AE has been defined as a belief held by students that they deserve high grades in school despite a lack of effort put forth into their work (Chowning & Campbell,…

  1. Student Entitlement Models in Australia's National Training System: Expert Views. Occasional Paper

    Science.gov (United States)

    Bowman, Kaye; McKenna, Suzy

    2016-01-01

    This occasional paper provides the views of 17 "thought leaders" in the Australian vocational education and training (VET) sector. Their insight and opinions were sought to inform a larger research project focused on the student entitlement reforms that were introduced into the national VET system from 2012. These individuals offered a…

  2. Generation Me in the spotlight : Linking reality TV to materialism, entitlement, and narcissism

    NARCIS (Netherlands)

    Opree, S.J.; Kühne, R.

    2016-01-01

    Today’s youth, the Generation Me, is deemed materialistic, entitled, and narcissistic. Individuality has become an important value in child-rearing and is cultivated in the media—especially within the reality TV genre. The aim of this study was to investigate whether adolescents’ and emerging

  3. Human Rights as Practice: Dalit Women's Collective Action to Secure Livelihood Entitlements in rural South India

    NARCIS (Netherlands)

    Mangubhai, Y.

    2012-01-01

    In this dissertation, I investigate how Dalit women in rural South India secure livelihood entitlements by analysing processes of social exclusion as well as collective action by these women through their perspectives. This problematic requires focus on how caste, class and gender mutually construct

  4. 76 FR 30366 - Draft Alert Entitled “Preventing Occupational Respiratory Disease From Dampness in Office...

    Science.gov (United States)

    2011-05-25

    ... DEPARTMENT OF HEALTH AND HUMAN SERVICES Centers for Disease Control and Prevention [Docket Number NIOSH-238] Draft Alert Entitled ``Preventing Occupational Respiratory Disease From Dampness in Office... Institute for Occupational Safety and Health, Centers for Disease Control and Prevention. [FR Doc. 2011...

  5. International comparison of systems to determine entitlements to medical specialist care: performance and organizational issues

    NARCIS (Netherlands)

    E.A. Stolk (Elly); A.A. de Bont (Antoinette); M.J. Poley (Marten); S. Jerak (Sonja); M. Stroet (Mary); F.F.H. Rutten (Frans)

    2008-01-01

    textabstractSummary Objective: CVZ has asked us to provide a comparison of criteria and procedures that different countries use to determine entitlements to medical specialist care. This question was asked within the context of the recent introduction of the DBC (diagnosis treatment combinations)

  6. 20 CFR 725.201 - Who is entitled to benefits; contents of this subpart.

    Science.gov (United States)

    2010-04-01

    ... surviving spouse or child, or the surviving dependent brothers or sisters, where there is no surviving... part the term “total disability” shall mean partial disability with respect to a claim for which... entitlement to benefits applicable to a miner, or a surviving spouse, child, parent, brother, or sister, and...

  7. 24 CFR 350.5 - Creation of Participant's Security Entitlement; Security Interests.

    Science.gov (United States)

    2010-04-01

    ... 24 Housing and Urban Development 2 2010-04-01 2010-04-01 false Creation of Participant's Security... AND URBAN DEVELOPMENT BOOK-ENTRY PROCEDURES § 350.5 Creation of Participant's Security Entitlement... States to secure deposits of public money, including without limitation deposits to the Treasury tax and...

  8. 12 CFR 987.4 - Creation of Participant's Security Entitlement; security interests.

    Science.gov (United States)

    2010-01-01

    ... 12 Banks and Banking 7 2010-01-01 2010-01-01 false Creation of Participant's Security Entitlement... BOOK-ENTRY PROCEDURE FOR CONSOLIDATED OBLIGATIONS § 987.4 Creation of Participant's Security... of the United States to secure deposits of public money, including, without limitation, deposits to...

  9. Entitlement Can Both Decrease and Increase Consumer Susceptibility to Social Influence

    NARCIS (Netherlands)

    van der Heide, Martine; Fennis, Bob; van Ittersum, Koert; Trampe, Debra; Diehl, Kristin; Yoon, Carolyn

    2015-01-01

    Two studies indicate that entitlement—a sense that one deserves special treatment and is exempt from normal social demands—can both buffer and boost consumers’ proneness to social influence. Specifically, Study 1 shows that entitlement reduces susceptibility to consistency appeals. Study 2, however,

  10. 31 CFR 354.4 - Creation of Participant's Security Entitlement; security interests.

    Science.gov (United States)

    2010-07-01

    ... REGULATIONS GOVERNING BOOK-ENTRY SECURITIES OF THE STUDENT LOAN MARKETING ASSOCIATION (SALLIE MAE) § 354.4... Entitlement is created when a Federal Reserve Bank indicates by book-entry that a Book-entry Sallie Mae... the books of a Federal Reserve Bank is thereby effected and perfected, and has priority over any other...

  11. 41 CFR 302-2.3 - What determines my entitlements and allowances for relocation?

    Science.gov (United States)

    2010-07-01

    ... 41 Public Contracts and Property Management 4 2010-07-01 2010-07-01 false What determines my entitlements and allowances for relocation? 302-2.3 Section 302-2.3 Public Contracts and Property Management Federal Travel Regulation System RELOCATION ALLOWANCES INTRODUCTION 2-EMPLOYEES ELIGIBILITY REQUIREMENTS...

  12. A Non-Member Spouse's Entitlement To The Member's Pension Interest

    Directory of Open Access Journals (Sweden)

    Motseotsile Clement Marumoagae

    2014-12-01

    Full Text Available It is important that married couples seek legal advice with regard to the assets falling within their joint estate, more particularly their retirement benefits. This article reflects on the entitlement (if any of non-member spouses to their spouses' retirement fund benefits. Pension benefits can be due before, during or after divorce, and parties to the marriage should be aware of their rights with regard to the accruing pension benefits of their spouses. While it is settled law that non-member spouses are entitled to receive a portion of their member spouses' pension benefits (known as "pension interest" immediately on divorce, it is not particularly clear whether non-member spouses are also entitled to receive the same before or sometime after divorce. In this article I provide a contextual understanding of the entitlements (if any which spouses or former spouses of members of pension funds have on such member spouses' retirement benefits. Furthermore, it shown in this article that various divisions of South African High Courts have been inconsistent in how they have approached the issue of the pension interest between divorcing spouses or divorced ex-spouses.

  13. 38 CFR 3.274 - Relationship of net worth to pension entitlement.

    Science.gov (United States)

    2010-07-01

    ... 38 Pensions, Bonuses, and Veterans' Relief 1 2010-07-01 2010-07-01 false Relationship of net worth to pension entitlement. 3.274 Section 3.274 Pensions, Bonuses, and Veterans' Relief DEPARTMENT OF VETERANS AFFAIRS ADJUDICATION Pension, Compensation, and Dependency and Indemnity Compensation Regulations...

  14. Developmental Trajectories of Work Values and Job Entitlement Beliefs in the Transition to Adulthood

    Science.gov (United States)

    Chow, Angela; Krahn, Harvey J.; Galambos, Nancy L.

    2014-01-01

    Employing a life span developmental systems perspective, this study used a 5-wave (1985-1992) Canadian longitudinal data set (N = 404) to examine trajectories of intrinsic and extrinsic work values and job entitlement beliefs from age 18 to 25. Piecewise growth models (Slope 1: age 18-20; Slope 2: age 20-25) showed intriguing patterns of change.…

  15. Measuring policy entitlements at the micro-level: maternity and parental leave in Europe

    NARCIS (Netherlands)

    Bártová, A.; Emery, T.

    2018-01-01

    Comparative social policy analysis has been shaped by the measurement of policy as a macro phenomenon. However, social policy theories have consistently asserted that policy entitlements vary across class, gender, ethnicity and the life-course. This paper synthesises a number of innovations to

  16. 20 CFR 404.467 - Nonpayment of benefits; individual entitled to disability insurance benefits or childhood...

    Science.gov (United States)

    2010-04-01

    ... type of substantial gainful activity. (b) Childhood disability benefits. An individual who has attained... Nonpayments of Benefits § 404.467 Nonpayment of benefits; individual entitled to disability insurance benefits... definition of disability for disability insurance benefits purposes based on statutory blindness, as defined...

  17. 5 CFR 1651.2 - Entitlement to funds in a deceased participant's account.

    Science.gov (United States)

    2010-01-01

    ... BOARD DEATH BENEFITS § 1651.2 Entitlement to funds in a deceased participant's account. (a) Death... participant will be paid as a death benefit to the individual or individuals surviving the participant, in the... representation in accordance with § 1651.6; (4) If there are no beneficiaries or persons as described in...

  18. 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

  19. 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....

  20. Is the Narcissistic Personality Inventory Still Relevant? A Test of Independent Grandiosity and Entitlement Scales in the Assessment of Narcissism

    Science.gov (United States)

    Miller, Joshua D.; Price, Joanna; Campbell, W. Keith

    2012-01-01

    Some scholars have called for the replacement of the Narcissistic Personality Inventory (NPI) with more narrow scales measuring grandiosity and entitlement instead. In the current study, the authors examined the relations among the NPI and measures of grandiosity and entitlement, as well as in relation to a measure of the Five-Factor Model (FFM).…

  1. 20 CFR 410.250 - Effect of conviction of felonious and intentional homicide on entitlement to benefits.

    Science.gov (United States)

    2010-04-01

    ... intentional homicide on entitlement to benefits. 410.250 Section 410.250 Employees' Benefits SOCIAL SECURITY... conviction of felonious and intentional homicide on entitlement to benefits. An individual who has been finally convicted by a court of competent jurisdiction of the felonious and intentional homicide of a...

  2. 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.

  3. Administrative Cicular No. 31 (Rev. 2) - International indemnity and non-resident allowance

    CERN Multimedia

    Department Head Office - HR Department

    2016-01-01

    Administrative Circular No. 31 (Rev. 2) entitled "International indemnity and non-resident allowance", approved by the Director-General following discussion in the Standing Concertation Committee meeting on 23 June 2016, will be available on 1st September 2016 via the following link: https://cds.cern.ch/record/2208547.   This revised circular cancels and replaces Administrative Circular No. 31 (Rev. 1) also entitled "International indemnity and non-resident allowance" of October 2007. The main changes reflect the decision taken in the framework of the five-yearly review to extend eligibility for international indemnity to all staff members, as well to introduce a distinction between current staff members and those recruited as from 1st September 2016. For the latter, the international indemnity will be calculated as a percentage of the minimum salary of the grade into which they are recruited; the amount granted to the former will not change, and is now expressed ...

  4. 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 …

  5. Provision of assisted reproductive technology for single women in China: a new challenge.

    Science.gov (United States)

    Zhou, Ling Jing

    2004-01-01

    Following the enactment of the Jilin Regulation, single women, for the first time, are allowed to access assisted reproductive services in China. This paper is intended to analyze the arguments over whether single women are entitled to access assisted reproductive services, in relation to Chinese legal, ethical and social characteristics.

  6. Entitlement to concessionary public transport and wellbeing: a qualitative study of young people and older citizens in London, UK.

    Science.gov (United States)

    Jones, Alasdair; Goodman, Anna; Roberts, Helen; Steinbach, Rebecca; Green, Judith

    2013-08-01

    Access to transport is an important determinant of health, and concessionary fares for public transport are one way to reduce the 'transport exclusion' that can limit access. This paper draws on qualitative data from two groups typically at risk of transport exclusion: young people (12-18 years of age, n = 118) and older citizens (60+ years of age, n = 46). The data were collected in London, UK, where young people and older citizens are currently entitled to concessionary bus travel. We focus on how this entitlement is understood and enacted, and how different sources of entitlement mediate the relationship between transport and wellbeing. Both groups felt that their formal entitlement to travel for free reflected their social worth and was, particularly for older citizens, relatively unproblematic. The provision of a concessionary transport entitlement also helped to combat feelings of social exclusion by enhancing recipients' sense of belonging to the city and to a 'community'. However, informal entitlements to particular spaces on the bus reflected less valued social attributes such as need or frailty. Thus in the course of travelling by bus the enactment of entitlements to space and seats entailed the negotiation of social differences and personal vulnerabilities, and this carried with it potential threats to wellbeing. We conclude that the process, as well as the substance, of entitlement can mediate wellbeing; and that where the basis for providing a given entitlement is widely understood and accepted, the risks to wellbeing associated with enacting that entitlement will be reduced. Copyright © 2012 Elsevier Ltd. All rights reserved.

  7. Entitlement theory of justice and end-state fairness in the allocation of goods

    OpenAIRE

    Ju, Biung-Ghi; Moreno-Ternero, Juan D.

    2016-01-01

    Robert Nozick allegedly introduced his liberal theory of private ownership as an objection to theories of end-state justice. Nevertheless, we show that, in a stylized framework for the allocation of goods in joint ventures, both approaches can be seen as complementary. More precisely, in such a context, self-ownership (the basis for Nozick's entitlement theory of justice) followed by voluntary transfer (Nozick's principle of just transfer) can lead to end-state fairness (as well as Pareto eff...

  8. Are undocumented migrants’ entitlements and barriers to healthcare a public health challenge for the European Union?

    OpenAIRE

    De Vito, Elisabetta; de Waure, Chiara; Specchia, Maria Lucia; Parente, Paolo; Azzolini, Elena; Frisicale, Emanuela Maria; Favale, Marcella; Teleman, Adele Anna; Ricciardi, Walter

    2016-01-01

    Undocumented migrants (UMs) are at higher risk for health problems because of their irregular status and the consequences of economic and social marginalization. Moreover, the emergent reality of undocumented migration in Europe calls for action in the field of management of UM’s health demands as their access to health services has become a sensitive political and social issue. In this light, this paper aims to address UMs’ entitlement and barriers to healthcare and related policies citing e...

  9. Perceived entitlement causes discrimination against attractive job candidates in the domain of relatively less desirable jobs.

    Science.gov (United States)

    Lee, Margaret; Pitesa, Marko; Pillutla, Madan M; Thau, Stefan

    2018-03-01

    People generally hold positive stereotypes of physically attractive people and because of those stereotypes often treat them more favorably. However, we propose that some beliefs about attractive people, specifically, the perception that attractive individuals have a greater sense of entitlement than less attractive individuals, can result in negative treatment of attractive people. We examine this in the context of job selection and propose that for relatively less desirable jobs, attractive candidates will be discriminated against. We argue that the ascribed sense of entitlement to good outcomes leads to perceptions that attractive individuals are more likely to be dissatisfied working in relatively less desirable jobs. When selecting candidates for relatively less desirable jobs, decision makers try to ascertain whether a candidate would be satisfied in those jobs, and the stereotype of attractive individuals feeling entitled to good outcomes makes decision makers judge attractive candidates as more likely to be dissatisfied in relatively less (but not more) desirable jobs. Consequently, attractive candidates are discriminated against in the selection for relatively less desirable jobs. Four experiments found support for this theory. Our results suggest that different discriminatory processes operate when decision makers select among candidates for relatively less desirable jobs and that attractive people might be systematically discriminated against in a segment of the workforce. (PsycINFO Database Record (c) 2018 APA, all rights reserved).

  10. Education research: neurology training reassessed. The 2011 American Academy of Neurology Resident Survey results.

    Science.gov (United States)

    Johnson, Nicholas E; Maas, Matthew B; Coleman, Mary; Jozefowicz, Ralph; Engstrom, John

    2012-10-23

    To assess the strengths and weaknesses of neurology resident education using survey methodology. A 27-question survey was sent to all neurology residents completing residency training in the United States in 2011. Of eligible respondents, 49.8% of residents returned the survey. Most residents believed previously instituted duty hour restrictions had a positive impact on resident quality of life without impacting patient care. Most residents rated their faculty and clinical didactics favorably. However, many residents reported suboptimal preparation in basic neuroscience and practice management issues. Most residents (71%) noted that the Residency In-service Training Examination (RITE) assisted in self-study. A minority of residents (14%) reported that the RITE scores were used for reasons other than self-study. The vast majority (86%) of residents will enter fellowship training following residency and were satisfied with the fellowship offers they received. Graduating residents had largely favorable neurology training experiences. Several common deficiencies include education in basic neuroscience and clinical practice management. Importantly, prior changes to duty hours did not negatively affect the resident perception of neurology residency training.

  11. Advantage and choice: social relationships and staff assistance in assisted living.

    Science.gov (United States)

    Burge, Stephanie; Street, Debra

    2010-05-01

    OBJECTIVES. To understand how "cumulative inequality" (CI), expressed as individual advantage and choice, and "external social supports" contribute to the quality of social relationships and perceptions of staff assistance for older individuals in different assisted living (AL) settings. Data are from 429 cognitively intact AL residents aged 60 years and older interviewed for the Florida Study of Assisted Living. Bivariate and multivariate statistical analyses show how individual advantage and choice and external social networks influence respondents' social relationships and staff assistance in AL. Controlling for resident and facility characteristics, being able to pay privately enhances resident satisfaction with staff assistance and having control over the move to AL is positively associated with perceptions of staff relationships and assistance. Maintaining contact with pre-AL friends predicts quality of coresident relationships, as does family contact. Regular contact with family buffers some of the disadvantages associated with CI for perceptions of staff relationships but not perceptions of staff assistance. Discussion. Individual advantage and choice influence the quality of staff relationships and assistance for AL residents but matter little for coresident relationships. External social relationships buffer some of the risks associated with CI for perceptions of staff relationships but not perceived quality of staff assistance. Findings highlight outcomes associated with CI, including predictable risks that disadvantaged elders face in particular types of AL settings, differential advantages others enjoy that influence positive perceptions of staff relationships and staff assistance, and the enduring importance of supportive social relationships.

  12. FISCAL SETTLEMENTS OF INCOMES OBTAINED FROM ABROAD BY NATURAL PERSONS RESIDENT IN ROMANIA

    Directory of Open Access Journals (Sweden)

    Buziernescu Radu

    2010-12-01

    Full Text Available The resident natural persons and those who qualify for residency conditions are subject to taxation in Romania for the incomes from any source, both from Romania and from abroad. External fiscal credit can be granted in order to avoid double taxation, so that the person can be entitled to deduct from the tax on income due in Romania the tax of income paid abroad, without exceeding the share of the income tax payable in Romania related to the income from abroad. The procedure of granting external fiscal credit vary depending on different categories of income.

  13. 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.

  14. Assistive Technology

    Science.gov (United States)

    ... Page Resize Text Printer Friendly Online Chat Assistive Technology Assistive technology (AT) is any service or tool that helps ... be difficult or impossible. For older adults, such technology may be a walker to improve mobility or ...

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

    Science.gov (United States)

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

    2013-12-01

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

  16. Using Reflections of Recent Resident Graduates and their Pediatric Colleagues to Evaluate a Residency Program

    Directory of Open Access Journals (Sweden)

    Robert K. Kamei, M.D.

    2003-01-01

    Full Text Available Background and Purposes: In response to the new Accreditation Council for Graduate Medical Education (ACGME mandate for residency programs to use feedback to improve its educational program, we piloted a novel evaluation strategy of a residency program using structured interviews of resident graduates working in a primary care practice and their physician associates. Methods: A research assistant performed a structured telephone interview. Quantitative data assessing the graduate’s self-assessment and the graduate’s clinical practice by the associate were analyzed. In addition, we performed a qualitative analysis of the interviews. Results: Thirteen resident graduates in primary care practice and seven physician practice associates participated in the study. Graduate self-assessment revealed high satisfaction with their residency training and competency. The associates judged our graduates as highly competent and mentioned independent decision-making and strong interpersonal skills (such as teamwork and communication as important. They specifically cited the graduate’s skills in intensive care medicine and adolescent medicine as well as communication and teamwork skills as important contributions to their practice. Conclusions: The ACGME Outcomes Project, which increases the emphasis on educational outcomes in the accreditation of residency education programs, requires programs to provide evidence of its effectiveness in preparing residents for practice. Direct assessment of the competency of our physician graduates in practice using structured interviews of graduates and their practice associates provide useful feedback information to a residency program as part of a comprehensive evaluation plan of our program’s curriculum and can be used to direct future educational initiatives of our training program

  17. Assisted Living

    Science.gov (United States)

    ... it, too. Back to top What is the Cost for Assisted Living? Although assisted living costs less than nursing home ... Primarily, older persons or their families pay the cost of assisted living. Some health and long-term care insurance policies ...

  18. Agentic and communal narcissism and satisfaction with life: The mediating role of psychological entitlement and self-esteem.

    Science.gov (United States)

    Żemojtel-Piotrowska, Magdalena A; Piotrowski, Jarosław P; Maltby, John

    2017-10-01

    This study examined the mediational role of self-esteem (as an enhancement) and psychological entitlement (as a cost) in the relationship between an agentic-communal model of grandiose narcissism and satisfaction with life. Two hundred and forty-eight university undergraduate students completed measures of agentic and communal narcissism, self-esteem, psychological entitlement and satisfaction with life. The findings suggest that there is support for the usefulness of the agentic-communal model of narcissism, and, consistent with predictions in the wider literature, self-esteem and psychological entitlement mediated the relationship between agentic-communal narcissism and life satisfaction. © 2015 International Union of Psychological Science.

  19. Gender Inequitable Masculinity and Sexual Entitlement in Rape Perpetration South Africa: Findings of a Cross-Sectional Study

    Science.gov (United States)

    Jewkes, Rachel; Sikweyiya, Yandisa; Morrell, Robert; Dunkle, Kristin

    2011-01-01

    Objective To describe the prevalence and patterns of rape perpetration in a randomly selected sample of men from the general adult population, to explore factors associated with rape and to describe how men explained their acts of rape. Design Cross-sectional household study with a two- stage randomly selected sample of men. Methods 1737 South African men aged 18–49 completed a questionnaire administered using an Audio-enhanced Personal Digital Assistant. Multivariable logistic regression models were built to identify factors associated with rape perpetration. Results In all 27.6% (466/1686) of men had raped a woman, whether an intimate partner, stranger or acquaintance, and whether perpetrated alone or with accomplices, and 4.7% had raped in the last 12 months. First rapes for 75% were perpetrated before age 20, and 53.9% (251) of those raping, did so on multiple occasions. The logistic regression model showed that having raped was associated with greater adversity in childhood, having been raped by a man and higher maternal education. It was associated with less equitable views on gender relations, having had more partners, and many more gender inequitable practices including transactional sex and physical partner violence. Also drug use, gang membership and a higher score on the dimensions of psychopathic personality, namely blame externalisation and Machiavellian egocentricity. Asked about why they did it, the most common motivations stemmed from ideas of sexual entitlement. Conclusions Perpetration of rape is so prevalent that population-based measures of prevention are essential to complement criminal justice system responses. Our findings show the importance of measures to build gender equity and change dominant ideas of masculinity and gender relations as part of rape prevention. Reducing men's exposure to trauma in childhood is also critically important. PMID:22216324

  20. 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.

  1. Counterstatement to Article Entitled "A Framework for Evaluation of Marine Spatial Data Geoportals Using Case Studies"

    Directory of Open Access Journals (Sweden)

    Seip Christian

    2015-12-01

    Full Text Available In December 2014 in volume 60 issue 4 a paper was published entitled “A Framework for Evaluation of Marine Spatial Data Geoportals Using Case Studies” by Marina Tavra, Vlado Cetl and Tea Duplancic Leder which is suspected to constitute academic misconduct. This comment reasons that the core of the paper was taken from another source and thus does not offer new and original scientific work and therefore does not add knowledge to the body of science. Furthermore it argues that apart from the plagiarism the paper shows major weaknesses and thus should have not been published even it was not plagiarized.

  2. Alien Registration Number Verification via the U.S. Citizenship and Immigration Service's Systematic Alien Verification for Entitlements System

    National Research Council Canada - National Science Library

    Ainslie, Frances M; Buck, Kelly R

    2008-01-01

    The purpose of this study was to evaluate the implications of conducting high-volume automated checks of the United States Citizenship and Immigration Services Systematic Allen Verification for Entitlements System (SAVE...

  3. Narcissistic self-esteem or optimal self-esteem? A Latent Profile Analysis of self-esteem and psychological entitlement

    OpenAIRE

    Stronge, Sam; Cichocka, Aleksandra; Sibley, Chris G.

    2016-01-01

    Research into the relationship between self-esteem and narcissism has produced conflicting results, potentially caused by hidden subpopulations that exhibit distinct positive or negative associations. This research uses Latent Profile Analysis to identify profiles within a national panel study (N = 6,471) with differing relationships between psychological entitlement and self-esteem. We identified a narcissistic self-esteem profile (9%) characterised by high entitlement and high self-esteem, ...

  4. Communication received from the Resident Representative of the Russian Federation to the IAEA on the establishment, structure and operation of the International Uranium Enrichment Centre

    International Nuclear Information System (INIS)

    2007-01-01

    The Director General has received a communication dated 7 June 2007 from the Resident Representative of the Russian Federation, with an attachment entitled 'Establishment, Structure and Operation of the International Uranium Enrichment Centre'. As requested in that communication, the letter and its attachment are circulated for the information of Member States

  5. Communication dated 16 July 2008 received from the Resident Representative of Japan to the Agency concerning an International Initiative on 3S-Based Nuclear Energy Infrastructure

    International Nuclear Information System (INIS)

    2008-01-01

    The Director General has received a communication dated 16 July 2008 from the Resident Representative of Japan attaching a document entitled 'International Initiative on 3S-based Nuclear Energy Infrastructure'. The communication, and as requested therein, its attachment, are circulated herewith for information

  6. 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...

