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Sample records for resident major discrepancies

  1. Increasing neuroradiology exam volumes on-call do not result in increased major discrepancies in primary reads performed by residents.

    Science.gov (United States)

    Verdoorn, Jared T; Hunt, Christopher H; Luetmer, Marianne T; Wood, Christopher P; Eckel, Laurence J; Schwartz, Kara M; Diehn, Felix E; Kallmes, David F

    2014-01-01

    A common perception is that increased on-call workload leads to increased resident mistakes. To test this, we evaluated whether increased imaging volume has led to increased errors by residents. A retrospective review was made of all overnight neuroradiology CT exams with a primary resident read from 2006-2010. All studies were over-read by staff neuroradiologists next morning. As the volume is higher on Friday through Sunday nights, weekend studies were examined separately. Discrepancies were classified as either minor or major. "Major" discrepancy was defined as a discrepancy that the staff radiologist felt was significant enough to potentially affect patient care, necessitating a corrected report and phone contact with the ordering physician and documentation. The total number of major discrepancies was recorded by quarter. In addition, the total number of neuroradiology CT studies read overnight on-call was noted. The mean number of cases per night during the weekday increased from 3.0 in 2006 to 5.2 in 2010 (pneuroradiology exam volumes, there continues to be a low major discrepancy rate for primary resident interpretations. While continued surveillance of on-call volumes is crucial to the educational environment, concern of increased major errors should not be used as sole justification to limit autonomy.

  2. Evaluating Resident On-Call Performance: Does Volume Affect Discrepancy Rate?

    Science.gov (United States)

    Wildman-Tobriner, Benjamin; Cline, Brendan; Swenson, Christopher; Allen, Brian C; Maxfield, Charles M

    2018-01-06

    To examinehow study volume affects discrepancy rates for on-call radiology residents. Inparticular, we studied how both total shift volume and volume at a particularpoint in time might effect performance. Weretrospectively analyzed 518 weekend call shifts at our institution. The totalnumber of computed tomography (CT) studies per shift was recorded. For everyabdomen-pelvis (AP) or chest-abdomen-pelvis (CAP) CT, preliminary and finalreports were compared for possible discrepancy and rated (by effect on short-termmanagement). We also developed "peristudy volume," defined as CTs read within ±30minutes of a given CT, an estimate of how busy a resident might be at a giventime. We performed logistic regressions to determine whether overall shiftvolume or peristudy volume were predictors of discrepancies. CTvolume/day increased from 58.1 ± 10.1 in 2011 to 75.3 ± 12.5 in 2015(p<0.001). 4695 AP (or CAP) CTs were reviewed, with 145 discrepancies thatcould affect short-term management (3.1%). When reading a study during a shift with≥51 total CTs,residents had increased odds of an error compared to reading a study during ashift with ≤30 studies (OR: 2.97, CI: 1.19-6.46) (p=0.01). When reading a CTwith a peristudy volume of ≥6, residents had increased odds of an error comparedto reading a study with ≤5 peristudy CTs (OR: 1.6, CI: 1.1-2.3) (p=0.01). Whenon-call residents interpret AP CT during high volume shiftsor during busy time-points, odds of discrepancies increase. Awareness of thesedata may inform residency programs in staffing decisions. Copyright © 2018 Elsevier Inc. All rights reserved.

  3. Estrogen, stress and the brain: progress toward unraveling gender discrepancies in major depressive disorder.

    Science.gov (United States)

    Shansky, Rebecca M

    2009-07-01

    Women are twice as likely as men to develop major depressive disorder (MDD) and, while the neurobiological factors underlying this discrepancy are yet to be identified, estrogen almost certainly plays a role. MDD can be precipitated or exacerbated by exposure to stress and there is substantial evidence to suggest that estrogen can interact with stress systems to produce unique stress effects in females. This review integrates current research in animal models regarding estrogen-stress interactions in three areas of the brain known to be relevant to MDD: the hippocampus, the amygdala and the prefrontal cortex. The results from these studies are discussed in the context of MDD, and their implications for future treatment of MDD in women are explored.

  4. Discrepancies in Cornell Scale for Depression in Dementia (CSDD items between residents and caregivers, and the CSDD's factor structure

    Directory of Open Access Journals (Sweden)

    Wongpakaran N

    2013-06-01

    Full Text Available Nahathai Wongpakaran,1 Tinakon Wongpakaran,1 Robert van Reekum2,3 1Department of Psychiatry, Chiang Mai University, Chiang Mai, Thailand; 2Department of Psychiatry, 3Institute of Medical Sciences, University of Toronto, Toronto, ON, Canada Purpose: This validation study aims to examine Cornell Scale for Depression in Dementia (CSDD items in terms of the agreement found between residents and caregivers, and also to compare alternative models of the Thai version of the CSDD. Patients and methods: A cross-sectional study was conducted of 84 elderly residents (46 women, 38 men, age range 60–94 years in a long-term residential home setting in Thailand between March and June 2011. The selected residents went through a comprehensive geriatric assessment that included use of the Mini-Mental State Examination, Mini-International Neuropsychiatric Interview, and CSDD instruments. Intraclass correlation (ICC was calculated in order to establish the level of agreement between the residents and caregivers, in light of the residents' cognitive status. Confirmatory factor analysis (CFA was adopted to evaluate the alternative CSDD models. Results: The CSDD yielded a high internal consistency (Cronbach's alpha = 0.87 and moderate agreement between residents and caregivers (ICC = 0.55; however, it was stronger in cognitively impaired subjects (ICC = 0.71. CFA revealed that there was no difference between the four-factor model, in which factors A (mood-related signs and E (ideational disturbance were collapsed into a single factor, and the five-factor model as per the original theoretical construct. Both models were found to be similar, and displayed a poor fit. Conclusion: The CSDD demonstrated a moderate level of interrater agreement between residents and caregivers, and was more reliable when used with cognitively impaired residents. CFA indicated a poorly fitting model in this sample. Keywords: Cornell Scale for Depression in Dementia (CSDD, factor structure

  5. Dietary intake of PBDEs of residents at two major electronic waste recycling sites in China

    Energy Technology Data Exchange (ETDEWEB)

    Chan, J.K.Y. [Croucher Institute for Environmental Sciences, and Department of Biology, Hong Kong Baptist University, Kowloon Tong, Hong Kong (China); School of Biological Sciences, The University of Hong Kong, Pokfulam, Hong Kong (China); Man, Y.B. [Croucher Institute for Environmental Sciences, and Department of Biology, Hong Kong Baptist University, Kowloon Tong, Hong Kong (China); Wu, S.C. [Croucher Institute for Environmental Sciences, and Department of Biology, Hong Kong Baptist University, Kowloon Tong, Hong Kong (China); State Key Laboratory in Marine Pollution, City University of Hong Kong, Tat Chee Avenue, Kowloon, Hong Kong (China); Wong, M.H., E-mail: mhwong@hkbu.edu.hk [Croucher Institute for Environmental Sciences, and Department of Biology, Hong Kong Baptist University, Kowloon Tong, Hong Kong (China)

    2013-10-01

    The dietary intake of polybrominated diphenyl ether (PBDE) of local residents from 2 major electronic waste (e-waste) processing sites (Guiyu, Guangdong Province and Taizhou, Zhejiang Province) in China was investigated. Seventy-four food items were collected from these sites, divided into 9 food groups (freshwater fish, marine fish, shellfish, pork, poultry, chicken offal, egg, vegetables and cereals), and examined for residual PBDE concentrations. Out of all food items examined, the freshwater bighead carp (Aristichthys nobilis) contained extremely high (11,400 ± 254 ng/g wet wt.) concentrations of PBDE, the highest concentrations amongst published data concerning PBDE detected in freshwater fish. Food consumption data obtained through semi-quantitative food intake questionnaires showed that Guiyu residents had a PBDE dietary intake of 931 ± 772 ng/kg bw/day, of which BDE-47 (584 ng/kg bw/day) exceeded the US EPA's reference dose (100 ng/kg/day). Taizhou (44.7 ± 26.3 ng/kg bw/day) and Lin'an (1.94 ± 0.86 ng/kg bw/day) residents exhibited lower readings. The main dietary source of PBDEs in Guiyu and Taizhou residents was seafood (88–98%) and pork (41%) in Lin'an. The present results indicated that health risks arising from PBDE dietary exposure are of significance in terms of public health and food safety to local residents of e-waste processing sites. - Highlights: ► Food basket analysis was conducted in 2 major e-waste processing sites in China. ► Different food items were contaminated by PBDE contained in e-waste sites in China. ► Guiyu residents had an potential unsafe level of PBDE dietary exposure.

  6. Orion: a web-based application designed to monitor resident and fellow performance on-call.

    Science.gov (United States)

    Itri, Jason N; Kim, Woojin; Scanlon, Mary H

    2011-10-01

    Radiology residency and fellowship training provides a unique opportunity to evaluate trainee performance and determine the impact of various educational interventions. We have developed a simple software application (Orion) using open-source tools to facilitate the identification and monitoring of resident and fellow discrepancies in on-call preliminary reports. Over a 6-month period, 19,200 on-call studies were interpreted by 20 radiology residents, and 13,953 on-call studies were interpreted by 25 board-certified radiology fellows representing eight subspecialties. Using standard review macros during faculty interpretation, each of these reports was classified as "agreement", "minor discrepancy", and "major discrepancy" based on the potential to impact patient management or outcome. Major discrepancy rates were used to establish benchmarks for resident and fellow performance by year of training, modality, and subspecialty, and to identify residents and fellows demonstrating a significantly higher major discrepancy rate compared with their classmates. Trends in discrepancies were used to identify subspecialty-specific areas of increased major discrepancy rates in an effort to tailor the didactic and case-based curriculum. A series of missed-case conferences were developed based on trends in discrepancies, and the impact of these conferences is currently being evaluated. Orion is a powerful information technology tool that can be used by residency program directors, fellowship programs directors, residents, and fellows to improve radiology education and training.

  7. Gender is a major factor explaining discrepancies in eye colour prediction based on HERC2/OCA2 genotype and the IrisPlex model

    OpenAIRE

    Martínez-Cadenas, Conrado; Peña Chilet, María; Ibarrola-Villava, Maider; Ribas, Gloria

    2013-01-01

    In recent years, several studies have greatly increased our understanding of the genetic basis underlying human eye colour variation. A large percentage of the eye colour diversity present in humans can already be genetically explained, so much so that different DNA-based eye colour prediction models, such as IrisPlex, have been recently developed for forensic purposes. Though these models are already highly accurate, they are by no means perfect, with many genotype-phenotype discrepancies st...

  8. Gender is a major factor explaining discrepancies in eye colour prediction based on HERC2/OCA2 genotype and the IrisPlex model.

    Science.gov (United States)

    Martinez-Cadenas, Conrado; Peña-Chilet, Maria; Ibarrola-Villava, Maider; Ribas, Gloria

    2013-07-01

    In recent years, several studies have greatly increased our understanding of the genetic basis underlying human eye colour variation. A large percentage of the eye colour diversity present in humans can already be genetically explained, so much so that different DNA-based eye colour prediction models, such as IrisPlex, have been recently developed for forensic purposes. Though these models are already highly accurate, they are by no means perfect, with many genotype-phenotype discrepancies still remaining unresolved. In this work we have genotyped six SNPs associated with eye colour (IrisPlex) in 535 individuals from Spain, a Mediterranean population. Aside from different SNP frequencies in Spain compared to Northern Europe, the results for eye colour prediction are quite similar to other studies. However, we have found an association between gender and eye colour prediction. When comparing similar eye colour genetic profiles, females tend, as a whole, to have darker eyes than males (and, conversely, males lighter than females). These results are also corroborated by the revision and meta-analysis of data from previously published eye colour genetic studies in several Caucasian populations, which significantly support the fact that males are more likely to have blue eyes than females, while females tend to show higher frequencies of green and brown eyes than males. This significant gender difference would suggest that there is an as yet unidentified gender-related factor contributing to human eye colour variation. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.

  9. Identification of medication discrepancies during hospital admission in Jordan: Prevalence and risk factors

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    Lana Salameh

    2018-01-01

    Full Text Available Objectives: Medication errors are considered among the most common causes of morbidity and mortality in hospital setting. Among these errors are discrepancies identified during transfer of patients from one care unit to another, from one physician care to another, or upon patient discharge. Thus, the aims of this study were to identify the prevalence and types of medication discrepancies at the time of hospital admission to a tertiary care teaching hospital in Jordan and to identify risk factors affecting the occurrence of these discrepancies. Methods: A three months prospective observational study was conducted at the department of internal medicine at Jordan university hospital. During the study period, 200 patients were selected using convenience sampling, and a pre-prepared data collection form was used for data collection. Later, a comparison between the pre-admission and admission medication was conducted to identify any possible discrepancies, and all of these discrepancies were discussed with the responsible resident to classify them into intentional (documentation errors or unintentional. Linear regression analysis was performed to assess risk factors associated with the occurrence of unintentional discrepancies. Results: A total of 412 medication discrepancies were identified at the time of hospital admission. Among them, 144 (35% were identified as unintentional while the remaining 268 (65% were identified as intentional discrepancies. Ninety-four patients (47% were found to have at least one unintentional discrepancy and 92 patients (46% had at least one documentation error. Among the unintentional discrepancies, 97 (67% were found to be associated with a potential harm/deterioration to the patients. Increasing patients’ age (beta = 0.195, p-value = .013 and being treated by female residents (beta = 0.139, p-value = .045 were significantly associated with higher number of discrepancies. Conclusion: The prevalence of

  10. Discrepancy in abo blood grouping

    International Nuclear Information System (INIS)

    Khan, M.N.; Ahmed, Z.; Khan, T.A.

    2013-01-01

    Discrepancies in blood typing is one of the major reasons in eliciting a transfusion reaction. These discrepancies can be avoided through detailed analysis for the blood typing. Here, we report a subgroup of blood group type-B in the ABO system. Donor's blood was analyzed by employing commercial antisera for blood grouping. The results of forward (known antisera) and reverse (known antigen) reaction were not complimentary. A detailed analysis using the standard protocols by American Association of Blood Banking revealed the blood type as a variant of blood group-B instead of blood group-O. This is suggestive of the fact that blood group typing should be performed with extreme care and any divergence, if identified, should be properly resolved to avoid transfusion reactions. Moreover, a major study to determine the blood group variants in Pakistani population is needed. (author)

  11. Increased error rates in preliminary reports issued by radiology residents working more than 10 consecutive hours overnight.

    Science.gov (United States)

    Ruutiainen, Alexander T; Durand, Daniel J; Scanlon, Mary H; Itri, Jason N

    2013-03-01

    To determine if the rate of major discrepancies between resident preliminary reports and faculty final reports increases during the final hours of consecutive 12-hour overnight call shifts. Institutional review board exemption status was obtained for this study. All overnight radiology reports interpreted by residents on-call between January 2010 and June 2010 were reviewed by board-certified faculty and categorized as major discrepancies if they contained a change in interpretation with the potential to impact patient management or outcome. Initial determination of a major discrepancy was at the discretion of individual faculty radiologists based on this general definition. Studies categorized as major discrepancies were secondarily reviewed by the residency program director (M.H.S.) to ensure consistent application of the major discrepancy designation. Multiple variables associated with each report were collected and analyzed, including the time of preliminary interpretation, time into shift study was interpreted, volume of studies interpreted during each shift, day of the week, patient location (inpatient or emergency department), block of shift (2-hour blocks for 12-hour shifts), imaging modality, patient age and gender, resident identification, and faculty identification. Univariate risk factor analysis was performed to determine the optimal data format of each variable (ie, continuous versus categorical). A multivariate logistic regression model was then constructed to account for confounding between variables and identify independent risk factors for major discrepancies. We analyzed 8062 preliminary resident reports with 79 major discrepancies (1.0%). There was a statistically significant increase in major discrepancy rate during the final 2 hours of consecutive 12-hour call shifts. Multivariate analysis confirmed that interpretation during the last 2 hours of 12-hour call shifts (odds ratio (OR) 1.94, 95% confidence interval (CI) 1.18-3.21), cross

  12. Dioxin body burden in women with long term residency near and away from major chemical industries in Teesside, UK

    Energy Technology Data Exchange (ETDEWEB)

    Pless-Mulloli, T.; Howel, D. [Univ. of Newcastle upon Tyne (United Kingdom); Edwards, R. [Univ. of Manchester (United Kingdom); Paepke, O. [ergo Forschungs Gesellschaft, Hamburg (Germany); Hermann, T.

    2004-09-15

    Retrospective exposure assessment poses a major challenge for environmental epidemiology studies. Body burden measures may act as markers for long-term exposure if biomarkers can be found with sufficiently long half lives in the human body. Some studies of human exposures have reported data from exposures over several years and before and after sources started production, however none have investigated the usefulness of such approach when exposure is estimated over more than a decade. Whilst for the general population food intake forms the major source of long term dioxin exposures other occupational and environmental sources can contribute to elevated body burdens. The UK has rich data sets for dioxin levels in food, but no body burden data are yet available for a general population sample. We tested the hypothesis that women with long term residence close to an industrial complex have a higher body burden and a distinct pattern of dioxins, furans (PCDD/F) and polychlorinated biphenyls (PCBs). We estimated exposure by recording residential history and food intakes and compared this information with body burden measurements as proxy for all forms of exposure.

  13. Cre/lox Studies Identify Resident Macrophages as the Major Source of Circulating Coagulation Factor XIII-A.

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    Beckers, Cora M L; Simpson, Kingsley R; Griffin, Kathryn J; Brown, Jane M; Cheah, Lih T; Smith, Kerrie A; Vacher, Jean; Cordell, Paul A; Kearney, Mark T; Grant, Peter J; Pease, Richard J

    2017-08-01

    To establish the cellular source of plasma factor (F)XIII-A. A novel mouse floxed for the F13a1 gene, FXIII-A flox/flox (Flox), was crossed with myeloid- and platelet-cre-expressing mice, and cellular FXIII-A mRNA expression and plasma and platelet FXIII-A levels were measured. The platelet factor 4-cre.Flox cross abolished platelet FXIII-A and reduced plasma FXIII-A to 23±3% ( P cre on plasma FXIII-A was exerted outside of the megakaryocyte lineage because plasma FXIII-A was not reduced in the Mpl -/- mouse, despite marked thrombocytopenia. In support of this, platelet factor 4-cre depleted FXIII-A mRNA in brain, aorta, and heart of floxed mice, where FXIII-A pos cells were identified as macrophages as they costained with CD163. In the integrin αM-cre.Flox and the double copy lysozyme 2-cre.cre.Flox crosses, plasma FXIII-A was reduced to, respectively, 75±5% ( P =0.003) and 30±7% ( P <0.001), with no change in FXIII-A content per platelet, further consistent with a macrophage origin of plasma FXIII-A. The change in plasma FXIII-A levels across the various mouse genotypes mirrored the change in FXIII-A mRNA expression in aorta. Bone marrow transplantation of FXIII-A +/+ bone marrow into FXIII-A -/- mice both restored plasma FXIII-A to normal levels and replaced aortic and cardiac FXIII-A mRNA, while its transplantation into FXIII-A +/+ mice did not increase plasma FXIII-A levels, suggesting that a limited population of niches exists that support FXIII-A-releasing cells. This work suggests that resident macrophages maintain plasma FXIII-A and exclude the platelet lineage as a major contributor. © 2017 The Authors.

  14. Relationships of outdoor and indoor ultrafine particles at residences downwind of a major international border crossing in Buffalo, NY.

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    McAuley, T R; Fisher, R; Zhou, X; Jaques, P A; Ferro, A R

    2010-08-01

    During winter 2006, indoor and outdoor ultrafine particle (UFP) size distribution measurements for particles with diameters from 5.6 to 165 nm were taken at five homes in a neighborhood directly adjacent to the Peace Bridge Complex (PBC), a major international border crossing connecting Buffalo, New York to Fort Erie, Ontario. Monitoring with 1-s time resolution was conducted for several hours at each home. Participants were instructed to keep all external windows and doors closed and to refrain from cooking, smoking, or other activity that may result in elevating the indoor UFP number concentration. Although the construction and age for the homes were similar, indoor-to-outdoor comparisons indicate that particle infiltration rates varied substantially. Overall, particle concentrations indoors were lower and less variable than particle concentrations outdoors, with average indoor-outdoor ratios ranging from 0.1 to 0.5 (mean 0.34) for particles between 5.6 and 165 nm in diameter. With no indoor sources, the average indoor-outdoor ratios were lowest (0.2) for 20-nm particles, higher (0.3) for particles <10 nm, and highest (0.5) for particles 70-165 nm. This study provides insight into the penetration of UFP into homes and the resulting change in particle size distributions as particles move indoors near a major diesel traffic source. Although people spend most of their time in their homes, exposure estimates for epidemiological studies are generally determined using ambient concentrations. The findings of this study will contribute to improved size-resolved UFP exposure estimates for near roadway exposure assessments and epidemiological studies.

  15. Discrepant Events: Why They Fascinate Students.

    Science.gov (United States)

    Shrigley, Robert L.

    1987-01-01

    Describes how discrepant events can be employed as a viable teaching strategy. Reviews the theory of cognitive dissonance and provides examples and approaches in its resolution. Offers samples of discrepancy events and unexpected situations. (ML)

  16. Difficulty in detecting discrepancies in a clinical trial report: 260-reader evaluation.

    Science.gov (United States)

    Cole, Graham D; Shun-Shin, Matthew J; Nowbar, Alexandra N; Buell, Kevin G; Al-Mayahi, Faisal; Zargaran, David; Mahmood, Saliha; Singh, Bharpoor; Mielewczik, Michael; Francis, Darrel P

    2015-06-01

    Scientific literature can contain errors. Discrepancies, defined as two or more statements or results that cannot both be true, may be a signal of problems with a trial report. In this study, we report how many discrepancies are detected by a large panel of readers examining a trial report containing a large number of discrepancies. We approached a convenience sample of 343 journal readers in seven countries, and invited them in person to participate in a study. They were asked to examine the tables and figures of one published article for discrepancies. 260 participants agreed, ranging from medical students to professors. The discrepancies they identified were tabulated and counted. There were 39 different discrepancies identified. We evaluated the probability of discrepancy identification, and whether more time spent or greater participant experience as academic authors improved the ability to detect discrepancies. Overall, 95.3% of discrepancies were missed. Most participants (62%) were unable to find any discrepancies. Only 11.5% noticed more than 10% of the discrepancies. More discrepancies were noted by participants who spent more time on the task (Spearman's ρ = 0.22, P < 0.01), and those with more experience of publishing papers (Spearman's ρ = 0.13 with number of publications, P = 0.04). Noticing discrepancies is difficult. Most readers miss most discrepancies even when asked specifically to look for them. The probability of a discrepancy evading an individual sensitized reader is 95%, making it important that, when problems are identified after publication, readers are able to communicate with each other. When made aware of discrepancies, the majority of readers support editorial action to correct the scientific record. © The Author 2015. Published by Oxford University Press on behalf of the International Epidemiological Association.

  17. Body Image, Self-Esteem, Media, Disordered Eating and Actual Ideal Weight Discrepancy: Findings in Cyprus

    Directory of Open Access Journals (Sweden)

    Marios Argyrides

    2017-02-01

    discrepancy. No differences were found concerning age, socioeconomic status and place of upbringing and residence. The results of this study offer important additional information to the body image and disordered eating literature regarding a construct (actual ideal weight discrepancy never examined before in Cyprus. This information could be used by Cypriot and European mental health professionals when working with children and teenagers who are at risk for or exhibit symptoms related to eating disorders and in developing prevention interventions.

  18. Maxillary bone defects and their relationship to transverse maxillary discrepancies

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    Claludia A Peña-Montero

    2016-01-01

    Full Text Available Objectives: The relationship between the presence of bone defects (fenestrations and dehiscences observed in lateral slices in computerized axial tomography (CAT images and maxillomandibular transverse discrepancies was determined. Methods: The sample was composed of 160 CAT scan files, corresponding to 9-25-year-old patients, which had been taken prior to orthodontic treatment at a radiology center in Guadalajara, México, from 2009 to 2012. They were grouped by age, and we identified bone defects in maxillary teeth (first and second premolars and first molars. The maxillary (JL-JR and mandibular (GA-AG widths were measured, and the maxillomandibular discrepancy ([GA-AG]-[JL-JR] was calculated. Chi-square and t-tests were performed. Results: The values of maxillomandibular discrepancies increased with the age of the patient. There was no association between the magnitude of the maxillomandibular discrepancy and the presence of bone defects. The gender of the individual was not a decisive factor in whether bone defects were present. Conclusion: Bone defects occur in the vast majority of patients pretreatment regardless of the magnitude of the maxillomandibular discrepancy.

  19. Abdominal and pelvic computed tomography (CT) interpretation: discrepancy rates among experienced radiologists

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    Abujudeh, Hani H.; Boland, Giles W.; Kaewlai, Rathachai; Rabiner, Pavel; Thrall, James H. [Massachusetts General Hospital and Harvard Medical School, Department of Radiology, Boston, MA (United States); Halpern, Elkarn F.; Gazelle, G.S. [Massachusetts General Hospital and Harvard Medical School, Department of Radiology, Boston, MA (United States); Massachusetts General Hospital and Harvard Medical School, Institute for Technology Assessment, Boston, MA (United States)

    2010-08-15

    To assess the discrepancy rate for the interpretation of abdominal and pelvic computed tomography (CT) examinations among experienced radiologists. Ninety abdominal and pelvic CT examinations reported by three experienced radiologists who specialize in abdominal imaging were randomly selected from the radiological database. The same radiologists, blinded to previous interpretation, were asked to re-interpret 60 examinations: 30 of their previous interpretations and 30 interpreted by others. All reports were assessed for the degree of discrepancy between initial and repeat interpretations according to a three-level scoring system: no discrepancy, minor, or major discrepancy. Inter- and intrareader discrepancy rates and causes were evaluated. CT examinations included in the investigation were performed on 90 patients (43 men, mean age 59 years, SD 14, range 19-88) for the following indications: follow-up/evaluation of malignancy (69/90, 77%), pancreatitis (5/90, 6%), urinary tract stone (4/90, 4%) or other (12/90, 13%). Interobserver and intraobserver major discrepancy rates were 26 and 32%, respectively. Major discrepancies were due to missed findings, different opinions regarding interval change of clinically significant findings, and the presence of recommendation. Major discrepancy of between 26 and 32% was observed in the interpretation of abdominal and pelvic CT examinations. (orig.)

  20. Functional scoliosis caused by leg length discrepancy

    Science.gov (United States)

    Daniszewska, Barbara; Zolynski, Krystian

    2010-01-01

    Introduction Leg length discrepancy (LLD) causes pelvic obliquity in the frontal plane and lumbar scoliosis with convexity towards the shorter extremity. Leg length discrepancy is observed in 3-15% of the population. Unequalized lower limb length discrepancy leads to posture deformation, gait asymmetry, low back pain and discopathy. Material and methods In the years 1998-2006, 369 children, aged 5 to 17 years (209 girls, 160 boys) with LLD-related functional scoliosis were treated. An external or internal shoe lift was applied. Results Among 369 children the discrepancy of 0.5 cm was observed in 27, 1 cm in 329, 1.5 cm in 9 and 2 cm in 4 children. During the first follow-up examination, within 2 weeks, the adjustment of the spine to new static conditions was noted and correction of the curve in 316 examined children (83.7%). In 53 children (14.7%) the correction was observed later and was accompanied by slight low back pain. The time needed for real equalization of limbs was 3 to 24 months. The time needed for real equalization of the discrepancy was 11.3 months. Conclusions Leg length discrepancy equalization results in elimination of scoliosis. Leg length discrepancy < 2 cm is a static disorder; that is why measurements should be performed in a standing position using blocks of adequate thickness and the position of the posterior superior iliac spine should be estimated. PMID:22371777

  1. Resident resistance.

    Science.gov (United States)

    Price, J L; Cleary, B

    1999-01-01

    Clearly, faculty must work hard with residents to explore the nature of their resistance to a program's learning and growth opportunities. Initial steps to a deeper, more effective, and longer-lasting change process must be pursued. If resident resistance is mishandled or misunderstood, then learning and professional growth may be sidetracked and the purposes of residency training defeated. Listening to the whole person of the resident and avoiding the trap of getting caught up in merely responding to select resident behaviors that irritate us is critical. Every faculty member in the family practice residency program must recognize resistance as a form of defense that cannot immediately be torn down or taken away. Resident defenses have important purposes to play in stress reduction even if they are not always healthy. Residents, especially interns, use resistance to avoid a deeper and more truthful look at themselves as physicians. A family practice residency program that sees whole persons in their residents and that respects resident defenses will effectively manage the stress and disharmony inherent to the resistant resident.

  2. Prevalence of hypertension and major cardiovascular risk factors in healthy residents of a rural region in south-eastern Poland – 1997–2008/9

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    Daniel Płaczkiewicz

    2016-07-01

    Detection of hypertension in the rural region in which the survey was carried out is still too low. Actions against tobacco addiction should be a major component of health-education programmes for the rural areas of south-eastern Poland.

  3. Endoplasmic reticulum resident protein of 90 kilodaltons associates with the T- and B-cell antigen receptors and major histocompatibility complex antigens during their assembly

    NARCIS (Netherlands)

    Hochstenbach, F.; DAVID, V.; WATKINS, S.; Brenner, M. B.

    1992-01-01

    In the endoplasmic reticulum (ER), newly synthesized subunits of the T-cell antigen receptor (TCR), membrane-bound immunoglobulin (mIg), and major histocompatibility complex (MHC) class I antigens must fold correctly and assemble completely into multimeric protein complexes prior to transport to the

  4. 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.

  5. Comparison of clinical causes of deth with autopsy diagnosis using discrepancy classification

    International Nuclear Information System (INIS)

    Ullah, K.; Alamgir, W.

    2006-01-01

    To determine the usefulness of autopsy findings in the quality improvement of patients care. The clinical and necropsy findings of all the cases, who died in hospital and had undergone autopsy examination at CMH, Kharian, from January 2001 to December 2003, were retrieved from record of clinical case sheet data and autopsy record of the hospital. The two were analyzed and compared according to the discrepancy classification. The exclusion and inclusion criteria, the international classification of disease (ICD) to code deaths, the global burden of disease (GBD) system to classify and group diseases, and the Goldman discrepancy classification to compare clinical and autopsy diagnosis and classify the discrepancies, were used as described. The death rate varied from 0.94% to 1.29% and autopsy rate from 4.69% to 10.10% annually between January 2001 and December 2003. The number of cases classified according to GBD system was 3 (5%) in Group 1, 26 (43.33 %) in Group 2 and 31 (51.66 %) in Group 3. The discrepancy classes included 9 (15 %) class I major discrepancies and 3 (5 %) class II major discrepancies. Non-discrepant diagnosis was seen in 37 cases (61.66 %) and 11 cases (18.32 %) were non classifiable. (author)

  6. 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......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 Scandinavian countries, where healthcare systems are slightly different. The aim of this study was to examine prevalence and characteristics of residents in difficulty in one out of three postgraduate medical training regions in Denmark, and to produce both a quantifiable overview and in-depth understanding...... of the topic. Methods We performed a mixed methods study. All regional residency program directors (N = 157) were invited to participate in an e-survey about residents in difficulty. Survey data were combined with database data on demographical characteristics of the background population (N = 2399...

  7. Discrepancy between snack choice intentions and behavior

    NARCIS (Netherlands)

    Weijzen, P.L.G.; Graaf, de C.; Dijksterhuis, G.B.

    2008-01-01

    Objective To investigate dietary constructs that affect the discrepancy between intentioned and actual snack choice. Design Participants indicated their intentioned snack choice from a set of 4 snacks (2 healthful, 2 unhealthful). One week later, they actually chose a snack from the same set. Within

  8. Naturally acquired antibodies against the major merozoite surface coat protein (MSP-1 of Plasmodium falciparum acquired by residents in an endemic area of Colombia

    Directory of Open Access Journals (Sweden)

    Zillka I. Terrientes

    1994-01-01

    Full Text Available A preliminary baseline epidemiological malaria survey was conducted in the village of Punta Soldado, Colombia. Parasite prevalence and density as well as serological data were obtained from 151 asymptomatic children and adults. Fifty individuals were infected with Plasmodium falciparum. The mean parasite density was 184 parasites/mm3. Greater than 90 of the sample population were P. falciparum antibody positive as detected by the indirect immunofluorescent antibody test (IFAT. The enzyme-linked immunosorbent assay (ELISA was used to detect antibodies against the major merozoite surface protein (MSP-1 of P. falciparum. In this population, anti-MSP-1 antibody concentration is acquired in an age dependent manner with equal immunogenicity to both the N- and C-terminal regions of the molecule. Infection at the time of sampling was associated with a higher anti-MSP-1 antibody concentration than that found in non-infected individuals. Further studies are planned to assess the role of immune and non-immune factors in limiting the number of cases of severe malaria seen in this population.

  9. Characterization of NCR1+ cells residing in lymphoid tissues in the gut of lambs indicates that the majority are NK cells.

    Science.gov (United States)

    Olsen, Line; Boysen, Preben; Åkesson, Caroline Piercey; Gunnes, Gjermund; Connelley, Timothy; Storset, Anne K; Espenes, Arild

    2013-11-13

    Natural killer (NK) cells are important for immune protection of the gut mucosa. Previous studies have shown that under pathologic conditions NK cells, T cells and dendritic cells are found co-localised in secondary lymphoid organs where their interaction coordinates immune responses. However, in the gut-associated lymphoid tissues (GALTs), there are few detailed reports on the distribution of NK cells. Sheep harbour several types of organised lymphoid tissues in the gut that have different functions. The ileal Peyer's patch (IPP) functions as a primary lymphoid tissue for B cell generation, while the jejunal Peyer's patches (JPPs) and colon patches (CPs) are considered secondary lymphoid tissues. In the present study, we analysed tissues from healthy lambs by flow cytometry and in situ multicolour immunofluorescence, using recently described NCR1 antibodies to identify ovine NK cells. Most NCR1+ cells isolated from all tissues were negative for the pan T cell marker CD3, and thus comply with the general definition of NK cells. The majority of NCR1+ cells in blood as well as secondary lymphoid organs expressed CD16, but in the GALT around half of the NCR1+ cells were negative for CD16. A semi-quantitative morphometric study on tissue sections was used to compare the density of NK cells in four compartments of the IPPs, JPP and CPs. NCR1+ cells were found in all gut segments. Statistical analysis revealed significant differences between compartments of the primary lymphoid organ IPP and the secondary lymphoid organs of the JPPs and CP. NK cells co-localised and made close contact with T cells, dendritic cells and other NK cells, but did not show signs of proliferation. We conclude that NK cells are present in all investigated segments of the sheep gut, but that presence of other innate lymphoid cells expressing NCR1 cannot be excluded.

  10. Imaging the elusive H-poor gas in planetary nebulae with large abundance discrepancy factors

    Science.gov (United States)

    García-Rojas, Jorge; Corradi, Romano L. M.; Boffin, Henri M. J.; Monteiro, Hektor; Jones, David; Wesson, Roger; Cabrera-Lavers, Antonio; Rodríguez-Gil, Pablo

    2017-10-01

    The discrepancy between abundances computed using optical recombination lines (ORLs) and collisionally excited lines (CELs) is a major, unresolved problem with significant implications for the determination of chemical abundances throughout the Universe. In planetary nebulae (PNe), the most common explanation for the discrepancy is that two different gas phases coexist: a hot component with standard metallicity, and a much colder plasma enhanced in heavy elements. This dual nature is not predicted by mass loss theories, and direct observational support for it is still weak. In this work, we present our recent findings that demonstrate that the largest abundance discrepancies are associated with close binary central stars. OSIRIS-GTC tunable filter imaging of the faint O ii ORLs and MUSE-VLT deep 2D spectrophotometry confirm that O ii ORL emission is more centrally concentrated than that of [Oiii] CELs and, therefore, that the abundance discrepancy may be closely linked to binary evolution.

  11. 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.

  12. Permanent resident.

    Science.gov (United States)

    Fisher, John F

    2016-01-01

    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. Stirring the Biology Teaching Pot with Discrepant Events.

    Science.gov (United States)

    Wright, Emmett L.; Govindarajan, Girish

    1992-01-01

    Proposes the use of conceptual discrepancies to stimulate student inquiry into scientific concepts. Provides a list of 20 examples of conceptual discrepancies from the biological sciences that have encouraged self-regulation in biology students. (Contains 12 references.) (MDH)

  14. Discrepancies in assessing undergraduates’ pragmatics learning

    Directory of Open Access Journals (Sweden)

    Oscar Ndayizeye

    2017-12-01

    Full Text Available The purpose of this research was to reveal the level of implementation of authentic assessment in the pragmatics course at the English Education Department of a university. Discrepancy Evaluation Model (DEM was used. The instruments were questionnaire, documentation, and observation. The result of the research shows that respectively, the effectiveness of definition, installation, process, and production stages in logits are -0.06, -0.14, 0.45, and 0.02 on its aspect of the assessment methods’ effectiveness in uncovering students’ ability. Such values indicate that the level of implementation fell respectively into ‘very high’,’high’, ‘low’, and ‘very low’ categories.  The students’ success rate is in ‘very high’ category with the average score of 3.22. However, the overall implementation of the authentic assessment fell into a ‘low’ category with the average score of 0.06. Discrepancies leading to such a low implementation are the unavailability of the assessment scheme, that of scoring rubric, minimal (only 54.54% diversification of assessment methods, infrequency of the lecturer’s feedback on the students’ academic achievement, and the non-use of portfolio assessment.

  15. Monitoring of heavy metal levels in the major rivers and in residents' blood in Zhenjiang City, China, and assessment of heavy metal elimination via urine and sweat in humans.

    Science.gov (United States)

    Sheng, Jianguo; Qiu, Wenhui; Xu, Bentuo; Xu, Hui; Tang, Chong

    2016-06-01

    The coastal areas of China face great challenges, owing to heavy metal contamination caused by rapid industrialization and urbanization. To our knowledge, this study is the first report of the levels of heavy metals in the major rivers of Zhenjiang, one of the most important cities of the Yangtze River Delta in China. In addition, we measured heavy metal levels in the blood of 76 residents of Zhenjiang. The results suggest that the presence of heavy metals in the blood may threaten human health and the distribution appeared to correspond to most highly populated areas and/or areas with high traffic. We also found that the concentration of heavy metals in human blood showed an accumulation effect with increase in age. Moreover, the levels of most heavy metals were lower in participants who regularly exercised than in those who did not. We studied heavy metal levels in the urine and sweat of another 17 volunteers to monitor the elimination of bioaccumulated heavy metal. Heavy metals were found in the urine and sweat of all the 17 participants and were more concentrated in sweat. Induced micturition and sweating appear to be potential methods for the elimination of heavy metals from the human body.

  16. Imaging with Kantorovich--Rubinstein Discrepancy

    KAUST Repository

    Lellmann, Jan

    2014-01-01

    © 2014 Society for Industrial and Applied Mathematics. We propose the use of the Kantorovich-Rubinstein norm from optimal transport in imaging problems. In particular, we discuss a variational regularization model endowed with a Kantorovich- Rubinstein discrepancy term and total variation regularization in the context of image denoising and cartoon-texture decomposition. We point out connections of this approach to several other recently proposed methods such as total generalized variation and norms capturing oscillating patterns. We also show that the respective optimization problem can be turned into a convex-concave saddle point problem with simple constraints and hence can be solved by standard tools. Numerical examples exhibit interesting features and favorable performance for denoising and cartoon-texture decomposition.

  17. Phase coupling gravity and astronomical mass discrepancies

    International Nuclear Information System (INIS)

    Sanders, R.H.

    1988-01-01

    A previous author has proposed a new theory of gravity in which an additional long-range force is associated with a complex scalar field. The unique aspect of the theory is that only the phase of the complex scalar field couples to matter; hence, the designation 'phase coupling gravity'. The scalar field Lagrangian density contains a self-interaction potential which, in original form, depends upon the sixth power of the scalar amplitude because then the resulting weak field phenomenology is similar to that of MOND, the empirically motivated modification of Newton's law in the limit of low accelerations previously suggested in order to account for the observed mass discrepancies in large astronomical systems. In the present paper I explore versions of phase coupling gravity with alternative forms for the scalar self-interaction. (author)

  18. Discrepancy between Clambda and Csub(E)

    International Nuclear Information System (INIS)

    Williams, P.C.

    1977-01-01

    The conversion factors Clambda and Csub(E) are used in relating ionization chamber readings (M) to absorbed dose in water for measurements made in phantoms irradiated with photons of quality lambda and electrons of mean energy - E respectively. New calculations of Clambda (Nahum, A.E., and Greening, J.R., 1976, Phys. Med. Biol., vol.21, 862) have yielded values which differ by up to 5% from those quoted by ICRU (ICRU, 1969, Report 14, ICRU Publications, P.O. Box 30165, Washington, DC 20014). Nahum and Greening have also pointed out that the recommended values of Clambda and Csub(E) for radiations of approximately the same primary electron energy should be the same, but differ by approximately 4%. Alternative explanations are offered for these discrepancies. If the ICRU values are corrected for the perturbation of the electron flux in the phantom by the introduction of a cavity, the ionization chamber, into the phantom, then the resulting values are in good agreement with those quoted by Nahum and Greening. The discrepancy between Clambda and Csub(E) is the result of inconsistent definitions. The ICRU definition of Csub(E) leads to a dose conversion factor which is dimensionally correct but is based on the assumption that the product M.Nsub(c), where Nsub(c) is the exposure calibration factor for the ionization chamber at the calibration quality, 2MV, can be identified as exposure, whereas this is only true at the calibration quality. More accurate definitions of Clambda and Csub(E) are therefore proposed. (U.K.)

  19. Residency training program: Perceptions of residents

    African Journals Online (AJOL)

    Abstract. Background: There is a phobia among doctors for the residency training program, since the establishment of ... Materials and Methods: Structured questionnaires were administered to residents at 3 training institutions in Nigeria. Results: ... Keywords: Decentralization, motivation, perception, remuneration, residents.

  20. Cultural estrangement: the role of personal and societal value discrepancies.

    Science.gov (United States)

    Bernard, Mark M; Gebauer, Jochen E; Maio, Gregory R

    2006-01-01

    Study 1 examined whether cultural estrangement arises from discrepancies between personal and societal values (e.g., freedom) rather than from discrepancies in attitudes toward political (e.g., censorship) or mundane (e.g., pizza) objects. The relations between different types of value discrepancies, estrangement, subjective well-being, and need for uniqueness also were examined. Results indicated that personal-societal discrepancies in values and political attitudes predicted estrangement, whereas mundane attitude discrepancies were not related to estrangement. As expected, value discrepancies were the most powerful predictor of estrangement. Value discrepancies were not related to subjective well-being but fulfilled a need for uniqueness. Study 2 replicated the relations between value discrepancies, subjective well-being, and need for uniqueness while showing that a self-report measure of participants' values and a peer-report measure of the participants' values yielded the same pattern of value discrepancies. Together, the studies reveal theoretical and empirical benefits of conceptualizing cultural estrangement in terms of value discrepancies.

  1. Breaking Bad News - Perceptions of Pediatric Residents.

    Science.gov (United States)

    Geeta, M G; Krishnakumar, P

    2017-08-15

    The present study evaluated the perceptions and practice of 92 final year pediatric residents with regard to breaking bad news. Only 16% of residents had received any training in communication skills. Majority (65%) of the residents were not comfortable while breaking bad news.

  2. Discrepancies Between Clinical Diagnoses and Autopsy Findings in Critically Ill Children: A Prospective Study.

    Science.gov (United States)

    Carlotti, Ana P C P; Bachette, Letícia G; Carmona, Fabio; Manso, Paulo H; Vicente, Walter V A; Ramalho, Fernando S

    2016-12-01

    To evaluate the discrepancies between clinical and autopsy diagnoses in patients who died in the pediatric intensive care units (PICUs) of a tertiary care university hospital. A prospective study of all consecutive autopsies discussed at monthly mortality conferences over 5 years. Discrepancies between premortem and autopsy diagnoses were classified according to modified Goldman et al criteria. From January 1, 2011, to December 31, 2015, a total of 2,679 children were admitted to the two PICUs of our hospital; 257 (9.6%) died, 150 (58.4%) underwent autopsy, and 123 were included. Complete concordance between clinical and postmortem diagnoses was observed in 86 (69.9%) patients; 20 (16.3%) had a class I discrepancy, and eight (6.5%) had a class II discrepancy. Comparing 2011 and 2015, the rate of major discrepancies decreased from 31.6% to 15%. Our results emphasize the importance of autopsy to clarify the cause of death and its potential contribution to improvement of team performance and quality of care. © American Society for Clinical Pathology, 2016. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

  3. Comparative Analysis of Clinical Samples Showing Weak Serum Reaction on AutoVue System Causing ABO Blood Typing Discrepancies

    OpenAIRE

    Jo, Su Yeon; Lee, Ju Mi; Kim, Hye Lim; Sin, Kyeong Hwa; Lee, Hyeon Ji; Chang, Chulhun Ludgerus; Kim, Hyung-Hoi

    2016-01-01

    Background ABO blood typing in pre-transfusion testing is a major component of the high workload in blood banks that therefore requires automation. We often experienced discrepant results from an automated system, especially weak serum reactions. We evaluated the discrepant results by the reference manual method to confirm ABO blood typing. Methods In total, 13,113 blood samples were tested with the AutoVue system; all samples were run in parallel with the reference manual method according to...

  4. Discrepancies in Parents' and Children's Reports of Child Emotion Regulation

    Science.gov (United States)

    Hourigan, Shannon E.; Goodman, Kimberly L.; Southam-Gerow, Michael A.

    2011-01-01

    The ability to regulate one's emotions effectively has been linked with many aspects of well-being. The current study examined discrepancies between mothers' and children's reports of child emotion regulation. This investigation examined patterns of discrepancies for key aspects of emotion regulation (i.e., inhibition and dysregulated expression)…

  5. A Discrepancy-Based Methodology for Nuclear Training Program Evaluation.

    Science.gov (United States)

    Cantor, Jeffrey A.

    1991-01-01

    A three-phase comprehensive process for commercial nuclear power training program evaluation is presented. The discrepancy-based methodology was developed after the Three Mile Island nuclear reactor accident. It facilitates analysis of program components to identify discrepancies among program specifications, actual outcomes, and industry…

  6. Asking Adolescents to Explain Discrepancies in Self-Reported Suicidality.

    Science.gov (United States)

    Velting, Drew M.; Rathus, Jill H.; Asnis, Gregory M.

    1998-01-01

    Determining suicide risk is a complex matter. A typology of adolescents' most common explanations for discrepant reporting of suicidal behavior is presented. Answers to interview questions were compared to a self-report measure, and adolescent in-patients (N=48) were asked to clarify discrepancies. Seven mutually exclusive and exhaustive…

  7. Postmortem CT versus forensic autopsy: frequent discrepancies of tracheobronchial content findings.

    Science.gov (United States)

    Zech, Wolf-Dieter; Jackowski, Christian; Schwendener, Nicole; Brencicova, Eva; Schuster, Frederick; Lombardo, Paolo

    2016-01-01

    In their daily forensic casework, the authors experienced discrepancies of tracheobronchial content findings between postmortem computed tomography (PMCT) and autopsy to an extent previously unnoticed in the literature. The goal of this study was to evaluate such discrepancies in routine forensic cases. A total of 327 cases that underwent PMCT prior to routine forensic autopsy were retrospectively evaluated for tracheal and bronchial contents according to PMCT and autopsy findings. Hounsfield unit (HU) values of tracheobronchial contents, causes of death, and presence of pulmonary edema were assessed in mismatching and matching cases. Comparing contents in PMCT and autopsy in each of the separately evaluated compartments of the respiratory tract low positive predictive values were assessed (trachea, 38.2%; main bronchi, 40%; peripheral bronchi, 69.1%) indicating high discrepancy rates. The majority of tracheobronchial contents were viscous stomach contents in matching cases and low radiodensity materials (i.e., HU autopsy occur in a considerable number of cases. Discrepancies may be explained by the runoff of contents via nose and mouth during external examination and the flow back of tracheal and main bronchial contents into the lungs caused by upright movement of the respiratory tract at autopsy.

  8. COMMUNICATION OF EDUCATIONAL ATTAINMENT AND INCOMES: THE REASONS AND DISCREPANCY CONSEQUENCES

    Directory of Open Access Journals (Sweden)

    Yriy Chistyakov

    2012-01-01

    Full Text Available According to the theory of human capital improvement of education attainment results in increase of income of human capital’s owner. This issue is interest to majority of wage earners, all the more at the economic crisis. Authors of this paper analyze presence and closeness of connection between worker’s education attainment and amount of salary on data of Kaluga region. In the paper probable reasons and discrepancy of revealed issue.

  9. The discrepancies in the results of bioinformatics tools for genomic structural annotation

    Science.gov (United States)

    Pawełkowicz, Magdalena; Nowak, Robert; Osipowski, Paweł; Rymuszka, Jacek; Świerkula, Katarzyna; Wojcieszek, Michał; Przybecki, Zbigniew

    2014-11-01

    A major focus of sequencing project is to identify genes in genomes. However it is necessary to define the variety of genes and the criteria for identifying them. In this work we present discrepancies and dependencies from the application of different bioinformatic programs for structural annotation performed on the cucumber data set from Polish Consortium of Cucumber Genome Sequencing. We use Fgenesh, GenScan and GeneMark to automated structural annotation, the results have been compared to reference annotation.

  10. Who is at risk for diagnostic discrepancies? Comparison of pre- and postmortal diagnoses in 1800 patients of 3 medical decades in East and West Berlin.

    Directory of Open Access Journals (Sweden)

    Daniel Wittschieber

    Full Text Available BACKGROUND: Autopsy rates in Western countries consistently decline to an average of <5%, although clinical autopsies represent a reasonable tool for quality control in hospitals, medically and economically. Comparing pre- and postmortal diagnoses, diagnostic discrepancies as uncovered by clinical autopsies supply crucial information on how to improve clinical treatment. The study aimed at analyzing current diagnostic discrepancy rates, investigating their influencing factors and identifying risk profiles of patients that could be affected by a diagnostic discrepancy. METHODS AND FINDINGS: Of all adult autopsy cases of the Charité Institute of Pathology from the years 1988, 1993, 1998, 2003 and 2008, the pre- and postmortal diagnoses and all demographic data were analyzed retrospectively. Based on power analysis, 1,800 cases were randomly selected to perform discrepancy classification (class I-VI according to modified Goldman criteria. The rate of discrepancies in major diagnoses (class I was 10.7% (95% CI: 7.7%-14.7% in 2008 representing a reduction by 15.1%. Subgroup analysis revealed several influencing factors to significantly correlate with the discrepancy rate. Cardiovascular diseases had the highest frequency among class-I-discrepancies. Comparing the 1988-data of East- and West-Berlin, no significant differences were found in diagnostic discrepancies despite an autopsy rate differing by nearly 50%. A risk profile analysis visualized by intuitive heatmaps revealed a significantly high discrepancy rate in patients treated in low or intermediate care units at community hospitals. In this collective, patients with genitourinary/renal or infectious diseases were at particularly high risk. CONCLUSIONS: This is the current largest and most comprehensive study on diagnostic discrepancies worldwide. Our well-powered analysis revealed a significant rate of class-I-discrepancies indicating that autopsies are still of value. The identified risk

  11. 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...

  12. 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.

  13. The INDC/NEANDC joint discrepancy file 1990

    International Nuclear Information System (INIS)

    Patrick, B.H.; Kocherov, N.P.

    1990-06-01

    The International Nuclear Data Committee (INDC) and the Nuclear Energy Agency Nuclear Data Committee (NEANDC) maintain a close interest in nuclear data which exhibit discrepancies and, by making known the details of the disagreements, encouragement is given to the undertaking of new measurements as a means of eliminating the ambiguities. The previous discrepancy file was published by NEANDC and INDC in 1984. This document contains 10 papers and a separate abstract was prepared for each of them. Refs, figs and tabs

  14. Error and discrepancy in radiology: inevitable or avoidable?

    OpenAIRE

    Brady, Adrian P.

    2016-01-01

    Abstract Errors and discrepancies in radiology practice are uncomfortably common, with an estimated day-to-day rate of 3?5% of studies reported, and much higher rates reported in many targeted studies. Nonetheless, the meaning of the terms ?error? and ?discrepancy? and the relationship to medical negligence are frequently misunderstood. This review outlines the incidence of such events, the ways they can be categorized to aid understanding, and potential contributing factors, both human- and ...

  15. Entropy discrepancy and total derivatives in trace anomaly

    Directory of Open Access Journals (Sweden)

    Amin Faraji Astaneh

    2015-12-01

    Full Text Available In this note we address the discrepancy found by Hung, Myers and Smolkin between the holographic calculation of entanglement entropy (using the Jacobson–Myers functional for the holographic minimal surface and the CFT trace anomaly calculation if one uses the Wald prescription to compute the entropy in six dimensions. As anticipated in our previous work [1] the discrepancy originates entirely from a total derivative term present in the trace anomaly in six dimensions.

  16. Entropy discrepancy and total derivatives in trace anomaly

    Energy Technology Data Exchange (ETDEWEB)

    Astaneh, Amin Faraji, E-mail: faraji@ipm.ir [Department of Physics, Sharif University of Technology, P.O. Box 11365-9161, Tehran (Iran, Islamic Republic of); School of Particles and Accelerators, Institute for Research in Fundamental Sciences (IPM), P.O. Box 19395-5531, Tehran (Iran, Islamic Republic of); Patrushev, Alexander, E-mail: apatrush@gmail.com [Bogoliubov Laboratory of Theoretical Physics, Joint Institute for Nuclear Research, 6 Joliot-Curie, 141980 Dubna (Russian Federation); Laboratoire de Mathématiques et Physique Théorique CNRS-UMR 7350, Fédération Denis Poisson, Université François-Rabelais Tours, Parc de Grandmont, 37200 Tours (France); Solodukhin, Sergey N., E-mail: Sergey.Solodukhin@lmpt.univ-tours.fr [Laboratoire de Mathématiques et Physique Théorique CNRS-UMR 7350, Fédération Denis Poisson, Université François-Rabelais Tours, Parc de Grandmont, 37200 Tours (France)

    2015-12-17

    In this note we address the discrepancy found by Hung, Myers and Smolkin between the holographic calculation of entanglement entropy (using the Jacobson–Myers functional for the holographic minimal surface) and the CFT trace anomaly calculation if one uses the Wald prescription to compute the entropy in six dimensions. As anticipated in our previous work [1] the discrepancy originates entirely from a total derivative term present in the trace anomaly in six dimensions.

  17. ASTRO's core physics curriculum for radiation oncology residents.

    Science.gov (United States)

    Klein, Eric E; Balter, James M; Chaney, Edward L; Gerbi, Bruce J; Hughes, Lesley

    2004-11-01

    In 2002, the Radiation Physics Committee of the American Society of Therapeutic Radiology and Oncology (ASTRO) appointed an Ad-hoc Committee on Physics Teaching to Medical Residents. The main initiative of the committee was to develop a core curriculum for physics education. Prior publications that have analyzed physics teaching have pointed to wide discrepancies among teaching programs. The committee was composed of physicists or physicians from various residency program based institutions. Simultaneously, members had associations with the American Association of Physicists in Medicine (AAPM), ASTRO, Association of Residents in Radiation Oncology (ARRO), American Board of Radiology (ABR), and the American College of Radiology (ACR). The latter two organizations' representatives were on the physics examination committees, as one of the main agendas was to provide a feedback loop between the examining organizations and ASTRO. The document resulted in a recommended 54-h course. Some of the subjects were based on American College of Graduate Medical Education (ACGME) requirements (particles, hyperthermia), whereas the majority of the subjects along with the appropriated hours per subject were devised and agreed upon by the committee. For each subject there are learning objectives and for each hour there is a detailed outline of material to be covered. Some of the required subjects/h are being taught in most institutions (i.e., Radiation Measurement and Calibration for 4 h), whereas some may be new subjects (4 h of Imaging for Radiation Oncology). The curriculum was completed and approved by the ASTRO Board in late 2003 and is slated for dissemination to the community in 2004. It is our hope that teaching physicists will adopt the recommended curriculum for their classes, and simultaneously that the ABR for its written physics examination and the ACR for its training examination will use the recommended curriculum as the basis for subject matter and depth of

  18. ASTRO's core physics curriculum for radiation oncology residents

    International Nuclear Information System (INIS)

    Klein, Eric E.; Balter, James M.; Chaney, Edward L.; Gerbi, Bruce J.; Hughes, Lesley

    2004-01-01

    In 2002, the Radiation Physics Committee of the American Society of Therapeutic Radiology and Oncology (ASTRO) appointed an Ad-hoc Committee on Physics Teaching to Medical Residents. The main initiative of the committee was to develop a core curriculum for physics education. Prior publications that have analyzed physics teaching have pointed to wide discrepancies among teaching programs. The committee was composed of physicists or physicians from various residency program based institutions. Simultaneously, members had associations with the American Association of Physicists in Medicine (AAPM), ASTRO, Association of Residents in Radiation Oncology (ARRO), American Board of Radiology (ABR), and the American College of Radiology (ACR). The latter two organizations' representatives were on the physics examination committees, as one of the main agendas was to provide a feedback loop between the examining organizations and ASTRO. The document resulted in a recommended 54-h course. Some of the subjects were based on American College of Graduate Medical Education (ACGME) requirements (particles, hyperthermia), whereas the majority of the subjects along with the appropriated hours per subject were devised and agreed upon by the committee. For each subject there are learning objectives and for each hour there is a detailed outline of material to be covered. Some of the required subjects/h are being taught in most institutions (i.e., Radiation Measurement and Calibration for 4 h), whereas some may be new subjects (4 h of Imaging for Radiation Oncology). The curriculum was completed and approved by the ASTRO Board in late 2003 and is slated for dissemination to the community in 2004. It is our hope that teaching physicists will adopt the recommended curriculum for their classes, and simultaneously that the ABR for its written physics examination and the ACR for its training examination will use the recommended curriculum as the basis for subject matter and depth of

  19. Understanding how residents' preferences for supervisory methods change throughout residency training: a mixed-methods study.

    Science.gov (United States)

    Olmos-Vega, Francisco; Dolmans, Diana; Donkers, Jeroen; Stalmeijer, Renée E

    2015-10-16

    A major challenge for clinical supervisors is to encourage their residents to be independent without jeopardising patient safety. Residents' preferences according to level of training on this regard have not been completely explored. This study has sought to investigate which teaching methods of the Cognitive Apprenticeship (CA) model junior, intermediate and senior residents preferred and why, and how these preferences differed between groups. We invited 301 residents of all residency programmes of Javeriana University, Bogotá, Colombia, to participate. Each resident was asked to complete a Maastricht Clinical Teaching Questionnaire (MCTQ), which, being based on the teaching methods of CA, asked residents to rate the importance to their learning of each teaching method and to indicate which of these they preferred the most and why. A total of 215 residents (71 %) completed the questionnaire. All concurred that all CA teaching methods were important or very important to their learning, regardless of their level of training. However, the reasons for their preferences clearly differed between groups: junior and intermediate residents preferred teaching methods that were more supervisor-directed, such as modelling and coaching, whereas senior residents preferred teaching methods that were more resident-directed, such as exploration and articulation. The results indicate that clinical supervision (CS) should accommodate to residents' varying degrees of development by attuning the configuration of CA teaching methods to each level of residency training. This configuration should initially vest more power in the supervisor, and gradually let the resident take charge, without ever discontinuing CS.

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

    Science.gov (United States)

    Nguyen, Hieu M

    2017-05-12

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

  1. Discrepancies Between Plastic Surgery Meeting Abstracts and Subsequent Full-Length Manuscript Publications.

    Science.gov (United States)

    Denadai, Rafael; Araujo, Gustavo Henrique; Pinho, Andre Silveira; Denadai, Rodrigo; Samartine, Hugo; Raposo-Amaral, Cassio Eduardo

    2016-10-01

    The purpose of this bibliometric study was to assess the discrepancies between plastic surgery meeting abstracts and subsequent full-length manuscript publications. Abstracts presented at the Brazilian Congress of Plastic Surgery from 2010 to 2011 were compared with matching manuscript publications. Discrepancies between the abstract and the subsequent manuscript were categorized as major (changes in the purpose, methods, study design, sample size, statistical analysis, results, and conclusions) and minor (changes in the title and authorship) variations. The overall discrepancy rate was 96 %, with at least one major (76 %) and/or minor (96 %) variation. There were inconsistencies between the study title (56 %), authorship (92 %), purpose (6 %), methods (20 %), study design (36 %), sample size (51.2 %), statistical analysis (14 %), results (20 %), and conclusions (8 %) of manuscripts compared with their corresponding meeting abstracts. As changes occur before manuscript publication of plastic surgery meeting abstracts, caution should be exercised in referencing abstracts or altering surgical practices based on abstracts' content. This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .

  2. Radiology residents as teachers: Current status of teaching skills training in United States residency programs.

    Science.gov (United States)

    Donovan, Andrea

    2010-07-01

    Radiology residents often teach medical students and other residents. Workshops developed with the goal of improving resident teaching skills are becoming increasingly common in various fields of medicine. The purpose of this study was to determine the prevalence and structure of resident-teacher training opportunities within radiology programs in the United States. Program directors with membership in the Association of Program Directors in Radiology (APDR) were surveyed to determine views on a panel of topics related to resident-teacher training programs. A total of 114 (56%) of 205 APDR members completed an online survey. Approximately one-third (32%) stated that their program provided instruction to residents on teaching skills. The majority of these programs (72%) were established within the last 5 years. Residents provided teaching to medical students (94%) and radiology residents (90%). The vast majority of program directors agreed that it is important for residents to teach (98%) and that these teaching experiences helped residents become better radiologists (85%). Ninety-four percent of program directors felt that the teaching skills of their residents could be improved, and 85% felt that residents would benefit from instruction on teaching methods. Only one-third of program directors felt their program adequately recognized teaching provided by residents. Program directors identified residents as being active contributors to teaching in most programs. Although teaching was viewed as an important skill to develop, few programs had instituted a resident-teacher curriculum. Program directors felt that residents would benefit from structured training to enhance teaching skills. Future studies are needed to determine how best to provide teaching skills training for radiology trainees. 2010 AUR. Published by Elsevier Inc. All rights reserved.

