Comparison of clinical causes of death with autopsy diagnosis using discrepency classification.

Science.gov (United States)

Ullah, Khalil; Alamgir, Wasim

2006-12-01

To determine the usefulness of autopsy findings in the quality improvement of patients care. An observational study. Departments of Pathology and Medicine, Combined Military Hospital (CMH) Kharian, a tertiary care hospital, from January 2001 to December 2003. 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. This study showed the usefulness of autopsy findings in the quality improvement of the diagnosis and management of the disease by showing only a minority of cases with discrepant diagnosis of the cause of death.

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.

Histopathological diagnostic discrepancies in soft tissue tumours referred to a specialist centre: reassessment in the era of ancillary molecular diagnosis.

Science.gov (United States)

Thway, Khin; Wang, Jayson; Mubako, Taka; Fisher, Cyril

2014-01-01

Introduction. Soft tissue tumour pathology is a highly specialised area of surgical pathology, but soft tissue neoplasms can occur at virtually all sites and are therefore encountered by a wide population of surgical pathologists. Potential sarcomas require referral to specialist centres for review by pathologists who see a large number of soft tissue lesions and where appropriate ancillary investigations can be performed. We have previously assessed the types of diagnostic discrepancies between referring and final diagnosis for soft tissue lesions referred to our tertiary centre. We now reaudit this 6 years later, assessing changes in discrepancy patterns, particularly in relation to the now widespread use of ancillary molecular diagnostic techniques which were not prevalent in our original study. Materials and Methods. We compared the sarcoma unit's histopathology reports with referring reports on 348 specimens from 286 patients with suspected or proven soft tissue tumours in a one-year period. Results. Diagnostic agreement was seen in 250 cases (71.8%), with 57 (16.4%) major and 41 (11.8%) minor discrepancies. There were 23 cases of benign/malignant discrepancies (23.5% of all discrepancies). 50 ancillary molecular tests were performed, 33 for aiding diagnosis and 17 mutational analyses for gastrointestinal stromal tumour to guide therapy. Findings from ancillary techniques contributed to 3 major and 4 minor discrepancies. While the results were broadly similar to those of the previous study, there was an increase in frequency of major discrepancies. Conclusion. Six years following our previous study and notably now in an era of widespread ancillary molecular diagnosis, the overall discrepancy rate between referral and tertiary centre diagnosis remains similar, but there is an increase in frequency of major discrepancies likely to alter patient management. A possible reason for the increase in major discrepancies is the increasing lack of exposure to soft tissue

A panorama of discrepancy theory

CERN Document Server

Srivastav, Anand; Travaglini, Giancarlo

2014-01-01

Discrepancy theory concerns the problem of replacing a continuous object with a discrete sampling. Discrepancy theory is currently at a crossroads between number theory, combinatorics, Fourier analysis, algorithms and complexity, probability theory and numerical analysis. There are several excellent books on discrepancy theory but perhaps no one of them actually shows the present variety of points of view and applications covering the areas "Classical and Geometric Discrepancy Theory", "Combinatorial Discrepancy Theory" and "Applications and Constructions". Our book consists of several chapters, written by experts in the specific areas, and focused on the different aspects of the theory. The book should also be an invitation to researchers and students to find a quick way into the different methods and to motivate interdisciplinary research.

Discrepancies between cognition and decision making in older adults

Science.gov (United States)

Boyle, Patricia A.; James, Bryan D.; Yu, Lei; Barnes, Lisa L.; Bennett, David A.

2015-01-01

Background and aims There is increasing clinical and legal interest in discrepancies between decision-making ability and cognition in old age, a stage of life when decisions have major ramifications. We investigated the frequency and correlates of such discrepancies in non-demented older adults participating in a large community-based cohort study of aging, the Rush Memory and Aging Project. Methods Participants [n = 689, mean age 81.8 (SD 7.6), mean education 15.2 (SD 3.1), 76.8 % female and 93.3 % white] completed a measure of financial and healthcare decision making (DM) and a battery of 19 neuropsychological tests from which a composite measure of global cognition (COG) was derived. Results Results indicated that 23.9 % of the sample showed a significant discrepancy between DM and COG abilities. Of these, 12.9 % showed DM COG. Logistic regression models showed older age, being non-white, greater temporal discounting, and greater risk aversion were associated with higher odds of being in the DM COG group. Education, income, depressive symptoms, and impulsivity were not associated with a discrepancy. Only demographic associations (age, sex, and race) remained significant in a fully adjusted model with terms included for all factors. Conclusion These results support the consideration of decision making and cognition as potentially separate constructs. PMID:25995167

Assessing dependency using self-report and indirect measures: examining the significance of discrepancies.