  7. Effects of customer entitlement on service workers' physical and psychological well-being: a study of waitstaff employees.

    Science.gov (United States)

    Fisk, Glenda M; Neville, Lukas B

    2011-10-01

    This exploratory study examines the nature of customer entitlement and its impact on front-line service employees. In an open-ended qualitative inquiry, 56 individuals with waitstaff experience described the types of behaviors entitled customers engage in and the kinds of service-related "perks" these individuals feel deserving of. Participants explained how they responded to entitled customers, how and when managers became involved, and how their dealings with these patrons influenced their subjective physical and psychological well-being. We found that the behaviors of entitled customers negatively impacted waitstaff employees. Participants reported physiological arousal, negative affect, burnout, and feelings of dehumanization as a result of dealing with these patrons. While respondents drew on a variety of strategies to manage their encounters with entitled customers, they indicated workplace support was often informal and described feeling abandoned by management in dealing with this workplace stressor. Approaching customer entitlement as a form of microaggression, we offer recommendations for practice and suggest new directions for future research. . (PsycINFO Database Record (c) 2011 APA, all rights reserved).

  8. Obesity and intensive staffing needs of nursing home residents.

    Science.gov (United States)

    Harris, John Alexander; Engberg, John; Castle, Nicholas George

    2018-06-05

    The objective of this study is to examine how increasing body mass index (BMI) among nursing home residents affects the amount of staffing assistance needed for activities of daily living (ADL). We analyzed 1,627,141 US nursing home residents reported in the 2013 Minimum Data Set in seven BMI categories, from underweight (BMI < 18.5 kg/m 2 ) to obesity Class IIIB (≥50 kg/m 2 ). Logistic regression models estimated the odds of nursing home-reported need for extensive (≥2 staff member) assistance needed for ADLs. The adjusted odds increased from 1.07 (95% Confidence Interval (95%CI) 1.06-1.08) for Class I, 1.16 (95%CI 1.14-1.17) for Class II, 1.33 (95%CI 1.31-1.35) for Class IIIA, and 1.90 (95%CI 1.86-1.95) for Class IIIB obesity residents compared to residents of normal weight. As a nursing home resident's BMI increases, especially for BMI ≥40 kg/m 2 , the need for extensive staffing assistance with ADLs also increases substantially. Copyright © 2018 Elsevier Inc. All rights reserved.

  9. The Making of a Good Woman: Extended Parental Leave Entitlements and Mothers' Work Commitment in Germany.

    Science.gov (United States)

    Gangl, Markus; Ziefle, Andrea

    2015-09-01

    The authors investigate the relationship between family policy and women's attachment to the labor market, focusing specifically on policy feedback on women's subjective work commitment. They utilize a quasi-experimental design to identify normative policy effects from changes in mothers' work commitment in conjunction with two policy changes that significantly extended the length of statutory parental leave entitlements in Germany. Using unique survey data from the German Socio-Economic Panel and difference-in-differences, triple-differenced, and instrumental variables estimators for panel data, they obtain consistent empirical evidence that increasing generosity of leave entitlements led to a decline in mothers' work commitment in both East and West Germany. They also probe potential mediating mechanisms and find strong evidence for role exposure and norm setting effects. Finally, they demonstrate that policy-induced shifts in mothers' preferences have contributed to. retarding women's labor force participation after childbirth in Germany, especially as far as mothers' return to full-time employment is concerned.

  10. Entitled vengeance: A meta-analysis relating narcissism to provoked aggression.

    Science.gov (United States)

    Rasmussen, Kyler

    2016-07-01

    Narcissism has long been used to predict aggressive or vengeful responses to provocations from others. The strength of this relation can, however, vary widely from study to study. Narcissism and revenge were examined in 84 independent samples (N = 11297), along with the moderating role of sample type (i.e., child/adolescent, prisoner, undergraduate, or general samples), type of narcissism measure used (i.e., Narcissistic Personality Inventory, Psychological Entitlement Scale, Short D3, etc.), the nature of the provocation, and the type of provoked aggression examined. Narcissism was positively related to provoked aggression across studies (ρ = .25), but that relation was stronger in child/adolescent samples (ρ = .36) and when measures of entitlement or vulnerable narcissism were employed (ρ = .29). Implications for practical research, as well as neglected areas of research on narcissism and provoked aggression are discussed. Aggr. Behav. 42:362-379, 2016. © 2015 Wiley Periodicals, Inc. © 2015 Wiley Periodicals, Inc.

  11. Entitlement to Sickness Benefits in Sweden: The Social Insurance Officers Experiences

    Directory of Open Access Journals (Sweden)

    Ulrika Müssener

    2008-01-01

    Full Text Available Background: Social insurance offices (SIOs handle a wide range of complex assessments of the entitlement to sickness benefits for an increasing number of clients on sick leave and consequently, the demands on the SIOs have increased considerably.Aim: To gain deeper knowledge of the problems experienced by the SIOs in their work associated with entitlement to sickness benefits.Method: A descriptive and explorative qualitative approach was used to analyse data from two focus-group interviews, including six participants in each group.Results: The participants discussed different dilemmas in regard to; physicians’ responsibility for issuing sickness certificates, interactions with the insured individuals, disclosure of decisions, communications with medical consultants, documentation of sickness benefit claims, threats in the workplace, as well as their own competence. The SIOs regarded incomplete information on sickness certificates as a main problem, because they frequently had to contact the client and the physicians who issued the certificates in order to obtain further details, leading to delays in the decision-making whether to grant sickness benefits.Conclusions: More knowledge regarding SIOs work is required to improve the methods used in the sickness insurance system and to ensure adequate training of new staff members.

  12. Economic Entitlements via Entrepreneurial Conduct? Women and Financial Inclusion in Neo-liberal India

    Directory of Open Access Journals (Sweden)

    K. Kalpana

    2015-08-01

    Full Text Available This paper examines the gendered local character of neoliberalism at the household level by focusing on microcredit/finance programs in India. Microfinance promoted by the state as an informal activity targeting women is intended to alleviate income inequalities, even as it contributes to maintaining the world capitalist system. In India the inception of microfinance-based Self Help Groups (SHGs or peer groups of women savers and borrowers in the 1990s has coincided with a rightward turn towards neoliberal policies of structural adjustment, privatization and economic deregulation. In this paper, I show how Indian policy makers have endeavored to make women's economic entitlements contingent upon their disciplined financial behavior and their willing participation in neoliberal agendas of creating and deepening 'self-regulating' markets at village levels. Drawing on an ethnographic study conducted in a South Indian state, I show that the community level 'neoliberal disciplining' that microfinance entails does not proceed without resistance. Whilst SHGs seek to constitute women as fiscally disciplined savers and borrowers, women stake their 'rightful' entitlement to bank credit even as they reject outright the entrepreneurial subjectivities they are expected to assume. They pursue purposes and ends that extend well beyond 'financial inclusion.'

  13. 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.

  14. 78 FR 63974 - Student Assistance General Provisions-Subpart K-Cash Management; Extension of Public Comment...

    Science.gov (United States)

    2013-10-25

    ... DEPARTMENT OF EDUCATION Student Assistance General Provisions--Subpart K--Cash Management... an information collection entitled, ``Student Assistance General Provisions--Subpart K--Cash Management''. ED is extending the comment period to November 18, 2013 due to the public's inability to access...

  15. Exploring Resident Assistants' Demonstration of Socially Responsible Leadership

    OpenAIRE

    Manz, Jonathan William

    2016-01-01

    For students who want to make a difference in college and beyond, involvement in a variety of available leadership positions while in college can lead to gains in many areas-and most importantly, the ability to work respectfully, flexibly, and effectively with an increasingly diverse population. While it is widely acknowledged that leadership qualities and skills are principally learned and developed (rather than inherently innate to the individual), scholars are less certain as to the specif...

  16. Telemonitoring for assisted living residences: the medical specialists' view.

    NARCIS (Netherlands)

    Alizadeh, S.; Bakkes, S.C.J.; Kanis, M.; Rijken, M.; Kröse, B.J.A.; Jordanova, M.; Lievens, F.

    2011-01-01

    Telemonitoring is regarded as a means to maintain a relatively high quality of life for independently living elderly. This paper discusses a requirements study of a system to, foremost, telemonitor activities of daily living (ADL) of the elderly. The study utilizes literature and in-depth interviews

  17. Left Ventricular Assist Devices

    Directory of Open Access Journals (Sweden)

    Khuansiri Narajeenron

    2017-04-01

    Full Text Available Audience: The audience for this classic team-based learning (cTBL session is emergency medicine residents, faculty, and students; although this topic is applicable to internal medicine and family medicine residents. Introduction: A left ventricular assist device (LVAD is a mechanical circulatory support device that can be placed in critically-ill patients who have poor left ventricular function. After LVAD implantation, patients have improved quality of life.1 The number of LVAD patients worldwide continues to rise. Left-ventricular assist device patients may present to the emergency department (ED with severe, life-threatening conditions. It is essential that emergency physicians have a good understanding of LVADs and their complications. Objectives: Upon completion of this cTBL module, the learner will be able to: 1 Properly assess LVAD patients’ circulatory status; 2 appropriately resuscitate LVAD patients; 3 identify common LVAD complications; 4 evaluate and appropriately manage patients with LVAD malfunctions. Method: The method for this didactic session is cTBL.

  18. 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

  19. Maximizing Technological Resources in Plastic Surgery Resident Education.

    Science.gov (United States)

    Khansa, Ibrahim; Janis, Jeffrey E

    2015-11-01

    Modern plastic surgery resident education demands the acquisition of an ever-increasing fund of knowledge and familiarity with more surgical techniques than ever before. This all must take place within the context and boundaries of Accreditation Council for Graduate Medical Education-mandated restrictions on work hours as well as balance of education and service. Technological resources have been developed and can be used to complement the skills that residents acquire while performing their day-to-day activities such as taking care of patients, reading textbooks and journal articles, and assisting or performing surgical procedures. Those complementary resources provide the benefits of portability and accessibility, and can thus be conveniently incorporated into the hectic daily life of a resident. This article presents a summary of the most commonly used currently available advanced technologies in plastic surgery resident education, and suggestions for integration of those technologies into a curriculum.

  20. What Residence Hall Staff Need to Know about Dealing with Death.

    Science.gov (United States)

    Jacobs, Bonita; Towns, James E.

    1984-01-01

    Emphasizes the responsibility for residence hall staff to understand the grief process. An adaptation of Kubler-Ross's stages of death has produced helpful techniques for successfully accepting the death. Through understanding these principles, staff can become aware of the grief process and can assist residents. (JAC)

  1. [Career plans of French residents in Psychiatry: results of a National Survey].

    Science.gov (United States)

    Berger-Vergiat, A; Chauvelin, L; Van Effenterre, A

    2015-02-01

    For many years, the numerus clausus limiting the number of medical students has increased in France. The government wants to reform the residency process to homogenize medical studies. However, the suggested residency program changes would imply changes in the length of residency, in the mobility of residents after residency, their access to unconventional sectors, and more generally, the responsibility of the resident and his/her status in the hospital. In this context, we have investigated the future plans of all psychiatry residents in France. To study the desires of psychiatry residents in France, regarding their training, their short and long-term career plans, and to analyze the evolution of those desires over the last 40 years. A survey was carried out among residents in psychiatry from November 2011 to January 2012. An anonymous questionnaire including four parts (resident's description, residency training and trainees choice, orientation immediately after residency, professional orientation in 5-10 years) was sent by the French Federative Association of Psychiatrists Trainees (AFFEP) to all French psychiatrist trainees, through their local trainee associations (n=26) and through an on line questionnaire. The questionnaire was answered by 853 of the 1615 psychiatry residents (53%), of which 71% were women. At the end of the residency, 76% of residents reported that they would like to pursue a post-residency position (chief resident, senior physician assistant university hospitals); 22% reported wanting to work in another city. Between 5 to 10 years after completion of the residency, 71% reported wanting to work in a hospital, and 40% preferred to have their own private practice. Almost a third of the trainees wished to work in the child and adolescent psychiatry field, for some of them in an exclusive way, for others, combined with a practice in adult psychiatry. Copyright © 2013 L’Encéphale, Paris. Published by Elsevier Masson SAS. All rights reserved.

  2. Un projet de logiciels d'assistance a l'apprentissage de la lecture en FLE (An Interdisciplinary Research Project Oriented toward Computer Programs for Reading Instruction in French as a Second Language).

    Science.gov (United States)

    Challe, Odile; And Others

    1985-01-01

    Describes a French project entitled "Lecticiel," jointly undertaken by specialists in reading, computer programing, and second language instruction to integrate these disciplines and provide assistance for students learning to read French as a foreign language. (MSE)

  3. 北京某农村住宅空气源热泵辅助太阳能供暖系统的运行性能%Operation performance of air-source heat pump assisted solar heating system in Beijing rural residence

    Institute of Scientific and Technical Information of China (English)

    李楠; 田昕; 王皆腾; 徐俊芳

    2017-01-01

    A rural residence adopts air-source heat pump assisted solar heating system.Tests the heating capacity,energy consumption and other performance parameters of the system in the heating season of 2014 to 2015.The results show that the indoor mean daily temperature is 19.6 ℃,the average COP of air-source heat pump is 4.29,mean daily comprehensive energy efficaiency ratio of heating system is about 3.52,and the mean daily solar energy contribution rate is 4.87%.The heat pump unit of the heating system has good operating performance in winter,but the solar energy contribution rate is low,the whole heating system still needs further optimization.%某农村住宅安装了空气源热泵辅助太阳能供暖系统.针对2014-2015年度供暖季系统的制热量、耗电量等性能参数进行了测试.结果表明,室内日平均温度为19.6℃,热泵机组日平均COP为4.29,供暖系统日均综合能效比为3.52,日均太阳能贡献率为4.87%.该供暖系统的热泵机组具有较好的运行性能,但太阳能贡献率偏低,整个供暖系统仍有进一步优化的空间.

  4. Do resident's leadership skills relate to ratings of technical skill?

    Science.gov (United States)

    Gannon, Samantha J; Law, Katherine E; Ray, Rebecca D; Nathwani, Jay N; DiMarco, Shannon M; D'Angelo, Anne-Lise D; Pugh, Carla M

    2016-12-01

    This study sought to compare general surgery research residents' survey information regarding self-efficacy ratings to their observed performance during a simulated small bowel repair. Their observed performance ratings were based on their leadership skills in directing their assistant. Participants were given 15 min to perform a bowel repair using bovine intestines with standardized injuries. Operative assistants were assigned to help assist with the repair. Before the procedure, participants were asked to rate their expected skills decay, task difficulty, and confidence in addressing the small bowel injury. Interactions were coded to identify the number of instructions given by the participants to the assistant during the repair. Statistical analyses assessed the relationship between the number of directional instructions and participants' perceptions self-efficacy measures. Directional instructions were defined as any dialog by the participant who guided the assistant to perform an action. Thirty-six residents (58.3% female) participated in the study. Participants who rated lower levels of decay in their intraoperative decision-making and small bowel repair skills were noted to use their assistant more by giving more instructions. Similarly, a higher number of instructions correlated with lower perceived difficulty in selecting the correct suture, suture pattern, and completing the entire surgical task. General surgery research residents' intraoperative leadership skills showed significant correlations to their perceptions of skill decay and task difficulty during a bowel repair. Evaluating resident's directional instructions may provide an additional individualized intraoperative assessment metric. Further evaluation relating to operative performance outcomes is warranted. Copyright © 2016 Elsevier Inc. All rights reserved.

  5. Columbia River System Operation Review final environmental impact statement. Appendix P: Canadian Entitlement Allocation Agreements (CEAA)

    International Nuclear Information System (INIS)

    1995-11-01

    The System Operation Review (SOR) is a study and environmental compliance process being used by the three Federal agencies to analyze future operations of the system and river use issues. The goal of the SOR is to achieve a coordinated system operation strategy for the river that better meets the needs of all river users. This technical appendix addresses only the effects of alternative system operating strategies for managing the Columbia River system. The purpose of this technical appendix is to provide the environmental review necessary to enter into agreements regarding the distribution between Federal and non-Federal project owners with respect to delivery of the Canadian Entitlement obligation to Canada for the period 1998 through 2024

  6. Human Rights Discourse in the Sustainable Development Agenda Avoids Obligations and Entitlements

    Science.gov (United States)

    Williams, Carmel; Blaiklock, Alison

    2016-01-01

    Our commentary on Forman et al paper explores their thesis that right to health language can frame global health policy responses. We examined human rights discourse in the outcome documents from three 2015 United Nations (UN) summits and found rights-related terms are used in all three. However, a deeper examination of the discourse finds the documents do not convey the obligations and entitlements of human rights and international human rights law. The documents contain little that can be used to empower the participation of those already left behind and to hold States and the private sector to account for their human rights duties. This is especially worrying in a neoliberal era. PMID:27285518

  7. International conference entitled Zdeněk Kopal’s Binary Star Legacy

    CERN Document Server

    Drechsel, Horst; ZDENEK KOPAL’S BINARY STAR LEGACY

    2005-01-01

    An international conference entitled "Zdenek Kopal's Binary Star Legacy" was held on the occasion of the late Professor Kopal's 90th birthday in his home town of Litomyšl/Czech Republic and dedicated to the memory of one of the leading astronomers of the 20th century. Professor Kopal, who devoted 60 years of his scientific life to the exploration of close binary systems, initiated a breakthrough in this field with his description of binary components as non-spherical stars deformed by gravity, with surfaces following Roche equipotentials. Such knowledge triggered the development of new branches of astrophysics dealing with the structure and evolution of close binaries and the interaction effects displayed by exciting objects such as cataclysmic variables, symbiotic stars or X-ray binaries. Contributions to this conference included praise of the achievements of a great astronomer and personal reminiscences brought forward by Kopal's former students and colleagues, and reflected the state of the art of the dyn...

  8. Basic package of health entitlements and solidarity in the Federation of Bosnia and Herzegovina.

    Science.gov (United States)

    Hrabac, B; Ljubic, B; Bagaric, I

    2000-09-01

    The aim of this report is to provide an overview of the methodology for designing a basic package of health entitlements and solidarity in the Federation of Bosnia and Herzegovina which will, respecting the principles of solidarity and equity, guarantee equal rights to all citizens of the Federation. After the analysis of the situation, we specified the reasons for the reform, listed the objectives, and described the basis of the basic package design, the establishment of federal solidarity, and the plan of realization. We discussed the background ethical theories of our policy choice, explicitly stated the normative and technical criteria for priority setting, and deliberated Federal financing solidarity policy and allocation methodology, as well as criteria for "risk equalization" among cantons.

  9. International assistance. Licensing assistance project

    International Nuclear Information System (INIS)

    Aleev, A.

    1999-01-01

    Description of licensing assistance project for VATESI is presented. In licensing of unit No.1 of INPP VATESI is supported by many western countries. Experts from regulatory bodies or scientific organizations of those countries assist VATESI staff in reviewing documentation presented by INPP. Among bilateral cooperation support is provided by European Commission through Phare programme

  10. Financial Contribution of Residents When Billing as "Junior Associates" in the "Surgical Firm".

    Science.gov (United States)

    Stoller, Jeremy; Pratt, Sarah; Stanek, Stephen; Zelenock, Gerald; Nazzal, Munier

    2016-01-01

    There is an increasing number of proposals to change the way Graduate Medical Education is funded. This study attempts to estimate the potential financial contribution of surgical residents using an alternative funding mechanism similar to that used by law firms, which would allow surgery departments to bill for resident activity as "junior associates." Following 24 residents over a period of 12 weeks, we were able to estimate the annual revenue that they generated from operating room procedures, independent consultations, patient management, and minor procedures using Medicare reimbursement rates. The appropriate first assistant modifier was used to calculate the operating room procedure fees, but full price was used to calculate the revenue for minor procedures, patient management, and consultations done independently. We adjusted for vacation time and academic activities. Including postgraduate year 1 residents, the estimated yearly revenue generated per resident in first assistant operative services was $33,305.67. For minor procedures, patient management, and independent consultations, the estimated yearly revenue per resident was $37,350.66. The total estimated financial contribution per resident per year was $70,656.33. Excluding postgraduate year 1 residents, as most states require completion of the intern year before full licensure, the estimated yearly revenue generated per resident in first assistant operative services was $38,914.56. For minor procedures, patient management, and independent consultations, the estimated yearly revenue per resident was $55,957.33. The total estimated financial contribution per resident per year was $94,871.89. Residents provide a significant service to hospitals. If resident activity was compensated at the level of supervised "junior associates" of a surgery department, more than 75% of the direct educational costs of training could be offset. Furthermore, we believe this value is underestimated. Given the foreseeable

  11. 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

  12. Administrative organization in diagnostic radiology residency program leadership.

    Science.gov (United States)

    Webber, Grant R; Mullins, Mark E; Chen, Zhengjia; Meltzer, Carolyn C

    2012-04-01

    The aim of this study was to document the current state of administrative structure in US diagnostic radiology (DR) residency program leadership. A secondary objective was to assess for correlation(s), if any, with DR residency programs that equipped positions such as assistant, associate, and emeritus program director (PD) with respect to residency size and region of the country. The Fellowship and Residency Electronic Interactive Database, as well as direct communication and programmatic Web site searches, were used to gather data regarding current US DR residency leadership. Data collected included the presence of additional leadership titles, including assistant PD, associate PD, and PD emeritus, and how many faculty members currently held each position. Programs were excluded if results could not be identified. Analysis of variance and t tests were used to estimate the correlations of the size of a residency with having additional or shared PD positions and the types of positions, respectively. Chi-square tests were used to assess for any regional differences. As of the time of this project, the Fellowship and Residency Electronic Interactive Database defined 186 US DR residency programs. A total of 173 programs (93%) were included in the analysis; the remainder were excluded because of unavailability of relevant data. Seventy-two percent (124 of 173) of programs had additional DR leadership positions. Of these, 30 programs (17%) had more than one such position. There were no significant differences in the sizes of the programs that used these additional positions (mean, 25 ± 12; range, 6-72) compared with those that did not (mean, 24 ± 12; range, 7-51). There were no significant differences between programs that had additional positions with respect to region of the country. The majority of US DR residency programs used some form of additional DR leadership position. In the majority of cases, this was in the form of an assistant or associate PD. Nearly one

  13. 24 CFR 5.661 - Section 8 project-based assistance programs: Approval for police or other security personnel to...

    Science.gov (United States)

    2010-04-01

    ... personnel who will reside in the project, and the period of residence by such personnel. How owner proposes... purpose, “owner” includes a principal or other interested party. (iv) How residence by security personnel in a project unit will increase security for Section 8 assisted families residing in the project. (v...

  14. Assisted Living

    Science.gov (United States)

    ... are not licensed by the federal government, the services provided and quality controls vary by state.) More than 500,000 ... residents ( Note : This does not mean that skilled nursing must be available 24 hours a day.) Social services Housekeeping and laundry Recreation and meals Help with ...

  15. 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

  16. Practical Implications for an Effective Radiology Residency Quality Improvement Program for Milestone Assessment.

    Science.gov (United States)

    Leddy, Rebecca; Lewis, Madelene; Ackerman, Susan; Hill, Jeanne; Thacker, Paul; Matheus, Maria; Tipnis, Sameer; Gordon, Leonie

    2017-01-01

    Utilization of a radiology resident-specific quality improvement (QI) program and curriculum based on the Accreditation Council for Graduate Medical Education (ACGME) milestones can enable a program's assessment of the systems-based practice component and prepare residents for QI implementation post graduation. This article outlines the development process, curriculum, QI committee formation, and resident QI project requirements of one institution's designated radiology resident QI program. A method of mapping the curriculum to the ACGME milestones and assessment of resident competence by postgraduate year level is provided. Sample projects, challenges to success, and lessons learned are also described. Survey data of current trainees and alumni about the program reveal that the majority of residents and alumni responders valued the QI curriculum and felt comfortable with principles and understanding of QI. The most highly valued aspect of the program was the utilization of a resident education committee. The majority of alumni responders felt the residency quality curriculum improved understanding of QI, assisted with preparation for the American Board of Radiology examination, and prepared them for QI in their careers. In addition to the survey results, outcomes of resident project completion and resident scholarly activity in QI are evidence of the success of this program. It is hoped that this description of our experiences with a radiology resident QI program, in accordance with the ACGME milestones, may facilitate the development of successful QI programs in other diagnostic radiology residencies. Copyright © 2017 The Association of University Radiologists. Published by Elsevier Inc. All rights reserved.

  17. 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

  18. 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.

  19. 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 ...