  3. Residency training program: Perceptions of residents

    African Journals Online (AJOL)

    This study was carried out to ascertain the perception of the residency ... the time of the study. Analysis of the respondents showed similar findings for both senior and junior levels of training. Discussion. The introduction of the residency training program .... Overseas training/ attachment should be re-introduced. 12. (10.1).

  4. Attempt to explain the uranium 238 resonance integral discrepancy

    International Nuclear Information System (INIS)

    Tellier, H.; Grandotto, M.

    1978-01-01

    For light water reactor physics, studies on uranium 238 resonance integral discrepancy were carried out. It was shown that using recently published resonance parameters and substituting a multilevel formalism to the usual Breit and Wigner formula reduced the well known discrepancy between two values of the uranium 238 effective resonance integral: the value calculated with the nuclear data and the one deduced from critical experiments. Since the cross section computed with these assumptions agrees quite well with the Oak Ridge transmission data, it was used to obtain the self-shielding effect and the capture rate in light water lattices. The multiplication factor calculated with this method is found very close to the experimental value. Preliminary results for a set of benchmarks relative to several types of thermal neutron reactors lead to very low discrepancies. The reactivity loss is only 130 x 10 -5 instead of 650 x 10 -5 in the case of the usual libraries and the single level formula

  5. An attempt to explain the uranium 238 resonance integral discrepancy

    International Nuclear Information System (INIS)

    Tellier, H.; Grandotto, M.

    1978-01-01

    Studies on uranium 238 resonance integral discrepancy were carried out for light water reactor physics. It was shown that using recently published resonance parameters and substituting a multilevel formalism to the usual Breit and Wigner formula reduced the well known discrepancy between two values of the uranium 238 effective resonance integral: the value calculated with the nuclear data and the one deduced from critical experiments. Since the cross section computed with these assumptions agrees quite well with the Oak-Ridge transmission data, it was used to obtain the self-shielding effect and the capture rate in light water lattices. The multiplication factor calculated with this method is found very close to the experimental value. Preliminary results for a set of benchmarks relative to several types of thermal neutron reactors lead to very low discrepancies. The reactivity loss is only 130 x 10 -5 instead of 650 x 10 -5 in the case of the usual libraries and the single level formula

  6. Discrepancies in reporting the CAG repeat lengths for Huntington's disease

    DEFF Research Database (Denmark)

    Quarrell, Oliver W; Handley, Olivia; O'Donovan, Kirsty

    2011-01-01

    results from 121 laboratories across 15 countries. We report on 1326 duplicate results; a discrepancy in reporting the upper allele occurred in 51% of cases, this reduced to 13.3% and 9.7% when we applied acceptable measurement errors proposed by the American College of Medical Genetics and the Draft......Huntington's disease results from a CAG repeat expansion within the Huntingtin gene; this is measured routinely in diagnostic laboratories. The European Huntington's Disease Network REGISTRY project centrally measures CAG repeat lengths on fresh samples; these were compared with the original...... European Best Practice Guidelines, respectively. Duplicate results were available for 1250 lower alleles; discrepancies occurred in 40% of cases. Clinically significant discrepancies occurred in 4.0% of cases with a potential unexplained misdiagnosis rate of 0.3%. There was considerable variation...

  7. Dietary restraint and self-discrepancy in male university students.

    Science.gov (United States)

    Orellana, Ligia; Grunert, Klaus G; Sepúlveda, José; Lobos, Germán; Denegri, Marianela; Miranda, Horacio; Adasme-Berríos, Cristian; Mora, Marcos; Etchebarne, Soledad; Salinas-Oñate, Natalia; Schnettler, Berta

    2016-04-01

    Self-discrepancy describes the distance between an ideal and the actual self. Research suggests that self-discrepancy and dietary restraint are related, causing a significant impact on the person's well-being. However, this relationship has been mostly reported in female and mixed populations. In order to further explore dietary behaviors and their relations to self-discrepancy and well-being-related variables in men, a survey was applied to a non-probabilistic sample of 119 male students from five Chilean state universities (mean age=21.8, SD=2.75). The questionnaire included the Revised Restraint Scale (RRS) with the subscales weight fluctuations (WF) and diet concern (DC), the Satisfaction with Life Scale (SWLS), the Satisfaction with Food-Related Life Scale (SWFL), the Nutrition Interest Scale (NIS), and the Self-discrepancy Index (SDI). Questions were asked about socio-demographic characteristics, eating and drinking habits, and approximate weight and height. A cluster analysis applied to the Z-scores of the RRS classified the following typologies: Group 1 (22.7%), men concerned about weight fluctuations; Group 2 (37.0%), men concerned about diet and weight fluctuations; Group 3 (40.3%), unconcerned about diet and weight fluctuations. The typologies differed in their SDI score, restriction on pastry consumption and reported body mass index (BMI). Students with higher DC and WF scores had a higher BMI, and tended to report high self-discrepancy not only on a physical level, but also on social, emotional, economic and personal levels. This study contributes to the literature on subjective well-being, dietary restraint and self-discrepancy in men from non-clinical samples. Copyright © 2016 Elsevier Ltd. All rights reserved.

  8. Discrepancies on Medication Plans detected in German Community Pharmacies.

    Science.gov (United States)

    Waltering, Isabel; Schwalbe, Oliver; Hempel, Georg

    2015-10-01

    A current medication plan was identified as important patient safety factor. Information is needed on how many patients possess such a plan and what problems can be identified with its use. This study tried to define factors that influence accuracy of medication plans and to detect discrepancies from planned and actually administered medication in polypharmacy patients. Participants of the 'Apo-AMTS' course in Germany evaluated medication plans from their patients during performing medication reviews in community pharmacies. Discrepancies were defined as additional or missing drugs and deviations in dosage and drug names for Rx drugs and missing or additional self-medication. Eighty per cent of the patients possessed a medication plan mainly written by general practitioners. Only 6.5% of the plans showed no discrepancies. Most discrepancies were seen on medication plans written by medical specialists and general practitioners, mainly name aberrations (41%) followed by additional drugs taken (30%) and prescribed drugs no longer taken (18%). Dosage variance was seen in 11% of all discrepancies. Deviations from the plan were observed frequently with antihypertensives (31.4%), analgesics (11.3%) and antidepressants/hypnotics as well as lipid-lowering drugs (6.7%). Four hundred thirty-three OTC drugs were not listed, mainly analgesics, mineral supplements and laxatives. Many patients possess a medication plan but most of these plans showed discrepancies which limits the use as patient safety indicator. Community pharmacies offering medication reviews have an essential position to use the medication plan as a central link between patients and their prescribers, and therefore improve patient safety. © 2015 John Wiley & Sons, Ltd.

  9. Medication discrepancies at discharge from an internal medicine service.

    Science.gov (United States)

    Herrero-Herrero, José-Ignacio; García-Aparicio, Judit

    2011-02-01

    Medication errors most commonly occur at the time of medication prescribing and particularly at the moment of the transitions of care. The objectives of this study were to identify and characterize the discrepancies between the physicians' discharge medication orders and the medication lists at admission obtained by an internal medicine specialist physician in a general internal medicine service. This descriptive, retrospective, study was carried out at a tertiary care university teaching hospital in Spain. It was based on the review of non selected, consecutive, hospital discharge reports. Discrepancies were identified, categorized and characterized through the analysis of the information (medication lists, laboratory tests results, diagnosis, and clinical evolution) contained in them. We analyzed 954 discharge reports. In the medication reconciliation process, we find discrepancies in 832 (87.2%) of them. Justified discrepancies were found in 828 (86.8%) reports and unjustified discrepancies in 52 (5.4%). Omission of a medication was the most frequent medication error detected in 86.4% of cases, followed by incomplete prescription (9.6%). The number of diagnosis, the length of hospital stay and the number of permanent medications at admission were the characteristics of cases associated with medication discrepancies in multivariate linear regression (Pmedication errors detected in our study. Appropriate routines to ensure an accurate medication history collection and a methodical elaboration of the medication list at discharge, when performed by trained internists, are important for an adequate medication reconciliation process. Copyright © 2010 European Federation of Internal Medicine. Published by Elsevier B.V. All rights reserved.

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

    Science.gov (United States)

    Schwartz, C; Rabinovitz, S

    2003-02-01

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

  11. Histopathology Discrepancy of Preoperative Endometrial Sampling and Final Specimen: How Does This Influence Selective Lymph Node Dissection?

    Science.gov (United States)

    Corr, Bradley R; Carrubba, Aakriti; Sheeder, Jeanelle; Cheng, Georgina; Guntupalli, Saketh R

    2017-02-01

    Preoperative histology is a major component in the perioperative selective lymph node (LN) dissection decision process. Discrepancy between preoperative endometrial sampling and final specimen histopathology is generally accepted. The goals of this project are to determine if discrepancy of histopathology is associated with alteration of adjuvant treatment or outcome. We performed a retrospective cross-sectional analysis of all patients undergoing surgery for endometrial cancer at a single institution from 2010 to 2014. All patients had preoperative endometrial sampling. Histopathology discrepancy was evaluated for potential in variation of perioperative LN dissection. Criteria for not performing LN dissection was defined as preoperative endometrioid histology, grade 1 or 2 lesion, myometrial invasion of 50% or less, and primary tumor diameter 2 cm or less. A total of 352 patients were identified; 44 were excluded because of no preoperative pathology or no residual disease on final pathology. Discrepancy of histopathology was noted in 64/308 (20.8%; 95% confidence interval [CI], 16.2%-25.3%) patients. Preoperative endometrioid histology was noted in 272 patients, and 17/272 (6.3%; 95% CI, 3.4%-9.1%) had preoperative sampling reviewed as a grade 1 or 2 endometrioid lesion and final specimen was upgraded to grade 3. Downstaging occurred in 3/272 (1.1%; 95% CI, 0%-2.3%) patients with preoperative grade 3 lesion and final specimen demonstrated grade 1 or 2 disease. All 3 patients' primary tumor diameter was greater than 2 cm and therefore received LN dissection. Histopathological discrepancy that would alter perioperative LN dissection decision based on the aforementioned criteria occurred in 2/272 (0.7%; 95% CI, 0%-1.8%). Despite a 20% discrepancy of preoperative and postoperative histopathology, discrepancy that would alter a perioperative decision for LN dissection occurs in only 0.7% of cases in this retrospective single-institutional experience. Myometrial

  12. 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.

  13. 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.

  14. 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

  15. 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...

  16. 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.

  17. Parent-child discrepancies in the report of adolescent emotional and behavioral problems in Taiwan.

    Science.gov (United States)

    Chen, Ying-Yeh; Ho, Suk-Yin; Lee, Pei-Chen; Wu, Chia-Kai; Gau, Susan Shur-Fen

    2017-01-01

    The majority of studies on parent-child discrepancies in the assessment of adolescent emotional and behavioral problems have been conducted in Western countries. It is believed that parent-adolescent agreement would be higher in societies with a strong culture of familism. We examined whether parent-adolescent discrepancies in the rating of adolescent emotional and behavioral problems are related to parental and family factors in Taiwan. Participants included 1,421 child-parent pairs of 7th-grade students from 12 middle schools in Northern Taiwan and their parents. We calculated Pearson's correlation coefficients to assess the relationship between parental (Child Behavior Checklist, CBCL) and adolescent (Youth Self Report, YSR) report of emotional/behavioral problem syndromes. Regression models were used to assess parent-adolescent differences in relation to parental psychopathology and family factors. We found that parent-adolescent agreement was moderate (r = 0.37). Adolescents reported higher symptom scores than their parents (Mean Total Problem Score: CBCL: 20.79, YSR: 33.14). Parental psychopathology was related to higher parental ratings and better informant agreement. Parents with higher socioeconomic status (SES) tended to report lower scores for adolescent problem syndromes, resulting in higher levels of disagreement. Greater maternal care was related to higher parent-adolescent agreement. Based on our study findings, we conclude that familism values do not seem to improve parent-child agreement in the assessment of adolescent problem syndromes. The finding that higher SES was related to increased discrepancies speaks to the need to explore the culture-specific mechanisms giving rise to informant discrepancies.

  18. The Cepheid mass discrepancy and pulsation-driven mass loss

    NARCIS (Netherlands)

    Neilson, H.R.; Cantiello, M.; Langer, N.

    2011-01-01

    Context. A longstanding challenge for understanding classical Cepheids is the Cepheid mass discrepancy, where theoretical mass estimates using stellar evolution and stellar pulsation calculations have been found to differ by approximately 10−20%. Aims. We study the role of pulsation-driven mass loss

  19. Error and discrepancy in radiology: inevitable or avoidable?

    Science.gov (United States)

    Brady, Adrian P

    2017-02-01

    Errors and discrepancies in radiology practice are uncomfortably common, with an estimated day-to-day rate of 3-5% of studies reported, and much higher rates reported in many targeted studies. Nonetheless, the meaning of the terms "error" and "discrepancy" and the relationship to medical negligence are frequently misunderstood. This review outlines the incidence of such events, the ways they can be categorized to aid understanding, and potential contributing factors, both human- and system-based. Possible strategies to minimise error are considered, along with the means of dealing with perceived underperformance when it is identified. The inevitability of imperfection is explained, while the importance of striving to minimise such imperfection is emphasised. • Discrepancies between radiology reports and subsequent patient outcomes are not inevitably errors. • Radiologist reporting performance cannot be perfect, and some errors are inevitable. • Error or discrepancy in radiology reporting does not equate negligence. • Radiologist errors occur for many reasons, both human- and system-derived. • Strategies exist to minimise error causes and to learn from errors made.

  20. Discrepancies between Parents' and Children's Attitudes toward TV Advertising

    Science.gov (United States)

    Baiocco, Roberto; D'Alessio, Maria; Laghi, Fiorenzo

    2009-01-01

    The authors conducted a study with 500 parent-child dyads. The sample comprised 254 boys and 246 girls. The children were grouped into 5 age groups (1 group for each age from 7 to 11 years), with each group comprising 100 children. The survey regards discrepancies between children and their parents on attitudes toward TV advertising to determine…

  1. Outcome discrepancies and selective reporting: impacting the leading journals?

    Science.gov (United States)

    Fleming, Padhraig S; Koletsi, Despina; Dwan, Kerry; Pandis, Nikolaos

    2015-01-01

    Selective outcome reporting of either interesting or positive research findings is problematic, running the risk of poorly-informed treatment decisions. We aimed to assess the extent of outcome and other discrepancies and possible selective reporting between registry entries and published reports among leading medical journals. Randomized controlled trials published over a 6-month period from July to December 31st, 2013, were identified in five high impact medical journals: The Lancet, British Medical Journal, New England Journal of Medicine, Annals of Internal Medicine and Journal of American Medical Association were obtained. Discrepancies between published studies and registry entries were identified and related to factors including registration timing, source of funding and presence of statistically significant results. Over the 6-month period, 137 RCTs were found. Of these, 18% (n = 25) had discrepancies related to primary outcomes with the primary outcome changed in 15% (n = 20). Moreover, differences relating to non-primary outcomes were found in 64% (n = 87) with both omission of pre-specified non-primary outcomes (39%) and introduction of new non-primary outcomes (44%) common. No relationship between primary or non-primary outcome change and registration timing (prospective or retrospective; P = 0.11), source of funding (P = 0.92) and presence of statistically significant results (P = 0.92) was found. Discrepancies between registry entries and published articles for primary and non-primary outcomes were common among trials published in leading medical journals. Novel approaches are required to address this problem.

  2. Prevalence of Gender Discrepancy in Internet Use in Nigeria ...

    African Journals Online (AJOL)

    One important agent of empowerment is information, provided with dispatch through the Internet. In essence, the research sought to determine the prevalence of gender discrepancies in Internet use with a view to indicating its implication to women empowerment. In the survey, cluster and proportionate sampling techniques ...

  3. Discrepancy between second and first opinion in surgical oncological patients

    NARCIS (Netherlands)

    Mellink, WAM; Henzen-Logmans, SC; Bongaerts, AHH; Ooijen, BV; Rodenburg, CJ; Wiggers, T

    Purpose: To prospectively describe in a population of oncological second opinion patients: (1) the outcome of routine revisions of histopathological and radiological material, (2) the frequency and extent of discrepancy between the second and first opinion and (3) the location of further treatment

  4. Discrepancy and Disliking Do Not Induce Negative Opinion Shifts

    NARCIS (Netherlands)

    Takács, Károly; Flache, Andreas; Maes, Michael

    2016-01-01

    Both classical social psychological theories and recent formal models of opinion differentiation and bi-polarization assign a prominent role to negative social influence. Negative influence is defined as shifts away from the opinion of others and hypothesized to be induced by discrepancy with or

  5. Comparative processes in personal and group judgments : Resolving the discrepancy

    NARCIS (Netherlands)

    Postmes, T; Branscombe, NR; Spears, R; Young, H

    The judgment mechanisms underlying personal- and group-level ratings of discrimination and privilege were investigated in high- and lour-status groups. PI consistent personal-group discrepancy is found for discrimination and privilege: but is not due to personal differentiation from the group.

  6. Sex Differences in Children's Discrepant Perceptions of Peer Acceptance

    Science.gov (United States)

    Smith, Stephanie D.; Van Gessel, Christine A.; David-Ferdon, Corinne; Kistner, Janet A.

    2013-01-01

    Sex differences in children's play patterns during middle childhood are thought to promote greater awareness of social acceptance among girls compared with boys. The present study posited that girls are more discerning of peer acceptance than are boys; however, these sex differences were predicted to vary depending on how discrepant perceptions…

  7. Radiology resident teaching skills improvement: impact of a resident teacher training program.

    Science.gov (United States)

    Donovan, Andrea

    2011-04-01

    Teaching is considered an essential competency for residents to achieve during their training. Instruction in teaching skills may assist radiology residents in becoming more effective teachers and increase their overall satisfaction with teaching. The purposes of this study were to survey radiology residents' teaching experiences during residency and to assess perceived benefits following participation in a teaching skills development course. Study participants were radiology residents with membership in the American Alliance of Academic Chief Residents in Radiology or the Siemens AUR Radiology Resident Academic Development Program who participated in a 1.5-hour workshop on teaching skills development at the 2010 Association of University Radiologists meeting. Participants completed a self-administered, precourse questionnaire that addressed their current teaching strategies, as well as the prevalence and structure of teaching skills training opportunities at their institutions. A second postcourse questionnaire enabled residents to evaluate the seminar and assessed new knowledge and skill acquisition. Seventy-eight residents completed the precourse and postcourse questionnaires. The vast majority of respondents indicated that they taught medical students (72 of 78 [92.3%]). Approximately 20% of residency programs (17 of 78) provided residents with formal didactic programs on teaching skills. Fewer than half (46.8%) of the resident respondents indicated that they received feedback on their teaching from attending physicians (36 of 77), and only 18% (13 of 78) routinely gave feedback to their own learners. All of the course participants agreed or strongly agreed that this workshop was helpful to them as teachers. Few residency programs had instituted resident teacher training curricula. A resident teacher training workshop was perceived as beneficial by the residents, and they reported improvement in their teaching skills. Copyright © 2011 AUR. Published by

  8. Case Reporting, Competence, and Confidence: A Discrepancy in the Numbers.

    Science.gov (United States)

    Shah, Deepa; Haisch, Carl E; Noland, Seth L

    The Accreditation Council for Graduate Medical Education (ACGME) continues to play an integral role in accreditation of surgical programs. The institution of case logs to demonstrate competency of graduating residents is a key component of evaluation. This study compared the number of vascular cases a surgical resident has completed according to the ACGME operative log to their operative proficiency, quality of anastomosis, operative experience, and confidence in both a simulation and operative setting. General surgery residents ranging from PGY 1 to 5 participated in a simulation laboratory in which they completed an end-to-side vascular anastomosis. Each participant was given a weighted score based on technical proficiency and anastomosis quality using a previously validated Global Rating Scale (Duran et al, 2014). These scores were correlated to the General Surgery Milestones. Participants completed preoperative and postoperative surveys assessing resident operative experience using the 4-level Zwisch scale (DaRosa et al., 2013), confidence with vascular procedures and confidence performing simulated anastomoses. Confidence was assessed on a scale from 1 to 9 (not confident to extremely confident). Case logs were recorded for each participant. An IRB approved questionnaire was distributed to assess preoperative and postoperative roles of both the resident physician and faculty, with a defined goal. Univariate and multivariate analysis was performed. Twenty-one general surgery residents were evaluated in the simulation laboratory and 8 residents were assessed intraoperatively. The residents were evenly distributed throughout clinical years. Groups of residents were divided into quartiles based upon the number of vascular cases recorded in the ACGME database. No correlation was found between number of cases, Milestones score and the weighted score (p = 0.94). No statistical significance was found between confidence and quality of anastomosis (p = 0.1). Resident

  9. Encuesta de opinión sobre la cirugía mayor ambulatoria en la formación del residente de especialidades quirúrgicas Opinion survey of the effect of major ambulatory surgery on the training of surgical residents

    Directory of Open Access Journals (Sweden)

    Carlos Martínez Ramos

    2004-12-01

    Full Text Available Introducción: La progresiva implantación en nuestro pais de la Cirugía Mayor Ambulatoria (CMA puede afectar a la enseñanza de la cirugía, si consideramos el desplazamiento presente y futuro hacia las Unidades de CMA de intervenciones quirúrgicas muy frecuentes, de riesgo medio y bajo, que constituyen la base del aprendizaje quirúrgico. El objetivo del presente trabajo es 1º conocer la opinión de los residentes de especialidades quirúrgicas sobre la repercusión que la CMA puede tener en su formación quirúrgica y 2º conocer las posibles soluciones que aportan en este sentido. Material y Métodos: Se ha realizado una encuesta de 17 preguntas (13 cerradas, 2 abiertas y 1 mixta a 72 residentes pertenecientes a 7 de las especialidades quirúrgicas que participan en la Unidad de CMA del Hospital Clínico San Carlos de Madrid. Resultados: La encuesta ha sido cumplimentada por el 36,1% de los residentes. De ellos, el 100% considera que: 1 es importante conocer y formarse en este tipo de cirugía. 2 las técnicas quirúrgicas que se realizan en la UCMA del Hospital son fundamentales para la formación del residente. 3 la Cirugía Mayor Ambulatoria debe incluirse en la formación de su especialidad durante el periodo de residencia. El 80,8% considera que tener formación en CMA contribuye a mejorar las expectativas laborales una vez finalizada la residencia. Conclusiones: Los residentes consideran que es necesaria su participación en la actividad de las Unidades de CMA, necesitándose, en este sentido, la creación de programas bien estructurados, elaborados y coordinados. Estos han de estar consensuados por todas las partes afectadas y se han de adaptar a las características de cada especialidad.Introduction: The progressive introduction in our country of Major Ambulatory Surgery (MAS may affect the training of surgical residents. The type of operations that may now be performed at MAS Units (frequent medium and low risk operations

  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. 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

  12. 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.

  13. The challenges of residents teaching neurology.

    Science.gov (United States)

    Frank, Samuel A; Józefowicz, Ralph F

    2004-07-01

    Teaching is integrated into the daily practice of residents, and it is a skill necessary for practice as well as academics. The settings in which teaching and learning take place are ubiquitous but include classrooms, small groups, bedside rounds, and grand rounds. Given the learning environment of residency, neurology residents should have working knowledge of basic principles of effective teaching to make learning successful. Teaching also reinforces knowledge, and residents will likely be better practitioners if some basic skills of teaching are practiced. Neurology teaching techniques for residents are rarely addressed in the medical literature. Although information regarding teaching principles in medicine exists, there is little information regarding how residents teach. We examine and review some of the more effective methods and appreciated qualities in teachers, with a particular emphasis for the neurology resident. We also review whom neurologists need to teach and the various settings in which teaching may take place. Neurology residents encounter a variety of audiences in a variety of settings that require diverse teaching skills to effectively convey information to other providers as well as patients. The majority of these skills should be learned in residency to establish a foundation for teaching, regardless of future practice settings.

  14. Perceived Competence, Discrepancy Scores, and Global Self-Worth.

    Science.gov (United States)

    Rose, Elizabeth; Larkin, Dawne

    2002-04-01

    According to Harter (1985a), global self-worth (GSW) can be predicted from the relationship between perceptions of competence and importance ratings. In this study, we employed Harter's (1985b) Importance Rating Scale (IRS) and Self-Perception Profile for Children (SPPC) to examine importance ratings, discrepancy scores, and domain-specific perceptions of competence as predictors of GSW. Children (N = 130, 62 boys and 68 girls) aged 8-12 years were categorized into high (HMC; n = 62) and low motor coordination (LMC; n = 68) groups according to their scores on a motor proficiency battery (McCarron, 1982). Regression analyses using domain-specific perceptions of competence, importance, and discrepancy scores confirmed that self-perception ratings were the best predictors of GSW. For both groups, perceptions of physical appearance, social acceptance, and behavioral conduct contributed significantly to prediction of GSW. By contrast, perceived athletic competence increased prediction of GSW for the HMC group but not the LMC group.

  15. Discrepancy and Disliking Do Not Induce Negative Opinion Shifts.

    Science.gov (United States)

    Takács, Károly; Flache, Andreas; Mäs, Michael

    2016-01-01

    Both classical social psychological theories and recent formal models of opinion differentiation and bi-polarization assign a prominent role to negative social influence. Negative influence is defined as shifts away from the opinion of others and hypothesized to be induced by discrepancy with or disliking of the source of influence. There is strong empirical support for the presence of positive social influence (a shift towards the opinion of others), but evidence that large opinion differences or disliking could trigger negative shifts is mixed. We examine positive and negative influence with controlled exposure to opinions of other individuals in one experiment and with opinion exchange in another study. Results confirm that similarities induce attraction, but results do not support that discrepancy or disliking entails negative influence. Instead, our findings suggest a robust positive linear relationship between opinion distance and opinion shifts.

  16. Numerical Monitoring of Natural Gas Distribution Discrepancy Using CFD Simulator

    OpenAIRE

    Seleznev, Vadim E.

    2010-01-01

    The paper describes a new method for numerical monitoring of discrepancies in natural gas supply to consumers, who receive gas from gas distribution loops. This method serves to resolve the vital problem of commercial natural gas accounting under the conditions of deficient field measurements of gas supply volumes. Numerical monitoring makes it possible to obtain computational estimates of actual gas deliveries over given time spans and to estimate their difference from corresponding values r...

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

    Directory of Open Access Journals (Sweden)

    Tainter, Christopher R

    2017-01-01

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

  18. [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.

  19. Resident-as-teacher in family medicine: a CERA survey.

    Science.gov (United States)

    Al Achkar, Morhaf; Davies, M Kelly; Busha, Michael E; Oh, Robert C

    2015-06-01

    Teaching has been increasingly recognized as a primary responsibility of residents. Residents enjoy teaching, and their majority report interest in the continuation of teaching activities after graduation. Resident-as-teacher programs have emerged nationally as a means of enhancing teaching skills. This study examined the current use of residents-as-teachers programs in family medicine residencies through a national survey of family medicine residency program directors. This survey project was part of the Council of Academic Family Medicine Education Research Alliance (CERA) 2014 survey to family medicine program directors that was conducted between February 2014 and May 2014. The response rate of the survey was 49.6% (224/451). The majority (85.8%) of residency programs offer residents formal instruction in teaching skills. The vast majority (95.6%) of programs mandated the training. The average total hours of teaching instruction residents receive while in residency training was 7.72. The residents are asked to formally evaluate the teaching instruction in 68.1% of the programs. Less than a quarter (22.6%) of residency programs offer the teaching instruction in collaboration with other programs. "Retreat, workshop, and seminars" were identified as the main form of instruction by 33.7% of programs. In 83.3% of programs not offering instruction, lack of resources was identified as the primary barrier. The majority of family medicine residency programs provide resident-as-teacher instructions, which reflects increasing recognition of importance of the teaching role of residents. Further research is needed to assess the effectiveness of such instruction on residents' teaching skills and their attitudes toward teaching.

  20. Prevalence of tooth size discrepancy among North Indian orthodontic patients

    Directory of Open Access Journals (Sweden)

    Rekha Sharma

    2011-01-01

    Full Text Available Objective: To determine the prevalence of tooth size discrepancy (TSD in a representative orthodontics population, to explore how many millimeters of TSD is clinically significant and to determine the ability of simple visual inspection to detect such a discrepancy. Materials and Methods: The sample comprised 150 pretreatment study casts with fully erupted and complete permanent dentitions from first molar to first molar, which were selected randomly from records of the orthodontic patients. The mesiodistal diameters of the teeth were measured at contact points using digital calipers and the Bolton′s analysis was carried out on them. Simple visual estimation of Bolton discrepancy was also performed. Results: In the sample group, 24% of the patients had anterior tooth width ratios and 8% had total arch ratios greater than ±2 standard deviation (SD from Bolton′s means. For the anterior analysis, correction greater than ±2 mm was required for 24% of patients in the upper arch or 14% in the lower arch. For the total arch analysis, correction greater than ±2 mm was required for 36% of patients in the upper arch or 32% in the lower arch. Conclusion: Bolton′s analysis should be routinely performed in all orthodontic patients and the findings should be included in orthodontic treatment planning. 2 mm of the required tooth size correction is an appropriate threshold for clinical significance. Visual estimation of TSD has low sensitivity and specificity. Careful measurement is more frequently required in clinical practice than visual estimation would suggest.

  1. Results of the 2005-2008 Association of Residents in Radiation Oncology Survey of Chief Residents in the United States: Clinical Training and Resident Working Conditions

    International Nuclear Information System (INIS)

    Gondi, Vinai; Bernard, Johnny Ray; Jabbari, Siavash; Keam, Jennifer; Amorim Bernstein, Karen L. de; Dad, Luqman K.; Li, Linna; Poppe, Matthew M.; Strauss, Jonathan B.; Chollet, Casey T.

    2011-01-01

    Purpose: To document clinical training and resident working conditions reported by chief residents during their residency. Methods and Materials: During the academic years 2005 to 2006, 2006 to 2007, and 2007 to 2008, the Association of Residents in Radiation Oncology conducted a nationwide survey of all radiation oncology chief residents in the United States. Chi-square statistics were used to assess changes in clinical training and resident working conditions over time. Results: Surveys were completed by representatives from 55 programs (response rate, 71.4%) in 2005 to 2006, 60 programs (75.9%) in 2006 to 2007, and 74 programs (93.7%) in 2007 to 2008. Nearly all chief residents reported receiving adequate clinical experience in commonly treated disease sites, such as breast and genitourinary malignancies; and commonly performed procedures, such as three-dimensional conformal radiotherapy and intensity-modulated radiotherapy. Clinical experience in extracranial stereotactic radiotherapy increased over time (p < 0.001), whereas clinical experience in endovascular brachytherapy (p <0.001) decreased over time. The distribution of gynecologic and prostate brachytherapy cases remained stable, while clinical case load in breast brachytherapy increased (p = 0.006). A small but significant percentage of residents reported receiving inadequate clinical experience in pediatrics, seeing 10 or fewer pediatric cases during the course of residency. Procedures involving higher capital costs, such as particle beam therapy and intraoperative radiotherapy, and infrequent clinical use, such as head and neck brachytherapy, were limited to a minority of institutions. Most residency programs associated with at least one satellite facility have incorporated resident rotations into their clinical training, and the majority of residents at these programs find them valuable experiences. The majority of residents reported working 60 or fewer hours per week on required clinical duties

  2. Canadian Plastic Surgery Resident Work Hour Restrictions: Practices and Perceptions of Residents and Program Directors.

    Science.gov (United States)

    McInnes, Colin W; Vorstenbosch, Joshua; Chard, Ryan; Logsetty, Sarvesh; Buchel, Edward W; Islur, Avinash

    2018-02-01

    The impact of resident work hour restrictions on training and patient care remains a highly controversial topic, and to date, there lacks a formal assessment as it pertains to Canadian plastic surgery residents. To characterize the work hour profile of Canadian plastic surgery residents and assess the perspectives of residents and program directors regarding work hour restrictions related to surgical competency, resident wellness, and patient safety. An anonymous online survey developed by the authors was sent to all Canadian plastic surgery residents and program directors. Basic summary statistics were calculated. Eighty (53%) residents and 10 (77%) program directors responded. Residents reported working an average of 73 hours in hospital per week with 8 call shifts per month and sleep 4.7 hours/night while on call. Most residents (88%) reported averaging 0 post-call days off per month and 61% will work post-call without any sleep. The majority want the option of working post-call (63%) and oppose an 80-hour weekly maximum (77%). Surgical and medical errors attributed to post-call fatigue were self-reported by 26% and 49% of residents, respectively. Residents and program directors expressed concern about the ability to master surgical skills without working post-call. The majority of respondents oppose duty hour restrictions. The reason is likely multifactorial, including the desire of residents to meet perceived expectations and to master their surgical skills while supervised. If duty hour restrictions are aggressively implemented, many respondents feel that an increased duration of training may be necessary.

  3. Facility Focus: Residence Halls.

    Science.gov (United States)

    College Planning & Management, 2003

    2003-01-01

    Describes four examples of residence hall design, one renovation and three new residence halls, that exemplify design principles that meet student and institutional requirements. The examples are at (1) the University of Illinois at Chicago; (2) Bowdoin College; (3) Muhlenberg College; and (4) Spring Arbor University. (SLD)

  4. Rain Forest Dance Residency.

    Science.gov (United States)

    Watson, Dawn

    1997-01-01

    Outlines the author's experience as a dancer and choreographer artist-in-residence with third graders at a public elementary school, providing a cultural arts experience to tie in with a theme study of the rain forest. Details the residency and the insights she gained working with students, teachers, and theme. (SR)

  5. Possible origin of the gamma-ray discrepancy in the summation calculations of fission product decay heat

    International Nuclear Information System (INIS)

    Yoshida, Tadashi; Tachibana, Takahiro; Storrer, F.; Oyamatsu, Kazuhiro; Katakura, Jun-ichi

    1999-01-01

    In order to identify the origin of the ubiquitous and long-standing discrepancy seen in the γ-ray component of the FP decay heat in the cooling time range 300-3,000 s, a comprehensive analysis of the differences between the summation calculations and the experiments has been carried out. There may be some missing of the β-strength in the high energy region of the FPs in the mass region A=100-110. Especially, 102 Tc, 104 Tc, 105 Tc and 108 Rh are potentially responsible for the γ-ray discrepancy seen in the three major fissioning nuclides, 235 U, 238 U and 239 Pu, systematically. The β-strength functions are theoretically calculated in order to validate this possibility. It is proved that the chance for finding the additional β-strength required to solve the discrepancy is not so large but still exists, and the exact β-feed from Tc to the highly excited levels in Rb should be identified experimentally. Finally, the impact of the γ-ray discrepancy on the reactor-core decay heat is evaluated quantitatively for the first time. It may introduce 0.5-1% underestimation of the total FP decay heat from 1 to 2,000 s after reactor shutdown, and the underestimation may reach 3% at the maximum when the γ-ray component of the decay heat is separately taken into consideration. (author)

  6. Psychologic effects of residency.

    Science.gov (United States)

    Reuben, D B

    1983-03-01

    The intense situational and physiologic stresses that accompany postgraduate training may have serious psychosocial ramifications. Although only a small proportion of residents have overt psychiatric illness, virtually all display some psychologic impairment. Contributing factors include life-changes, stresses associated with providing patient care, loss of social support, long working hours, sleep deprivation, and underlying personality traits of residents. The manifestations of this impairment are variable and may be subtle. In response to these problems, residency programs have taken steps to provide psychosocial support. Unfortunately, most programs do not offer formal support groups or seminars to discuss difficulties that accompany residency. Further definition of the psychosocial effects of residency may prompt changes that make the training of physicians a more humane process.

  7. Global health education in emergency medicine residency programs.

    Science.gov (United States)

    Havryliuk, Tatiana; Bentley, Suzanne; Hahn, Sigrid

    2014-06-01

    Interest in global health and international electives is growing among Emergency Medicine (EM) residents in the United States (US). The majority of EM residency programs offer opportunities for international electives. The degree of participation among residents and type of support provided by the residency program, however, remains unclear. To explore the current state of global health education among EM residents who participate in international electives. A 12-question survey was e-mailed to the program directors of the 192 EM residency programs in the US. The survey included questions about the number of residents participating in international electives and the types of preparation, project requirements, supervision, and feedback participating residents receive. The response rate was 53% with 102 responses. Seventy-five of 102 (74%) programs reported that at least one resident participated in an international elective in the 2010-2011 academic year. Forty-three programs (42%) report no available funding to support any resident on an international elective. Residents receive no preparation for international work in 41 programs (40%). Only 25 programs (26%) required their residents to conduct a project while abroad. Forty-nine programs (48%) reported no formal debriefing session, and no formal feedback was collected from returning residents in 57 of 102 (59%) programs. The majority of EM residencies have residents participating in international electives. However, the programs report variable preparation, requirements, and resident supervision. These results suggest a need for an expanded and more structured approach to international electives undertaken by EM residents. Copyright © 2014 Elsevier Inc. All rights reserved.

  8. An ABO blood grouping discrepancy: Probable B(A) phenotype.

    Science.gov (United States)

    Jain, Ashish; Gupta, Anubhav; Malhotra, Sheetal; Marwaha, Neelam; Sharma, Ratti Ram

    2017-06-01

    In B(A) phenotype, an autosomal dominant phenotype, there is a weak A expression on group B RBCs. We herein report a case of a probable B(A) phenotype in a first time 20-year old male donor. The cell and serum grouping were done using tube technique and also with blood grouping gel card (Diaclone, ABD cards for donors, BioRad, Switzerland). The antisera used were commercial monoclonal IgM type. To check for the weak subgroup of A, cold adsorption and heat elution was performed. The cell grouping was A weak B RhD positive while the serum grouping was B. There was no agglutination with O cells and the autologous control was also negative. It was a group II ABO discrepancy with or without group IV discrepancy. Results for both the eluate and last wash were negative. Hence, the possibility of weak subgroup of A was unlikely. Blood grouping gel card also showed a negative reaction in the anti-A column. One lot of anti-A was showing 'weak +' agglutination while the other lot was showing 'negative' reaction with the donor RBCs by tube technique. There was no agglutination observed with anti-A1 lectin. Our case highlights the serological characteristics of a B(A) phenotype. This case emphasizes the vital role of cell and serum grouping in detecting such discrepancies especially in donors which can lead to mislabeling of the blood unit and may be a potential risk for the transfusion recipient if not resolved appropriately. Copyright © 2017 Elsevier Ltd. All rights reserved.

  9. Resolving Discrepancies Between Observed and Predicted Dynamic Topography on Earth

    Science.gov (United States)

    Richards, F. D.; Hoggard, M.; White, N. J.

    2017-12-01

    Compilations of well-resolved oceanic residual depth measurements suggest that present-day dynamic topography differs from that predicted by geodynamic simulations in two significant respects. At short wavelengths (λ ≤ 5,000 km), much larger amplitude variations are observed, whereas at long wavelengths (λ > 5,000 km), observed dynamic topography is substantially smaller. Explaining the cause of this discrepancy with a view to reconciling these different approaches is central to constraining the structure and dynamics of the deep Earth. Here, we first convert shear wave velocity to temperature using an experimentally-derived anelasticity model. This relationship is calibrated using a pressure and temperature-dependent plate model that satisfies age-depth subsidence, heat flow measurements, and seismological constraints on the depth to the lithosphere-asthenosphere boundary. In this way, we show that, at short-wavelengths, observed dynamic topography is consistent with ±150 ºC asthenospheric temperature anomalies. These inferred thermal buoyancy variations are independently verified by temperature measurements derived from geochemical analyses of mid-ocean ridge basalts. Viscosity profiles derived from the anelasticity model suggest that the asthenosphere has an average viscosity that is two orders of magnitude lower than that of the underlying upper mantle. The base of this low-viscosity layer coincides with a peak in azimuthal anisotropy observed in recent seismic experiments. This agreement implies that lateral asthenospheric flow is rapid with respect to the underlying upper mantle. We conclude that improved density and viscosity models of the uppermost mantle, which combine a more comprehensive physical description of the lithosphere-asthenosphere system with recent seismic tomographic models, can help to resolve spectral discrepancies between observed and predicted dynamic topography. Finally, we explore possible solutions to the long

  10. A reflection on radiographic cephalometry: the evaluation of sagittal discrepancy.

    Science.gov (United States)

    Duterloo, Herman S

    2014-09-01

    A critical review is presented of the basic properties and applications of cephalometry as a clinical tool with a focus on the evaluation of sagittal discrepancy. Diagnostic cephalometric assessments are subjective and not based on evidence. To assess individual skeletal and/or facial soft tissue form subjectively, selected norms are used. Norms have been developed for various ethnical groups to improve clinical applicability, but subjectivity remains. That subjectivity precludes application of a modern review system, making the present review a personal account. The cephalometric evaluation of sagittal discrepancy finds its historic origin in the Angle classification. Recent publications try to improve accuracy in classifying sagittal discrepancy. It remains unclear in what sense such efforts influence treatment decisions and/or treatment effect. Almost all selected landmarks are located on or dependent upon periosteal/endosteal bone image contours. Their homology is based on circumstantial reasoning and stability over time, which is implicitly assumed. However, implant growth studies and histological investigations show most landmarks to be unstable, as they are involved in displacement and bone remodelling. These landmarks are therefore heterologous when used for individual evaluation of change over time. Notwithstanding the above-indicated limitations, diagnostic cephalometric assessments are clinically useful and help to develop perceptions of balance and harmony and communication between colleagues and patients. There is no evidence-based method to prefer one particular diagnostic method. Landmark location accuracy and geometric issues do not play a decisive role. The subjective characteristic of diagnostic evaluations limits their power to size/shape comparisons. Structural superimposition is the valid biologically evidence-based method to provide advanced insight in individual growth and/or treatment changes and their variations. © 2014 British Orthodontic

  11. Creativity and intelligence: analyzing developmental similarities and discrepancies

    OpenAIRE

    Wechsler, Solange Muglia; Nunes, Maiana Farias Oliveira; Schelini, Patrícia Waltz; Ferreira, Adriana Aparecida; Pereira, Dejenane Aparecida Pascoal

    2010-01-01

    As semelhanças e discrepâncias entre inteligência e criatividade foram investigadas, assim como os possíveis impactos de gênero e série educacional sobre o seu desenvolvimento. A amostra foi composta por 172 estudantes (91 mulheres, 81 homens), com idades variando dos 7 aos 17 anos. A avaliação da inteligência foi feita por meio da versão brasileira da Bateria Woodcock-Johnson III enquanto que criatividade foi avaliada pelos Testes de Pensamento Criativo de Torrance. Os resultados obtidos pel...

  12. Reporter Discrepancies Among Parents, Adolescents, and Peers: Adolescent Attachment and Informant Depressive Symptoms as Explanatory Factors

    Science.gov (United States)

    Ehrlich, Katherine B.; Cassidy, Jude; Dykas, Matthew J.

    2010-01-01

    The issue of informant discrepancies about child and adolescent functioning is an important concern for clinicians, developmental psychologists, and others who must consider ways of handling discrepant reports of information, but reasons for discrepancies in reports have been poorly understood. Adolescent attachment and informant depressive symptoms were examined as two explanations for absolute and directional discrepancies about adolescent symptoms, relationships, and social behavior in a sample of 189 eleventh-grade students (mean age = 16.5 years). Adolescent attachment predicted absolute discrepancies, with greater attachment coherence associated with fewer discrepancies in reports of adolescent depressive symptoms, parent-adolescent conflict, and adolescent externalizing behavior. Parents’ but not adolescents’ depressive symptoms sometimes predicted absolute discrepancies. Mothers’ depressive symptoms and adolescent attachment predicted the direction of discrepancies for mother-peer reports only. PMID:21410916

  13. Neuropsychological and Academic Achievement Correlates of Abnormal WISC-R Verbal-Performance Discrepancies.

    Science.gov (United States)

    Lueger, Robert J.; And Others

    1985-01-01

    Examined neuropsychological and academic achievement correlates of statistically abnormal verbal-performance discrepancies on the Wechsler Intelligence Scale for Children (Revised). Results indicated that abnormal discrepancies reflect specific aphasia deficits rather than generalized neuropsychological dysfunction and that academic achievement…

  14. Subjective-objective sleep discrepancy among older adults: Associations with insomnia diagnosis and insomnia treatment

    OpenAIRE

    Kay, Daniel B.; Buysse, Daniel J.; Germain, Anne; Hall, Martica; Monk, Timothy H.

    2014-01-01

    Discrepancy between subjective and objective measures of sleep is associated with insomnia and increasing age. Cognitive behavioral therapy for insomnia improves sleep quality and decreases subjective-objective sleep discrepancy. This study describes differences between older adults with insomnia and controls in sleep discrepancy, and tests the hypothesis that reduced sleep discrepancy following cognitive behavioral therapy for insomnia correlates with the magnitude of symptom improvement rep...

  15. An Alternative Presentation of Incremental Validity: Discrepant SAT and HSGPA Performance

    Science.gov (United States)

    Mattern, Krista D.; Shaw, Emily J.; Kobrin, Jennifer L.

    2011-01-01

    This study examined discrepant high school grade point average (HSGPA) and SAT performance as measured by the difference between a student's standardized SAT composite score and standardized HSGPA. The SAT-HSGPA discrepancy measure was used to examine whether certain students are more likely to exhibit discrepant performance and in what direction.…

  16. 78 FR 48418 - Proposed Information Collection; Comment Request; Nautical Discrepancy Reporting System

    Science.gov (United States)

    2013-08-08

    ... Discrepancy Reporting System AGENCY: National Oceanic and Atmospheric Administration (NOAA), Commerce. ACTION... information through the online Nautical Discrepancy Reporting ] System ( http://ocsdata.ncd.noaa.gov/idrs/discrepancy.aspx ). The data obtained through this system is used to update U.S. nautical charts and the...

  17. The Regression-Based Discrepancy Definition of Learning Disability: A Critical Appraisal

    Science.gov (United States)

    Cahan, Sorel; Fono, Dafna; Nirel, Ronit

    2012-01-01

    The regression-based discrepancy definition of learning disabilities has been suggested by Rutter and Yule as an improvement of the well-known and much criticized achievement-intelligence discrepancy definition, whereby the examinee's predicted reading attainment is substituted for the intelligence score in the discrepancy expression. Even though…

  18. The role of ambiguity and discrepancy in the early phases of innovation

    DEFF Research Database (Denmark)

    Laursen, Linda Nhu; Tollestrup, Christian H. T.

    2015-01-01

    and discrepancy, we seek to understand if it might be there for a reason. Through a laboratory experiment, we propose ambiguity and discrepancy actually have a function in concept development. Accordingly the paper contributes with a better understanding of, the role ambiguity and discrepancy as triggers of sense...

  19. Relationship of functional leg-length discrepancy to abnormal pronation.

    Science.gov (United States)

    Rothbart, Brian A

    2006-01-01

    The objective of this study was to determine whether a correlation exists between abnormal pronation and functional leg-length discrepancies. Visual assessment and a pelvic thrust maneuver were used to identify the functionally short leg in 56 indigenous Mexicans (20 males and 36 females; mean age, 33 years; mean weight, 59 kg; and mean height, 1.60 m). The Foot Posture Index was used with a modified stance position to identify the more pronated foot. The posterosuperior iliac spines were used to identify the "relative" position of the innominate bones. The raw data obtained from this study were evaluated using the McNemar test for paired proportions. A significant positive correlation was found between abnormal pronation and hip position and between hip position and functional leg-length discrepancy. These results are consistent with a theoretical ascending dysfunctional pelvic model: Abnormal pronation pulls the innominate bones anteriorly (forward); anterior rotation of the innominate bones shifts the acetabula posteriorly and cephalad (backward and upward); and this shift in the acetabula hyperextends the knees and shortens the legs, with the shortest leg corresponding to the most pronated foot.

  20. Exploration of Quantum Interference in Document Relevance Judgement Discrepancy

    Directory of Open Access Journals (Sweden)

    Benyou Wang

    2016-04-01

    Full Text Available Quantum theory has been applied in a number of fields outside physics, e.g., cognitive science and information retrieval (IR. Recently, it has been shown that quantum theory can subsume various key IR models into a single mathematical formalism of Hilbert vector spaces. While a series of quantum-inspired IR models has been proposed, limited effort has been devoted to verify the existence of the quantum-like phenomenon in real users’ information retrieval processes, from a real user study perspective. In this paper, we aim to explore and model the quantum interference in users’ relevance judgement about documents, caused by the presentation order of documents. A user study in the context of IR tasks have been carried out. The existence of the quantum interference is tested by the violation of the law of total probability and the validity of the order effect. Our main findings are: (1 there is an apparent judging discrepancy across different users and document presentation orders, and empirical data have violated the law of total probability; (2 most search trials recorded in the user study show the existence of the order effect, and the incompatible decision perspectives in the quantum question (QQ model are valid in some trials. We further explain the judgement discrepancy in more depth, in terms of four effects (comparison, unfamiliarity, attraction and repulsion and also analyse the dynamics of document relevance judgement in terms of the evolution of the information need subspace.

  1. A probable stellar solution to the cosmological lithium discrepancy.

    Science.gov (United States)

    Korn, A J; Grundahl, F; Richard, O; Barklem, P S; Mashonkina, L; Collet, R; Piskunov, N; Gustafsson, B

    2006-08-10

    The measurement of the cosmic microwave background has strongly constrained the cosmological parameters of the Universe. When the measured density of baryons (ordinary matter) is combined with standard Big Bang nucleosynthesis calculations, the amounts of hydrogen, helium and lithium produced shortly after the Big Bang can be predicted with unprecedented precision. The predicted primordial lithium abundance is a factor of two to three higher than the value measured in the atmospheres of old stars. With estimated errors of 10 to 25%, this cosmological lithium discrepancy seriously challenges our understanding of stellar physics, Big Bang nucleosynthesis or both. Certain modifications to nucleosynthesis have been proposed, but found experimentally not to be viable. Diffusion theory, however, predicts atmospheric abundances of stars to vary with time, which offers a possible explanation of the discrepancy. Here we report spectroscopic observations of stars in the metal-poor globular cluster NGC 6397 that reveal trends of atmospheric abundance with evolutionary stage for various elements. These element-specific trends are reproduced by stellar-evolution models with diffusion and turbulent mixing. We thus conclude that diffusion is predominantly responsible for the low apparent stellar lithium abundance in the atmospheres of old stars by transporting the lithium deep into the star.

  2. Elective time during dermatology residency: A survey of residents and program directors.

    Science.gov (United States)

    Uppal, Pushpinder; Shantharam, Rohini; Kaufmann, Tara Lynn

    2017-12-15

    Elective time during residency training provides residents with exposure to different subspecialties. This opportunity gives residents the chance tonurture growth in particular areas of interest and broaden their knowledge base in certain topics in dermatology by having the chance to work withexperts in the field. The purpose of this study was to assess the views of residency program directors and dermatology residents on the value of elective time through a cross sectional survey. An eight-questionIRB exempt survey was sent out to 113 residency program directors via email through the American Professors of Dermatology (APD) program director listserv. Program directors were asked to forward a separate set of 9 questions to their residents. The majority of programs that responded allowed for some elective time within their schedule, often duringthe PGY 4 (3rd year of dermatology training), but the amount of time allowed widely varied among many residency programs. Overall, residents and program directors agree that elective is important in residencytraining, but no standardization is established across programs.

  3. Analysis of discrepancy between neurologic findings and CT findings in 60 patients with herniated nucleus pulposus

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Hyun; Kim, Kab Tae; Sol, Chang Hyo; Kim, Byung Soo [College of Medicine, Pusan National University, Busan(Korea, Republic of)

    1987-06-15

    The herniated nucleus pulposus (HNP) is a major cause of low back pain and sciatica. High resolution computed tomography is the most accurate diagnostic tool to define a HNP, because it provides a complete in vivo analysis of bony framework of lumbar spine as well as the supporting soft tissue structures and neural elements. But the discrepancy between neurologic findings and CT findings is often confusing. From May 1983 to August 1986, sixty patients with HNP who had both CT and surgical intervention at Pusan National University Hospital were analyzed. The feasibility of the neurologic examination on HNP and the effect of HNP on nerve root were evaluated on the basis of CT findings. The results were as follows : 1. Thirty-four cases (56.7%) of clinical impression were matched to CT findings in determining level of HNP and affected nerve root. 2. In evaluation of affected level, there was high trend to cause discrepancy between neurologic findings and CT findings in multiple disc involvement than in single involvement. 3. There was no correlation between degree of nerve root compression determined by CT and pattern of neurologic signs (motor weakness, sensory deficit, and reflex change)

  4. Analysis of discrepancy between neurologic findings and CT findings in 60 patients with herniated nucleus pulposus

    International Nuclear Information System (INIS)

    Lee, Hyun; Kim, Kab Tae; Sol, Chang Hyo; Kim, Byung Soo

    1987-01-01

    The herniated nucleus pulposus (HNP) is a major cause of low back pain and sciatica. High resolution computed tomography is the most accurate diagnostic tool to define a HNP, because it provides a complete in vivo analysis of bony framework of lumbar spine as well as the supporting soft tissue structures and neural elements. But the discrepancy between neurologic findings and CT findings is often confusing. From May 1983 to August 1986, sixty patients with HNP who had both CT and surgical intervention at Pusan National University Hospital were analyzed. The feasibility of the neurologic examination on HNP and the effect of HNP on nerve root were evaluated on the basis of CT findings. The results were as follows : 1. Thirty-four cases (56.7%) of clinical impression were matched to CT findings in determining level of HNP and affected nerve root. 2. In evaluation of affected level, there was high trend to cause discrepancy between neurologic findings and CT findings in multiple disc involvement than in single involvement. 3. There was no correlation between degree of nerve root compression determined by CT and pattern of neurologic signs (motor weakness, sensory deficit, and reflex change)

  5. Implementation of a "Flipped Classroom" for Neurosurgery Resident Education.

    Science.gov (United States)

    Girgis, Fady; Miller, Jonathan P

    2018-01-01

    Engaging residents across a multiyear training spectrum is challenging given the heterogeneity of experience and limited time available for educational activities. A "flipped classroom" model, in which residents prepare ahead of time for mentored topic discussions, has potential advantages. We implemented a curriculum consisting of topics distributed across the specialty. Weekly, each resident was randomly assigned to research a specific aspect of an assigned topic appropriate to his or her level of experience: junior residents about what characterizes each clinical entity, midlevel residents about when to intervene, and chief residents about how to administer treatment. Residents completed an anonymous survey 6 months after implementation. Board examination performance was assessed before and after implementation. A total of 12 residents participated in the program. Weekly, 1.75±0.40 hours were spent in preparation, with senior residents reporting less time than junior residents. All residents indicated that the accumulation of experience across 7 years of residency was a major advantage of this program, and all preferred it to lectures. Performance on the board examination significantly increased after implementation (from 316±36 to 468±45, pflipped classroom is a viable approach to resident education and is associated with increased engagement and improved performance using validated knowledge-assessment tools.

  6. Assessment of medical residents technology readiness for an online residents-as-teachers curriculum.

    Science.gov (United States)

    Silva, Débora; Lewis, Kadriye O

    2014-06-01

    The University of Puerto Rico School of Medicine has a need to expand the current Residents-as-Teachers workshops into a comprehensive curriculum. One way to do so is to implement an online curriculum, but prior to this, the readiness of the medical residents to participate in such a curriculum should be assessed. Our objective was to determine whether the residents at the University of Puerto Rico School of Medicine are prepared to engage in an online Residents-as-Teachers program. This was a descriptive, mixed-method-design study that collected qualitative and quantitative data using an online survey and a focus-group interview. The study was conducted with students from 11 of the residency programs at the University of Puerto Rico School of Medicine. More than 80% of the participating residents had the technical knowledge to engage in an online program; 90.5% thought an online Residents-as-Teachers course would be a good alternative to what was currently available; 87.5% would be willing to participate in an online program, and 68.6% of the residents stated that they preferred an online course to a traditional one. Determinants of readiness for online learning at the University of Puerto Rico School of Medicine were identified and discussed. Our results suggest that the majority of the residents who participated in this study are ready to engage in an online Residents-as-Teachers program. The only potential barrier found was that one-third of the residents still preferred a traditional curriculum, even when they thought an online Residents-as-Teachers curriculum was a good alternative and were willing to participate in the course or courses forming part of such a curriculum. Therefore, prior to wide-spread implementation of such a curriculum, a pilot test should be conducted to maximize the presumed and eventual success of that curriculum.

  7. 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.

  8. Neurosurgery resident leadership development: an innovative approach.

    Science.gov (United States)

    Pettit, Jeffrey E; Dahdaleh, Nader S; Albert, Gregory W; Greenlee, Jeremy D

    2011-02-01

    A great deal of time and resources go into the development and training of neurosurgeons. One area that has minimal literature and assessment is leadership development. Under the core competency of interpersonal and communication skills, the Accreditation Council for Graduate Medical Education has indicated that residents are expected to work effectively as a member or leader of a healthcare team. This article reveals how a structured leadership program was developed so that residents are better prepared for the role of chief resident and future leadership roles. Beginning in October 2006, residents attended a series of 1-hour workshops conducted monthly. Topics included leadership style, conflict management, effective feedback, team building, team leadership, motivation, and moving from peer to leader. A retrospective pretest was conducted at the end of the program. Residents reported a significant knowledge gain for the majority of topics. Resident comments indicated a greater awareness of the impact of leading and ways to improve their personal leadership. Quantitatively and qualitatively, residents and faculty reported that the leadership program made a significant impact on the development of future neurosurgical leaders.

  9. Major Links.

    Science.gov (United States)

    Henderson, Tona

    1995-01-01

    Provides electronic mail addresses for resources and discussion groups related to the following academic majors: art, biology, business, chemistry, computer science, economics, health sciences, history, literature, math, music, philosophy, political science, psychology, sociology, and theater. (AEF)

  10. Technology in Residence.

    Science.gov (United States)

    Fox, Jordan

    1999-01-01

    Discusses the necessity for incorporating current technology in today's college residence halls to meet the more diverse and continued activities of its students. Technology addressed covers data networking and telecommunications, heating and cooling systems, and fire-safety systems. (GR)

  11. Cancer survival discrepancies in developed and developing countries: comparisons between the Philippines and the United States.

    Science.gov (United States)

    Redaniel, M T; Laudico, A; Mirasol-Lumague, M R; Gondos, A; Pulte, D; Mapua, C; Brenner, H

    2009-03-10

    Despite the availability of population-based cancer survival data from the developed and developing countries, comparisons remain very few. Such comparisons are important to assess the magnitude of survival discrepancies and to disentangle the impact of ethnic background and health care access on cancer survival. Using the SEER 13 database and databases from the Manila and Rizal Cancer Registries in the Philippines, a 5-year relative survival for 9 common cancers in 1998-2002 of Filipino-American cancer patients were compared with both cancer patients from the Philippines, having the same ethnicity, and Caucasians in the United States, being exposed to a similar societal environment and the same health care system. Survival estimates were much higher for the Filipino-Americans than the Philippine resident population, with particularly large differences (more than 20-30% units) for cancers with good prognosis if diagnosed and treated early (colorectal, breast and cervix), or those with expensive treatment regimens (leukaemias). Filipino-Americans and Caucasians showed very similar survival for all cancer sites except stomach cancer (30.7 vs 23.2%) and leukaemias (37.8 vs 48.4%). The very large differences in the survival estimates of Filipino-Americans and the Philippine resident population highlight the importance of the access to and utilisation of diagnostic and therapeutic facilities in developing countries. Survival differences in stomach cancer and leukaemia between Filipino-Americans and Caucasians in the United States most likely reflect biological factors rather than the differences in access to health care.

  12. Explaining Late Life Urban vs. Rural Health Discrepancies in Beijing

    Science.gov (United States)

    Zimmer, Zachary; Kaneda, Toshiko; Tang, Zhe; Fang, Xianghua

    2010-01-01

    Social characteristics that differ by place of residence are consequential for health. To study implications of this among older adults in rural vs. urban China, this study employs data from the Beijing municipality, a region that has witnessed growth and gaps in development. Life and active life expectancy is assessed using a multistate life…

  13. Discrepancies in normative data between Lunar and Hologic DXA systems.

    Science.gov (United States)

    Faulkner, K G; Roberts, L A; McClung, M R

    1996-01-01

    Many studies have shown the high correlation between Lunar and Hologic DXA bone mineral density (BMD) measurements despite differences in absolute calibration. However, in clinical practice, raw BMD values (in g/cm2) are not normally used for assessing skeletal status and fracture risk. Instead, the BMD values are expressed in terms of the number of standard deviations above or below the young normal value (commonly referred to as the T-score). If the normative populations of the various systems are consistent, the standard deviation scores should also be consistent. For this reason, the World Health Organization (WHO) recently established diagnostic criteria for osteoporosis based on T-scores and not BMD. However, few studies have compared the instruments in terms of their standard deviation scores. In this study, we used linear regression to compare T-scores in 83 women at L1-4 and 120 women at the femoral neck obtained on a Lunar DPX and a Hologic QDR-1000/W system. patient BMD and T-score measurements were highly correlated between the two systems (r > 0.95). No clinically significant difference in L1-4 T-scores was seen (less than 0.1 SD). However, linear regression analysis confirmed a systematic difference of 0.9 SD between the femoral neck T-scores. This discrepancy is caused by: (1) differences in the normal populations, and (2) differences in statistical models used to determine the young normal mean and standard deviation. In an attempt to correct the discrepancy, the female young normal mean and standard deviation were recalculated for the femoral neck using published epidemiological data from NHANES and existing DXA cross-calibration equations. The Hologic young normal value (mean +/- SD) was redefined as 0.85 +/- 0.11 g/cm2, while the Lunar value was redefined as 1.00 +/- 0.11 g/cm2. When the femoral neck T-scores for the study population were recalculated on the basis of these new values, the results were equivalent between manufactures, effectively

  14. Satisfaction among residents in ASHP-accredited pharmacy residency programs.

    Science.gov (United States)

    VanDenBerg, C; Murphy, J E

    1997-07-01

    The level of work satisfaction among pharmacists in ASHP-accredited residencies was studied. In March 1996 a questionnaire designed to measure residency satisfaction was mailed to 697 individuals in ASHP-accredited pharmacy practice and specialty practice residencies. Subjects responded to 16 statements relating to intrinsic and extrinsic determinants of work satisfaction on a scale of 1 to 5, where 1 = strongly disagree and 5 = strongly agree. Questionnaires were returned by 413 (59%) of the residents. The respondents were predominantly women (76%), and most (86%) had at least a Pharm. D. degree. Hospitals were the primary work setting (88%). Of the 413 residents, 305 were in pharmacy practice residencies and 108 were in specialized residencies. None of the mean scores indicated disagreement (scores 3) with the negatively worded statements. The median and mode were equal to 2 (disagree) for the three negatively worded items and 4 (agree) for all but three positively worded items. Only 8% of the residents indicated that they would not accept the residency again if given the chance. Specialized residents tended to rate positively worded statements higher and negatively worded statements lower than pharmacy practice residents. Female residents indicated greater satisfaction than male residents. Pay and benefits were rated slightly better than neutral. Pharmacy residents appeared generally satisfied with their residencies. Specialized pharmacy residents were more satisfied than pharmacy practice residents, and women were more satisfied than men.