Science.gov (United States)

Cogswell, Alex; Alloy, Lauren B; Karpinski, Andrew; Grant, David A

2010-07-01

The present study addressed convergence between self-report and indirect approaches to assessing dependency. We were moderately successful in validating an implicit measure, which was found to be reliable, orthogonal to 2 self-report instruments, and predictive of external criteria. This study also examined discrepancies between scores on self-report and implicit measures, and has implications for their significance. The possibility that discrepancies themselves are pathological was not supported, although discrepancies were associated with particular personality profiles. Finally, this study offered additional evidence for the relation between dependency and depressive symptomatology and identified implicit dependency as contributing unique variance in predicting past major depression.

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.

Binarity and the Abundance Discrepancy Problem in Planetary Nebulae

Science.gov (United States)

Corradi, Romano L. M.; García-Rojas, Jorge; Jones, David; Rodríguez-Gil, Pablo

2015-04-01

The discrepancy between abundances computed using optical recombination lines and collisionally excited lines is a major unresolved problem in nebular astrophysics. Here, we show that the largest abundance discrepancies are reached in planetary nebulae with close binary central stars. We illustrate this using deep spectroscopy of three nebulae with a post common-envelope (CE) binary star. Abell 46 and Ou 5 have O2+/H+ abundance discrepancy factors larger than 50, and as high as 300 in the inner regions of Abell 46. Abell 63 has a smaller discrepancy factor around 10, which is still above the typical values in ionized nebulae. Our spectroscopic analysis supports previous conclusions that, in addition to “standard” hot ({{T}e} ˜ 104 K) gas, there exists a colder ({{T}e} ˜ 103 K), ionized component that is highly enriched in heavy elements. These nebulae have low ionized masses, between 10-3 and 10-1 M⊙ depending on the adopted electron densities and temperatures. Since the much more massive red giant envelope is expected to be entirely ejected in the CE phase, the currently observed nebulae would be produced much later, during post-CE mass loss episodes when the envelope has already dispersed. These observations add constraints to the abundance discrepancy problem. We revise possible explanations. Some explanations are naturally linked to binarity such as, for instance, high-metallicity nova ejecta, but it is difficult at this stage to depict an evolutionary scenario consistent with all of the observed properties. We also introduce the hypothesis that these nebulae are the result of tidal destruction, accretion, and ejection of Jupiter-like planets.

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.

The resolution of discrepancies among nuclear data

International Nuclear Information System (INIS)

Peelle, R.

1992-01-01

Significant differences among input data occur in the evaluation of nuclear data because it is difficult to achieve experimental results with the accuracy required for some applications. Types of ''discrepancies'' are classified. The means are reviewed by which an evaluator may treat discrepancies in the process of evaluation. When all means fail that are based on how the discrepant data were obtained, the perplexed evaluator must sometimes combine discrepant data based just on the stated values and uncertainties; techniques for treating such challenges are compared. Some well-known data discrepancies are examined as examples

Self-Esteem Discrepancies and Depression.

Science.gov (United States)

Schafer, Robert B.; Keith, Patricia M.

1981-01-01

Examined the relationship between self-esteem discrepancies and depression in a long-term intimate relationship. Findings supported the hypothesis that depression is associated with discrepancies between married partners' self-appraisals, perceptions of spouse's appraisal, and spouse's actual appraisal. (Author/DB)

Medicare covers the majority of FDA-approved devices and Part B drugs, but restrictions and discrepancies remain.