  20. 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

  1. CERN CERTIFICATE REQUIRED FOR AN APPLICATION FOR A FRENCH RESIDENCE PERMIT ISSUED BY A PREFECTURE

    CERN Multimedia

    Relations with the Host States Service

    2001-01-01

    All non-French nationals who reside in France for more than three consecutive months or who, in the case of intermittent periods of residence, are effectively present in France for more than three months in any six-month period must obtain a residence or stay permit (titre de séjour). If members of the CERN personnel and members of their families fulfil those conditions inter alia, they normally receive a legitimation document, which is valid as a residence or stay permit, from the French Ministry of Foreign Affairs (Carte spéciale FI or AT, Carte d'assimilé à un membre de mission diplomatique). However, members of the personnel with permanent resident status (résident permanent) are not, by virtue of that status, entitled to a legitimation document and must obtain a residence permit issued by a Prefecture. For the latter purpose, with the agreement of the Prefecture de l'Ain, CERN (i.e. the Personnel Records Office, Human Resources Division, office 33/1-...

  2. Weathering the storm: challenges to nurses providing care to nursing home residents during hurricanes.

    Science.gov (United States)

    Hyer, Kathryn; Brown, Lisa M; Christensen, Janelle J; Thomas, Kali S

    2009-11-01

    This article documents the experience of 291 Florida nursing homes during the 2004 hurricane season. Using quantitative and qualitative methods, the authors described and compared the challenges nurses encountered when evacuating residents with their experiences assisting residents of facilities that sheltered in place. The primary concerns for evacuating facilities were accessing appropriate evacuation sites for residents and having ambulance transportation contracts honored. The main issue for facilities that sheltered in place was the length of time it took for power to be restored. Barriers to maintaining resident health during disasters for those who evacuated or sheltered in place are identified.

  3. 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.

  4. 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.

  5. Activity Engagement: Perspectives from Nursing Home Residents with Dementia

    Science.gov (United States)

    Tak, Sunghee H.; Kedia, Satish; Tongumpun, Tera Marie; Hong, Song Hee

    2014-01-01

    Engagement in social and leisure activities is an indicator of quality of life and well-being in nursing homes. There are few studies in which nursing home residents with dementia self-reported their experiences in activity engagement. This qualitative study describes types of current activity involvement and barriers to activities as perceived by nursing home residents with dementia. Thirty-one residents participated in short, open-ended interviews and six in in-depth interviews. Thematic content analysis showed that participants primarily depended on activities organized by their nursing homes. Few participants engaged in self-directed activities such as walking, visiting other residents and family members, and attending in church services. Many residents felt they had limited opportunities and motivation for activities. They missed past hobbies greatly but could not continue them due to lack of accommodation and limitation in physical function. Environmental factors, along with fixed activity schedule, further prevented them from engaging in activities. Residents with dementia should be invited to participate in activity planning and have necessary assistance and accommodation in order to engage in activities that matter to them. Based on the findings, a checklist for individualizing and evaluating activities for persons with dementia is detailed. PMID:25489122

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

    Science.gov (United States)

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

    2016-02-01

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

  7. 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.

  8. Overworked and underpaid: on the nature of gender differences in personal entitlement.

    Science.gov (United States)

    Major, B; McFarlin, D B; Gagnon, D

    1984-12-01

    This research investigated gender differences in feelings of personal entitlement with respect to monetary payment for work performed. Two experiments were conducted to test the hypothesis that women's internal standards of fair pay for their work are lower than men's and to examine possible causes of this difference. In Experiment 1, men and women were asked to pay themselves in a private situation what they thought was fair pay for a fixed amount of work. Social comparison information was varied. As predicted, women paid themselves less money than men in the absence, but not the presence, of social comparison information. In Experiment 2, men and women were asked to do as much work as they thought was fair for a fixed, prepaid, amount of money. Subjects believed that their work was either monitored or unmonitored. Women worked significantly longer, did more work, and did more correct work than men in both public and private work settings. Furthermore, women, but not men, worked longer when they believed their work was monitored than when they believed it was unmonitored. Possible explanations for these gender differences are discussed.

  9. Federalism, entitlements, and discretionary grants: the fiscal context of national support for immunization programs.

    Science.gov (United States)

    Miller, V J

    2000-10-01

    This paper defines the appropriation and resource allocation structure of federal government programs that deliver vaccines to the public through state and local governments, with a special focus on the Centers for Disease Control and Prevention (CDC) Section 317 program. The paper places these programs in the context of the overall intergovernmental finance system of the United States, and the manner in which that system has responded to societal changes in other areas, such as unemployment insurance and environmental protection. The paper concludes that a changing environment for vaccine financing, and uncertain appropriations for state government immunization infrastructure, may have made the current CDC Section 317 program inadequate. Increased entitlement resources for federally funded vaccines have not been matched with increased and stable resources for the balance of program costs. To the contrary, funding provided to the Section 317 program has proven unstable, and its discretionary appropriations have proven vulnerable to both executive and legislative branch earmarking for such activities as overseas disease eradication or home state earmarking by congressional appropriations subcommittee members. In addition, the rigidity of some CDC program requirements makes it difficult for states to effectively use program funds. Consideration should be given to strengthening the Section 317 program and its relationships to other federal aid programs to ensure that adequate immunization protections are provided in all states to adequately protect all citizens.

  10. Possible administrative structures and procedures (for implementing a tradeable entitlement approach to controlling global warming)

    International Nuclear Information System (INIS)

    Tietenberg, T.; Victor, D.G.

    1994-01-01

    The United Nations Framework Convention on Climate Change was opened for signature at the United Nations Conference on Environment and Development (UNCED) held at Rio de Janeiro in June 1992. By August 1994, it had been signed by representatives of some 166 countries; with 93 ratifications. Reducing greenhouse gas emissions to 1990 levels by the year 2000 was specified as a voluntary target within the Convention. Making this target mandatory was originally supported by the European Union, Japan and most other countries, but opposed by the United States. Following the change of administrations, however, the new United States President announced his support for both the concept of holding emissions at their 1990 levels and the deadline for achieving that target. Limiting greenhouse gas emissions to specific levels now appears to be an internationally recognized objective. In this paper we examine how to implement a tradeable entitlements system for greenhouse-gas emissions, using the United Nations Framework Convention on Climate Change as our point of departure. Using this particular point of departure establishes certain parameters of our inquiry. Currently no mandatory targets for emission reductions have been accepted by the participating States. Furthermore, even the stabilization goal, to the extent it is a factor at all, will be a factor only for the industrialized countries

  11. POLITENESS PRINCIPLE ANALYSIS IN CARTOON MOVIE ENTITLED STAND BY ME DORAEMON

    Directory of Open Access Journals (Sweden)

    Eko Mulyono

    2016-04-01

    Full Text Available This article examines the use of politeness principle in cartoon movie entitled “Stand By Me Doraemon”. It aims at giving a description on the use of politeness principle in this movie so that this is the source of data as well. The data are collected by note taking technique and then analyzed descriptively. After analyzing the data, the researcher finds the use of politeness principle in the movie script. They are utterances of the use of politeness principle covering the kinds of maxim in politeness principle. The utterances covey the use of tact maxim, generosity maxim, approbation maxim, modesty maxim, agreement maxim, and sympathy maxim. Then, it focused also in politeness scale such as formality scale, hesitancy scale, and equality scale. The finding result showed that there are 25 politeness principle found in cartoon movie “Stand By Me Doraemon”. 1 tact maxim, 3 generosity maxim, 6 approbation maxim, 1 modesty maxim, 2 agreement maxim, 3 sympathy maxim, 2 formality scale, 4 hesitancy scale, and 3 equality scale. Approbation maxim is the maxim of the most numerous in the movie. This is because the characters in this film seek to avoid conflict and create an environment that is comfortable in communication.   Key words: politeness principle, cartoon movie, utterance, maxim, scale.

  12. 45 CFR 506.18 - Entitlement of survivors to award in case of death of prisoner of war.

    Science.gov (United States)

    2010-10-01

    ... of prisoner of war. 506.18 Section 506.18 Public Welfare Regulations Relating to Public Welfare..., ADMINISTRATION, AND PAYMENT OF CLAIMS UNDER TITLE I OF THE WAR CLAIMS ACT OF 1948, AS AMENDED ELIGIBILITY REQUIREMENTS FOR COMPENSATION Prisoners of War § 506.18 Entitlement of survivors to award in case of death of...

  13. 20 CFR 222.53 - When a legally adopted child is dependent-child adopted after entitlement.

    Science.gov (United States)

    2010-04-01

    ... 20 Employees' Benefits 1 2010-04-01 2010-04-01 false When a legally adopted child is dependent-child adopted after entitlement. 222.53 Section 222.53 Employees' Benefits RAILROAD RETIREMENT BOARD REGULATIONS UNDER THE RAILROAD RETIREMENT ACT FAMILY RELATIONSHIPS Child Support and Dependency § 222.53 When...

  14. 20 CFR 222.54 - When a legally adopted child is dependent-grandchild or stepgrandchild adopted after entitlement.

    Science.gov (United States)

    2010-04-01

    ... 20 Employees' Benefits 1 2010-04-01 2010-04-01 false When a legally adopted child is dependent-grandchild or stepgrandchild adopted after entitlement. 222.54 Section 222.54 Employees' Benefits RAILROAD RETIREMENT BOARD REGULATIONS UNDER THE RAILROAD RETIREMENT ACT FAMILY RELATIONSHIPS Child Support and...

  15. 20 CFR 404.340 - How do I become entitled to mother's or father's benefits as a surviving divorced spouse?

    Science.gov (United States)

    2010-04-01

    ... described in § 404.345 or you were deemed to be validly married as described in § 404.346 but the marriage... not entitled to widow's or widower's benefits, or to an old-age benefit that is equal to or larger...

  16. 12 CFR 617.7100 - Who must make and who is entitled to receive an effective interest rate disclosure?

    Science.gov (United States)

    2010-01-01

    ... effective interest rate disclosure? 617.7100 Section 617.7100 Banks and Banking FARM CREDIT ADMINISTRATION FARM CREDIT SYSTEM BORROWER RIGHTS Disclosure of Effective Interest Rates § 617.7100 Who must make and who is entitled to receive an effective interest rate disclosure? (a) A qualified lender must make the...

  17. 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.

  18. 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

  19. A Longitudinal Study of Sexual Entitlement and Self-Efficacy among Young Women and Men: Gender Differences and Associations with Age and Sexual Experience

    Directory of Open Access Journals (Sweden)

    Gillian Hewitt-Stubbs

    2016-01-01

    Full Text Available Many scholars have called for an increased focus on positive aspects of sexual health and sexuality. Using a longitudinal design with two assessments, we investigated patterns of entitlement to sexual partner pleasure and self-efficacy to achieve sexual pleasure among 295 young men and women aged 17–25 years attending one Australian university. We also tested whether entitlement and efficacy differed by gender, and hypothesized that entitlement and efficacy would be higher in older participants and those with more sexual experience. A sense of entitlement to sexual partner pleasure increased significantly over the year of the study, whereas, on average, there was no change in self-efficacy over time. At Time 1 (T1, young women reported more entitlement than young men. Age was positively associated with T1 entitlement, and experience with a wider range of partnered sexual behaviors was concurrently associated with more entitlement and efficacy and was also associated with increased entitlement to partner pleasure and increased self-efficacy in achieving sexual pleasure at T2 relative to T1. A group with the least amount of sexual experience was particularly low in entitlement and efficacy when compared to groups with a history of coital experience. There was no evidence that any association differed between young men and young women. Limitations of the study include a sample of predominantly middle class, Caucasian students at one university and the possibility that students more interested in sex and relationships, and with more sexual experience, chose to participate.

  20. A Longitudinal Study of Sexual Entitlement and Self-Efficacy among Young Women and Men: Gender Differences and Associations with Age and Sexual Experience

    Science.gov (United States)

    Hewitt-Stubbs, Gillian; Zimmer-Gembeck, Melanie J.; Mastro, Shawna; Boislard, Marie-Aude

    2016-01-01

    Many scholars have called for an increased focus on positive aspects of sexual health and sexuality. Using a longitudinal design with two assessments, we investigated patterns of entitlement to sexual partner pleasure and self-efficacy to achieve sexual pleasure among 295 young men and women aged 17–25 years attending one Australian university. We also tested whether entitlement and efficacy differed by gender, and hypothesized that entitlement and efficacy would be higher in older participants and those with more sexual experience. A sense of entitlement to sexual partner pleasure increased significantly over the year of the study, whereas, on average, there was no change in self-efficacy over time. At Time 1 (T1), young women reported more entitlement than young men. Age was positively associated with T1 entitlement, and experience with a wider range of partnered sexual behaviors was concurrently associated with more entitlement and efficacy and was also associated with increased entitlement to partner pleasure and increased self-efficacy in achieving sexual pleasure at T2 relative to T1. A group with the least amount of sexual experience was particularly low in entitlement and efficacy when compared to groups with a history of coital experience. There was no evidence that any association differed between young men and young women. Limitations of the study include a sample of predominantly middle class, Caucasian students at one university and the possibility that students more interested in sex and relationships, and with more sexual experience, chose to participate. PMID:26797642

  1. 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.

  2. Investigating walking environments in and around assisted living facilities: a facility visit study.

    Science.gov (United States)

    Lu, Zhipeng

    2010-01-01

    This study explores assisted living residents' walking behaviors, locations where residents prefer to walk, and walking environments in and around assisted living facilities. Regular walking is beneficial to older adults' physical and psychological health. Yet frail older residents in assisted living are usually too sedentary to achieve these benefits. The physical environment plays an important role in promoting physical activity. However, there is little research exploring this relationship in assisted living settings. The researcher visited 34 assisted living facilities in a major Texas city. Methods included walk-through observation with the Assisted Living Facility Walking Environment Checklist, and interviews with administrators by open- and close-ended questions. The data from 26 facilities were analyzed using descriptive statistics (for quantitative data) and content analysis (for qualitative data). The results indicate that (a) residents were walking both indoors and outdoors for exercise or other purposes (e.g., going to destinations); (b) assisted living facility planning and design details-such as neighborhood sidewalk conditions, facility site selection, availability of seating, walking path configuration (e.g., looped/nonlooped path), amount of shading along the path, presence of handrails, existence of signage, etc.-may influence residents' walking behaviors; and (c) current assisted living facilities need improvement in all aspects to make their environments more walkable for residents. Findings of the study provide recommendations for assisted living facilities to improve the walkability of environments and to create environmental interventions to promote regular walking among their residents. This study also implies several directions for future research.

  3. 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.

  4. Assistive Devices

    Science.gov (United States)

    If you have a disability or injury, you may use a number of assistive devices. These are tools, products or types of equipment that help you perform tasks and activities. They may help you move around, see, communicate, eat, or get ...

  5. A Quality Improvement System to Manage Feeding Assistance Care in Assisted-Living.

    Science.gov (United States)

    Simmons, Sandra F; Coelho, Chris S; Sandler, Andrew; Schnelle, John F

    2018-03-01

    To describe a feasible quality improvement system to manage feeding assistance care processes in an assisted living facility (ALF) that provides dementia care and the use of these data to maintain the quality of daily care provision and prevent unintentional weight loss. Supervisory ALF staff used a standardized observational protocol to assess feeding assistance care quality during and between meals for 12 consecutive months for 53 residents receiving dementia care. Direct care staff received feedback about the quality of assistance and consistency of between-meal snack delivery for residents with low meal intake and/or weight loss. On average, 78.4% of the ALF residents consumed more than one-half of each served meal and/or received staff assistance during meals to promote consumption over the 12 months. An average of 79.7% of the residents were offered snacks between meals twice per day. The prevalence of unintentional weight loss averaged 1.3% across 12 months. A quality improvement system resulted in sustained levels of mealtime feeding assistance and between-meal snack delivery and a low prevalence of weight loss among ALF residents receiving dementia care. Given that many ALF residents receiving dementia care are likely to be at risk for low oral intake and unintentional weight loss, ALFs should implement a quality improvement system similar to that described in this project, despite the absence of regulations to do so. Copyright © 2018 AMDA – The Society for Post-Acute and Long-Term Care Medicine. Published by Elsevier Inc. All rights reserved.

  6. Thoughts of Quitting General Surgery Residency: Factors in Canada.

    Science.gov (United States)

    Ginther, David Nathan; Dattani, Sheev; Miller, Sarah; Hayes, Paul

    2016-01-01

    Attrition rates in general surgery training are higher than other surgical disciplines. We sought to determine the prevalence with which Canadian general surgery residents consider leaving their training and the contributing factors. An anonymous survey was administered to all general surgery residents in Canada. Responses from residents who considered leaving their training were assessed for importance of contributing factors. The study was conducted at the Royal University Hospital, University of Saskatchewan, Saskatoon, Saskatchewan, Canada, a tertiary academic center. The response rate was approximately 34.0%. A minority (32.0%) reported very seriously or somewhat seriously considering leaving their training, whereas 35.2% casually considered doing so. Poor work-life balance in residency (38.9%) was the single-most important factor, whereas concern about future unemployment (16.7%) and poor future quality of life (15.7%) were next. Enjoyment of work (41.7%) was the most frequent mitigating factor. Harassment and intimidation were reported factors in 16.7%. On analysis, only intention to practice in a nonacademic setting approached significant association with thoughts of leaving (odds ratio = 1.92, CI = 0.99-3.74, p = 0.052). There was no association with sex, program, postgraduate year, relationship status, or subspecialty interest. There was a nonsignificant trend toward more thoughts of leaving with older age. Canadian general surgery residents appear less likely to seriously consider quitting than their American counterparts. Poor work-life balance in residency, fear of future unemployment, and anticipated poor future quality of life are significant contributors to thoughts of quitting. Efforts to educate prospective residents about the reality of the surgical lifestyle, and to assist residents in securing employment, may improve completion rates. Copyright © 2016 Association of Program Directors in Surgery. Published by Elsevier Inc. All rights reserved.

  7. Learning from an Ambient Assisted Living Lab

    DEFF Research Database (Denmark)

    Bygholm, Ann; Kanstrup, Anne Marie

    2014-01-01

    -registration, diaries, observations, interviews and workshops with residents, nurses, nursing assistants, management, building officers, and purchasers from the Municipality. The paper presents an analysis within the overall themes of technology, use, and care, which is discussed by use of the SWOT framework presenting...

  8. Experience of health-system pharmacy administration residents in a longitudinal human resource management program.

    Science.gov (United States)

    Amerine, Lindsey B Poppe; Granko, Robert P; Savage, Scott W; Daniels, Rowell; Eckel, Stephen F

    2014-12-15

    The experience of health-system pharmacy administration (HSPA) residents in a longitudinal human resource (HR) management program is described. The subsequent benefits to the residents, department, and profession are also discussed. Postgraduate year 2 HSPA residents at an academic medical center desired more responsibility for managing an operational area. To this end, a program was created in which these residents directly manage a small group of pharmacy technicians and report to a clinical manager or assistant director with oversight responsibility. These "resident managers" are responsible, under the direction of the area's clinical manager, for the personnel, schedule, time and attendance, and HR activities of the area. Resident managers have led and sustained operational improvement projects in their areas. In addition to providing learning experiences to residents, the HSPA residency program has also improved the operations of the areas in which these residents work. Benefits to the residents include conducting annual performance evaluations for employees with whom they have a relationship as it is a task every administrator completes. Resident managers at UNC have consistently stated that this longitudinal HR experience is one of the most rewarding and most challenging experiences offered in the two-year HSPA residency. The involvement of HSPA residents in longitudinal management responsibilities furthers residents' leadership success by providing trained managers who are ready to immerse themselves into practice postresidency, having employee engagement and HR skills as well as experiences with leading operational improvements. A longitudinal HR management experience was successfully incorporated into an HSPA residency combined Master of Science degree program. Copyright © 2014 by the American Society of Health-System Pharmacists, Inc. All rights reserved.

  9. The Cost of Employment Discrimination against Transgender Residents of Massachusetts

    OpenAIRE

    Herman, Jody L.

    2011-01-01

    Transgender residents of Massachusetts have reported experiencing discrimination in employment. Loss of employment due to anti-transgender bias often means lost wages, lost health insurance coverage, and housing instability. Therefore, employment discrimination might affect the budget of the Commonwealth of Massachusetts in several ways: reduced income tax revenues, higher public assistance expenditures, and other costs. For instance, if a worker is fired for being transgender and loses wages...

  10. Certified Nursing Assistants’ Explanatory Models of Nursing Home Resident Depression

    OpenAIRE

    Piven, Mary Lynn; Anderson, Ruth A.; Colón-Emeric, Cathleen S.; Sandelowski, Margarete

    2008-01-01

    In this study, we explored how Certified Nursing Assistants (CNAs) understood resident depression. Interviews with 18 CNAs, working in two nursing homes were guided by Kleinman’s Explanatory Models of Illness framework. Interview data were content analyzed and CNAs’ descriptions of depression were compared to the MDS 2.0 Mood Screen and to DSM-IV-TR Depression Criteria. CNAs identified causes, signs, and symptoms of depression, but they were unsure about the duration and normalcy of depressio...

  11. AN ANALYSIS OF FIGURATIVE LANGUAGES USED IN COELHOS’S NOVEL ENTITLED “ALCHEMIST”

    Directory of Open Access Journals (Sweden)

    Trisna Dinillah Harya

    2017-05-01

    Full Text Available The title of this study is, “An Analysis of Figurative Languages Used in Paulo Coelho’s novel Entitled “The Alchemist”. The objectives of the study are to describe the types of the figurative language found in the book and to identify the contextual meaning of the figurative language. The method used in collecting the data related to the subject of this research is documentation method because the researcher collected the data from novel. This study was conducted by collecting any relevant data and information about the topic or problem of the study from novels and internet that are available for the analysis. The data collection used the following steps: reading the novel, and then selecting the data that used the types of figurative language. While the steps to analyze the data are identifying the types of figurative language according to Leech, identifying the contextual meaning of the figurative language, and the last is interpreting the data.The result shows that there are 70 sentences that have figurative language. From all the sentences, there are 30 items or 42.9% of simile, 27 items or 38.6% of personification, 12 items or 17.1% of metaphor, and 1 item or 1.4% of hyperbole. It can be indicated that the dominant type of figurative language in the novel is simile. The author uses simile to explain circumstances, to describe the characters, to express emotion of the characters, and to make his writing more vivid and entertaining. It can be concluded that figurative language has important roles in this novel. That‘s why the author used so many sentences that have figurative language in this novel. Using figurative language makes the novel more interesting to read, and helps the readers to imagine the story, the character based on the illustration that the author has already given in the story.

  12. Exclusive purpose: abstinence-only proponents create federal entitlement in welfare reform.

    Science.gov (United States)

    Daley, D

    1997-01-01

    Since 1981, the US government has funded a program promoting sexual abstinence among young people through its Office of Population's Adolescent Family Life Demonstration Grants program (AFLA). A 1983 court challenge which held that AFLA violated the separation of church and state by endorsing a particular religious viewpoint was settled out of court in 1993 with stipulations that AFLA-funded sexuality education must not include religious references, must be medically accurate, must respect the principle of self-determination of teenagers regarding contraceptive referrals, and must not be implemented on church property. Critics continue to charge that AFLA's abstinence-only programs have failed to receive proper evaluation. While AFLA has no broad-based support, it is backed by the same small group of Congressional proponents who are attempting to promote broad-scale, federally-funded abstinence-only programs. Thus, the August 1996 welfare reform legislation represents the broadest attack on the provision of comprehensive sexuality education in the US. While opponents of sexuality education could not restrict the content of education programs, they could restrict programs through health policy and funding mechanisms. Congress, thus, mandated $50 million a year for 1998-2002 to a matching grant with entitlement status, which was tagged on to final versions of the larger welfare reform bill. The intent of this action was to use federal law to change the social norm of premarital sexual activity. Funds will not go to programs which discuss contraception. Additional problems with the statute include misinformation, ambiguity, and a lack of evaluation requirements. It remains for states to decide whether to accept the restricted funds and for parties on both sides of the issue to continue to lobby for their positions.

  13. 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....

  14. Foreign assistance

    International Nuclear Information System (INIS)

    1991-07-01

    This paper reports that providing energy assistance to developing countries remains a relatively low priority of the Agency for International Development. AID is helping some developing countries meet their energy needs, but this assistance varies substantially because of the agency's decentralized structure. Most AID energy funding has gone to a handful of countries-primarily Egypt and Pakistan. With limited funding in most other countries, AID concentrates on providing technical expertise and promoting energy policy reforms that will encourage both energy efficiency and leverage investment by the private sector and other donors. Although a 1989 congressional directive to pursue a global warming initiative has had a marginal impact on the agency's energy programming, many AID energy programs, including those directed at energy conservation, help address global warming concerns

  15. Factors Associated With the Do-Not-Resuscitate Decision Among Surrogates of Elderly Residents at a Nursing Home in Taiwan

    Directory of Open Access Journals (Sweden)

    Yi-Ping Tseng

    2017-06-01

    Conclusions: The findings indicated the DNR decision was associated with residents' conditions and surrogates' factors. These information are helpful to medical personnel in nursing homes to better understand and to assist the DNR decision-making process.

  16. 20 CFR 416.986 - Why and when we will find that you are no longer entitled to benefits based on statutory blindness.