  15. Masculine discrepancy stress, substance use, assault and injury in a survey of US men

    Science.gov (United States)

    Reidy, Dennis E; Berke, Danielle S; Gentile, Brittany; Zeichner, Amos

    2018-01-01

    To understand and ultimately prevent injury and behavioural health outcomes associated with masculinity, we assessed the influence of masculine discrepancy stress (stress that occurs when men perceive themselves as falling short of the traditional gender norms) on the propensity to engage in stereotypically masculine behaviours (eg, substance use, risk taking and violence) as a means of demonstrating masculinity. Six-hundred men from the USA were recruited via Amazon’s Mechanical Turk (MTurk) online data collection site to complete surveys assessing self-perceptions of gender role discrepancy and consequent discrepancy stress, substance use/abuse, driving while intoxicated (DWI) and violent assaults. Negative binomial regression analyses indicated significant interactive effects wherein men high on gender role discrepancy and attendant discrepancy stress reported significantly more assaults with a weapon (B=1.01; SE=0.63; IRR=2.74; p=0.05) and assaults causing injury (B=1.01; SE=0.51; IRR=2.74; p<0.05). There was no association of discrepancy stress to substance abuse, but there was a protective effect of gender role discrepancy for DWI among men low on discrepancy stress (B=−1.19, SE=0.48; IRR=0.30; p=0.01). These findings suggest that gender role discrepancy and associated discrepancy stress, in particular, represent important injury risk factors and that prevention of discrepancy stress may prevent acts of violence with the greatest consequences and costs to the victim, offender and society. PMID:26303670

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

    Science.gov (United States)

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

    2013-01-01

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

  17. Does Mother Know Best? Parental Discrepancies in Assessing Child Functioning

    DEFF Research Database (Denmark)

    Datta Gupta, Nabanita; Lausten, Mette; Pozzoli, Dario

    We investigate the degree of correspondence between parents’ reports on child behavioral and educational outcomes using the most recent available wave of a rich Danish longitudinal survey of children (the DALSC). All outcomes are measured at age 11 when the children are expected to be in fifth...... grade. Once discrepancies are detected, we analyze whether they are driven by noisy evaluations or by systematic bias, focusing on the role of parental characteristics and response heterogeneity. We then explicitly assess the relative importance of the mother’s versus the father’s assessments...... in explaining child academic performance and diagnosed mental health to investigate whether one parent is systematically a better informant of their child’s outcomes than the other....

  18. Linking Cognition to Cognitive Dissonance through Scientific Discrepant Events

    Directory of Open Access Journals (Sweden)

    Allen G. Rauch

    2010-10-01

    Full Text Available The aim of this workshop and paper is to provide a conceptual framework that will develop skills in the areas of observation, cognition/meta-cognition with emphasis on critical thinking, decision making and problem solving. Simultaneously, this endeavour is designed to stimulate one‟s curiosity and thereby provide motivation to learn. These are accomplished through the learning style methodology with emphasis on interactive instructional resources addressing a multi-modality approach to teaching and learning. It will be shown that discrepant events impact thinking with respect to problem solving. The aforementioned is demonstrated with the use of gravity, molecular structure and optical illusions. The workshop presenters will show how cognitive dissonance, precipitated within each of these constituents, fosters curiosity and therefore provides an ideal motivational component for exploration.

  19. Unresolved resonance self shielding calculation: causes and importance of discrepancies

    International Nuclear Information System (INIS)

    Ribon, P.; Tellier, H.

    1986-09-01

    To compute the self shielding coefficient, it is necessary to know the point-wise cross-sections. In the unresolved resonance region, we do not know the parameters of each level but only the average parameters. Therefore we simulate the point-wise cross-section by random sampling of the energy levels and resonance parameters with respect to the Wigner law and the X 2 distributions, and by computing the cross-section in the same way as in the resolved regions. The result of this statistical calculation obviously depends on the initial parameters but also on the method of sampling, on the formalism which is used to compute the cross-section or on the weighting neutron flux. In this paper, we will survey the main phenomena which can induce discrepancies in self shielding computations. Results are given for typical dilutions which occur in nuclear reactors. 8 refs

  20. OSTEOPATHIC APPROACH: LEG LENGTH DISCREPANCY AND LOW BACK PAIN

    Directory of Open Access Journals (Sweden)

    Taner AYDIN

    2015-12-01

    Full Text Available Leg length discrepancy (LLD is a biomechanical impediment, which is a potential factor in affecting musculoskeletal disorders in the rest of life, such as scoliosis, osteoarthritis and muscle tightness, or even tenderness in lumbar and pelvic area. Athletes who have developed LLD have symptoms in gait, running, standing posture. Skeletal regions related to the disorder are the lumbar spine, ilium, hip joint, greater trochanter and knee, or even ankle and plantar region. Muscles involved in these areas are numeous. In osteopathic management, the manual practitioner can use a lot of basic techniques to handle these dysfunctions. To cope with musculoskeletal problems, osteopathic manipulation techniques would be an ideal modality to alleviate the LLD syndrome. An overview of the mentioned topics of concern will be discussed in the review.

  1. Phase change in uranium: Discrepancy between experiment and theory

    International Nuclear Information System (INIS)

    Akella, J.

    1996-01-01

    Using a diamond-anvil cell (DAC) phase transformation and room temperature Equation of State (EOS) for some actinides and lanthanides were studied to multimegabar (megabar = 100 GPa) pressures. Experimental data are compared with the theoretically predicted crystal structural changes and the pressure-volume relationships. There is a general agreement between theory and experiment for the structural changes in the lighter actinides, however in detail there are some discrepancies still. A generalized trend for the phase transformations in the lanthanides can be seen, which again has broad agreement with theory. We conclude that an accurate and robust theoretical base for predicting the phase transformations in the f-electron metals can be developed by incorporating the DAC data

  2. Radiological social risk perception: something more than experts/ public discrepancies

    International Nuclear Information System (INIS)

    Prades Lopez, Ana; Gonzalez Reyes, Felisa

    1998-01-01

    One of the most important concerns of the postindustrial societies lies on the specification and quantification of risk, the Risk Assesment. However, the efforts and resources devoted to such goal have not avoided a growing worry about both the environmental conditions and the situations that potentially threaten it, generating an intense social debate about risks. In this framework, discrepancies between experts and public evaluations risks leaded to the study of social Risk perception. Several theoretical scopes have tried to characterize the phenomenon. A worthy conclusion of the empirical studies carried out on this issue is that all of them, experts and public, are influence by some factors which, in turns, affect their risk perception,. Specially striking is the fact that perception of risk among experts is also modulated by qualitative, personal and social factors. Social Risk Perception, through the process of Communication and Social Participation, has been configurated as a critical tool for both risk prevention and management

  3. Management of bimaxillary transverse discrepancy with vertical excess

    Directory of Open Access Journals (Sweden)

    Dinesh C Chaudhary

    2015-01-01

    Full Text Available A 14-year-old boy reported with a complaint of severe irregularity of lower teeth and forwardly placed upper teeth. History revealed snoring as an occasional complaint. The case was diagnosed as mild class II skeletally with increased lower anterior face height, bimaxillary transverse discrepancy leading to severe crowding in the lower arch, V-shaped upper arch with increased overjet and deep bite. Three phase treatment was planned. In the first phase, bimaxillary expansion with mid-symphyseal distraction osteogenesis and rapid maxillary expansion was carried out. After this phase of treatment, the episodes of snoring vanished. The second phase was 1 year of orthodontics to produce symmetric well-aligned arches in good function and aesthetics. Third, the treatment concluded with reduction-advancement genioplasty for correction of vertical excess and surgical camouflage.

  4. A note on the resolution of the entropy discrepancy

    International Nuclear Information System (INIS)

    Huang, Yue; Miao, Rong-Xin

    2015-01-01

    It was found by Hung, Myers and Smolkin that there is entropy discrepancy for the CFTs in 6-dimensional space–time, between the field theoretical and the holographic analyses. Recently, two different resolutions to this puzzle have been proposed. One of them suggests to utilize the anomaly-like entropy and the generalized Wald entropy to resolve the HMS puzzle, while the other one initiates the use of the entanglement entropy which arises from total derivative terms in the Weyl anomaly to explain the HMS mismatch. We investigate these two proposals carefully in this note. By studying the CFTs dual to Einstein gravity, we find that the second proposal cannot solve the HMS puzzle. Moreover, the Wald entropy formula is not well-defined on horizon with extrinsic curvatures, in the sense that, in general, it gives different results for equivalent actions.

  5. A note on the resolution of the entropy discrepancy

    Energy Technology Data Exchange (ETDEWEB)

    Huang, Yue, E-mail: huangyue@itp.ac.cn [State Key Laboratory of Theoretical Physics, Institute of Theoretical Physics, Chinese Academy of Sciences, Beijing, 100190 (China); Kavli Institute for Theoretical Physics China, Chinese Academy of Sciences, Beijing, 100190 (China); Miao, Rong-Xin, E-mail: rong-xin.miao@aei.mpg.de [Max Planck Institute for Gravitational Physics (Albert Einstein Institute), Am Mühlenberg 1, 14476 Golm (Germany)

    2015-10-07

    It was found by Hung, Myers and Smolkin that there is entropy discrepancy for the CFTs in 6-dimensional space–time, between the field theoretical and the holographic analyses. Recently, two different resolutions to this puzzle have been proposed. One of them suggests to utilize the anomaly-like entropy and the generalized Wald entropy to resolve the HMS puzzle, while the other one initiates the use of the entanglement entropy which arises from total derivative terms in the Weyl anomaly to explain the HMS mismatch. We investigate these two proposals carefully in this note. By studying the CFTs dual to Einstein gravity, we find that the second proposal cannot solve the HMS puzzle. Moreover, the Wald entropy formula is not well-defined on horizon with extrinsic curvatures, in the sense that, in general, it gives different results for equivalent actions.

  6. [Conservative treatment of upper anterior dental discrepancy during orthodontic therapy].

    Science.gov (United States)

    Messina, G; Verzì, P; Pappalardo, S

    1999-06-01

    The orthodontic therapeutic sequence used in cases with dento-dental discrepancy for reduced mesiodistal size and congenital absent lateral upper incisors, is described. The importance of correct conoid tooth replacement in the programmed space between the other teeth and its restorative treatment in order to obtain the best biomechanical control is stressed. The contemporaneous presence of the form and volume anomaly of the 12th and the missing 22nd due to agenesia demanded an interdisciplinary approach. For the restoration of the conoid tooth the authors used a microhybrid composite for the alloy properties with the grain size of the inorganic particles. In fact this type of composite responds well to mechanical stress and has a high shining capacity and good aesthetical rendering. Meanwhile the temporary dental prothesis solution of the 22nd in this case has suggested the application of the artificial element on the superior Hawley holding plaque.

  7. 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.

  8. Telephone interpreter discrepancies: videotapes of Hmong medication consultations.

    Science.gov (United States)

    Lor, Maichou; Chewning, Betty

    2016-02-01

    Over 25 million people in the USA have limited English proficiency (LEP). Interpreters are often used to facilitate communication with health care providers. Little is currently known about interpreter quality. To explore the quality of telephone interpretation during medication consultations between Hmong clients and their pharmacists. This descriptive study analyzed transcripts from videos of consultations between six triads of Hmong patients, pharmacy students and interpreters. Analysis was divided into two segments: (1) pharmacy: communication from student pharmacist the interpreter to patient and (2) patient: communication from patient to interpreter to student pharmacist. Researchers coded transcripts separately then compared codes. The six encounters yielded 496 communications with 275 discrepancies including omissions, additions, and word substitutions. Pharmacy to patient communications included, 45% (118/262) of omissions, 27.5% (72/262) of substitutions, and 15.6% (41/262) of additions. The patient to provider communications included, 8.1% (19/234) of omissions, 6.0% (14/234) of substitutions, and 4.2% (10/234) of word additions. Some omissions, additions, and substitutions in the pharmacy to patient communications were classified as potentially clinically relevant. Significantly, substantial discrepancies between the student pharmacists' comments and the interpretation to patients had potential for hindering relationship building between patients and their providers. Pharmacists may assume that the presence of an interpreter ensures accurate communication from pharmacist to patient and from patient to pharmacist. This study confirms that those assumptions may not be valid. These findings highlight the need to improve pharmacy education and interventions to improve pharmacist communication with LEP patients. © 2015 Royal Pharmaceutical Society.

  9. Discrepancies in expert decision-making in forensic fingerprint examination.

    Science.gov (United States)

    Mustonen, Virpi; Hakkarainen, Kai; Tuunainen, Juha; Pohjola, Pasi

    2015-09-01

    The purpose of the present study was to analyse professional fingerprint examiners' investigative practices in the context of discrepancy decisions concerning challenging latents during fingerprint analysis and identification. The participants were fingerprint experts from the Forensic Laboratory of the Finnish National Bureau of Investigation. The data were from five audio-recorded "discrepancy meetings" where two examiners were discussing the rationale and justification for their differing interpretations of challenging and distorted fingerprint evidence. The meetings were chaired by the quality manager of the fingerprint group, who also in the first author of this article. The research questions addressed were as follows: What does the examiner see in the latent fingerprints? What does the examiner actively do with the latents? How were decisions made during the investigative process? In accordance with Goodwin's professional vision framework, the results revealed how the participants used partial and limited information in making judgments about the difficult and distorted latents. The examiners appeared to be involved in active, constructive efforts, mentally, to repair poor latents by supplementing with missing information. They also highlighted various aspects of latents by colour coding as well as manipulated fingerprint images in several ways so as to make the significant patterns easier to recognize. Because the methods and practices of characterizing latents were only vaguely specified, the examiners used locally developed ad hoc practices to facilitate their investigations, ending up with different interpretations. It is concluded in the article that the fingerprint community in Finland should make strong efforts to develop the methods of fingerprint investigation and determine clearer criteria for decision making and documentation practices. Furthermore, the interpretations made by fingerprint experts should be made more transparent to the customers

  10. Analysis of Resident Case Logs in an Anesthesiology Residency Program

    DEFF Research Database (Denmark)

    Yamamoto, Satoshi; Tanaka, Pedro; Madsen, Matias Vested

    2016-01-01

    Our goal in this study was to examine Accreditation Council for Graduate Medical Education case logs for Stanford anesthesia residents graduating in 2013 (25 residents) and 2014 (26 residents). The resident with the fewest recorded patients in 2013 had 43% the number of patients compared with the...

  11. Residents as teachers: survey of Canadian family medicine residents.

    Science.gov (United States)

    Ng, Victor K; Burke, Clarissa A; Narula, Archna

    2013-09-01

    To examine Canadian family medicine residents' perspectives surrounding teaching opportunities and mentorship in teaching. A 16-question online survey. Canadian family medicine residency programs. Between May and June 2011, all first- and second-year family medicine residents registered in 1 of the 17 Canadian residency programs as of September 2010 were invited to participate. A total of 568 of 2266 residents responded. Demographic characteristics, teaching opportunities during residency, and resident perceptions about teaching. A total of 77.7% of family medicine residents indicated that they were either interested or highly interested in teaching as part of their future careers, and 78.9% of family medicine residents had had opportunities to teach in various settings. However, only 60.1% of respondents were aware of programs within residency intended to support residents as teachers, and 33.0% of residents had been observed during teaching encounters. It appears that most Canadian family medicine residents have the opportunity to teach during their residency training. Many are interested in integrating teaching as part of their future career goals. Family medicine residencies should strongly consider programs to support and further develop resident teaching skills.

  12. Change of Job and Change of Residence - Geographical Mobility of the Labour Force

    DEFF Research Database (Denmark)

    Deding, Mette; Filges, Trine

    Solving regional labour market discrepancies through geographical mobility has gained increased political interest. The decision of changing job is closely related to the decision of changing residence as either change may imply a change in commuting cost. In this paper we set up a search model...... that can explain the residence and job changing behaviour of workers. The model is a double search model, in the sense that workers search for better jobs and dwellings simultaneously. Results show that the interrelationship between change of job and change of residence is very complex. However, scope...

  13. What Influences Mental Illness? Discrepancies Between Medical Education and Conception

    Directory of Open Access Journals (Sweden)

    Evan Hy Einstein

    2017-04-01

    Full Text Available Objective: This preliminary study examined the differences between what was taught during a formal medical education and medical students’ and psychiatry residents’ conceptions of notions regarding the causes and determinants of mental illness. Methods: The authors surveyed 74 medical students and 11 residents via convenience sampling. The survey contained 18 statements which were rated twice based on truthfulness in terms of a participant’s formal education and conception, respectively. Descriptive statistics and a Wilcoxon signed rank test determined differences between education and conception. Results: Results showed that students were less likely to perceive a neurotransmitter imbalance to cause mental illness, as opposed to what was emphasized during a formal medical education. Students and residents also understood the importance of factors such as systemic racism and socioeconomic status in the development of mental illness, which were factors that did not receive heavy emphasis during medical education. Furthermore, students and residents believed that not only did mental illnesses have nonuniform pathologies, but that the Diagnostic and Statistical Manual of Mental Disorders also had the propensity to sometimes arbitrarily categorize individuals with potentially negative consequences. Conclusions: If these notions are therefore part of students’ and residents’ conceptions, as well as documented in the literature, then it seems appropriate for medical education to be further developed to emphasize these ideas.

  14. Subjective-objective sleep discrepancy among older adults: associations with insomnia diagnosis and insomnia treatment.

    Science.gov (United States)

    Kay, Daniel B; Buysse, Daniel J; Germain, Anne; Hall, Martica; Monk, Timothy H

    2015-02-01

    Discrepancy between subjective and objective measures of sleep is associated with insomnia and increasing age. Cognitive behavioural therapy for insomnia improves sleep quality and decreases subjective-objective sleep discrepancy. This study describes differences between older adults with insomnia and controls in sleep discrepancy, and tests the hypothesis that reduced sleep discrepancy following cognitive behavioural therapy for insomnia correlates with the magnitude of symptom improvement reported by older adults with insomnia. Participants were 63 adults >60 years of age with insomnia, and 51 controls. At baseline, participants completed sleep diaries for 7 days while wearing wrist actigraphs. After receiving cognitive behavioural therapy for insomnia, insomnia patients repeated this sleep assessment. Sleep discrepancy variables were calculated by subtracting actigraphic sleep onset latency and wake after sleep onset from respective self-reported estimates, pre- and post-treatment. Mean level and night-to-night variability in sleep discrepancy were investigated. Baseline sleep discrepancies were compared between groups. Pre-post-treatment changes in Insomnia Severity Index score and sleep discrepancy variables were investigated within older adults with insomnia. Sleep discrepancy was significantly greater and more variable across nights in older adults with insomnia than controls, P ≤ 0.001 for all. Treatment with cognitive behavioural therapy for insomnia was associated with significant reduction in the Insomnia Severity Index score that correlated with changes in mean level and night-to-night variability in wake after sleep onset discrepancy, P treatments for late-life insomnia. © 2014 European Sleep Research Society.

  15. The Chief Resident Role in Emergency Medicine Residency Programs

    Directory of Open Access Journals (Sweden)

    Hafner, John W. Jr., MD, MPH

    2010-05-01

    Full Text Available Study Objectives: Although other specialties have examined the role of the chief resident (CR, the role and training of the emergency medicine (EM CR has largely been undefined.Methods: A survey was mailed to all EM CRs and their respective program directors (PD in 124 EM residency programs. The survey consisted of questions defining demographics, duties of the typical CR, and opinions regarding the level of support and training received. Multiple choice, Likert scale (1 strong agreement, 5 strong disagreement and short-answer responses were used. We analyzed associations between CR and PD responses using Chi-square, Student’s T and Mann-Whitney U tests.Results: Seventy-six percent of CRs and 65% of PDs responded and were similar except for age (31 vs. 42 years; p<0.001. CR respondents were most often male, in year 3 of training and held the position for 12 months. CRs and PDs agreed that the assigned level of responsibility is appropriate (2.63 vs. 2.73, p=0.15; but CRs underestimate their influence in the residency program (1.94 vs. 2.34, p=0.002 and the emergency department (2.61 vs. 3.03, p=0.002. The majority of CRs (70% and PDs (77% report participating in an extramural training program, and those CRs who participated in training felt more prepared for their job duties (2.26 vs. 2.73; p=0.03.Conclusion: EM CRs feel they have appropriate job responsibility but believe they are less influential in program and department administration than PD respondents. Extramural training programs for incoming CRs are widely used and felt to be helpful. [West J Emerg Med. 2010; 11(2:120-125.

  16. Results of the 2003 Association of Residents in Radiation Oncology (ARRO) surveys of residents and chief residents in the United States

    International Nuclear Information System (INIS)

    Jagsi, Reshma; Buck, David A.; Singh, Anurag K.; Engleman, Mark; Thakkar, Vipul; Frank, Steven J.; Flynn, Daniel

    2005-01-01

    Purpose: To document demographic characteristics of current residents, career motivations and aspirations, and training program policies and resources. Methods: In 2003, the Association of Residents in Radiation Oncology (ARRO) conducted two nationwide surveys: one of all U.S. radiation oncology residents and one of chief residents. Results: The Chief Residents' Survey was completed by representatives from all 77 programs (response rate, 100%). The Residents' Survey was returned by 229 respondents (response rate, 44%). In each, 32% of respondents were female. The most popular career after residency was private practice (46%), followed by permanent academic practice (28%). Changes that would entice those choosing private practice to consider an academic career included more research experience as a resident (76%), higher likelihood of tenure (69%), lesser time commitment (66%), and higher salary (54%). Although the majority of respondents were satisfied with educational experience overall, a number of programs were reported to provide fewer resources than required. Conclusions: Median program resources and numbers of outliers are documented to allow residents and program directors to assess the relative adequacy of experience in their own programs. Policy-making bodies and individual programs should consider these results when developing interventions to improve educational experiences of residents and to increase retention of radiation oncologists in academic practice

  17. 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.

  18. Adverse Event Reporting: Harnessing Residents to Improve Patient Safety.

    Science.gov (United States)

    Tevis, Sarah E; Schmocker, Ryan K; Wetterneck, Tosha B

    2017-10-13

    Reporting of adverse and near miss events are essential to identify system level targets to improve patient safety. Resident physicians historically report few events despite their role as front-line patient care providers. We sought to evaluate barriers to adverse event reporting in an effort to improve reporting. Our main outcomes were as follows: resident attitudes about event reporting and the frequency of event reporting before and after interventions to address reporting barriers. We surveyed first year residents regarding barriers to adverse event reporting and used this input to construct a fishbone diagram listing barriers to reporting. Barriers were addressed, and resident event reporting was compared before and after efforts were made to reduce obstacles to reporting. First year residents (97%) recognized the importance of submitting event reports; however, the majority (85%) had not submitted an event report in the first 6 months of residency. Only 7% of residents specified that they had not witnessed an adverse event in 6 months, whereas one third had witnessed 10 or more events. The main barriers were as follows: lack of knowledge about how to submit events (38%) and lack of time to submit reports (35%). After improving resident education around event reporting and simplifying the reporting process, resident event reporting increased 230% (68 to 154 annual reports, P = 0.025). We were able to significantly increase resident event reporting by educating residents about adverse events and near misses and addressing the primary barriers to event reporting. Moving forward, we will continue annual resident education about patient safety, focus on improving feedback to residents who submit reports, and empower senior residents to act as role models to junior residents in patient safety initiatives.

  19. Do parent-adolescent discrepancies in family functioning increase the risk of Hispanic adolescent HIV risk behaviors?

    Science.gov (United States)

    Cordova, David; Huang, Shi; Lally, Meghan; Estrada, Yannine; Prado, Guillermo

    2014-06-01

    In the family-based prevention science literature, family functioning, defined as positive parenting, parental involvement, family cohesion, family communication, parental monitoring of peers, and parent-adolescent communication, has been shown to ameliorate HIV risk behaviors in Hispanic youth. However, the majority of studies have relied solely on parent or adolescent reports and we know very little about parent-adolescent family functioning discrepancies. Therefore, the purpose of this study was to examine whether and to what extent parent-adolescent discrepancies in family functioning increased the risk of HIV risk behaviors, including substance use and sexual risk behaviors, and whether these associations vary as a function of acculturation and youth gender. A total of 746 Hispanic 8th grade youth and their primary caregivers were included in the study. Structural equation modeling findings indicate that parent-adolescent family functioning discrepancies are associated with an increased risk of Hispanic adolescent HIV risk behaviors, including lifetime and past 90-day alcohol and illicit drug use, and early sex initiation. In addition, study findings indicate that results vary by acculturation and youth gender. Findings are discussed in the context of existing family-based research and practice in preventing and reducing HIV risk behaviors among Hispanic youth and their families. © 2014 FPI, Inc.

  20. Discrepancies in listed adverse drug reactions in pharmaceutical product information supplied by the regulatory authorities in Denmark and the USA.

    Science.gov (United States)

    Eriksson, Robert; Aagaard, Lise; Jensen, Lars Juhl; Borisova, Liza; Hørlück, Dorte; Brunak, Søren; Hansen, Ebba Holme

    2014-06-01

    Pharmaceutical product information (PI) supplied by the regulatory authorities serves as a source of information on safe and effective use of drugs. The objectives of this study were to qualitatively and quantitatively compare PIs for selected drugs marketed in both Denmark and the USA with respect to consistency and discrepancy of listed adverse drug reaction (ADR) information. We compared individual ADRs listed in PIs from Denmark and the USA with respect to type and frequency. Consistency was defined as match of ADRs and of ADR frequency or match could not be ruled out. Discrepancies were defined as ADRs listed only in one country or listed with different frequencies. We analyzed PIs for 40 separate drugs from ten therapeutic groups and assigned the 4003 identified ADRs to System Organ Classes (Medical Dictionary for Regulatory Activities [MedDRA] terminology). Less than half of listed ADRs (n = 1874; 47%) showed consistency. Discrepancies (n = 2129; 53%) were split into ADRs listed only in the USA (n = 1558; 39%), ADRs listed only in Denmark (n = 325; 8%) and ADRs listed with different frequencies (n = 246; 6%). The majority of listed ADRs were of the type "gastrointestinal disorders" and "nervous system disorders". Our results show great differences in PIs for drugs approved in both Denmark and the USA illuminating concerns about the credibility of the publicly available PIs. The results also represent an argument for further harmonization across borders to improve consistency between authority-supplied information.

  1. Global Health Imaging in Radiology Residency: A Survey of Canadian Radiology Residents.

    Science.gov (United States)

    Zener, Rebecca; Ross, Ian

    2017-11-01

    The study sought to determine Canadian radiology resident perception of and interest in global health imaging (GHI) and the barriers they encounter in pursuing GHI experiences during residency training. A peer-reviewed, online, anonymous, multiple-choice survey was distributed to Canadian radiology residents at English-language programs. Fifty residents responded to the survey (∼16% response rate); 72% of respondents perceived an unmet need for medical imaging in the developing world. A majority of residents (60%) would have been likely to participate in a GHI experience if one had been available during their residency; 65% planned on pursuing international outreach work as future radiologists, 81% of whom with on-site collaboration in education and training of local staff. However, 82% of respondents were uncertain or believed they would not be adequately prepared to help improve access and availability of medical imaging services in developing countries upon completion of residency. Overall, residents believed a GHI program would increase their knowledge of infectious diseases, increase their exposure to diseases at advanced stage presentation, enhance their knowledge of basic imaging modalities, and improve their cultural competence. Lack of information about opportunities, lack of funding, and lack of infrastructure were ranked as the most important barriers to participating in a radiology rotation in a developing country during residency. While many Canadian radiology residents are interested in participating in GHI, their preparation to do so may be inadequate. Formalizing international GHI rotations may alleviate barriers impeding their pursuit. Copyright © 2017 Canadian Association of Radiologists. Published by Elsevier Inc. All rights reserved.

  2. Relationship between self-discrepancy and worries about penis size in men with body dysmorphic disorder.

    Science.gov (United States)

    Veale, David; Miles, Sarah; Read, Julie; Bramley, Sally; Troglia, Andrea; Carmona, Lina; Fiorito, Chiara; Wells, Hannah; Wylie, Kevan; Muir, Gordon

    2016-06-01

    We explored self-discrepancy in men with body dysmorphic disorder (BDD) concerned about penis size, men without BDD but anxious about penis size, and controls. Men with BDD (n=26) were compared to those with small penis anxiety (SPA; n=31) and controls (n=33), objectively (by measuring) and investigating self-discrepancy: actual size, ideal size, and size they felt they should be according to self and other. Most men under-estimated their penis size, with the BDD group showing the greatest discrepancy between perceived and ideal size. The SPA group showed a larger discrepancy than controls. This was replicated for the perceptions of others, suggesting the BDD group internalised the belief that they should have a larger penis size. There was a significant correlation between symptoms of BDD and this discrepancy. This self-actual and self-ideal/self-should discrepancy and the role of comparing could be targeted in therapy. Copyright © 2016. Published by Elsevier Ltd.

  3. Quantifying discrepancies in opinion spectra from online and offline networks.

    Science.gov (United States)

    Lee, Deokjae; Hahn, Kyu S; Yook, Soon-Hyung; Park, Juyong

    2015-01-01

    Online social media such as Twitter are widely used for mining public opinions and sentiments on various issues and topics. The sheer volume of the data generated and the eager adoption by the online-savvy public are helping to raise the profile of online media as a convenient source of news and public opinions on social and political issues as well. Due to the uncontrollable biases in the population who heavily use the media, however, it is often difficult to measure how accurately the online sphere reflects the offline world at large, undermining the usefulness of online media. One way of identifying and overcoming the online-offline discrepancies is to apply a common analytical and modeling framework to comparable data sets from online and offline sources and cross-analyzing the patterns found therein. In this paper we study the political spectra constructed from Twitter and from legislators' voting records as an example to demonstrate the potential limits of online media as the source for accurate public opinion mining, and how to overcome the limits by using offline data simultaneously.

  4. Discrepancies between judgment and choice of action in moral dilemmas

    Directory of Open Access Journals (Sweden)

    Sébastien eTassy

    2013-05-01

    Full Text Available Everyone has experienced the potential discrepancy between what one judges as morally acceptable and what one actually does when a choice between alternative behaviors is to be made. The present study explores empirically whether judgment and choice of action differ when people make decisions on dilemmas involving moral issues. 240 participants evaluated 24 moral and non-moral dilemmas either by judging (Is it acceptable to… or reporting the choice of action they would make (Would you do…. We also investigated the influence of varying the number of people benefiting from the decision and the closeness of relationship of the decision maker with the potential victim on these two types of decision. Variations in the number of beneficiaries from the decision did not influence judgment nor choice of action. By contrast, closeness of relationship with the victim had a greater influence on the choice of action than on judgment. This differentiation between evaluative judgments and choices of action argues in favor of each of them being supported by (at least partially different psychological processes.

  5. Quantifying discrepancies in opinion spectra from online and offline networks.

    Directory of Open Access Journals (Sweden)

    Deokjae Lee

    Full Text Available Online social media such as Twitter are widely used for mining public opinions and sentiments on various issues and topics. The sheer volume of the data generated and the eager adoption by the online-savvy public are helping to raise the profile of online media as a convenient source of news and public opinions on social and political issues as well. Due to the uncontrollable biases in the population who heavily use the media, however, it is often difficult to measure how accurately the online sphere reflects the offline world at large, undermining the usefulness of online media. One way of identifying and overcoming the online-offline discrepancies is to apply a common analytical and modeling framework to comparable data sets from online and offline sources and cross-analyzing the patterns found therein. In this paper we study the political spectra constructed from Twitter and from legislators' voting records as an example to demonstrate the potential limits of online media as the source for accurate public opinion mining, and how to overcome the limits by using offline data simultaneously.

  6. Deep Semisupervised Zero-Shot Learning with Maximum Mean Discrepancy.

    Science.gov (United States)

    Zhang, Lingling; Liu, Jun; Luo, Minnan; Chang, Xiaojun; Zheng, Qinghua

    2018-03-22

    Due to the difficulty of collecting labeled images for hundreds of thousands of visual categories, zero-shot learning, where unseen categories do not have any labeled images in training stage, has attracted more attention. In the past, many studies focused on transferring knowledge from seen to unseen categories by projecting all category labels into a semantic space. However, the label embeddings could not adequately express the semantics of categories. Furthermore, the common semantics of seen and unseen instances cannot be captured accurately because the distribution of these instances may be quite different. For these issues, we propose a novel deep semisupervised method by jointly considering the heterogeneity gap between different modalities and the correlation among unimodal instances. This method replaces the original labels with the corresponding textual descriptions to better capture the category semantics. This method also overcomes the problem of distribution difference by minimizing the maximum mean discrepancy between seen and unseen instance distributions. Extensive experimental results on two benchmark data sets, CU200-Birds and Oxford Flowers-102, indicate that our method achieves significant improvements over previous methods.

  7. Discrepancies confer vulnerability to depressive symptoms: a three-wave longitudinal study.

    Science.gov (United States)

    Sherry, Simon B; Mackinnon, Sean P; Macneil, Matthew A; Fitzpatrick, Skye

    2013-01-01

    Discrepancies (i.e., a subjective sense of falling short of one's own standards) are a key part of the perfectionism construct. Theory suggests discrepancies confer vulnerability to depressive symptoms. Since most research in this area is cross-sectional, longitudinal research is needed to disentangle directionality of relationships and to permit stronger causal inferences. Determining whether discrepancies are an antecedent of depressive symptoms, a consequence of depressive symptoms, or both is critical to understanding the discrepancies-depressive symptoms relationship. Knowledge about the temporal stability of discrepancies is also only starting to emerge, and it is unclear whether discrepancies predict incremental variance in depressive symptoms above and beyond neuroticism (i.e., a dispositional tendency to experience negative emotional states). The present study tested relationships among discrepancies, neuroticism, and depressive symptoms in 127 1st-year undergraduates using a 3-wave longitudinal design. Results suggest discrepancies may be understood as a trait-state where people are both highly consistent in their rank order on discrepancies and fluctuate somewhat in the level of discrepancies they experience at a particular point in time. As hypothesized, discrepancies predicted increases in depressive symptoms, even after controlling for neuroticism. Contrary to hypotheses, depressive symptoms did not predict changes in discrepancies. This study extends a long tradition of theory noting the depressing consequences of believing that one has fallen short of one's own standards. Harsh self-criticism and unobtainable self-expectations involving a strong sense of imperfection may be part of the premorbid personality of people vulnerable to depressive symptoms. PsycINFO Database Record (c) 2013 APA, all rights reserved.

  8. Implementation of a bag medication reconciliation initiative to decrease posthospitalization medication discrepancies.

    Science.gov (United States)

    Becker, Dawn

    2015-01-01

    Medication discrepancies occur in 70% of hospital patients, especially during discharge. In community settings, bag medication reconciliation events have demonstrated effectiveness in evaluating current medication use and identifying medication discrepancies. A bag medication reconciliation process was implemented in the hospital setting to decrease medication discrepancies by encouraging evaluation of medication adherence, side effects, and monitoring at posthospitalization follow-up. After implementation, a 7% decrease in reportable errors was noted.

  9. Difficulty in detecting discrepancies in a clinical trial report: 260-reader evaluation

    OpenAIRE

    Cole, Graham D; Shun-Shin, Matthew J; Nowbar, Alexandra N; Buell, Kevin G; Al-Mayahi, Faisal; Zargaran, David; Mahmood, Saliha; Singh, Bharpoor; Mielewczik, Michael; Francis, Darrel P

    2015-01-01

    Background: Scientific literature can contain errors. Discrepancies, defined as two or more statements or results that cannot both be true, may be a signal of problems with a trial report. In this study, we report how many discrepancies are detected by a large panel of readers examining a trial report containing a large number of discrepancies. Methods: We approached a convenience sample of 343 journal readers in seven countries, and invited them in person to participate in a study. They were...

  10. Comparative Analysis of Clinical Samples Showing Weak Serum Reaction on AutoVue System Causing ABO Blood Typing Discrepancies.

    Science.gov (United States)

    Jo, Su Yeon; Lee, Ju Mi; Kim, Hye Lim; Sin, Kyeong Hwa; Lee, Hyeon Ji; Chang, Chulhun Ludgerus; Kim, Hyung Hoi

    2017-03-01

    ABO blood typing in pre-transfusion testing is a major component of the high workload in blood banks that therefore requires automation. We often experienced discrepant results from an automated system, especially weak serum reactions. We evaluated the discrepant results by the reference manual method to confirm ABO blood typing. In total, 13,113 blood samples were tested with the AutoVue system; all samples were run in parallel with the reference manual method according to the laboratory protocol. The AutoVue system confirmed ABO blood typing of 12,816 samples (97.7%), and these results were concordant with those of the manual method. The remaining 297 samples (2.3%) showed discrepant results in the AutoVue system and were confirmed by the manual method. The discrepant results involved weak serum reactions (serum reactions, samples from patients who had received stem cell transplants, ABO subgroups, and specific system error messages. Among the 98 samples showing ≤1+ reaction grade in the AutoVue system, 70 samples (71.4%) showed a normal serum reaction (≥2+ reaction grade) with the manual method, and 28 samples (28.6%) showed weak serum reaction in both methods. ABO blood tying of 97.7% samples could be confirmed by the AutoVue system and a small proportion (2.3%) needed to be re-evaluated by the manual method. Samples with a 2+ reaction grade in serum typing do not need to be evaluated manually, while those with ≤1+ reaction grade do.

  11. Discharge residence of TLD tagged fish

    International Nuclear Information System (INIS)

    Romberg, G.P.; Prepejchal, W.

    1974-01-01

    Although visual observations suggested that fish remained in the discharge for considerable periods, temperature-sensitive tags indicated the majority of fish spend less than 50 hr or 10 percent of the time at discharge temperatures. During 1974 a second fish tagging study was conducted, using temperature-sensitive tags to yield discharge residence times of Lake Michigan salmonids at Point Beach thermal discharge. Preliminary results revealed that many fish tag values were close to Unit I line indicating that calculated maximum discharge residence times for these fish will be nearly 100 percent of the elapsed time

  12. Consensuses and discrepancies of basin-scale ocean heat content changes in different ocean analyses

    Science.gov (United States)

    Wang, Gongjie; Cheng, Lijing; Abraham, John; Li, Chongyin

    2018-04-01

    Inconsistent global/basin ocean heat content (OHC) changes were found in different ocean subsurface temperature analyses, especially in recent studies related to the slowdown in global surface temperature rise. This finding challenges the reliability of the ocean subsurface temperature analyses and motivates a more comprehensive inter-comparison between the analyses. Here we compare the OHC changes in three ocean analyses (Ishii, EN4 and IAP) to investigate the uncertainty in OHC in four major ocean basins from decadal to multi-decadal scales. First, all products show an increase of OHC since 1970 in each ocean basin revealing a robust warming, although the warming rates are not identical. The geographical patterns, the key modes and the vertical structure of OHC changes are consistent among the three datasets, implying that the main OHC variabilities can be robustly represented. However, large discrepancies are found in the percentage of basinal ocean heating related to the global ocean, with the largest differences in the Pacific and Southern Ocean. Meanwhile, we find a large discrepancy of ocean heat storage in different layers, especially within 300-700 m in the Pacific and Southern Oceans. Furthermore, the near surface analysis of Ishii and IAP are consistent with sea surface temperature (SST) products, but EN4 is found to underestimate the long-term trend. Compared with ocean heat storage derived from the atmospheric budget equation, all products show consistent seasonal cycles of OHC in the upper 1500 m especially during 2008 to 2012. Overall, our analyses further the understanding of the observed OHC variations, and we recommend a careful quantification of errors in the ocean analyses.

  13. Borderline personality disorder features: the role of self-discrepancies and self-complexity.

    Science.gov (United States)

    Parker, Alexandra G; Boldero, Jennifer M; Bell, Richard C

    2006-09-01

    Borderline personality disorder (BPD) involves disordered self-conceptions, along with dysphoria and anxiety. The present study examined the role of actual-ideal (AI) and actual-ought (AO) self-discrepancies, and self-complexity as predictors of borderline personality features in a student population. AI and AO self-discrepancy magnitudes across all self-domains were assessed, along with self-complexity, idiographically and nomothetically. Borderline personality features were assessed using subscales of the Minnesota Multiphasic Personality Inventory (MMPI-2). Both AI and AO self-discrepancies were directly related to BPD personality features, in that those with larger self-discrepancies of both types reported more features. Self-complexity had no direct relationship to BPD personality features; rather, it moderated the relationship between AI, but not AO, self-discrepancies and BPD personality features. For individuals low in self-complexity, a stronger relationship between AI self-discrepancies and BPD personality features existed. This study is novel in its consideration of the impact of features of the self-system on BPD personality features. It highlights the important role that AO self-discrepancies, and the combined role of AI self-discrepancies and self-complexity, have in increasing vulnerability to BPD. The findings suggest that different pathways might be involved in the vulnerability to BPD, depending on self-discrepancy type and level of self-complexity.

  14. DETERMINANTS OF SPECIALTY CHOICE OF RESIDENT DOCTORS; CASE STUDY--AMONG RESIDENT DOCTORS IN NIGERIA.

    Science.gov (United States)

    Osuoji, Roland I; Adebanji, Atinuke; Abdulsalam, Moruf A; Oludara, Mobolaji A; Abolarinwa, Abimbola A

    2015-01-01

    This study examined medical specialty selection by Nigerian resident doctors using a marketing research approach to determine the selection criteria and the role of perceptions, expected remuneration, and job placement prospects of various specialties in the selection process. Data were from the Community of residents from April 2014 to July 2014. The cohort included 200 residents, but only 171 had complete information. Data were obtained from a cross section of resident doctors in the Lagos State University Teaching Hospital and at the 2014 Ordinary General Meeting of the National Association of Resident Doctors(NARD) where representatives from over 50 Teaching hospitals in Nigeria attended. Using a client behaviour model as a framework, a tripartite questionnaire was designed and administered to residents to deduce information on their knowledge about and interests in various specialties, their opinions of sixteen specialties, and the criteria they used in specialty selection. A total of 171 (85.5%) questionnaires were returned. ln many instances, consistency between selection criteria and perceptions of a specialty were accompanied by interest in pursuing the specialty. Job security, job availability on completion of programme, duration of training and qualifying examinations were highly correlated with p value job security and financial remuneration related variables. Using marketing research concepts for medical specialty selection (Weissmanet al 2012) stipulates that choice of speciality is influenced by criteria and perception. This study shows that job security expected financial remuneration, and examination requirements for qualification are major determinants of the choice of speciality for residents.

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

    Science.gov (United States)

    Smalley, Hannah K; Keskinocak, Pinar

    2016-03-01

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

  16. Policies and attitudes toward the pregnant radiology resident

    International Nuclear Information System (INIS)

    Sheth, S.; Freedman, M.T.; Arak, G.

    1985-01-01

    To evaluate attitudes and policies toward pregnant radiology residents, a questionnaire was sent to the chiefs of radiology residency programs across the country. A return rate of 76.4% and a response rate of 75.4% were achieved. A large majority of the respondents indicated that schedule changes would be made to avoid excessive exposure of a pregnant resident to radiation. The accommodations they suggest are reviewed, and suggestions are made that would help alleviate some of the stress and conflicts that invariably arise when a resident becomes pregnant

  17. Discrepancies between descriptions and illustrations of colours in Congo red-stained amyloid, and explanation of discrepant colours.

    Science.gov (United States)

    Howie, Alexander J; Owen-Casey, Mared P

    2010-09-01

    Congo red-stained sections of amyloid may show various colours between crossed polariser and analyser. The aims were to see how papers described the colours, to compare descriptions with illustrations, and to explain the colours. In 160 papers on Congo red-stained amyloid, the commonest descriptions were 'green birefringence' and 'apple-green birefringence'. In 191 figures in 82 papers, 59 (31%) showed a pure green colour, 62 (32%) showed green and yellow or blue and yellow, 38 (20%) showed green and a colour other than yellow, mostly red, and 32 (17%) showed other colours. Discrepancies between colours reported and illustrated were noted in 127 figures (66%). Most (77) were between green alone in descriptions and green and another colour in figures, and 30 were between green in descriptions and no green at all in figures. Pure green can be seen in ideal conditions, but more often there are green and yellow, explained by strain birefringence, and green and red or other combinations, explained by uncrossing of polariser and analyser. These other anomalous colours are just as characteristic of amyloid as the pure green colour. Many papers on Congo red-stained amyloid appear to describe what is expected theoretically rather than what is actually seen.

  18. Simulation Training in Obstetrics and Gynaecology Residency Programs in Canada.

    Science.gov (United States)

    Sanders, Ari; Wilson, R Douglas

    2015-11-01

    The integration of simulation into residency programs has been slower in obstetrics and gynaecology than in other surgical specialties. The goal of this study was to evaluate the current use of simulation in obstetrics and gynaecology residency programs in Canada. A 19-question survey was developed and distributed to all 16 active and accredited obstetrics and gynaecology residency programs in Canada. The survey was sent to program directors initially, but on occasion was redirected to other faculty members involved in resident education or to senior residents. Survey responses were collected over an 18-month period. Twelve programs responded to the survey (11 complete responses). Eleven programs (92%) reported introducing an obstetrics and gynaecology simulation curriculum into their residency education. All respondents (100%) had access to a simulation centre. Simulation was used to teach various obstetrical and gynaecological skills using different simulation modalities. Barriers to simulation integration were primarily the costs of equipment and space and the need to ensure dedicated time for residents and educators. The majority of programs indicated that it was a priority for them to enhance their simulation curriculum and transition to competency-based resident assessment. Simulation training has increased in obstetrics and gynaecology residency programs. The development of formal simulation curricula for use in obstetrics and gynaecology resident education is in early development. A standardized national simulation curriculum would help facilitate the integration of simulation into obstetrics and gynaecology resident education and aid in the shift to competency-based resident assessment. Obstetrics and gynaecology residency programs need national collaboration (between centres and specialties) to develop a standardized simulation curriculum for use in obstetrics and gynaecology residency programs in Canada.

  19. Obstetrics and Gynecology Resident Interest and Participation in Global Health.

    Science.gov (United States)

    Stagg, Amy R; Blanchard, May Hsieh; Carson, Sandra A; Peterson, Herbert B; Flynn, Erica B; Ogburn, Tony

    2017-05-01

    To evaluate obstetrics and gynecology resident interest and participation in global health experiences and elucidate factors associated with resident expectation for involvement. A voluntary, anonymous survey was administered to U.S. obstetrics and gynecology residents before the 2015 Council on Resident Education in Obstetrics and Gynecology in-training examination. The 23-item survey gathered demographic data and queried resident interest and participation in global health. Factors associated with resident expectation for participation in global health were analyzed by Pearson χ tests. Of the 5,005 eligible examinees administered the survey, 4,929 completed at least a portion of the survey for a response rate of 98.5%. Global health was rated as "somewhat important" or "very important" by 96.3% (3,761/3,904) of residents. "Educational opportunity" (69.2%) and "humanitarian effort" (17.7%) were cited as the two most important aspects of a global health experience. Residents with prior global health experience rated the importance of global health more highly and had an increased expectation for future participation. Global health electives were arranged by residency programs for 18.0% (747/4,155) of respondents, by residents themselves as an elective for 44.0% (1,828/4,155), and as a noncredit experience during vacation time for 36.4% (1,514/4,155) of respondents. Female gender, nonpartnered status, no children, prior global health experience, and intention to incorporate global health in future practice were associated with expectations for a global health experience. Most obstetrics and gynecology residents rate a global health experience as somewhat or very important, and participation before or during residency increases the perceived importance of global health and the likelihood of expectation for future participation. A majority of residents report arranging their own elective or using vacation time to participate, suggesting that residency programs have

  20. Frequency of discrepancies in retracted clinical trial reports versus unretracted reports: blinded case-control study.

    Science.gov (United States)

    Cole, Graham D; Nowbar, Alexandra N; Mielewczik, Michael; Shun-Shin, Matthew J; Francis, Darrel P

    2015-09-20

    To compare the frequency of discrepancies in retracted reports of clinical trials with those in adjacent unretracted reports in the same journal. Blinded case-control study. Journals in PubMed. 50 manuscripts, classified on PubMed as retracted clinical trials, paired with 50 adjacent unretracted manuscripts from the same journals. Reports were randomly selected from PubMed in December 2012, with no restriction on publication date. Controls were the preceding unretracted clinical trial published in the same journal. All traces of retraction were removed. Three scientists, blinded to the retraction status of individual reports, reviewed all 100 trial reports for discrepancies. Discrepancies were pooled and cross checked before being counted into prespecified categories. Only then was the retraction status unblinded for analysis. Total number of discrepancies (defined as mathematically or logically contradictory statements) in each clinical trial report. Of 479 discrepancies found in the 100 trial reports, 348 were in the 50 retracted reports and 131 in the 50 unretracted reports. On average, individual retracted reports had a greater number of discrepancies than unretracted reports (median 4 (interquartile range 2-8.75) v 0 (0-5); Pretracted than those without a discrepancy (odds ratio 5.7 (95% confidence interval 2.2 to 14.5); Pretracted than unretracted reports: factual discrepancies (P=0.002), arithmetical errors (P=0.01), and missed P values (P=0.02). Results from a retrospective analysis indicated that citations and journal impact factor were unlikely to affect the result. Discrepancies in published trial reports should no longer be assumed to be unimportant. Scientists, blinded to retraction status and with no specialist skill in the field, identify significantly more discrepancies in retracted than unretracted reports of clinical trials. Discrepancies could be an early and accessible signal of unreliability in clinical trial reports. © Cole et al 2015.

  1. Measuring the intensity of resident supervision in the department of veterans affairs: the resident supervision index.

    Science.gov (United States)

    Byrne, John M; Kashner, Michael; Gilman, Stuart C; Aron, David C; Cannon, Grant W; Chang, Barbara K; Godleski, Linda; Golden, Richard M; Henley, Steven S; Holland, Gloria J; Kaminetzky, Catherine P; Keitz, Sheri A; Kirsh, Susan; Muchmore, Elaine A; Wicker, Annie B

    2010-07-01

    To develop a survey instrument designed to quantify supervision by attending physicians in nonprocedural care and to assess the instrument's feasibility and reliability. In 2008, the Department of Veterans Affairs (VA) Office of Academic Affiliations convened an expert panel to adopt a working definition of attending supervision in nonprocedural patient care and to construct a survey to quantify it. Feasibility was field-tested on residents and their supervising attending physicians at primary care internal medicine clinics at the VA Loma Linda Healthcare System in their encounters with randomly selected outpatients diagnosed with either major depressive disorder or diabetes. The authors assessed both interrater concurrent reliability and test-retest reliability. The expert panel adopted the VA's definition of resident supervision and developed the Resident Supervision Index (RSI) to measure supervision in terms of residents' case understanding, attending physicians' contributions to patient care through feedback to the resident, and attending physicians' time (minutes). The RSI was field-tested on 60 residents and 37 attending physicians for 148 supervision episodes from 143 patient encounters. Consent rates were 94% for residents and 97% for attending physicians; test-retest reliability intraclass correlations (ICCs) were 0.93 and 0.88, respectively. Concurrent reliability between residents' and attending physicians' reported time was an ICC of 0.69. The RSI is a feasible and reliable measure of resident supervision that is intended for research studies in graduate medical education focusing on education outcomes, as well as studies assessing quality of care, patient health outcomes, care costs, and clinical workload.

  2. Personality Testing May Improve Resident Selection in Anesthesiology Programs

    Science.gov (United States)

    Merlo, Lisa J.; Matveevskii, Alexander S.

    2010-01-01

    Background Current methods of selecting future residents for anesthesiology training programs do not adequately distinguish those who will succeed from the pool of seemingly well-qualified applicants. Some residents, despite high exam scores, may struggle in the OR in stressful situations. Aims This study examined whether specific neuropsychological and personality measures can distinguish high competency residents from low competency residents to aid in resident selection. Methods 25 residents enrolled in an anesthesiology program at a major academic institution were identified for participation. 13 were evaluated identified as “high competency” residents and 12 as “low competency ” by the department's clinical competency committee. Groups were evaluated on measures of fine motor dexterity, executive functioning, processing speed, attention, and personality using IPIP-NEO. Results There were no significant differences between groups on measures of fine-motor dexterity, executive functioning, processing speed, or attention. High competency residents scored significantly higher than low competency residents on measures of cooperation, self-efficacy, and adventurousness, and lower on measures of neuroticism, anxiety, anger, and vulnerability. Conclusion Although measures of fine-motor dexterity, executive functioning, processing speed, and attention do not appear to distinguish between high- and low competency residents in anesthesiology, specific personality characteristics may be associated with future success in an anesthesiology training program. PMID:19995155

  3. 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...

  4. Results of the American Academy of Neurology resident survey.

    Science.gov (United States)

    Freeman, W D; Nolte, C M; Matthews, B R; Coleman, M; Corboy, J R

    2011-03-29

    To assess the effect of neurology residency education as trainees advance into independent practice, the American Academy of Neurology (AAN) elected to survey all graduating neurology residents at time of graduation and in 3-year cycles thereafter. A 22-question survey was sent to all neurology residents completing residency training in the United States in 2007. Of 523 eligible residents, 285 (54.5%) responded. Of these, 92% reported good to excellent quality teaching of basic neurology from their faculty; however, 47% noted less than ideal training in basic neuroscience. Two-thirds indicated that the Residency In-service Training Examination was used only as a self-assessment tool, but reports of misuse were made by some residents. After residency, 78% entered fellowships (with 61% choosing a fellowship based on interactions with a mentor at their institution), whereas 20% entered practice directly. After adjustment for the proportion of residents who worked before the duty hour rules were implemented and after their implementation, more than half reported improvement in quality of life (87%), education (60%), and patient care (62%). The majority of international medical graduates reported wanting to stay in the United States to practice rather than return to their country of residence. Neurology residents are generally satisfied with training, and most entered a fellowship. Duty hour implementation may have improved resident quality of life, but reciprocal concerns were raised about impact on patient care and education. Despite the majority of international trainees wishing to stay in the United States, stricter immigration laws may limit their entry into the future neurology workforce.

  5. A critical look at the discrepancy reduction mechanism of study time allocation

    NARCIS (Netherlands)

    Verkoeijen, Peter PJL; Rikers, Remy MJP; Augustus, Manon I; Schmidt, Henk G

    The discrepancy reduction mechanism predicts that most study time is allocated to information for which the discrepancy between the current and the desired state of learning is perceived to be largest. The aim of the present series of two experiments was to assess this mechanism by examining the

  6. The Discrepancy between Teachers' Beliefs and Practices: A Study of Kindergarten Teachers in Hong Kong

    Science.gov (United States)

    Chan, Wai Ling

    2016-01-01

    This study examines the discrepancy between teachers' beliefs and practices in Hong Kong kindergartens and the factors that influence this discrepancy. Three kindergartens, considered by the Hong Kong Education Bureau to be of varying quality, were chosen from different areas of Hong Kong. Questionnaires about teaching beliefs were administered to…

  7. Can the Media Affect Us? Social Comparison, Self-Discrepancy, and the Thin Ideal

    Science.gov (United States)

    Bessenoff, Gayle R.

    2006-01-01

    The current study explored body image self-discrepancy as moderator and social comparison as mediator in the effects on women from thin-ideal images in the media. Female undergraduates (N = 112) with high and low body image self-discrepancy were exposed to advertisements either with thin women (thin ideal) or without thin women…

  8. Discrepancies Confer Vulnerability to Depressive Symptoms: A Three-Wave Longitudinal Study

    Science.gov (United States)

    Sherry, Simon B.; Mackinnon, Sean P.; Macneil, Matthew A.; Fitzpatrick, Skye

    2013-01-01

    Discrepancies (i.e., a subjective sense of falling short of one's own standards) are a key part of the perfectionism construct. Theory suggests discrepancies confer vulnerability to depressive symptoms. Since most research in this area is cross-sectional, longitudinal research is needed to disentangle directionality of relationships and to permit…

  9. Working Memory in Children with Learning Disabilities: Rethinking the Criterion of Discrepancy

    Science.gov (United States)

    Maehler, Claudia; Schuchardt, Kirsten

    2011-01-01

    The criterion of discrepancy is used to distinguish children with learning disorders from children with intellectual disabilities. The justification of the criterion of discrepancy for the diagnosis of learning disorders relies on the conviction of fundamental differences between children with learning difficulties with versus without discrepancy…

  10. Parent-Adolescent Discrepancies in Reports of Parenting and Adolescent Outcomes in Mexican Immigrant Families.

    Science.gov (United States)

    Hou, Yang; Kim, Su Yeong; Benner, Aprile D

    2018-02-01

    Parents and adolescents often have discrepant views of parenting which pose challenges for researchers regarding how to deal with information from multiple informants. Although recent studies indicate that parent-adolescent discrepancies in reports of parenting can be useful in predicting adolescent outcomes, their findings are mixed regarding whether discrepancies relate to more positive or more negative adolescent outcomes. This study examined the longitudinal implications of parent-adolescent discrepancies in reports of parenting (warmth, monitoring, and reasoning) on adolescent behavioral, psychological, academic, and physical health outcomes among Mexican immigrant families in the United States. Participants were 604 adolescents (54% female, M age.wave1  = 12.41 years) and their parents. Taking a person-centered approach, this study identified distinct patterns of parent-adolescent discrepancies in parenting and their different associations with later adolescent outcomes. Adolescents' more negative perceptions of parenting relative to parents were associated with more negative adolescent outcomes, whereas adolescents' more positive perceptions relative to parents related to more positive adolescent outcomes. There were also variations in discrepancy patterns and their associations with adolescent outcomes between mother-adolescent vs. father-adolescent dyads. Findings of the current study highlight individual variations of discrepancies among parent-adolescent dyads and the importance of considering both the magnitude and direction of discrepancies regarding their associations with adolescent well-being.

  11. Implicit and Explicit Self-Esteem Discrepancies, Victimization and the Development of Late Childhood Internalizing Problems

    NARCIS (Netherlands)

    Leeuwis, F.H.; Koot, J.M.; Creemers, D.H.M.; Lier, P.A.C. van

    2015-01-01

    Discrepancies between implicit and explicit self-esteem have been linked with internalizing problems among mainly adolescents and adults. Longitudinal research on this association in children is lacking. This study examined the longitudinal link between self-esteem discrepancies and the development

  12. Understanding Parent-Child Social Informant Discrepancy in Youth with High Functioning Autism Spectrum Disorders

    Science.gov (United States)

    Lerner, Matthew D.; Calhoun, Casey D.; Mikami, Amori Yee; De Los Reyes, Andres

    2012-01-01

    We investigated discrepancies between parent- and self-reported social functioning among youth with autism spectrum disorders (ASD). Three distinct samples showed discrepancies indicating that parents viewed their children as performing one standard deviation below a standardization mean, while youth viewed themselves as comparably-skilled…

  13. Does Hot Water Freeze Faster Than Cold? Or Why Mpemba's Ice Cream Is a Discrepant Event

    Science.gov (United States)

    Palmer, Bill

    1993-01-01

    A discrepant event is a happening contrary to our current beliefs. Discrepant events are said to be useful in clarifying concepts. This is one of the interesting features of current theories of constructivism. The story of Mpemba's ice cream is quite well known, but it is the educational aspects of the experiment that are of interest in this…

  14. Discrepâncias na imagem corporal e na dieta de obesos Self-discrepancy in body image and diet

    Directory of Open Access Journals (Sweden)

    Patrícia Kanno

    2008-08-01

    Full Text Available OBJETIVO: Este estudo avaliou a discrepância entre a imagem real e a imagem ideal de indivíduos obesos e procurou relacionar possíveis alterações no comportamento alimentar na busca desse corpo ideal. MÉTODOS: A amostra foi composta por 25 sujeitos, sendo 76% do sexo feminino e idade média de 39,24 (desviopadrão=5,01 anos. Dois instrumentos foram utilizados: a Escala de Aparência Física, cuja análise fatorial extraiu um único fator "Aparência Física" com precisão de α=0,74 para mulheres e α=0,73 para homens e o Questionário de Prioridade Alimentar elaborado para agrupar itens nas categorias que compõem a Pirâmide Alimentar. Foram realizados testes t pareados para comparar diferenças entre as imagens real e ideal e para comparar os comportamentos alimentares real e ideal. RESULTADOS: Os resultados apresentaram diferenças entre as imagens ideal e real, sendo a primeira representada de forma mais positiva que a última. Com relação ao comportamento alimentar, os resultados demonstraram diminuição no consumo de carnes e café preto e aumento no consumo de frutas e vegetais para atingir o corpo ideal. Porém, a amostra não mudaria os seus hábitos em relação ao consumo de cereais, laticínios, óleos e gorduras, doces e refrigerantes. CONCLUSÃO: Embora os resultados apresentem diferenças na percepção da imagem corporal, a amostra não mudaria os seus hábitos em relação às categorias do topo da pirâmide alimentar.OBJECTIVE: This study evaluated the discrepancy between actual and ideal body images of obese individuals and listed changes in the dietary behaviors used to achieve this ideal body image. METHODS: The sample was composed of 25 obese individuals with a mean age of 39.24 years (standard deviation=5.01 where 76% were females. Two instruments were used for this end: the Physical Appearance Scale whose factorial analysis extracted a single factor "Physical Appearance" with an accuracy of α=0.74 for women and

  15. Struggling to be self-directed: residents' paradoxical beliefs about learning.

    Science.gov (United States)

    Nothnagle, Melissa; Anandarajah, Gowri; Goldman, Roberta E; Reis, Shmuel

    2011-12-01

    Self-directed learning (SDL) skills serve as the basis for physician lifelong learning; however, residency training does not typically emphasize SDL skills. To understand residents' needs regarding SDL curricula, the authors used qualitative methods to examine the residency learning culture and residents' views of SDL. The authors conducted individual, in-depth, semistructured interviews with all 13 final-year residents at the Brown University Family Medicine Residency Program. Interviews were audio taped and transcribed verbatim. Using an iterative individual and group process, four researchers conducted a qualitative analysis of the transcripts, identifying major themes and higher-order interpretations. Major themes included resident beliefs about learning, the learning culture in residency, and developmental progress in learning. Four paradoxes emerged in the analysis: (1) Residents understand and value the concept of SDL, but they engage in limited goal setting and reflection and report lack of skills to manage their own learning, particularly in the clinical setting. (2) Despite being immersed in what aims to be a learner-centered culture, many residents still value traditional, teacher-centered approaches. (3) Residents recognize patient care as the most powerful stimulus for SDL, but they often perceive patient care and learning as competing priorities. (4) Residents desire external guidance for SDL. Graduating residents lacked confidence in their SDL skills and their ability to manage their learning, especially in clinical settings. Fostering SDL skills during residency will likely require training and guidance for SDL as well as changes in the structure and culture of residency.

  16. Discrepancies in reporting of physical and sexual abuse among homeless young adults.

    Science.gov (United States)

    Tyler, Kimberly A; Melander, Lisa A

    2009-09-01

    This study investigated risk factors for discrepant reporting of physical and sexual abuse among 172 homeless young adults. Discrepant reporting includes situations in which a respondent denies experiencing abuse in general but reports being a victim of specific forms of maltreatment. The results revealed that discrepant reporting rates tended to be highest for minor physical assault and for noncontact sexual abuse. Multivariate results revealed that demographic characteristics were important correlates of both discrepant physical and sexual abuse reporters. Family background characteristics also played a role in discrepant reporting for physical abuse. Overall, some young people with abuse histories are not adequately labeling their maltreatment experiences and, as a result, may not be receiving the necessary treatment.

  17. Identifying and Characterizing Discrepancies Between Test and Analysis Results of Compression-Loaded Panels

    Science.gov (United States)

    Thornburgh, Robert P.; Hilburger, Mark W.

    2005-01-01

    Results from a study to identify and characterize discrepancies between validation tests and high-fidelity analyses of compression-loaded panels are presented. First, potential sources of the discrepancies in both the experimental method and corresponding high-fidelity analysis models were identified. Then, a series of laboratory tests and numerical simulations were conducted to quantify the discrepancies and develop test and analysis methods to account for the discrepancies. The results indicate that the discrepancies between the validation tests and high-fidelity analyses can be attributed to imperfections in the test fixture and specimen geometry; test-fixture-induced changes in specimen geometry; and test-fixture-induced friction on the loaded edges of the test specimen. The results also show that accurate predictions of the panel response can be obtained when these specimen imperfections and edge conditions are accounted for in the analysis. The errors in the tests and analyses, and the methods used to characterize these errors are presented.

  18. Discrepancy-based and anticipated emotions in behavioral self-regulation.

    Science.gov (United States)

    Brown, Christina M; McConnell, Allen R

    2011-10-01

    Discrepancies between one's current and desired states evoke negative emotions, which presumably guide self-regulation. In the current work we evaluated the function of discrepancy-based emotions in behavioral self-regulation. Contrary to classic theories of self-regulation, discrepancy-based emotions did not predict the degree to which people engaged in self-regulatory behavior. Instead, expectations about how future self-discrepancies would make one feel (i.e., anticipated emotions) predicted self-regulation. However, anticipated emotions were influenced by previous discrepancy-based emotional experiences, suggesting that the latter do not directly motivate self-regulation but rather guide expectations. These findings are consistent with the perspective that emotions do not necessarily direct immediate behavior, but rather have an indirect effect by guiding expectations, which in turn predict goal-directed action.

  19. Discrepancies between sources providing the medication histories of acutely hospitalised patients

    DEFF Research Database (Denmark)

    Karkov, Louise Lindved; Schytte-Hansen, Simon; Nørgaard, Lotte Stig

    2010-01-01

    Objective The aim of this study was to clarify the number and type of discrepancies between four medication sources as well as their potential clinical significance to the patient. Method The study was conducted as a cross-sectional study comprising all patients hospitalised with hip fractures...... in the Orthopaedic Surgery Ward at Amager Hospital. Data were collected from four sources. All information was counted, and the potential clinical significance of discrepancies was evaluated on a five-point scale. The four sources are: patients, the Personal Electronic Medication Profile (PEM), the general...... sources. Results A total of 69 medications were registered for nine patients or an average of 7.7 medications per patient. 10.1 discrepancies per patient and 1.3 discrepancies per drug were registered. Two discrepancies were assessed as having potentially lethal clinical significance. Forty...

  20. Remembering and telling self-consistent and self-discrepant memories.

    Science.gov (United States)

    Mutlutürk, Aysu; Tekcan, Ali I

    2016-01-01

    It has been argued that memories that are inconsistent with one's self would differ from those that are consistent with the self. The present study addresses retrieval, phenomenology, rehearsal and narrative characteristics of autobiographical memories that are consistent versus discrepant with one's self. One hundred participants were asked to recall one self-consistent and one self-discrepant memory as well as an episode of telling these memories to others. They also filled out the Autobiographical Memory Questionnaire and the Centrality of Event Scale for each memory. Results showed no difference between self-consistent and self-discrepant memories in retrieval time, specificity or phenomenology. However, self-discrepant memory narratives contained more meaning-making statements and less autonomy than self-consistent memories. Compared to self-consistent memories, self-discrepant memories were told to fewer people, and listener responses were more negative when they were told. Results are discussed in relation to the functions these memories serve.

  1. 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 < 0.001%). Important perceived barriers to seeking 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.

  2. 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.

  3. En Route to Depression: Self-Esteem Discrepancies and Habitual Rumination.

    Science.gov (United States)

    Phillips, Wendy J; Hine, Donald W

    2016-02-01

    Dual-process models of cognitive vulnerability to depression suggest that some individuals possess discrepant implicit and explicit self-views, such as high explicit and low implicit self-esteem (fragile self-esteem) or low explicit and high implicit self-esteem (damaged self-esteem). This study investigated whether individuals with discrepant self-esteem may employ depressive rumination in an effort to reduce discrepancy-related dissonance, and whether the relationship between self-esteem discrepancy and future depressive symptoms varies as a function of rumination tendencies. Hierarchical regressions examined whether self-esteem discrepancy was associated with rumination in an Australian undergraduate sample at Time 1 (N = 306; M(age) = 29.9), and whether rumination tendencies moderated the relationship between self-esteem discrepancy and depressive symptoms assessed 3 months later (n = 160). Damaged self-esteem was associated with rumination at Time 1. As hypothesized, rumination moderated the relationship between self-esteem discrepancy and depressive symptoms at Time 2, where fragile self-esteem and high rumination tendencies at Time 1 predicted the highest levels of subsequent dysphoria. Results are consistent with dual-process propositions that (a) explicit self-regulation strategies may be triggered when explicit and implicit self-beliefs are incongruent, and (b) rumination may increase the likelihood of depression by expending cognitive resources and/or amplifying negative implicit biases. © 2014 Wiley Periodicals, Inc.

  4. Mother-son discrepant reporting on parenting practices: The contribution of temperament and depression.

    Science.gov (United States)

    Shishido, Yuri; Latzman, Robert D

    2017-06-01

    Despite low to moderate convergent correlations, assessment of youth typically relies on multiple informants for information across a range of psychosocial domains including parenting practices. Although parent-youth informant discrepancies have been found to predict adverse youth outcomes, few studies have examined contributing factors to the explanation of informant disagreements on parenting practices. The current study represents the first investigation to concurrently examine the role of mother and son's self-reported affective dimensions of temperament and depression as pathways to informant discrepancies on parenting practices. Within a community sample of 174 mother-son dyads, results suggest that whereas mother's self-reported temperament evidenced no direct effects on discrepancies, the association between the product term of mother's negative and positive temperament and discrepancies on positive parenting was fully mediated by mother's depression (a mediated moderation). In contrast, son's self-reported temperament evidenced both direct and indirect effects, partially mediated by depression, on rating discrepancies for positive parenting. All told, both son's self-reported affective dimensions of temperament and depression contributed to the explanation of discrepant reporting on parenting practices; only mother's self-reported depression, but not temperament, uniquely contributed. Results highlight the importance of considering both parent and youth's report in the investigation of informant discrepancies on parenting practices. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

  5. Discrepancies in Leader and Follower Ratings of Transformational Leadership: Relationship with Organizational Culture in Mental Health.

    Science.gov (United States)

    Aarons, Gregory A; Ehrhart, Mark G; Farahnak, Lauren R; Sklar, Marisa; Horowitz, Jonathan

    2017-07-01

    The role of leadership in the management and delivery of health and allied health services is often discussed but lacks empirical research. Discrepancies are often found between leaders' self-ratings and followers' ratings of the leader. To our knowledge no research has examined leader-follower discrepancies and their association with organizational culture in mental health clinics. The current study examines congruence, discrepancy, and directionality of discrepancy in relation to organizational culture in 38 mental health teams (N = 276). Supervisors and providers completed surveys including ratings of the supervisor transformational leadership and organizational culture. Polynomial regression and response surface analysis models were computed examining the associations of leadership discrepancy and defensive organizational culture and its subscales. Discrepancies between supervisor and provider reports of transformational leadership were associated with a more negative organizational culture. Culture suffered more where supervisors rated themselves more positively than providers, in contrast to supervisors rating themselves lower than the provider ratings of the supervisor. Leadership and leader discrepancy should be a consideration in improving organizational culture and for strategic initiatives such as quality of care and the implementation and sustainment of evidence-based practice.

  6. Impact of Computerized Order Entry to Pharmacy Interface on Order-Infusion Pump Discrepancies

    Directory of Open Access Journals (Sweden)

    Rebecca A. Russell

    2015-01-01

    Full Text Available Background. The ability of safety technologies to decrease errors, harm, and risk to patients has yet to be demonstrated consistently. Objective. To compare discrepancies between medication and intravenous fluid (IVF orders and bedside infusion pump settings within a pediatric intensive care unit (PICU before and after implementation of an interface between computerized physician order entry (CPOE and pharmacy systems. Methods. Within a 72-bed PICU, medication and IVF orders in the CPOE system and bedside infusion pump settings were collected. Rates of discrepancy were calculated and categorized by type. Results were compared to a study conducted prior to interface implementation. Expansion of PICU also occurred between study periods. Results. Of 455 observations, discrepancy rate decreased for IVF (p=0.01 compared to previous study. Overall discrepancy rate for medications was unchanged; however, medications infusing without an order decreased (p<0.01, and orders without corresponding infusion increased (p<0.05. Conclusions. Following implementation of an interface between CPOE and pharmacy systems, fewer discrepancies between IVF orders and infusion pump settings were observed. Discrepancies for medications did not change, and some types of discrepancies increased. In addition to interface implementation, changes in healthcare delivery and workflow related to ICU expansion contributed to observed changes.

  7. The role of self-image concerns in discrepancies between implicit and explicit self-esteem.

    Science.gov (United States)

    Laws, Valerie L; Rivera, Luis M

    2012-11-01

    Four experiments examined the hypothesis that individuals who hold discrepant implicit and explicit self-esteem possess relatively strong self-image concerns. As a result, they may act irrationally when expressing sexual health attitudes. In support of the hypothesis, Experiments 1a and 1b demonstrate that large self-esteem discrepancy participants possess strong implicit self-image ambivalence relative to small self-esteem discrepancy participants. In Experiments 2 and 3, participants who varied in self-esteem discrepancies received either negative or positive (or no) feedback on an intelligence test, and then they were given an opportunity to express implicit and explicit attitudes toward condoms. Large self-esteem discrepancy participants who received a self-threat responded irrationally and expressed relatively strong negative implicit (but not explicit) attitudes toward condoms. However, this detrimental effect was completely reversed following a self-affirmation to large discrepancy participants. The implicit and explicit attitudes toward condoms of small discrepancy participants were unaffected by a self-threat or a self-affirmation.

  8. Improving Clinical Feedback to Anesthesia Residents by Using an Optical Scanner and a Microcomputer.

    Science.gov (United States)

    Albanese, Mark A.; And Others

    1989-01-01

    At the University of Iowa problems associated with managing evaluations of anesthesia residents led to a major backlog of unanalyzed evaluation forms. A system developed at the University that enables ongoing feedback to residents and provides a method to assess the clinical competence of residents is described. (Author/MLW)

  9. Workplace Violence and Harassment Against Emergency Medicine Residents.

    Science.gov (United States)

    Schnapp, Benjamin H; Slovis, Benjamin H; Shah, Anar D; Fant, Abra L; Gisondi, Michael A; Shah, Kaushal H; Lech, Christie A

    2016-09-01

    Several studies have shown that workplace violence in the emergency department (ED) is common. Residents may be among the most vulnerable staff, as they have the least experience with these volatile encounters. The goal for this study was to quantify and describe acts of violence against emergency medicine (EM) residents by patients and visitors and to identify perceived barriers to safety. This cross-sectional survey study queried EM residents at multiple New York City hospitals. The primary outcome was the incidence of violence experienced by residents while working in the ED. The secondary outcomes were the subtypes of violence experienced by residents, as well as the perceived barriers to safety while at work. A majority of residents (66%, 78/119) reported experiencing at least one act of physical violence during an ED shift. Nearly all residents (97%, 115/119) experienced verbal harassment, 78% (93/119) had experienced verbal threats, and 52% (62/119) reported sexual harassment. Almost a quarter of residents felt safe "Occasionally," "Seldom" or "Never" while at work. Patient-based factors most commonly cited as contributory to violence included substance use and psychiatric disease. Self-reported violence against EM residents appears to be a significant problem. Incidence of violence and patient risk factors are similar to what has been found previously for other ED staff. Understanding the prevalence of workplace violence as well as the related systems, environmental, and patient-based factors is essential for future prevention efforts.

  10. Discrepancy Between Clinician and Research Assistant in TIMI Score Calculation (TRIAGED CPU

    Directory of Open Access Journals (Sweden)

    Taylor, Brian T.

    2014-11-01

    Full Text Available Introduction: Several studies have attempted to demonstrate that the Thrombolysis in Myocardial Infarction (TIMI risk score has the ability to risk stratify emergency department (ED patients with potential acute coronary syndromes (ACS. Most of the studies we reviewed relied on trained research investigators to determine TIMI risk scores rather than ED providers functioning in their normal work capacity. We assessed whether TIMI risk scores obtained by ED providers in the setting of a busy ED differed from those obtained by trained research investigators. Methods: This was an ED-based prospective observational cohort study comparing TIMI scores obtained by 49 ED providers admitting patients to an ED chest pain unit (CPU to scores generated by a team of trained research investigators. We examined provider type, patient gender, and TIMI elements for their effects on TIMI risk score discrepancy. Results: Of the 501 adult patients enrolled in the study, 29.3% of TIMI risk scores determined by ED providers and trained research investigators were generated using identical TIMI risk score variables. In our low-risk population the majority of TIMI risk score differences were small; however, 12% of TIMI risk scores differed by two or more points. Conclusion: TIMI risk scores determined by ED providers in the setting of a busy ED frequently differ from scores generated by trained research investigators who complete them while not under the same pressure of an ED provider. [West J Emerg Med. 2015;16(1:24–33.

  11. Medication reconciliation errors in a tertiary care hospital in Saudi Arabia: admission discrepancies and risk factors

    Directory of Open Access Journals (Sweden)

    Mazhar F

    2017-03-01

    Full Text Available Background: Medication reconciliation is a major component of safe patient care. One of the main problems in the implementation of a medication reconciliation process is the lack of human resources. With limited resources, it is better to target medication reconciliation resources to patients who will derive the most benefit from it. Objective: The primary objective of this study was to determine the frequency and types of medication reconciliation errors identified by pharmacists performing medication reconciliation at admission. Each medication error was rated for its potential to cause patient harm during hospitalization. A secondary objective was to determine risk factors associated with medication reconciliation errors. Methods: This was a prospective, single-center pilot study conducted in the internal medicine and surgical wards of a tertiary care teaching hospital in the Eastern province of Saudi Arabia. A clinical pharmacist took the best possible medication history of patients admitted to medical and surgical services and compared with the medication orders at hospital admission; any identified discrepancies were noted and analyzed for reconciliation errors. Multivariate logistic regression was performed to determine the risk factors related to reconciliation errors. Results: A total of 328 patients (138 in surgical and 198 in medical were included in the study. For the 1419 medications recorded, 1091 discrepancies were discovered out of which 491 (41.6% were reconciliation errors. The errors affected 177 patients (54%. The incidence of reconciliation errors in the medical patient group was 25.1% and 32.0% in the surgical group (p<0.001. In both groups, the most frequent reconciliation error was the omission (43.5% and 51.2%. Lipid-lowering (12.4% and antihypertensive agents were most commonly involved. If undetected, 43.6% of order errors were rated as potentially requiring increased monitoring or intervention to preclude harm; 17

  12. Medication reconciliation errors in a tertiary care hospital in Saudi Arabia: admission discrepancies and risk factors.

    Science.gov (United States)

    Mazhar, Faizan; Akram, Shahzad; Al-Osaimi, Yousif A; Haider, Nafis

    2017-01-01

    Medication reconciliation is a major component of safe patient care. One of the main problems in the implementation of a medication reconciliation process is the lack of human resources. With limited resources, it is better to target medication reconciliation resources to patients who will derive the most benefit from it. The primary objective of this study was to determine the frequency and types of medication reconciliation errors identified by pharmacists performing medication reconciliation at admission. Each medication error was rated for its potential to cause patient harm during hospitalization. A secondary objective was to determine risk factors associated with medication reconciliation errors. This was a prospective, single-center pilot study conducted in the internal medicine and surgical wards of a tertiary care teaching hospital in the Eastern province of Saudi Arabia. A clinical pharmacist took the best possible medication history of patients admitted to medical and surgical services and compared with the medication orders at hospital admission; any identified discrepancies were noted and analyzed for reconciliation errors. Multivariate logistic regression was performed to determine the risk factors related to reconciliation errors. A total of 328 patients (138 in surgical and 198 in medical) were included in the study. For the 1419 medications recorded, 1091 discrepancies were discovered out of which 491 (41.6%) were reconciliation errors. The errors affected 177 patients (54%). The incidence of reconciliation errors in the medical patient group was 25.1% and 32.0% in the surgical group (perror was the omission (43.5% and 51.2%). Lipid-lowering (12.4%) and antihypertensive agents were most commonly involved. If undetected, 43.6% of order errors were rated as potentially requiring increased monitoring or intervention to preclude harm; 17.7% were rated as potentially harmful. A multivariate logistic regression model showed that patients aged ≥65 years

  13. Resident satisfaction on their residence and environment (case study of Srondol Bumi Indah Housing of Semarang City)

    Science.gov (United States)

    Hariyono, Paulus

    2017-12-01

    A piece of an architecture work will be meaningful if it meets the needs of the residents. Likewise, the design and natural environment of a residence will surely be meaningful if it is able to satisfy the residents. The degree of satisfaction can be referred to the theory of human need hierarchy proposed by Abraham Maslow. Although his theory is an old one, it is still a good one for a reference. Socio economic status (SES)also affects someone in understanding the comfort of his resident. This research has some purpose: 1) to know the satisfaction level of the residents, 2) to know the effects of socio economic status towards the residents, and 3) to know the natural environment aspect to resident satisfaction. The methode analysis used is qualitative analysis. The major finding are: 1)security factor is the main aspect of the human need residents; 2) upper and lowerclass residents have different knowledge and understanding regarding the natural environment satisfaction on the house they live.

  14. 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

  15. Cardiovascular drugs : discrepancies in demographics between pre- and post-registration use

    NARCIS (Netherlands)

    Wieringa, NF; de Graeff, PA; van der Werf, GT; Vos, R

    Objectives: To study discrepancies in demographic characteristics between patients participating in pre-registration phase III trials of cardiovascular drugs, registered in the Netherlands, and patient populations in daily practice representing the actual users of the drugs after registration.

  16. Comments on the discrepancies found in running NJOY and LINEAR - RECENT - GROUPIE for some actinides

    International Nuclear Information System (INIS)

    Corcuera, R.P.; Moraes, M. de.

    1986-08-01

    Some discrepancies encountered between the two processing codes NJOY and RECENT-GROUPIE were analysed. It was found that they are due to different interpretation of inadequate representation of the evaluated date. (author) [pt

  17. A Case for Not Going SAT-Optional: Students with Discrepant SAT and HSGPA Performance

    Science.gov (United States)

    Mattern, Krista D.; Shaw, Emily J.; Kobrin, Jennifer L.

    2010-01-01

    Presented at the national conference for the American Educational Research Association (AERA) in 2010. This presentation describes an alternative way of presenting the unique information provided by the SAT over HSGPA, namely examining students with discrepant SAT-HSGPA performance.

  18. A Decision-Making Model to Remove Discrepancies: Application to a Reading Program

    Science.gov (United States)

    van Gigch, John P.

    1974-01-01

    Author believes that the application of the Decision-Making Model to the removal of "discrepancies" allows the teachers and other school agents to proceed with changes in an orderly and rational manner. (Author)

  19. Closeness discrepancies in romantic relationships: implications for relational well-being, stability, and mental health.

    Science.gov (United States)

    Frost, David M; Forrester, Cat

    2013-04-01

    Experiences of closeness in romantic relationships are associated with heightened levels of relational well-being and mental health. However, individuals differ in the degree of closeness they desire in their relationships. This study used the construct of inclusion of other in self (IOS) to analyze discrepancies between individuals' actual and ideal levels of closeness in their relationships and the implications of these discrepancies for relational well-being and mental health. A longitudinal survey of partnered individuals demonstrated that optimal levels of relational well-being and mental health existed when individuals had minimal discrepancies between actual and ideal IOS, regardless of their actual levels of IOS. Individuals whose actual levels of IOS moved closer to their ideal levels over a 2-year period reported improved relational well-being and mental health. Individuals with little to no discrepancies between actual and ideal IOS were also less likely to break-up with their partners over time.

  20. Emotional trade-offs of becoming a parent: how social roles influence self-discrepancy effects.

    Science.gov (United States)

    Alexander, M J; Higgins, E T

    1993-12-01

    Why do some people suffer from becoming a parent, whereas others do not? New parents' actual selves were related to their own hopes for themselves (ideal self) and to their spouse's sense of their responsibilities (ought self). Prebirth actual-ideal discrepancies predicted increased sadness or dejection after birth (especially for couples in longer marriages), whereas prebirth actual-ought discrepancies predicted decreased nervousness or agitation after birth (especially for mothers and couples with a less "easy" child). Becoming a parent introduces new demands that both interfere with attaining one's own hopes (increasing dejection in parents high in ideal [own] discrepancy) and shift attention to the new parenting role (decreasing agitation in parents high in ought [spouse] discrepancy).

  1. . Interparental violence; similarities and discrepancies between narratives of mothers and their children.

    NARCIS (Netherlands)

    van Rooij, F.B.; van der Schuur, W.; Mak, J.; Steketee, M.; Pels, T.V.M.

    2015-01-01

    Previous studies and intervention programs on interparental violence have relied largely on reports either solely from parents or solely from children. Nevertheless, the literature and the theoretical background provide indications of the existence of discrepancies between the narratives of parents

  2. Interparental violence: Similarities and discrepancies between narratives of mothers and their children

    NARCIS (Netherlands)

    van Rooij, F.B.; van der Schuur, W.A.; Steketee, M.; Mak, J.; Pels, T.

    2015-01-01

    Previous studies and intervention programs on interparental violence have relied largely on reports either solely from parents or solely from children. Nevertheless, the literature and the theoretical background provide indications of the existence of discrepancies between the narratives of parents

  3. Content validity and inter-rater reliability of an instrument to characterize unintentional medication discrepancies.

    Science.gov (United States)

    Claeys, Coraline; Nève, Jean; Tulkens, Paul M; Spinewine, Anne

    2012-07-01

    Medication discrepancies are medication-related problems (MRPs) that frequently occur when patients are transferred between settings of care. Older patients are at high risk for several reasons, including high consumption of medicines, and physical and cognitive deficiencies that can impair the communication process. Most previous studies that have evaluated medication discrepancies used instruments designed for clinical practice, but a well-validated and reliable instrument for clinical research is still lacking. The aims of this study were to (i) develop an instrument to characterize medication discrepancies that fulfils quality requirements for classification of MRPs related to continuity of care and (ii) assess its content validity and inter-rater reliability. The instrument was developed based on three main inputs: (i) a literature review to collect information about the quality requirements of instruments to characterize MRPs; (ii) another literature review to identify existing instruments to characterize MRPs and, more specifically, medication discrepancies; and (iii) previous experience from a pilot study on Belgian patients discharged from surgical and medical wards. Content validity was assessed using a modified Delphi technique with 11 healthcare professionals. Content validity indexes were calculated. For inter-rater reliability, three pharmacists (one experienced and two naive) were asked to identify and categorize (type and cause of) unintentional medication discrepancies for 21 patients discharged from hospital into the community. The intra-class correlation coefficient was calculated to compare the number of discrepancies identified, and a paradox-resistant index (AC1) was used to determine the inter-rater reliability for the type and cause of the discrepancy. The instrument had 54 items classified in three sections (type of discrepancy, cause and intervention), with detailed specifications on how to use it. All evaluations relative to content

  4. Patterns and Predictors of Mother-Adolescent Discrepancies across Family Constructs.

    Science.gov (United States)

    Rote, Wendy M; Smetana, Judith G

    2016-10-01

    Parent-child discrepancies pervade the family literature; they appear in reports of relationship dynamics (e.g., conflict; Laursen et al. 1998), parent and child behaviors (e.g., monitoring; De Los Reyes et al. 2010), and individual family members' beliefs (e.g., parental legitimate authority; Smetana 2011). Discrepancies are developmentally normative (Steinberg 2001) but also may be indicators of relationship and adjustment problems for teens (Ohannessian 2012). Because of this variation, it is important to consider the extent to which parent-child discrepancies are a function of both the dyad and the family construct considered. The present study contributed to our understanding of informant discrepancies in family relationships by considering the patterning, consistency, and correlates of mother-adolescent discrepancies across three family constructs that vary in their objectivity. Using person-centered analyses, discrepancies in adolescents' and mothers' ratings of parents' right to know about teens' activities, mothers' knowledge of them, and positive mother-adolescents relationships were examined in 167 middle class, primarily European American mother-adolescent dyads (M teen age = 15.68 years, SD = .64, 53 % female). Each construct was best described by three profiles, one where adolescents' standardized ratings were consistently higher than mothers', one showing the reverse, and one revealing little disagreement. Adolescent-reported problem behavior (but not depression), behavioral and psychological control, and mothers' wellbeing significantly predicted profile membership. Most dyads maintained consistent membership in a discrepancy profile across at least two family constructs. Results contribute to understanding the different sources of discrepancies in views of the family.

  5. Informant Discrepancies in Assessing Child Dysfunction Relate to Dysfunction Within Mother-Child Interactions

    OpenAIRE

    De Los Reyes, Andres; Kazdin, Alan E.

    2006-01-01

    Examined whether mother-child discrepancies in perceived child behavior problems relate to dysfunctional interactions between mother and child and stress in the mother. Participants included 239 children (6–16 years old; 58 girls, 181 boys) referred for oppositional, aggressive, and antisocial behavior, and their mothers. Mother-child discrepancies in perceived child behavior problems were related to mother-child conflict. Moreover, maternal stress mediated this relationship. The findings sug...

  6. A mixed integer linear programming formulation for low discrepancy consecutive k-sums permutation problem

    Directory of Open Access Journals (Sweden)

    Bogdanović Milena

    2017-01-01

    Full Text Available In this paper, low discrepancy consecutive k-sums permutation problem is considered. A mixed integer linear programing (MILP formulation with a moderate number of variables and constraints is proposed. The correctness proof shows that the proposed formulation is equivalent to the basic definition of low discrepancy consecutive k-sums permutation problem. Computational results, obtained on standard CPLEX solver, give 88 new exact values, which clearly show the usefulness of the proposed MILP formulation.

  7. Parental and Peer Factors Associated with Body Image Discrepancy among Fifth-Grade Boys and Girls

    Science.gov (United States)

    Wentzel, Kathryn; Elliott, Marc N.; Dittus, Patricia J.; Kanouse, David E.; Wallander, Jan L.; Pasch, Keryn E.; Franzini, Luisa; Taylor, Wendell C.; Qureshi, Tariq; Franklin, Frank A.; Schuster, Mark A.

    2015-01-01

    Many young adolescents are dissatisfied with their body due to a discrepancy between their ideal and actual body size, which can lead to weight cycling, eating disorders, depression, and obesity. The current study examined the associations of parental and peer factors with fifth-graders’ body image discrepancy, physical self-worth as a mediator between parental and peer factors and body image discrepancy, and how these associations vary by child’s sex. Body image discrepancy was defined as the difference between young adolescents’ self-perceived body size and the size they believe a person their age should be. Data for this study came from Healthy Passages, which surveyed 5,147 fifth graders (51 % females; 34 % African American, 35 % Latino, 24 % White, and 6 % other) and their primary caregivers from the United States. Path analyses were conducted separately for boys and girls. The findings for boys suggest father nurturance and getting along with peers are related negatively to body image discrepancy; however, for girls, fear of negative evaluation by peers is related positively to body image discrepancy. For both boys and girls, getting along with peers and fear of negative evaluation by peers are related directly to physical self-worth. In addition, mother nurturance is related positively to physical self-worth for girls, and father nurturance is related positively to physical self-worth for boys. In turn, physical self-worth, for both boys and girls, is related negatively to body image discrepancy. The findings highlight the potential of parental and peer factors to reduce fifth graders’ body image discrepancy. PMID:23334988

  8. Factors Influencing Resident Choice of Prosthodontic Residency Program.

    Science.gov (United States)

    Wojnarwsky, Pandora Keala Lee; Wang, Yan; Shah, Kumar; Koka, Sreenivas

    2017-06-01

    The decision by prosthodontic residency program directors to employ the Match process highlights the need to understand applicant priorities that influence their choice of which programs to rank highly. The purpose of this study is to determine the factors that were most important to residents when choosing from among nonmilitary based prosthodontics dental residency programs in the United States. Following completion of a pilot study, all currently enrolled prosthodontic residents at nonmilitary residency programs were invited to participate via the internet. The study consisted of a survey instrument asking residents to rank 26 possible factors that might impact an applicant's choice of residency program. In addition, the instrument collected other possible influencing variables including gender and debt load. Mean rank scores were compared to determine the most and least important factors. Kruskal-Wallis test was used to compare specific factors between the possible influencing variables. Two hundred and thirty residents completed the survey instrument, representing a 54.1% response rate of possible participants. With regard to factors influencing program choice, reputation of the residency program was the factor ranked the highest by participants, followed in descending order by the program director's personality, curriculum content, access to use of the latest digital technology, and opportunities for dental implant placement. Quality of schools for children, community outreach opportunities, and the ability to moonlight were ranked as the least important factors. Male and female residents ranked factors such as tuition/stipend, curriculum content, and community outreach opportunities significantly differently. Depending on debt load, residents ranked the factors tuition/stipend, ability to moonlight, curriculum content, and safety of the area where the program is differently. Current prosthodontic residents valued the reputation of the program as the most

  9. Surgical resident working hours in South Africa | Kong | South ...

    African Journals Online (AJOL)

    Background: Surgical training has undergone major changes worldwide, especially with regard to work hour regulations. Very little is known regarding the situation in South Africa, and how it compares with other countries. Method: We conducted a retrospective review of the hours worked by surgical residents in a major ...

  10. Physics-informed machine learning approach for reconstructing Reynolds stress modeling discrepancies based on DNS data

    Science.gov (United States)

    Wang, Jian-Xun; Wu, Jin-Long; Xiao, Heng

    2017-03-01

    Turbulence modeling is a critical component in numerical simulations of industrial flows based on Reynolds-averaged Navier-Stokes (RANS) equations. However, after decades of efforts in the turbulence modeling community, universally applicable RANS models with predictive capabilities are still lacking. Large discrepancies in the RANS-modeled Reynolds stresses are the main source that limits the predictive accuracy of RANS models. Identifying these discrepancies is of significance to possibly improve the RANS modeling. In this work, we propose a data-driven, physics-informed machine learning approach for reconstructing discrepancies in RANS modeled Reynolds stresses. The discrepancies are formulated as functions of the mean flow features. By using a modern machine learning technique based on random forests, the discrepancy functions are trained by existing direct numerical simulation (DNS) databases and then used to predict Reynolds stress discrepancies in different flows where data are not available. The proposed method is evaluated by two classes of flows: (1) fully developed turbulent flows in a square duct at various Reynolds numbers and (2) flows with massive separations. In separated flows, two training flow scenarios of increasing difficulties are considered: (1) the flow in the same periodic hills geometry yet at a lower Reynolds number and (2) the flow in a different hill geometry with a similar recirculation zone. Excellent predictive performances were observed in both scenarios, demonstrating the merits of the proposed method.

  11. Parent-Adolescent Discrepancies in Perceived Parenting Characteristics and Adolescent Developmental Outcomes in Poor Chinese Families.

    Science.gov (United States)

    Leung, Janet T Y; Shek, Daniel T L

    2014-01-01

    We examined the relationships between parent-adolescent discrepancies in perceived parenting characteristics (indexed by parental responsiveness, parental demandingness, and parental control) and adolescent developmental outcomes (indexed by achievement motivation and psychological competence) in poor families in Hong Kong. A sample of 275 intact families having at least one child aged 11-16 experiencing economic disadvantage were invited to participate in the study. Fathers and mothers completed the Parenting Style Scale and Chinese Parental Control Scale, and adolescents completed the Social-Oriented Achievement Motivation Scale and Chinese Positive Youth Development Scale in addition to paternal and maternal Parenting Style Scale and Chinese Parental Control Scale. Results indicated that parents and adolescents had different perceptions of parental responsiveness, parental demandingness, and paternal control, with adolescents generally perceived lower levels of parenting behaviors than did their parents. While father-adolescent discrepancy in perceived paternal responsiveness and mother-adolescent discrepancy in perceived maternal control negatively predicted adolescent achievement motivation, mother-adolescent discrepancy in perceptions of maternal responsiveness negatively predicted psychological competence in adolescents experiencing economic disadvantage. The present findings provided support that parent-child discrepancies in perceived parenting characteristics have negative impacts on the developmental outcomes of adolescents experiencing economic disadvantage. The present study addresses parent-child discrepancies in perceived parental behaviors as "legitimate" constructs, and explores their links with adolescent psychosocial development, which sheds light for researchers and clinical practitioners in helping the Chinese families experiencing economic disadvantage.

  12. The Discrepancy between Einstein Mass and Dynamical Mass for SIS and Power-law Mass Models

    Science.gov (United States)

    Li, Rui; Wang, Jiancheng; Shu, Yiping; Xu, Zhaoyi

    2018-03-01

    We investigate the discrepancy between the two-dimensional projected lensing mass and the dynamical mass for an ensemble of 97 strong gravitational lensing systems discovered by the Sloan Lens ACS Survey, the BOSS Emission-Line Lens Survey (BELLS), and the BELLS for GALaxy-Lyα EmitteR sYstems Survey. We fit the lensing data to obtain the Einstein mass and use the velocity dispersion of the lensing galaxies provided by the Sloan Digital Sky Survey to get the projected dynamical mass within the Einstein radius by assuming the power-law mass approximation. The discrepancy is found to be obvious and quantified by Bayesian analysis. For the singular isothermal sphere mass model, we obtain that the Einstein mass is 20.7% more than the dynamical mass, and the discrepancy increases with the redshift of the lensing galaxies. For the more general power-law mass model, the discrepancy still exists within a 1σ credible region. We suspect the main reason for this discrepancy is mass contamination, including all invisible masses along the line of sight. In addition, the measurement errors and the approximation of the mass models could also contribute to the discrepancy.

  13. Friendship, real-ideal discrepancies, and well-being: gender differences in college students.

    Science.gov (United States)

    Demir, Melikşah; Orthel, Haley

    2011-01-01

    Do men and women have different ideals for their friendships? What do men and women experience when their actual friendship experiences fall short of their ideals? The authors of the current study investigated gender differences in real-ideal same-sex best friendships and friendship discrepancy scores. Correlates of friendship discrepancies were also examined. For this purpose, a sample of 382 college students completed the McGill Friendship Questionnaire (M. J. Mendelson & F. E. Aboud, 1999), the Friendship Conflict Scale (M. Demir & L. A. Weitekamp, 2007), the Need Satisfaction Scale (J. G. La Guardia, R. M. Ryan, C. E. Couchman, & E. L. Deci, 2000), and the PANAS (D. Watson, L. A. Clark, & A. Tellegen, 1988). Results showed that (a) the real and ideal best friendships of women were higher in quality and lower in conflict when compared to those of men; and (b) men's discrepancy scores for friendship quality were significantly higher when compared to women, whereas no differences were obtained on friendship conflict discrepancy scores. Findings also revealed that for both women and men, discrepancy scores were negatively related to friendship satisfaction, happiness, and satisfaction of basic psychological needs. The authors discuss the findings in light of theory, highlight ways to address relationship discrepancies, and make suggestions for future research.

  14. Body Image Self-Discrepancy and Depressive Symptoms Among Early Adolescents.

    Science.gov (United States)

    Solomon-Krakus, Shauna; Sabiston, Catherine M; Brunet, Jennifer; Castonguay, Andree L; Maximova, Katerina; Henderson, Mélanie

    2017-01-01

    This study examined whether body image self-discrepancy was a correlate of depressive symptoms among 556 early adolescents (45% girls; M age  = 11.65, SD = .94 years). Participants completed self-report measures of their self-perceived actual and ideal body shapes and depressive symptoms. Sex-stratified polynomial regressions were used to examine the associations between depressive symptoms and (1) agreement (i.e., similar actual and ideal body shapes); (2) discrepancy (i.e., different actual and ideal body shapes); (3) direction of discrepancy (i.e., actual > ideal or actual self-perceptions are). For both sexes, depressive symptoms were more frequent when the direction of the discrepancy was such that participants perceived their actual body was larger than their ideal body. Furthermore, depressive symptoms were more frequent when the degree of the discrepancy between actual and ideal body shape perceptions was larger. Based on these findings, body image self-discrepancy may be a risk factor for depressive symptoms among early adolescents. Copyright © 2016 Society for Adolescent Health and Medicine. Published by Elsevier Inc. All rights reserved.

  15. A four-phase approach for systematically collecting data and measuring medication discrepancies when patients transition between health care settings

    Science.gov (United States)

    Kennelty, Korey A.; Witry, Matthew J.; Gehring, Michael; Dattalo, Melissa; Rogus-Pulia, Nicole

    2016-01-01

    Background No methodological standards are available for researchers and clinicians to examine medication discrepancies between health care settings. Systematic methods of examining medication discrepancies will allow researchers and clinicians to better understand factors driving medication discrepancies, to better measure effects of medication reconciliation interventions, and to compare findings across studies. Objective This article proposes a four-phase approach for systematically collecting medication data and measuring medication discrepancies between a hospital and community pharmacies. Methodologic considerations related to studying medication discrepancies in health services research are also discussed. Methods A multi-disciplinary study team developed a four-phase systematic approach to improve quality of data and study rigor: 1) operationalization of a medication discrepancy, 2) acquiring medication data, 3) abstraction of medication data and creation of dataset, and 4) measuring and reporting medication discrepancies. Results Using this phase-based approach, the study team successfully identified and reported medication discrepancies between a hospital and community pharmacies at the patient, medication, and community pharmacy units of analyses. Conclusions Systematically measuring medication discrepancies that occur in the care transitions process is a critical step as researchers, clinicians, and other stakeholders work to improve health care quality and patient outcomes. This article detailed how a phase-based approach can be used in research to examine medication discrepancies as well as address the complexity of collecting medication data and analyzing medication discrepancies. Such methods should be considered when developing, conducting, and reporting research on medication discrepancies. PMID:26781670

  16. Pathology Informatics Essentials for Residents

    Science.gov (United States)

    Karcher, Donald S.; Harrison, James H.; Sinard, John H.; Riben, Michael W.; Boyer, Philip J.; Plath, Sue; Thompson, Arlene; Pantanowitz, Liron

    2016-01-01

    Context: Recognition of the importance of informatics to the practice of pathology has surged. Training residents in pathology informatics has been a daunting task for most residency programs in the United States because faculty often lacks experience and training resources. Nevertheless, developing resident competence in informatics is essential for the future of pathology as a specialty. Objective: To develop and deliver a pathology informatics curriculum and instructional framework that guides pathology residency programs in training residents in critical pathology informatics knowledge and skills, and meets Accreditation Council for Graduate Medical Education Informatics Milestones. Design: The College of American Pathologists, Association of Pathology Chairs, and Association for Pathology Informatics formed a partnership and expert work group to identify critical pathology informatics training outcomes and to create a highly adaptable curriculum and instructional approach, supported by a multiyear change management strategy. Results: Pathology Informatics Essentials for Residents (PIER) is a rigorous approach for educating all pathology residents in important pathology informatics knowledge and skills. PIER includes an instructional resource guide and toolkit for incorporating informatics training into residency programs that vary in needs, size, settings, and resources. PIER is available at http://www.apcprods.org/PIER (accessed April 6, 2016). Conclusions: PIER is an important contribution to informatics training in pathology residency programs. PIER introduces pathology trainees to broadly useful informatics concepts and tools that are relevant to practice. PIER provides residency program directors with a means to implement a standardized informatics training curriculum, to adapt the approach to local program needs, and to evaluate resident performance and progress over time. PMID:28725772

  17. Pathology Informatics Essentials for Residents

    Directory of Open Access Journals (Sweden)

    Walter H. Henricks MD

    2016-07-01

    Full Text Available Context: Recognition of the importance of informatics to the practice of pathology has surged. Training residents in pathology informatics has been a daunting task for most residency programs in the United States because faculty often lacks experience and training resources. Nevertheless, developing resident competence in informatics is essential for the future of pathology as a specialty. Objective: To develop and deliver a pathology informatics curriculum and instructional framework that guides pathology residency programs in training residents in critical pathology informatics knowledge and skills, and meets Accreditation Council for Graduate Medical Education Informatics Milestones. Design: The College of American Pathologists, Association of Pathology Chairs, and Association for Pathology Informatics formed a partnership and expert work group to identify critical pathology informatics training outcomes and to create a highly adaptable curriculum and instructional approach, supported by a multiyear change management strategy. Results: Pathology Informatics Essentials for Residents (PIER is a rigorous approach for educating all pathology residents in important pathology informatics knowledge and skills. PIER includes an instructional resource guide and toolkit for incorporating informatics training into residency programs that vary in needs, size, settings, and resources. PIER is available at http://www.apcprods.org/PIER (accessed April 6, 2016. Conclusions: PIER is an important contribution to informatics training in pathology residency programs. PIER introduces pathology trainees to broadly useful informatics concepts and tools that are relevant to practice. PIER provides residency program directors with a means to implement a standardized informatics training curriculum, to adapt the approach to local program needs, and to evaluate resident performance and progress over time.

  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. PMID:23901305

  19. Saccharomyces cerevisiae and metabolic activators: HXT3 gene expression and fructose/glucose discrepancy in sluggish fermentation conditions.

    Science.gov (United States)

    Díaz-Hellín, Patricia; Naranjo, Victoria; Úbeda, Juan; Briones, Ana

    2016-12-01

    When exposed to mixtures of glucose and fructose, as occurs during the fermentation of grape juice into wine, Saccharomyces cerevisiae uses these sugars at different rates. Moreover, glucose and fructose are transported by the same hexose transporters (HXT), which present a greater affinity for glucose, so that late in fermentation, fructose becomes the predominant sugar. Only a few commercial fermentation activators are available to optimally solve the problems this entails. The aim of this study was to investigate the relation between HXT3 gene expression and fructose/glucose discrepancy in two different media inoculated with a commercial wine strain of S. cerevisiae in the presence of three metabolic activators. Fermentation kinetics, vitality and major metabolites were also measured. Rehydration with ergosterol improved the area under the curve and the growth rate (µ max ) in both studied media. Also, the fructose/glucose discrepancy values were improved with all activator treatments, highlighting rehydration in the presence of ascorbic acid. The yeast rehydration process was demonstrated to influence HXT3 expression under the studied conditions. Tetrahydrofolic acid treatment greatly influenced HXT3 gene expression, especially on the 12th day of the fermentation process. To a lesser extent, ergosterol and ascorbic acid also improved this parameter.

  20. Discrepancies between academic achievement and intellectual ability in higher-functioning school-aged children with autism spectrum disorder.

    Science.gov (United States)

    Estes, Annette; Rivera, Vanessa; Bryan, Matthew; Cali, Philip; Dawson, Geraldine

    2011-08-01

    Academic achievement patterns and their relationships with intellectual ability, social abilities, and problem behavior are described in a sample of 30 higher-functioning, 9-year-old children with autism spectrum disorder (ASD). Both social abilities and problem behavior have been found to be predictive of academic achievement in typically developing children but this has not been well studied in children with ASD. Participants were tested for academic achievement and intellectual ability at age 9. Problem behaviors were assessed through parent report and social functioning through teacher report at age 6 and 9. Significant discrepancies between children's actual academic achievement and their expected achievement based on their intellectual ability were found in 27 of 30 (90%) children. Both lower than expected and higher than expected achievement was observed. Children with improved social skills at age 6 demonstrated higher levels of academic achievement, specifically word reading, at age 9. No relationship was found between children's level of problem behavior and level of academic achievement. These results suggest that the large majority of higher-functioning children with ASD show discrepancies between actual achievement levels and levels predicted by their intellectual ability. In some cases, children are achieving higher than expected, whereas in others, they are achieving lower than expected. Improved social abilities may contribute to academic achievement. Future studies should further explore factors that can promote strong academic achievement, including studies that examine whether intervention to improve social functioning can support academic achievement in children with ASD.

  1. Types of tourism and residents' attitudes: the case of Ibiza

    OpenAIRE

    José Ramón Cardona

    2014-01-01

    The types and forms of tourism and, above all, perception and attitude of tourists influence how evolving attitudes of residents. But the vast majority of studies of residents' attitudes discussed the tourism sector as a whole, with few cases that focus on a particular type of supply. The aim of this paper is to analyze whether tourism products with worse or better rating. The main difference between the two surveys used is that effects of the economic crisis are expected in 2011. Residents c...

  2. 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

  3. 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 ...

  4. Diagnosing potential discrepancies in satellite rainfall estimates over Ethiopia

    Science.gov (United States)

    Young, Matthew; Williams, Charles; Chiu, Christine; Maidment, Ross; Chen, Shu-Hua

    2015-04-01

    Reliable satellite precipitation estimates are vital over many regions of Africa because of the importance of rainfall monitoring for rain-fed agriculture and water resources. In particular, regions with mountainous terrain pose a major challenge for satellite-based rainfall algorithms because retrievals based upon thermal infrared and microwave observations tend to miss orographic precipitation, often associated with warm temperatures and a weak scattering signal. To investigate the skill of satellite rainfall retrievals over mountainous terrain, we evaluate several satellite-based rainfall algorithms against rain gauge measurements over the mountainous Oromia region in Ethiopia. In particular, we assess the skill of rainfall retrieved from algorithms that only use thermal infrared observations and algorithms that combine both thermal infrared and microwave observations. We also investigate the dependency of retrievals on topography by classifying the relationship between the retrieval errors and elevation. Furthermore, we conduct high resolution simulations using the Weather Research and Forecasting model (WRF) during days with significant retrieval errors to determine how the errors relate to the characteristics of precipitation. A qualitative assessment of the vertical atmospheric structure and microphysical content of simulations reveals the potential sources of underestimation and overestimation in the rainfall algorithms. This study will highlight the importance of understanding regional precipitation systems causing uncertainties in satellite rainfall estimates, with a view toward using this knowledge to improve rainfall algorithms.

  5. 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.

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

    Science.gov (United States)

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

    2014-01-01

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

  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. Ten-year trends in family medicine residency productivity and staffing: impact of electronic health records, resident duty hours, and the medical home.

    Science.gov (United States)

    Lesko, Sarah; Hughes, Lauren; Fitch, Wes; Pauwels, Judith

    2012-02-01

    Electronic health records (EHRs), resident duty hour restrictions, and Patient-centered Medical Home (PCMH) innovations have all impacted the clinical practices of residency programs over the past decade. The University of Washington Family Medicine Network (UWFMN) residencies have collaborated for 10 years in collecting and comparing data regarding the productivity and operations of their training programs to identify the program-level effects of such changes. Based on five survey results from 2000 to 2010, this study examines changes in faculty and resident productivity and staffing models of UWFMN residency training clinics using a standardized methodology, specifically describing the productivity impact of EHR changes and duty hour restrictions and the implementation of the PCMH by residencies. Data were systematically collected via standardized questionnaire, evaluated for quality, clarified, and then analyzed. Resident productivity decreased over the 10-year interval, with resident total yearly patient visits down 17.2%. Core family medicine faculty productivity was highly variable among programs, and nonphysician provider visits increased. Faculty part-time status increased. Front office, medical assistant, and nursing staffing grew significantly, but other administrative staff decreased, resulting in minimal change in total non-provider staffing. A majority of programs engaged in PCMH initiatives in 2010 and had implemented an EHR. Physician productivity in UWFMN residency programs decreased for all resident physicians from 2000 to 2010, likely due to a combination of decreased resident duty hours and other clinical practice changes. Productivity trends have implications for the structure and training requirements for family medicine residency programs.

  9. Medication discrepancies at transitions in pediatrics: a review of the literature.

    Science.gov (United States)

    Huynh, Chi; Wong, Ian C K; Tomlin, Stephen; Terry, David; Sinclair, Anthony; Wilson, Keith; Jani, Yogini

    2013-06-01

    Medication reconciliation is an important process in reducing medication errors in many countries. Canada, the USA, and UK have incorporated medication reconciliation as a priority area for national patient safety initiatives and goals. The UK national guidance excludes the pediatric population. The aim of this review was to explore the occurrence of medication discrepancies in the pediatric population. The primary objective was to identify studies reporting the rate and clinical significance of the discrepancies and the secondary objective was to ascertain whether any specific interventions have been used for medication reconciliation in pediatric settings. The following electronic bibliographic databases were used to identify studies: PubMed, OVID EMBASE (1980 to 2012 week 1), ISI Web of Science, ISI Biosis, Cumulative Index to Nursing and Allied Health Literature, and OVID International Pharmaceutical Abstracts (1970 to January 2012). Primary studies were identified that observed medication discrepancies in children under 18 years of age upon hospital admission, transfer and discharge, or had reported medication reconciliation interventions. Two independent reviewers screened titles and abstracts for relevant articles and extracted data using pre-defined data fields, including risk of bias assessment. Ten studies were identified with variances in reportage of stage and rate of discrepancies. Studies were heterogeneous in definitions, methods, and patient populations. Most studies related to admissions and reported consistently high rates of discrepancies ranging from 22 to 72.3 % of patients (sample size ranging from 23 to 272). Seven of the studies were low-quality observational studies and three studies were 'grey literature' non-peer reviewed conference abstracts. Studies involving small numbers of patients have shown that medication discrepancies occur at all transitions of care in children. Further research is required to investigate and demonstrate how

  10. Work-family conflict and self-discrepant time allocation at work.

    Science.gov (United States)

    Dahm, Patricia C; Glomb, Theresa M; Manchester, Colleen Flaherty; Leroy, Sophie

    2015-05-01

    We examine the relationships between work-to-family conflict, time allocation across work activities, and the outcomes of work satisfaction, well-being, and salary in the context of self-regulation and self-discrepancy theories. We posit work-to-family conflict is associated with self-discrepant time allocation such that employees with higher levels of work-to-family conflict are likely to allocate less time than preferred to work activities that require greater self-regulatory resources (e.g., tasks that are complex, or those with longer term goals that delay rewards and closure) and allocate more time than preferred to activities that demand fewer self-regulatory resources or are replenishing (e.g., those that provide closure or are prosocial). We suggest this self-discrepant time allocation (actual vs. preferred time allocation) is one mechanism by which work-to-family conflict leads to negative employee consequences (Allen, Herst, Bruck, & Sutton, 2000; Mesmer-Magnus & Viswesvaran, 2005). Using polynomial regression and response surface methodology, we find that discrepancies between actual and preferred time allocations to work activities negatively relate to work satisfaction, psychological well-being, and physical well-being. Self-discrepant time allocation mediates the relationship between work-to-family conflict and work satisfaction and well-being, while actual time allocation (rather than the discrepancy) mediates the relationship between work-to-family conflict and salary. We find that women are more likely than men to report self-discrepant time allocations as work-to-family conflict increases. (c) 2015 APA, all rights reserved.

  11. The Impact of the 80-Hour Resident Workweek on Surgical Residents and Attending Surgeons

    Science.gov (United States)

    Hutter, Matthew M.; Kellogg, Katherine C.; Ferguson, Charles M.; Abbott, William M.; Warshaw, Andrew L.

    2006-01-01

    Objective: To assess the impact of the 80-hour resident workweek restrictions on surgical residents and attending surgeons. Summary Background Data: The ACGME mandated resident duty hour restrictions have required a major workforce restructuring. The impact of these changes needs to be critically evaluated for both the resident and attending surgeons, specifically with regards to the impact on motivation, job satisfaction, the quality of surgeon training, the quality of the surgeon's life, and the quality of patient care. Methods: Four prospective studies were performed at a single academic surgical program with data collected both before the necessary workforce restructuring and 1 year after, including: 1) time cards to assess changes in components of daily activity; 2) Web-based surveys using validated instruments to assess burnout and motivation to work; 3) structured, taped, one-on-one interviews with an external PhD investigator; and 4) statistical analyses of objective, quantitative data. Results: After the work-hour changes, surgical residents have decreased “burnout” scores, with significantly less “emotional exhaustion” (Maslach Burnout Inventory: 29.1 “high” vs. 23.1 “medium,” P = 0.02). Residents have better quality of life both in and out of the hospital. They felt they got more sleep, have a lighter workload, and have increased motivation to work (Herzberg Motivation Dimensions). We found no measurable, statistically significant difference in the quality of patient care (NSQIP data). Resident training and education objectively were not statistically diminished (ACGME case logs, ABSITE scores). Attending surgeons perceived that their quality of their life inside and outside of the hospital was “somewhat worse” because of the work-hour changes, as they had anticipated. Many concerns were identified with regards to the professional development of future surgeons, including a change toward a shift-worker mentality that is not patient

  12. Increased delta power and discrepancies in objective and subjective sleep measurements in borderline personality disorder.

    Science.gov (United States)

    Philipsen, Alexandra; Feige, Bernd; Al-Shajlawi, Anam; Schmahl, Christian; Bohus, Martin; Richter, Harald; Voderholzer, Ulrich; Lieb, Klaus; Riemann, Dieter

    2005-09-01

    Previous studies have shown depression-like sleep abnormalities in borderline personality disorder (BPD). However, findings in BPD are not unequivocal for REM dysregulation, as well as for a decrement of slow wave sleep and sleep continuity disturbances. Earlier findings in sleep EEG abnormalities in BPD may have been confounded by concomitant depressive symptoms. Twenty unmedicated female BPD patients without current comorbid major depression and 20 sex- and age-matched control subjects entered the study. Conventional polysomnographic parameters and for the first time sleep EEG spectral power analysis was performed on two sleep laboratory nights. Subjective sleep parameters were collected by sleep questionnaires in order to assess the relationship between objective and subjective sleep measurements. BPD patients showed a tendency for shortened REM latency and significantly decreased NonREM sleep (stage 2). Spectral EEG analysis showed increased delta power in total NREM sleep as well as in REM sleep in BPD patients. Subjective ratings documented drastically impaired sleep quality in BPD patients for the two weeks before the study and during the two laboratory nights. Not-depressed BPD patients only showed tendencies for depression-like REM sleep abnormalities. Surprisingly, BPD patients displayed higher levels of delta power in the sleep EEG in NREM sleep than healthy control subjects. There was a marked discrepancy between objective and subjective sleep measurements, which indicates an altered perception of sleep in BPD. The underlying psychological and neurobiological mechanisms of these alterations are still unclear and need to be clarified in future studies including interventions on a pharmacological and cognitive-behavioral level.

  13. Side-to-side growth discrepancies in children with hemiplegic cerebral palsy: association with function, activity and social participation

    Directory of Open Access Journals (Sweden)

    Marise Bueno Zonta

    2014-05-01

    Full Text Available Objective: Evaluate side-to-side discrepancies in children with hemiplegic cerebral palsy (HCP, and investigate associations of these discrepancies with patients’ age at initiation of physical therapy, motor and cognitive function, and degree of activities and social participation. Method: We obtained eight side-to-side measurements from 24 HCP children with mean age 49.3±5.2 months. Results: Early initiation of physical therapy was associated with lower discrepancy in hand length (p=0.037. Lower foot length discrepancy was associated with lower requirement for caregiver assistance in activities related to mobility. Increased side-to-side discrepancy was associated with reduced wrist extension and increased spasticity. Discrepancy played a larger role in children with hemineglect and in those with right involvement. Conclusion: Increased discrepancy in HCP children was associated with reduced degree of activity/social participation. These results suggest an association between functional use of the extremities and limb growth.

  14. 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.

  15. Needs assessment of Wisconsin primary care residents and faculty regarding interest in global health training

    Directory of Open Access Journals (Sweden)

    Sanders James

    2009-06-01

    Full Text Available Abstract Background The primary objectives of this study were to assess Wisconsin's primary care residents' attitudes toward international health training, the interest among faculty to provide IH training, and the preferred modality of IH training. Methods Surveys were administered using 505 residents and 413 medical faculty in primary care residencies in Wisconsin. Results from 128 residents and 118 medical school faculty members were collected during the spring of 2007 and analyzed. Results In total, 25% of residents (128/505 and 28% of faculty (118/413 responded to the survey. A majority of residents (58% and faculty (63% were interested in global health issues. Among residents, 63% planned on spending professional time working abroad. Few residents (9% and faculty (11% assess their residencies as preparing residents well to address topics relating to international health. The survey indicates that adequate faculty in Wisconsin could provide mentorship in international health as 47% (55 of faculty had experience working as a physician internationally, 49% (58 of faculty spend more than 25% clinical time caring for patient from underserved communities and 39% (46 would be willing to be involved with developing curriculum, lecturing and/or mentoring residents in international health. Conclusion Overall, the majority of the respondents expressed high interest in IH and few felt prepared to address IH issues indicating a need for increased training in this area. The findings of this survey are likely relevant as a prototype for other primary care residencies.

  16. Smoking cessation counseling by surgical and nonsurgical residents: opportunities for health promotion education.

    Science.gov (United States)

    Turner, Simon R; Lai, Hollis; Bédard, Eric L R

    2014-01-01

    Cigarette smoking is the leading cause of preventable death in North America and a major contributor to surgically treated diseases and operative complications. Counseling by residents can be an effective means of helping patients to quit smoking, and with the introduction of the Accreditation Council for Graduate Medical Education and CanMEDS competency frameworks, health promotion is a required component of residency training. However, past studies have found that smoking cessation counseling by residents, and in particular surgical residents, is lacking. In light of the introduction of health promotion as a core competency in residency training, this study was designed to examine the attitudes and practices of residents at our institution regarding smoking cessation counseling, comparing surgical and nonsurgical residents and seeking to identify barriers to resident counseling. An internet-based questionnaire was distributed to all residents at the University of Alberta in the fall of 2012. Items examined residents׳ attitudes and practices related to smoking cessation counseling and barriers to counseling. Although almost all residents believed that smoking cessation was important and that counseling was part of their job as a resident, far fewer routinely practiced the counseling behaviors examined. Surgical residents were less likely to perform counseling and more likely to think that counseling was not part of their job. Surgical residents were also more likely to identify obstacles to counseling such as a lack of time and formal training. Residents, and surgical residents in particular, are missing opportunities to help their patients quit smoking and improve their health. Given their positive attitudes toward counseling, it may be possible to improve their counseling practices through simple means. By identifying obstacles to counseling and tools that may increase residents׳ tendency to perform counseling, this study can help to guide training programs

  17. Discrepancies in autobiographical memories— implications for the assessment of asylum seekers: repeated interviews study

    Science.gov (United States)

    Herlihy, Jane; Scragg, Peter; Turner, Stuart

    2002-01-01

    Objective To investigate the consistency of autobiographical memory of people seeking asylum, in light of the assumption that discrepancies in asylum seekers' accounts of persecution mean that they are fabricating their stories. Design Repeated interviews. Setting England, 1999 and 2000. Participants Community sample of 27 Kosovan and 12 Bosnian refugees. Main outcome measures Discrepancies in repeated descriptions of one traumatic and one non-traumatic event, including specific details, rated as central or peripheral to the event. Self report measures of post-traumatic stress disorder and depression. Results Discrepancies between an individual's accounts were common. For participants with high levels of post-traumatic stress, the number of discrepancies increased with length of time between interviews. More discrepancies occurred in details peripheral to the account than in details that were central to the account. Conclusion The assumption that inconsistency of recall means that accounts have poor credibility is questionable. Discrepancies are likely to occur in repeated interviews. For refugees showing symptoms of high levels of post-traumatic stress, the length of the application process may also affect the number of discrepancies. Recall of details rated by the interviewee as peripheral to the account is more likely to be inconsistent than recall of details that are central to the account. Thus, such inconsistencies should not be relied on as indicating a lack of credibility. What is already known on this topicDiscrepancies between accounts of an event are often used to judge the credibility of asylum seekersWhat this study addsDiscrepancies arise between two accounts of the same event even when there is no reason for fabricationRefugees with high levels of post-traumatic stress are more likely to give inconsistent accounts if they have a long time to wait between interviewsInterviewees are more likely to be inconsistent in details that they rate as peripheral

  18. Thrombus length discrepancy on dual-phase CT can predict clinical outcome in acute ischemic stroke

    International Nuclear Information System (INIS)

    Park, Mina; Kim, Kyung-eun; Lee, Seung-Koo; Shin, Na-Young; Lim, Soo Mee; Song, Dongbeom; Heo, Ji Hoe; Kim, Jin Woo; Oh, Se Won

    2016-01-01

    The thrombus length may be overestimated on early arterial computed tomography angiography (CTA) depending on the collateral status. We evaluated the value of a grading system based on the thrombus length discrepancy on dual-phase CT in outcome prediction. Forty-eight acute ischemic stroke patients with M1 occlusion were included. Dual-phase CT protocol encompassed non-contrast enhanced CT, CTA with a bolus tracking technique, and delayed contrast enhanced CT (CECT) performed 40s after contrast injection. The thrombus length discrepancy between CTA and CECT was graded by using a three-point scale: G0 = no difference; G1 = no difference in thrombus length, but in attenuation distal to thrombus; G2 = difference in thrombus length. Univariate and multivariate analyses were performed to define independent predictors of poor clinical outcome at 3 months. The thrombus discrepancy grade showed significant linear relationships with both the collateral status (P = 0.008) and the presence of antegrade flow on DSA (P = 0.010) with good interobserver agreement (κ = 0.868). In a multivariate model, the presence of thrombus length discrepancy (G2) was an independent predictor of poor clinical outcome [odds ratio = 11.474 (1.350-97.547); P =0.025]. The presence of thrombus length discrepancy on dual-phase CT may be a useful predictor of unfavourable clinical outcome in acute M1 occlusion patients. (orig.)