    Science.gov (United States)

    2010-04-01

    ... longer entitled to benefits based on statutory blindness. 416.986 Section 416.986 Employees' Benefits... Disability and Blindness Blindness § 416.986 Why and when we will find that you are no longer entitled to benefits based on statutory blindness. (a) If your vision does not meet the definition of blindness. If you...

  17. College instruction is not so stress free after all: A qualitative and quantitative study of academic entitlement, uncivil behaviors, and instructor strain and burnout.

    Science.gov (United States)

    Jiang, Lixin; Tripp, Thomas M; Hong, Phan Y

    2017-12-01

    The vast majority of today's college students are millennials, who have traits of confidence, tolerance, but also of entitlement and narcissism (Twenge, 2006). Therefore, college instructors face a unique challenge: dealing with the requests from academically entitled students, who have unreasonable expectations of receiving academic success, regardless of performance (Chowning & Campbell, 2009). We conducted two studies to examine whether student academic entitlement would increase instructors' strain and burnout via uncivil behaviors. A qualitative inquiry asked 136 instructors with college-teaching experience to describe types of behaviors entitled students display, their responses to entitled students, and the influence of these interactions on instructors' well-being. Next, a quantitative study with data from 857 college students nested in 34 instructors tested a multilevel mediation model where students' academic entitlement was related to instructor-reported uncivil behaviors, which in turn related to instructors' strain and burnout. Both studies largely support our hypothesis that uncivil behaviors fully mediate the relationship between students' academic entitlement and instructors' strain and burnout. We recommend employing behavioral modification strategies to decrease uncivil behaviors (e.g., class rules regarding uncivil behaviors might be specified in the course syllabus and consistently enforced) because academic entitlement attitudes are largely stable beliefs and thus may be less amenable to modification. Copyright © 2017 John Wiley & Sons, Ltd.

  18. 38 CFR 3.1000 - Entitlement under 38 U.S.C. 5121 to benefits due and unpaid upon death of a beneficiary.

    Science.gov (United States)

    2010-07-01

    ... 38 Pensions, Bonuses, and Veterans' Relief 1 2010-07-01 2010-07-01 false Entitlement under 38 U.S.C. 5121 to benefits due and unpaid upon death of a beneficiary. 3.1000 Section 3.1000 Pensions... Dependency and Indemnity Compensation Accrued § 3.1000 Entitlement under 38 U.S.C. 5121 to benefits due and...

  19. Implementing a Universal Well-Being Assessment to Mitigate Barriers to Resident Utilization of Mental Health Resources.

    Science.gov (United States)

    Sofka, Sarah; Grey, Carl; Lerfald, Nathan; Davisson, Laura; Howsare, Janie

    2018-02-01

    Physician utilization of well-being resources remains low despite efforts to promote use of these resources. We implemented a well-being assessment for internal medicine residents to improve access and use of mental health services. We scheduled all postgraduate year 1 (PGY-1) and PGY-2 residents at West Virginia University for the assessment at our faculty and staff assistance program (FSAP). While the assessment was intended to be universal (all residents), we allowed residents to "opt out." The assessment visit consisted of an evaluation by a licensed therapist, who assisted residents with a wellness plan. Anonymous surveys were distributed to all residents, and means were compared by Student's t test. Thirty-eight of 41 PGY-1 and PGY-2 residents (93%) attended the scheduled appointments. Forty-two of 58 residents (72%, including PGY-3s) completed the survey. Of 42 respondents, 28 (67%) attended the assessment sessions, and 14 (33%) did not. Residents who attended the sessions gave mean ratings of 7.8 for convenience (1, not convenient, to 9, very convenient), and 7.9 for feeling embarrassed if colleagues knew they attended (1, very embarrassed, to 9, not embarrassed). Residents who attended the assessment sessions reported they were more likely to use FSAP services in the future, compared with those who did not attend ( P  barriers to using counseling resources. The majority of residents who participated had a positive view of the program and indicated they would return to FSAP if they felt they needed counseling.

  20. The diagnosis of depression and use of antidepressants in nursing home residents with and without dementia.

    Science.gov (United States)

    van Asch, Iris F M; Nuyen, Jasper; Veerbeek, Marjolein A; Frijters, Dinnus H M; Achterberg, Wilco P; Pot, Anne Margriet

    2013-03-01

    To compare the prevalence of diagnosed depressive disorders, depressive symptoms and use of antidepressant medication between nursing home residents with and without dementia. This cross-sectional study used Minimal Data Set of the Resident Assessment Instrument 2.1 data collected in seven nursing homes located in an urbanized region in the Netherlands. Trained nurse assistants recorded all medical diagnoses made by a medical specialist, including dementia and depressive disorder, and medication use. Depressive symptoms were measured with the Depression Rating Scale. Multivariate logistic regression analysis was used to compare data between residents with and without dementia. Included in the study were 1885 nursing home residents (aged 65 years or older), of which 837 had dementia. There was no significant difference in the prevalence of diagnosed depressive disorder between residents with (9.6%) and without dementia (9.8%). Residents with dementia (46.4%) had more depressive symptoms than residents without dementia (22.6%). Among those with depressive symptoms, residents with dementia had the same likelihood of being diagnosed with a depressive disorder as residents without dementia. Among residents with a diagnosed depressive disorder, antidepressant use did not differ significantly between residents with dementia (58.8%) and without dementia (57.3%). The same holds true for residents with depressive symptoms, where antidepressant use was 25.3% in residents with dementia and 24.6% in residents without dementia. Regarding the prevalence rates of diagnosed depressive disorder and antidepressant use found in this study, our findings demonstrate that there is room for improvement not only for the detection of depression but also with regard to its treatment. Copyright © 2012 John Wiley & Sons, Ltd.

  1. 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

  2. Performance criteria for emergency medicine residents: a job analysis.

    Science.gov (United States)

    Blouin, Danielle; Dagnone, Jeffrey Damon

    2008-11-01

    A major role of admission interviews is to assess a candidate's suitability for a residency program. Structured interviews have greater reliability and validity than do unstructured ones. The development of content for a structured interview is typically based on the dimensions of performance that are perceived as important to succeed in a particular line of work. A formal job analysis is normally conducted to determine these dimensions. The dimensions essential to succeed as an emergency medicine (EM) resident have not yet been studied. We aimed to analyze the work of EM residents to determine these essential dimensions. The "critical incident technique" was used to generate scenarios of poor and excellent resident performance. Two reviewers independently read each scenario and labelled the performance dimensions that were reflected in each. All labels assigned to a particular scenario were pooled and reviewed again until a consensus was reached. Five faculty members (25% of our total faculty) comprised the subject experts. Fifty-one incidents were generated and 50 different labels were applied. Eleven dimensions of performance applied to at least 5 incidents. "Professionalism" was the most valued performance dimension, represented in 56% of the incidents, followed by "self-confidence" (22%), "experience" (20%) and "knowledge" (20%). "Professionalism," "self-confidence," "experience" and "knowledge" were identified as the performance dimensions essential to succeed as an EM resident based on our formal job analysis using the critical incident technique. Performing a formal job analysis may assist training program directors with developing admission interviews.

  3. Preresidency publication record and its association with publishing during paediatric residency.

    Science.gov (United States)

    Gupta, Ronish; Norris, Mark Lorne; Writer, Hilary

    2016-05-01

    To determine whether an association exists between the publication of journal articles before and during paediatrics residency. A retrospective search of PubMed was conducted for publications by all 567 Canadian paediatricians certified between 2009 and 2012, inclusive. Paediatricians were separated into groups based on the number of articles published preresidency (0 or ≥1) and during residency (0 or ≥1). The methodology was validated using a group of local paediatricians who were contacted to verify whether their publications were identified accurately. A total of 160 of 567 (28%) certified paediatricians had preresidency publications; of these, 93 (58%) subsequently published during their residency period. Among the remaining 407 (72%) paediatricians without preresidency publications, 129 (32%) published during residency. The association between publication before and during paediatric residency was statistically significant (OR 2.98 [95% CI 2.04 to 4.36]; Ppublication status with 87% and 90% accuracy, respectively. Individuals with previous publications were more likely to publish as residents; however, 42% of individuals with pre-residency publications did not publish as residents. Residency selection committees may find these data helpful in assessing the publication potential of their applicants. In addition, this information may assist in building more targeted and individualized research curricula within residency programs.

  4. Cost of Incremental Expansion of an Existing Family Medicine Residency Program.

    Science.gov (United States)

    Ashkin, Evan A; Newton, Warren P; Toomey, Brian; Lingley, Ronald; Page, Cristen P

    2017-07-01

    Expanding residency training programs to address shortages in the primary care workforce is challenged by the present graduate medical education (GME) environment. The Medicare funding cap on new GME positions and reductions in the Health Resources and Services Administration (HRSA) Teaching Health Center (THC) GME program require innovative solutions to support primary care residency expansion. Sparse literature exists to assist in predicting the actual cost of incremental expansion of a family medicine residency program without federal or state GME support. In 2011 a collaboration to develop a community health center (CHC) academic medical partnership (CHAMP), was formed and created a THC as a training site for expansion of an existing family medicine residency program. The cost of expansion was a critical factor as no Federal GME funding or HRSA THC GME program support was available. Initial start-up costs were supported by a federal grant and local foundations. Careful financial analysis of the expansion has provided actual costs per resident of the incremental expansion of the residencyRESULTS: The CHAMP created a new THC and expanded the residency from eight to ten residents per year. The cost of expansion was approximately $72,000 per resident per year. The cost of incremental expansion of our residency program in the CHAMP model was more than 50% less than that of the recently reported cost of training in the HRSA THC GME program.

  5. Public access to New Hampshire state waters: a comparison of three cohorts of residents across three distinct geographic

    Science.gov (United States)

    Kim Pawlawski; Robert A. Robertson; Laura Pfister

    2003-01-01

    This study was intended to provide New Hampshire agencies with a better understanding of public access-related demand information. Through an analysis of three groups of New Hampshire residents based upon geographic location and length of residency, important issues and attitudes were identified from all over the State. The results of this study will assist in policy-...

  6. An integrated model to measure service management and physical constraints' effect on food consumption in assisted-living facilities.

    Science.gov (United States)

    Huang, Hui-Chun; Shanklin, Carol W

    2008-05-01

    The United States is experiencing remarkable growth in the elderly population, which provides both opportunities and challenges for assisted-living facilities. The objective of this study was to explore how service management influences residents' actual food consumption in assisted-living facilities. Physical factors influencing residents' service evaluation and food consumption also were investigated. A total of 394 questionnaires were distributed to assisted-living residents in seven randomly selected facilities. The questionnaire was developed based on an in-depth literature review and pilot study. Residents' perceived quality evaluations, satisfaction, and physical constraints were measured. Residents' actual food consumption was measured using a plate waste technique. A total of 118 residents in five facilities completed both questionnaires and food consumption assessments. Descriptive, multivariate analyses and structural equation modeling techniques were employed. Service management, including food and service quality and customer satisfaction, was found to significantly influence residents' food consumption. Physical constraints associated with aging, including a decline in health status, chewing problems, sensory loss, and functional disability, also significantly influenced residents' food consumption. A significant relationship was found between physical constraints and customer satisfaction. Foodservice that provides good food and service quality increases customer satisfaction and affects residents' actual food consumption. Physical constraints also influence residents' food consumption directly, or indirectly through satisfaction. The findings suggest that food and nutrition professionals in assisted-living should consider the physical profiles of their residents to enhance residents' satisfaction and nutrient intake. Recommendations for exploring residents' perspectives are discussed.

  7. Assisted Suicide in Switzerland: Clarifying Liberties and Claims.

    Science.gov (United States)

    Hurst, Samia A; Mauron, Alex

    2017-03-01

    Assisting suicide is legal in Switzerland if it is offered without selfish motive to a person with decision-making capacity. Although the 'Swiss model' for suicide assistance has been extensively described in the literature, the formally and informally protected liberties and claims of assistors and recipients of suicide assistance in Switzerland are incompletely captured in the literature. In this article, we describe the package of rights involved in the 'Swiss model' using the framework of Hohfeldian rights as modified by Wenar. After outlining this framework, we dissect the rights involved in suicide assistance in Switzerland, and compare it with the situation in England and Germany. Based on this approach, we conclude that in Switzerland, claim rights exist for those requesting suicide assistance, and for those who are considering providing such assistance, even though no entitlements exist toward suicide assistance. We then describe the implementation of the 'Swiss model' and difficulties arising within it. Clarifying these issues is important to understand the Swiss situation, to evaluate what features of it may or may not be worth correcting or emulating, and to understand how it can impact requests for suicide assistance in other countries due to 'suicide tourism'. It is also important to understand exactly what sets Switzerland apart from other countries with different legislations regarding suicide assistance. © 2016 John Wiley & Sons Ltd.

  8. Transfer of single farm payment entitlements to farm successors: impact on structural change and rental prices in Switzerland

    Directory of Open Access Journals (Sweden)

    Gabriele Mack

    2013-09-01

    Full Text Available This paper analyses the impact of tradable and non-tradable single farm payment (SFP entitlements for farm successors on structural change and the lease market. Using the example of Swiss agriculture, the effects on rental-price trends and farm-exit rates are investigated. An ex-ante normative impact analysis is performed with the agent-based agricultural-sector model SWISSland, which simulates structural change processes and income trends in Swiss agriculture over a period of up to 15 years. A land market implemented at municipality level simulates the plot-by-plot leasing of land to surrounding neighbouring agents that is common in Switzerland. Allocation of plots to tenants as well as lease pricing is modelled taking into account the farm-specific land rents. The results show that personalised SFP entitlements which could not be transferred to a farm successor not only cause an intensification of structural change, but would also thus lead to a substantial reduction in rental prices. SFP entitlements which were successfully transferred to farm successors have only a slight impact on structural change and the rental prices of arable land. Only for grassland in the mountain region does a stronger shift result in a significant reduction in rental prices.

  9. Entitlement to vote in the Cantons of Geneva and Vaud and eligibility for election in the Canton of Vaud

    CERN Multimedia

    2006-01-01

    The Permanent Mission of Switzerland has informed CERN that some international civil servants and members of their families are henceforth entitled to vote on commune matters in the Canton of Geneva and are entitled to vote and are eligible for election at commune level in the Canton of Vaud. For further information, in particular regarding the special procedure to be followed to apply to exercise this entitlement, you are invited to consult the information published, in French only, on the Swiss Mission's website: http://www.dfae.admin.ch/eda/fr/home/topics/intorg/un/unge/gepri/manvot/manvt1.html (for the Canton of Geneva), http://www.eda.admin.ch/eda/fr/home/topics/intorg/un/unge/gepri/manvot/manvt2.html (for the Canton of Vaud), In this regard, you are reminded that: Under Articles I 3.05 and I 3.07 of the Staff Rules, a member of the personnel 'may take part, outside the Organization, in the public and political life of a State in accordance with the relevant legislation' and 'express his own person...

  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. Communication of 1 October 2009 received from the Resident Representative of Hungary to the Agency on behalf of the Participating Governments of the Nuclear Suppliers Group

    International Nuclear Information System (INIS)

    2009-01-01

    The Director General has received a letter dated 1 October 2009 from the Resident Representative of Hungary to the Agency on behalf of the Participating Governments of the Nuclear Suppliers Group. Attached to this letter is an updated version of a paper entitled 'The Nuclear Suppliers Group: Its Origins, Role and Activities.' The original version of this paper was issued as INFCIRC/539 on 15 September 1997: revisions were issued on 17 April 2000, 16 September 2003 and 30 May 2005

  12. Communication of 1 October 2009 received from the Resident Representative of Hungary to the Agency on behalf of the Participating Governments of the Nuclear Suppliers Group

    International Nuclear Information System (INIS)

    2009-01-01

    The Director General has received a letter dated 1 October 2009 from the Resident Representative of Hungary to the Agency on behalf of the Participating Governments of the Nuclear Suppliers Group. Attached to this letter is an updated version of a paper entitled 'The Nuclear Suppliers Group: Its Origins, Role and Activities.' The original version of this paper was issued as INFCIRC/539 on 15 September 1997: revisions were issued on 17 April 2000, 16 September 2003 and 30 May 2005 [es

  13. 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.

  14. 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.

  15. 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, ...

  16. 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.

  17. 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.

  18. 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.

  19. Nursing Assistants for Long-Term Care. Performance-Based Instructional Materials.

    Science.gov (United States)

    Indiana Univ., Bloomington. Vocational Education Services.

    This guide is intended to assist students enrolled in programs to train nursing assistants for employment in an Indiana long-term health care facility. The first part discusses human development (growth, aging, and dying); communication with residents; sexuality; legal, ethical, and professional responsibilities of nursing assistants in long-term…

  20. An Entitlement Approach to Address the Water-Energy-Food Nexus in Rural India

    Science.gov (United States)

    Siegfried, T. U.; Fishman, R.; Modi, V.; Lall, U.

    2008-12-01

    prices and rainfall patterns due to climate change only enhance these concerns. Given these deficiencies, any corrective strategy should at least target the following long-term policy goals: a) increase the efficiency of rural electricity consumption in terms of grain production and rural income, b) providing the farmers greater flexibility with timely, high quality energy and more efficient means of production, c) enable proper energy accounting on the use side so as to recover costs at sufficient levels for the SEBs and thus enable long-term investments in energy infrastructure and d) secure and eventually increase agricultural production without depleting groundwater resources over the long run. We will present an entitlement approach with which the above issues can be addressed in the future. A case study example from the semi-arid Telangana Region in Andhra Pradesh will be discussed in depth and preliminary results shown.

  1. The assisted presentations of self in nursing home life.

    Science.gov (United States)

    Næss, Anders; Fjær, Eivind Grip; Vabø, Mia

    2016-02-01

    In this paper, based on ethnographic data from five nursing homes, we introduce the concept of assisted self-presentation as an analytical tool for exploring how different care practices affect nursing home residents' dignity and sense of self. Practices of assisted self-presentation are geared at recognizing and preserving the individuality and autonomy of residents in situations where it may otherwise come under threat or be misrecognized. Sufficient or appropriate forms of attentiveness to residents' selves and sense of dignity is thus a matter of finding the right balance between intervening too much or too little in residents' production of their physical or social appearance. Here, staff-members' knowledge and recognition of the individuality of residents is essential. Whereas intervening too much in residents' appearance or performance of self might be perceived and experienced as pacifying, infantilizing, or as paternalistic overbearingness, intervening too little might be seen as neglectfulness or inhumane. Since practices of assisted self-presentation refer to a kind of social action, which will always be contingent upon the specific capacities and conditions of performing actors, it allows for the simultaneous recognition of failed or perverted work practices as well as promising practices through which residents' selves are successfully recognized. Copyright © 2015 Elsevier Ltd. All rights reserved.

  2. 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.

  3. 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)

  4. Use of computers and the Internet by residents in US family medicine programmes.

    Science.gov (United States)

    King, Richard V; Murphy-Cullen, Cassie L; Mayo, Helen G; Marcee, Alice K; Schneider, Gregory W

    2007-06-01

    Computers, personal digital assistants (PDA), and the Internet are widely used as resources in medical education and clinical care. Educators who intend to incorporate these resources effectively into residency education programmes can benefit from understanding how residents currently use these tools, their skills, and their preferences. The researchers sent questionnaires to 306 US family medicine residency programmes for all of their residents to complete. Respondents were 1177 residents from 125 (41%) programmes. Access to a computer was reported by 95% of respondents. Of these, 97% of desktop and 89% of laptop computers could access the Internet. Residents accessed various educational and clinical resources. Half felt they had 'intermediate' skills at Web searches, 23% had 'some skills,' and 27% were 'quite skilled.' Those under 30 years of age reported higher skill levels. Those who experienced a Web-based curriculum in medical school reported higher search skills and greater success in finding clinical information. Respondents preferred to use technology to supplement the didactic sessions offered in resident teaching conferences. Favourable conditions exist in family medicine residency programmes to implement a blend of traditional and technology-based learning experiences. These conditions include residents' experience, skills, and preferences.

  5. A novel mentorship programme for residents integrating academic development, clinical teaching and graduate medical education assessment.

    Science.gov (United States)

    Bhatia, Kriti; Takayesu, James Kimo; Nadel, Eric S

    2016-02-01

    Mentorship fosters career development and growth. During residency training, mentorship should support clinical development along with intellectual and academic interests. Reported resident mentoring programmes do not typically include clinical components. We designed a programme that combines academic development with clinical feedback and assessment in a four-year emergency medicine residency programme. Incoming interns were assigned an advisor. At the conclusion of the intern year, residents actively participated in selecting a mentor for the duration of residency. The programme consisted of quarterly meetings, direct clinical observation and specific competency assessment, assistance with lecture preparation, real-time feedback on presentations, simulation coaching sessions, and discussions related to career development. Faculty participation was recognized as a valuable component of the annual review process. Residents were surveyed about the overall programme and individual components. Over 88 % of the respondents said that the programme was valuable and should be continued. Senior residents most valued the quarterly meetings and presentation help and feedback. Junior residents strongly valued the clinical observation and simulation sessions. A comprehensive mentorship programme integrating clinical, professional and academic development provides residents individualized feedback and coaching and is valued by trainees. Individualized assessment of clinical competencies can be conducted through such a programme.

  6. Charting the Road to Competence: Developmental Milestones for Internal Medicine Residency Training

    Science.gov (United States)

    Green, Michael L.; Aagaard, Eva M.; Caverzagie, Kelly J.; Chick, Davoren A.; Holmboe, Eric; Kane, Gregory; Smith, Cynthia D.; Iobst, William

    2009-01-01

    Background The Accreditation Council for Graduate Medical Education (ACGME) Outcome Project requires that residency program directors objectively document that their residents achieve competence in 6 general dimensions of practice. Intervention In November 2007, the American Board of Internal Medicine (ABIM) and the ACGME initiated the development of milestones for internal medicine residency training. ABIM and ACGME convened a 33-member milestones task force made up of program directors, experts in evaluation and quality, and representatives of internal medicine stakeholder organizations. This article reports on the development process and the resulting list of proposed milestones for each ACGME competency. Outcomes The task force adopted the Dreyfus model of skill acquisition as a framework the internal medicine milestones, and calibrated the milestones with the expectation that residents achieve, at a minimum, the “competency” level in the 5-step progression by the completion of residency. The task force also developed general recommendations for strategies to evaluate the milestones. Discussion The milestones resulting from this effort will promote competency-based resident education in internal medicine, and will allow program directors to track the progress of residents and inform decisions regarding promotion and readiness for independent practice. In addition, the milestones may guide curriculum development, suggest specific assessment strategies, provide benchmarks for resident self-directed assessment-seeking, and assist remediation by facilitating identification of specific deficits. Finally, by making explicit the profession's expectations for graduates and providing a degree of national standardization in evaluation, the milestones may improve public accountability for residency training. PMID:21975701

  7. Surgical resident perceptions of trauma surgery as a specialty.

    Science.gov (United States)

    Hadzikadic, Lejla; Burke, Peter A; Esposito, Thomas J; Agarwal, Suresh

    2010-05-01

    Presenting the opinions of surgical residents about the appeal of trauma surgery as a specialty may influence current reform. Survey study. Academic research. General surgery residents (postgraduate years 1-5 and recent graduates) registered with the American College of Surgeons. A 22-item survey. Career plans and perceptions about trauma surgery as a specialty. Of 6006 mailed surveys, we had a 20.1% response rate. Midlevel residents comprised most of the respondents, and most were undecided about their career choice or planned to enter general surgical private practice. The typical residency programs represented were academic (81.7%), urban (90.6%), and level I trauma centers (78.7%), and included more than 6 months of trauma experience (77.6%). Most respondents (70.6%) thought that trauma surgery was unappealing. The most important deterrents to entering the field were lifestyle, poor reimbursement, and limited operating room exposure, while increased surgical critical care was not seen as a restriction. When questioned about the future of trauma surgery, they believed that trauma surgeons should perform elective (86.8%) and nontrauma emergency (91.5%) cases and would benefit from active association with an outpatient clinic (76.0%). Intellectual challenge and exciting nature of the field were listed as the most appealing aspects, and ideal practice characteristics included guaranteed salary and time away from work. As demand for trauma surgeons increases, resident interest has dwindled. As a specialty, trauma surgery must undergo changes that reflect the needs of the incoming generation. We present a sampling of current surgical resident opinion and offer these data to assist the changing discipline and the evolving field of acute care surgery.

  8. Assessing and counseling the obese patient: Improving resident obesity counseling competence.

    Science.gov (United States)

    Iyer, Shwetha; Jay, Melanie; Southern, William; Schlair, Sheira

    To evaluate obesity counseling competence among residents in a primary care training program METHODS: We delivered a 3h obesity curriculum to 28 Primary Care residents and administered a pre-curriculum and post curriculum survey looking specifically at self-assessed obesity counseling competence. Nineteen residents completed both the pre curriculum survey and the post curriculum survey. The curriculum had a positive impact on residents' ability to ascertain patient's stage of change, use different methods to obtain diet history (including 24h recall, food record or food frequency questionnaire), respond to patient's questions regarding treatment options, assist patients in setting realistic goals for weight loss based on making permanent lifestyle changes, and use of motivational interviewing to change behavior. When looking at the 5As domains, there was a significant improvement in the domains of Assess, Advise, and Assist. The proportion of residents with a lower level of self-assessed obesity counseling competence reduced from 75% before the curriculum to 37.5% (p=0.04) after the curriculum. Our curriculum addressing weight loss counseling using the 5As model increased obesity counseling competence among residents in a primary care internal medicine residency program. Copyright © 2018 Asia Oceania Association for the Study of Obesity. Published by Elsevier Ltd. All rights reserved.