  19. Parent-Adolescent Discrepancies Regarding Adolescents' Peer-Related Loneliness: Associations with Adolescent Adjustment.

    Science.gov (United States)

    Spithoven, Annette W M; Vanhalst, Janne; Lodder, Gerine; Bijttebier, Patricia; Goossens, Luc

    2017-05-01

    Because loneliness is a subjective experience, it is often examined using self-reports. Yet, researchers have started to use other-reports to examine loneliness. As previous research suggests that discrepancies between self- and other views might have important implications for adolescents' mental health, the current study examines discrepancies in multi-informant reports on adolescents' loneliness in relation with prosocial behavior, aggression, and adolescents' parent-related loneliness. The sample consisted of 374 mother-adolescent dyads and 318 father-adolescent dyads (41.80% male, M age  = 15.67 years, SD = 1.25). Results indicated that informants used different reference points to assess adolescents' peer-related loneliness, but were otherwise comparable. Moreover, informant discrepancies were associated with greater adolescents' reported parent-related loneliness. The current study did not provide evidence that discrepancies were related to prosocial or aggressive behavior. The current study adds to the notion that other-reports on loneliness show substantial convergence with self-reports. In addition, this study indicates that the discrepancy between other- and self-reports on loneliness holds valuable information for adolescent socio-emotional adjustment.

  20. Masculine discrepancy stress, teen dating violence, and sexual violence perpetration among adolescent boys.

    Science.gov (United States)

    Reidy, Dennis E; Smith-Darden, Joanne P; Cortina, Kai S; Kernsmith, Roger M; Kernsmith, Poco D

    2015-06-01

    Addressing gender norms is integral to understanding and ultimately preventing violence in both adolescent and adult intimate relationships. Males are affected by gender role expectations which require them to demonstrate attributes of strength, toughness, and dominance. Discrepancy stress is a form of gender role stress that occurs when boys and men fail to live up to the traditional gender norms set by society. Failure to live up to these gender role expectations may precipitate this experience of psychological distress in some males which, in turn, may increase the risk to engage in physically and sexually violent behaviors as a means of demonstrating masculinity. Five-hundred eighty-nine adolescent males from schools in Wayne County, Michigan completed a survey assessing self-perceptions of gender role discrepancy, the experience of discrepancy stress, and history of physical and sexual dating violence. Logistic regression analyses indicated boys who endorsed gender role discrepancy and associated discrepancy stress were generally at greater risk to engage in acts of sexual violence but not necessarily physical violence. Boys who experience stress about being perceived as "sub-masculine" may be more likely to engage in sexual violence as a means of demonstrating their masculinity to self and/or others and thwarting potential "threats" to their masculinity by dating partners. Efforts to prevent sexual violence perpetration among male adolescents should perhaps consider the influence of gender socialization in this population and include efforts to reduce distress about masculine socialization in primary prevention strategies. Published by Elsevier Inc.

  1. Procedure for statistical analysis of one-parameter discrepant experimental data

    International Nuclear Information System (INIS)

    Badikov, Sergey A.; Chechev, Valery P.

    2012-01-01

    A new, Mandel–Paule-type procedure for statistical processing of one-parameter discrepant experimental data is described. The procedure enables one to estimate a contribution of unrecognized experimental errors into the total experimental uncertainty as well as to include it in analysis. A definition of discrepant experimental data for an arbitrary number of measurements is introduced as an accompanying result. In the case of negligible unrecognized experimental errors, the procedure simply reduces to the calculation of the weighted average and its internal uncertainty. The procedure was applied to the statistical analysis of half-life experimental data; Mean half-lives for 20 actinides were calculated and results were compared to the ENSDF and DDEP evaluations. On the whole, the calculated half-lives are consistent with the ENSDF and DDEP evaluations. However, the uncertainties calculated in this work essentially exceed the ENSDF and DDEP evaluations for discrepant experimental data. This effect can be explained by adequately taking into account unrecognized experimental errors. - Highlights: ► A new statistical procedure for processing one-parametric discrepant experimental data has been presented. ► Procedure estimates a contribution of unrecognized errors in the total experimental uncertainty. ► Procedure was applied for processing half-life discrepant experimental data. ► Results of the calculations are compared to the ENSDF and DDEP evaluations.

  2. The discrepancy between implicit and explicit attitudes in predicting disinhibited eating.

    Science.gov (United States)

    Goldstein, Stephanie P; Forman, Evan M; Meiran, Nachshon; Herbert, James D; Juarascio, Adrienne S; Butryn, Meghan L

    2014-01-01

    Disinhibited eating (i.e., the tendency to overeat, despite intentions not to do so, in the presence of palatable foods or other cues such as emotional stress) is strongly linked with obesity and appears to be associated with both implicit (automatic) and explicit (deliberative) food attitudes. Prior research suggests that a large discrepancy between implicit and explicit food attitudes may contribute to greater levels of disinhibited eating; however this theory has not been directly tested. The current study examined whether the discrepancy between implicit and explicit attitudes towards chocolate could predict both lab-based and self-reported disinhibited eating of chocolate. Results revealed that, whereas neither implicit nor explicit attitudes alone predicted disinhibited eating, absolute attitude discrepancy positively predicted chocolate consumption. Impulsivity moderated this effect, such that discrepancy was less predictive of disinhibited eating for those who exhibited lower levels of impulsivity. The results align with the meta-cognitive model to indicate that attitude discrepancy may be involved in overeating. © 2013.

  3. Masculine discrepancy stress, substance use, assault and injury in a survey of US men.

    Science.gov (United States)

    Reidy, Dennis E; Berke, Danielle S; Gentile, Brittany; Zeichner, Amos

    2016-10-01

    To understand and ultimately prevent injury and behavioural health outcomes associated with masculinity, we assessed the influence of masculine discrepancy stress (stress that occurs when men perceive themselves as falling short of the traditional gender norms) on the propensity to engage in stereotypically masculine behaviours (eg, substance use, risk taking and violence) as a means of demonstrating masculinity. Six-hundred men from the USA were recruited via Amazon's Mechanical Turk (MTurk) online data collection site to complete surveys assessing self-perceptions of gender role discrepancy and consequent discrepancy stress, substance use/abuse, driving while intoxicated (DWI) and violent assaults. Negative binomial regression analyses indicated significant interactive effects wherein men high on gender role discrepancy and attendant discrepancy stress reported significantly more assaults with a weapon (B=1.01; SE=0.63; IRR=2.74; p=0.05) and assaults causing injury (B=1.01; SE=0.51; IRR=2.74; pviolence with the greatest consequences and costs to the victim, offender and society. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

  4. What opportunities are available for resident involvement in national orthopedic and subspecialty societies?

    Science.gov (United States)

    Dy, Christopher J; Cross, Michael B; Osbahr, Daryl C; Parks, Michael L; Green, Daniel W

    2011-10-05

    As physician involvement in health policy grows, there will be an increasing need for future leaders in orthopedics. Interested orthopedic residents may be unaware of opportunities for leadership involvement in professional and subspecialty organizations. This article investigates whether national and subspecialty organizations offer membership to residents, allow residents to participate in committees, and provide opportunities for scholarly activity and mentorship. The authors surveyed 20 national orthopedic professional and subspecialty societies to evaluate the availability and cost of resident membership, meeting attendance and participation, research funding, committee membership, and mentorship opportunities. Each society's Web site was reviewed, and societies were contacted by phone if further inquiry was needed. Of the 20 orthopedic societies surveyed, 11 allowed resident membership. Five of 20 societies allowed residents to serve on committees, with a total of 14 total positions for residents. Four organizations provided formalized mentorship programs to residents. Although opportunities for resident involvement in subspecialty and professional societies are available in the majority of groups surveyed, the Orthopaedic Trauma Association and American Society for Surgery of the Hand provided the most comprehensive collection of opportunities. Residents should also pursue involvement in other organizations that may be more readily accessible, such as local, state, and regional orthopedic and medical societies. Increased resident participation in these organizations may help in increasing the 14 nationally available committee positions for orthopedic residents. Our orthopedic profession and societies should encourage motivated residents to pursue involvement and leadership at the national level. Copyright 2011, SLACK Incorporated.

  5. Comprehensive intermaxillary tooth width proportion of Bangkok residents

    Directory of Open Access Journals (Sweden)

    Somchai Manopatanakul

    2011-04-01

    Full Text Available Proper occlusion depends on the correct width ratio between upper and lower teeth, known as Bolton's ratio. In fact, this ratio can be calculated for each pair of teeth from the central incisor to the first permanent molar. This set of ratios, known as comprehensive cumulative percentage ratios (CPRs, can be used not only to determine which tooth or teeth have a tooth width discrepancy, but can also enable the partial graphical analysis of tooth width discrepancy when there is agenesis of certain permanent teeth. Although CPRs have been calculated for Caucasians, tooth width is known to vary depending on racial origin. Therefore, a test of differences between racial groups should be carried out. If these ratios of the Caucasians and Bangkokians are significantly different, the ratio of the Bangkokians is recommended. The objective of this study was to measure tooth size disproportion for Thai patients and to calculate a corresponding set of CPRs. Thirty-seven pairs of dental models were made from a group of Bangkok residents with normal occlusion. Mesiodistal tooth width was measured for each model. The intra- and inter-examiner measurement errors were ascertained as insignificant (p > 0.05. CPRs were then calculated and compared to those derived from other studies. Ten of thirteen CPRs were significantly different from corresponding values derived from Caucasians. We conclude that tooth width ratios vary between different racial groups, and therefore that these should be calculated specifically for each patient racial group.

  6. Amputee care education in physical medicine and rehabilitation residency programs.

    Science.gov (United States)

    Elias, Joseph Abraham; Morgenroth, David Crespi

    2013-02-01

    The aim of this study was to assess amputee care-related educational offerings and barriers to further educational opportunities in United States physical medicine and rehabilitation residency programs. A two-part survey was distributed to all United States physical medicine and rehabilitation residency program directors. Part 1 assessed the use of educational tools in amputee education. Part 2 assessed the potential barriers to amputee care-related education. Sixty-nine percent of the program directors responded. Seventy-five percent or more of the programs that responded have didactic lectures; grand rounds; reading lists; self-assessment exam review; gait analysis training; training with prosthetists; faculty with amputee expertise; and amputee care during inpatient, outpatient, and consult rotations. Less than 25% of the programs use intranet resources. No more than 14% of the programs said any one factor was a major barrier. However, some of the most prominent major barriers were limited faculty number, finances, and patient volume. The factors many of the programs considered somewhat of a barrier included lack of national standardized resources for curriculum, resident time, and faculty time. This study identified the most commonly used amputee educational opportunities and methods in physical medicine and rehabilitation residencies as well as the barriers to furthering resident amputee education. Developing Web-based resources on amputee care and increasing awareness of physiatrists as perioperative consultants could improve resident amputee education and have important implications toward optimizing care of individuals with amputation.

  7. Helping Residents Protect Water Sources

    Science.gov (United States)

    Building on the successful early engagement of the Plain Sect agricultural community, the Eastern Lancaster County Source Water Protection Collaborative is expanding its efforts to involve local residents in the work of protecting drinking water sources.

  8. Using Emotionally Focused Therapy to Treat Sexual Desire Discrepancy in Couples.

    Science.gov (United States)

    Girard, Abby; Woolley, Scott R

    2017-11-17

    Couples in committed relationships encounter a multitude of issues. According to Metz and McCarthy (2010), when couples report high sexual satisfaction, it accounts for 15% to 20% of their overall relationship satisfaction. However, when couples report low sexual satisfaction, it contributes 50% to 70% of their overall satisfaction with their partner. Issues of sexual desire, currently referred to as sexual desire discrepancy, are among the most difficult to treat. Although there are many factors contributing to the issue of sexual desire discrepancy, current literature highlights the importance of emotional intimacy as an outcome and predictor of increased sexual desire. Given the complex nature of sexual desire, clinicians often lack the understanding and treatment options that are systemic. By viewing sexual desire discrepancy as a relational problem that can be treated using emotionally focused therapy, clinicians are better equipped to work with emotional and sexual factors that impact desire and couple distress.

  9. Development of WAIS-III General Ability Index Minus WMS-III memory discrepancy scores.

    Science.gov (United States)

    Lange, Rael T; Chelune, Gordon J; Tulsky, David S

    2006-09-01

    Analysis of the discrepancy between intellectual functioning and memory ability has received some support as a useful means for evaluating memory impairment. In recent additions to Wechlser scale interpretation, the WAIS-III General Ability Index (GAI) and the WMS-III Delayed Memory Index (DMI) were developed. The purpose of this investigation is to develop base rate data for GAI-IMI, GAI-GMI, and GAI-DMI discrepancy scores using data from the WAIS-III/WMS-III standardization sample (weighted N = 1250). Base rate tables were developed using the predicted-difference method and two simple-difference methods (i.e., stratified and non-stratified). These tables provide valuable data for clinical reference purposes to determine the frequency of GAI-IMI, GAI-GMI, and GAI-DMI discrepancy scores in the WAIS-III/WMS-III standardization sample.

  10. Self-esteem discrepancies and identity-expressive consumption: Evidence from Norwegian adolescents.

    Science.gov (United States)

    Tunca, Burak

    2018-02-01

    Prior research established that simultaneously holding discrepant explicit (deliberate, controlled) and implicit (automatic, uncontrolled) self-esteem gives rise to self-enhancing behaviours. Given that individuals tend to enhance their self-concepts with brands that are associated with positive identities, this study examined whether self-esteem discrepancy was related to the extent to which individuals developed connections with brands that are associated with their in-groups. Findings from an adolescent sample (ages 16-18) indicated that adolescents with larger discrepancies between explicit and implicit self-esteem were more likely to construct their self-concepts using in-group-linked brands. © 2016 International Union of Psychological Science.

  11. Culture-Led Discrepancies and Negotiating Conflicts in Strategic Outsourcing Alliances

    DEFF Research Database (Denmark)

    Gammelgaard, Jens; Kumar, Rajesh; Worm, Verner

    2013-01-01

    of outsourcing alliances. We suggest that national cultural differences give rise to process and outcome discrepancies in outsourcing alliances. Notably, outsourcing alliances evolve through three stages–formation, operation and outcome–with discrepancies arising in each of these stages (Das & Teng, 2002). We......Outsourcing and alliance collaboration have become prominent features of the global economy. Empirical studies demonstrate that outsourcing alliances are often not as successful as their initiators expect them to be. National cultural differences are frequently viewed as a crucial factor when...... such alliances fail. While empirical studies are abundant, theoretical frameworks that explicate the role of national cultural differences in shaping the dynamics of outsourcing alliances are rare. This article builds on Kumar and Nti's (1998) discrepancy model to specify how culture affects the dynamics...

  12. National cultural values and the evolution of process and outcome discrepancies in international strategic alliances

    DEFF Research Database (Denmark)

    Kumar, Rajesh; Nti, Kofi O

    2004-01-01

    The article assesses the role played by national cultural values in shaping the evolution of international strategic alliances. The authors build on a systems dynamic model of alliance evolution in which the developmental path of an alliance depends on how the partners manage process and outcome...... discrepancies that may emerge during the course of an alliance. They argue that national culture affects alliance evolution by influencing partners sensitivity to discrepancy detection , shaping the nature of attributions they make, and by affecting the partners reactions to discrepancies. They focus...... on differences in three value orientations among cultures. activity orientation, mastery over nature, and assumptions about human nature are the value orientations that affect alliance functioning. The author/s argue that alliances are prone to interpretational, attributional, and behavioral conflicts...

  13. Shared temporoparietal dysfunction in dyslexia and typical readers with discrepantly high IQ.

    Science.gov (United States)

    Hancock, Roeland; Gabrieli, John D E; Hoeft, Fumiko

    2016-12-01

    It is currently believed that reading disability (RD) should be defined by reading level without regard to broader aptitude (IQ). There is debate, however, about how to classify individuals who read in the typical range but less well than would be expected by their higher IQ. We used functional magnetic resonance imaging (fMRI) in 49 children to examine whether those with typical, but discrepantly low reading ability relative to IQ, show dyslexia-like activation patterns during reading. Children who were typical readers with high-IQ discrepancy showed reduced activation in left temporoparietal neocortex relative to two control groups of typical readers without IQ discrepancy. This pattern was consistent and spatially overlapping with results in children with RD compared to typically reading children. The results suggest a shared neurological atypicality in regions associated with phonological processing between children with dyslexia and children with typical reading ability that is substantially below their IQ.

  14. the contribution of resident physicians

    OpenAIRE

    Trusch, Klaus

    2011-01-01

    A telephone survey of resident physicians to the basic conditions in which they work has been conducted in 14 of the 16 federal states. In the center of the survey stood the general medicine within the prisons. This limitation was necessary in order to achieve comparability to primary medical care outside of correctional services. There are 140 salaried and tenured resident pysicians and 97 contract doctors in the general medical care of approx. 70000 prisoners in 185 independent prisons ...

  15. 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....

  16. The effect of a clinical pharmacist discharge service on medication discrepancies in patients with heart failure.

    Science.gov (United States)

    Eggink, Rixt Nynke; Lenderink, Albert W; Widdershoven, Jos W M G; van den Bemt, Patricia M L A

    2010-12-01

    Heart failure patients are regularly admitted to hospital and frequently use multiple medication. Besides intentional changes in pharmacotherapy, unintentional changes may occur during hospitalisation. The aim of this study was to investigate the effect of a clinical pharmacist discharge service on medication discrepancies and prescription errors in patients with heart failure. A general teaching hospital in Tilburg, the Netherlands. An open randomized intervention study was performed comparing an intervention group, with a control group receiving regular care by doctors and nurses. The clinical pharmacist discharge service consisted of review of discharge medication, communicating prescribing errors with the cardiologist, giving patients information, preparation of a written overview of the discharge medication and communication to both the community pharmacist and the general practitioner about this medication. Within 6 weeks after discharge all patients were routinely scheduled to visit the outpatient clinic and medication discrepancies were measured. The primary endpoint was the frequency of prescription errors in the discharge medication and medication discrepancies after discharge combined. Forty-four patients were included in the control group and 41 in the intervention group. Sixty-eight percent of patients in the control group had at least one discrepancy or prescription error against 39% in the intervention group (RR 0.57 (95% CI 0.37-0.88)). The percentage of medications with a discrepancy or prescription error in the control group was 14.6% and in the intervention group it was 6.1% (RR 0.42 (95% CI 0.27-0.66)). This clinical pharmacist discharge service significantly reduces the risk of discrepancies and prescription errors in medication of patients with heart failure in the 1st month after discharge.

  17. A STUDY OF THE DISCREPANCY BETWEEN FEDERAL AND STATE MEASUREMENTS OF ON-HIGHWAY FUEL CONSUMPTION

    Energy Technology Data Exchange (ETDEWEB)

    Hwang, HL

    2003-08-11

    Annual highway fuel taxes are collected by the Treasury Department and placed in the Highway Trust Fund (HTF). There is, however, no direct connection between the taxes collected by the Treasury Department and the gallons of on-highway fuel use, which can lead to a discrepancy between these totals. This study was conducted to determine how much of a discrepancy exists between the total fuel usages estimated based on highway revenue funds as reported by the Treasury Department and the total fuel usages used in the apportionment of the HTF to the States. The analysis was conducted using data from Highway Statistics Tables MF-27 and FE-9 for the years 1991-2001. It was found that the overall discrepancy is relatively small, mostly within 5% difference. The amount of the discrepancy varies from year to year and varies among the three fuel types (gasoline, gasohol, special fuels). Several potential explanations for these discrepancies were identified, including issues on data, tax measurement, gallon measurement, HTF receipts, and timing. Data anomalies caused by outside forces, such as deferment of tax payments from one fiscal year to the next, can skew fuel tax data. Fuel tax evasion can lead to differences between actual fuel use and fuel taxes collected. Furthermore, differences in data collection and reporting among States can impact fuel use data. Refunds, credits, and transfers from the HTF can impact the total fuel tax receipt data. Timing issues, such as calendar year vs. fiscal year, can also cause some discrepancy between the two data sources.

  18. Algorithmic identification of discrepancies between published ratios and their reported confidence intervals and p-values.

    Science.gov (United States)

    Georgescu, Constantin; Wren, Jonathan D

    2017-12-22

    Studies, mostly from the operations/management literature, have shown that the rate of human error increases with task complexity. What is not known is how many errors make it into the published literature, given that they must slip by peer-review. By identifying paired, dependent values within text for reported calculations of varying complexity, we can identify discrepancies, quantify error rates and identify mitigating factors. We extracted statistical ratios from MEDLINE abstracts (Hazard Ratio, Odds Ratio, Relative Risk), their 95% confidence intervals (CIs), and their p-values. We re-calculated the ratios and p-values using the reported CIs. For comparison, we also extracted percent-ratio pairs, one of the simplest calculation tasks. Over 486,000 published values were found and analyzed for discrepancies, allowing for rounding and significant figures. Per reported item, discrepancies were less frequent in percent-ratio calculations (2.7%) than in ratio-CI and p-value calculations (5.6% to 7.5%), and smaller discrepancies were more frequent than large ones. Systematic discrepancies (multiple incorrect calculations of the same type) were higher for more complex tasks (14.3%) than simple ones (6.7%). Discrepancy rates decreased with increasing journal impact factor (JIF) and increasing number of authors, but with diminishing returns and JIF accounting for most of the effect. Approximately 87% of the 81,937 extracted p-values were ≤ 0.05. Using a simple, yet accurate, approach to identifying paired values within text, we offer the first quantitative evaluation of published error frequencies within these types of calculations. N/A. Jonathan-Wren@OMRF.org; jdwren@gmail.com. Available online. © The Author (2017). Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oup.com

  19. Sleep Quality Among Psychiatry Residents.

    Science.gov (United States)

    Carvalho Aguiar Melo, Matias; das Chagas Medeiros, Francisco; Meireles Sales de Bruin, Veralice; Pinheiro Santana, José Abraão; Bastos Lima, Alexandre; De Francesco Daher, Elizabeth

    2016-01-01

    Medical residency programs are traditionally known for long working hours, which can be associated with a poor quality of sleep and daytime sleepiness. However, few studies have focused on this theme. Our objective was to investigate sleep quality, daytime sleepiness, and their relation with anxiety, social phobia, and depressive symptoms. This cross-sectional observational study involved 59 psychiatry residents. The Pittsburgh Sleep Quality Index (PSQI) and the Epworth Sleepiness Scale (ESS) were used to measure the quality of sleep and excessive daytime sleepiness ([EDS] and ESS > 10), respectively. Among the 59 psychiatry residents, 59.3% had poor sleep quality (PSQI > 5) and 28.8% had EDS. Poor sleep quality was associated with higher EDS (P = 0.03) and the year of residency program (P = 0.03). Only 20% of residents with poor sleep had consulted at least once for sleep problems; 54.2% had used medications for sleep; and 16.9% were using medications at the time of interview. Only 30% obtained medication during medical consultations. Poor sleep was associated with irregular sleep hours (P = 0.001) and long periods lying down without sleep (P = 0.03). Poor sleep quality was also associated with high scores of anxiety symptoms (P Psychiatry residents frequently have poor sleep quality and EDS. Considering that sleep disorders can affect quality of life, predispose to metabolic syndrome, and be associated with worse performance at work, attention to this clinical problem is needed. © The Author(s) 2016.

  20. 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.

  1. Outcomes of the first Family Practice Chief Resident Leadership Conference.

    Science.gov (United States)

    Mygdal, W K; Monteiro, M; Hitchcock, M; Featherston, W; Conard, S

    1991-01-01

    In June 1989 the first Family Practice Chief Resident Leadership Conference was presented to 27 Texas second-year residents who had been selected to serve as chief residents during their third year. The objectives of the conference were to assist these emerging leaders to develop better stress management and leadership skills and to strengthen their ties with the Texas Academy of Family Physicians. The conference featured two major workshops on stress management and leadership skills, and included plenary speeches and large and small group discussions. This article reports the outcomes of the conference as measured by the evaluation instrument completed by participants. Analysis of the results indicated that the conference had a positive effect on the residents.

  2. Cervical and incisal marginal discrepancy in ceramic laminate veneering materials: A SEM analysis

    Directory of Open Access Journals (Sweden)

    Hemalatha Ranganathan

    2017-01-01

    Full Text Available Context: Marginal discrepancy influenced by the choice of processing material used for the ceramic laminate veneers needs to be explored further for better clinical application. Aims: This study aimed to evaluate the amount of cervical and incisal marginal discrepancy associated with different ceramic laminate veneering materials. Settings and Design: This was an experimental, single-blinded, in vitro trial. Subjects and Methods: Ten central incisors were prepared for laminate veneers with 2 mm uniform reduction and heavy chamfer finish line. Ceramic laminate veneers fabricated over the prepared teeth using four different processing materials were categorized into four groups as Group I - aluminous porcelain veneers, Group II - lithium disilicate ceramic veneers, Group III - lithium disilicate-leucite-based veneers, Group IV - zirconia-based ceramic veneers. The cervical and incisal marginal discrepancy was measured using a scanning electron microscope. Statistical Analysis Used: ANOVA and post hoc Tukey honest significant difference (HSD tests were used for statistical analysis. Results: The cervical and incisal marginal discrepancy for four groups was Group I - 114.6 ± 4.3 μm, 132.5 ± 6.5 μm, Group II - 86.1 ± 6.3 μm, 105.4 ± 5.3 μm, Group III - 71.4 ± 4.4 μm, 91.3 ± 4.7 μm, and Group IV - 123.1 ± 4.1 μm, 142.0 ± 5.4 μm. ANOVA and post hoc Tukey HSD tests observed a statistically significant difference between the four test specimens with regard to cervical marginal discrepancy. The cervical and incisal marginal discrepancy scored F = 243.408, P < 0.001 and F = 180.844, P < 0.001, respectively. Conclusion: This study concluded veneers fabricated using leucite reinforced lithium disilicate exhibited the least marginal discrepancy followed by lithium disilicate ceramic, aluminous porcelain, and zirconia-based ceramics. The marginal discrepancy was more in the incisal region than in the cervical region in all the groups.

  3. Hospitalist involvement in family medicine residency training: A CERA study.

    Science.gov (United States)

    Baldor, Robert; Savageau, Judith A; Shokar, Navkiran; Potts, Stacy; Gravel, Joseph; Eisenstock, Kimberly; Ledwith, James

    2014-02-01

    Little is known about the impact of hospitalists on family medicine residencies. We surveyed family medicine residency directors to assess attitudes about hospitalists and their involvement in residency teaching. Questions were included in the 2012 Council of Academic Family Medicine Educational Research Alliance (CERA) survey of family medicine residency directors. Univariate statistics were used to describe programs, directors, and our questions on the use of hospitalists. Bivariate statistics were used to examine relationships between the use of hospitalists to teach and program characteristics. Forty-one percent (n=175) of residency directors completed the hospitalist section of the CERA survey. Sixty-six percent of residency programs were community based/university affiliated. The majority of directors who have, or are planning to develop, a hospitalist service currently use an internal medicine service (92.5%), followed by family medicine (39.1%), pediatrics (35.4%), OB/laborists (18.0%), and combined services (8.7%). The majority of programs with a hospitalist training track (or plans to develop one) indicated that this was for a family medicine service. Sixty percent of programs that have a hospitalist service involve hospitalists in teaching. Twenty percent of directors reported that hospitalists serve as family medicine faculty, and 63% viewed them as "good educators." However, 85% reported no reduction in inpatient teaching by family medicine faculty despite using hospitalist teaching services. Hospitalists have a significant educational role in family medicine resident training. Further research is needed to explore how hospitalists and family medicine faculty can collaborate to promote enhanced efficiency and effectiveness as residency teachers.

  4. Life in a university residence: Issues, concerns and responses.

    Science.gov (United States)

    Shaikh, Babar T; Deschamps, Jean-Pierre

    2006-03-01

    Students living in university residences experience frail living conditions, being away from their homes and families, the stress of studies, a bizarre routine, and absence of readily available guidance. Their overall health suffers. Our study aims at collecting information on health and related problems of the students in university residences and to identify the solutions to ameliorate the prevailing situation. A qualitative study conducted in five university residences of Nancy, Metz and Strasbourg, France. The majority of students have complaints about the living conditions in the residences. They mention that they are not in sound health. Stress, depression, fatigue, insomnia, and problems with diet are common. Foreign students suffer more due to culture shock, language, and nostalgia. A tendency for suicides has been observed, especially in girls. Financial problems, too much to study, and relationship break-up are important factors. For their health problems, they generally seek advice from a peer and consume medicines without prescription. Many do not use the "students' health service" because of lack of information or difficult access from certain universities or university residences. To solve their problems and to facilitate their social integration, student volunteers ought to be trained in the university residences because a majority prefers to have their peers' advice. Reinforcement of the role of administration of residences, of student-counselors and of the faculty in the university would be another crucial step. More leisure and social activities are imperative. This study itself constitutes the first element of creating awareness regarding the situation of the health of students living in residence halls in France.

  5. Management training for pathology residents: a regional approach.

    Science.gov (United States)

    Horowitz, Richard E; Naritoku, Wesley; Wagar, Elizabeth A

    2004-01-01

    Success in the practice of pathology demands proficiency in management, but management training for pathology residents is generally inadequate, with little agreement on an appropriate curriculum or competency assessment. Most residency training programs do not have faculty members who are interested and have expertise in management and who are dedicated to and have time available for teaching. To develop a didactic management training program for the residents from 6 separate pathology residency programs in Southern California, with a comprehensive curriculum taught by experts in each area without undue burden on any single training program. Faculty from the University of California-Los Angeles and the University of Southern California reviewed the literature and the management needs of practicing pathologists and devised the curriculum. Pathologist and nonpathologist speakers were identified who were working in important management positions both regionally and nationally. Seminars were presented in alternate months during a 2-year period. Sessions were videotaped, and each session was evaluated by the attendees. The curriculum consisted of 12 major topics, and seminars were delivered by 15 presenters from 6 institutions. Attendance was highest for residents in postgraduate years 2 and 3. The overall evaluation scores were exceedingly high (4.66 of a possible 5.0), and residents reported a significant increase in subject knowledge. Videotaping of presentations provided flexibility for residents who were unable to attend the seminars. This program was effective and could serve as a template for other pathology residency training programs to establish curriculum content and develop resident competency. Teaching responsibilities were less burdensome when spread among several programs and when supplemented by nonpathology faculty. Electronic and audiovisual support enhanced flexibility and access to the program.

  6. Workplace Violence and Harassment Against Emergency Medicine Residents

    Directory of Open Access Journals (Sweden)

    Benjamin H. Schnapp

    2016-09-01

    Full Text Available Introduction: Several studies have shown that workplace violence in the emergency department (ED is common. Residents may be among the most vulnerable staff, as they have the least experience with these volatile encounters. The goal for this study was to quantify and describe acts of violence against emergency medicine (EM residents by patients and visitors and to identify perceived barriers to safety. Methods: This cross-sectional survey study queried EM residents at multiple New York City hospitals. The primary outcome was the incidence of violence experienced by residents while working in the ED. The secondary outcomes were the subtypes of violence experienced by residents, as well as the perceived barriers to safety while at work. Results: A majority of residents (66%, 78/119 reported experiencing at least one act of physical violence during an ED shift. Nearly all residents (97%, 115/119 experienced verbal harassment, 78% (93/119 had experienced verbal threats, and 52% (62/119 reported sexual harassment. Almost a quarter of residents felt safe “Occasionally,” “Seldom” or “Never” while at work. Patient-based factors most commonly cited as contributory to violence included substance use and psychiatric disease. Conclusion: Self-reported violence against EM residents appears to be a significant problem. Incidence of violence and patient risk factors are similar to what has been found previously for other ED staff. Understanding the prevalence of workplace violence as well as the related systems, environmental, and patient-based factors is essential for future prevention efforts.

  7. The use of error analysis to assess resident performance.

    Science.gov (United States)

    D'Angelo, Anne-Lise D; Law, Katherine E; Cohen, Elaine R; Greenberg, Jacob A; Kwan, Calvin; Greenberg, Caprice; Wiegmann, Douglas A; Pugh, Carla M

    2015-11-01

    The aim of this study was to assess validity of a human factors error assessment method for evaluating resident performance during a simulated operative procedure. Seven postgraduate year 4-5 residents had 30 minutes to complete a simulated laparoscopic ventral hernia (LVH) repair on day 1 of a national, advanced laparoscopic course. Faculty provided immediate feedback on operative errors and residents participated in a final product analysis of their repairs. Residents then received didactic and hands-on training regarding several advanced laparoscopic procedures during a lecture session and animate lab. On day 2, residents performed a nonequivalent LVH repair using a simulator. Three investigators reviewed and coded videos of the repairs using previously developed human error classification systems. Residents committed 121 total errors on day 1 compared with 146 on day 2. One of 7 residents successfully completed the LVH repair on day 1 compared with all 7 residents on day 2 (P = .001). The majority of errors (85%) committed on day 2 were technical and occurred during the last 2 steps of the procedure. There were significant differences in error type (P ≤ .001) and level (P = .019) from day 1 to day 2. The proportion of omission errors decreased from day 1 (33%) to day 2 (14%). In addition, there were more technical and commission errors on day 2. The error assessment tool was successful in categorizing performance errors, supporting known-groups validity evidence. Evaluating resident performance through error classification has great potential in facilitating our understanding of operative readiness. Copyright © 2015 Elsevier Inc. All rights reserved.

  8. 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

  9. Attitudes toward inter-hospital electronic patient record exchange: discrepancies among physicians, medical record staff, and patients.

    Science.gov (United States)

    Wang, Jong-Yi; Ho, Hsiao-Yun; Chen, Jen-De; Chai, Sinkuo; Tai, Chih-Jaan; Chen, Yung-Fu

    2015-07-12

    In this era of ubiquitous information, patient record exchange among hospitals still has technological and individual barriers including resistance to information sharing. Most research on user attitudes has been limited to one type of user or aspect. Because few analyses of attitudes toward electronic patient records (EPRs) have been conducted, understanding the attitudes among different users in multiple aspects is crucial to user acceptance. This proof-of-concept study investigated the attitudes of users toward the inter-hospital EPR exchange system implemented nationwide and focused on discrepant behavioral intentions among three user groups. The system was designed by combining a Health Level 7-based protocol, object-relational mapping, and other medical informatics techniques to ensure interoperability in realizing patient-centered practices. After implementation, three user-specific questionnaires for physicians, medical record staff, and patients were administered, with a 70 % response rate. The instrument showed favorable convergent construct validity and internal consistency reliability. Two dependent variables were applied: the attitudes toward privacy and support. Independent variables comprised personal characteristics, work characteristics, human aspects, and technology aspects. Major statistical methods included exploratory factor analysis and general linear model. The results from 379 respondents indicated that the patients highly agreed with privacy protection by their consent and support for EPRs, whereas the physicians remained conservative toward both. Medical record staff was ranked in the middle among the three groups. The three user groups demonstrated discrepant intentions toward privacy protection and support. Experience of computer use, level of concerns, usefulness of functions, and specifically, reason to use electronic medical records and number of outpatient visits were significantly associated with the perceptions. Overall, four

  10. 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.

  11. Cross-modal discrepancies in coarticulation and the integration of speech information: the McGurk effect with mismatched vowels.

    Science.gov (United States)

    Green, K P; Gerdeman, A

    1995-12-01

    Two experiments examined the impact of a discrepancy in vowel quality between the auditory and visual modalities on the perception of a syllable-initial consonant. One experiment examined the effect of such a discrepancy on the McGurk effect by cross-dubbing auditory /bi/ tokens onto visual /ga/ articulations (and vice versa). A discrepancy in vowel category significantly reduced the magnitude of the McGurk effect and changed the pattern of responses. A 2nd experiment investigated the effect of such a discrepancy on the speeded classification of the initial consonant. Mean reaction times to classify the tokens increased when the vowel information was discrepant between the 2 modalities but not when the vowel information was consistent. These experiments indicate that the perceptual system is sensitive to cross-modal discrepancies in the coarticulatory information between a consonant and its following vowel during phonetic perception.

  12. Perceptions of the 2011 ACGME duty hour requirements among residents in all core programs at a large academic medical center.

    Science.gov (United States)

    Sandefur, Benjamin J; Shewmaker, Diana M; Lohse, Christine M; Rose, Steven H; Colletti, James E

    2017-11-10

    The Accreditation Council for Graduate Medical Education (ACGME) implemented revisions to resident duty hour requirements (DHRs) in 2011 to improve patient safety and resident well-being. Perceptions of DHRs have been reported to vary by training stage and specialty among internal medicine and general surgery residents. The authors explored perceptions of DHRs among all residents at a large academic medical center. The authors administered an anonymous cross-sectional survey about DHRs to residents enrolled in all ACGME-accredited core residency programs at their institution. Residents were categorized as medical and pediatric, surgery, or other. In total, 736 residents representing 24 core specialty residency programs were surveyed. The authors received responses from 495 residents (67%). A majority reported satisfaction (78%) with DHRs and believed DHRs positively affect their training (73%). Residents in surgical specialties and in advanced stages of training were significantly less likely to view DHRs favorably. Most respondents believed fatigue contributes to errors (89%) and DHRs reduce both fatigue (80%) and performance of clinical duties while fatigued (74%). A minority of respondents (37%) believed that DHRs decrease medical errors. This finding may reflect beliefs that handovers contribute more to errors than fatigue (41%). Negative perceived effects included diminished patient familiarity and continuity of care (62%) and diminished clinical educational experiences for residents (41%). A majority of residents reported satisfaction with the 2011 DHRs, although satisfaction was significantly less among residents in surgical specialties and those in advanced stages of training.

  13. Understanding the exercise habits of residents and attending physicians: a mixed methodology study.

    Science.gov (United States)

    Williams, Amy S; Williams, Casey D; Cronk, Nikole J; Kruse, Robin L; Ringdahl, Erika N; Koopman, Richelle J

    2015-02-01

    Although the benefits of exercise are well known, rates of exercise among residents are much lower than those of attendings or medical students. Little is known about the barriers that prevent residents from exercising regularly. This mixed methodology study identifies and compares these barriers for resident and attending physicians practicing in the same setting. We conducted three focus groups with first-year and senior residents and attending physicians in the University of Missouri Department of Family and Community Medicine from April to August 2013. We also administered a survey inquiring about exercise rates and habits to 110 resident and attending physicians in the same department using both paper and electronic versions. During both inpatient and non-inpatient rotations, residents reported exercising less than attending physicians. No residents exercised more than 150 minutes/week during inpatient rotations compared to 18.42% of attendings. Only 6.9% of residents exercised more than 150 minutes/week during non-inpatient rotations, compared to 25% of attendings. Residents and attendings reported different barriers to regular exercise. Residents reported lack of time for a traditional structured workout as a major barrier, which leads to an adversarial relationship between work and exercise. Residency programs can help residents overcome exercise barriers by reframing exercise expectations to include more frequent but brief periods of exercise during the workday and by developing a supportive exercise culture. Changing worksite environments to support physician exercise may improve physician wellness.

  14. The Canadian general surgery resident: defining current challenges for surgical leadership.

    Science.gov (United States)

    Tomlinson, Corey; Labossière, Joseph; Rommens, Kenton; Birch, Daniel W

    2012-08-01

    Surgery training programs in Canada and the United States have recognized the need to modify current models of training and education. The shifting demographic of surgery trainees, lifestyle issues and an increased trend toward subspecialization are the major influences. To guide these important educational initiatives, a contemporary profile of Canadian general surgery residents and their impressions of training in Canada is required. We developed and distributed a questionnaire to residents in each Canadian general surgery training program, and residents responded during dedicated teaching time. In all, 186 surveys were returned for analysis (62% response rate). The average age of Canadian general surgery residents is 30 years, 38% are women, 41% are married, 18% have dependants younger than 18 years and 41% plan to add to or start a family during residency. Most (87%) residents plan to pursue postgraduate education. On completion of training, 74% of residents plan to stay in Canada and 49% want to practice in an academic setting. Almost half (42%) of residents identify a poor balance between work and personal life during residency. Forty-seven percent of respondents have appropriate access to mentorship, whereas 37% describe suitable access to career guidance and 40% identify the availability of appropriate social supports. Just over half (54%) believe the stress level during residency is manageable. This survey provides a profile of contemporary Canadian general surgery residents. Important challenges within the residency system are identified. Program directors and chairs of surgery are encouraged to recognize these challenges and intervene where appropriate.

  15. The Drinking Partnership and Marital Satisfaction: The Longitudinal Influence of Discrepant Drinking

    Science.gov (United States)

    Homish, Gregory G.; Leonard, Kenneth E.

    2007-01-01

    The objective was to determine whether discrepancies between husbands' and wives' past year heavy drinking predicted decreased marital satisfaction over time. Participants (N = 634) were recruited at the time they applied for their marriage licenses. Couples completed questionnaires about their alcohol use and marital satisfaction at the time of…

  16. Morozov-type discrepancy principle for nonlinear ill-posed problems ...

    Indian Academy of Sciences (India)

    For proving the existence of a regularization parameter under a Morozov-type discrepancy principle for Tikhonov regularization of nonlinear ill-posed problems, it is required to impose additional nonlinearity assumptions on the forward operator. Lipschitz continuity of the Freéchet derivative and requirement of the Lipschitz ...

  17. The SAT® and SAT Subject Tests™: Discrepant Scores and Incremental Validity. Research Report 2012-2

    Science.gov (United States)

    Kobrin, Jennifer L.; Patterson, Brian F.

    2012-01-01

    This study examines student performance on the SAT and SAT Subject Tests in order to identify groups of students who score differently on these two tests, and to determine whether certain demographic groups score higher on one test compared to the other. Discrepancy scores were created to capture individuals' performance differences on the…

  18. Parent-Adolescent Discrepancies Regarding Adolescents' Peer-Related Loneliness : Associations with Adolescent Adjustment

    NARCIS (Netherlands)

    Spithoven, Annette W. M.; Vanhalst, Janne; Lodder, Gerine; Bijttebier, Patricia; Goossens, Luc

    Because loneliness is a subjective experience, it is often examined using self-reports. Yet, researchers have started to use other-reports to examine loneliness. As previous research suggests that discrepancies between self- and other views might have important implications for adolescents' mental

  19. Black-White IQ Discrepancies May Be Related to Differences in Hemisphericity.

    Science.gov (United States)

    Reynolds, Cecil R.; And Others

    1981-01-01

    Wechsler Preschool and Primary Scale of Intelligence (WPPSI) and McCarthy Scales subtests were ranked according to relative reliance on left-cerebral-hemisphere function. Results suggest that black-white IQ discrepancies may be partially explained by differences in hemisphericity. (Author/RD)

  20. Discrepancies in Parent and Teacher Ratings of Low-Income Preschooler's Social Skills

    Science.gov (United States)

    Heyman, Miriam; Poulakos, Anthoula; Upshur, Carole; Wenz-Gross, Melodie

    2016-01-01

    Parent-teacher rating discrepancies in rating of children's social skills were examined in a low-income, ethnically diverse preschool sample, using the Social Skills Improvement System-Rating Scales [Gresham, F. J. & Elliott, S. N. (2008). "Social Skills Improvement System-Rating Scales." Minneapolis, MN: Pearson Assessments].…

  1. Consonant Differentiation Mediates the Discrepancy between Non-verbal and Verbal Abilities in Children with ASD

    Science.gov (United States)

    Key, A. P.; Yoder, P. J.; Stone, W. L.

    2016-01-01

    Background: Many children with autism spectrum disorder (ASD) demonstrate verbal communication disorders reflected in lower verbal than non-verbal abilities. The present study examined the extent to which this discrepancy is associated with atypical speech sound differentiation. Methods: Differences in the amplitude of auditory event-related…

  2. Discrepancy between Hepatitis C Virus Genotypes and NS4-Based Serotypes: Association with Their Subgenomic Sequences

    Directory of Open Access Journals (Sweden)

    Nan Nwe Win

    2017-01-01

    Full Text Available Determination of hepatitis C virus (HCV genotypes plays an important role in the direct-acting agent era. Discrepancies between HCV genotyping and serotyping assays are occasionally observed. Eighteen samples with discrepant results between genotyping and serotyping methods were analyzed. HCV serotyping and genotyping were based on the HCV nonstructural 4 (NS4 region and 5′-untranslated region (5′-UTR, respectively. HCV core and NS4 regions were chosen to be sequenced and were compared with the genotyping and serotyping results. Deep sequencing was also performed for the corresponding HCV NS4 regions. Seventeen out of 18 discrepant samples could be sequenced by the Sanger method. Both HCV core and NS4 sequences were concordant with that of genotyping in the 5′-UTR in all 17 samples. In cloning analysis of the HCV NS4 region, there were several amino acid variations, but each sequence was much closer to the peptide with the same genotype. Deep sequencing revealed that minor clones with different subgenotypes existed in two of the 17 samples. Genotyping by genome amplification showed high consistency, while several false reactions were detected by serotyping. The deep sequencing method also provides accurate genotyping results and may be useful for analyzing discrepant cases. HCV genotyping should be correctly determined before antiviral treatment.

  3. Dietary restraint, life satisfaction and self-discrepancy by gender in university students

    Directory of Open Access Journals (Sweden)

    Berta Schnettler

    2017-01-01

    Full Text Available This study aimed to characterize dieting and non-dieting university students by gender, based on their satisfaction with life and their food-related life, self-discrepancy, food behavior and health-related aspects. A non-probabilistic sample of 305 students from five Chilean state universities responded a questionnaire that included the Revised Restraint Scale, the Satisfaction with Life Scale, the Satisfaction with Food-related Life Scale, the Health-related Quality of Life Index, the Nutrition Interest Scale and the Self-Discrepancy Index. Socio-demographic characteristics, food behavior, and approximate weight and height were also enquired. Chronic dieters and non-dieters were distinguished according to the median score of the Revised Restraint Scale. 51.1% of women and 55.5% of men classified as chronic dieters, sharing characteristics such as nutrition concern, mental health problems, higher body mass index, and physical and economic self-discrepancy. Women dieters reported lower life satisfaction and satisfaction with food-related life, more health problems and health-related restriction of food, while men dieters showed higher social and emotional self-discrepancy.

  4. Microdose acquisition in adolescent leg length discrepancy using a low-dose biplane imaging system

    DEFF Research Database (Denmark)

    Jensen, Janni; Mussmann, Bo Redder; Hjarbæk, John

    2017-01-01

    Background Children with leg length discrepancy often undergo repeat imaging. Therefore, every effort to reduce radiation dose is important. Using low dose preview images and noise reduction software rather than diagnostic images for length measurements might contribute to reducing dose. Purpose ...

  5. Informant Discrepancies in the Assessment of Attention-Deficit/Hyperactivity Disorder

    Science.gov (United States)

    Kennerley, Stephanie; Jaquiery, Ben; Hatch, Burt; Healey, Matthew; Wheeler, Benjamin J.; Healey, Dione

    2018-01-01

    An attention-deficit/hyperactivity disorder (ADHD) diagnosis requires symptoms to be present across two or more settings, thus requiring information from multiple informants. Research consistently shows low to moderate agreement between parents and teachers; however, the mechanisms underlying these discrepancies remain unclear. This study examined…

  6. Utilities and patient preferences discrepancies between chained and classic utilities induced by anchoring with occasional adjustments

    NARCIS (Netherlands)

    Stalmeier, P.F.M.

    2002-01-01

    Background: Classic utility assessment uses death and perfect health as end points. Chained utility assessment uses other health states as end points. It has been previously noted that these two assessment procedures lead to different utilities. Purpose: To explain these discrepancies between

  7. Social self-discrepancies from own and other standpoints and collective self-esteem.

    Science.gov (United States)

    Bizman, Aharon; Yinon, Yoel

    2004-04-01

    On the basis of an extension of Self-Discrepancy Theory (SDT) to the social aspect of the self (A. Bizman, Y. Yinon, & S. Krotman, 2001), the authors examined the relationships between social self-discrepancies from own and other standpoints and collective self-esteem. The authors assessed perceptions of actual, ideal, and ought attributes of Israelis from own and other standpoints; perceived importance of others' evaluation of Israel; and the Collective Self-Esteem Scale (CSES) among 114 Israelis. The results revealed that the association of the discrepancy between actual Israelis and ideal Israelis from the other standpoint with the public Collective Self-Esteem (CSE) subscale was negative among participants with high perceived importance and positive among those with low perceived importance. In addition, the discrepancy between actual and ideal Israelis from the own standpoint was related to the private, public, and membership CSE subscales. Overall, the findings suggest that the SDT distinction between the own and other standpoints on the self is applicable to the social self.

  8. The Valued Living Questionnaire for Alcohol Use: Measuring value-behavior discrepancy in college student drinking.

    Science.gov (United States)

    Miller, Mary Beth; Meier, Ellen; Lombardi, Nathaniel; Leavens, Eleanor L; Grant, DeMond M; Leffingwell, Thad R

    2016-09-01

    Developing discrepancy between one's values and behaviors is theoretically important in motivating change; however, existing studies lack a validated measure of value-behavior discrepancy for alcohol misuse. The current studies aimed to modify Wilson & DuFrene (2008) Valued Living Questionnaire (VLQ) to assess consistency of alcohol use with important values. In Study 1, the initial factor structure and test-retest reliability of the VLQ for Alcohol Use (VLQ-A) was tested in a sample of college students who regularly drink alcohol (N = 150). Results guided modifications to the measure. In Study 2, the revised measure's factor structure and predictive validity were tested with a second sample of college students who drink alcohol (N = 222). In both studies, exploratory factor analysis supported a unidimensional factor structure. Perceived discrepancy between alcohol use and important values predicted greater readiness to change, while perceived consistency between alcohol use and important values predicted more frequent heavy episodic drinking. Certain values were more useful in predicting outcomes than others. Alcohol use (heavy vs. moderate drinking) did not moderate outcomes. The VLQ-A is a brief and reliable self-report measure of perceived discrepancy between drinking behaviors and important values that may increase readiness to change. Future research examining the generalizability of findings to various samples and the efficacy of the VLQ-A as a supplement to brief interventions is warranted. (PsycINFO Database Record (c) 2016 APA, all rights reserved).

  9. Misleading University Rankings: Cause and Cure for Discrepancies between Nominal and Attained Weights

    Science.gov (United States)

    Soh, Kaycheng

    2013-01-01

    Recent research into university ranking methodologies uncovered several methodological problems among the systems currently in vogue. One of these is the discrepancy between the nominal and attained weights. The problem is the summation of unstandardized indicators for the total scores used in ranking. It is demonstrated that weight discrepancy…

  10. Explaining the discrepancy between intentions and actions: the case of hypothetical bias in contingent valuation

    Science.gov (United States)

    Icek Ajzen; Thomas C. Brown; Franklin Carvajal

    2004-01-01

    An experiment was designed to account for intention-behavior discrepancies by applying the theory of planned behavior to contingent valuation. College students (N = 160) voted in hypothetical and real payment referenda to contribute $8 to a scholarship fund. Overestimates of willingness to pay in the hypothetical referendum could not be attributed to moderately...

  11. Discrepancies between patients' and partners' perceptions of unsupportive behavior in chronic obstructive pulmonary disease.

    Science.gov (United States)

    Snippe, Evelien; Maters, Gemma A; Wempe, Johan B; Hagedoorn, Mariët; Sanderman, Robbert

    2012-06-01

    The literature on chronic diseases indicates that partner support, as perceived by patients, contributes to well-being of patients in either a positive or a negative way. Previous studies indicated that patients' and partners' perceptions of unsupportive partner behavior are only moderately related. Our aim was (1) to investigate whether discrepancies between patients' and partners' perceptions of two types of unsupportive partner behavior-overprotection and protective buffering-were associated with the level of distress reported by patients with chronic obstructive pulmonary disease (COPD) and (2) to evaluate whether the direction of the differences between patients' and partners' perceptions was associated with distress (i.e., whether patient distress was associated with greater patient or greater partner reports of unsupportive partner behavior). A cross-sectional study was performed using the data of a sample of 68 COPD patients and their spouses. Distress was assessed using the Hopkins Symptom Checklist-25. Patients' and partners' perceptions of unsupportive partner behavior were assessed with a questionnaire measuring overprotection and protective buffering. Distress was independently associated with patients' perceptions of protective buffering and discrepancies in spouses' perceptions of overprotection. Regarding the direction of the discrepancy, we found that greater partner reports of overprotection as compared with patient reports were related to more distress in COPD patients. Our study showed that patients' distress was associated not only with patients' perceptions, but also with discrepancies between patients' and partners' perceptions of unsupportive partner behavior. PsycINFO Database Record (c) 2012 APA, all rights reserved.

  12. Discrepant Story Task (DST): An Instrument Used to Explore Narrative Strategies in Bullying

    Science.gov (United States)

    Smorti, Andrea.; Ortega-Rivera, J.; Ortega, R.

    2006-01-01

    The main aim of this contribution is to describe an instrument devised to study some of the cognitive processes that occur when people interpret social events (Discrepant Story Task-DST; Smorti, 2004). In particular, this instrument analyses the narrative processes of interpretation used by an observer when witnessing progressive and…

  13. Understanding Discrepancy in Perceptions of Values: Individuals with Mild to Moderate Dementia and Their Family Caregivers

    Science.gov (United States)

    Reamy, Allison M.; Kim, Kyungmin; Zarit, Steven H.; Whitlatch, Carol J.

    2011-01-01

    Purpose of the Study: We explore discrepancies in perceptions of values and care preferences between individuals with dementia (IWDs) and their family caregivers. Design and Methods: We interviewed 266 dyads consisting of an individual with mild to moderate dementia and his or her family caregiver to determine IWDs' beliefs for 5 values related to…

  14. Morozov-type discrepancy principle for nonlinear ill-posed problems ...

    Indian Academy of Sciences (India)

    2016-08-26

    Aug 26, 2016 ... For proving the existence of a regularization parameter under a Morozov-type discrepancy principle for Tikhonov regularization of nonlinear ill-posed problems, it is required to impose additional nonlinearity assumptions on the forward operator. Lipschitz continuity of the Freéchet derivative and requirement ...

  15. Gender discrepancies in the HIV/AIDS Community Home-Based ...

    African Journals Online (AJOL)

    The aim and objective of this paper is to discuss the gender discrepancies associated with caregiving based on empirical findings from the Kanye HIV/AIDS ... The study recommends gender mainstreaming and analysis in all the institutions of social development, as well as poverty mitigation measures and education to ...

  16. Parent-child discrepancy in reporting children's post-traumatic stress reactions after a traffic accident.

    Science.gov (United States)

    Dyb, Grete; Holen, Are; Braenne, Kjersti; Indredavik, Marit S; Aarseth, Jon

    2003-01-01

    This study examines possible parent-child discrepancies in the reporting of post-traumatic stress reactions in children after a traffic accident. Sixteen children exposed to the same traffic accident were interviewed about post-traumatic stress reactions at 5 weeks and at 6 months after the event, utilizing the Child Posttraumatic Stress Reaction Index (CPTS-RI). Independently, the parents' reported their child's degree of post-traumatic stress reactions on the CPTS-RI: Parent questionnaire, at the same two times. Clinicians also assessed the children's level of general functioning on the Children's Global Assessment Scale. The children reported significantly more post-traumatic stress reactions than observed by their parents 4 weeks after the accident. The parent-child discrepancy was more pronounced among younger children. The level of children's self-reported post-traumatic stress reactions decreased significantly from the first to the second assessment. At the second assessment, 6 months after the accident, there was no significant parent-child discrepancy observed. The children showed a normal level of functioning despite their post-traumatic stress reactions. The reported parent-child discrepancy indicates that information about children's post-traumatic stress reactions after an accident is best obtained directly from the children.

  17. 12 CFR 222.82 - Duties of users regarding address discrepancies.

    Science.gov (United States)

    2010-01-01

    ... Identity Theft § 222.82 Duties of users regarding address discrepancies. (a) Scope. This section applies to... consumer's identity in accordance with the requirements of the Customer Identification Program (CIP) rules implementing 31 U.S.C. 5318(l) (31 CFR 103.121); (B) Maintains in its own records, such as applications, change...

  18. Media Representations of Bullying toward Queer Youth: Gender, Race, and Age Discrepancies

    Science.gov (United States)

    Paceley, Megan S.; Flynn, Karen

    2012-01-01

    In 2010, media coverage on the bullying of queer youth increased dramatically. This study examined online news media's portrayal of the gender, race, and age of bullying victims. Content analyses of ten sources were compared to research on the dynamics of sexuality-based bullying. Discrepancies were found for gender and race (with White males…

  19. Correlation of Reading and Listening Comprehension Discrepancy with Teacher Perceptions of Reading Disability in Ghana

    Science.gov (United States)

    Taylor, Mark

    2014-01-01

    The catalyst for this study emerged from the unprecedented number of Ghanaian students with reading difficulties, in an environment where school counselors are generally unavailable, funding is limited, and most educators do not recognize learning disabilities as true disabilities. Based on the limitations of the IQ-achievement discrepancy model…

  20. Determination of peak bone mass density and composition in low income urban residents of metro Manila using isotope techniques

    International Nuclear Information System (INIS)

    Lim-Abrahan, M.A.

    2000-01-01

    The work described in this paper is a continuation of the first phase of the study, which is the determination of the peak bone mass density among residents of Metro Manila using dual energy x-ray absorptiometry. However, it also aims to correlate sex, body mass index, nutritional factors, physical activity and lifestyle to peak bone mass and thus attempts to explain any discrepancies in peak bone mass density to that seen in other countries

  1. Self-discrepancies in work-related upper extremity pain: relation to emotions and flexible-goal adjustment.

    Science.gov (United States)

    Goossens, Mariëlle E; Kindermans, Hanne P; Morley, Stephen J; Roelofs, Jeffrey; Verbunt, Jeanine; Vlaeyen, Johan W

    2010-08-01

    Recurrent pain not only has an impact on disability, but on the long term it may become a threat to one's sense of self. This paper presents a cross-sectional study of patients with work-related upper extremity pain and focuses on: (1) the role of self-discrepancies in this group, (2) the associations between self-discrepancies, pain, emotions and (3) the interaction between self-discrepancies and flexible-goal adjustment. Eighty-nine participants completed standardized self-report measures of pain intensity, pain duration, anxiety, depression and flexible-goal adjustment. A Selves Questionnaire was used to generate self-discrepancies. A series of hierarchical regression analyses showed relationships between actual-ought other, actual-ought self, actual-feared self-discrepancies and depression as well as a significant association between actual-ought other self-discrepancy and anxiety. Furthermore, significant interactions were found between actual-ought other self-discrepancies and flexibility, indicating that less flexible participants with large self-discrepancies score higher on depression. This study showed that self-discrepancies are related to negative emotions and that flexible-goal adjustment served as a moderator in this relationship. The view of self in pain and flexible-goal adjustment should be considered as important variables in the process of chronic pain. Copyright (c) 2009 European Federation of International Association for the Study of Pain Chapters. Published by Elsevier Ltd. All rights reserved.

  2. Comparative analyses reveal discrepancies among results of commonly used methods for Anopheles gambiaemolecular form identification

    Directory of Open Access Journals (Sweden)

    Pinto João

    2011-08-01

    Full Text Available Abstract Background Anopheles gambiae M and S molecular forms, the major malaria vectors in the Afro-tropical region, are ongoing a process of ecological diversification and adaptive lineage splitting, which is affecting malaria transmission and vector control strategies in West Africa. These two incipient species are defined on the basis of single nucleotide differences in the IGS and ITS regions of multicopy rDNA located on the X-chromosome. A number of PCR and PCR-RFLP approaches based on form-specific SNPs in the IGS region are used for M and S identification. Moreover, a PCR-method to detect the M-specific insertion of a short interspersed transposable element (SINE200 has recently been introduced as an alternative identification approach. However, a large-scale comparative analysis of four widely used PCR or PCR-RFLP genotyping methods for M and S identification was never carried out to evaluate whether they could be used interchangeably, as commonly assumed. Results The genotyping of more than 400 A. gambiae specimens from nine African countries, and the sequencing of the IGS-amplicon of 115 of them, highlighted discrepancies among results obtained by the different approaches due to different kinds of biases, which may result in an overestimation of MS putative hybrids, as follows: i incorrect match of M and S specific primers used in the allele specific-PCR approach; ii presence of polymorphisms in the recognition sequence of restriction enzymes used in the PCR-RFLP approaches; iii incomplete cleavage during the restriction reactions; iv presence of different copy numbers of M and S-specific IGS-arrays in single individuals in areas of secondary contact between the two forms. Conclusions The results reveal that the PCR and PCR-RFLP approaches most commonly utilized to identify A. gambiae M and S forms are not fully interchangeable as usually assumed, and highlight limits of the actual definition of the two molecular forms, which might

  3. An Innovative Educational and Mentorship Program for Emergency Medicine Women Residents to Enhance Academic Development and Retention.

    Science.gov (United States)

    Bhatia, Kriti; Takayesu, James Kimo; Arbelaez, Christian; Peak, David; Nadel, Eric S

    2015-11-01

    Given the discrepancy between men and women's equal rates of medical school matriculation and their rates of academic promotion and leadership role acquisition, the need to provide mentorship and education to women in academic medicine is becoming increasingly recognized. Numerous large-scale programs have been developed to provide support and resources for women's enrichment and retention in academic medicine. Analyses of contributory factors to the aforementioned discrepancy commonly cite insufficient mentoring and role modeling as well as challenges with organizational navigation. Since residency training has been shown to be a critical juncture for making the decision to pursue an academic career, there is a need for innovative and tailored educational and mentorship programs targeting residents. Acknowledging residents' competing demands, we designed a program to provide easily accessible mentorship and contact with role models for our trainees at the departmental and institutional levels. We believe that this is an important step towards encouraging women's pursuit of academic careers. Our model may be useful to other emergency medicine residencies looking to provide such opportunities for their women residents.

  4. Gender stereotype endorsement differentially predicts girls' and boys' trait-state discrepancy in math anxiety.

    Science.gov (United States)

    Bieg, Madeleine; Goetz, Thomas; Wolter, Ilka; Hall, Nathan C

    2015-01-01

    Mathematics is associated with anxiety for many students; an emotion linked to lower well-being and poorer learning outcomes. While findings typically show females to report higher trait math anxiety than males, no gender differences have to date been found in state (i.e., momentary) math anxiety. The present diary study aimed to replicate previous findings in investigating whether levels of academic self-concept was related to this discrepancy in trait vs. state anxiety measures. Additionally, mathematics-related gender stereotype endorsement (mathematics is a male domain) was investigated as an additional predictor of the trait-state discrepancy. The sample included 755 German 9th and 10th graders who completed self-report measures of trait math anxiety, math self-concept, and gender stereotype endorsement, in addition to state measures of anxiety after math classes by use of a standardized diary for 2-3 weeks (N within = 6207). As expected, females reported higher trait math anxiety but no gender differences were found for state math anxiety. Also in line with our assumptions, multilevel analyses showed the discrepancy between trait and state anxiety to be negatively related to students' self-concept (i.e., a lower discrepancy for students with higher self-concepts). Furthermore, gender stereotype endorsement differentially predicted the trait-state discrepancy: When controlling for self-concept in mathematics, females who endorsed the gender stereotype of math being a male domain more strongly overestimated their trait math anxiety as compared to their state anxiety whereas this effect was not significant for males. The present findings suggest that gender stereotype endorsement plays an important role in explaining gender differences in math anxiety above and beyond academic self-concept. Implications for future research and educational practice are discussed.

  5. The amplitude of the Love-Rayleigh discrepancy created by small-scale heterogeneities

    Science.gov (United States)

    Maupin, Valérie

    2002-07-01

    At global as well as at regional scale, the lithosphere appears faster to Love waves than to Rayleigh waves. This Love-Rayleigh discrepancy can be modelled by introducing transverse isotropy in the upper mantle. In some regions however, it is so large that the question arises as to whether part of it could be an artefact related to the presence of heterogeneities in the lithosphere. Using a multiple-scattering scheme to model surface waves in 3-D structures, we analyse the influence of small-scale heterogeneities in the lithosphere on the Love-Rayleigh discrepancy in the period range 25 to 60 s. Small-scale heterogeneities tend to lower the apparent phase velocity of the surface waves, and have a larger effect on the Love waves than on the Rayleigh waves. This is not due to mode-coupling, which plays a negligible role here, but to the interference of the primary field with the one backscattered twice. For models with S-wave velocity variations of rms 2.5 per cent, and spatial correlations at distances of 20 to 100 km, we find that the Love waves are on average and at most 0.1 per cent slower than the Rayleigh waves. This apparent Love-Rayleigh discrepancy varies linearly with the variance of S-wave velocity variation in the structure. We conclude that small-scale heterogeneities do not contribute significantly to the large Love-Rayleigh discrepancies of 4 to 9 per cent observed in some regions, since they produce an apparent discrepancy which is negligible in comparison, and which even has the opposite sign.

  6. Reasons for discrepancy between incidence and prevalence of epilepsy in lower income countries: Epilepsia's survey results.

    Science.gov (United States)

    Mathern, Gary W; Beninsig, Laurie; Nehlig, Astrid

    2015-02-01

    From July to August 2014, Epilepsia conducted an online survey seeking opinions that explained the discrepancy between the incidence and prevalence of epilepsy in lower income countries. Data on cumulative incidence suggest a higher rate of active epilepsy than reported in lifetime prevalence surveys. This study reports the findings of that poll addressing the proposal in our Controversy in Epilepsy series that it could be from increased death rates. The survey consisted of a question addressing possible reasons to explain the discrepancy between the incidence and prevalence of epilepsy. Another four questions addressed demographic information. There were 34 responders who completed the survey. Half (50%) of the responders felt that the discrepancy between cumulative incidence and lifetime prevalence was due to lack of uniform definitions and misclassification of patients in study design, 23.5% said the discrepancy was due to a higher mortality from diseases and conditions such as trauma and infections associated with epilepsy, 23.5% indicated that the stigma of epilepsy prevented people from acknowledging their disease in prevalence surveys, and 2.9% felt it was from poor access to qualified medical personal and utilization of medical treatments that increased death rates directly related to epilepsy. Within the limitations of sample size, the results of this survey support that the discrepancy between the incidence and prevalence of epilepsy in lower income regions of the world is due to problems in acquiring the data and stigma rather than higher mortality from diseases associated with epilepsy and repeated seizures. Wiley Periodicals, Inc. © 2014 International League Against Epilepsy.

  7. Masculine Discrepancy Stress, Teen Dating Violence, and Sexual Violence Perpetration Among Adolescent Boys

    Science.gov (United States)

    Reidy, Dennis E.; Smith-Darden, Joanne P.; Cortina, Kai S.; Kernsmith, Roger M.; Kernsmith, Poco D.

    2018-01-01

    Purpose Addressing gender norms is integral to understanding and ultimately preventing violence in both adolescent and adult intimate relationships. Males are affected by gender role expectations which require them to demonstrate attributes of strength, toughness, and dominance. Discrepancy stress is a form of gender role stress that occurs when boys and men fail to live up to the traditional gender norms set by society. Failure to live up to these gender role expectations may precipitate this experience of psychological distress in some males which, in turn, may increase the risk to engage in physically and sexually violent behaviors as a means of demonstrating masculinity. Methods Five-hundred eighty-nine adolescent males from schools in Wayne County, Michigan completed a survey assessing self-perceptions of gender role discrepancy, the experience of discrepancy stress, and history of physical and sexual dating violence. Results Logistic regression analyses indicated boys who endorsed gender role discrepancy and associated discrepancy stress were generally at greater risk to engage in acts of sexual violence but not necessarily physical violence. Conclusions Boys who experience stress about being perceived as “sub-masculine” may be more likely to engage in sexual violence as a means of demonstrating their masculinity to self and/or others and thwarting potential “threats” to their masculinity by dating partners. Efforts to prevent sexual violence perpetration among male adolescents should perhaps consider the influence of gender socialization in this population and include efforts to reduce distress about masculine socialization in primary prevention strategies. PMID:26003576

  8. Gender stereotype endorsement differentially predicts girls' and boys' trait-state discrepancy in math anxiety

    Directory of Open Access Journals (Sweden)

    Madeleine eBieg

    2015-09-01

    Full Text Available Mathematics is associated with anxiety for many students; an emotion linked to lower well-being and poorer learning outcomes. While findings typically show females to report higher trait math anxiety than males, no gender differences have to date been found in state (i.e., momentary math anxiety. The present diary study aimed to replicate previous findings in investigating whether levels of academic self-concept was related to this discrepancy in trait versus state anxiety measures. Additionally, mathematics-related gender stereotype endorsement (mathematics is a male domain was investigated as an additional predictor of the trait-state discrepancy. The sample included 755 German 9th and 10th graders who completed self-report measures of trait math anxiety, math self-concept, and gender stereotype endorsement, in addition to state measures of anxiety after math classes by use of a standardized diary for 2-3 weeks (Nwithin = 6207. As expected, females reported higher trait math anxiety but no gender differences were found for state math anxiety. Also in line with our assumptions, multilevel analyses showed the discrepancy between trait and state anxiety to be negatively related to students’ self-concept (i.e., a lower discrepancy for students with higher self-concepts. Furthermore, gender stereotype endorsement differentially predicted the trait-state discrepancy: When controlling for self-concept in mathematics, females who endorsed the gender stereotype of math being a male domain more strongly overestimated their trait math anxiety as compared to their state anxiety whereas this effect was not significant for males. The present findings suggest that gender stereotype endorsement plays an important role in explaining gender differences in math anxiety above and beyond academic self-concept. Implications for future research and educational practice are discussed.

  9. Possible involvement of distinct phylogenetic clusters of HIV-1 variants in the discrepancies between coreceptor tropism predictions based on viral RNA and proviral DNA.

    Science.gov (United States)

    Kotani, Hiroshi; Sudo, Koji; Hasegawa, Naoki; Fujiwara, Hiroshi; Hayakawa, Tomohisa; Iketani, Osamu; Yamaguchi, Masaya; Mochizuki, Mayumi; Iwata, Satoshi; Kato, Shingo

    2016-01-01

    The coreceptor tropism testing should be conducted prior to commencing a regimen containing a CCR5 antagonist for treatment of HIV-1 infection. For aviremic patients on long antiretroviral therapy, proviral DNA is often used instead of viral RNA in genotypic tropism testing. However, the tropism predictions from RNA and DNA are sometimes different. We examined the cause of the discrepancies between HIV-1 tropism predictions based on viral RNA and proviral DNA. The nucleotide sequence of the env C2V3C3 region was determined using pair samples of plasma RNA and peripheral blood mononuclear cell DNA from 50 HIV-1 subtype B-infected individuals using population-based sequencing. The samples with discrepant tropism assessments between RNA and DNA were further analyzed using deep sequencing, followed by phylogenetic analysis. The tropism was assessed using the algorithm geno2pheno with a false-positive rate cutoff of 10 %. In population-based sequencing, five of 50 subjects showed discrepant tropism predictions between their RNA and DNA samples: four exhibited R5 tropism in RNA and X4 tropism in DNA, while one exhibited the opposite pattern. In the deep sequencing and phylogenetic analysis, three subjects had single clusters comprising of RNA- and DNA-derived sequences that were a mixture of R5 and X4 sequences. The other two subjects had two and three distinct phylogenetic clusters of sequences, respectively, each of which was dominated by R5 or X4 sequences; sequences of the R5-dominated cluster were mostly found in RNA, while sequences of the X4-dominated cluster were mostly in DNA. Some of HIV-1 tropism discrepancies between viral RNA and proviral DNA seem to be caused by phylogenetically distinct clusters which resides in plasma and cells in different frequencies. Our findings suggest that the tropism testing using PBMC DNA or deep sequencing may be required when the viral load is not suppressed or rebounds in the course of a CCR5 antagonist-containing regimen.

  10. Evolving Perceptions of the Plastic Surgery Integrated Residency Training Program.

    Science.gov (United States)

    Pace, Elizabeth; Mast, Bruce; Pierson, Justine M; Leavitt, Adam; Reintgen, Christian

    2016-01-01

    In recent years, there has been a transition in plastic surgery residency training. Many programs across the country are now using integrated training modalities vs. independent training programs. This change in residency training has brought into question the effectiveness of integrated residency programs, in which medical students immediately enter the plastic surgery specialty upon graduation. This study assessed plastic surgery residency program directors and faculty members׳ viewpoints on the transition to integrated training programs and the effect this transition has had on the training of plastic surgery residents. An anonymous 13-question survey was formulated using a pilot survey sent to members of the plastic surgery department at the University of Florida. The final survey was then electronically sent via SurveyMonkey.com to 92 current plastic surgery residency program directors. Program directors were identified via program lists provided by the American Council of Academic Surgeons. Program directors were then asked to forward the survey to faculty members of their respective institutions. Responses collected were analyzed via SurveyMonkey.com and Microsoft Excel. University of Florida College of Medicine, Department of Plastic Surgery. Plastic surgery residency program directors as identified by the American Council of Academic Surgeons. A response rate of 40.2% was achieved via 37 of the 92 plastic surgery program directors responding to the electronic survey. An additional 6 anonymous faculty members also responded to the survey, 13.9% of all responses. Institutions indicated that the majority was using integrated residency programs, with some institutions using both integrated and independent training programs simultaneously. Most respondents indicated that they supported the transition to the integrated residency program at their respective institutions. Respondents indicated several reasons as to why or why not programs have transitioned to the

  11. Perception Of Obstetrics And Gynaecology Resident Doctors Of ...

    African Journals Online (AJOL)

    Background: Nigeria has one of the highest maternal and perinatal morbidity and mortality rates in the world and the practice of traditional birth assistants (TBAs) is a major contributory factor. Objective: To assess the perception of traditional birth attendants' practices by resident Nigerian obstetriciangynaecologists.

  12. Evaluation of surgical resident staff knowledge of cancer pain ...

    African Journals Online (AJOL)

    Objective: Inadequate knowledge and expertise are major contributing factors to poor pain management in the cancer patient. This study was carried out to evaluate the effect of formal teaching on pain management on the current practice of the resident surgeons at the University College Hospital (UCH). Ibadan. Method: ...

  13. Implementing Interpersonal Psychotherapy in a Psychiatry Residency Training Program

    Science.gov (United States)

    Lichtmacher, Jonathan; Eisendrath, Stuart J.; Haller, Ellen

    2006-01-01

    Objective: Interpersonal psychotherapy (IPT) for depression is a brief, well researched treatment for acute major depression. This article describes the implementation of IPT as an evidence-based treatment for depression in a psychiatry residency program. Method: The authors tracked the implementation process over 5 years as interpersonal…

  14. 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.

  15. 38 CFR 51.70 - Resident rights.

    Science.gov (United States)

    2010-07-01

    ... FOR NURSING HOME CARE OF VETERANS IN STATE HOMES Standards § 51.70 Resident rights. The resident has a... legal representative. (5) Conveyance upon death. Upon the death of a resident with a personal fund...; (iii) Physicians of the resident's choice (to provide care in the nursing home, physicians must meet...

  16. 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, ...

  17. Surgery resident learning styles and academic achievement.

    Science.gov (United States)

    Contessa, Jack; Ciardiello, Kenneth A; Perlman, Stacie

    2005-01-01

    To determine if surgical residents share a preferred learning style as measured by Kolb's Learning Style Inventory (LSI) and if a relationship exists between resident learning style and achievement as measured by a standardized examination (AME). Also, core faculty learning styles were assessed to determine if faculty and residents share a preferred learning style. Kolb's LSI, Version 3, was administered to 16 surgical residents and the residency program's core faculty of 6 attending physicians. To measure academic achievement, the American Medical Education (AME) examination was administered to residents. The Hospital of Saint Raphael, General Surgery Residency Program, New Haven, Connecticut. Both instruments were administered to residents during protected core curriculum time. Core faculty were administered the LSI on an individual basis. Surgical residents of the Hospital of Saint Raphael's General Surgery Residency Program and 6 core faculty members Analysis of resident learning style preference revealed Converging as the most commonly occurring style for residents (7) followed by Accommodating (5), Assimilating (3), and Diverging (1). The predominant learning style for core faculty was also Converging (4) with 2 Divergers. The average score for the Convergers on the AME was 62.6 compared with 42 for the next most frequently occurring learning style, Accommodators. In this surgical residency program, a preferred learning style for residents seems to exist (Converging), which confirms what previous studies have found. Additionally, residents with this learning style attained a higher average achievement score as measured by the AME. Also, core faculty share the same preferential learning style as this subset of residents.

  18. 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.

  19. 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.

  20. Understanding how residents’ preferences for supervisory methods change throughout residency training: a mixed-methods study

    OpenAIRE

    Olmos-Vega, Francisco; Dolmans, Diana; Donkers, Jeroen; Stalmeijer, Renée E.

    2015-01-01

    Background A major challenge for clinical supervisors is to encourage their residents to be independent without jeopardising patient safety. Residents’ preferences according to level of training on this regard have not been completely explored. This study has sought to investigate which teaching methods of the Cognitive Apprenticeship (CA) model junior, intermediate and senior residents preferred and why, and how these preferences differed between groups. Methods We invited 301 residents of a...

  1. A Required Rotation in Clinical Laboratory Management for Pathology Residents

    Science.gov (United States)

    Hoda, Syed T.; Crawford, James M.

    2016-01-01

    Leadership and management training during pathology residency have been identified repeatedly by employers as insufficient. A 1-month rotation in clinical laboratory management (CLM) was created for third-year pathology residents. We report on our experience and assess the value of this rotation. The rotation was one-half observational and one-half active. The observational component involved being a member of department and laboratory service line leadership, both at the departmental and institutional level. Observational participation enabled learning of both the content and principles of leadership and management activities. The active half of the rotation was performance of a project intended to advance the strategic trajectory of the department and laboratory service line. In our program that matriculates 4 residents per year, 20 residents participated from April 2010 through December 2015. Their projects either activated a new priority area or helped propel an existing strategic priority forward. Of the 16 resident graduates who had obtained their first employment or a fellowship position, 9 responded to an assessment survey. The majority of respondents (5/9) felt that the rotation significantly contributed to their ability to compete for a fellowship or their first employment position. The top reported benefits of the rotation included people management; communication with staff, departmental, and institutional leadership; and involvement in department and institutional meetings and task groups. Our 5-year experience demonstrates both the successful principles by which the CLM rotation can be established and the high value of this rotation to residency graduates. PMID:28725766

  2. A Required Rotation in Clinical Laboratory Management for Pathology Residents

    Directory of Open Access Journals (Sweden)

    Arvind Rishi MD

    2016-05-01

    Full Text Available Leadership and management training during pathology residency have been identified repeatedly by employers as insufficient. A 1-month rotation in clinical laboratory management (CLM was created for third-year pathology residents. We report on our experience and assess the value of this rotation. The rotation was one-half observational and one-half active. The observational component involved being a member of department and laboratory service line leadership, both at the departmental and institutional level. Observational participation enabled learning of both the content and principles of leadership and management activities. The active half of the rotation was performance of a project intended to advance the strategic trajectory of the department and laboratory service line. In our program that matriculates 4 residents per year, 20 residents participated from April 2010 through December 2015. Their projects either activated a new priority area or helped propel an existing strategic priority forward. Of the 16 resident graduates who had obtained their first employment or a fellowship position, 9 responded to an assessment survey. The majority of respondents (5/9 felt that the rotation significantly contributed to their ability to compete for a fellowship or their first employment position. The top reported benefits of the rotation included people management; communication with staff, departmental, and institutional leadership; and involvement in department and institutional meetings and task groups. Our 5-year experience demonstrates both the successful principles by which the CLM rotation can be established and the high value of this rotation to residency graduates.

  3. The Economic Burden of Orthopedic Surgery Residency Interviews on Applicants.

    Science.gov (United States)

    Fogel, Harold A; Finkler, Elissa S; Wu, Karen; Schiff, Adam P; Nystrom, Lukas M

    2016-01-01

    The intense competition for orthopedic surgery residency positions influences the interview process. The financial impact on residency applicants is less well understood. The purpose of the present study was to define the economic burden of the orthopedic surgery residency interview process while additionally describing how applicants finance the expense. We distributed surveys to 48 nonrotating applicants at our institution's residency interview days for the 2015 match year. The survey consisted of eleven questions specific to the costs of interviewing for orthopedic surgery residency positions. The survey response rate was 90% (43/48). Applicants applied to a median of 65 orthopedic surgery residency programs (range 21-88) and targeted a median of 15 interviews (range 12-25). The mean cost estimate for a single interview was $450 (range $200-800) and the cost estimate for all interviews was $7,119 (range $2,500-15,000). Applicants spent a mean of $344 (range $0-750) traveling to our interview. Seventy-two percent borrowed money to finance their interview costs and 28% canceled interviews for financial reasons. The financial cost of interviewing for orthopedic surgery is substantial and a majority of applicants add to their educational debt by taking out loans to finance interviews. Future considerations should be made to minimize these costs for an already financially burdened population.

  4. Long-term Retention of Musculoskeletal Ultrasound Training During Residency.

    Science.gov (United States)

    Irwin, Robert W; Smith, Jeffrey; Issenberg, S Barry

    2018-03-15

    The Accreditation Council for Graduate Medical Education (ACGME) and the American Board of Physical Medicine and Rehabilitation (ABPMR) developed milestones for evaluation of resident physicians that include proper musculoskeletal ultrasound (MSUS) examination of major joints. To date, there have been no published data demonstrating acquisition and retention of these skills and correlation with the milestone evaluation. The investigators developed and implemented a curriculum in musculoskeletal ultrasound examination for Physical Medicine and Rehabilitation (PM&R) residents at a large academic medical center. The investigators chose six joints for training and evaluation: ankle, elbow, hip, knee, shoulder and wrist/hand. The program included: 1) didactic lectures on anatomy and ultrasound technique; 2) peer-led demonstrations of the procedure on a standardized patient (SP); 3) individual practice on SPs; 4) faculty observation and feedback; 5) review sessions and additional practice; and, 6) assessment of skills in an objective structured clinical examination (OSCE). From 2013-2017, 30 PM&R residents were trained and evaluated. The results, based on OSCE scores, showed that the majority of residents achieved the appropriate level of competency for their year. A blended, standardized curriculum in MSUS instruction with assessment by an OSCE, can be used to evaluate MSUS skills, and can help align this education with residency milestones.

  5. Nationwide survey of US integrated 6-year cardiothoracic surgical residents.

    Science.gov (United States)

    Lebastchi, Amir H; Yuh, David D

    2014-08-01

    Integrated 6-year cardiothoracic surgical residency programs have recently been implemented in the United States. We report the results of the first published nationwide survey assessing the motivations, satisfaction, and ambitions of integrated 6-year residents. A 63-question web-based survey was distributed to 83 residents enrolled in 21 Accreditation Council for Graduate Medical Education-accredited integrated 6-year programs in November 2013. There was an outstanding 69% response rate. The median age of integrated 6-year residents was 29 years with women comprising 24%. A clear majority had faculty mentorship (95%) and significant clinical exposure in medical school. Focused (100%) and abbreviated (74%) training curricula were identified as the top advantages of integrated 6-year programs; the format itself was a significant factor (46%) in career choice. Most integrated 6-year residents (95%) were satisfied with their program; 80.7% were satisfied with their operative experience thus far. Career plans skewed toward adult cardiac surgery (67%), followed by pediatric cardiac (24%) and general thoracic (9%) surgery; 49% were not particularly concerned about future employment, with 65% foreseeing an increase in opportunities. Specialized training (eg, aortic, heart failure, minimally invasive, congenital) was anticipated by 77%. Most integrated 6-year residents envision an academic career (94.7%). This survey takes an important snapshot of the nascent integrated 6-year format. Mentorship and intense clinical exposure are critical in attracting applicants. Purported advantages of the format are holding true among integrated 6-year residents, with the majority satisfied with their programs. These early data indicate that this format holds significant promise in attracting and retaining highly qualified trainees to academic cardiothoracic surgery. Copyright © 2014 The American Association for Thoracic Surgery. Published by Mosby, Inc. All rights reserved.

  6. Increasing Trends in Orthopedic Fellowships Are Not due to Inadequate Residency Training

    Directory of Open Access Journals (Sweden)

    K. A. Almansoori

    2015-01-01

    Full Text Available Orthopedic residents have one of the highest fellowship participation rates among medical specialities and there are growing concerns that inadequate residency training may be contributing to this trend. Therefore, a mixed-exploratory research survey was distributed to all 148 graduating Canadian orthopedic residents to investigate their perceptions and attitudes for pursuing fellowships. A response rate of 33% (n=49 was obtained with the majority of residents undertaking one (27% or two (60% fellowships. Surgical-skill development was reported as the most common motivating factor, followed by employment and marketability; malpractice protection and financial reasons were the least relevant. The overwhelming majority of residents (94%, n=46 felt adequately prepared by their residency training for independent general practice, and 84% (n=41 of respondents did not feel that current fellowship trends were due to poor residency training. Three common themes were expressed in their comments: the growing perceived expectation by healthcare professionals and employers to be fellowship-certified, the integration of fellowship training into the surgical education hierarchy, and the failure of residency training curriculums to accommodate for this trend. In conclusion, Canadian orthopedic residents are confident of their residency training and are increasingly pursuing fellowships to primarily develop their surgical skills and expertise.

  7. Education on the Business of Plastic Surgery During Training: A Survey of Plastic Surgery Residents.

    Science.gov (United States)

    Ovadia, Steven A; Gishen, Kriya; Desai, Urmen; Garcia, Alejandro M; Thaller, Seth R

    2018-02-14

    Entrepreneurial skills are important for physicians, especially plastic surgeons. Nevertheless, these skills are not typically emphasized during residency training. Evaluate the extent of business training at plastic surgery residency programs as well as means of enhancing business training. A 6-question online survey was sent to plastic surgery program directors for distribution to plastic surgery residents. Responses from residents at the PGY2 level and above were included for analysis. Tables were prepared to present survey results. Hundred and sixty-six residents including 147 PGY2 and above residents responded to our survey. Only 43.5% reported inclusion of business training in their plastic surgery residency. A majority of residents reported they do not expect on graduation to be prepared for the business aspects of plastic surgery. Additionally, a majority of residents feel establishment of a formal lecture series on the business of plastic surgery would be beneficial. Results from our survey indicate limited training at plastic surgery programs in necessary business skills. Plastic surgery residency programs should consider incorporating or enhancing elements of business training in their curriculum. This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .

  8. Vacuum and forceps training in residency: experience and self-reported competency.

    Science.gov (United States)

    Powell, J; Gilo, N; Foote, M; Gil, K; Lavin, J P

    2007-06-01

    Determine chief residents' experience with vacuum and forceps deliveries and self-perceived competencies with the procedures. Study 1: A written questionnaire was mailed to all fourth year residents in US RRC approved Ob/Gyn programs. Study 2: The study was replicated using a web-based survey the following year. Data were analyzed with chi (2) and Wilcoxon Signed Rank tests using SPSS. Surveys were received from 238 residents (20%) in Study 1 and 269 residents in Study 2 (23%, representing 50% of all residency programs). In both studies, residents reported performing significantly less forceps than vacuum deliveries. Virtually all residents wanted to learn to perform both deliveries, indicated attendings were willing to teach both, and felt competent to perform vacuum deliveries (Study 1, 94.5%; Study 2, 98.5%); only half felt competent to perform forceps deliveries (Study 1, 57.6%; Study 2, 55.0%). The majority of residents who felt competent to perform forceps deliveries reported that they would predominately use forceps or both methods of deliveries in their practice (Study 1, 75.8%; Study 2, 64.6%). The majority of residents who reported that they did not feel competent to perform forceps deliveries reported that they would predominately use vacuum deliveries in their practice (Study 1, 86.1%; Study 2, 84.2%). Current training results in a substantial portion of residents graduating who do not feel competent to perform forceps deliveries. Perceived competency affected future operative delivery plans.

  9. Surgical residency market research-what are applicants looking for?

    Science.gov (United States)

    Parker, Anna M; Petroze, Robin T; Schirmer, Bruce D; Calland, James F

    2013-01-01

    We propose that one of the integral parts of building a stronger residency program is the ability to recruit top applicants. Little is known about the factors applicants use to evaluate residency programs. Given that the top applicants are likely to be ranked highly by multiple programs, we sought to determine which factors applicants themselves used to evaluate potential residency programs. An anonymous, voluntary survey was distributed to all interviewing applicants, asking them to rank 12 factors when choosing a residency. They were additionally asked about any prior research or international medical experience. Surveys were distributed at the beginning of the interview day and collected in sealed unmarked envelopes. All applicants interviewing for general surgery residency at the University of Virginia during the 2009-2010 and 2010-2011 seasons. Resident satisfaction was rated the highest, 8.7 out of 9. In descending order of importance, applicants ranked record of the chiefs (8.0), resident case volume (7.8), academic reputation (7.6), geography (7.4), research opportunities (7.3), laparoscopic laboratory (6.2), elective time (5.4), international opportunities (5.1), benefits (4.8), and vacation (4.7), respectively. No correlation was found between prior research experience and research ranking score. A significant positive correlation was found between those applicants with prior international experience and their ranking of international opportunities during residency (p < 0.0001). Applicants rated a program on a broad range of factors and commonly cited a "gut feeling" or "esprit de corps." The ability to pursue an identified area of special interest, in this case an international opportunity, proved to be an additional major selection factor for a subset of candidates. Copyright © 2012 Association of Program Directors in Surgery. Published by Elsevier Inc. All rights reserved.

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

    Science.gov (United States)

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

    1982-11-01

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

  11. Challenges Facing Medical Residents' Satisfaction in the Middle East: A Report From United Arab Emirates.

    Science.gov (United States)

    Abdulrahman, Mahera; Qayed, Khalil I; AlHammadi, Hisham H; Julfar, Adnan; Griffiths, Jane L; Carrick, Frederick R

    2015-01-01

    PHENOMENON: Medical residents' satisfaction with the quality of training for medical residency training specialists is one of the core measures of training program success. It will also therefore contribute to the integrity of healthcare in the long run. Yet there is a paucity of research describing medical residents' satisfaction in the Middle East, and there are no published studies that measure the satisfaction of medical residents trained within the United Arab Emirates (UAE). This makes it difficult to develop a quality residency training program that might meet the needs of both physicians and society. The authors designed a questionnaire to assess medical residents' satisfaction with the Dubai residency training program in order to identify insufficiencies in the training, clinical, and educational aspects. The survey was a self-report questionnaire composed of different subscales covering sociodemographic and educational/academic profile of the residents along with their overall satisfaction of their training, curriculum, work environment, peer teamwork, and their personal opinion on their medical career. Respondents showed a substantial level of satisfaction with the residency training. The vast majority of residents (80%, N = 88) believe that their residency program curriculum and rotation was "good," "very good," or "excellent." Areas of dissatisfaction included salary, excessive paperwork during rotations, and harassment. INSIGHTS: This is the first report that studies the satisfaction of medical residents in all specialties in Dubai, UAE. Our findings provide preliminary evidence on the efficiency of different modifications applied to the residency program in UAE. To our knowledge, there has not been any previous study in the Middle East that has analyzed this aspect of medical residents from different specialties. The authors believe that this report can be used as a baseline to monitor the effectiveness of interventions applied in the future toward

  12. Residency in urology and training in kidney transplantation. Results of a national survey.

    Science.gov (United States)

    Cabello-Benavente, R; González-Enguita, C

    2015-06-01

    To determine the current state of kidney transplantation (KT) training in a country that is leader in organ donation and transplantation. We conducted an online survey by e-mail to 138 urology residents. The survey contained 5 sections: affiliation, training in KT, interest in KT, residents of transplant centers and residents of nontransplant centers. Sixty-five residents responded, 47.1% of the urologists in training surveyed, representing 28 cities and 15 provinces. Fifty-five percent (n=36) of the respondents deemed the KT training offered during their residency as insufficient, and 85% (n=55) demanded more resources. More than half were not confident in their abilities to perform transplantation surgery over the course of their residency (n=35). Nineteen percent of the residents considered KT an important discipline in their residency, with a mean score of 56.2 (1-100). Among the residents of the transplant centers (69.2%, n=45), 73% (n=33) considered KT when choosing a center for their residency. Of the surveyed residents from nontransplant centers (30.7%, n=20), 45% (n=9) do not perform an external rotation in KT. The surveyed residents demand more training in KT. The most common situation is to end a residency without having performed a complete KT. KT is considered an asset when selecting a resident medical intern position and commonly they are part of the transplantation team. The majority of residents are trained in centers with less than 75 transplants/year. External rotations in KT are not the rule in centers where transplantation is not performed. Copyright © 2014 AEU. Publicado por Elsevier España, S.L.U. All rights reserved.

  13. Implicit and explicit self-esteem discrepancies in people with psychogenic nonepileptic seizures.

    Science.gov (United States)

    Dimaro, Lian V; Roberts, Nicole A; Moghaddam, Nima G; Dawson, David L; Brown, Ian; Reuber, Markus

    2015-05-01

    Self-esteem (SE), or one's sense of competence and worth, is reduced in many mental and physical disorders. Low SE is associated with perceived stigma and disability and poor treatment outcomes. The present study examined implicit and explicit SE (automatic and deliberate views about the self) in people with epilepsy and people with psychogenic nonepileptic seizures (PNESs). Discrepancies between implicit SE and explicit SE have been found to correlate with psychological distress in disorders often associated with PNESs but are relatively unexplored in PNESs. We hypothesized that, compared with epilepsy, PNESs would be associated with lower self-reported SE and greater discrepancies between implicit SE and explicit SE. Thirty adults with PNESs, 25 adults with epilepsy, and 31 controls without a history of seizures were asked to complete the Rosenberg Self-esteem Scale as a measure of explicit SE and an Implicit Relational Assessment Procedure as a measure of implicit SE. The State-Trait Anxiety Inventory and Patient Health Questionnaire-15 (a somatic symptom inventory) were also administered. We found significant group differences in explicit (p<0.001) but not implicit SE. Patients with PNESs reported lower SE than the other groups. No group differences were found in implicit SE. Implicit-explicit SE discrepancies were larger in the group with PNESs than in the other groups (p<0.001). Higher frequency of PNESs (but not epileptic seizures) was associated with lower explicit SE (rs=-.83, p<0.01) and greater SE discrepancies (i.e., lower explicit relative to implicit SE; rs=.65, p<0.01). These relationships remained significant when controlling for anxiety and somatization. Patients with PNESs had lower explicit SE than those with epilepsy or healthy controls. In keeping with our expectations, there were greater discrepancies between implicit SE and explicit SE among patients with PNESs than in the other groups. Our results, including the strong relationship between

  14. Model Legislation on Student Residency.

    Science.gov (United States)

    Higher Education in the States, 1971

    1971-01-01

    Because of the radical variance in residency requirements from state to state and sometimes from institution to institution, and because of several court cases involving this issue, the Education Commission of the States appointed a Committee to develop (1) a statement of principles for consideration in drafting legislation in connection with…

  15. 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.

  16. Major Depression Among Adults

    Science.gov (United States)

    ... Depressive Episode Among Adolescents Data Sources Share Major Depression Definitions Major depression is one of the most common mental disorders in the United States. For some individuals, major depression can result in severe impairments that interfere with ...

  17. Continuity of Care in Resident Outpatient Clinics: A Scoping Review of the Literature.

    Science.gov (United States)

    Walker, Jeremey; Payne, Brittany; Clemans-Taylor, B Lee; Snyder, Erin Dunn

    2018-02-01

    Continuity between patients and physicians is a core principle of primary care and an accreditation requirement. Resident continuity clinics face challenges in nurturing continuity for their patients and trainees. We undertook a scoping review of the literature to better understand published benchmarks for resident continuity; the effectiveness of interventions to improve continuity; and the impact of continuity on resident and patient satisfaction, patient outcomes, and resident career choice. We developed a MEDLINE search strategy to identify articles that defined continuity in residency programs in internal medicine, family medicine, and pediatrics published prior to December 31, 2015, and used a quality evaluation tool to assess included studies. The review includes 34 articles describing 12 different measures of continuity. The usual provider of care and continuity for physician formulas were most commonly utilized, and mean baseline continuity was 56 and 55, respectively (out of a total possible score of 100). Clinic and residency program redesign innovations (eg, advanced access scheduling, team-based care, and block scheduling) were studied and had mixed impact on continuity. Continuity in resident clinics is lower than published continuity rates for independently practicing physicians. Interventions to enhance continuity in resident clinics have mixed effects. More research is needed to understand how changes in continuity affect resident and patient satisfaction, patient outcomes, and resident career choice. A major challenge to research in this area is the lack of empanelment of residents' patients, creating difficulties in scheduling and measuring continuity visits.

  18. Student Expenses in Residency Interviewing.

    Science.gov (United States)

    Walling, Anne; Nilsen, Kari; Callaway, Paul; Grothusen, Jill; Gillenwater, Cole; King, Samantha; Unruh, Gregory

    2017-08-01

    The student costs of residency interviewing are of increasing concern but limited current information is available. Updated, more detailed information would assist students and residency programs in decisions about residency selection. The study objective was to measure the expenses and time spent in residency interviewing by the 2016 graduating class of the University of Kansas School of Medicine and assess the impact of gender, regional campus location, and primary care application. All 195 students who participated in the 2016 National Residency Matching Program (NRMP) received a 33 item questionnaire addressing interviewing activity, expenses incurred, time invested and related factors. Main measures were self-reported estimates of expenses and time spent interviewing. Descriptive analyses were applied to participant characteristics and responses. Multivariate analysis of variance (MANOVA) and chi-square tests compared students by gender, campus (main/regional), and primary care/other specialties. Analyses of variance (ANOVA) on the dependent variables provided follow-up tests on significant MANOVA results. A total of 163 students (84%) completed the survey. The average student reported 38 (1-124) applications, 16 (1-54) invitations, 11 (1-28) completed interviews, and spent $3,500 ($20-$12,000) and 26 (1-90) days interviewing. No significant differences were found by gender. After MANOVA and ANOVA analyses, non-primary care applicants reported significantly more applications, interviews, and expenditures, but less program financial support. Regional campus students reported significantly fewer invitations, interviews, and days interviewing, but equivalent costs when controlled for primary care application. Cost was a limiting factor in accepting interviews for 63% and time for 53% of study respondents. Students reported investing significant time and money in interviewing. After controlling for other variables, primary care was associated with significantly

  19. Medication Discrepancies at Outpatient Departments for Mood and Anxiety Disorders in the Netherlands : Risks and Clinical Relevance

    NARCIS (Netherlands)

    Simoons, Mirjam; Mulder, Hans; Risselada, Arne J; Wilmink, Frederik W; Schoevers, Robert; Ruhé, Henricus G; van Roon, Eric N

    2016-01-01

    OBJECTIVE: To identify discrepancies between actual drug use by outpatients with mood and anxiety disorders and medication overviews from health care providers as well as to investigate the clinical relevance of those discrepancies. METHODS: A cross-sectional study in adults visiting 1 of 4

  20. Medication discrepancies despite pharmacist led medication reconciliation: the challenges of maintaining an accurate medication list in primary care.

    Science.gov (United States)

    Stewart, Autumn L; Lynch, Kevin J

    2014-01-01

    Describe the types of medication discrepancies that persist despite pharmacist-led medication reconciliation using the primary care electronic medical record (EMR). Observational case series study of established patients from an urban, indigent care clinic. Medication reconciliation was conducted immediately prior to the physician visit at baseline and return visit. Main outcome measures included: frequency, types, and reasons for discrepancies, patient knowledge, and adherence. There was a 14.5% reduction in the number of patients with a discrepancy and the frequency of discrepancies was reduced by 7.3%. The rate of medication discrepancies in the chart was reduced by 31.3%. The most common type of discrepancy that persisted at follow up were medications listed on the chart that the patient stopped taking. Discrepancies were more likely to persist in Caucasian subjects when compared to African Americans. While pharmacist led medication reconciliation appears effective at reducing the likelihood of a medication discrepancy in the EMR, challenges persist in maintaining this accuracy specifically as it relates to patient driven changes to the medication regimen.

  1. The Relations among Measurements of Informant Discrepancies within a Multisite Trial of Treatments for Childhood Social Phobia

    Science.gov (United States)

    De Los Reyes, Andres; Alfano, Candice A.; Beidel, Deborah C.

    2010-01-01

    Discrepancies between informants' reports of children's behavior are robustly observed in clinical child research and have important implications for interpreting the outcomes of controlled treatment trials. However, little is known about the basic psychometric properties of these discrepancies. This study examined the relation between…

  2. Informant Discrepancies in Externalizing and Internalizing Symptoms and Adaptive Skills of High-Functioning Children with Autism Spectrum Disorder

    Science.gov (United States)

    McDonald, Christin A.; Lopata, Christopher; Donnelly, James P.; Thomeer, Marcus L.; Rodgers, Jonathan D.; Jordan, Allyson K.

    2016-01-01

    Assessment of clinical symptoms requires information from multiple informants. Discrepancies between informants' ratings can have significant implications in school settings (e.g., access to services, treatment planning, progress monitoring). This study examined parent-teacher discrepancies for ratings of internalizing and externalizing symptoms,…

  3. The First State Dream Act: In-State Resident Tuition and Immigration in Texas

    Science.gov (United States)

    Flores, Stella M.

    2010-01-01

    In 2001, Texas became the first state to pass an in-state resident tuition policy that benefits undocumented immigrant students, a majority of whom are of Latino/a origin. This analysis estimates the effect of the Texas in-state resident tuition policy on students likely to be undocumented. Using a differences-in-differences strategy and two…

  4. The muddle of ages, turnover, transit, and residence times in the carbon cycle.

    Science.gov (United States)

    Sierra, Carlos A; Müller, Markus; Metzler, Holger; Manzoni, Stefano; Trumbore, Susan E

    2017-05-01

    Comparisons among ecosystem models or ecosystem dynamics along environmental gradients commonly rely on metrics that integrate different processes into a useful diagnostic. Terms such as age, turnover, residence, and transit times are often used for this purpose; however, these terms are variably defined in the literature and in many cases, calculations ignore assumptions implicit in their formulas. The aim of this opinion piece was i) to make evident these discrepancies and the incorrect use of formulas, ii) highlight recent results that simplify calculations and may help to avoid confusion, and iii) propose the adoption of simple and less ambiguous terms. © 2016 John Wiley & Sons Ltd.

  5. Discrepancy between self- and observer ratings of performance in social phobics.

    Science.gov (United States)

    Rapee, R M; Lim, L

    1992-11-01

    Twenty-eight subjects meeting Diagnostic and Statistical Manual of Mental Disorders (rev. 3rd ed.; American Psychiatric Association, 1987) criteria for social phobia and without a comorbid affective disorder and 33 nonclinical controls were asked to present a brief, impromptu speech to a small audience. Speakers themselves, as well as members of the audience, rated each speaker on a public speaking questionnaire that included both specific items (e.g., voice shook) and global items (e.g., appeared confident). For global items, no significant difference was indicated between the two groups on observers' ratings of public speaking performance. However, social phobics rated their own performance worse than did nonclinical controls, and there was a significantly greater discrepancy between self and other ratings for social phobics than controls. Fear of negative evaluation was the only significant predictor of the self-other discrepancy on global items.

  6. Marginal discrepancy of CAD-CAM complete-arch fixed implant-supported frameworks.

    Science.gov (United States)

    Yilmaz, Burak; Kale, Ediz; Johnston, William M

    2018-02-21

    Computer-aided design and computer-aided manufacturing (CAD-CAM) high-density polymers (HDPs) have recently been marketed for the fabrication of long-term interim implant-supported fixed prostheses. However, information regarding the precision of fit of CAD-CAM HDP implant-supported complete-arch screw-retained prostheses is scarce. The purpose of this in vitro study was to evaluate the marginal discrepancy of CAD-CAM HDP complete-arch implant-supported screw-retained fixed prosthesis frameworks and compare them with conventional titanium (Ti) and zirconia (Zir) frameworks. A screw-retained complete-arch acrylic resin prototype with multiunit abutments was fabricated on a typodont model with 2 straight implants in the anterior region and 2 implants with a 30-degree distal tilt in the posterior region. A 3-dimensional (3D) laboratory laser scanner was used to digitize the typodont model with scan bodies and the resin prototype to generate a virtual 3D CAD framework. A CAM milling unit was used to fabricate 5 frameworks from HDP, Ti, and Zir blocks. The 1-screw test was performed by tightening the prosthetic screw in the maxillary left first molar abutment (terminal location) when the frameworks were on the typodont model, and the marginal discrepancy of frameworks was evaluated using an industrial computed tomographic scanner and a 3D volumetric software. The 3D marginal discrepancy at the abutment-framework interface of the maxillary left canine (L1), right canine (L2), and right first molar (L3) sites was measured. The mean values for 3D marginal discrepancy were calculated for each location in a group with 95% confidence limits. The results were analyzed by repeated-measures 2-way ANOVA using the restricted maximum likelihood estimation and the Satterthwaite degrees of freedom methods, which do not require normality and homoscedasticity in the data. The between-subjects factor was material, the within-subjects factor was location, and the interaction was

  7. Radiative Heating in MSL Entry: Comparison of Flight Heating Discrepancy to Ground Test and Predictive Models

    Science.gov (United States)

    Cruden, Brett A.; Brandis, Aaron M.; White, Todd R.; Mahzari, Milad; Bose, Deepak

    2014-01-01

    During the recent entry of the Mars Science Laboratory (MSL), the heat shield was equipped with thermocouple stacks to measure in-depth heating of the thermal protection system (TPS). When only convective heating was considered, the derived heat flux from gauges in the stagnation region was found to be underpredicted by as much as 17 W/sq cm, which is significant compared to the peak heating of 32 W/sq cm. In order to quantify the contribution of radiative heating phenomena to the discrepancy, ground tests and predictive simulations that replicated the MSL entry trajectory were performed. An analysis is carried through to assess the quality of the radiation model and the impact to stagnation line heating. The impact is shown to be significant, but does not fully explain the heating discrepancy.

  8. Intelligence quotient discrepancy indicates levels of motor competence in preschool children at risk for developmental delays

    Directory of Open Access Journals (Sweden)

    Yu TY

    2016-02-01

    Full Text Available Tzu-Ying Yu,1 Kuan-Lin Chen,2,3 Willy Chou,4,5 Shu-Han Yang,4 Sheng-Chun Kung,4 Ya-Chen Lee,2 Li-Chen Tung4,6,7 1Department of Occupational Therapy, College of Medicine, I-Shou University, Kaohsiung, 2Department of Occupational Therapy, College of Medicine, National Cheng Kung University, Tainan, 3Department of Physical Medicine and Rehabilitation, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, 4Department of Physical Medicine and Rehabilitation, Chi-Mei Medical Center, Tainan, 5Department of Recreation and Health Care Management, Cha Nan University of Pharmacy and Science, Tainan, 6School of Medicine, Kaohsiung Medical University, Kaohsiung, 7School of Medicine, Chung Shan Medical University, Taichung, Taiwan Purpose: This study aimed to establish 1 whether a group difference exists in the motor competence of preschool children at risk for developmental delays with intelligence quotient discrepancy (IQD; refers to difference between verbal intelligence quotient [VIQ] and performance intelligence quotient [PIQ] and 2 whether an association exists between IQD and motor competence.Methods: Children’s motor competence and IQD were determined with the motor subtests of the Comprehensive Developmental Inventory for Infants and Toddlers and Wechsler Preschool and Primary Scale of Intelligence™ – Fourth Edition. A total of 291 children were included in three groups: NON-IQD (n=213; IQD within 1 standard deviation [SD], VIQ>PIQ (n=39; VIQ>PIQ greater than 1 SD, and PIQ>VIQ (n=39; PIQ>VIQ greater than 1 SD.Results: The results of one-way analysis of variance indicated significant differences among the subgroups for the “Gross and fine motor” subdomains of the Comprehensive Developmental Inventory for Infants and Toddlers, especially on the subtests of “body-movement coordination” (F=3.87, P<0.05 and “visual-motor coordination” (F=6.90, P<0.05. Motor competence was significantly

  9. Discrepant Alcohol Use, Intimate Partner Violence, and Relationship Adjustment among Lesbian Women and their Relationship Partners.

    Science.gov (United States)

    Kelley, Michelle L; Lewis, Robin J; Mason, Tyler B

    2015-11-01

    This study examined the association between relationship adjustment and discrepant alcohol use among lesbian women and their same-sex intimate partners after controlling for verbal and physical aggression. Lesbian women ( N = 819) who were members of online marketing research panels completed an online survey in which they reported both their own and same-sex intimate partner's alcohol use, their relationship adjustment, and their own and their partner's physical aggression and psychological aggression (i.e., verbal aggression and dominance/isolation). Partners' alcohol use was moderately correlated. Discrepancy in alcohol use was associated with poorer relationship adjustment after controlling for psychological aggression and physical aggression. Results are discussed in terms of the similarity and differences with previous literature primarily focused on heterosexual couples.

  10. A novel JK null allele associated with typing discrepancies among African Americans.

    Science.gov (United States)

    Billingsley, Katrina L; Posadas, Jeff B; Moulds, Joann M; Gaur, Lakshmi K

    2013-01-01

    The Jknun (Jk-3) phenotype, attributable to null or silenced alleles, has predominantly been found in persons of Polynesian descent. With the increased use of molecular genotyping, many new silencing mutations have been identified in persons of other ethnic backgrounds. To date, only two JK null alleles have been reported in African Americans, JK*01N.04 and JK*OlN.OS.A comparative study was undertaken to determine whether JK mutations were present in the regional African American population. Results of donor genotyping were compared with previously recorded results of serologic tests, and discrepant results were investigated. Although the two previously identified polymorphisms were not detected in the discrepant samples, a novel allele (191G>A) was identified and was assigned the ISBT number JK*02N.09. This study illustrates a limitation of using single-nucleotide polymorphisms for prediction of blood group antigens.

  11. Conceptualizing body dissatisfaction in eating disorders within a self-discrepancy framework: a review of evidence.

    Science.gov (United States)

    Lantz, Elin L; Gaspar, Monika E; DiTore, Rebecca; Piers, Amani D; Schaumberg, Katherine

    2018-02-09

    Body dissatisfaction, the negative subjective evaluation of one's body, is associated with many negative psychological and physical health consequences. One conceptualization of body dissatisfaction includes an experience of discrepancy between perceived actual and ideal body shapes. This paper reviews the literature on three facets of body dissatisfaction from the framework of self-discrepancy theory: perceptions of current weight, ideal body weight, and the relative importance of conforming to ideals. We review components of body dissatisfaction among healthy individuals and eating-disordered individuals. We also address the conceptualization's relationship among body dissatisfaction, weight history, and dieting to expand the impact of body dissatisfaction research and to provide more information on the nature and treatment of eating disorders.

  12. Facts and Findings on the Statistical Discrepancies of the Korean Balance of Payments

    Directory of Open Access Journals (Sweden)

    Sangyong Joo

    2000-03-01

    Full Text Available The Korea experienced drastic increases in the statistical discrepancy in balance of payments since 1997. In general, the expansion and complexity of external transactions induced by contributing capital account liberalization has contributed to this fact. The abolition of the export/import approval system seems to have accelerated the mismeasurement and omissions in external transactions. Of course, the influence of currency crisis occurred cannot be ruled out. Among economic factors, Won/dollar exchange rate volatility is found to have significant explanatory power on the magnitude of statistical discrepancy, while exchange rate returns have not. WE interpret this as the demand for relatively safe currency rising in presence of the uncertainty in domestic currency values.

  13. Caregiver and Adolescent Discrepancies in Perceptions of Violence and Their Associations with Early Adolescent Aggression.

    Science.gov (United States)

    Lindstrom Johnson, Sarah; Reichenberg, Raymond; Bradshaw, Catherine P; Haynie, Denise L; Cheng, Tina L

    2016-10-01

    This article examined the role of caregiver messages about violence and exposure to neighborhood violence on adolescent aggression in light of research regarding discrepancies between parents and their children. Drawing upon data from an urban African American sample of 144 caregiver/early adolescent dyads (M = 12.99; SD = 0.93; 58.7 % female) we examined covariates of discrepancies between caregiver and adolescent reports of perceptions of violence as well as their association with adolescent aggression. Analyses suggested that concordance in perceptions of violence was associated with children's attitudes about violence and caregivers' perceptions of family communication. Structural equation modeling indicated a unique role for individual perceptions and suggested that agreement in awareness of neighborhood violence could be protective for early adolescent involvement in aggression.

  14. Factors associated with diagnostic discrepancy for left ventricular hypertrophy between electrocardiography and echocardiography

    DEFF Research Database (Denmark)

    Sandager Petersen, Søren; Reinholdt Pedersen, Line; Pareek, Manan

    2017-01-01

    (absolute value/cut-off value for LVH) were used as outcome variables in order to identify explanatory variables associated with diagnostic discrepancies between ECG and echocardiography. RESULTS: Of the 1382 subjects included, 77% did not display any signs of LVH, 6% had LVH defined by ECG only, 13% had...... LVH defined by echocardiography only, and 5% had LVH on both ECG and echocardiography. Older subjects and those with higher blood pressure and RWT were more likely to have a relatively greater LVMI on echocardiography than that predicted on ECG (odds ratio: 1.65 per 10 years (95% confidence interval...... and odds ratio: 1.41 (95% CI: 1.06-1.87), p = .02), but FPG did not independently influence discrepancy between ECG and echocardiography. CONCLUSION: Age, blood pressure, female sex, greater RWT and use of antihypertensive medication were associated with a greater risk of non-consistency between LVH...

  15. Angular distributions for double photoionization of helium: Discrepancies between theory and experiment

    Energy Technology Data Exchange (ETDEWEB)

    Pont, M.; Shakeshaft, R. [Physics Department, University of Southern California, Los Angeles, California 90089-0484 (United States); Maulbetsch, F.; Briggs, J.S. [Fakultaet fuer Physik, University of Freiburg, Hermann-Herder-Strasse 3, 79104 Freiburg (Germany)

    1996-05-01

    We apply two different methods to the calculation of the triply differential cross section (TDCS) for double ionization of helium. In one method, the 3C method, the final state is described by a product of 3 Coulomb continuum wave functions, while in the other method, the 2SC method, the final state is described by a product of 2 {ital screened} Coulomb wave functions employing effective charges. We present results at the energies and geometries covered in the recent experiment by Lablanquie {ital et} {ital al}. [Phys. Rev. Lett. {bold 74}, 2192 (1995)]. There are substantial discrepancies. We also comment on a recent measurement of the {ital absolute} TDCS by Schwarzkopf and Schmidt [J. Phys. B {bold 28}, 2847 (1995)]. The measured result, as originally reported, is a factor of two smaller than the value for the absolute TDCS calculated using the 2SC method. We discuss this discrepancy. {copyright} {ital 1996 The American Physical Society.}

  16. Predictors of the discrepancy between objective and subjective cognition in bipolar disorder

    DEFF Research Database (Denmark)

    Miskowiak, K. W.; Petersen, Jeff Zarp; Ott, C. V.

    2016-01-01

    OBJECTIVE: The poor relationship between subjective and objective cognitive impairment in bipolar disorder (BD) is well-established. However, beyond simple correlation, this has not been explored further using a methodology that quantifies the degree and direction of the discrepancy. This study...... aimed to develop such a methodology to explore clinical characteristics predictive of subjective-objective discrepancy in a large BD patient cohort. METHODS: Data from 109 remitted BD patients and 110 healthy controls were pooled from previous studies, including neuropsychological test scores, self......-reported cognitive difficulties, and ratings of mood, stress, socio-occupational capacity, and quality of life. Cognitive symptom 'sensitivity' scores were calculated using a novel methodology, with positive scores reflecting disproportionately more subjective complaints than objective impairment and negative values...

  17. Teaching residents to write a research paper.

    Science.gov (United States)

    Coleridge, S T

    1993-09-01

    Medical writing and publications are important in developing a scholarly basis for residency programs and in providing a learning experience for both resident and faculty mentors. Residency directors must provide the stimulus and support for both faculty and residents' varied creative activities. This support manifests itself in a commitment to scholarly activity (including a dedicated research person), the procurement of available research materials, the establishment of a process or plan for beginning a research project, and the development of a method for rewarding or recognizing faculty and residents who produce scholarly works. Some osteopathic residency programs may need to train faculty in research skills at the same time that residents are learning to write. Trained faculty are better models and coaches for residents engaged in research. Beginning with a fundamental, but disciplined, writing program, both faculty and residents may learn methods for sharing new knowledge or acquiring those skills necessary to critically analyze the medical literature.

  18. Implicit and Explicit Self-Esteem Discrepancies, Victimization and the Development of Late Childhood Internalizing Problems.

    Science.gov (United States)

    Leeuwis, Franca H; Koot, Hans M; Creemers, Daan H M; van Lier, Pol A C

    2015-07-01

    Discrepancies between implicit and explicit self-esteem have been linked with internalizing problems among mainly adolescents and adults. Longitudinal research on this association in children is lacking. This study examined the longitudinal link between self-esteem discrepancies and the development of internalizing problems in children. It furthermore examined the possible mediating role of self-esteem discrepancies in the longitudinal link between experiences of peer victimization and internalizing problems development. Children (N = 330, M(age) = 11.2 year; 52.5 % female) were followed over grades five (age 11 years) and six (age 12 years). Self-report measures were used annually to test for victimization and internalizing problems. Implicit self-esteem was assessed using an implicit association test, while explicit self-esteem was assessed via self-reports. Self-esteem discrepancies represented the difference between implicit and explicit self-esteem. Results showed that victimization was associated with increases in damaged self-esteem (higher levels of implicit than explicit self-esteem. Additionally, damaged self-esteem at age 11 years predicted an increase in internalizing problems in children over ages 11 to 12 years. Furthermore, damaged self-esteem mediated the relationship between age 11 years victimization and the development of internalizing problems. No impact of fragile self-esteem (lower levels of implicit than explicit self-esteem) on internalizing problems was found. The results thus underscore that, as found in adolescent and adult samples, damaged self-esteem is a predictor of increases in childhood internalizing problems. Moreover, damaged self-esteem might explain why children who are victimized develop internalizing problems. Implications are discussed.

  19. Toward resolving model-measurement discrepancies of radon entry into houses

    International Nuclear Information System (INIS)

    Garbesi, K.; Lawrence Berkeley Lab., CA

    1994-10-01

    Analysis of the literature indicated that radon transport models significantly and consistently underpredict the advective entry into houses of soil-gas borne radon. Advective entry is the dominant mechanism resulting in high concentrations of radon indoors. The author investigated the source of the model-measurement discrepancy via carefully controlled field experiments conducted at an experimental basement located in natural soil in Ben Lomond, California. Early experiments at the structure confirmed the existence and magnitude of the model-measurement discrepancy, ensuring that it was not merely an artifact of inherently complex and poorly understood field sites. The measured soil-gas entry rate during structure depressurization was found to be an order of magnitude larger than predicted by a current three-dimensional numerical model of radon transport. The exact magnitude of the discrepancy depends on whether the arithmetic or geometric mean of the small-scale measurements of permeability is used to estimate the effective permeability of the soil. This factor is a critical empirical input to the model and was determined for the Ben Lomond site in the typical fashion using single-probe static depressurization measurements at multiple locations. The remainder of the dissertation research tests a hypothesis to explain the observed discrepancy: that soil permeability assessed using relatively small-scale probe measurements does not reflect bulk soil permeability for flows that is likely to occur at larger scales of several meters or more in real houses and in the test structure. The idea is that soil heterogeneity is of a nature that, as flows occur over larger scales, larger scales of heterogeneity are encountered that facilitate larger flux rates, resulting in a scale dependence of effective soil permeability

  20. Discrepancies between implicit and explicit self-esteem among adolescents with social anxiety disorder.

    Science.gov (United States)

    Schreiber, Franziska; Bohn, Christiane; Aderka, Idan M; Stangier, Ulrich; Steil, Regina

    2012-12-01

    Previous studies have found high implicit self-esteem (ISE) to prevail concurrently with low explicit self-esteem (ESE) in socially anxious adults. This suggests that self-esteem discrepancies are associated with social anxiety disorder (SAD). Given that the onset of SAD often occurs in adolescence, we investigated self-esteem discrepancies between ISE and ESE in adolescents suffering from SAD. Two implicit measures (Affect Misattribution Procedure, Implicit Association Test) were used both before and after a social threat activation in 20 adolescents with SAD (14-20 years), and compared to 20 healthy adolescents who were matched for age and gender. The Rosenberg Self-Esteem Scale, the Social Cognitions Questionnaire and Beck Depression Inventory were administered as explicit measures. We expected discrepant self-esteem (high ISE, low ESE) in adolescents with SAD, in comparison to congruent self-esteem (positive ISE, positive ESE) in healthy controls, after social threat activation. Both the patient and control groups exhibited high positive ISE on both implicit measures, before as well as after social threat induction. Explicitly, patients suffering from SAD revealed lower levels of ESE, compared to the healthy adolescents. This study is the first to examine ISE and ESE in a clinical sample of adolescent patients with SAD. Our results suggest that SAD is associated with a discrepancy between high ISE and low ESE, after a social-threat manipulation. The findings are discussed in relation to other studies using implicit measures in SAD and may provide a more comprehensive understanding of the role of self-esteem in adolescent SAD. Copyright © 2012 Elsevier Ltd. All rights reserved.

  1. Explaining Discrepancies in Arrest Rates Between Black and White Male Juveniles

    OpenAIRE

    Fite, Paula J.; Wynn, Porche’; Pardini, Dustin A.

    2009-01-01

    The authors investigated discrepancies in arrest rates between Black and White male juveniles by examining the role of early risk factors for arrest. Two hypotheses were evaluated: (a) Disproportionate minority arrest is due to increased exposure to early risk factors, and (b) a differential sensitivity to early risk factors contributes to disproportionate minority arrest. The study included 481 Black and White boys who were followed from childhood to early adulthood. A higher incidence of ea...