  9. Pros and cons of using paid feeding assistants in nursing homes.

    Science.gov (United States)

    Remsburg, Robin E

    2004-01-01

    Recently the Centers for Medicare and Medicaid Services (CMS), citing increasing resident acuity, staffing shortages, and high turnover rates that make it difficult for nursing homes to provide adequate feeding assistance to residents who need minimal help at mealtimes, began allowing nursing facilities to use single-task workers to provide assistance during mealtimes. This article describes the use of single-task workers to provide feeding assistance to nutritionally at-risk residents during a 6-month clinical study designed to evaluate the effectiveness and feasibility of implementing a buffet-dining program in an academic long-term care facility.

  10. Perspectives on the changing healthcare system: teaching systems-based practice to medical residents

    Directory of Open Access Journals (Sweden)

    Johanna Martinez

    2013-09-01

    Full Text Available Purpose: The Accreditation Council for Graduate Medical Education restructured its accreditation system to be based on educational outcomes in six core competencies. Systems-based practice is one of the six core competencies. The purpose of this report is to describe Weill Cornell Medical College's Internal Medicine Residency program curriculum for systems-based practice (SBP and its evaluation process. Methods: To examine potential outcomes of the POCHS curriculum, an evaluation was conducted, examining participants': (1 knowledge gain; (2 course ratings; and (3 qualitative feedback. Results: On average, there was a 19 percentage point increase in knowledge test scores for all three cohorts. The course was rated overall highly, receiving an average of 4.6 on a 1–5 scale. Lastly, the qualitative comments supported that the material is needed and valued. Conclusion: The course, entitled Perspectives on the Changing Healthcare System (POCHS and its evaluation process support that systems-based practice is crucial to residency education. The course is designed not only to educate residents about the current health care system but also to enable them to think critically about the risk and benefits of the changes. POCHS provides a framework for teaching and assessing this competency and can serve as a template for other residency programs looking to create or restructure their SBP curriculum.

  11. Debt management and financial planning support for primary care students and residents at Boston University School of Medicine.

    Science.gov (United States)

    Terrell, C; Hindle, D

    1999-01-01

    Boston University Medical Center created the Office of Residency Planning and Practice Management as part of The Robert Wood Johnson Foundation's Generalist Physician Initiative. Since 1995, the office has improved the medical center's ability to promote and support the generalist career decisions of its students and residents by removing indebtedness as a disincentive. After a brief review of the relationship between indebtedness and specialty selection, the authors delineate the nature and volume of debt-management assistance provided by the office to students and residents through individual counseling sessions, workshops, and other means between April 1995 and March 1998. A case study shows the progression of these services throughout residency training. The medical center also coordinates its debt-management assistance with counseling from physician-oriented financial planning groups. In conclusion, the authors discuss several characteristics of a successful debt-management program for residents.

  12. Surgical resident technical skill self-evaluation: increased precision with training progression.

    Science.gov (United States)

    Quick, Jacob A; Kudav, Vishal; Doty, Jennifer; Crane, Megan; Bukoski, Alex D; Bennett, Bethany J; Barnes, Stephen L

    2017-10-01

    Surgical resident ability to accurately evaluate one's own skill level is an important part of educational growth. We aimed to determine if differences exist between self and observer technical skill evaluation of surgical residents performing a single procedure. We prospectively enrolled 14 categorical general surgery residents (six post-graduate year [PGY] 1-2, three PGY 3, and five PGY 4-5). Over a 6-month period, following each laparoscopic cholecystectomy, residents and seven faculty each completed the Objective Structured Assessment of Technical Skills (OSATS). Spearman's coefficient was calculated for three groups: senior (PGY 4-5), PGY3, and junior (PGY 1-2). Rho (ρ) values greater than 0.8 were considered well correlated. Of the 125 paired assessments (resident-faculty each evaluating the same case), 58 were completed for senior residents, 54 for PGY3 residents, and 13 for junior residents. Using the mean from all OSATS categories, trainee self-evaluations correlated well to faculty (senior ρ 0.97, PGY3 ρ 0.9, junior ρ 0.9). When specific OSATS categories were analyzed, junior residents exhibited poor correlation in categories of respect for tissue (ρ -0.5), instrument handling (ρ 0.71), operative flow (ρ 0.41), use of assistants (ρ 0.05), procedural knowledge (ρ 0.32), and overall comfort with the procedure (ρ 0.73). PGY3 residents lacked correlation in two OSATS categories, operative flow (ρ 0.7) and procedural knowledge (ρ 0.2). Senior resident self-evaluations exhibited strong correlations to observers in all areas. Surgical residents improve technical skill self-awareness with progressive training. Less-experienced trainees have a tendency to over-or-underestimate technical skill. Copyright © 2017 Elsevier Inc. All rights reserved.

  13. First Author Research Productivity of United States Radiation Oncology Residents: 2002-2007

    International Nuclear Information System (INIS)

    Morgan, Peter B.; Sopka, Dennis M.; Kathpal, Madeera; Haynes, Jeffrey C.; Lally, Brian E.; Li, Linna

    2009-01-01

    Purpose: Participation in investigative research is a required element of radiation oncology residency in the United States. Our purpose was to quantify the first author research productivity of recent U.S. radiation oncology residents during their residency training. Methods and Materials: We performed a computer-based search of PubMed and a manual review of the proceedings of the annual meetings of the American Society for Therapeutic Radiology and Oncology to identify all publications and presented abstracts with a radiation oncology resident as the first author between 2002 and 2007. Results: Of 1,098 residents trained at 81 programs, 50% published ≥1 article (range, 0-9), and 53% presented ≥1 abstract (range, 0-3) at an American Society for Therapeutic Radiology and Oncology annual meeting. The national average was 1.01 articles published and 1.09 abstracts presented per resident during 4 years of training. Of 678 articles published, 82% represented original research and 18% were review articles. Residents contributed 15% of all abstracts at American Society for Therapeutic Radiology and Oncology annual meetings, and the resident contribution to orally presented abstracts increased from 12% to 21% during the study period. Individuals training at programs with >6 residents produced roughly twice as many articles and abstracts. Holman Research Pathway residents produced double the national average of articles and abstracts. Conclusion: Although variability exists among individuals and among training programs, U.S. radiation oncology residents routinely participate in investigative research suitable for publication or presentation at a scientific meeting. These data provide national research benchmarks that can assist current and future radiation oncology residents and training programs in their self-assessment and research planning.

  14. The role of librarians in teaching evidence-based medicine to pediatric residents: a survey of pediatric residency program directors.

    Science.gov (United States)

    Boykan, Rachel; Jacobson, Robert M

    2017-10-01

    The research sought to identify the general use of medical librarians in pediatric residency training, to define the role of medical librarians in teaching evidence-based medicine (EBM) to pediatric residents, and to describe strategies and curricula for teaching EBM used in pediatric residency training programs. We sent a 13-question web-based survey through the Association of Pediatric Program Directors to 200 pediatric residency program directors between August and December 2015. A total of 91 (46%) pediatric residency program directors responded. Most (76%) programs had formal EBM curricula, and more than 75% of curricula addressed question formation, searching, assessment of validity, generalizability, quantitative importance, statistical significance, and applicability. The venues for teaching EBM that program directors perceived to be most effective included journal clubs (84%), conferences (44%), and morning report (36%). While 80% of programs utilized medical librarians, most of these librarians assisted with scholarly or research projects (74%), addressed clinical questions (62%), and taught on any topic not necessarily EBM (58%). Only 17% of program directors stated that librarians were involved in teaching EBM on a regular basis. The use of a librarian was not associated with having an EBM curriculum but was significantly associated with the size of the program. Smaller programs were more likely to utilize librarians (100%) than were medium (71%) or large programs (75%). While most pediatric residency programs have an EBM curriculum and engage medical librarians in various ways, librarians' expertise in teaching EBM is underutilized. Programs should work to better integrate librarians' expertise, both in the didactic and clinical teaching of EBM.

  15. Nursing home work practices and nursing assistants' job satisfaction.

    Science.gov (United States)

    Bishop, Christine E; Squillace, Marie R; Meagher, Jennifer; Anderson, Wayne L; Wiener, Joshua M

    2009-10-01

    To estimate the impact of nursing home work practices, specifically compensation and working conditions, on job satisfaction of nursing assistants employed in nursing homes. Data are from the 2004 National Nursing Assistant Survey, responses by the nursing assistants' employers to the 2004 National Nursing Home Survey, and county-level data from the Area Resource File. Multinomial logistic regression was used to estimate effects of compensation and working conditions on nursing assistants' overall job satisfaction, controlling for personal characteristics and local labor market characteristics. Wages, benefits, and job demands, measured by the ratio of nursing assistant hours per resident day, were associated with job satisfaction. Consistent with previous studies, job satisfaction was greater when nursing assistants felt respected and valued by their employers and had good relationships with supervisors. Nursing assistants were more satisfied when they had enough time to complete their work, when their work was challenging, when they were not subject to mandatory overtime, and where food was not delivered to residents on trays. This is the first investigation of nursing assistant job satisfaction using a nationally representative sample of nursing assistants matched to information about their employing nursing homes. The findings corroborate results of previous studies in showing that compensation and working conditions that provide respect, good relationships with supervisors, and better staffing levels are important to nursing assistant job satisfaction.

  16. Governing atmospheric sinks: the architecture of entitlements in the global commons

    Directory of Open Access Journals (Sweden)

    Jouni Paavola

    2008-07-01

    Full Text Available This article revisits key works on the management of common-pool resources under common property arrangements, in order to elicit a broader notion of collective ownership for analysing institutional arrangements that govern the use of large-scale environmental resources such as biodiversity and atmospheric sinks. The article proposes a model for analysing the institutional design of governance solutions which draws attention to 1 tiers and levels, 2 organisation of generic governance functions, and 3 formulation of specific institutional rules. The article exemplifies these analytical solutions by examining the emerging governance framework for global atmospheric sinks. The article indicates how crucial parts of the institutional framework for governing atmospheric sinks are still missing, a shortcoming which maintains the ‘‘tragedy of the commons’’ in their use. The article suggests that a workable governance solution for global atmospheric sinks has to 1 cap the use of atmospheric sinks; 2 provide for a more equitable benefit sharing; 3 provide for compensation of climate change impacts and assistance for adaptation to climate change impacts; and 4 create institutional solutions for enhancing participation in environmental decisions in order to guarantee progress in and legitimacy of the governance framework.

  17. 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.

  18. 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.

  19. Informing resource-poor populations and the delivery of entitled health and social services in rural India: a cluster randomized controlled trial.

    Science.gov (United States)

    Pandey, Priyanka; Sehgal, Ashwini R; Riboud, Michelle; Levine, David; Goyal, Madhav

    2007-10-24

    A lack of awareness about entitled health and social services may contribute to poor delivery of such services in developing countries, especially among individuals of low socioeconomic status. To determine the impact of informing resource-poor rural populations about entitled services. Community-based, cluster randomized controlled trial conducted from May 2004 to May 2005 in 105 randomly selected village clusters in Uttar Pradesh state in India. Households (548 intervention and 497 control) were selected by a systematic sampling design, including both low-caste and mid- to high-caste households. Four to 6 public meetings were held in each intervention village cluster to disseminate information on entitled health services, entitled education services, and village governance requirements. No intervention took place in control village clusters. Visits by nurse midwife; prenatal examinations, tetanus vaccinations, and prenatal supplements received by pregnant women; vaccinations received by infants; excess school fees charged; occurrence of village council meetings; and development work in villages. At baseline, there were no significant differences in self-reported delivery of health and social services. After 1 year, intervention villagers reported better delivery of several services compared with control villagers: in a multivariate analysis, 30% more prenatal examinations (95% confidence interval [CI], 17%-43%; P India about entitled services enhanced the delivery of health and social services among both low- and mid- to high-caste households. Interventions that emphasize educating resource-poor populations about entitled services may improve the delivery of such services. clinicaltrials.gov Identifier: NCT00421291.

  20. 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.

  1. [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.

  2. 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

  3. Evaluation of ethics education in obstetrics and gynecology residency programs.

    Science.gov (United States)

    Byrne, John; Straub, Heather; DiGiovanni, Laura; Chor, Julie

    2015-03-01

    education in residency training. Therefore, additional resources are needed to assist program directors in enhancing resident ethics education. Copyright © 2015 Elsevier Inc. All rights reserved.

  4. Working hours of surgical residence: perspective of a group of surgeons in a regional hospital in Hong Kong.

    Science.gov (United States)

    Lo, Siu-Fai; Spurgeon, Peter

    2007-01-01

    The Accreditation Council for Graduate Medical Education and European working time directive have restricted residents' workweek to 80 and 48 hours, respectively. Impacts on resident's training and health services are under evaluation in western countries. However, relevant studies are deficient in Hong Kong. Surgeons in a regional hospital of Hong Kong were recruited. Opinions were collected by semi-structured questionnaire. Response rate was 82%. Most respondents agreed that residents' work hours should be limited. Seventy-two percent thought that the addition of physician assistants, nurse practitioners and ancillary staff could help decrease the workload of residents. More than 60% thought that residents should have post-call afternoon off. Seventy-two percent worried that the number of operations residents performed would decrease. Only half agreed that long work hours was part of resident training and 56.3% agreed that the training period should be lengthened because of limiting work hours. Ninety-four percent agreed that sleep-deprived residents would create more medical errors; 72% thought that long work hours would impair quality of care. Surprisingly, only 28% thought that limiting work hours would compromise continued patient care. Most respondents opine that resident work hours should be regulated and welcome minor rescheduling of residents' workflow. The impacts on residents' training and patient care require further evaluation.

  5. Assisted Vaginal Delivery

    Science.gov (United States)

    ... Education & Events Advocacy For Patients About ACOG Assisted Vaginal Delivery Home For Patients Search FAQs Assisted Vaginal ... Vaginal Delivery FAQ192, February 2016 PDF Format Assisted Vaginal Delivery Labor, Delivery, and Postpartum Care What is ...

  6. 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...

  7. 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...

  8. 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...

  9. 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...

  10. 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...

  11. 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...

  12. 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...

  13. Resident dashboards: helping your clinical competency committee visualize trainees’ key performance indicators

    Directory of Open Access Journals (Sweden)

    Karen A. Friedman

    2016-03-01

    Full Text Available Introduction: Under the Next Accreditation System, programs need to find ways to collect and assess meaningful reportable information on its residents to assist the program director regarding resident milestone progression. This paper discusses the process that one large Internal Medicine Residency Program used to provide both quantitative and qualitative data to its clinical competency committee (CCC through the creation of a resident dashboard. Methods: Program leadership at a large university-based program developed four new end of rotation evaluations based on the American Board of Internal Medicine (ABIM and Accreditation Council of Graduated Medical Education's (ACGME 22 reportable milestones. A resident dashboard was then created to pull together both milestone- and non-milestone-based quantitative data and qualitative data compiled from faculty, nurses, peers, staff, and patients. Results: Dashboards were distributed to the members of the CCC in preparation for the semiannual CCC meeting. CCC members adjudicated quantitative and qualitative data to present their cohort of residents at the CCC meeting. Based on the committee's response, evaluation scores remained the same or were adjusted. Final milestone scores were then entered into the accreditation data system (ADS on the ACGME website. Conclusions: The process of resident assessment is complex and should comprise both quantitative and qualitative data. The dashboard is a valuable tool for program leadership to use both when evaluating house staff on a semiannual basis at the CCC and to the resident in person.

  14. Resident dashboards: helping your clinical competency committee visualize trainees' key performance indicators.

    Science.gov (United States)

    Friedman, Karen A; Raimo, John; Spielmann, Kelly; Chaudhry, Saima

    2016-01-01

    Under the Next Accreditation System, programs need to find ways to collect and assess meaningful reportable information on its residents to assist the program director regarding resident milestone progression. This paper discusses the process that one large Internal Medicine Residency Program used to provide both quantitative and qualitative data to its clinical competency committee (CCC) through the creation of a resident dashboard. Program leadership at a large university-based program developed four new end of rotation evaluations based on the American Board of Internal Medicine (ABIM) and Accreditation Council of Graduated Medical Education's (ACGME) 22 reportable milestones. A resident dashboard was then created to pull together both milestone- and non-milestone-based quantitative data and qualitative data compiled from faculty, nurses, peers, staff, and patients. Dashboards were distributed to the members of the CCC in preparation for the semiannual CCC meeting. CCC members adjudicated quantitative and qualitative data to present their cohort of residents at the CCC meeting. Based on the committee's response, evaluation scores remained the same or were adjusted. Final milestone scores were then entered into the accreditation data system (ADS) on the ACGME website. The process of resident assessment is complex and should comprise both quantitative and qualitative data. The dashboard is a valuable tool for program leadership to use both when evaluating house staff on a semiannual basis at the CCC and to the resident in person.

  15. Canine assisted reading

    OpenAIRE

    Sever, Jerneja

    2016-01-01

    The diploma thesis presents various aspects of animals included in animal-assisted interventions. In theoretical part, I introduced different possible ways of animal-assisted interventions: animal-assisted therapy, animal-assisted activities and animal-assisted education. Animals became common visitors in educational settings all over the world. I presented positive influences on various aspects of human life, as well limitations when animal-assisted interventions are not possible to perform ...

  16. Residency Programs and Clinical Leadership Skills Among New Saudi Graduate Nurses.

    Science.gov (United States)

    Al-Dossary, Reem Nassar; Kitsantas, Panagiota; Maddox, P J

    2016-01-01

    Nurse residency programs have been adopted by health care organizations to assist new graduate nurses with daily challenges such as intense working environments, increasing patient acuity, and complex technologies. Overall, nurse residency programs are proven beneficial in helping nurses transition from the student role to independent practitioners and bedside leaders. The purpose of this study was to assess the impact of residency programs on leadership skills of new Saudi graduate nurses who completed a residency program compared to new Saudi graduate nurses who did not participate in residency programs. The study design was cross-sectional involving a convenience sample (n = 98) of new graduate nurses from three hospitals in Saudi Arabia. The Clinical Leadership Survey was used to measure the new graduate nurses' clinical leadership skills based on whether they completed a residency program or not. Descriptive statistics, correlation, and multiple linear regression analyses were conducted to examine leadership skills in this sample of new Saudi graduate nurses. A significant difference was found between residents and nonresidents in their leadership skills (t = 10.48, P = .000). Specifically, residents were significantly more likely to show higher levels of leadership skills compared to their counterparts. Attending a residency program was associated with a significant increase in clinical leadership skills. The findings of this study indicate that there is a need to implement more residency programs in hospitals of Saudi Arabia. It is imperative that nurse managers and policy makers in Saudi Arabia consider these findings to improve nurses' leadership skills, which will in turn improve patient care. Further research should examine how residency programs influence new graduate nurses' transition from student to practitioner with regard to clinical leadership skills in Saudi Arabia. Copyright © 2016 Elsevier Inc. All rights reserved.

  17. The impact of a head and neck microvascular fellowship program on otolaryngology resident training.

    Science.gov (United States)

    Zender, Chad A; Clancy, Kate; Melki, Sami; Li, Shawn; Fowler, Nicole

    2018-01-01

    To assess the impact of a microvascular head and neck (H&N) fellowship on senior residents' surgical experience. Retrospective review of Accreditation Council for Graduate Medical Education-generated operative case log reports, retrospective chart review, and electronic survey. A retrospective review of one institution's residents' H&N operative case logs and free flap operative reports was performed to determine changes in key indicator cases (KICs) after the addition of a H&N fellowship. An electronic survey was distributed to senior residents at all U.S. otolaryngology residency programs to determine residents' perceptions of a H&N fellow's impact on their surgical experience. An electronic survey was distributed to senior medical students applying to surgical residencies to explore the perceived impact that a fellowship has on the desirability of a residency program. The average number of each postgraduate year (PGY)5's H&N KIC before and after the addition of the fellowship were: parotidectomy, 19 versus 17.8; neck dissection, 33.2 versus 40.6; oral cavity resection, 15.3 versus 12.6; thyroid/parathyroid, 45.5 versus 45.6; and flaps/grafts, 56.7 versus 42. PGY5 participation as first assistant in free flaps dropped from 78% to 17%; however, residents still participated in some aspect of 45% of the cases. Seventy percent of senior residents reported a positive perception of the H&N fellow on their H&N operative experience. Eighty-nine percent of senior medical student respondents reported a nonnegative perception of a fellowship in their applied field. The addition of a H&N fellowship did not decrease senior residents' H&N KIC, and most senior residents at programs with fellowships report that the fellow has a positive impact on their H&N operative experience. 4. Laryngoscope, 128:52-56, 2018. © 2017 The American Laryngological, Rhinological and Otological Society, Inc.

  18. 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

  19. 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

  20. 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...

  1. 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...

  2. 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...

  3. 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…

  4. CNA Training Requirements and Resident Care Outcomes in Nursing Homes.

    Science.gov (United States)

    Trinkoff, Alison M; Storr, Carla L; Lerner, Nancy B; Yang, Bo Kyum; Han, Kihye

    2017-06-01

    To examine the relationship between certified nursing assistant (CNA) training requirements and resident outcomes in U.S. nursing homes (NHs). The number and type of training hours vary by state since many U.S. states have chosen to require additional hours over the federal minimums, presumably to keep pace with the increasing complexity of care. Yet little is known about the impact of the type and amount of training CNAs are required to have on resident outcomes. Compiled data on 2010 state regulatory requirements for CNA training (clinical, total initial training, in-service, ratio of clinical to didactic hours) were linked to 2010 resident outcomes data from 15,508 NHs. Outcomes included the following NH Compare Quality Indicators (QIs) (Minimum Data Set 3.0): pain, antipsychotic use, falls with injury, depression, weight loss and pressure ulcers. Facility-level QIs were regressed on training indicators using generalized linear models with the Huber-White correction, to account for clustering of NHs within states. Models were stratified by facility size and adjusted for case-mix, ownership status, percentage of Medicaid-certified beds and urban-rural status. A higher ratio of clinical to didactic hours was related to better resident outcomes. NHs in states requiring clinical training hours above federal minimums (i.e., >16hr) had significantly lower odds of adverse outcomes, particularly pain falls with injury, and depression. Total and in-service training hours also were related to outcomes. Additional training providing clinical experiences may aid in identifying residents at risk. This study provides empirical evidence supporting the importance of increased requirements for CNA training to improve quality of care. © The Author 2016. Published by Oxford University Press on behalf of The Gerontological Society of America. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

  5. Health of the elderly: multidisciplinary residence as an instrument for the care improvement Saúde do idoso: residência multiprofissional como instrumento transformador do cuidado

    Directory of Open Access Journals (Sweden)

    Rosana Klaesener

    2009-08-01

    Full Text Available Objective: To describe the actions taken by the team of the Health Aging Program Multidisciplinary Residency in Health (PREMUS / PUCRS. Description of the experience: In the primary care, the residents participated in home assistance, outpatient services and developed actions of health popular education in aged groups. The team was also inserted in a University hospital, assisting in the fields of outpatient and hospitalization units. Conclusion: The Multidisciplinary Residency Program in Health, with emphasis on the health of the elderly, has proposed a dynamic care based on the concepts of interdisciplinarity, integration and humanized care, as well as guided by the guidelines of the Unified Health System (SUS.Objetivo: Relatar as ações realizadas pela equipe Saúde do Idoso do Programa de Residência Multiprofissional em Saúde (PREMUS/PUCRS. Descrição da experiência: Na atenção básica, os residentes participaram na assistência domiciliar, ambulatorial e desenvolveram ações de educação popular em saúde em um grupo de idosos. A equipe também atuou em um hospital universitário, prestando assistência nos âmbitos ambulatorial e unidades de internação. Conclusão: O Programa de Residência Multiprofissional em Saúde, com ênfase na saúde do idoso, proporcionou aos residentes uma dinâmica assistencial fundamentada nos conceitos da interdisciplinaridade, integralidade e humanização do cuidado, tal como orientado pelas diretrizes do Sistema Único de Saúde (SUS.

  6. 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

  7. How do urology residents manage personal finances?

    Science.gov (United States)

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

    2001-05-01

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

  8. Peer observation and feedback of resident teaching.

    Science.gov (United States)

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

    2013-02-01

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

  9. The DISAM Journal of International Security Assistance Management. Volume 23, Number 3, Spring 2001

    Science.gov (United States)

    2001-01-01

    there are rights and freedoms to which every human is entitled, no matter where he or she lives. In this issue we offer the introduction to the report...Assistance Management INTRODUCTION The last DISAM Journal, Winter 2000/2001 Edition, provided an extensive description and analysis of the numerous...FY2001 Country/Program by ESF Budget ESF Geographical Region Funding Request Funding Partnerships to Eliminate Sweatshops 4.000 5.000 3.986 Environmental

  10. The pediatric resident training on tobacco project: baseline findings from the Parent/Guardian Tobacco Survey.

    Science.gov (United States)

    Hymowitz, Norman; Schwab, Joseph; Haddock, Christopher keith; Pyle, Sara; Moore, Glenisha; Meshberg, Sarah

    2005-07-01

    about 10% of the smokers stated that the doctor offered to help them stop smoking, and just 25% of all parents/guardians indicated that the doctor offered to help them stop exposing their children to ETS in the home or elsewhere. Parents of children brought to Continuity Clinic may benefit from advice and assistance on quitting cigarette smoking and protecting their children from ETS. While pediatric residents offer advice and encouragement, few provide the assistance parents require. These findings underscore the importance of training pediatric residents to address tobacco with the parents/guardians of the patients they serve.

  11. 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.

  12. 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.

  13. 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

  14. 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.

  15. 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.

  16. An examination of mobbing and burnout of residents.

    Science.gov (United States)

    Dikmetaş, Elif; Top, Mehmet; Ergin, Gülpembe

    2011-01-01

    Mobbing and burnout in human resources management are important topics in labor psychology. It is important to research the levels of mobbing and burnout of human resources in the health sector, primarily in doctors. Although there have been some studies on the mobbing and burnout of doctors, there has been a limited number of studies on the relationship between mobbing and burnout in the health sector. This study aims to examine the relationship between mobbing and burnout (emotional exhaustion, depersonalization, personal accomplishment) levels of resident doctors at a public university research and training hospital in Turkey and to investigate whether mobbing and burnout levels vary significantly according to gender, marital status, medical branch and age. This study was conducted on resident doctors at the Ondokuz Mayıs University Research and Training Hospital between 01.04.2009 and 30.06.2009. Legal permission for the study was received from the Rector's Office of Ondokuz Mayıs University. The Maslach Burnout Inventory for measuring burnout levels in doctors and the Leymann Inventory of Psychological Terror for measuring doctors' mobbing levels were the research instruments employed. Sampling was not used in this study. The aim was to administer the research instruments to all the residents (the universe of this study consisted of 510 assistant doctors). 52.94 % of residents responded to all of the questions in these instruments. In the data analysis, a t-test, ANOVA, regression analysis and descriptive statistics were used. At the end of the analyses, it was found that the mean mobbing level of residents is 1.97; the mean emotional exhaustion level of residents is 2.97; the mean level of depersonalization is 2.95; and the mean level of personal accomplishment is 2.94. Mobbing and burnout levels of residents vary significantly in terms of medical branch. This study indicated that there are relationships between mobbing, emotional exhaustion

  17. Cross-cultural invariance of NPI-13: Entitlement as culturally specific, leadership and grandiosity as culturally universal.

    Science.gov (United States)

    Żemojtel-Piotrowska, Magdalena; Piotrowski, Jarosław; Rogoza, Radosław; Baran, Tomasz; Hitokoto, Hidefumi; Maltby, John

    2018-04-15

    The current study explores the problem with the lack of measurement invariance for the Narcissistic Personality Inventory (NPI) by addressing two issues: conceptual heterogeneity of narcissism and methodological issues related to the binary character of data. We examine the measurement invariance of the 13-item version of the NPI in three populations in Japan, Poland and the UK. Analyses revealed that leadership/authority and grandiose exhibitionism dimensions of the NPI were cross-culturally invariant, while entitlement/exploitativeness was culturally specific. Therefore, we proposed NPI-9 as indicating scalar invariance, and we examined the pattern of correlations between NPI-9 and other variables across three countries. The results suggest that NPI-9 is valid brief scale measuring general levels of narcissism in cross-cultural studies, while the NPI-13 remains suitable for research within specific countries. © 2018 International Union of Psychological Science.

  18. Fourth meeting entitled “Visualization and Processing of Tensors and Higher Order Descriptors for Multi-Valued Data”

    CERN Document Server

    Vilanova, Anna; Burgeth, Bernhard; Visualization and Processing of Tensors and Higher Order Descriptors for Multi-Valued Data

    2014-01-01

    Arising from the fourth Dagstuhl conference entitled Visualization and Processing of Tensors and Higher Order Descriptors for Multi-Valued Data (2011), this book offers a broad and vivid view of current work in this emerging field. Topics covered range from applications of the analysis of tensor fields to research on their mathematical and analytical properties. Part I, Tensor Data Visualization, surveys techniques for visualization of tensors and tensor fields in engineering, discusses the current state of the art and challenges, and examines tensor invariants and glyph design, including an overview of common glyphs. The second Part, Representation and Processing of Higher-order Descriptors, describes a matrix representation of local phase, outlines mathematical morphological operations techniques, extended for use in vector images, and generalizes erosion to the space of diffusion weighted MRI. Part III, Higher Order Tensors and Riemannian-Finsler Geometry, offers powerful mathematical language to model and...

  19. An Analysis of Figurative Language Elements upon an American Short Story Entitled “The Monkey’s Paw

    Directory of Open Access Journals (Sweden)

    Nur Muhammad Ardiansyah

    2018-04-01

    Full Text Available This article describes the study of semantic in a specified domain of figurative language upon a selected work of American English literature, in form of short story written by the renowned writer and author, William Wymark Jacobs, entitled as ‘The Monkey’s Paw’. Several objectives are deduced by the researcher in quest of finding the forms of this figurative language within the passage. Briefly, figurative language itself is a feature of every languages, which emphasized the use of expression to symbolize a different meaning from the usual literal interpretation. In our analysis of ‘The Monkey’s Paw’, the varieties of figurative language: Metaphor, Personification, Hyperbole, Symbolism, also another terms used to represent unusual words construction or combination such as Onomatopoeia, Idiom, and even Imagery, are discussed in order in relation with true meaning discovery behind each figurative language properties.

  20. Accrual of ROCs LECs and REGOs. Phase 3a: pre-determined entitlements to ROCs for small microgenerators

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    2005-07-01

    This report describes a proposed scheme to enable microgenerators in the UK to claim Renewable Obligation Certificates (ROCs) on the basis of predetermined estimates of output rather than data from meters. The aim of the scheme, which has been developed following discussions with representatives of the microgeneration community in the UK, is to make it easier for small generators to access to ROCs and thus encourage householders and smaller commercial/business users to install renewable microgeneration technologies. The work was commissioned as part of the review of the Renewables Obligation. The report considers: background information; the Australian scheme for small generating units; eligibility and entitlements; the operation of the scheme; new procedural and legislative requirements; measures to protect and improve the Renewables Obligation; alterative approaches; scheme benefits; and recommendations. An overview of the scheme's key features is given in the report's executive summary.

  1. Combating global warming. Possible rules, regulations and administrative arrangements for a global market in CO2 emission entitlements

    International Nuclear Information System (INIS)

    1994-12-01

    When in 1991 the UNCTAD secretariat launched its research into the idea of controlling carbon dioxide emissions through a system of 'tradeable permits', there was little support for this approach. Some felt that the idea was premature and should not detract from efforts to introduce more conventional measures, such as environmental taxes and new regulations. However, in a few short years, the idea of using tradeable market-based instruments to combat global warming has gained widespread acceptance. The UNCTAD secretariat's 1992 study on a global system of tradeable carbon emission entitlements (UNCTAD/RDP/DFP/1), was widely regarded as a major breakthrough in this area. This study argued that tradeable permits were both an efficient means of controlling man-made carbon dioxide emissions at minimum cost, and an effective mechanism for transferring resources to developing countries and countries in transition, to help them to contribute to the international effort to abate emissions of greenhouse gases. The study contained a detailed assessment of key technical elements of a tradeable CO 2 entitlements system, including permit allocation techniques, resource transfers, equity/distributional implications, institutional and administrative requirements. The present publication explores the institutional requirements for both policy-making and the organization of a global market in CO 2 emission allowances. It shows that one can start with a simple pilot scheme based on the joint implementation of commitments, which constitutes the cornerstone of the Framework Convention, and evolve gradually to a more complete system on the basis of 'learning by doing'. Since the use of markets can dramatically lower the cost of controlling greenhouse gas emissions, it is clearly in the self-interest of major emitters to act as 'market leaders' willing to pioneer

  2. The formation of nurses in residency programs in public and private intensive care units

    Directory of Open Access Journals (Sweden)

    Iasmim Lima Aguiar

    Full Text Available This qualitative study aimed to acknowledge the importance of practice in public and private institutions in the training of nurses in residency programs. Data were collected at two hospitals between February and March 2013, through interviews. From their analysis the following categories emerged: experience of graduate nurses in residency programs in ICUs of public and private institutions and potential for learning in public and private institutions regarding the training of nurses. Differences were detected in the work process and in the profile of patients between the public and private fields, and dissociation between caring and management functions carried out by residents was demonstrated. It was concluded that the development of practices in public and private institutions provides different and complementary experiences which prepare residents for management and care activities, improve management and technical assistance skills, encourages the exercise of in-service education and, by means of surveys, the search for solutions to problems that emerge from daily work.

  3. KARL: A Knowledge-Assisted Retrieval Language. Presentation visuals. M.S. Thesis Final Report, 1 Jul. 1985 - 31 Dec. 1987

    Science.gov (United States)

    Dominick, Wayne D. (Editor); Triantafyllopoulos, Spiros

    1985-01-01

    A collection of presentation visuals associated with the companion report entitled KARL: A Knowledge-Assisted Retrieval Language, is presented. Information is given on data retrieval, natural language database front ends, generic design objectives, processing capababilities and the query processing cycle.

  4. Can Better Outdoor Environments Lead to Cost Benefits in Assisted Living Facilities Through Increased Word-of-Mouth Referrals?

    Science.gov (United States)

    Rodiek, Susan; Boggess, May M; Lee, Chanam; Booth, Geoffrey J; Morris, Alisan

    2013-01-01

    This study explores how better outdoor environments may produce cost benefits for assisted living providers by raising occupancy levels through increased resident satisfaction and word-of-mouth referrals. Older adults who spend even minimal time outdoors may reap substantial health benefits. However, many existing outdoor areas in assisted living facilities are reportedly underutilized, in part because of design issues. Providers may be more willing to improve outdoor areas if they produce cost benefits for provider organizations. This study used data from a recent assisted living survey to assess the relationship between satisfaction with outdoor spaces, time spent outdoors, and resulting improvements in mood. A financial analysis was developed to estimate potential benefits from improved outdoor areas attributable to increased occupancy and decreased marketing costs associated with increased word-of-mouth referrals. Increasing resident satisfaction with outdoor areas (from approximately 29% to 96%) results in residents spending more time outdoors (increase of 1½ hours per week per resident) and improved psychological well-being (12% increase in feeling better). This greater overall satisfaction leads to 8% more residents willing to refer potential residents to their community. Because word-of-mouth referrals by current residents are a major factor in resident recruitment, improving outdoors areas leads to an estimated 4% increase in new residents, resulting in over $170,000 of increased revenue per year for a community of 100 residents. Improved outdoor space can provide substantial cost benefits for assisted living providers. Increasing resident well-being and satisfaction, and thereby generating additional word-of-mouth referrals, can result in higher occupancy levels. Outdoor environments, assisted living, cost benefits, resident satisfaction, occupancy levels, seniors, rental income, word-of-mouth referralPreferred Citation: Rodiek, S., Boggess, M. M., Lee

  5. Strategies to accommodate resident work-hour restrictions: impact on surgical education.

    Science.gov (United States)

    Freiburg, Carter; James, Ted; Ashikaga, Takamura; Moalem, Jacob; Cherr, Greg

    2011-01-01

    The introduction of duty-hour restrictions has impacted surgical training. Several strategies were introduced by training programs in response to these restrictions. The purpose of this study was to assess the various strategies employed by residency programs to comply with work-hour restrictions with respect to the impact on the quality of surgical education. A national survey was developed and distributed to resident members of the Resident and Associate Society of the American College of Surgeons in all accredited residency programs across North America. Questions in the survey addressed 10 separate accommodation strategies used by training programs to adhere to resident work-hour restrictions. Resident respondents completed a 5-point Likert scale rating each strategy according to its impact on surgical education (detrimental, not very helpful, neutral, somewhat helpful, and very helpful). A total of 599 (9.7%) responses were received from 6186 members of the Resident Associate Society. The use of health information technology (IT), nurse practitioners, and physician assistants were most highly rated. Hiring clinical fellows, establishing nonteaching services, and shift-work scheduling were the three most poorly rated accommodations to work-hour restrictions with respect to resident education. Hospital IT and nonphysician care providers were rated by residents to optimize surgical education in the current work-hour limitation environment. We infer that strategies which lead to increased efficiency and redistribution of resident workload allow surgical trainees to spend more time on activities perceived to have higher educational value. Copyright © 2011 Association of Program Directors in Surgery. Published by Elsevier Inc. All rights reserved.

  6. Remediation in the Context of the Competencies: A Survey of Pediatrics Residency Program Directors

    Science.gov (United States)

    Riebschleger, Meredith P.; Haftel, Hilary M.

    2013-01-01

    Background The 6 competencies defined by the Accreditation Council for Graduate Medical Education provide the framework of assessment for trainees in the US graduate medical education system, but few studies have investigated their impact on remediation. Methods We obtained data via an anonymous online survey of pediatrics residency program directors. For the purposes of the survey, remediation was defined as “any form of additional training, supervision, or assistance above that required for a typical resident.” Respondents were asked to quantify 3 groups of residents: (1) residents requiring remediation; (2) residents whose training was extended for remediation purposes; and (3) residents whose training was terminated owing to issues related to remediation. For each group, the proportion of residents with deficiencies in each of the 6 competencies was calculated. Results In all 3 groups, deficiencies in medical knowledge and patient care were most common; deficiencies in professionalism and communication were moderately common; and deficiencies in systems-based practice and practice-based learning and improvement were least common. Residents whose training was terminated were more likely to have deficiencies in multiple competencies. Conclusion Although medical knowledge and patient care are reported most frequently, deficiencies in any of the 6 competencies can lead to the need for remediation in pediatrics residents. Residents who are terminated are more likely to have deficits in multiple competencies. It will be critical to develop and refine tools to measure achievement in all 6 competencies as the graduate medical education community may be moving further toward individualized training schedules and competency-based, rather than time-based, training. PMID:24404228

  7. U.S. Midwestern Residents Perceptions of Water Quality

    Directory of Open Access Journals (Sweden)

    Lois Wright Morton

    2011-02-01

    Full Text Available The plurality of conservation and environmental viewpoints often challenge community leaders and government agency staff as they seek to engage citizens and build partnerships around watershed planning and management to solve complex water quality issues. The U.S. Midwest Heartland region (covering the states of Missouri, Kansa, Iowa, and Nebraska is dominated by row crop production and animal agriculture, where an understanding of perceptions held by residents of different locations (urban, rural non-farm, and rural farm towards water quality and the environment can provide a foundation for public deliberation and decision making. A stratified random sample mail survey of 1,042 Iowa, Kansas, Missouri, and Nebraska residents (54% response rate reveals many areas of agreement among farm, rural non-farm, and those who live in towns on the importance of water issues including the importance and use of water resources; beliefs about water quality and perceptions of impaired water quality causality; beliefs about protecting local waters; and environmental attitudes. With two ordinal logistic models, we also found that respondents with strong environmental attitudes have the least confidence in ground and surface water quality. The findings about differences and areas of agreement among the residents of different sectors can provide a communication bridge among divergent viewpoints and assist local leaders and agency staff as they seek to engage the public in discussions which lead to negotiating solutions to difficult water issues.

  8. Occupational Therapy in Multidisciplinary Residency in Family and Community Health

    Directory of Open Access Journals (Sweden)

    Luzianne Feijó Alexandre Paiva

    2013-12-01

    Full Text Available In this study, we report the experiences of occupational therapist during the Multidisciplinary Residency Program in Family and Community Health in Fortaleza, Ceará state, Brazil. With the creation of the Support Center for Family Health – NASF, occupational therapists began to participate more effectively in the Family Health Strategy of the Brazilian National Health System. Given this rocess, the category, which historically has trained its professionals following the biomedical model, is faced with the challenge to build a new field of knowledge. Objective: To analyze the inclusion of occupational therapy in the Family Health Strategy within the scope of Multidisciplinary Residency. Methodology: This is a descriptive study of qualitative approach, which was based on the experience of four occupational therapy resident students, performed through the documental analysis of field diaries, scientific papers, and case studies produced between 2009 and 2011. Results: The occupational therapists as well as the other NASF professionals operated the logic of Matrix Support to the Family Health teams, sharing their knowledge and assisting in resolving complex cases of the families, groups, and communities served. In this context, we found people with different relationships with their doings and a reduced repertoire of activities. The occupational therapists invested in the creation or consolidation of groups in the Family Health Centers and in the territory, which also stood as living and socializing spaces, focusing on prevention and health promotion.

  9. 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

  10. Impact of a Dedicated Emergency Medicine Teaching Resident Rotation at a Large Urban Academic Center.

    Science.gov (United States)

    Ahn, James; Golden, Andrew; Bryant, Alyssa; Babcock, Christine

    2016-03-01

    In the face of declining bedside teaching and increasing emergency department (ED) crowding, balancing education and patient care is a challenge. Dedicated shifts by teaching residents (TRs) in the ED represent an educational intervention to mitigate these difficulties. We aimed to measure the perceived learning and departmental impact created by having TR. TRs were present in the ED from 12 pm-10 pm daily, and their primary roles were to provide the following: assist in teaching procedures, give brief "chalk talks," instruct junior trainees on interesting cases, and answer clinical questions in an evidence-based manner. This observational study included a survey of fourth-year medical students (MSs), residents and faculty at an academic ED. Surveys measured the perceived effect of the TR on teaching, patient flow, ease of procedures, and clinical care. Survey response rates for medical students, residents, and faculty are 56%, 77%, and 75%, respectively. MSs perceived improved procedure performance with TR presence and the majority agreed that the TR was a valuable educational experience. Residents perceived increased patient flow, procedure performance, and MS learning with TR presence. The majority agreed that the TR improved patient care. Faculty agreed that the TR increased resident and MS learning, as well as improved patient care and procedure performance. The presence of a TR increased MS and resident learning, improved patient care and procedure performance as perceived by MSs, residents and faculty. A dedicated TR program can provide a valuable resource in achieving a balance of clinical education and high quality healthcare.

  11. PNEUMONIA IN NURSING HOME RESIDENTS

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    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

  12. 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.

  13. 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.

  14. 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.

  15. Regulations implementing the Byrd Amendments to the Black Lung Benefits Act: determining coal miners' and survivors' entitlement to benefits. Final rule.

    Science.gov (United States)

    2013-09-25

    This final rule revises the Black Lung Benefits Act (BLBA or Act) regulations to implement amendments made by the Patient Protection and Affordable Care Act (ACA). The ACA amended the BLBA in two ways. First, it revived a rebuttable presumption of total disability or death due to pneumoconiosis for certain claims. Second, it reinstituted automatic entitlement to benefits for certain eligible survivors of coal miners whose lifetime benefit claims were awarded because they were totally disabled due to pneumoconiosis. These regulations clarify how the statutory presumption may be invoked and rebutted and the application and scope of the survivor-entitlement provision. The rule also eliminates several unnecessary or obsolete provisions.

  16. 24 CFR 401.421 - Rental Assistance Assessment Plan.

    Science.gov (United States)

    2010-04-01

    ... PROGRAM (MARK-TO-MARKET) Restructuring Plan § 401.421 Rental Assistance Assessment Plan. (a) Plan required..., comparable, and affordable housing in the local market; (2) The types of tenants residing in the project (such as elderly families, disabled families, large families, and cooperative homeowners); (3) The local...

  17. Práticas de cuidados produzidas no serviço de residências terapêuticas: percorrendo os trilhos de retorno à sociedade Las prácticas de cuidados ofrecidos en el servicio de residencias terapéuticas: recorriendo los caminos de retorno a la sociedad Health-care practices performed at assisted living facilities: pursuing the paths back to society

    Directory of Open Access Journals (Sweden)

    Hudson Pires de Oliveira Santos Junior

    2009-12-01

    Full Text Available Esta pesquisa objetivou buscar a visão dos profissionais do Serviço de Residências Terapêuticas, sobre a prática de cuidado produzida neste dispositivo de atenção à saúde mental. Para isso, optou-se pela abordagem qualitativa, exploratória e analítica. Os instrumentos para a coleta de dados foram: formulário de observação sistemática, diário de campo e roteiro de entrevista semiestruturada, realizada com 10 profissionais atuantes nas residências. Como resultado, foi encontrado que o cuidado na moradia se dá de modo mais humanizado, valorizando a singularidade dos moradores, seus valores e crenças, tentando (reestabelecer as relações sociais dos indivíduos e estimulá-los para a prática do autocuidado. Percebe-se que esse modo de atenção vem alcançando uma (recidadanização e valorização da vida dos sofredores psíquicos.Esta investigación objetivó buscar la perspectiva de los profesionales del Servicio de Residencias Terapéuticas, sobre la práctica del cuidado ofrecida en este dispositivo de atención a la salud mental. Para esto, se optó por el abordaje cualitativo, exploratorio y analítico. Los instrumentos para la recolección de datos fueron: formulario de observación sistemática, diario de campo y guión de entrevista semiestructurada, realizada con 10 profesionales actuantes en las residencias. Como resultado, fue encontrado que el cuidado en la residencia se ofrece de modo más humanizado, valorizando la singularidad de los residentes, sus valores y creencias, tratando de (reestablecer las relaciones sociales de los individuos y estimularlos para practicar el auto cuidado. Se percibe que ese modo de atención viene alcanzando una (reciudadanización y valorización de la vida de los que sufren psíquicamente.The objective of this exploratory study was to understand the perspective of professionals working at assisted living facilities about the healthcare practices performed in the mental health

  18. 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.

  19. 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...

  20. Art-science integration: Portrait of a residency

    Science.gov (United States)

    Feldman, Rhoda Lynn

    children and makes sense from their perspective. Findings seem to indicate the need for rethinking the manner in which arts integration residencies are conducted. Assisting artists and teachers in bridging their worlds as well as crossing discipline boundaries may improve educational practices within these programs and with them learning opportunities in and through the arts for children.

  1. 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

  2. Improving pediatric immunization rates: description of a resident-led clinical continuous quality improvement project.

    Science.gov (United States)

    Jones, Kyle Bradford; Gren, Lisa H; Backman, Richard

    2014-09-01

    Increased emphasis is being placed on the continuous quality improvement (CQI) education of residents of all specialties. This article describes a resident-led continuous quality improvement (CQI) project, based on a novel curriculum, to improve the immunization rates of children under 2 years old at the Madsen Family Health Center (MHC). All third-year residents were trained in the FOCUS-PDSA CQI methodology through concurrent didactic lectures and experience leading the CQI team. The CQI team included clinical staff led by a third-year family medicine resident and mentored by a member of the family medicine faculty. Immunization records were distributed to provider-medical assistant teamlets daily for each pediatric patient scheduled in clinic as the intervention. Compliance with the intervention (process measure), as well as immunization rates at 2 and 5 months post-intervention (outcome measure), were monitored. Immunization records were printed on 84% of clinic days from October 24, 2011 to March 31, 2012. The percentage of patients immunized at baseline was 66%. The percentage immunized as of December 31, 2011 was 96% and was 91% as of March 31, 2012. An important educational experience was organized for third-year family medicine residents through learning CQI skills, leading a CQI team, and directing a CQI project to completion. Significant improvement in the percentage of patients under 2 years old immunized at the MHC was achieved by presenting provider-medical assistant teamlets with immunization records of all pediatric patients on the daily clinic schedule.

  3. Implementing the 2009 Institute of Medicine recommendations on resident physician work hours, supervision, and safety.