  2. Relationship and significance of gait deviations associated with limb length discrepancy: A systematic review.

    Science.gov (United States)

    Khamis, Sam; Carmeli, Eli

    2017-09-01

    Controversy still exists as to the clinical significance of leg length discrepancy (LLD) in spite of the fact that further evidence has been emerging regarding the relationship between several clinical conditions and LLD. The objectives of our study were to review the available research with regard to LLD as a cause of clinically significant gait deviations, to determine if there is a relationship between the magnitude of LLD and the presence of gait deviations and to identify the most common gait deviations associated with LLD. In line with the PRISMA guidelines, a literature search was carried out throughout the Medline, CINAHL and EMBASE databases. Twelve articles met the predetermined inclusion criteria and were included in the review. Quality assessment using the Methodological Index for Non-Randomized Studies (MINORS) scale was completed for all included studies. Two main methodologies were found in 4 studies evaluating gait asymmetry in patients or healthy participants with anatomic LLD and 8 studies evaluating gait deviations while simulating LLD by employing artificial lifts of 1-5cm on healthy subjects. A significant relationship was found between anatomic LLD and gait deviation. Evidence suggests that gait deviations may occur with discrepancies of >1cm, with greater impact seen as the discrepancy increases. Compensatory strategies were found to occur in both the shorter and longer limb, throughout the lower limb. As the discrepancy increases, more compensatory strategies occur. Sagittal plane deviations seem to be the most effective deviations, although, frontal plane compensations also occur in the pelvis, hip and foot. Copyright © 2017 Elsevier B.V. All rights reserved.

  3. Frequency and causes of discrepancy between Kt/V and creatinine clearance.

    Science.gov (United States)

    Satko, S G; Burkart, J M; Bleyer, A J; Jordan, J R; Manning, T

    1999-01-01

    This study examines the frequency of discrepancy between Kt/V urea and creatinine clearance (Ccr) measurements in patients on peritoneal dialysis (PD) and the reasons for this discrepancy. Nonrandomized, retrospective data analysis. Single PD unit of a university teaching hospital. All adult patients receiving PD at our center from January 1995 to December 1996. Actual (a) and desired (d) body weight (BW) were used to calculate urea volume of distribution (V) and body surface area (BSA). Patients were divided into four groups based upon their total small solute clearances (Kt/V and Ccr, normalized by actual weight) and three additional groups based upon actual/desired (a/d) body weight ratio. An additional analysis was performed for the subset of anuric patients. Data collected for all patients included the following: total Kt, total Ccr, 4-hour dialysate/ plasma (D/P) creatinine, serum albumin concentration, duration of PD, actual body weight, age, and height. Twenty-three percent of the clearance measurements in our study were discrepant, defined as having values for either Kt/V or Ccr (but not both) above the accepted targets of Kt/V > or = 2.0/wk and Ccr > or = 60 L/wk/ 1.73 m2. Patients with both values above target are more likely to have higher residual renal function. Patients who are significantly less than BWd and patients on PD for a longer time are more likely to have adequate Kt/V but not Ccr. Furthermore, patients who are less than 90% or greater than 110% of BWd have markedly different values for Kt/V and Ccr when BWa versus BWd values are used. Kt/V and Ccr values are frequently discrepant; a number of factors affect these two measurements to varying degrees, including weight, degree of residual renal function, and duration of PD.

  4. Comments on the New Tesla Electromagnetics. Part I. Discrepancies in Present EM Theory,

    Science.gov (United States)

    1982-01-01

    new "superrelativity" to describe the expanded electromagnetic reality uncovered by Nikola Tesla . (14) "Charge" is assumed to be quantized, in addition...California, 94030, 1980. The present electromagnetics is just a special case of a much more fundamental electromagnetics discovered by Nikola Tesla , just...AD-RI27 574 COMMENTS ON THE NEW TESLA ELECTROMAGNET ICS PART I L/i DISCREPANCIES IN PRESENT EM THEORY(U) BEARDEN (THOMAS E) HUNTSVILLE AL T E BEARDEN

  5. Discrepancies between direct and indirect measures of interpersonal and neurocognitive skills in autism spectrum disorder children.

    Science.gov (United States)

    Gómez-Pérez, M Mar; Calero, M Dolores; Mata, Sara; Molinero, Clara

    2016-10-01

    Subjects with autistic spectrum disorders (ASD) show persistent deficits in social interaction. In order to explore the scope of their deficits, it is of great interest to compare the different interpersonal skills and executive functions of ASD subjects to those of children with typical development. Assessing these skills usually involves a large variety of informants (parents, teachers, other family members) and of measures, with frequent discrepancies between direct performance measures and indirect measures (third-party report). Different explanations of this mismatch between measures have been addressed in previous studies. We wish to analyze whether there are differences between children with ASD and children with typical development on several direct performance measures of interpersonal and neurocognitive skills and one third-party report on real-life performance of interpersonal skills; we also want to look at whether discrepancies appear between the two types of measurements in the two groups of participants. A total of 68 Spanish children between the ages of 7 and 12 years participated; 34 were children with ASD, and 34 showed typical development. All participants were tested for recognition of emotions, solving interpersonal conflicts, and executive function. Significant differences between the two groups were not found on most of the direct performance measures, but they did appear in the report by third parties, in favor of the group with typical development. There was also a significant association between neurocognitive and social variables in the latter group. There were intergroup differences and discrepancies between the direct performance and indirect measures in children with ASD, and these must be explained. For this reason, future studies could seek to explain the cause of these discrepancies with a greater number of measures for each of the skills.

  6. Using IQ discrepancy scores to examine the neural correlates of specific cognitive abilities.

    Science.gov (United States)

    Margolis, Amy; Bansal, Ravi; Hao, Xuejun; Algermissen, Molly; Erickson, Cole; Klahr, Kristin W; Naglieri, Jack A; Peterson, Bradley S

    2013-08-28

    The underlying neural determinants of general intelligence have been studied intensively, and seem to derive from the anatomical and functional characteristics of a frontoparietal network. Little is known, however, about the underlying neural correlates of domain-specific cognitive abilities, the other factors hypothesized to explain individual performance on intelligence tests. Previous preliminary studies have suggested that spatially distinct neural structures do not support domain-specific cognitive abilities. To test whether differences between abilities that affect performance on verbal and performance tasks derive instead from the morphological features of a single anatomical network, we assessed in two independent samples of healthy human participants (N=83 and N=58; age range, 5-57 years) the correlation of cortical thickness with the magnitude of the verbal intelligence quotient (VIQ)-performance intelligence quotient (PIQ) discrepancy. We operationalized the VIQ-PIQ discrepancy by regressing VIQ onto PIQ (VIQ-regressed-on-PIQ score), and by regressing PIQ onto VIQ (PIQ-regressed-on-VIQ score). In both samples, a progressively thinner cortical mantle in anterior and posterior regions bilaterally was associated with progressively greater (more positive) VIQ-regressed-on-PIQ scores. A progressively thicker cortical mantle in anterior and posterior regions bilaterally was associated with progressively greater (more positive) PIQ-regressed-on-VIQ scores. Variation in cortical thickness in these regions accounted for a large portion of the overall variance in magnitude of the VIQ-PIQ discrepancy. The degree of hemispheric asymmetry in cortical thickness accounted for a much smaller but statistically significant portion of variance in VIQ-PIQ discrepancy.

  7. The drinking partnership and marital satisfaction: The longitudinal influence of discrepant drinking

    OpenAIRE

    Homish, Gregory G.; Leonard, Kenneth E.

    2007-01-01

    The objective was to determine whether discrepancies between husbands’ and wives’ past year heavy drinking predicted decreased marital satisfaction over time. Participants were recruited at the time they applied for their marriage licenses (N= 634). Couples completed questionnaires about their alcohol use and marital satisfaction at the time of marriage, and again at their first and second anniversaries. Generalized estimating equation models were used to evaluate the association between disc...

  8. In vitro evaluation of the marginal and internal discrepancies of different esthetic restorations

    Directory of Open Access Journals (Sweden)

    Amal Abdelsamad SAKRANA

    2013-12-01

    Full Text Available Objective: This study examined the fit of two types of all-ceramic single crowns and indirect composite resin full coverage crowns. Material and Methods: Thirty intact human mandibular first premolars were selected for this study and prepared using a machine to standardize the dimensions and randomly divided into 3 groups. Slip cast (IC (In-Ceram Zirconia, Vita Zahnfabrik, copy-milled zirconia (CM (ICE, Zirkonzahn and indirect composite resin crowns (NECO, HeraeusKulzer, Hanau, Germany, (N=30, 10 per group were fabricated according to each manufacturer's recommendations. Before cementation, discrepancies were measured at the marginal zone in each crown. Crowns were then cemented with G-Cem capsule self-adhesive luting cement (GC Corporation, Tokyo, Japan. Four positions were marked for each zone (mid-facial, mid-mesial, mid-distal, and mid-lingual and three measurements were made at each of the four positions yielding to a total of 12 measurements per crown before and after cementation. The measurements were performed at a different magnification using a stereo microscope (SZ11, Olympus, Japan. Marginal, axial and occlusal zone discrepancies (µm were evaluated after cementation. The data were statistically analyzed using two-way ANOVA and Tukey's test. Results: Before cementation, significantly less marginal discrepancies were noted compared with after cementation in all groups (p0.05. Occlusal zone discrepancies were significantly higher than those of the marginal and axial zones in all groups (p<0.05. Conclusions: Slip cast and copy-milled zirconia crowns showed comparable fit to composite resin crowns in all marginal, axial and occlusal areas.

  9. Measurements of dose discrepancies due to inhomogeneities and radiographic contrast in balloon catheter brachytherapy

    International Nuclear Information System (INIS)

    Oh, Seungjong; Scott, Jacob; Shin, Dong Hoon; Suh, Tae-Suk; Kim, Siyong

    2009-01-01

    Recently, a device called MammoSite, consisting of a balloon and a catheter, was developed to perform partial-breast irradiation using a high-dose-rate (HDR) brachytherapy unit with ease and reproducibility. However, the actual dose to the skin does not agree well with the calculated dose by the treatment planning system because of the difference between the calculation condition and the real treatment condition (i.e., homogeneous water and full scatter condition vs contrast solution and lack of full scatter condition). In this study, the authors experimentally estimated dose discrepancies due to contrast and lack of full scatter in breast HDR brachytherapy with MammoSite. Using metal-oxide-semiconductor field-effect transistor detectors and a breast phantom, the dose discrepancies between the calculation and the treatment conditions were measured according to contrast concentration (10% and 20% volume ratios), balloon size (35 and 60 cm 3 ), and source to detector distance ranging from 25 to 50 mm. The source was an Ir-192 isotope from Nucletron HDR unit. The dose discrepancies from the calculation condition due to both contrast and lack of full scatter combined ranged from about -1.4±2.5% to -18.2±2.0% in the studied cases (error bound is in two sided confidence interval of 80% based on Student's t distribution). In all cases, the effect of lack of full scatter was dominant to that of contrast and significant dose discrepancies existed between the calculation and the real treatment conditions, indicating that the actual skin dose is less than that which is currently calculated.

  10. Assessment of discrepancies between bottom-up and regional emission inventories in Norwegian urban areas

    Science.gov (United States)

    López-Aparicio, Susana; Guevara, Marc; Thunis, Philippe; Cuvelier, Kees; Tarrasón, Leonor

    2017-04-01

    This study shows the capabilities of a benchmarking system to identify inconsistencies in emission inventories, and to evaluate the reason behind discrepancies as a mean to improve both bottom-up and downscaled emission inventories. Fine scale bottom-up emission inventories for seven urban areas in Norway are compared with three regional emission inventories, EC4MACS, TNO_MACC-II and TNO_MACC-III, downscaled to the same areas. The comparison shows discrepancies in nitrogen oxides (NOx) and particulate matter (PM2.5 and PM10) when evaluating both total and sectorial emissions. The three regional emission inventories underestimate NOx and PM10 traffic emissions by approximately 20-80% and 50-90%, respectively. The main reasons for the underestimation of PM10 emissions from traffic in the regional inventories are related to non-exhaust emissions due to resuspension, which are included in the bottom-up emission inventories but are missing in the official national emissions, and therefore in the downscaled regional inventories. The benchmarking indicates that the most probable reason behind the underestimation of NOx traffic emissions by the regional inventories is the activity data. The fine scale NOx traffic emissions from bottom-up inventories are based on the actual traffic volume at the road link and are much higher than the NOx emissions downscaled from national estimates based on fuel sales and based on population for the urban areas. We have identified important discrepancies in PM2.5 emissions from wood burning for residential heating among all the inventories. These discrepancies are associated with the assumptions made for the allocation of emissions. In the EC4MACs inventory, such assumptions imply high underestimation of PM2.5 emissions from the residential combustion sector in urban areas, which ranges from 40 to 90% compared with the bottom-up inventories. The study shows that in three of the seven Norwegian cities there is need for further improvement of

  11. Discrepancy between mRNA and protein abundance: insight from information retrieval process in computers.

    Science.gov (United States)

    Wang, Degeng

    2008-12-01

    Discrepancy between the abundance of cognate protein and RNA molecules is frequently observed. A theoretical understanding of this discrepancy remains elusive, and it is frequently described as surprises and/or technical difficulties in the literature. Protein and RNA represent different steps of the multi-stepped cellular genetic information flow process, in which they are dynamically produced and degraded. This paper explores a comparison with a similar process in computers-multi-step information flow from storage level to the execution level. Functional similarities can be found in almost every facet of the retrieval process. Firstly, common architecture is shared, as the ribonome (RNA space) and the proteome (protein space) are functionally similar to the computer primary memory and the computer cache memory, respectively. Secondly, the retrieval process functions, in both systems, to support the operation of dynamic networks-biochemical regulatory networks in cells and, in computers, the virtual networks (of CPU instructions) that the CPU travels through while executing computer programs. Moreover, many regulatory techniques are implemented in computers at each step of the information retrieval process, with a goal of optimizing system performance. Cellular counterparts can be easily identified for these regulatory techniques. In other words, this comparative study attempted to utilize theoretical insight from computer system design principles as catalysis to sketch an integrative view of the gene expression process, that is, how it functions to ensure efficient operation of the overall cellular regulatory network. In context of this bird's-eye view, discrepancy between protein and RNA abundance became a logical observation one would expect. It was suggested that this discrepancy, when interpreted in the context of system operation, serves as a potential source of information to decipher regulatory logics underneath biochemical network operation.

  12. The commonality of extreme discrepancies in the ability profiles of academically gifted students

    OpenAIRE

    DAVID F. LOHMAN; JAMES GAMBRELL; JONI LAKIN

    2008-01-01

    Extreme discrepancies in abilities are more common among the most and least able students than among average ability children. Therefore, procedures for identifying gifted children that deliberately or inadvertently rely on a composite score that averages across ability domains will exclude many children who reason exceptionally well in particular symbol systems. In this article, we first discuss general issues in the measurement of ability profiles. We then introduce a method for categorizin...

  13. Origin of Discrepancies in Inelastic Electron Tunneling Spectra of Molecular Junctions

    OpenAIRE

    Yu, Lam H.; Zangmeister, Christopher D.; Kushmerick, James G.

    2007-01-01

    We report inelastic electron tunneling spectroscopy (IETS) of multilayer molecular junctions with and without incorporated metal nano-particles. The incorporation of metal nanoparticles into our devices leads to enhanced IET intensity and a modified line-shape for some vibrational modes. The enhancement and line-shape modification are both the result of a low lying hybrid metal nanoparticle-molecule electronic level. These observations explain the apparent discrepancy between earlier IETS mea...

  14. [About six observations of double discrepancy of the heart: feasibility of prenatal diagnosis?].

    Science.gov (United States)

    Omarjee, A; Cuillier, F; Julien, E; Alessandri, J-L; Cartault, F

    2013-04-01

    The double discrepancy (DD) is an exceptional cardiopathy, manifested by atrioventricular and ventriculo-arterial discordances. DD is rarely diagnosed in the antenatal period and is often found in adults when cardiac complications occur. We describe six cases of DD, the different forms, their ultrasound semiology, and the assessment of prognosis, correlated with the existence of associated cardiac anomalies. Copyright © 2012 Elsevier Masson SAS. All rights reserved.

  15. Bolton's tooth size discrepancy in malaysian orthodontic patients: Are occlusal characteristics such as overjet, overbite, midline, and crowding related to tooth size discrepancy in specific malocclusions and ethnicities?

    Directory of Open Access Journals (Sweden)

    Priti Subhash Mulimani

    2018-01-01

    Full Text Available Introduction: Tooth size, occlusal traits, and ethnicity are closely interrelated, and their impact on desirable orthodontic treatment outcome cannot be underestimated. This study was undertaken to assess the occlusal characteristics and ethnic variations in occlusion of Malaysian orthodontic patients and evaluate their correlation with Bolton's tooth size discrepancy. Materials and Methods: On 112 pretreatment study models of orthodontic patients, molar relationship, overjet, overbite, spacing, crowding, midline shift, and Bolton's ratios were assessed. ANOVA, one-sample t-test, Chi-squared test, and Spearman's rho correlation coefficient were used for statistical analysis. Results: Significant difference between anterior ratio of our study and Bolton's ideal values was found, for the entire study sample and Chinese ethnic group. Differences between races and malocclusion groups were not statistically significant (P > 0.05. Significant correlations were found as follows – in Angle's Class I malocclusion between 1 anterior ratio and overbite, 2 overall ratio and maxillary crowding and spacing; in Angle's Class II malocclusion between 1 anterior ratio and overjet and midline shift, 2 overall ratio and mandibular crowding; in Angle's Class III malocclusion between 1 anterior ratio and mandibular crowding and both maxillary and mandibular spacing 2 overall ratio and mandibular crowding. Conclusions: Significant differences in anterior ratio and Bolton's ideal values for the Malaysian population were found, indicating variations in anterior tooth size as compared to Caucasians. Statistically significant correlations existed between Bolton's ratios and occlusal traits. These findings can be applied clinically in diagnosis and treatment planning by keeping in mind the specific discrepancies that can occur in certain malocclusions and addressing them accordingly.

  16. Subjective-Objective Sleep Discrepancy in Older Adults With MCI and Subsyndromal Depression.

    Science.gov (United States)

    DiNapoli, Elizabeth A; Gebara, Marie Anne; Kho, Terry; Butters, Meryl A; Gildengers, Ariel G; Albert, Steven M; Dew, Mary Amanda; Erickson, Kirk I; Reynolds, Charles F; Karp, Jordan F

    2017-11-01

    We investigated the prevalence and correlates of discrepancies between self-reported sleep quality (Pittsburgh Sleep Quality Index) and objective sleep efficiency (actigraphy) in older adults with mild cognitive impairment (MCI) and subsyndromal depression. This was a secondary analysis of a clincial trial with 59 adults aged 60 years and older with MCI and subsyndromal depression. We included baseline data on participants' subjective sleep quality, objective sleep efficiency, depressive symptoms, insomnia diagnosis, and cognitive functioning. Pittsburgh Sleep Quality Index subjective sleep quality and actigraphy-measured sleep efficiency were not significantly correlated ( r = -.06; P = .64), with 61% of participants having subjective-objective sleep discrepancies. Correlates of subjective-objective sleep discrepancy included the presence of an insomnia diagnosis and impaired memory, particularly delayed memory. These findings are important because subjective underestimation of symptoms in older adults with memory impairments may result in sleep disturbances going unrecognized in clinical practice; on the other hand, an insomnia disorder may be a possible remediable contribution to subjective overestimation of sleep disturbances.

  17. Informative Disagreements: Associations Between Relationship Distress, Depression, and Discrepancy in Interpersonal Perception Within Couples.

    Science.gov (United States)

    Knobloch-Fedders, Lynne M; Critchfield, Kenneth L; Staab, Erin M

    2017-06-01

    This study evaluated the associations between relationship distress, depression symptoms, and discrepancy in interpersonal perception within couples. After completing a series of discussion tasks, couples (N = 88) rated their behavior using the circumplex-based Structural Analysis of Social Behavior Model (SASB; Benjamin, 1979, 1987, 2000). Overall, couple members were strikingly similar in their interpersonal perceptions, and tended to see themselves as friendly, reciprocal in their focus, and balanced between connection and separateness. As hypothesized, however, perceptual discrepancy was related to relationship distress and depression. Relationship distress was associated with discrepancy regarding transitive behavior focused on the partner, while depression was associated with disagreement about intransitive, self-focused behavior. Analysis of affiliation and autonomy revealed that relationship distress was associated with seeing oneself as reacting with more hostility than the partner sees, and perceiving one's partner as more hostile, more controlling, and less submissive than he or she does. Partners of depressed individuals viewed themselves as more controlling than their mate did. Men's depression was associated with disagreement between partners regarding men's self-focused behavior. Results underscore the importance of considering interpersonal perception when conceptualizing relationship distress and depression within intimate relationships. © 2015 Family Process Institute.

  18. Micro-macro-discrepancies in nonlinear microrheology: I. Quantifying mechanisms in a suspension of Brownian ellipsoids

    International Nuclear Information System (INIS)

    DePuit, Ryan J; Squires, Todd M

    2012-01-01

    Active and nonlinear microrheology experiments involve a colloidal probe that is forced to move within a material, with the goal of recovering the nonlinear rheological response properties of the material. Various mechanisms cause discrepancies between the nonlinear rheology measured microrheologically and macroscopically, including direct probe-bath collisions, the Lagrangian unsteadiness experienced by the material elements, and the spatially inhomogeneous and rheologically mixed strain field set up around the probe. Here, we perform computational nonlinear microrheology experiments, in which a colloidal probe translates through a dilute suspension of Brownian ellipsoids, whose results we compare against analogous computational experiments on the macroscopic shear rheology of the same model material. The quantitative impact of each of the mechanisms for micro-macro-discrepancy can thus be computed directly, with additional computational experiments performed where the processes in question are ‘turned off’. We show that all three discrepancy mechanisms impact the microrheological measurement quantitatively, and that none can be neglected. This motivates a search for microrheological probes whose geometry or forcing is optimized to minimize these impacts, which we present in a companion article.

  19. Tooth-size discrepancy: A comparison between manual and digital methods

    Directory of Open Access Journals (Sweden)

    Gabriele Dória Cabral Correia

    2014-08-01

    Full Text Available INTRODUCTION: Technological advances in Dentistry have emerged primarily in the area of diagnostic tools. One example is the 3D scanner, which can transform plaster models into three-dimensional digital models. OBJECTIVE: This study aimed to assess the reliability of tooth size-arch length discrepancy analysis measurements performed on three-dimensional digital models, and compare these measurements with those obtained from plaster models. MATERIAL AND METHODS: To this end, plaster models of lower dental arches and their corresponding three-dimensional digital models acquired with a 3Shape R700T scanner were used. All of them had lower permanent dentition. Four different tooth size-arch length discrepancy calculations were performed on each model, two of which by manual methods using calipers and brass wire, and two by digital methods using linear measurements and parabolas. RESULTS: Data were statistically assessed using Friedman test and no statistically significant differences were found between the two methods (P > 0.05, except for values found by the linear digital method which revealed a slight, non-significant statistical difference. CONCLUSIONS: Based on the results, it is reasonable to assert that any of these resources used by orthodontists to clinically assess tooth size-arch length discrepancy can be considered reliable.

  20. An Assessment of Correlation between Dermatoglyphic Patterns and Sagittal Skeletal Discrepancies.

    Science.gov (United States)

    George, Susha Miriam; Philip, Biju; Madathody, Deepika; Mathew, Manu; Paul, Jose; Dlima, Johnson Prakash

    2017-03-01

    Investigators over years have been fascinated by dermatoglyphic patterns which has led to the development of dermatoglyphics as a science with numerous applications in various fields other than being the best and most widely used method for personal identification. To assess the correlation between dermatoglyphic patterns and sagittal skeletal discrepancies. A total of 180 patients, aged 18-40 years, were selected from those who attended the outpatient clinic of the Deparment of Orthodontics and Dentofacial Orthopedics, Mar Baselios Dental College, Kothamangalam, Kerala, India. The fingerprints of both hands were taken by ink and stamp method after proper hand washing. The patterns of arches, loops and whorls in fingerprints were assessed. The total ridge count was also evaluated. Data was also sent to the fingerprint experts for expert evaluation. The sagittal jaw relation was determined from the patient's lateral cephalogram. The collected data was then statistically analyzed using Chi-square tests, ANOVA and Post-hoc tests and a Multinomial regression prediction was also done. A significant association was observed between the dermatoglyphic pattern exhibited by eight fingers and the sagittal skeletal discrepancies (pdermatoglyphic patterns and sagittal skeletal discrepancies. Dermatoglyphics could serve as a cost effective screening tool of these craniofacial problems.

  1. Coping with Weight-related Discrepancies: Initial Development of the WEIGHTCOPE.

    Science.gov (United States)

    Faries, Mark D; Bartholomew, John B

    2015-01-01

    The present research sought to provide the initial development, validation and reliability for a measure (WEIGHTCOPE) to assess the variation in how women, who are currently trying to lose or maintain weight, cope with common, perceived weight-related discrepancies. To this end, two studies were conducted to 1) develop an initial list of coping responses to common weight-related triggers, 2) create an initial measurement model through exploratory factor analysis (study 1; n = 470), and 3) provide initial validation for the measure through confirmatory factor analysis (study 2; n = 310). Results support the initial validity and reliability of a 38-item, 10-factor structure: Physical Activity, Healthy Eating, Suppressed Eating, Supplement Use, Self-Regulation, Positive Reframing, Social Support, Disengagement, Camouflage, and Comfort Food. The present findings reiterate individual variation in coping choice in response to a perceived weight-related discrepancy, and its prospective assessment with the WEIGHTCOPE. The WEIGHTCOPE can be an integral tool for public health and clinical practice, where triggers are common, and interventions are employed to enhance the use of more positive forms of weight control behaviors and/or avoid negative consequences of weight- and fat-related discrepancies. Future research can use the WEIGHTCOPE to help guide theoretical and pragmatic approaches to various triggering events and potential moderators of coping. Copyright © 2015 Jacobs Institute of Women's Health. Published by Elsevier Inc. All rights reserved.

  2. Limb lengthening in Africa: tibial lengthening indicated for limb length discrepancy and postosteomyelitis pseudarthrosis

    Directory of Open Access Journals (Sweden)

    Ibrahima F

    2014-05-01

    Full Text Available Farikou Ibrahima,1,2 Pius Fokam,2 Félicien Faustin Mouafo Tambo11Department of Surgery and Specialties, Faculty of Medicine and Biomedical Sciences, University of Yaoundé I, Yaoundé, 2Department of Surgery, Douala General Hospital, Douala, CameroonBackground: We present a case of lengthening of a tibia to treat postosteomyelitis pseudarthrosis and limb length discrepancy by the Ilizarov device.Objective: The objective was to treat the pseudarthrosis and correct the consequent limb length discrepancy of 50 mm.Materials and methods: The patient was a 5-year-old boy. Osteotomy of the tibia, excision of fibrosis, and decortications were carried out. After a latency period of 5 days, the lengthening started at a rate of 1 mm per day.Results: The pseudarthrosis healed and the gained correction was 21.73%. The index consolidation was 49 days/cm. Minor complications were reported.Discussion: Osteomyelitis of long bones is a common poverty-related disease in Africa. The disease usually is diagnosed at an advanced stage with complications. In these conditions, treatment is much more difficult. Most surgical procedures treating this condition use the Ilizarov device. The most common reported surgical complications are refractures and recurrence of infection.Conclusion: This technique should be popularized in countries with limited resources because it would be an attractive alternative to the amputations that are sometimes performed.Keywords: Limb length discrepancy (LLD, bone gap, Ilizarov device

  3. Tooth-size discrepancy: A comparison between manual and digital methods

    Science.gov (United States)

    Correia, Gabriele Dória Cabral; Habib, Fernando Antonio Lima; Vogel, Carlos Jorge

    2014-01-01

    Introduction Technological advances in Dentistry have emerged primarily in the area of diagnostic tools. One example is the 3D scanner, which can transform plaster models into three-dimensional digital models. Objective This study aimed to assess the reliability of tooth size-arch length discrepancy analysis measurements performed on three-dimensional digital models, and compare these measurements with those obtained from plaster models. Material and Methods To this end, plaster models of lower dental arches and their corresponding three-dimensional digital models acquired with a 3Shape R700T scanner were used. All of them had lower permanent dentition. Four different tooth size-arch length discrepancy calculations were performed on each model, two of which by manual methods using calipers and brass wire, and two by digital methods using linear measurements and parabolas. Results Data were statistically assessed using Friedman test and no statistically significant differences were found between the two methods (P > 0.05), except for values found by the linear digital method which revealed a slight, non-significant statistical difference. Conclusions Based on the results, it is reasonable to assert that any of these resources used by orthodontists to clinically assess tooth size-arch length discrepancy can be considered reliable. PMID:25279529

  4. Effects of CO-CR discrepancy in daily orthodontic treatment planning

    Science.gov (United States)

    COSTEA, CARMEN MARIA; BADEA, MÎNDRA EUGENIA; VASILACHE, SORIN; MESAROŞ, MICHAELA

    2016-01-01

    Background and aims Nowadays centric relation is defined as a musculoskeletal stable position, with the condyles forward, as far upward as possible, centered transversely and with the articular disc properly interposed. On the other hand, centric occlusion or maximum intercuspidation is a dental determined position. The purpose of this pilot study is to evaluate the direction, frequency and magnitude of the discrepancy between centric occlusion and centric relation in all three axial directions, in a muscular non-deprogrammed population, before the beginning of orthodontic treatment. Methods The study group was represented by 40 symptomatic and asymptomatic patients seeking orthodontic treatment in a private dental office in Cluj-Napoca, Romania between 2014 and 2015. All patients had full records and articulator mounted models. All measurements were analyzed three-dimensionally. Results 85% of the patients had vertical and 87.5% had horizontal CO-CR discrepancy for both condyles. 87.5% of the cases have had a significant condylar displacement in at least one of the three planes. Conclusions We should be aware of the dental occlusion determined by the dental contacts and the occlusion dictated by the musculoskeletal stable position of the condyles. The bigger the discrepancy between these two positions at the level of the condyles, the greater the chances to have either a patient who will develop a form of TMD before/during or after the orthodontic or prosthetic treatment, or a patient suffering already, but poorly diagnosed. PMID:27152081

  5. Photogrammetric determination of discrepancies between actual and planned position of dental implants

    Science.gov (United States)

    Forlani, G.; Rivara, F.

    2014-05-01

    The paper describes the design and testing of a photogrammetric measurement protocol set up to determine the discrepancies between the planned and actual position of computer-guided template-based dental implants. Two moulds with the implants positioned in pre- and post- intervention are produced and separately imaged with a highly redundant block of convergent images; the model with the implants is positioned on a steel frame with control points and with suitable targets attached. The theoretical accuracy of the system is better than 20 micrometers and 0.3-0.4° respectively for positions of implants and directions of implant axes. In order to compare positions and angles between the planned and actual position of an implant, coordinates and axes directions are brought to a common reference system with a Helmert transformation. A procedure for comparison of positions and directions to identify out-of-tolerance discrepancies is presented; a numerical simulation study shows the effectiveness of the procedure in identifying the implants with significant discrepancies between pre- and post- intervention.

  6. A patient safety curriculum for medical residents based on the perspectives of residents and supervisors

    NARCIS (Netherlands)

    Jansma, J.D.; Wagner, C.; Bijnen, A.B.

    2011-01-01

    Objectives: To develop a patient safety course for medical residents based on the views of medical residents and their supervisors. Methods: In 2007, questionnaires were distributed to investigate residents' and supervisors' perspectives on the current patient safety performance and educational

  7. Discrepancies in Outcome Reporting Exist Between Protocols and Published Oral Health Cochrane Systematic Reviews.

    Directory of Open Access Journals (Sweden)

    Nikolaos Pandis

    Full Text Available To assess discrepancies in the analyzed outcomes between protocols and published reviews within Cochrane oral health systematic reviews (COHG on the Cochrane Database of Systematic Reviews (CDSR.All COHG systematic reviews on the CDSR and the corresponding protocols were retrieved in November 2014 and information on the reported outcomes was recorded. Data was collected at the systematic review level by two reviewers independently.One hundred and fifty two reviews were included. In relation to primary outcomes, 11.2% were downgraded to secondary outcomes, 9.9% were omitted altogether in the final publication and new primary outcomes were identified in 18.4% of publications. For secondary outcomes, 2% were upgraded to primary, 12.5% were omitted and 30.9% were newly introduced in the publication. Overall, 45.4% of reviews had at least one discrepancy when compared to the protocol; these were reported in 14.5% reviews. The number of review updates appears to be associated with discrepancies between final review and protocol (OR: 3.18, 95% CI: 1.77, 5.74, p<0.001. The risk of reporting significant results was lower for both downgraded outcomes [RR: 0.52, 95% CI: 0.17, 1.58, p = 0.24] and upgraded or newly introduced outcomes [RR: 0.77, 95% CI: 0.36, 1.64, p = 0.50] compared to outcomes with no discrepancies. The risk of reporting significant results was higher for upgraded or newly introduced outcomes compared to downgraded outcomes (RR = 1.19, 95% CI: 0.65, 2.16, p = 0.57. None of the comparisons reached statistical significance.While no evidence of selective outcome reporting was found in this study, based on the present analysis of SRs published within COHG systematic reviews, discrepancies between outcomes in pre-published protocols and final reviews continue to be common. Solutions such as the use of standardized outcomes to reduce the prevalence of this issue may need to be explored.

  8. Do emergency medicine residents and faculty have similar learning styles when assessed with the Kolb learning style assessment tool?

    Science.gov (United States)

    Fredette, Jenna; O'Brien, Corinne; Poole, Christy; Nomura, Jason

    2015-04-01

    Experiential learning theory and the Kolb Learning Style Inventory (Kolb LSI) have influenced educators worldwide for decades. Knowledge of learning styles can create efficient learning environments, increase information retention, and improve learner satisfaction. Learning styles have been examined in medicine previously, but not specifically with Emergency Medicine (EM) residents and attendings. Using the Kolb LSI, the learning styles of Emergency Medicine residents and attendings were assessed. The findings showed that the majority of EM residents and attendings shared the accommodating learning style. This result was different than prior studies that found the majority of medical professionals had a converging learning style and other studies that found attendings often have different learning styles than residents. The issue of learning styles among emergency medical residents and attendings is important because learning style knowledge may have an impact on how a residency program structures curriculum and how EM residents are successfully, efficiently, and creatively educated.

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

    Science.gov (United States)

    Kolade, Victor O; Staton, Lisa J; Jayarajan, Ramesh; Bentley, Nanette K; Huang, Xiangke

    2014-01-01

    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. 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. 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). 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.

  10. Tetanus immunity in nursing home residents of Bolu, Turkey

    Directory of Open Access Journals (Sweden)

    Tamer Ali

    2005-01-01

    Full Text Available Abstract Background Tetanus is a serious but vaccine-preventable disease and fatality rate of the disease is high in the neonates and the elderly. The aim of this study was to detect the tetanus antibody prevalence in the over sixty-year age residents of the nursing homes in Bolu. Methods A voluntary-based study was done in the residents of two nursing homes in Bolu, Turkey. Blood samples were taken from 71 volunteers residing in there nursing homes. Tetanus IgG antibodies were measured by a commercial ELISA kit. Results Among overall subjects, only 11 (15.7 % had the protective tetanus antibody titers at the time of the study. Totally, 10 subjects were examined in emergency rooms due to trauma or accidents within the last ten years and, four (40% of them had protective antibody levels. Of the remaining 61 subjects only 7 (11% had protective antibody levels (p Conclusions Tetanus antibody level is below the protective level in the majority of the over-sixty-year-age subjects residing in the nursing homes. Each over sixty-year age person in our country should be vaccinated. Until this is accomplished, at least, nursing home residents should be vaccinated during registration.

  11. The Humble Leader: Association of Discrepancies in Leader and Follower Ratings of Implementation Leadership With Organizational Climate in Mental Health.

    Science.gov (United States)

    Aarons, Gregory A; Ehrhart, Mark G; Torres, Elisa M; Finn, Natalie K; Beidas, Rinad S

    2017-02-01

    Discrepancies, or perceptual distance, between leaders' self-ratings and followers' ratings of the leader are common but usually go unrecognized. Research on discrepancies is limited, but there is evidence that discrepancies are associated with organizational context. This study examined the association of leader-follower discrepancies in Implementation Leadership Scale (ILS) ratings of mental health clinic leaders and the association of those discrepancies with organizational climate for involvement and performance feedback. Both involvement and performance feedback are important for evidence-based practice (EBP) implementation in mental health. A total of 593 individuals-supervisors (leaders, N=80) and clinical service providers (followers, N=513)-completed surveys that included ratings of implementation leadership and organizational climate. Polynomial regression and response surface analyses were conducted to examine the associations of discrepancies in leader-follower ILS ratings with organizational involvement climate and performance feedback climate, aspects of climate likely to support EBP implementation. Both involvement climate and performance feedback climate were highest where leaders rated themselves low on the ILS and their followers rated those leaders high on the ILS ("humble leaders"). Teams with "humble leaders" showed more positive organizational climate for involvement and for performance feedback, contextual factors important during EBP implementation and sustainment. Discrepancy in leader and follower ratings of implementation leadership should be a consideration in understanding and improving leadership and organizational climate for mental health services and for EBP implementation and sustainment in mental health and other allied health settings.

  12. Impact of a pharmacy technician-centered medication reconciliation program on medication discrepancies and implementation of recommendations

    Directory of Open Access Journals (Sweden)

    Kraus SK

    2017-06-01

    Full Text Available Objectives: To evaluate the impact of a pharmacy-technician centered medication reconciliation (PTMR program by identifying and quantifying medication discrepancies and outcomes of pharmacist medication reconciliation recommendations. Methods: A retrospective chart review was performed on two-hundred patients admitted to the internal medicine teaching services at Cooper University Hospital in Camden, NJ. Patients were selected using a stratified systematic sample approach and were included if they received a pharmacy technician medication history and a pharmacist medication reconciliation at any point during their hospital admission. Pharmacist identified medication discrepancies were analyzed using descriptive statistics, bivariate analyses. Potential risk factors were identified using multivariate analyses, such as logistic regression and CART. The priority level of significance was set at 0.05. Results: Three-hundred and sixty-five medication discrepancies were identified out of the 200 included patients. The four most common discrepancies were omission (64.7%, non-formulary omission (16.2%, dose discrepancy (10.1%, and frequency discrepancy (4.1%. Twenty-two percent of pharmacist recommendations were implemented by the prescriber within 72 hours. Conclusion: A PTMR program with dedicated pharmacy technicians and pharmacists identifies many medication discrepancies at admission and provides opportunities for pharmacist reconciliation recommendations.

  13. Neurocritical care education during neurology residency: AAN survey of US program directors.

    Science.gov (United States)

    Sheth, K N; Drogan, O; Manno, E; Geocadin, R G; Ziai, W

    2012-05-29

    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. 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. 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%. 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.

  14. 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...

  15. 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...

  16. 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...

  17. 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...

  18. Lawful Permanent Residents Fiscal Year 2011 State

    Data.gov (United States)

    Department of Homeland Security — Lawful permanent residents (LPRs) are foreign nationals who have been granted the right to reside permanently in the United States. LPRs are also known as 'permanent...

  19. Lawful Permanent Residents Fiscal Year 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...

  20. 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...

  1. Concordances and discrepancies between ICD-10 and DSM-IV criteria for anxiety disorders in childhood and adolescence

    Directory of Open Access Journals (Sweden)

    Adornetto Carmen

    2012-12-01

    Full Text Available Abstract Background Mental disorders are classified by two major nosological systems, the ICD-10 and the DSM-IV-TR, consisting of different diagnostic criteria. The present study investigated the diagnostic concordance between the two systems for anxiety disorders in childhood and adolescence, in particular for separation anxiety disorder (SAD, specific phobia, social phobia, and generalized anxiety disorder (GAD. Methods A structured clinical interview, the Kinder-DIPS, was administered to 210 children and 258 parents. The percentage of agreement, kappa, and Yule’s Y coefficients were calculated for all diagnoses. Specific criteria causing discrepancies between the two classification systems were identified. Results DSM-IV-TR consistently classified more children than ICD-10 with an anxiety disorder, with a higher concordance between DSM-IV-TR and the ICD-10 child section (F9 than with the adult section (F4 of the ICD-10. This result was found for all four investigated anxiety disorders. The results revealed low to high levels of concordance and poor to good agreement between the classification systems, depending on the anxiety disorder. Conclusions The two classification systems identify different children with an anxiety disorder. However, it remains an open question, whether the research results can be generalized to clinical practice since DSM-IV-TR is mainly used in research while ICD-10 is widely established in clinical practice in Europe. Therefore, the population investigated by the DSM (research population is not identical with the population examined using the ICD (clinical population.

  2. Our House Is Burning: Discrepancy in Climate Change vs. Biodiversity Coverage in the Media as Compared to Scientific Literature

    Directory of Open Access Journals (Sweden)

    Pierre Legagneux

    2018-01-01

    Full Text Available Scientists, policy makers, and journalists are three key, interconnected players involved in prioritizing and implementing solutions to mitigate the consequences of anthropogenic pressures on the environment. The way in which information is framed and expertise is communicated by the media is crucial for political decisions and for the integrated management of environmental issues. Here we present a comparative study of scientific literature and press articles addressing climate change and biodiversity. We extensively scrutinized the scientific literature, research funding, and press articles from the USA, Canada, and United Kingdom addressing climate change and biodiversity issues between 1991 and 2016. We found that media coverage of climate change was up to eight times higher compared to biodiversity. This discrepancy could not be explained by different scientific output between the two issues. Moreover, climate change media coverage was often related to specific events whereas no such indication of a connection was found in the case of biodiversity. An international communication strategy is urgently required to raise public awareness on biodiversity issues. We discussed several initiatives that scientists could undertake to better communicate major discoveries to the public and policy makers.

  3. Concordances and discrepancies between ICD-10 and DSM-IV criteria for anxiety disorders in childhood and adolescence

    Science.gov (United States)

    2012-01-01

    Background Mental disorders are classified by two major nosological systems, the ICD-10 and the DSM-IV-TR, consisting of different diagnostic criteria. The present study investigated the diagnostic concordance between the two systems for anxiety disorders in childhood and adolescence, in particular for separation anxiety disorder (SAD), specific phobia, social phobia, and generalized anxiety disorder (GAD). Methods A structured clinical interview, the Kinder-DIPS, was administered to 210 children and 258 parents. The percentage of agreement, kappa, and Yule’s Y coefficients were calculated for all diagnoses. Specific criteria causing discrepancies between the two classification systems were identified. Results DSM-IV-TR consistently classified more children than ICD-10 with an anxiety disorder, with a higher concordance between DSM-IV-TR and the ICD-10 child section (F9) than with the adult section (F4) of the ICD-10. This result was found for all four investigated anxiety disorders. The results revealed low to high levels of concordance and poor to good agreement between the classification systems, depending on the anxiety disorder. Conclusions The two classification systems identify different children with an anxiety disorder. However, it remains an open question, whether the research results can be generalized to clinical practice since DSM-IV-TR is mainly used in research while ICD-10 is widely established in clinical practice in Europe. Therefore, the population investigated by the DSM (research population) is not identical with the population examined using the ICD (clinical population). PMID:23267678

  4. Attitudes and knowledge levels of nurses and residents caring for adolescents with an eating disorder.

    Science.gov (United States)

    Raveneau, Gladys; Feinstein, Ronald; Rosen, Lisa M; Fisher, Martin

    2014-01-01

    Although the vast majority of youths with an eating disorder (ED) are treated as outpatients, some require treatment in an inpatient unit. The purpose of this study was to determine the attitudes of nurses and pediatric residents towards adolescents and young adults with ED. Nursing questionnaires were distributed through a nurse manager and resident questionnaires were distributed in coordination with the chief residents. A total of 82 individuals (32 nurses and 50 pediatric residents) completed the survey. Only two nurses and six residents had not worked with a patient with an ED in the previous year. The vast majority of nurses and residents recognized that fear of gaining weight, refusal to maintain body weight and, disturbed body image were frequent signs occurring in patients with an ED. Both nurses and residents believed that emotional problems, influence of friends and family, family pressure, influence of the media, and being self-induced were the most likely causes of EDs. Genetics and influence of other medical problems were deemed less likely causes. The majority of residents identified having different rules for different patients and poor communication as factors that make it difficult to take care of ED patients. More than half of all nurses and residents (58.2%) thought that ED patients were responsible for their disease "always" or "in most cases". Residents (68.8%) were more likely than nurses (45.2%) to frequently feel frustrated with ED patients (χ2, p<0.0370). Adolescents with an ED provide a unique challenge to nurses and residents caring for them.

  5. Pediatric Program Leadership's Contribution Toward Resident Wellness.

    Science.gov (United States)

    Carson, Savanna L; Perkins, Kate; Reilly, Maura R; Sim, Myung-Shin; Li, Su-Ting T

    2018-02-27

    Residency program leaders are required to support resident well-being, but often do not receive training in how to do so. Determine frequency in which program leadership provides support for resident well-being, comfort in supporting resident well-being, and factors associated with need for additional training in supporting resident well-being. National cross-sectional web-based survey of pediatric program directors, associate program directors, and coordinators in June 2015, on their experience supporting resident well-being. Univariate and bivariate descriptive statistics compared responses between groups. Generalized linear modeling, adjusting for program region, size, program leadership role, and number of years in role determined factors associated with need for additional training. 39.3% (322/820) of participants responded. Most respondents strongly agreed that supporting resident well-being is an important part of their role, but few reported supporting resident well-being as part of their job description. Most reported supporting residents' clinical, personal, and health issues at least annually, and in some cases weekly, with 72% spending >10% of their time on resident well-being. Most program leaders desired more training. After adjusting for level of comfort in dealing with resident well-being issues, program leaders more frequently exposed to resident well-being issues were more likely to desire additional training (pProgram leaders spend a significant amount of time supporting resident well-being. While they feel that supporting resident well-being is an important part of their job, opportunities exist for developing program leaders through including resident wellness on job descriptions and training program leaders how to support resident well-being. Copyright © 2018 Academic Pediatric Association. Published by Elsevier Inc. All rights reserved.

  6. An evaluation of knowledge, attitude and practices about prescribing fixed dose combinations among resident doctors

    Directory of Open Access Journals (Sweden)

    Nimit Goswami

    2013-01-01

    Full Text Available Background: Fixed Dose Combinations (FDCs improve patient compliance and decrease pill burden. However, irrational prescribing of FDCs is a major health concern. As resident doctors are primarily involved in patient management at tertiary care hospitals, knowledge about prescribing FDCs is of paramount importance. Objective: To evaluate knowledge, attitude and practice, regarding use of FDCs by resident doctors at a tertiary care teaching hospital. Materials and Methods: The study was carried out among resident doctors working at Civil Hospital, Ahmedabad, a tertiary care teaching hospital. One hundred resident doctors from the departments of medicine, obstetrics and gynaecology, surgery, paediatrics, skin and psychiatry, who gave their informed consent, were enrolled. A prevalidated questionnaire regarding knowledge, attitude and prescribing practice of fixed dose combinations was filled up. Data was analyzed with suitable statistical tests. Results: Out of the 100 residents recruited for the study, 34, 33 and 33 residents were selected from the 1 st , 2 nd and 3 rd year respectively. The resident doctors were not aware about all of the advantages and disadvantages of FDCs. On an average, only 31% of the residents (lowest 16% among 1 st year residents had knowledge about the Essential Medicine List (EML. Knowledge about rationality of given FDCs was lacking in 81% of the residents. Only 47% could name a single banned FDC in India. Common sources of information about FDCs were medical representatives, colleagues/peers, the Monthly Index of Medical Specialities (MIMS and Continuous Medical Education (CMEs. A majority of residents (96% agreed that FDCs should be allowed to be marketed. The residents opined that most commonly prescribed FDCs were of antimicrobial drugs, amongst which amoxicillin + clavulanic acid was the most frequent. Conclusion: There is need to improve knowledge about rationality, EML, usage and banned FDCs in post graduate

  7. Association of reproductive health training on intention to provide services after residency: the family physician resident survey.

    Science.gov (United States)

    Romero, Diana; Maldonado, Lisa; Fuentes, Liza; Prine, Linda

    2015-01-01

    High rates of unintended pregnancy and need for reproductive health services (RHS), including abortion, require continued efforts to train medical professionals and increase availability of these services. With US approval 12 years ago of Mifepristone, a medication abortion pill, abortion services are additionally amenable to primary care. Family physicians are a logical group to focus on given that they provide the bulk of primary care. We analyzed data from an annual survey (2007--2010) of third-year family medicine residents (n=284, response rate=48%--64%) in programs offering abortion training to examine the association between such training and self-reported competence and intentions to provide RHS (with a particular focus on abortion) upon graduation from residency. The majority of residents (75% in most cases) were trained in each of the RHS we asked about; relatively fewer trained in implant insertion (39%), electric vacuum aspiration (EVA) (58%), and manual vacuum aspiration (MVA) (69%). Perceived competence on the part of the graduating residents ranged from high levels in pregnancy options counseling (89%) and IUD insertion (85%) to lows in ultrasound and EVA (both 34%). Bivariate analysis revealed significant associations between number of procedures performed and future intentions to provide them. The association between competence and intentions persisted for all procedures in multivariate analysis, adjusting for number of procedures. Further, the total number of abortions performed during residency increased the odds of intending to provide MVA and medication abortion by 3% and 2%, respectively. Findings support augmenting training in RHS for family medicine residents, given that almost half (45%) of those trained intended to provide abortions. The volume of training should be increased so more residents feel competent, particularly in light of the fact that combined exposure to different abortion procedures has a cumulative impact on intention to

  8. General surgery resident rotations in surgical critical care, trauma, and burns: what is optimal for residency training?

    Science.gov (United States)

    Napolitano, Lena M; Biester, Thomas W; Jurkovich, Gregory J; Buyske, Jo; Malangoni, Mark A; Lewis, Frank R

    2016-10-01

    There are no specific Accreditation Council for Graduate Medical Education General Surgery Residency Program Requirements for rotations in surgical critical care (SCC), trauma, and burn. We sought to determine the experience of general surgery residents in SCC, trauma, and burn rotations. Data analysis of surgical rotations of American Board of Surgery general surgery resident applicants (n = 7,299) for the last 8 years (2006 to 2013, inclusive) was performed through electronic applications to the American Board of Surgery Qualifying Examination. Duration (months) spent in SCC, trauma, and burn rotations, and postgraduate year (PGY) level were examined. The total months in SCC, trauma and burn rotations was mean 10.2 and median 10.0 (SD 3.9 months), representing approximately 16.7% (10 of 60 months) of a general surgery resident's training. However, there was great variability (range 0 to 29 months). SCC rotation duration was mean 3.1 and median 3.0 months (SD 2, min to max: 0 to 15), trauma rotation duration was mean 6.3 and median 6.0 months (SD 3.5, min to max: 0 to 24), and burn rotation duration was mean 0.8 and median 1.0 months (SD 1.0, min to max: 0 to 6). Of the total mean 10.2 months duration, the longest exposure was 2 months as PGY-1, 3.4 months as PGY-2, 1.9 months as PGY-3, 2.2 months as PGY-4 and 1.1 months as PGY-5. PGY-5 residents spent a mean of 1 month in SCC, trauma, and burn rotations. PGY-4/5 residents spent the majority of this total time in trauma rotations, whereas junior residents (PGY-1 to 3) in SCC and trauma rotations. There is significant variability in total duration of SCC, trauma, and burn rotations and PGY level in US general surgery residency programs, which may result in significant variability in the fund of knowledge and clinical experience of the trainee completing general surgery residency training. As acute care surgery programs have begun to integrate emergency general surgery with SCC, trauma, and burn rotations

  9. Major Sport Venues

    Data.gov (United States)

    Department of Homeland Security — The Major Public Venues dataset is composed of facilities that host events for the National Association for Stock Car Auto Racing, Indy Racing League, Major League...

  10. 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...

  11. 8 CFR 325.3 - Residence.

    Science.gov (United States)

    2010-01-01

    ... 8 Aliens and Nationality 1 2010-01-01 2010-01-01 false Residence. 325.3 Section 325.3 Aliens and Nationality DEPARTMENT OF HOMELAND SECURITY NATIONALITY REGULATIONS NATIONALS BUT NOT CITIZENS OF THE UNITED STATES; RESIDENCE WITHIN OUTLYING POSSESSIONS § 325.3 Residence. (a) For purposes of applying the...

  12. 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…

  13. 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

  14. 24 CFR 206.39 - Principal residence.

    Science.gov (United States)

    2010-04-01

    ... 24 Housing and Urban Development 2 2010-04-01 2010-04-01 false Principal residence. 206.39 Section... CONVERSION MORTGAGE INSURANCE Eligibility; Endorsement Eligible Mortgagors § 206.39 Principal residence. The property must be the principal residence of each mortgagor at closing. For purposes of this section, the...

  15. 25 CFR 700.97 - Residence.

    Science.gov (United States)

    2010-04-01

    ... 25 Indians 2 2010-04-01 2010-04-01 false Residence. 700.97 Section 700.97 Indians THE OFFICE OF NAVAJO AND HOPI INDIAN RELOCATION COMMISSION OPERATIONS AND RELOCATION PROCEDURES General Policies and Instructions Definitions § 700.97 Residence. (a) Residence is established by proving that the head of household...

  16. 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

  17. Does Targeted Training Improve Residents' Teaching Skills?

    Science.gov (United States)

    Polreis, Sean; D'Eon, Marcel F.; Premkumar, Kalyani; Trinder, Krista; Bonnycastle, Deirdre

    2015-01-01

    Resident doctors have an important and integral responsibility of teaching a number of individuals. The purpose of this study was to measure the effectiveness of the University of Saskatchewan's resident-as-teacher training course--Teaching Improvement Project Systems (TIPS). Residents who attended the TIPS course from January, 2010 through June,…

  18. 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...

  19. The perceived social impacts of the 2006 World Cup on Munich residents

    OpenAIRE

    Ohmann, Susanne; Jones, Ian; Wilkes, Keith

    2006-01-01

    All major sporting events result in a variety of impacts upon the host community. To date, the majority of existing studies have focused upon the wider economic impacts, with few empirical studies of the social impacts upon local residents. This paper explores the perceived impacts of the 2006 Football World Cup upon residents of one of the host\\ud cities–Munich. Using a multi-stage sampling technique, 180 Munich residents were randomly selected. Of these, 132 agreed to participate in face-to...

  20. A single-institution experience: the integrated vascular surgery residency's effect on fellowship and general surgery resident case volume and diversity.

    Science.gov (United States)

    Carroll, Megan I; Downes, Kathryne; Miladinovic, Branko; Illig, Karl A; Armstrong, Paul A; Back, Martin R; Johnson, Brad L; Shames, Murray L

    2014-01-01

    To determine whether the formation of an integrated vascular surgery residency (0 + 5) has negatively impacted the case volume and diversity of the vascular surgery fellows (5 + 2) and chief general surgeons at the same institution. Operative data from the vascular integrated (0 + 5), independent (5 + 2), and general surgery residencies at a single institution were retrospectively reviewed and analyzed to determine vascular surgery case volumes from 2006-2012. National operative data (Residency Review Committee) were used for comparison of diversity and volume. Standard statistical methods were applied. During this period, the 5 + 2 fellows at our institution performed on average 741 (range, 554-1002) primary cases and 1091 (range, 844-1479) combined primary and secondary cases for the 2-year fellowship. Our integrated residency began in July 2007. Our fellows' primary case volumes remained relatively stable between 2006 and 2011, with a 4% increase in the number of cases, although their total (primary and secondary) case volumes fell 15%; by comparison, the equivalent national 50th percentile rates rose 16% during this time frame. Our institution's general surgery residents performed an average of 116 (range, 56-221) vascular cases individually during their 5-year residency from 2005-2011. From 2006-2011, the total case volume fell only 5%, while the national 50th percentile rate fell 24%. Across all years, however, resident and fellow volumes both continue to be above Accreditation Council for Graduate Medical Education minimum requirements, and the major vascular case volume at our institution in all groups studied remained statistically greater than or equal to the national 50th percentile of cases. Our first integrated resident to graduate finished in June 2012 with 931 total vascular cases and 249 general surgery cases for a total operative experience of 1180 cases during the 5-year residency. Finally, after an 8-year period (2003-2010) in which none of

  1. Factors associated with diagnostic discrepancy for left ventricular hypertrophy between electrocardiography and echocardiography.

    Science.gov (United States)

    Petersen, Søren Sandager; Pedersen, Line Reinholdt; Pareek, Manan; Nielsen, Mette Lundgren; Diederichsen, Søren Zöga; Leósdóttir, Margrét; Nilsson, Peter M; Diederichsen, Axel Cosmus Pyndt; Olsen, Michael Hecht

    2017-02-01

    To investigate the influence of cardiovascular risk factors, including fasting plasma glucose (FPG), on the association between electrocardiographic (ECG) and echocardiographic left ventricular hypertrophy (LVH) in an elderly population. We tested cross-sectional associations between electrocardiographic and echocardiographic LVH, defining LVH according to the Sokolow-Lyon voltage combination, Cornell voltage-duration product, or left ventricular mass index (LVMI). Differences between standardized LVMI and Sokolow-Lyon voltage combination or Cornell voltage-duration product (absolute value/cut-off value for LVH) were used as outcome variables in order to identify explanatory variables associated with diagnostic discrepancies between ECG and echocardiography. Of the 1382 subjects included, 77% did not display any signs of LVH, 6% had LVH defined by ECG only, 13% had LVH defined by echocardiography only, and 5% had LVH on both ECG and echocardiography. Older subjects and those with higher blood pressure and RWT were more likely to have a relatively greater LVMI on echocardiography than that predicted on ECG (odds ratio: 1.65 per 10 years (95% confidence interval (CI): 1.27-2.15), p = .0002, odds ratio: 1.17 per 10 mmHg (95% CI: 1.09-1.25), p < .0001, and odds ratio: 1.21 per 0.10 (95% CI: 1.02-1.42), p = .03). In addition, discrepancy was also seen in females and subjects receiving antihypertensive medication (odds ratio: 1.41 (95% CI: 1.04-1.89), p = .03 and odds ratio: 1.41 (95% CI: 1.06-1.87), p = .02), but FPG did not independently influence discrepancy between ECG and echocardiography. Age, blood pressure, female sex, greater RWT and use of antihypertensive medication were associated with a greater risk of non-consistency between LVH determined by ECG and echocardiography.

  2. Size discrepancy between sonographic and pathological evaluation of solitary papillary thyroid carcinoma

    Energy Technology Data Exchange (ETDEWEB)

    Bachar, Gideon, E-mail: gidybahar@gmail.com [Department of Otorhinolaryngology and Head and Neck Surgery, Rabin Medical Center, Beilinson Campus, Petach Tikva 49100 (Israel); Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv (Israel); Buda, Inon, E-mail: inonbuda@gmail.com [Department of Otorhinolaryngology and Head and Neck Surgery, Rabin Medical Center, Beilinson Campus, Petach Tikva 49100 (Israel); Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv (Israel); Cohen, Maya, E-mail: mayac@clalit.org.il [Department of Imaging, Rabin Medical Center, Beilinson Campus, Petach Tikva 49100 (Israel); Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv (Israel); Hadar, Tuvia, E-mail: hadartuv@gmail.com [Department of Otorhinolaryngology and Head and Neck Surgery, Rabin Medical Center, Beilinson Campus, Petach Tikva 49100 (Israel); Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv (Israel); Hilly, Ohad, E-mail: ohadhilly@gmail.com [Department of Otorhinolaryngology and Head and Neck Surgery, Rabin Medical Center, Beilinson Campus, Petach Tikva 49100 (Israel); Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv (Israel); Schwartz, Nofrat, E-mail: nofrat@gmail.com [Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv (Israel); Department of Otolaryngology, Meir Hospital, Kefar Sabah, Tel Aviv University, Tel Aviv (Israel); Shpitzer, Thomas, E-mail: thomas-s@013net.net [Department of Otorhinolaryngology and Head and Neck Surgery, Rabin Medical Center, Beilinson Campus, Petach Tikva 49100 (Israel); Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv (Israel); Segal, Karl, E-mail: segalk@clalit.org.il [Department of Otorhinolaryngology and Head and Neck Surgery, Rabin Medical Center, Beilinson Campus, Petach Tikva 49100 (Israel); Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv (Israel)

    2013-11-01

    Background: Sonographic size of suspicious thyroid lesions is an essential parameter in the evaluation of thyroid nodules, determining the need for needle biopsy and has impact on the extent of surgery. Limited data is available on the correlation between the size of the thyroid nodule on sonography and the actual size measured during histological examination. The aim of the present study was to compare these two modalities and to discuss the potential clinical implications of the findings in the study population. Methods: The database of Rabin Medical Center was reviewed for all patients with histologically proven papillary carcinoma of the thyroid treated by thyroid surgery between 2005 and 2010. Results: 292 patients with papillary thyroid carcinoma were included. The mean sonographic size of the nodule was 2.19 ± 1.15 cm. The mean pathological diameter was 1.69 ± 1.09 cm. Discrepancies between tumor histological diameter and the sonographically measurement were more prominent in tumors larger than 1.5 cm. Nonetheless, 18.8% of thyroid nodules that were measured by US as larger than 1 cm, were found to be smaller than 1 cm on final pathology. Similarly, 7.2% of nodules evaluated by sonography were determined as being larger than 4 cm, while their definitive size was smaller than 4 cm. Conclusions: We noted a significant discrepancy between the preoperative sonographic and the pathologic size measurements for papillary thyroid carcinoma. The sonographic evaluation misclassifies both patients with small and large thyroid tumors, and consequently exposes them to unnecessary workup and more extensive operation. This discrepancy between the ultrasound findings and actual tumor size should be taken into account in clinical practice and help guide the evaluation and treatment of patients with thyroid nodules.

  3. The Probable Cause of a Discrepancy in the CCIR Report 322-3 Radio Noise Model

    Science.gov (United States)

    1993-05-01

    error is the difference between those given in these figures and the coirection L• clil Input ltor lioul&i:i. Colorado. I, was anticipated that the...partial derivatives for bivariate interpolation on scattered data, Rocky Mountain J. Math .. 14, 41-52. 1984 Bowen, N.M. and A.C. Fraser-Smith, A...sphere, Rocky Mountain J. Math . 14, 177-202, 198n4 Ripley. B.D., Spatial Statistics, John Wiley & Sons, New York, 1981 Sailors. D.B., A discrepancy in the

  4. A new method for ABO genotyping to avoid discrepancy between genetic and serological determinations.

    Science.gov (United States)

    Shintani-Ishida, Kaori; Zhu, Bao-Li; Maeda, Hitoshi; Uemura, Koichi; Yoshida, Ken-Ichi

    2008-01-01

    In Japan and elsewhere, ABO genotyping is frequently used in forensic practice for identification of a decomposed body. However, the phenotype deduced from the genotyping data is occasionally inconsistent with the real phenotype. In this paper, we report a simple ABO genotyping method in which five single nucleotide polymorphism at nps 220, 261, 796, 802, and 803 are analyzed simultaneously to avoid discrepancies between genetic and serological determinations in ABO*A204, *O303, *O207, *cis-AB01 and *cis-AB02 alleles. This method can be used for the genotyping of badly decomposed remains or old bloodstains.