    Science.gov (United States)

    Blum, Alexander B; Shea, Sandra; Czeisler, Charles A; Landrigan, Christopher P; Leape, Lucian

    2011-01-01

    Long working hours and sleep deprivation have been a facet of physician training in the US since the advent of the modern residency system. However, the scientific evidence linking fatigue with deficits in human performance, accidents and errors in industries from aeronautics to medicine, nuclear power, and transportation has mounted over the last 40 years. This evidence has also spawned regulations to help ensure public safety across safety-sensitive industries, with the notable exception of medicine. In late 2007, at the behest of the US Congress, the Institute of Medicine embarked on a year-long examination of the scientific evidence linking resident physician sleep deprivation with clinical performance deficits and medical errors. The Institute of Medicine's report, entitled "Resident duty hours: Enhancing sleep, supervision and safety", published in January 2009, recommended new limits on resident physician work hours and workload, increased supervision, a heightened focus on resident physician safety, training in structured handovers and quality improvement, more rigorous external oversight of work hours and other aspects of residency training, and the identification of expanded funding sources necessary to implement the recommended reforms successfully and protect the public and resident physicians themselves from preventable harm. Given that resident physicians comprise almost a quarter of all physicians who work in hospitals, and that taxpayers, through Medicare and Medicaid, fund graduate medical education, the public has a deep investment in physician training. Patients expect to receive safe, high-quality care in the nation's teaching hospitals. Because it is their safety that is at issue, their voices should be central in policy decisions affecting patient safety. It is likewise important to integrate the perspectives of resident physicians, policy makers, and other constituencies in designing new policies. However, since its release, discussion of the

  4. Reflections on International Certified Nursing Assistants.

    Science.gov (United States)

    Shaw, Penelope Ann

    2017-01-01

    The author, a former university faculty member who taught English to speakers of other languages and now a nursing home resident, shares her observations about how English language proficiency, culture, and religious differences affect her care. She provides examples of communication challenges that can be annoying or cause harm, her coping strategies, and reasons many certified nursing assistants might never be fully fluent in English. She explains how international certified nursing assistants can benefit residents because of skills developed by family-centered care in their countries of origin. She also discusses related issues-the importance of being culturally competent about U.S. culture. She points out how religiousness not only affects residents but is a buffer for staff against the stress of physically and emotionally demanding low-wage work. Overall, the author likes receiving care from individuals from other countries, finding reward in comparing how her personal struggle with illness and paralysis resonates with the trauma of migration and how learning firsthand about varying beliefs and attitudes clarifies her identity and place in world history.

  5. 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.

  6. Laparoscopic assistance by operating room nurses: Results of a virtual-reality study.

    Science.gov (United States)

    Paschold, M; Huber, T; Maedge, S; Zeissig, S R; Lang, H; Kneist, W

    2017-04-01

    Laparoscopic assistance is often entrusted to a less experienced resident, medical student, or operating room nurse. Data regarding laparoscopic training for operating room nurses are not available. The aim of the study was to analyse the initial performance level and learning curves of operating room nurses in basic laparoscopic surgery compared with medical students and surgical residents to determine their ability to assist with this type of procedure. The study was designed to compare the initial virtual reality performance level and learning curves of user groups to analyse competence in laparoscopic assistance. The study subjects were operating room nurses, medical students, and first year residents. Participants performed three validated tasks (camera navigation, peg transfer, fine dissection) on a virtual reality laparoscopic simulator three times in 3 consecutive days. Laparoscopic experts were enrolled as a control group. Participants filled out questionnaires before and after the course. Nurses and students were comparable in their initial performance (p>0.05). Residents performed better in camera navigation than students and nurses and reached the expert level for this task. Residents, students, and nurses had comparable bimanual skills throughout the study; while, experts performed significantly better in bimanual manoeuvres at all times (p<0.05). The included user groups had comparable skills for bimanual tasks. Residents with limited experience reached the expert level in camera navigation. With training, nurses, students, and first year residents are equally capable of assisting in basic laparoscopic procedures. Copyright © 2017 Elsevier Ltd. All rights reserved.

  7. Spectrum of tablet computer use by medical students and residents at an academic medical center.

    Science.gov (United States)

    Robinson, Robert

    2015-01-01

    Introduction. The value of tablet computer use in medical education is an area of considerable interest, with preliminary investigations showing that the majority of medical trainees feel that tablet computers added value to the curriculum. This study investigated potential differences in tablet computer use between medical students and resident physicians. Materials & Methods. Data collection for this survey was accomplished with an anonymous online questionnaire shared with the medical students and residents at Southern Illinois University School of Medicine (SIU-SOM) in July and August of 2012. Results. There were 76 medical student responses (26% response rate) and 66 resident/fellow responses to this survey (21% response rate). Residents/fellows were more likely to use tablet computers several times daily than medical students (32% vs. 20%, p = 0.035). The most common reported uses were for accessing medical reference applications (46%), e-Books (45%), and board study (32%). Residents were more likely than students to use a tablet computer to access an electronic medical record (41% vs. 21%, p = 0.010), review radiology images (27% vs. 12%, p = 0.019), and enter patient care orders (26% vs. 3%, p e-Books, and to study for board exams. Residents were more likely to use tablet computers to complete clinical tasks. Conclusions. Tablet computer use among medical students and resident physicians was common in this survey. All learners used tablet computers for point of care references and board study. Resident physicians were more likely to use tablet computers to access the EMR, enter patient care orders, and review radiology studies. This difference is likely due to the differing educational and professional demands placed on resident physicians. Further study is needed better understand how tablet computers and other mobile devices may assist in medical education and patient care.

  8. Sensorimotor and executive function slowing in anesthesiology residents after overnight shifts.

    Science.gov (United States)

    Williams, George W; Shankar, Bairavi; Klier, Eliana M; Chuang, Alice Z; El Marjiya-Villarreal, Salma; Nwokolo, Omonele O; Sharma, Aanchal; Sereno, Anne B

    2017-08-01

    Medical residents working overnight call shifts experience sleep deprivation and circadian clock disruption. This leads to deficits in sensorimotor function and increases in workplace accidents. Using quick tablet-based tasks, we investigate whether measureable executive function differences exist following a single overnight call versus routine shift, and whether factors like stress, rest and caffeine affect these measures. A prospective, observational, longitudinal, comparison study was conducted. An academic tertiary hospital's main operating room suite staffed by attending anesthesiologists, anesthesiology residents, anesthesiologist assistants and nurse anesthetists. Subjects were 30 anesthesiology residents working daytime shifts and 30 peers working overnight call shifts from the University of Texas Health Science Center at Houston. Before and after their respective work shifts, residents completed the Stanford Sleepiness Scale (SSS) and the ProPoint and AntiPoint tablet-based tasks. These latter tasks are designed to measure sensorimotor and executive functions, respectively. The SSS is a self-reported measure of sleepiness. Response times (RTs) are measured in the pointing tasks. Call residents exhibited increased RTs across their shifts (post-pre) on both ProPoint (p=0.002) and AntiPoint (pRoutine residents. Increased stress was associated with decreases in AntiPoint RT for Routine (p=0.007), but with greater increases in sleepiness for Call residents (proutine daytime shift residents, (2) sensorimotor slowing is greater in overnight Call residents who drink caffeine habitually, and (3) increased stress during a shift reduces (improves) cognitive RTs during routine daytime but not overnight call shifts. Copyright © 2017 Elsevier Inc. All rights reserved.

  9. Institutionalizing Security Force Assistance

    National Research Council Canada - National Science Library

    Binetti, Michael R

    2008-01-01

    .... It looks at the manner in which security assistance guidance is developed and executed. An examination of national level policy and the guidance from senior military and civilian leaders highlights the important role of Security Force Assistance...

  10. ForeignAssistance.gov

    Data.gov (United States)

    US Agency for International Development — ForeignAssistance.gov provides a view of U.S. Government foreign assistance funds across agencies and enables users to explore, analyze, and review aid investments...

  11. Partnership for Prescription Assistance

    Science.gov (United States)

    ... may use our name without our permission. The Partnership for Prescription Assistance will help you find the ... Events Blog Facebook Twitter Start living better. The Partnership for Prescription Assistance helps qualifying patients without prescription ...

  12. Assisted delivery with forceps

    Science.gov (United States)

    ... page: //medlineplus.gov/ency/patientinstructions/000509.htm Assisted delivery with forceps To use the sharing features on ... called vacuum assisted delivery . When is a Forceps Delivery Needed? Even after your cervix is fully dilated ( ...

  13. Vacuum-assisted delivery

    Science.gov (United States)

    ... medlineplus.gov/ency/patientinstructions/000514.htm Vacuum-assisted delivery To use the sharing features on this page, ... through the birth canal. When is Vacuum-assisted Delivery Needed? Even after your cervix is fully dilated ( ...

  14. 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

  15. 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

  16. Remedial training for the radiology resident: a template for optimization of the learning plan.

    Science.gov (United States)

    Mar, Colin; Chang, Silvia; Forster, Bruce

    2015-02-01

    All radiology residency programs should strive for the early identification of individuals in need of remedial training and have an approach ready to address this situation. This article provides a template for a step-by-step approach which is team based. It includes definition of the learning or performance issues, creation of suitable learning objectives and learning plan, facilitation of feedback and assessment, and definition of outcomes. Using such a template will assist the resident in returning to the path toward a safe and competent radiologist. Copyright © 2015 AUR. Published by Elsevier Inc. All rights reserved.

  17. 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...

  18. 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...

  19. 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...

  20. 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...

  1. 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.

  2. Development of a novel sports medicine rotation for emergency medicine residents

    Directory of Open Access Journals (Sweden)

    Waterbrook AL

    2016-04-01

    Full Text Available Anna L Waterbrook,1 T Gail Pritchard,2 Allison D Lane,1 Lisa R Stoneking,1 Bryna Koch,2 Robert McAtee,1 Kristi H Grall,1 Alice A Min,1 Jessica Prior,1 Isaac Farrell,1 Holly G McNulty,1 Uwe Stolz1 1Department of Emergency Medicine, 2Office of Medical Student Education, The University of Arizona, Tucson, AZ, USA Abstract: Musculoskeletal complaints are the most common reason for patients to visit a physician, yet competency in musculoskeletal medicine is invariably reported as a deficiency in medical education in the USA. Sports medicine clinical rotations improve both medical students' and residents' musculoskeletal knowledge. Despite the importance of this knowledge, a standardized sports medicine curriculum in emergency medicine (EM does not exist. Hence, we developed a novel sports medicine rotation for EM residents to improve their musculoskeletal educational experience and to improve their knowledge in musculoskeletal medicine by teaching the evaluation and management of many common musculoskeletal disorders and injuries that are encountered in the emergency department. The University of Arizona has two distinct EM residency programs, South Campus (SC and University Campus (UC. The UC curriculum includes a traditional 4-week orthopedic rotation, which consistently rated poorly on evaluations by residents. Therefore, with the initiation of a new EM residency at SC, we replaced the standard orthopedic rotation with a novel sports medicine rotation for EM interns. This rotation includes attendance at sports medicine clinics with primary care and orthopedic sports medicine physicians, involvement in sport event coverage, assigned reading materials, didactic experiences, and an on-call schedule to assist with reductions in the emergency department. We analyzed postrotation surveys completed by residents, postrotation evaluations of the residents completed by primary care sports medicine faculty and orthopedic chief residents, as well as the

  3. Evaluation of Social Media Use by Emergency Medicine Residents and Faculty

    Directory of Open Access Journals (Sweden)

    David Pearson

    2015-10-01

    Full Text Available Introduction: Clinicians and residency programs are increasing their use of social media (SM websites for educational and promotional uses, yet little is known about the use of these sites by residents and faculty. The objective of the study is to assess patterns of SM use for personal and professional purposes among emergency medicine (EM residents and faculty. Methods: In this multi-site study, an 18-question survey was sent by e-mail to the residents and faculty in 14 EM programs and to the Council of Emergency Medicine Residency Directors (CORD listserv via the online tool SurveyMonkey™. We compiled descriptive statistics, including assessment with the chi-square test or Fisher’s exact test. StatsDirect software (v 2.8.0, StatsDirect, Cheshire, UK was used for all analyses. Results: We received 1,314 responses: 63% of respondents were male, 40% were <30 years of age, 39% were between the ages 31 and 40, and 21% were older than 40. The study group consisted of 772 residents and 542 faculty members (15% were program directors, 21% were assistant or associate PDs, 45% were core faculty, and 19% held other faculty positions. Forty-four percent of respondents completed residency more than 10 years ago. Residents used SM markedly more than faculty for social interactions with family and friends (83% vs 65% [p<0.0001], entertainment (61% vs 47% [p<0.0001], and videos (42% vs 23% [p=0.0006]. Residents used Facebook™ and YouTube™ more often than faculty (86% vs 67% [p<0.001]; 53% vs 46% [p=0.01], whereas residents used Twitter™ (19% vs 26% [p=0.005] and LinkedIn™ (15% vs 32% [p<0.0001] less than faculty. Overall, residents used SM sites more than faculty, notably in daily use (30% vs 24% [p<0.001]. For professional use, residents were most interested in its use for open positions/hiring (30% vs 18% [p<0.0001] and videos (33% vs 26% [p=0.005] and less interested than faculty with award postings (22% vs 33% [p<0.0001] or publications (30

  4. Development of a novel sports medicine rotation for emergency medicine residents.

    Science.gov (United States)

    Waterbrook, Anna L; Pritchard, T Gail; Lane, Allison D; Stoneking, Lisa R; Koch, Bryna; McAtee, Robert; Grall, Kristi H; Min, Alice A; Prior, Jessica; Farrell, Isaac; McNulty, Holly G; Stolz, Uwe

    2016-01-01

    Musculoskeletal complaints are the most common reason for patients to visit a physician, yet competency in musculoskeletal medicine is invariably reported as a deficiency in medical education in the USA. Sports medicine clinical rotations improve both medical students' and residents' musculoskeletal knowledge. Despite the importance of this knowledge, a standardized sports medicine curriculum in emergency medicine (EM) does not exist. Hence, we developed a novel sports medicine rotation for EM residents to improve their musculoskeletal educational experience and to improve their knowledge in musculoskeletal medicine by teaching the evaluation and management of many common musculoskeletal disorders and injuries that are encountered in the emergency department. The University of Arizona has two distinct EM residency programs, South Campus (SC) and University Campus (UC). The UC curriculum includes a traditional 4-week orthopedic rotation, which consistently rated poorly on evaluations by residents. Therefore, with the initiation of a new EM residency at SC, we replaced the standard orthopedic rotation with a novel sports medicine rotation for EM interns. This rotation includes attendance at sports medicine clinics with primary care and orthopedic sports medicine physicians, involvement in sport event coverage, assigned reading materials, didactic experiences, and an on-call schedule to assist with reductions in the emergency department. We analyzed postrotation surveys completed by residents, postrotation evaluations of the residents completed by primary care sports medicine faculty and orthopedic chief residents, as well as the total number of dislocation reductions performed by each graduating resident at both programs over the last 5 years. While all residents in both programs exceeded the ten dislocation reductions required for graduation, residents on the sports medicine rotation had a statistically significant higher rate of satisfaction of their educational

  5. Knowledge, attitudes, and intentions toward fertility awareness and oocyte cryopreservation among obstetrics and gynecology resident physicians.

    Science.gov (United States)

    Yu, L; Peterson, B; Inhorn, M C; Boehm, J K; Patrizio, P

    2016-02-01

    What knowledge, attitudes and intentions do US obstetrics and gynecology (OB/GYN) residents have toward discussing age-related fertility decline and oocyte cryopreservation with their patients? Most OB/GYN residents believe that age-related fertility decline, but not oocyte cryopreservation, should be discussed during well-woman annual exams; furthermore, nearly half of residents overestimated the age at which female fertility markedly declines. Oocyte cryopreservation can be utilized to preserve fertility potential. Currently, no studies of US OB/GYN residents exist that question their knowledge, attitudes, and intentions toward discussing age-related fertility decline and oocyte cryopreservation with patients. A cross-sectional online survey was conducted during the fall of 2014 among residents in American Council for Graduate (ACOG) Medical Education-approved OB/GYN residency programs. Program directors were emailed via the ACOG Council on Resident Education in Obstetrics and Gynecology server listing and asked to solicit resident participation. Participants included 238 residents evenly distributed between post-graduate years 1-4 with varied post-residency plans; 90% of residents were women and 75% were 26-30 years old. The survey was divided into three sections: demographics, fertility awareness, and attitudes toward discussing fertility preservation options with patients. Descriptive and inferential statistics were conducted. A strong majority of residents (83%) believed an OB/GYN should initiate discussions about age-related fertility decline with patients (mean patient age 31.8), and 73% percent believed these discussions should be part of an annual exam. One third of residents overestimated the age at which there is a slight decline in female fertility, while nearly half of residents overestimated the age at which female fertility markedly declines. Over three-quarters of residents (78.4%) also overestimated the likelihood of success using assisted

  6. Preventing falls in assisted living: Results of a quality improvement pilot study.

    Science.gov (United States)

    Zimmerman, Sheryl; Greene, Angela; Sloane, Philip D; Mitchell, Madeline; Giuliani, Carol; Nyrop, Kirsten; Walsh, Edith

    Residents of assisted living (AL) communities are at high risk for falls, which result in negative outcomes and high health care costs. Adapting effective falls prevention programs for AL quality improvement (QI) has the potential to reduce falls, improve resident quality of life, and reduce costs. This project tested the feasibility and outcomes of an evidence-based multi-component QI program, the Assisted Living Falls Prevention and Monitoring Program (AL-FPMP). Resident posture and gait improved, likely due to exercise and/or physical therapy. Effective falls prevention QI programs can be implemented in AL, and are advised to (1) establish and maintain a falls team to create a culture focused on the reduction of falls risk; (2) teach staff to assess residents using the Morse Falls Scale to increase their awareness of residents' falls risk and improvement; and (3) modify existing exercise programs to address balance and lower body strength. Copyright © 2016 Elsevier Inc. All rights reserved.

  7. Older people. Courtesy entitles.

    Science.gov (United States)

    Calnan, Michael; Woolhead, Gillian; Dieppe, Paul

    2003-02-20

    A study of 72 people, with an average age of 72, showed that dignity--and lack of it--were key issues in their estimation of care. Concerns about lack of dignity centred on lack of privacy, mixed sex wards, forms of address and loss of independence. The study suggested that older people do not complain about care for fear of retaliation.

  8. Annexure to Commentary entitled

    Indian Academy of Sciences (India)

    Madhsudhan

    (14) Comparing the inputs required for optimal growth of the GMO relative to the parent organism and comparison ... of published data on the progressive increase in the population of pests that were initially known to be resistant ... technology.

  9. 20 CFR 411.552 - What effect will the subsequent entitlement to title II benefits have on EN payments for title...

    Science.gov (United States)

    2010-04-01

    ... 20 Employees' Benefits 2 2010-04-01 2010-04-01 false What effect will the subsequent entitlement to title II benefits have on EN payments for title XVI beneficiaries after they assign their ticket? 411.552 Section 411.552 Employees' Benefits SOCIAL SECURITY ADMINISTRATION THE TICKET TO WORK AND SELF...

  10. Between Soft Legality and Strong Legitimacy : A Political Economy Approach to the Struggle for Basic Entitlements to Safe Water and Sanitation

    NARCIS (Netherlands)

    de Gaay Fortman, B.|info:eu-repo/dai/nl/068346581; Marcatelli, M.

    2015-01-01

    This article argues that the internationally declared “human right to safe water and sanitation,” although characterized by soft legality, may yet support universal access to such basic entitlements by virtue of its strong legitimacy. From a strategic perspective, human rights do indeed provide

  11. Micro and Macro Content Analysis of English Textbook Entitled "Mosaic One Listening and Speaking (Student's Book)" in the Light of Communicative Competence

    Science.gov (United States)

    Al-Mashaqba, Nisreen Juma'a Hamed

    2017-01-01

    The purpose of this study is to investigate the extent to which the listening and speaking lessons which are presented in textbook entitled "Mosaic One Listening and speaking (Student's Book)" are characterized with appropriateness and meaningfulness in light of communicative competence and meet the Principles and features of…

  12. 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.

  13. 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...

  14. 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.

  15. 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.

  16. 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.

  17. 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...

  18. 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...

  19. 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…

  20. Leave entitlements, time off work and the household financial impacts of quarantine compliance during an H1N1 outbreak.

    Science.gov (United States)

    Kavanagh, Anne M; Mason, Kate E; Bentley, Rebecca J; Studdert, David M; McVernon, Jodie; Fielding, James E; Petrony, Sylvia; Gurrin, Lyle; LaMontagne, Anthony D

    2012-11-20

    The Australian state of Victoria, with 5.2 million residents, enforced home quarantine during a H1N1 pandemic in 2009. The strategy was targeted at school children. The objective of this study was to investigate the extent to which parents' access to paid sick leave or paid carer's leave was associated with (a) time taken off work to care for quarantined children, (b) household finances, and (c) compliance with quarantine recommendations. We conducted an online and telephone survey of households recruited through 33 schools (85% of eligible schools), received 314 responses (27%), and analysed the subsample of 133 households in which all resident parents were employed. In 52% of households, parents took time off work to care for quarantined children. Households in which no resident parent had access to leave appeared to be less likely to take time off work (42% vs 58%, p=0.08) although this difference had only borderline significance. Among parents who did take time off work, those in households without access to leave were more likely to lose pay (73% vs 21%, pparent lost pay due to taking time off work, 42% experienced further financial consequences such as being unable to pay a bill. Access to leave did not predict compliance with quarantine recommendations. Future pandemic plans should consider the economic costs borne by households and options for compensating quarantined families for income losses.

  1. 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.

  2. Doctor-assisted suicide: What is the present legal position in South Africa?

    Science.gov (United States)

    McQuoid-Mason, David J

    2015-09-21

    In the recent case of Stransham-Ford v. the Minister of Justice and Correctional Services, the North Gauteng High Court held that a terminally ill patient who was experiencing intractable suffering was entitled to commit suicide with the assistance of his doctor and that the doctor's conduct would not be unlawful. The court was careful to state that it was not making a general rule about doctor-assisted suicide. The latter should be left to the Parliament, the Constitutional Court and 'future courts'. The judge dealt specifically with the facts of the case at hand. In order to understand the basis of the decision it is necessary to consider: (i) the facts of the case; (ii) the question of causation; (iii) the paradox of 'passive' and 'active' euthanasia; (iv) the test for unlawfulness in euthanasia cases; and (v) the meaning of doctor-assisted suicide. It is also necessary to clarify the present legal position regarding doctor-assisted suicide.

  3. Comparative Analysis of the Social Assistance System in Romania vs. Hungary

    Directory of Open Access Journals (Sweden)

    Oprișan Oana

    2017-01-01

    Full Text Available The problems of social assistance are addressed and solved within the national framework of each state, social assistance by its nature having an internal character. Social assistance is being restructured and develops according to the existing situation of the population and the local and regional traditions, but it also takes into account the international regulations. According to the provisions of art. 22 of the Universal Declaration of Human Rights states that any person, in his capacity as a member of society, has the right to social security (social protection and therefore to social assistance; she is entitled to achieve the economic, social and cultural rights indispensable for her dignity and for the free development of her personality through national effort and international collaboration, taking into account the resources of each country.

  4. 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.

  5. Foreign Assistance: Treasury's Technical Assistance Program

    National Research Council Canada - National Science Library

    Ford, Jess

    1999-01-01

    After the collapse of communism in Central Europe and the dissolution of the Soviet Union, the United States developed programs of technical assistance to help countries transition to market economies and democracy...

  6. 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.

  7. 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.

  8. 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

  9. International issues: Obtaining an adult neurology residency position in the United States: an overview.

    Science.gov (United States)

    Jordan, Justin T; Sellner, Johann; Struhal, Walter; Schneider, Logan; Mayans, David

    2014-04-08

    Around the world, there are marked differences in neurology training, including training duration and degree of specialization. In the United States, adult neurology residency is composed of 1 year of internal medicine training (preliminary year) and 3 years of neurology-specific training. Child neurology, which is not the focus of this article, is 2 years of pediatrics and 3 years of neurology training. The route to adult neurology residency training in the United States is standardized and is similar to most other US specialties. Whereas US medical graduates often receive stepwise guidance from their medical school regarding application for residency training, international graduates often enter this complex process with little or no such assistance. Despite this discrepancy, about 10%-15% of residency positions in the United States are filled by international medical graduates.(1,2) In adult neurology specifically, 35% of matched positions were filled by international graduates in 2013, 75% of whom were not US citizens.(1) In an effort to provide a preliminary understanding of the application process and related terminology (table 1) and thereby encourage international residency applicants, we describe the steps necessary to apply for neurology residency in the United States.

  10. Comprehensive innovative solution for resident education using the Intranet Journal of Chest Radiology.

    Science.gov (United States)

    Nishino, Mizuki; Wolfe, Donna; Yam, Chun-Shan; Larson, Michael; Boiselle, Phillip M; Hatabu, Hiroto

    2004-10-01

    Because of the rapid increase in clinical workload in academic radiology departments, time for teaching rotating residents is getting more and more limited. As a solution to this problem, we introduced the Intranet Journal of Chest Radiology as a comprehensive innovative tool for assisting resident education. The Intranet Journal of Chest Radiology is constructed using Microsoft FrontPage version 2002 (Microsoft Corp, Redmond, WA) and is hosted in our departmental web server (Beth Israel Deaconess Medical Center, Boston, MA). The home page of the intranet journal provides access to the main features, "Cases of the Month," "Teaching File," "Selected Articles for Residents," "Lecture Series," and "Current Publications." These features provide quick access to the selected radiology articles, the interesting chest cases, and the lecture series and current publication from the chest section. Our intranet journal has been well utilized for 6 months after its introduction. It enhances residents' interest and motivation to work on case collections, to search and read articles, and to generate interest in research. Frequent updating is necessary for the journal to be kept current, relevant, and well-utilized. The intranet journal serves as a comprehensive innovative solution for resident education, providing basic educational resources and opportunities of interactive participation by residents.

  11. 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

  12. Residency evaluation and adherence design study: Young ophthalmologists' perception of their residency programs – Clinical and surgical skills

    Directory of Open Access Journals (Sweden)

    Parikshit Gogate

    2017-01-01

    Full Text Available Background: Residency training is the basis of good clinical and surgical practice. Purpose: The aim is to know the demographics, training experience, and perception of young ophthalmologists to improve the present residency programs in India. Setting: Young ophthalmologists trained in India. Methods: A survey was conducted by the Academic and Research Committee of the All India Ophthalmology Society, in 2014–2016 of young ophthalmologists (those trained between 2002 and 2012, with 2–10 years' postresidency experience to gauge teaching of clinical and surgical skills during the postgraduate residency program. Statistical Analysis: Statistical Package for Social Sciences version 16. Results: Of the 1005 respondents, 531 fulfilled inclusion criteria. Average age was 32.6 years (standard deviation [SD] 4. On a scale of 0–10, clinical skills teaching was graded as (mean, SD: Slit lamp examination (7.2, SD 2.8, indirect ophthalmoscopy (6.2, SD 3.3, gonioscopy (5.7, SD 3.4, perimetry (6.2, SD 3.2, optical coherence tomography (4.6, SD 4, and orthoptic evaluation (4.3, SD 3.1. The mean (SD and median of surgeries performed independently was intracapsular cataract extraction 3.0 (14.9, 0; extracapsular cataract extraction 39.9 (53.2, 18; small incision cataract surgery 75.3 (64.4, 55; phacoemulsification 30 (52.6, 1; pterygium excision 31.5 (43.5, 15; dacryocystectomy 20.3 (38.1, 4; dacryocystorhinostomy 11.7 (26.2, 2; chalazion 46.4 (48.3, 30; trabeculectomies 4 (14.9, 0; strabismus correction 1.4 (4.9, 0; laser-assisted in situ Keratomileusis 1.5 (12.2, 0; retinal detachment 1.5 (12.5, 0; vitrectomy 3.0 (17.0, 0; keratoplasty 5.2 (17.8, 0; eyelid surgery 8.6 (18.9, 2 and ocular emergencies 41.7 (52.4, 20. Observed and assisted surgeries were more common. However, the range of grading was 0–10 in all categories. Conclusion: Residency training in India varies considerably from program to program. Standardization is needed to assure all graduates

  13. 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

  14. Intelligent Temporal Data Driven World Actuation in Ambient Environments Case Study: Anomaly Recognition and Assistance Provision in Smart Home

    Data.gov (United States)

    National Aeronautics and Space Administration — Abstract — A possible resident of smart home is an old person or an Alzheimer patient that should be assisted continuously for the rest of his life; however,...

  15. 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.

  16. 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.

  17. Communication of 1 October 2009 received from the Resident Representative of Hungary to the Agency on behalf of the participating Governments of the Nuclear Suppliers Group

    International Nuclear Information System (INIS)

    2009-01-01

    The Director General has received a letter dated 1 October 2009 from the Resident Representative of Hungary to the Agency on behalf of the Participating Governments of the Nuclear Suppliers Group.1 Attached to this letter is an updated version of a paper entitled 'The Nuclear Suppliers Group: Its Origins, Role and Activities. The original version of this paper was issued as INFCIRC/539 on 15 September 1997: revisions were issued on 17 April 2000, 16 September 2003 and 30 May 2005. As requested in the letter, the revised version of the paper, attached hereto, is being circulated to Member States of the IAEA

  18. Use of a formal assessment instrument for evaluation of resident operative skills in pediatric neurosurgery.

    Science.gov (United States)

    Hadley, Caroline; Lam, Sandi K; Briceño, Valentina; Luerssen, Thomas G; Jea, Andrew

    2015-08-28

    OBJECT Currently there is no standardized tool for assessment of neurosurgical resident performance in the operating room. In light of enhanced requirements issued by the Accreditation Council for Graduate Medical Education's Milestone Project and the Matrix Curriculum Project from the Society of Neurological Surgeons, the implementation of such a tool seems essential for objective evaluation of resident competence. Beyond compliance with governing body guidelines, objective assessment tools may be useful to direct early intervention for trainees performing below the level of their peers so that they may be given more hands-on teaching, while strong residents can be encouraged by faculty members to progress to conducting operations more independently with passive supervision. The aims of this study were to implement a validated assessment tool for evaluation of operative skills in pediatric neurosurgery and determine its feasibility and reliability. METHODS All neurosurgery residents completing their pediatric rotation over a 6-month period from January 1, 2014, to June 30, 2014, at the authors' institution were enrolled in this study. For each procedure, residents were evaluated by means of a form, with one copy being completed by the resident and a separate copy being completed by the attending surgeon. The evaluation form was based on the validated Objective Structured Assessment of Technical Skills for Surgery (OSATS) and used a 5-point Likert-type scale with 7 categories: respect for tissue; time and motion; instrument handling; knowledge of instruments; flow of operation; use of assistants; and knowledge of specific procedure. Data were then stratified by faculty versus resident (self-) assessment; postgraduate year level; and difficulty of procedure. Descriptive statistics (means and SDs) were calculated, and the results were compared using the Wilcoxon signed-rank test and Student t-test. A p value assessment scores overall or in any of the 7 domains scores

  19. 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.

  20. 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.

  1. 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.

  2. Why do adults entitled to free or highly subsidized dental services select fully out-of-pocket-paid care?

    Science.gov (United States)

    Bayat, Fariborz; Vehkalahti, Miira M; Murtomaa, Heikki; Tala, Heikki

    2010-02-01

    To investigate patients' reasons for selecting a dental clinic given their choice of free or highly-subsidized dental services. The study was based on cross-sectional data obtained through phone interviews with adults in Tehran, Iran. The present study included those entitled to free or highly-subsidized dental services (n = 726). The data covered the patients' awareness of subsidized dental services and type of dental clinic for their most recent visit and their reasons for selecting that clinic. Awareness of subsidized dental services was dichotomized as being either aware or unaware of such subsidy. The type of clinic was dichotomized as providing either free or highly-subsidized (FHS) or fully out-of-pocket paid (FOP) services. Free format answers about the subjects' reasons for selecting a particular clinic were later sub-grouped as: convenient access, good technical aspects, good interpersonal aspects, low or reasonable fees, recommendation by a friend, and no reason. Socio-demographic status was based on background. Data analysis included the chi-square test and logistic regression model. Of the subjects (n = 726), 60% were women and 58% were under 35 years of age. The subjects' mean age was 33.5 years with no difference by gender (P = 0.24) and the majority had public insurance (91%). Of all the subjects, 60% selected FOP. Good interpersonal aspects were the strongest reason for selecting FOP (OR = 4.6), follow by good technical aspects (OR = 2.3). Those subjects who were unaware of their benefit had 4.6 times the odds of selecting FOP. Despite the opportunity to use highly-subsidized dental services, good interpersonal and good technical aspects lead patients to select private dentists and to pay fully out of pocket.

  3. 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.

  4. Neurosurgical Resident Training in Germany.

    Science.gov (United States)

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

    2017-07-01

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

  5. Three-year emergency medicine training program in The Netherlands: first evaluation from the residents' perspective.

    Science.gov (United States)

    Koning, Salomon Willem; Gaakeer, Menno Iskander; Veugelers, Rebekka

    2013-07-26

    The Netherlands' 3-year training in Emergency Medicine (EM) was formally approved and introduced in November 2008. To identify areas for improvement, we conducted the first evaluation of this curriculum from the residents' perspective. A questionnaire was composed on ten aspects of the curriculum. It contained multiple-choice, open and opinion questions; answers to the latter were classified using the Likert scale. The questionnaires were mailed to all enrolled residents. We mailed questionnaires to all 189 enrolled residents, and 105 responded (55.6%). Although they were satisfied with their training overall, 96.2% thought it was currently too short: 18.3% desired extension to 4 years, 76.0% to 5 and 1.9% to 6 years. Nevertheless, residents expected that they would function effectively as emergency physicians (EPs) after finishing their 3-year training program. Bedside teaching was assessed positively by 35.2%. All rotations were assessed positively, with the general practice rotation seen as contributing the least to the program. According to 43.7%, supervising EPs were available for consultation; 40.7% thought that, in a clinical capacity, the EP was sufficiently present during residents' shifts. When EPs were present, 82.5% found them to be easily accessible, and 66.6% viewed them as role models. In the Emergency Medicine Departments (EDs) with a higher number of EPs employed, residents tended to perceive better supervision and were more likely to see their EPs as role models. While residents were stimulated to do research, actual support and assistance needed to be improved. Although overall, the current training program was evaluated positively, the residents identified four areas for improvement: (1) in training hospitals, trained EPs should be present more continuously for clinical supervision; (2) bedside teaching should be improved, (3) scientific research should be facilitated more and (4) the training program should be extended.

  6. 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...

  7. Scholar in Residence: an innovative application of the scholarship of engagement.

    Science.gov (United States)

    Jacelon, Cynthia S; Donoghue, Linda Carey; Breslin, Eileen

    2010-01-01

    Universities are expected to engage with communities for the benefit of both. Based on the definition of scholarship advanced by Boyer in the 1990s, inclusive of the scholarship of discovery, integration, teaching, and application, the School of Nursing and Jewish Geriatric Services, Inc., have instituted a unique collaboration entitled the Scholar in Residence. Unlike traditional agreements between schools of nursing and agencies to provide clinical experience and educate students, this agreement is designed to build scholarship for both university and agency. Outcomes include building opportunities for faculty and staff scholarship at the agency, enhancing the integration of knowledge into practice, intensifying opportunities for the sharing of knowledge by providing opportunities for students to work with faculty and staff on individual projects, and enriching the application of knowledge by providing opportunities for faculty clinical practice and consultation. The Scholar in Residence is a model of collaboration between the university and the community that reflects the mission of the university and provides value to the community agency through strategic engagement of both entities. Copyright 2010 Elsevier Inc. All rights reserved.

  8. 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...

  9. 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.

  10. Health state of the population residing in the vicinity of Eleshnitsa Uranium Deposits

    International Nuclear Information System (INIS)

    Bliznakov, V.; Panova, D.; Bakalov, M.; Stateva, E.; Nuryan, L.; Sultanov, E.; Ivanov, Z.; Tomov, P.; Krystev, D.; Madoleva, S.; Bulev, A.

    1993-01-01

    Disease prevalence rate was studied in residents of Eleshnitsa village, Bulgaria, situated in an immediate vicinity of two uranium mines and one uranium flotation plant. Determinations were made of gamma radiation dose rate in the open and within some premises, and of the level of 'hidden energy' at some outdoor sites. The investigation was performed by physicians and assistant personnel specialized in eight different medical fields. A total of 186 children and 257 adults residing in Eleshnitsa were examined. The control group included residents of the 'clear' Dobrinishte village, Razlog district. The evidence from statistical data processing indicated the health impairments to be more frequent among the control group population. No disorders that might be related to exposure to environmental radiation factors were revealed. (author)

  11. Dust Allergens within Rural Northern Rocky Mountain Residences.

    Science.gov (United States)

    Weiler, Emily; Semmens, Erin; Noonan, Curtis; Cady, Carol; Ward, Tony

    2015-01-23

    To date, few studies have characterized allergens within residences located in rural areas of the northern Rocky Mountain region. In this study, we collected dust samples from 57 homes located throughout western Montana and northern Idaho. Dust samples were collected and later analyzed for dust mite allergens Der f 1 and Der p 1 , Group 2 mite allergens ( Der p 2 and Der f 2 ), domestic feline ( Fel d 1 ), and canine ( Can f 1 ). Indoor temperature and humidity levels were also measured during the sampling program, as were basic characteristics of each home. Dog (96%) and cat (82%) allergens were the most prevalent allergens found in these homes (even when a feline or canine did not reside in the home). Results also revealed the presence of dust mites. Seven percent (7%) of homes tested positive for Der p 1 , 19% of homes were positive for Der f 1 , and 5% of homes were positive for the Group 2 mite allergens. Indoor relative humidity averaged 27.0 ± 7.6% within the homes. Overall, humidity was not significantly associated with dust mite presence, nor was any of the other measured home characteristics. This study provides a descriptive assessment of indoor allergen presence (including dust mites) in rural areas of the northern Rocky Mountains, and provides new information to assist regional patients with reducing allergen exposure using in-home intervention strategies.

  12. Using spaced retrieval and Montessori-based activities in improving eating ability for residents with dementia.

    Science.gov (United States)

    Lin, Li-Chan; Huang, Ya-Ju; Su, Su-Gen; Watson, Roger; Tsai, Belina W-J; Wu, Shiao-Chi

    2010-10-01

    To construct a training protocol for spaced retrieval (SR) and to investigate the effectiveness of SR and Montessori-based activities in decreasing eating difficulty in older residents with dementia. A single evaluator, blind, and randomized control trial was used. Eighty-five residents with dementia were chosen from three special care units for residents with dementia in long-term care facilities in Taiwan. To avoid any confounding of subjects, the three institutions were randomized into three groups: spaced retrieval, Montessori-based activities, and a control group. The invention consisted of three 30-40 min sessions per week, for 8 weeks. After receiving the intervention, the Edinburgh Feeding Evaluation in Dementia (EdFED) scores and assisted feeding scores for the SR and Montessori-based activity groups were significantly lower than that of the control group. However, the frequencies of physical assistance and verbal assistance for the Montessori-based activity group after intervention were significantly higher than that of the control group, which suggests that residents who received Montessori-based activity need more physical and verbal assistance during mealtimes. In terms of the effects of nutritional status after intervention, Mini-Nutritional Assessment (MNA) in the SR group was significantly higher than that of the control group. This study confirms the efficacy of SR and Montessori-based activities for eating difficulty and eating ability. A longitudinal study to follow the long-term effects of SR and Montessori-based activities on eating ability and nutritional status is recommended. Copyright © 2010 John Wiley & Sons, Ltd.

  13. 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.

  14. 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.

  15. 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.

  16. 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.

  17. 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.

  18. 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

  19. 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.

  20. 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...

  1. 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

  2. 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.

  3. 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...

  4. 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

  5. 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.

  6. Optimizing Communications Between Arctic Residents and IPY Scientific Researchers

    Science.gov (United States)

    Stapleton, M.; Carpenter, L.

    2007-12-01

    in San Francisco on December 10 to 14, 2007. One component of this conference is entitled « Education, Outreach and Communications During IPY and Beyond ». ACIC proposes to present a discussion paper, « Optimizing Communications Between Arctic Residents and IPY Scientific Researchers », describing the status of IPY outreach and communications in the Arctic at this time. The paper will be complemented by photographs which illustrate the context of communication activity in these regions. ACIC has an existing international network of indigenous northern communicators. The IPY Northern Coordination Offices in Canada, and key informants in Alaska, RAIPON in the Russian Federation, and the Association of Sami Journalists, will be interviewed to determine involvement in IPY activities planned and/or undertaken. The level of community and professional awareness will be surveyed through interviews with community radio personnel. Aspirations and expectations for further cooperation with IPY reseearchers will be determined. Barriers and shortfalls will be identified. The usability and potential of current communications will be assessed. Endorsed IPY projects will be contacted to determine their Arctic communication plans and activities, barriers and opportunities. Information gained from the Joint Committee Assessment in October will be considered in the context of northern informant input. Conclusions and recommendations will reported, with the goal of optimizing opportunities to connect indigenous Arctic residents and IPY scientific research centres.

  7. 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.

  8. 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

  9. 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.

  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. A physical workload index to evaluate a safe resident handling program for nursing home personnel.

    Science.gov (United States)

    Kurowski, Alicia; Buchholz, Bryan; Punnett, Laura

    2014-06-01

    The aim of this study was to obtain a comprehensive analysis of the physical workload of clinical staff in long-term care facilities, before and after a safe resident handling program (SRHP). Ergonomic exposures of health care workers include manual handling of patients and many non-neutral postures. A comprehensive assessment requires the integration of loads from these varied exposures into a single metric. The Postures, Activities, Tools, and Handling observational protocol, customized for health care, was used for direct observations of ergonomic exposures in clinical jobs at 12 nursing homes before the SRHP and 3, 12, 24, and 36 months afterward. Average compressive forces on the spine were estimated for observed combinations of body postures and manual handling and then weighted by frequencies of observed time for the combination. These values were summed to obtain a biomechanical index for nursing assistants and nurses across observation periods. The physical workload index (PWI) was much higher for nursing assistants than for nurses and decreased more after 3 years (-24% versus -2.5%). Specifically during resident handling, the PWI for nursing assistants decreased by 41% of baseline value. Spinal loading was higher for nursing assistants than for nurses in long-term care centers. Both job groups experienced reductions in physical loading from the SRHP, especially the nursing assistants and especially while resident handling. The PWI facilitates a comprehensive investigation of physical loading from both manual handling and non-neutral postures. It can be used in any work setting to identify high-risk tasks and determine whether reductions in one exposure are offset by increases in another.

  12. Pakistan's national legislation entitled: 'Export Control on Goods, Technologies, Material and Equipment related to Nuclear and Biological Weapons and their Delivery Systems Act, 2004'

    International Nuclear Information System (INIS)

    2004-01-01

    The Director General has received a letter from the Permanent Mission of Pakistan, dated 4 November 2004, concerning Pakistan's national legislation entitled 'Export Control on Goods, Technologies, Material and Equipment related to Nuclear and Biological Weapons and their Delivery Systems Act, 2004'. As requested by the Permanent Mission of Pakistan, the letter and the Export Control Act of 2004, are reproduced herein for the information of the Member States

  13. [Luís Gomes Ferreira reports on the health of slaves in his work entitled Erário mineral (1735)].

    Science.gov (United States)

    Eugênio, Alisson

    2015-01-01

    The article analyzes the reports of Luís Gomes Ferreira published in his manual on practical medicine entitled Erário mineral, of 1735, on the most common illnesses in captivity. It is shown that such reports can be interpreted as a criticism of the social relations of the slave era by issuing some warnings to the landowners who failed to look after the health of their slaves.

  14. Assisted suicide and euthanasia.

    Science.gov (United States)

    van der Heide, Agnes

    2013-01-01

    Several countries have adopted laws that regulate physician assistance in dying. Such assistance may consist of providing a patient with a prescription of lethal medication that is self-administered by the patient, which is usually referred to as (physician) assistance in suicide, or of administering lethal medication to a patient, which is referred to as euthanasia. The main aim of regulating physician assistance in dying is to bring these practices into the open and to provide physicians with legal certainty. A key condition in all jurisdictions that have regulated either assistance in suicide or euthanasia is that physicians are only allowed to engage in these acts upon the explicit and voluntary request of the patient. All systems that allow physician assistance in dying have also in some way included the notion that physician assistance in dying is only accepted when it is the only means to address severe suffering from an incurable medical condition. Arguments against the legal regulation of physician assistance in dying include principled arguments, such as the wrongness of hastening death, and arguments that emphasize the negative consequences of allowing physician assistance in dying, such as a devaluation of the lives of older people, or people with chronic disease or disabilities. Opinion polls show that some form of accepting and regulating euthanasia and physician assistance in suicide is increasingly supported by the general population in most western countries. Studies in countries where physician assistance in dying is regulated suggest that practices have remained rather stable in most jurisdictions and that physicians adhere to the legal criteria in the vast majority of cases. © 2013 Elsevier B.V. All rights reserved.

  15. 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.

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

    OpenAIRE

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

    2017-01-01

    Purpose 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. Method The authors used a constructivist grounded theory approach. In 2012–2014, they conducted semistructured interviews with a purposive and theoretical sample of 1...

  17. Orthopedic resident work-shift analysis: are we making the best use of resident work hours?

    Science.gov (United States)

    Hamid, Kamran S; Nwachukwu, Benedict U; Hsu, Eugene; Edgerton, Colston A; Hobson, David R; Lang, Jason E

    2014-01-01

    Surgery programs have been tasked to meet rising demands in patient surgical care while simultaneously providing adequate resident training in the midst of increasing resident work-hour restrictions. The purpose of this study was to quantify orthopedic surgery resident workflow and identify areas needing improved resident efficiency. We hypothesize that residents spend a disproportionate amount of time involved in activities that do not relate directly to patient care or maximize resident education. We observed 4 orthopedic surgery residents on the orthopedic consult service at a major tertiary care center for 72 consecutive hours (6 consecutive shifts). We collected minute-by-minute data using predefined work-task criteria: direct new patient contact, direct existing patient contact, communications with other providers, documentation/administrative time, transit time, and basic human needs. A seventh category comprised remaining less-productive work was termed as standby. In a 720-minute shift, residents spent on an average: 191 minutes (26.5%) performing documentation/administrative duties, 167.0 minutes (23.2%) in direct contact with new patient consults, 129.6 minutes (17.1%) in communication with other providers regarding patients, 116.2 (16.1%) minutes in standby, 63.7 minutes (8.8%) in transit, 32.6 minutes (4.5%) with existing patients, and 20 minutes (2.7%) attending to basic human needs. Residents performed an additional 130 minutes of administrative work off duty. Secondary analysis revealed residents were more likely to perform administrative work rather than directly interact with existing patients (p = 0.006) or attend to basic human needs (p = 0.003). Orthopedic surgery residents spend a large proportion of their time performing documentation/administrative-type work and their workday can be operationally optimized to minimize nonvalue-adding tasks. Formal workflow analysis may aid program directors in systematic process improvements to better align

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

    Science.gov (United States)

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

    2012-01-01

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

  19. Personal Therapy in Psychiatry Residency Training: A National Survey of Canadian Psychiatry Residents.

    Science.gov (United States)

    Hadjipavlou, George; Halli, Priyanka; Hernandez, Carlos A Sierra; Ogrodniczuk, John S

    2016-02-01

    The authors collected nationally representative data on Canadian residents' experiences with and perspectives on personal psychotherapy in their psychiatric training. A 43-item questionnaire was distributed electronically to all current psychiatry residents in Canada (N = 839). Four hundred residents from every program across Canada returned the survey (response rate 47.7%). The prevalence of personal therapy at any time was 55.3%, with 42.8% receiving personal therapy during residency. Of residents who undertook personal psychotherapy, 59.3% engaged in weekly therapy, 74.1% received psychodynamic psychotherapy, and 81.5% participated in long-term therapy (>1 year). Personal growth, self-understanding, and professional development were the most common reasons for engaging in personal therapy; however, one-third of residents did so to alleviate symptoms of depression, anxiety, or other mental health concerns. Time was the most important factor impeding residents from personal therapy; only 8.8% found stigma to act as a barrier. The vast majority of residents rated their experience with personal therapy as having a positive or very positive impact on their personal life (84.8%) and overall development as psychiatrists (81.8%). For 64% of respondents, personal therapy had an important or very important role in psychiatry residency training. Residents who received personal therapy rated themselves as better able to understand what happens moment by moment during therapy sessions, detect and deal with patients' emotional reactions, and constructively use their personal reactions to patients. Interest in personal therapy remains strong among psychiatry trainees in Canada. Residents who engaged in psychotherapy endorsed greater confidence in psychotherapy and rated their psychotherapy skills more favorably than those who had never been in the patient role, supporting the view of personal therapy as an important adjunct to psychotherapy training during residency.

  20. Laparoscopic hand-assisted versus robotic-assisted laparoscopic sleeve gastrectomy: experience of 103 consecutive cases.

    Science.gov (United States)

    Kannan, Umashankkar; Ecker, Brett L; Choudhury, Rashikh; Dempsey, Daniel T; Williams, Noel N; Dumon, Kristoffel R

    2016-01-01

    Laparoscopic sleeve gastrectomy has become a stand-alone procedure in the treatment of morbid obesity. There are very few reports on the use of robotic approach in sleeve gastrectomy. The purpose of this retrospective study is to report our early experience of robotic-assisted laparoscopic sleeve gastrectomy (RALSG) using a proctored training model with comparison to an institutional cohort of patients who underwent laparoscopic hand-assisted sleeve gastrectomy (LASG). University hospital. The study included 108 patients who underwent sleeve gastrectomy either via the laparoscopic-assisted or robot-assisted approach during the study period. Of these 108 patients, 62 underwent LASG and 46 underwent RALSG. The console surgeon in the RALSG is a clinical year 4 (CY4) surgery resident. All CY4 surgery residents received targeted simulation training before their rotation. The console surgeon is proctored by the primary surgeon with assistance as needed by the second surgeon. The patients in the robotic and laparoscopic cohorts did not have a statistical difference in their demographic characteristics, preoperative co-morbidities, or complications. The mean operating time did not differ significantly between the 2 cohorts (121 min versus 110 min, P = .07). Patient follow-up in the LSG and RALSG were 91% and 90% at 3 months, 62% and 64% at 6 months, and 60% and 55% at 1 year, respectively. The mean percentage estimated weight loss (EWL%) at 3 months, 6 months, and 1 year was greater in the robotic group but not statistically significant (27 versus 22 at 3 mo [P = .05] and 39 versus 34 at 6 mo [P = .025], 57 versus 48 at 1 yr [P = .09]). There was no mortality in either group. Early results of our experience with RALSG indicate low perioperative complication rates and comparable weight loss with LASG. The concept of a stepwise education model needs further validation with larger studies. Copyright © 2016 American Society for Bariatric Surgery. Published by Elsevier Inc