  5. Thermal epiphysiodesis Made with RFA. An Alternative Treatment for Leg Length Discrepancy

    DEFF Research Database (Denmark)

    Shiguetomi Medina, Juan Manuel

    Introduction Anisomelia is a condition of leg length discrepancy. It is often treated with epiphysiodesis of the growth plate to inhibit growth. Epiphysiodesis has become the most commonly used procedure for leg length equalization. Current techniques involve opening cortical windows, usage...... ablation sites (lateral and medial) identified at the proximal tibia growth plate using x-ray. Under general anesthesia, a probe was inserted and the ablation performed. T1, T2 and water content MR images were performed right after the procedure, 12 weeks later for 6 animals, and 6 months later...

  6. Discrepancy measurements of copings prepared by three casting methods and two different alloys, on ITI implants

    Directory of Open Access Journals (Sweden)

    Siadat H.

    2008-04-01

    Full Text Available Background and Aim: An important criterion for success assessment of implant-supported prostheses is marginal fit. Vertical and horizontal discrepancy can result in loosening of the prosthetic screw, crestal bone resorption, peri-implantitis and loss of osseointegration. Despite careful attention to waxing, investing, and casting, marginal discrepancies are inevitable. The aim of this study was to evaluate the marginal gap and overhang in three casting methods with two different alloys in ITI implants.Materials and Methods: In this experimental in vitro study 48 analog abutments were randomly divided into six groups as follows: 1 burn out cap + BegoStar, 2 impression cap + BegoStar, 3 conventional wax up + BegoStar, 4 burn out cap + Verabond2, 5 impression cap + Verabond2, 6 conventional wax up + Verabond2. Waxing was done in 0.7 mm thickness verified by a digital gauge and a putty index was made for all groups. Reamer was used for correction of the finish line after casting in all groups. Castings were seated on analog abutments and embedded in acrylic resin. Specimens were sectioned by isomet instrument and polished and cleaned by ultrasonic cleaner for 10 min. The marginal gap and overextended margins of castings were examined under a  Scanning Electron Microscope (SEM (X200. The mean gap and margin overextension were calculated for each group. Data were analyzed by multivariate analysis and Bonferroni post-hoc test with p<0.05 as the level of significance.Results: No significant difference in gap size was observed among the three casting methods with two alloys (P=0.056. The marginal gap was not different in the studied casting methods (P=0.092. Gold alloy crowns showed lower marginal gaps compared to base metal alloy crowns (P<0.001. No significant difference in overhang size was observed among casting methods with two alloys (P=0.093. Base metal alloy crowns showed less overhang compared to gold alloy crowns (P<0.001. There was a

  7. Origin of discrepancies in inelastic electron tunneling spectra of molecular junctions.

    Science.gov (United States)

    Yu, Lam H; Zangmeister, Christopher D; Kushmerick, James G

    2007-05-18

    We report inelastic electron tunneling spectroscopy (IETS) of multilayer molecular junctions with and without incorporated metal nanoparticles. The incorporation of metal nanoparticles into our devices leads to enhanced IET intensity and a modified line shape for some vibrational modes. The enhancement and line-shape modification are both the result of a low lying hybrid metal nanoparticle-molecule electronic level. These observations explain the apparent discrepancy between earlier IETS measurements of alkane thiolate junctions by Kushmerick et al. [Nano Lett. 4, 639 (2004)] and Wang et al. [Nano Lett. 4, 643 (2004)].

  8. Perceived body image and weight: discrepancies and gender differences among University undergraduates.

    Science.gov (United States)

    Maruf, F A; Akinpelu, A O; Nwankwo, M J

    2012-12-01

    Body image (BI) is a multidimensional construct that includes perceptual, attitudinal, behavioural components, and feedback from other people's perception of oneself. The feedback from others and the degree to which one accepts or rejects it can determine self evaluation and perception. Body weight perception is a strong determinant of nutritional habits and weight management among adolescents. One of the barriers to reducing rise in obesity prevalence could be its cultural acceptability in some developing countries. To explore the gender influences on perception of self- and opposite-sex body images (BI), perceived body weight and the actual body weight categories at which discrepancies occur among the perceived BIs in undergraduates. This was a survey of perceptual dimension of BI, perceived body weight and actual body weight carried out in 121 undergraduates aged 21-29 years. Discrepancies occurred between self-perceived BI and each of actual body weight (p= 0.00 at 0.00-0.02 confidence interval (CI)), perceived body weight (p= 0.01 at 0.000-0.02 CI) and self-ideal BI (p= 0.03 at 0.000-0.05 CI) of normal-weight males. Self-perceived BI and perceived body weight also differed in normal-weight females (p= 0.02 at 0.000-0.04 CI). Discrepancies (p= 0.02 at 0.00-0.04 CI) occurred between self-perceived BI and self-ideal BI, and between self-perceived BI and desired BI (p= 0.02 at 0.00-0.04 CI) in overweight females. Gender differences occurred for self-ideal BI (p= 0.00 at 0.00-0.02 CI), ideal image for the opposite sex (IBIOS) (p= 0.02 at 0.00-0.04 CI) and desired BI (p= 0.00 at 0.00-0.02 CI). Normal-weight males perceived their BI differently from their actual body weight, perceived body weight and self-ideal BI whereas normal-weight females perceived their BI differently from only their perceived body weight. Discrepancies occur between self-ideal BI and self-perceived BI, and between self-perceived BI and desired BI in overweight females. There are differential

  9. Reducing discrepancies of personal goals in the context of cancer : A longitudinal study on the relation with well-being, psychological characteristics, and goal progress

    NARCIS (Netherlands)

    Pama, Marlous R.; Janse, Moniek; Sprangers, Mirjam A. G.; Fleer, Joke; Ranchor, Adelita V.

    OBJECTIVES: To (1) examine whether reducing discrepancies between goal importance and goal attainability is an adaptive predictor of well-being, (2) investigate intrusion, awareness, optimism, and pessimism as determinants of reducing discrepancies between goal importance and goal attainability, and

  10. Operative experience of residents in US general surgery programs: a gap between expectation and experience.

    Science.gov (United States)

    Bell, Richard H; Biester, Thomas W; Tabuenca, Arnold; Rhodes, Robert S; Cofer, Joseph B; Britt, L D; Lewis, Frank R

    2009-05-01

    The purpose of the study was to identify a group of operations which general surgery residency program directors believed residents should be competent to perform by the end of 5 years of training and then ascertain actual resident experience with these procedures during their training. There is concern about the adequacy of training of general surgeons in the United States. The American Board of Surgery and the Association of Program Directors in Surgery undertook a study to determine what operative procedures residency program directors consider to be essential to the practice of general surgery and then we measured the actual operative experience of graduating residents in those procedures, as reported to the Residency Review Committee for Surgery (RRC). An electronic survey was sent to residency program directors at the 254 general surgery programs in the US accredited by the RRC as of spring 2006. The program directors were presented with a list of 300 types of operations. Program directors graded the 300 procedures "A," "B," or "C" using the following criteria: A--graduating general surgery residents should be competent to perform the procedure independently; B--graduating residents should be familiar with the procedure, but not necessarily competent to perform it; and C--graduating residents neither need to be familiar with nor competent to perform the procedure. After ballots were tallied, the actual resident operative experience reported to the RRC by all residents finishing general surgery training in June 2005 was reviewed. One hundred twenty-one of the 300 operations were considered A level procedures by a majority of program directors (PDs). Graduating 2005 US residents (n = 1022) performed only 18 of the 121 A procedures, an average of more than 10 times during residency; 83 of 121 procedures were performed on an average less than 5 times and 31 procedures less than once. For 63 of the 121 procedures, the mode (most commonly reported) experience was 0

  11. Fetoplacental cytogenetic discrepancy in a pregnancy with fetal mosaic tetrasomy 12p and Pallister–Killian syndrome detected by amniocentesis

    Directory of Open Access Journals (Sweden)

    Chih-Ping Chen

    2017-12-01

    Conclusion: Pregnancy with fetal PKS and mosaic tetrasomy 12p may present fetoplacental cytogenetic discrepancy. Therefore, genetic analysis on placenta alone may fail to detect fetal mosaic tetrasomy 12p associated with PKS.

  12. Coparenting in immigrant Chinese Canadian families: the role of discrepancies in acculturation and expectations for adolescent assistance.

    Science.gov (United States)

    Chance, Lauren J; Costigan, Catherine L; Leadbeater, Bonnie J

    2013-12-01

    For immigrant families, differential acculturation between mothers and fathers may present challenges to parenting adolescents. The current study investigated the concurrent relations among discrepancies in parental acculturation, discrepancies in parental expectations for adolescents, and coparenting quality with a sample of 162 married immigrant Chinese Canadian couples with adolescents (mean age = 14.94 years; SD = 1.73). Acculturation was assessed as parents' behavioral involvement in both Canadian and Chinese cultures. As predicted, mother-father differences in acculturation (in relation to both cultures) were related to discrepant expectations for how much adolescents should assist the family. Further, mother-father differences in Chinese acculturation were related to fathers' perceptions of a poorer coparenting relationship. Finally, this relation was partially mediated by discrepant parental expectations for adolescent assistance. Implications for parenting roles, enculturation, family dynamics, and intervention are considered.

  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. 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.

  15. Resident-Led Palliative Care Education Project.

    Science.gov (United States)

    Karlen, Naomi; Cruz, Brian; Leigh, A E

    2016-04-01

    Despite the growth of palliative medicine, 39% of hospitals do not have palliative care teams for consultation or to provide resident education. We examined the impact of resident-led education in palliative care principles on attitudes toward and comfort with palliative medicine and end-of-life care among internal medicine residents. An educational module designed by the authors was presented to other internal medicine residents in the program. Pre- and post-intervention survey data measuring residents' agreement with various statements regarding palliative medicine and end-of-life care were analyzed. Residents' agreement with various statements regarding palliative medicine and end-of-life care on a 5-point Likert scale was analyzed. Following the intervention, participants reported improved comfort with general knowledge of palliative medicine (p palliative care and end-of-life care (p curriculum in palliative medicine can improve resident comfort within this still-under-represented area of medicine.

  16. Tissue-resident memory T cells.

    Science.gov (United States)

    Shin, Haina; Iwasaki, Akiko

    2013-09-01

    Tissues such as the genital tract, skin, and lung act as barriers against invading pathogens. To protect the host, incoming microbes must be quickly and efficiently controlled by the immune system at the portal of entry. Memory is a hallmark of the adaptive immune system, which confers long-term protection and is the basis for efficacious vaccines. While the majority of existing vaccines rely on circulating antibody for protection, struggles to develop antibody-based vaccines against infections such as herpes simplex virus (HSV) and human immunodeficiency virus (HIV) have underscored the need to generate memory T cells for robust antiviral control. The circulating memory T-cell population is generally divided into two subsets: effector memory (TEM ) and central memory (TCM ). These two subsets can be distinguished by their localization, as TCM home to secondary lymphoid organs and TEM circulate through non-lymphoid tissues. More recently, studies have identified a third subset, called tissue-resident memory (TRM ) cells, based on its migratory properties. This subset is found in peripheral tissues that require expression of specific chemoattractants and homing receptors for T-cell recruitment and retention, including barrier sites such as the skin and genital tract. In this review, we categorize different tissues in the body based on patterns of memory T-cell migration and tissue residency. This review also describes the rules for TRM generation and the properties that distinguish them from circulating TEM and TCM cells. Finally, based on the failure of recent T-cell-based vaccines to provide optimal protection, we also discuss the potential role of TRM cells in vaccine design against microbes that invade through the peripheral tissues and highlight new vaccination strategies that take advantage of this newly described memory T-cell subset. © 2013 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  17. Association of resident fatigue and distress with perceived medical errors.

    Science.gov (United States)

    West, Colin P; Tan, Angelina D; Habermann, Thomas M; Sloan, Jeff A; Shanafelt, Tait D

    2009-09-23

    Fatigue and distress have been separately shown to be associated with medical errors. The contribution of each factor when assessed simultaneously is unknown. To determine the association of fatigue and distress with self-perceived major medical errors among resident physicians using validated metrics. Prospective longitudinal cohort study of categorical and preliminary internal medicine residents at Mayo Clinic, Rochester, Minnesota. Data were provided by 380 of 430 eligible residents (88.3%). Participants began training from 2003 to 2008 and completed surveys quarterly through February 2009. Surveys included self-assessment of medical errors, linear analog self-assessment of overall quality of life (QOL) and fatigue, the Maslach Burnout Inventory, the PRIME-MD depression screening instrument, and the Epworth Sleepiness Scale. Frequency of self-perceived, self-defined major medical errors was recorded. Associations of fatigue, QOL, burnout, and symptoms of depression with a subsequently reported major medical error were determined using generalized estimating equations for repeated measures. The mean response rate to individual surveys was 67.5%. Of the 356 participants providing error data (93.7%), 139 (39%) reported making at least 1 major medical error during the study period. In univariate analyses, there was an association of subsequent self-reported error with the Epworth Sleepiness Scale score (odds ratio [OR], 1.10 per unit increase; 95% confidence interval [CI], 1.03-1.16; P = .002) and fatigue score (OR, 1.14 per unit increase; 95% CI, 1.08-1.21; P error was also associated with burnout (ORs per 1-unit change: depersonalization OR, 1.09; 95% CI, 1.05-1.12; P errors when adjusted for burnout or depression. Among internal medicine residents, higher levels of fatigue and distress are independently associated with self-perceived medical errors.

  18. Determinants of internal medicine residents' choice in the canadian R4 Fellowship Match: A qualitative study

    Directory of Open Access Journals (Sweden)

    Kassam Narmin

    2011-06-01

    Full Text Available Abstract Background There is currently a discrepancy between Internal Medicine residents' decisions in the Canadian subspecialty fellowship match (known as the R4 match and societal need. Some studies have been published examining factors that influence career choices. However, these were either demographic factors or factors pre-determined by the authors' opinion as possibly being important to incorporate into a survey. Methods A qualitative study was undertaken to identify factors that determine the residents choice in the subspecialty (R4 fellowship match using focus group discussions involving third and fourth year internal medicine residents Results Based on content analysis of the discussion data, we identified five themes: 1 Practice environment including acuity of practice, ability to do procedures, lifestyle, job prospects and income 2 Exposure in rotations and to role models 3 Interest in subspecialty's patient population and common diseases 4 Prestige and respect of subspecialty 5 Fellowship training environment including fellowship program resources and length of training Conclusions There are a variety of factors that contribute to Internal Medicine residents' fellowship choice in Canada, many of which have been identified in previous survey studies. However, we found additional factors such as the resources available in a fellowship program, the prestige and respect of a subspecialty/career, and the recent trend towards a two-year General Internal Medicine fellowship in our country.

  19. The influence of discrepancies between adolescent and parent ratings of family dynamics on the well-being of adolescents.

    Science.gov (United States)

    Stuart, Jaimee; Jose, Paul E

    2012-12-01

    The present study examined whether discrepancies between adolescent and parent ratings of family dynamics predict adolescent well-being over time. Self-report data from 972 adolescent-parent dyads collected at two time points separated by one year were analyzed. Both adolescents and parents rated a variety of family dynamics (e.g., cohesion), and adolescents reported on their levels of well-being (confidence, purpose in life, and positive relations with others). Significant discrepancies between adolescents' and parents' perceptions of family functioning were found for all positive family dynamics, but not for family conflict. Furthermore, discrepancies increased over time and larger discrepancies were noted for older adolescents. Results from the residualized path model showed that discrepancies were bidirectionally related to adolescent well-being. In addition, age was found to moderate the predictive model. Specifically, 14-15 year olds (year 10) were found to be more stable in their well-being over time than younger adolescents. Also, results indicate that well-being is a significantly stronger negative predictor of discrepancies over time for the 14-15 year olds (year 10) than the for 10-11 year olds (year 6). The authors suggest that future research would benefit from investigations of the relationship between divergent perspectives of family members and adjustment outcomes of adolescents. PsycINFO Database Record (c) 2012 APA, all rights reserved.

  20. Relationship between parenting stress and informant discrepancies on symptoms of ADHD/ODD and internalizing behaviors in preschool children.

    Directory of Open Access Journals (Sweden)

    Yu-Chi Chen

    Full Text Available Parent and teacher ratings of child behaviors are often discrepant, and these discrepancies may be correlated with parenting stress. The present study explored whether various parenting stress factors are associated with discrepancies between parent and teacher ratings of attention-deficit/hyperactivity disorder and oppositional defiant disorder (ODD as well as internalizing symptoms in preschool children. We recruited 299 Taiwanese preschool children (aged 4-6 years from the community or via clinical referrals. A structural equation modeling was used to analyze the relationships among three factors derived from the Parenting Stress Index-Short Form and informant discrepancies on symptoms of inattention, hyperactivity/impulsivity, ODD, and internalizing behaviors. Scores reported by parents were higher for each of the symptoms examined than those reported by teachers, and the degree of agreement between informants ranged from low to moderate. The parental distress factor of parenting stress was associated only with parent ratings, whereas other factors of parenting stress-parent-child dysfunctional interaction and parents' stress resulted from their child's temperament-were correlated with both parent and teacher ratings. Only parental distress factor predicted informant discrepancies for all behavioral symptoms assessed. Our findings suggest that parental distress should be considered when parent rating scores show significant discrepancies from that of teacher rating scores.

  1. Sexual Closeness Discrepancies: What They Are and Why They Matter for Sexual Well-Being in Romantic Relationships.

    Science.gov (United States)

    Frost, David M; McClelland, Sara I; Dettmann, Miranda

    2017-11-01

    This study examined the impact of sexual closeness on sexual well-being. We developed a nuanced and multifaceted conceptualization of sexual closeness in the form of a constellation of ideal sexual closeness with a partner, actual sexual closeness, and the discrepancy between the two. Data were obtained from a diverse sample of N = 619 participants who took part in the Lives and Relationships Study: A longitudinal survey of men and women in relationships living in the U.S. and Canada. Increases in sexual closeness discrepancies over a period of 1 year predicted concomitant decreases in two indicators of sexual well-being: sexual satisfaction and orgasm frequency evaluations. Decreases in sexual closeness discrepancies resulted in improvement in sexual well-being. Individuals who reported no sexual closeness discrepancies and experienced no changes in sexual closeness discrepancies tended to have the highest levels of sexual well-being. Importantly, sexual closeness discrepancies were robust predictors of sexual well-being, above and beyond individuals' actual sexual closeness, general relationship closeness, and other demographic and relationship characteristics known to be associated with sexual well-being. The present findings demonstrate that how close people feel sexually to their relationship partners is part of a general constellation of factors related to relationship closeness that, only when considered together, sufficiently explain the ways in which experiences of closeness impact sexual well-being in romantic relationships.

  2. Degree and Direction of Sexual Desire Discrepancy are Linked to Sexual and Relationship Satisfaction in Couples Transitioning to Parenthood.

    Science.gov (United States)

    Rosen, Natalie O; Bailey, Kristen; Muise, Amy

    2018-02-01

    Many new parents are concerned that they have different levels of interest in sex than their partner. Understanding the role of desire discrepancies in their sexual and relationship satisfaction could help promote adjustment. In community couples, larger desire discrepancies have been inconsistently linked to lower sexual and relationship satisfaction. However, these studies rarely accounted for both the degree and direction (e.g., which partner has higher desire) of the discrepancy. We surveyed 255 mixed-sex new parent couples to assess their sexual desire, sexual satisfaction, and relationship satisfaction. Using polynomial regression with response surface analysis (RSA), we found that desire discrepancies between partners (i.e., when partners were more mismatched as opposed to matched on their levels of sexual desire) were associated with lower sexual (but not relationship) satisfaction for both partners. However, the direction of desire discrepancy mattered: Parents felt less satisfied when mothers were the higher-desire partner compared to when fathers were the higher-desire partner. In addition, when partners' level of sexual desire was in agreement, they were more sexually and relationally satisfied if both partners reported higher compared to lower desire. Results demonstrate the important role of both the magnitude and direction of desire discrepancies in new parent couples.

  3. Discrepancias entre diagnósticos clínicos y hallazgos de autopsia Discrepancies between clinical diagnoses and autopsy findings

    Directory of Open Access Journals (Sweden)

    María Virginia Bürgesser

    2011-04-01

    respiratory infections and acute myocardial infarction. There were 17 major discrepancies and 30 coincidences. No any minor discrepancy was detected. Respiratory infections were the main cause of error, followed by myocardial infarction. We conclude that in 17/47 (37% of cases the pre-mortem and postmortem diagnoses were different, and that respiratory infections were the main cause of error. We suggest to adopt educational and informative strategies, to revalue the importance of autopsy, and traditional clinical practices.

  4. The State of Communication Education in Family Medicine Residencies.

    Science.gov (United States)

    Jansen, Kate L; Rosenbaum, Marcy E

    2016-06-01

    Communication skills are essential to medical training and have lasting effects on patient satisfaction and adherence rates. However, relatively little is reported in the literature identifying how communication is taught in the context of residency education. Our goal was to determine current practices in communication curricula across family medicine residency programs. Behavioral scientists and program directors in US family medicine residencies were surveyed via email and professional organization listservs. Questions included whether programs use a standardized communication model, methods used for teaching communication, hours devoted to teaching communication, as well as strengths and areas for improvement in their program. Analysis identified response frequencies and ranges complemented by analysis of narrative comments. A total of 204 programs out of 458 family medicine residency training sites responded (45%), with 48 out of 50 US states represented. The majority of respondents were behavioral scientists. Seventy-five percent of programs identified using a standard communication model; Mauksch's patient-centered observation model (34%) was most often used. Training programs generally dedicated more time to experiential teaching methods (video review, work with simulated patients, role plays, small groups, and direct observation of patient encounters) than to lectures (62% of time and 24% of time, respectively). The amount of time dedicated to communication education varied across programs (average of 25 hours per year). Respondent comments suggest that time dedicated to communication education and having a formal curriculum in place are most valued by educators. This study provides a picture of how communication skills teaching is conducted in US family medicine residency programs. These findings can provide a comparative reference and rationale for residency programs seeking to evaluate their current approaches to communication skills teaching and

  5. Simulation-based interpersonal communication skills training for neurosurgical residents.

    Science.gov (United States)

    Harnof, Sagi; Hadani, Moshe; Ziv, Amitai; Berkenstadt, Haim

    2013-09-01

    Communication skills are an important component of the neurosurgery residency training program. We developed a simulation-based training module for neurosurgery residents in which medical, communication and ethical dilemmas are presented by role-playing actors. To assess the first national simulation-based communication skills training for neurosurgical residents. Eight scenarios covering different aspects of neurosurgery were developed by our team: (1) obtaining informed consent for an elective surgery, (2) discharge of a patient following elective surgery, (3) dealing with an unsatisfied patient, (4) delivering news of intraoperative complications, (5) delivering news of a brain tumor to parents of a 5 year old boy, (6) delivering news of brain death to a family member, (7) obtaining informed consent for urgent surgery from the grandfather of a 7 year old boy with an epidural hematoma, and (8) dealing with a case of child abuse. Fifteen neurosurgery residents from all major medical centers in Israel participated in the training. The session was recorded on video and was followed by videotaped debriefing by a senior neurosurgeon and communication expert and by feedback questionnaires. All trainees participated in two scenarios and observed another two. Participants largely agreed that the actors simulating patients represented real patients and family members and that the videotaped debriefing contributed to the teaching of professional skills. Simulation-based communication skill training is effective, and together with thorough debriefing is an excellent learning and practical method for imparting communication skills to neurosurgery residents. Such simulation-based training will ultimately be part of the national residency program.

  6. Breaking Bad News: A Survey of Radiology Residents' Experiences Communicating Results to Patients.

    Science.gov (United States)

    Narayan, Anand; Dromi, Sergio; Meeks, Adam; Gomez, Erin; Lee, Bonmyong

    The practice of radiology often includes routine communication of diagnostic test results directly to patients in breast imaging and interventional radiology. There is increasing interest in expanding direct communication throughout radiology. Though these conversations can substantially affect patient well-being, there is limited evidence indicating that radiology residents are specifically taught methods to effectively convey imaging results to patients. Our purpose is to evaluate resident experience communicating imaging results to patients. An IRB-approved study with a total of 11 pilot-tested questions was used. Surveyed programs included radiology residents (PGY2-PGY5) at 2 urban residency programs. Online surveys were administered using SurveyMonkey and e-mailed to residents at both programs (starting November 20, 2015, completed March 31, 2016). Demographics were obtained with survey proportions compared using logistic regression (P < 0.05, statistically significant). A total of 73 residents responded (93.6% response rate) with similar response rates at each institution (P = 0.689). Most were male (71.2%) with 17.8% planning to go into breast imaging (21.9%, interventional radiology (IR)). Furthermore, 83.6% described no training in communicating radiology results to patients; 91.8% of residents communicated results with patients (87.7% diagnostic imaging tests and 57.5% biopsies). Residents most commonly communicated results in person (75.3%) followed by phone (64.4%), and 79.4% agreed or strongly agreed that additional training relaying results would be helpful. A large majority of radiology residents have communicated test results to patients, yet few have received training in how to communicate these results. A large majority of residents expressed interest in obtaining additional communication training. Additional research is required to determine ideal methods to educate residents on communicating test results. Copyright © 2018 Elsevier Inc. All

  7. Perceptions, attitudes, and satisfaction concerning resident participation in health care among dermatology outpatients.

    Science.gov (United States)

    AlGhamdi, Khalid M; Almohanna, Hind M; Alkeraye, Salim S; Alsaif, Fahad M; Alrasheed, Saleh K

    2014-01-01

    A limited number of published studies have discussed patient attitudes toward resident physicians' participation in dermatology clinics. A literature search failed to identify any such study in the Middle East. The aim of this study was to explore patient perceptions and attitudes toward resident participation in dermatology outpatient clinics. A self-administered questionnaire focused on patient attitudes toward dermatology resident participation was distributed randomly to all adult outpatients attending dermatology clinics at a university hospital in Saudi Arabia between July and September 2010. The questionnaire was returned by 742 of 900 patients, for an 82% response rate. The mean patient age was 30.58 ± 11.67 years. Forty-two percent (311 of 742) of the respondents were male. The major reason for visiting the hospital was a medical dermatology consultation (80.4%). Only 35% of the patients self-reported an accurate understanding of the "resident" designation. In total, 86.4% of patients were satisfied with the residents' behavior. Furthermore, 98.4% of the patients were satisfied with the medical care provided by the residents. The patients agreed with resident participation in their health care. The majority of the patients expressed their willingness to provide a medical history and receive counseling from residents (87.6% and 86.3%, respectively). There was no gender-associated effect on the understanding of the resident position or the decision to receive a physical examination by a resident. Dermatology outpatients are satisfied and have positive perceptions and attitudes toward resident participation in the dermatology clinic.

  8. The longitudinal association between multiple substance use discrepancies and marital satisfaction.

    Science.gov (United States)

    Homish, Gregory G; Leonard, Kenneth E; Kozlowski, Lynn T; Cornelius, Jack R

    2009-07-01

    The objective of this work was to examine the relation between patterns of substance use among newly married couples and marital satisfaction over time. In particular, this work examined if differences between husbands' and wives' heavy alcohol use and cigarette smoking, rather than simply use per se, predicted decreases in marital satisfaction over the first 7 years of marriage. Married couples (n = 634 couples) were assessed on a variety of substance use and relationship variables at the time of marriage and again at the first, second, fourth and seventh years of marriage. After controlling for key socio-demographic variables, discrepancies in husband and wife cigarette smoking and heavy alcohol use were related to significant reductions in marital satisfaction. Importantly, couples who were discrepant on both substances experienced the greatest declines in marital satisfaction over time. Patterns of substance use among newly married couples are important predictors of changes in marital functioning over time. It was not simply the heavy alcohol use or cigarette smoking that predicted dissatisfaction but, rather, differences between husbands' and wives' substance use that impacted the relationship.

  9. Explaining discrepancies in arrest rates between Black and White male juveniles.

    Science.gov (United States)

    Fite, Paula J; Wynn, Porche'; Pardini, Dustin A

    2009-10-01

    The authors investigated discrepancies in arrest rates between Black and White male juveniles by examining the role of early risk factors for arrest. Two hypotheses were evaluated: (a) Disproportionate minority arrest is due to increased exposure to early risk factors, and (b) a differential sensitivity to early risk factors contributes to disproportionate minority arrest. The study included 481 Black and White boys who were followed from childhood to early adulthood. A higher incidence of early risk factors accounted for racial differences related to any juvenile arrest, as well as differences in violence- and theft-related arrests. However, increased exposure to early risk factors did not explain race differences in drug-related arrests. Minimal support was found for the hypothesis that a differential sensitivity to risk factors accounts for disproportionate rate of minority male arrests. In sum, most racial discrepancies in juvenile male arrests were accounted for by an increased exposure to childhood risk factors. Specifically, Black boys were more likely to display early conduct problems and low academic achievement and experience poor parent-child communication, peer delinquency, and neighborhood problems, which increased their risk for juvenile arrest. (c) 2009 APA, all rights reserved.

  10. Impedance computations and beam-based measurements: A problem of discrepancy

    Science.gov (United States)

    Smaluk, Victor

    2018-04-01

    High intensity of particle beams is crucial for high-performance operation of modern electron-positron storage rings, both colliders and light sources. The beam intensity is limited by the interaction of the beam with self-induced electromagnetic fields (wake fields) proportional to the vacuum chamber impedance. For a new accelerator project, the total broadband impedance is computed by element-wise wake-field simulations using computer codes. For a machine in operation, the impedance can be measured experimentally using beam-based techniques. In this article, a comparative analysis of impedance computations and beam-based measurements is presented for 15 electron-positron storage rings. The measured data and the predictions based on the computed impedance budgets show a significant discrepancy. Three possible reasons for the discrepancy are discussed: interference of the wake fields excited by a beam in adjacent components of the vacuum chamber, effect of computation mesh size, and effect of insufficient bandwidth of the computed impedance.

  11. Resolving a long-standing model-observation discrepancy on ozone solar-cycle response

    Science.gov (United States)

    Li, K. F.; Zhang, Q.; Tung, K. K.; Yung, Y. L.

    2016-12-01

    To have the capability for long-term prediction of stratospheric ozone (O3), chemistry-climate models have often been tested against observations on decadal time scales. A model-observation discrepancy in the tropical O3 response to the 11-year solar cycle, first noted in 1993, persists for more than 20 years: While standard photochemical models predict a single-peak response in the stratosphere, satellite observations show an unexpected double-peak structure. Various studies have explored uncertainties in photochemistry and dynamics but there has not been compelling evidence of model biases. Here we suggest that decadal satellite orbital drifts relative to the diurnal cycle could be the primary cause of the discrepancy. We show that the double-peak structure can be reproduced by adding the AM/PM diurnal difference to the single-peak response predicted by the standard photochemistry. This work illustrates the importance of a synergistic and iterative process involving observations and theory in search of robust climate signals.

  12. Reasons for discrepancies in hip fracture risk estimates using FRAX and Garvan calculators.

    Science.gov (United States)

    Billington, Emma O; Gamble, Greg D; Reid, Ian R

    2016-03-01

    Both the FRAX and Garvan calculators are used to estimate absolute risk of fracture, but they sometimes produce different estimates. We sought to determine which patient characteristics contribute to these discrepancies. Ten-year hip fracture risk was estimated for 122 women, using both FRAX and Garvan with bone mineral density (BMD). Differences in estimates of hip fracture were assessed, both in absolute terms and with respect to a treatment threshold of 3%. Garvan estimates were higher than FRAX estimates across the range of ages and BMDs studied. A history of falls or of multiple fractures increased risk calculated by Garvan 3-6-fold, but did not account for all differences between calculators. Discrepancies around a 3% treatment threshold occurred in 31/122 (25%). Women aged 70-74 years, and women with osteopenia were most likely to have discordant estimates. Most discordant estimates (29/31) had a Garvan estimate ≥ 3% and FRAX calculator, use of the other calculator should be considered to help guide treatment decisions. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

  13. Comparison of radioassay and microbiological assay for serum folate, with clinical assessment of discrepant results

    International Nuclear Information System (INIS)

    Baril, L.; Carmel, R.

    1978-01-01

    Folate assays by use of radiolabeled folate provide obvious practical advantages over the standard microbiological assay, but remain incompletely tested. We therefore compared results for 415 sera with a kit involving 3 H-labeled folate and the Lactobacillus casei microbiological method. We examined the patients' data when there were discrepancies between the two methods. Although the correlation overall was satisfactory, results were discrepant in 25% of cases. In 74% of the latter, the radioassay result appeared to be the correct one, primarily because L. casei results were suppressed by antibiotics being taken by the patient. The radioassay occasionally gave falsely high values for patients with liver disease and falsely low ones for patients who had received isotopes for scanning purposes. Several assay kits that make use of 125 I- or 75 Se-labeled folate were also tested. Although these results correlated with the results of 3 H-labeled folate assay, various problems appeared, including the possible need for serum-supernate control tubes in one kit. Answers to these and other questions and careful clinical correlation of results are needed for any folate radioassays before their adoption for routine clinical use

  14. Effects of creatine supplementation on high-intensity intermittent exercise: discrepancies and methodological appraisals

    Directory of Open Access Journals (Sweden)

    Bruno Gualano

    2008-07-01

    Full Text Available http://dx.doi.org/10.5007/1980-0037.2008v10n2p189 After a brief review of the literature on the effects of creatine supplementation on high-intensity intermittent exercise performance, the main aim of this study was to discuss methodological differences between studies which could explain the discrepancies observed in the literature. The effects of creatine supplementation on high-intensity intermittent exercise performance have been investigated in depth. Although the results of much research demonstrates the effi cacy of this supplement, there is just as much evidence that does not support this ergogenic effect. The explanation for this divergence appears to be multifactorial, although it is always linked to methodological characteristics. Study design (crossover or parallel groups, individual variability of muscular creatine content, chronic high meat intake, sample size, exercise protocol characteristics (body weight dependence and time between series, and gender and age all differ between studies and are potentially the variables responsible, to differing extents, for the discrepancies observed in the literature. Studies involving young males, with parallel group design, adequate statistical power, control of the incorporation of creatine into muscles, food intake assessment and intermittent exercise protocols in which performance is independent of body weight and with rest-recovery intervals of 1 to 6 minutes, usually produce positive results. The many methodological factors which can contribute to divergence on the ergogenic effects of creatine should be considered in futures studies, as well as when prescribing creatine supplementation.

  15. Price Discrepancy Between Sellers and Buyers When Making Decisions for the Self and Others.

    Science.gov (United States)

    Zhang, Ziyuan; Zhang, Baojun; Li, Zhongquan

    2016-06-01

    In daily life, people make decisions not only for themselves but also on behalf of others. There may be differences in terms of the endowment effect when making decisions in these two situations. In Study 1, this question was investigated with an existing dataset exploring the traditional endowment effect, in which 86 students (M age = 20.8 years, SD = 5.0) at Harvard University were asked to make a decision on selling or buying a coffee mug for themselves or for others as brokers. When making decisions for the self, the average price demanded by sellers was much higher than that offered by buyers; while making decisions for others, the price discrepancy disappeared. In Study 2, a similar study was conducted with a sample of 42 Chinese university students (M age = 22.3 years, SD = 2.5), and a similar pattern of results was obtained. Further analysis indicated that when making decisions for others, only buyers increased their valuations, therefore mitigating the seller-buyer price discrepancy. Finally, the findings were interpreted from the perspective of Construal Level Theory. © The Author(s) 2016.

  16. A comparison of cancer burden and research spending reveals discrepancies in the distribution of research funding

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    Carter Ashley JR

    2012-07-01

    Full Text Available Abstract Background Ideally, the distribution of research funding for different types of cancer should be equitable with respect to the societal burden each type of cancer imposes. These burdens can be estimated in a variety of ways; “Years of Life Lost” (YLL measures the severity of death in regard to the age it occurs, "Disability-Adjusted Life-Years" (DALY estimates the effects of non-lethal disabilities incurred by disease and economic metrics focus on the losses to tax revenue, productivity or direct medical expenses. We compared research funding from the National Cancer Institute (NCI to a variety of burden metrics for the most common types of cancer to identify mismatches between spending and societal burden. Methods Research funding levels were obtained from the NCI website and information for societal health and economic burdens were collected from government databases and published reports. We calculated the funding levels per unit burden for a wide range of different cancers and burden metrics and compared these values to identify discrepancies. Results Our analysis reveals a considerable mismatch between funding levels and burden. Some cancers are funded at levels far higher than their relative burden suggests (breast cancer, prostate cancer, and leukemia while other cancers appear underfunded (bladder, esophageal, liver, oral, pancreatic, stomach, and uterine cancers. Conclusions These discrepancies indicate that an improved method of health care research funding allocation should be investigated to better match funding levels to societal burden.

  17. Discrepancies in general surgery medical terminology between South and North Korea.

    Science.gov (United States)

    Hur, Keunyoung; Park, Do-Eon; Oh, Heung-Kwon; Yang, Hyun Hui; Ko, Dayoung; Kim, Min-Hyun; Kim, Myung Jo; Kang, Sung Il; Kim, Duck-Woo; Kang, Sung-Bum

    2018-03-01

    The purpose of this study was to categorize surgery-related medical terminologies used in South and North Korea and to compare and analyze discrepancies observed in the terms. This study collected medical terminology used in the North Korean medical book "Surgery" and compared it to medical terminology found in the medical glossary of South Korea. The order of the subtitle was described according to the Instruction to Authors. In total, there were 2,168 individual medical terms, of which only 1,004 words (46.3%) were identical to South Korean medical terms. There were 581 similar terms (26.8%), 265 different terms (12.2%), and 318 terms that are nonexistent in South Korea (14.7%). Less than half of the medical terms used in North Korea match those used in South Korea. It is expected that the prolongation of the current division of South and North Korea will only worsen this discrepancy. Further efforts to bridge the gap through academic exchange between South Korea and North Korea are required in preparation for an era of reunification.

  18. Discrepancies in marginal and internal fits for different metal and alumina infrastructures cemented on implant abutments.

    Science.gov (United States)

    Faot, Fernanda; Suzuki, Dalton; Senna, Plinio M; da Silva, Wander J; de Mattias Sartori, Ivete A

    2015-06-01

    Cemented crowns are increasingly being used on dental implants instead of on screw-retained prostheses because of the reliability of internal Morse taper implant-abutment connections. However, there is a lack of information on the fit of metal ceramic and premachined alumina infrastructures. Therefore, the aim of this study was to evaluate the marginal and internal fits of different metal and alumina infrastructures cemented on universal post abutments. A total of 45 abutments (6 mm in height and 3.3 mm in diameter) were divided into five groups on the basis of their infrastructure material: cobalt-chromium (CoCr), nickel-chromium (NiCr), nickel-chromium-molybdenum-titanium (NiCrMoTi), gold (Au), and premachined alumina. The alumina group showed marginal overextension, and the Au group showed the highest discrepancy in marginal fit among the metal alloys. The CoCr and alumina groups showed the lowest discrepancies in internal fit. In conclusion, the alumina cylinders exhibited the best internal fit, despite their horizontal overextension. Among the metal alloys, CoCr exhibited the best fit at critical regions, such as the cervical and occlusal areas. © 2015 Eur J Oral Sci.

  19. Neurohospitalists enhance resident perception of the educational and clinical value of a night float rotation.

    Science.gov (United States)

    Greene, James G

    2013-10-01

    Neurology residency training programs have been profoundly impacted by recent changes in resident duty hours, workloads, and supervisory requirements. In response, many programs have adopted a night float coverage system to minimize the requirements for overnight call. The majority involves residents working a block of night shifts in what is typically a service-oriented rotation. Recently, concerns have arisen regarding the impact of this design on resident education and patient care. We have developed a novel on-site nighttime neurohospitalist model for the explicit purpose of steepening the initial learning curve for neurology residents in an effort to rapidly improve their neurological skills and, in conjunction, overnight patient care. We surveyed residents after the initiation of this system to assess their perception of the impact of direct overnight supervision on education and patient care. As part of ongoing quality improvement efforts, surveys were administered to neurology house staff at a tertiary academic medical center after they had completed service on the night float rotation both with and without an attending in the hospital using a retrospective pre/postdesign. There was a robust positive impact on resident's perception of overall quality, educational value, and clinical quality on the night float rotation with an attending on-site. Despite an overall perception that their autonomy was maintained, residents believed barriers to contact the attending were lower, and attending interaction during critical decision making was more frequent. Direct overnight supervision by a neurohospitalist enhances the educational value and care quality on overnight resident rotations.

  20. A Descriptive Study of a Spirituality Curriculum for General Psychiatry Residents.

    Science.gov (United States)

    McGovern, Thomas F; McMahon, Terry; Nelson, Jessica; Bundoc-Baronia, Regina; Giles, Chuck; Schmidt, Vanessa

    2017-08-01

    The study collected data on the attitudes of residents toward religion and spirituality in their practice after taking part in a 3-year curriculum on spirituality during their residency. This is a descriptive, single-site study with psychiatry residents as subjects. A questionnaire was given to the residents at the end of their third year of residency (N = 12). The responses heavily endorsed the religiousness/spirituality curriculum to be helpful and meaningful. Residents consider addressing spiritual and religious needs of patients to be important (76.9%) and appropriate. For majority of the residents (69.2%), there is strong agreement in the management of addictions having spiritual dimensions. Residents also strongly agreed that treatment of suffering, depression, guilt, and complicated grief may require attention to spiritual concerns (92-100%). Regardless of cultural or religious background, the residents endorsed the curriculum as a worthwhile experience and increased their appreciation of the place of spirituality in the holistic care of patients with psychiatric conditions.

  1. The Gap of Self - States and Its Association to an Individual‟s Interaction and Emotional Bond to their Significant Relationships: A Correlational Study about Filipino Youth‟s Self - Discrepancy and Their Attachment Styl

    Directory of Open Access Journals (Sweden)

    Mae R. Galing

    2017-05-01

    Full Text Available A youth is expected to experience difficulties due to the opposing desire to be free while still remaining dependent to family and other significant individuals in their lives. Filipino youth are known as being family - oriented and being submissive which is one of the factors that pounds the importance of what people around them utters. Thus, creating a gap or discrepancy between what they truly want and what other people expect them to do. When these internal battles began, significant external aspects such as social interaction can be compromised. These occurrences can be elucidated by using the two frameworks Self - Discrepancy Theory and Attachment Style. In this study, correlational research design and survey method were employed to 384 Filipino Youth from Makati whom are selected through convenience sampling. Results of the study showed that the respondents have positive image of themselves. Also, a big majority of the respondents were discerned to have high discrepancies between their self - states. In this study, it was also seen that the respondents were dismissive and were characterized to be independent, self - reliant, and gave low importance to relationships. Finally, findings of this study revealed a weak positive correlation between secure attachment s tyle towards the self - discrepancy of the respondents while weak negative correlation was found between the rest of the attachment styles towards the discrepancy among their self - states. With this, the researchers recommended stabilizing internal discrepanc ies and strengthening significant relationships as the two were seen as big factors in respondents’ social interaction and self - esteem.

  2. Resident interest and factors involved in entering a pediatric pulmonary fellowship

    Directory of Open Access Journals (Sweden)

    Gershan William M

    2004-07-01

    Full Text Available Abstract Background Relatively little is known about interest in pediatric pulmonology among pediatric residents. The purpose of this study, therefore, was to determine at this institution: 1 the level of pediatric resident interest in pursuing a pulmonary fellowship, 2 potential factors involved in development of such interest, 3 whether the presence of a pulmonary fellowship program affects such interest. Methods A questionnaire was distributed to all 52 pediatric residents at this institution in 1992 and to all 59 pediatric residents and 14 combined internal medicine/pediatrics residents in 2002, following development of a pulmonary fellowship program. Results Response rates were 79% in 1992 and 86% in 2002. Eight of the 43 responders in 1992 (19% had considered doing a pulmonary fellowship compared to 7 of 63 (11% in 2002. The highest ranked factors given by the residents who had considered a fellowship included wanting to continue one's education after residency, enjoying caring for pulmonary patients, and liking pulmonary physiology and the pulmonary faculty. Major factors listed by residents who had not considered a pulmonary fellowship included not enjoying the tracheostomy/ventilator population and chronic pulmonary patients in general, and a desire to enter general pediatrics or another fellowship. Most residents during both survey periods believed that they would be in non-academic or academic general pediatrics in 5 years. Only 1 of the 106 responding residents (~1% anticipated becoming a pediatric pulmonologist. Conclusions Although many pediatric residents consider enrolling in a pulmonary fellowship (~10–20% here, few (~1% here will actually pursue a career in pediatric pulmonology. The presence of a pulmonary fellowship program did not significantly alter resident interest, though other confounding factors may be involved.

  3. Automated data mining: an innovative and efficient web-based approach to maintaining resident case logs.

    Science.gov (United States)

    Bhattacharya, Pratik; Van Stavern, Renee; Madhavan, Ramesh

    2010-12-01

    Use of resident case logs has been considered by the Residency Review Committee for Neurology of the Accreditation Council for Graduate Medical Education (ACGME). This study explores the effectiveness of a data-mining program for creating resident logs and compares the results to a manual data-entry system. Other potential applications of data mining to enhancing resident education are also explored. Patient notes dictated by residents were extracted from the Hospital Information System and analyzed using an unstructured mining program. History, examination and ICD codes were obtained and compared to the existing manual log. The automated data History, examination, and ICD codes were gathered for a 30-day period and compared to manual case logs. The automated method extracted all resident dictations with the dates of encounter and transcription. The automated data-miner processed information from all 19 residents, while only 4 residents logged manually. The manual method identified only broad categories of diseases; the major categories were stroke or vascular disorder 53 (27.6%), epilepsy 28 (14.7%), and pain syndromes 26 (13.5%). In the automated method, epilepsy 114 (21.1%), cerebral atherosclerosis 114 (21.1%), and headache 105 (19.4%) were the most frequent primary diagnoses, and headache 89 (16.5%), seizures 94 (17.4%), and low back pain 47 (9%) were the most common chief complaints. More detailed patient information such as tobacco use 227 (42%), alcohol use 205 (38%), and drug use 38 (7%) were extracted by the data-mining method. Manual case logs are time-consuming, provide limited information, and may be unpopular with residents. Data mining is a time-effective tool that may aid in the assessment of resident experience or the ACGME core competencies or in resident clinical research. More study of this method in larger numbers of residency programs is needed.

  4. Exploring end-of-residency transitions in a VA Patient Aligned Care Team.

    Science.gov (United States)

    Wang, Emily S; Conde, Michelle V; Simon, Bret; Leykum, Luci K

    2014-07-01

    End-of-residency transitions create disruptions in primary care continuity. The national implementation of Patient Aligned Care Teams (PACT) in Veterans Health Administration (VA) primary care clinics creates an opportunity to mitigate this discontinuity through the provision of team-based care. To identify team-based solutions to end-of-residency transitions in a resident PACT continuity clinic by assessing the knowledge, attitudes, and perceptions of non-physician PACT members and resident PACT physicians. Cross-sectional survey of 27 resident physicians and 24 non-physician PACT members in the Internal Medicine Clinic at the Audie L. Murphy VA Hospital in the South Texas Veterans Health Care System. Twenty-seven residents and 24 non-physician PACT members completed the survey, with response rates of 90 % and 100 %, respectively. All residents and 96 % of non-physician PACT members agreed or strongly agreed that the residents were responsible for informing patients about end-of-residency transitions. Only 38 % of non-physician PACT members versus 52 % of residents indicated that non-physician PACT members should be responsible for this transition. Approximately 80 % of resident physicians and non-physician PACT members agreed there should be a formalized approach to these transitions; 67 % of non-physician PACT members were willing to support this transition. Potential barriers to team-based care transitions were identified. Major themes of write-in suggestions for improving the transition focused on communication and relationships between the patient and PACT and among the PACT members. PACT implementation changes the roles and relationship structures among all team members. While end-of-residency transitions create a disruption in the relationship system, the remainder of the PACT may bridge this transition. Our results demonstrate the importance of a team-based solution that engages all PACT members by improving communication and fostering effective team

  5. Evaluation of resident attitudes and self-reported competencies in health advocacy

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    Fok Mark C

    2010-11-01

    Full Text Available Abstract Background The CanMEDS Health Advocate role, one of seven roles mandated by the Royal College of Physicians and Surgeons Canada, pertains to a physician's responsibility to use their expertise and influence to advance the wellbeing of patients, communities, and populations. We conducted our study to examine resident attitudes and self-reported competencies related to health advocacy, due to limited information in the literature on this topic. Methods We conducted a pilot experience with seven internal medicine residents participating in a community health promotion event. The residents provided narrative feedback after the event and the information was used to generate items for a health advocacy survey. Face validity was established by having the same residents review the survey. Content validity was established by inviting an expert physician panel to review the survey. The refined survey was then distributed to a cohort of core Internal Medicine residents electronically after attendance at an academic retreat teaching residents about advocacy through didactic sessions. Results The survey was completed by 76 residents with a response rate of 68%. The majority agreed to accept an advocacy role for societal health needs beyond caring for individual patients. Most confirmed their ability to identify health determinants and reaffirmed the inherent requirements for health advocacy. While involvement in health advocacy was common during high school and undergraduate studies, 76% of residents reported no current engagement in advocacy activity, and 36% were undecided if they would engage in advocacy during their remaining time as residents, fellows or staff. The common barriers reported were insufficient time, rest and stress. Conclusions Medical residents endorsed the role of health advocate and reported proficiency in determining the medical and bio-psychosocial determinants of individuals and communities. Few residents, however, were

  6. Prospects after Major Trauma

    NARCIS (Netherlands)

    Holtslag, H.R.

    2007-01-01

    Introduction. After patients survived major trauma, their prospects, in terms of the consequences for functioning, are uncertain, which may impact severely on patient, family and society. The studies in this thesis describes the long-term outcomes of severe injured patients after major trauma. In

  7. Discrepancy in reporting among specialist registrars and the role of a paediatric neuroradiologist in reporting paediatric CT head examinations

    International Nuclear Information System (INIS)

    Nagaraja, S.; Ullah, Q.; Lee, K.J.; Bickle, I.; Hon, L.Q.; Griffiths, P.D.; Raghavan, A.; Flynn, P.; Connolly, D.J.A.

    2009-01-01

    Aim: To evaluate the discrepancy rate among specialist registrars (SPR) to assess whether seniority had a bearing on the discrepancy rate. To investigate which were the commonly missed abnormalities and the consequences for teaching purposes. To investigate the role of a specialist consultant neuroradiologist in reporting paediatric head computed tomography examinations. Materials and methods: The study was carried out over a 9-month period at the regional paediatric hospital during which time 270 CT head examinations were reported. Reporting in the department is carried out by one of the five general paediatric radiologists (GR) and also a specialist paediatric neuroradiologist (NR). The NR was considered the reference standard, who corroborated in areas of discrepancy with a second senior NR for this study. Of the 270 examinations, 260 were reported by the paediatric NR, 160 were reported by the SPR, GR, and NR, and 51 were reported by an SPR and the NR. In addition, four were reported by the GR and the NR, 45 by the NR only, seven by the GR only, and three cases were reported by the GR and an SPR. The discrepancy rates were calculated for GR versus NR, and SPR versus NR. All the discrepancies were re-evaluated by a second senior NR and confirmed in all cases. The reports of the SPR were further scrutinized. The trainees of training years 1-3 were considered junior and 4-5 were considered senior. Results: There was a discrepancy in 26/164 cases (15.9%) reported by the GR and NR. There was a discrepancy in 59/211 cases (28%) reported by an SPR and NR. The chi-squared test (two-sided) showed a significant difference (p = 0.005) between the two groups. There was a discrepancy in 36/118 cases (30.5%) reported by the junior SPR and NR. There was a discrepancy in 23/93 cases (24.7%) reported by a senior SPR and NR. The chi-squared test (two-sided) showed a non-significant difference (p = 0.353) between the two groups. Conclusion: The performance of the SPR was

  8. Residency Training: The need for an integrated diversity curriculum for neurology residency.

    Science.gov (United States)

    Rosendale, Nicole; Josephson, S Andrew

    2017-12-12

    Providing culturally responsive care to an increasingly multicultural population is essential and requires formal cultural humility training for residents. We sought to understand the current prevalence and need for this type of training within neurology programs and to pilot an integrated curriculum locally. We surveyed via email all program directors of academic neurology programs nationally regarding the prevalence of and need for formal cultural responsiveness training. Forty-seven program directors (36%) responded to the survey. The majority of respondents did not have a formalized diversity curriculum in their program (65%), but most (85%) believed that training in cultural responsiveness was important. We developed locally an integrated diversity curriculum as a proof of concept. The curriculum covered topics of diversity in language, religion, sexual orientation, gender identity/expression, and socioeconomic status designed to focus on the needs of the local community. Program evaluation included a pre and post survey of the learner attitudes toward cultural diversity. There is an unmet need for cultural responsiveness training within neurology residencies, and integrating this curriculum is both feasible and efficacious. When adapted to address cultural issues of the local community, this curriculum can be generalizable to both academic and community organizations. © 2017 American Academy of Neurology.

  9. 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

  10. Learning environment: assessing resident experience.

    Science.gov (United States)

    Byszewski, Anna; Lochnan, Heather; Johnston, Donna; Seabrook, Christine; Wood, Timothy

    2017-06-01

    Given their essential role in developing professional identity, academic institutions now require formal assessment of the learning environment (LE). We describe the experience of introducing a novel and practical tool in postgraduate programmes. The Learning Environment for Professionalism (LEP) survey, validated in the undergraduate setting, is relatively short, with 11 questions balanced for positive and negative professionalism behaviours. LEP is anonymous and focused on rotation setting, not an individual, and can be used on an iterative basis. We describe how we implemented the LEP, preliminary results, challenges encountered and suggestions for future application. Academic institutions now require formal assessment of the learning environment METHODS: The study was designed to test the feasibility of introducing the LEP in the postgraduate setting, and to establish the validity and the reliability of the survey. Residents in four programmes completed 187 ratings using LEP at the end of one of 11 rotations. The resident response rate was 87 per cent. Programme and rotation ratings were similar but not identical. All items rated positively (favourably), but displays of altruism tended to have lower ratings (meaning less desirable behaviour was witnessed), as were ratings for derogatory comments (again meaning that less desirable behaviour was witnessed). We have shown that the LEP is a feasible and valid tool that can be implemented on an iterative basis to examine the LE. Two LEP questions in particular, regarding derogatory remarks and demonstrating altruism, recorded the lowest scores, and these areas deserve attention at our institution. Implementation in diverse programmes is planned at our teaching hospitals to further assess reliability. This work may influence other postgraduate programmes to introduce this assessment tool. © 2016 John Wiley & Sons Ltd and The Association for the Study of Medical Education.

  11. 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.

  12. 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

    The objective of the study was to assess the current status of ethics education in obstetrics-gynecology residency programs. A cross-sectional, web-based survey was designed in conjunction with a professional survey laboratory at the University of Chicago. The survey was piloted with a convenience sample of clinical medical ethics fellows to assess question content and clarity. The survey was deployed by e-mail to all obstetrics-gynecology residency program directors. Descriptive statistics were used to analyze participant responses. The University of Chicago's Institutional Review Board deemed this study exempt from institutional review board formal review. Of 242 eligible obstetrics-gynecology residency program directors, 118 (49%) completed the survey. Most respondents were from university-based programs (n = 78, 66%) that were not religiously affiliated (n = 98, 83%) and trained 4-6 residents per postgraduate year (n = 64, 70%). Although 50% of program directors (n = 60) reported having ethics as part of their core curriculum, most programs teach ethics in an unstructured manner. Fifty-seven percent of respondents (n = 66) stated their program dedicated 5 or fewer hours per year to ethics. The majority of program directors (n = 80, 73%) responded they would like more to a lot more ethics education and believed that ethics education should be required (n = 93, 85%) for residents to complete their training. Respondents identified that crowding in the curriculum was a significant barrier to increased ethics training (n = 50, 45%) and two-thirds (n = 74, 67%) reported a lack of faculty expertise as a moderate barrier to providing ethics education in the residency curriculum. This study found that a lack of structured curricula, inadequate faculty expertise, and limited time were important barriers for ethics education in obstetrics-gynecology programs across the nation. Despite these existing challenges, program directors have a strong interest in increasing ethics

  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. What is an anesthesiology resident worth?

    Science.gov (United States)

    Ferrera, Marisa H; Beaman, Shawn T; Metro, David G; Handley, Linda J; Walker, James E

    2009-08-01

    To determine the cost of replacing an anesthesiology resident with a certified registered nurse anesthetist (CRNA) for equal operating room (OR) work. Retrospective financial analysis. Academic anesthesiology department. Clinical anesthesia (CA)-1 through CA-3 residents. Cost of replacing anesthesiology residents with CRNAs for equal OR work was determined. The cost of replacing one anesthesiology resident with a CRNA for the same number of OR hours ranged from $9,940.32 to $43,300 per month ($106,241.68 to $432,937.50 per yr). Numbers varied depending on the CRNA pay scale and whether the calculations were based on the number of OR hours worked at our residency program or OR hours worked in a maximum duty hour model. A CRNA is paid substantially more per OR hour worked, at all pay levels, than an anesthesiology resident.

  15. Strong discrepancies between local temperature mapping and interpolated climatic grids in tropical mountainous agricultural landscapes.

    Directory of Open Access Journals (Sweden)

    Emile Faye

    Full Text Available Bridging the gap between the predictions of coarse-scale climate models and the fine-scale climatic reality of species is a key issue of climate change biology research. While it is now well known that most organisms do not experience the climatic conditions recorded at weather stations, there is little information on the discrepancies between microclimates and global interpolated temperatures used in species distribution models, and their consequences for organisms' performance. To address this issue, we examined the fine-scale spatiotemporal heterogeneity in air, crop canopy and soil temperatures of agricultural landscapes in the Ecuadorian Andes and compared them to predictions of global interpolated climatic grids. Temperature time-series were measured in air, canopy and soil for 108 localities at three altitudes and analysed using Fourier transform. Discrepancies between local temperatures vs. global interpolated grids and their implications for pest performance were then mapped and analysed using GIS statistical toolbox. Our results showed that global interpolated predictions over-estimate by 77.5 ± 10% and under-estimate by 82.1 ± 12% local minimum and maximum air temperatures recorded in the studied grid. Additional modifications of local air temperatures were due to the thermal buffering of plant canopies (from -2.7 °K during daytime to 1.3 °K during night-time and soils (from -4.9 °K during daytime to 6.7 °K during night-time with a significant effect of crop phenology on the buffer effect. This discrepancies between interpolated and local temperatures strongly affected predictions of the performance of an ectothermic crop pest as interpolated temperatures predicted pest growth rates 2.3-4.3 times lower than those predicted by local temperatures. This study provides quantitative information on the limitation of coarse-scale climate data to capture the reality of the climatic environment experienced by living organisms. In highly

  16. Maternal and fetal characteristics affect discrepancies between pregnancy-dating methods: a population-based cross-sectional register study.

    Science.gov (United States)

    Kullinger, Merit; Wesström, Jan; Kieler, Helle; Skalkidou, Alkistis

    2017-01-01

    Gestational age is estimated by ultrasound using fetal size as a proxy for age, although variance in early growth affects reliability. The aim of this study was to identify characteristics associated with discrepancies between last menstrual period-based (EDD-LMP) and ultrasound-based (EDD-US) estimated delivery dates. We identified all singleton births (n = 1 201 679) recorded in the Swedish Medical Birth Register in 1995-2010, to assess the association between maternal/fetal characteristics and large negative and large positive discrepancies (EDD-LMP earlier than EDD-US and 10th percentile in the discrepancy distribution vs. EDD-LMP later than EDD-US and 90th percentile). Analyses were adjusted for age, parity, height, body mass index, smoking, and employment status. Women with a body mass index >40 kg/m 2 had the highest odds for large negative discrepancies (-9 to -20 days) [odds ratio (OR) 2.16, 95% CI 2.01-2.33]. Other factors associated with large negative discrepancies were: diabetes, young maternal age, multiparity, body mass index between 30 and 39.9 kg/m 2 or +1 SD), and unemployment. Several maternal and fetal characteristics were associated with discrepancies between dating methods. Systematic associations of discrepancies with maternal height, fetal sex, and partly obesity, may reflect an influence on the precision of the ultrasound estimate due to variance in early growth. © 2016 The Authors. Acta Obstetricia et Gynecologica Scandinavica published by John Wiley & Sons Ltd on behalf of Nordic Federation of Societies of Obstetrics and Gynecology (NFOG).

  17. IQ discrepancy differentiates levels of fine motor skills and their relationship in children with autism spectrum disorders.

    Science.gov (United States)

    Yu, Tzu-Ying; Chou, Willy; Chow, Julie Chi; Lin, Chien-Ho; Tung, Li-Chen; Chen, Kuan-Lin

    2018-01-01

    We investigated 1) the impact of differences in intelligence quotient discrepancy (IQD) on motor skills of preschool-aged children with autism spectrum disorders (ASD); 2) the relationships between IQD and motor skills in preschool-aged children with ASD. A total of 127 ASD preschool-aged children were divided into three groups according to the size of the IQD: IQD within 1 standard deviation (1SD; EVENIQ; n=81), discrepantly higher verbal intelligence quotient (VIQ; n=22; VIQ>performance intelligence quotient [PIQ] above 1SD [≥15 points]), and discrepantly higher PIQ (n=24; PIQ>VIQ above 1SD [≥15 points]). Children's IQD and motor skills were determined with the Wechsler Preschool and Primary Scale of Intelligence™ - Fourth Edition and the motor subtests of the Comprehensive Developmental Inventory for Infants and Toddlers (CDIIT), respectively. One-way analysis of variance revealed significant group differences for the fine motor domain of the CDIIT and the visual-motor coordination su