Science.gov (United States)

Chambers, James D; May, Katherine E; Neumann, Peter J

2013-06-01

The Food and Drug Administration (FDA) and Medicare use different standards to determine, first, whether a new drug or medical device can be marketed to the public and, second, if the federal health insurance program will pay for use of the drug or device. This discrepancy creates hurdles and uncertainty for drug and device manufacturers. We analyzed discrepancies between FDA approval and Medicare national coverage determinations for sixty-nine devices and Part B drugs approved during 1999-2011. We found that Medicare covered FDA-approved drugs or devices 80 percent of the time. However, Medicare often added conditions beyond FDA approval, particularly for devices and most often restricting coverage to patients with the most severe disease. In some instances, Medicare was less restrictive than the FDA. Our findings highlight the importance for drug and device makers of anticipating Medicare's needs when conducting clinical studies to support their products. Our findings also provide important insights for the FDA's and Medicare's pilot parallel review program.

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.

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.

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.

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

Rate of Unverifiable Publications Among Ophthalmology Residency Applicants Invited to Interview.

Science.gov (United States)

Tamez, Heather M; Tauscher, Robert; Brown, Eric N; Wayman, Laura; Mawn, Louise A

2018-04-19

Unverifiable publications in applications for ophthalmology residencies could be a serious concern if they represent publication dishonesty. To determine the rate of unverifiable publications among applicants offered an interview. Retrospective review of 322 ophthalmology residency applications for entering classes 2012 to 2017 at Vanderbilt University School of Medicine, Nashville, Tennessee. Full-length publications reported in the applications were searched in PubMed, Google, Google Scholar, and directly on the journal's website. Applications were deemed unverifiable if there was no record of the publication by any of these means or if substantial discrepancies existed, such as incorrect authorship, incorrect journal, or a meaningful discrepancy in title or length (full-length article vs abstract). Inability to locate publication with search, incorrect author position, applicant not listed as an author, article being an abstract and not a published paper, substantial title discrepancy suggesting an alternative project, and incorrect journal. Of the 322 applicants offered interviews during the 6-year study period, 22 (6.8%) had 24 unverifiable publications. Two hundred thirty-nine of these applicants (74.2%) reported at least 1 qualifying publication; of this group, 22 (9.2%) had an unverifiable publication. The applications with unverifiable publications were evenly distributed across the years of the study (range, 2-6 per cycle; Pearson χ25 = 3.65; P = .60). Two applicants had 2 unverifiable publications each. Two of the 22 applicants (9.1%) with unverifiable publications were graduates of medical schools outside the United States. Among the unverifiable publications, the most common reason was inability to locate the publication (13 [54%]). Additional issues included abstract rather than full-length publication (5 [20.8%]), incorrect author position (4 [16.7%]), applicant not listed as an author on the publication (1 [4.2%]), and substantial title

Staff attitudes and reactions towards residents' masturbation in Spanish long-term care facilities.

Science.gov (United States)

Villar, Feliciano; Serrat, Rodrigo; Celdrán, Montserrat; Fabà, Josep

2016-03-01

To explore staff attitudes and reactions towards masturbation in long-term care facilities. Staff attitudes and reactions towards the expression of sexuality in long-term care facilities may be influenced by the nature of the sexual behaviour being expressed. Staff attitudes towards masturbation, a common sexual behaviour in such settings, have gone largely unexplored so far. An exploratory, descriptive, qualitative research design. Fifty-three staff members working in five different long-term care facilities participated in the study. They were asked about what they would think, how they would react, and what possible reactions they might expect from workmates if they entered a room and found a resident masturbating. The majority of participants considered that masturbation was acceptable and avoiding interference was by far the most common reaction, although other reactions also arose. When asked about reactions attributed to workmates, mentions to reprimanding the resident and gossiping/joking about the issue were more frequent than acceptance. The discrepancy between professionals' own reported attitudes and those attributed to workmates suggests the existence of widespread negative reactions towards sexual activity in later life. In the light of these results, we underline the necessity of developing explicit policies regarding sexual issues. Formal training offered to staff would also help to recognise and preserve resident's sexual rights and needs. © 2016 John Wiley & Sons Ltd.

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.

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

Science.gov (United States)

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

2018-05-30

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

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.

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.

Prevalence of Clonorchis sinensis Infection among Residents along 5 Major Rivers in the Republic of Korea.

Science.gov (United States)

Jeong, Young-Il; Shin, Hee-Eun; Lee, Sang-Eun; Cheun, Hyeng-Il; Ju, Jung-Won; Kim, Jung-Yeon; Park, Mi Yeoun; Cho, Shin-Hyeong

2016-04-01

Clonorchis sinensis is currently the most important parasite affecting public health problems in the Republic of Korea. We investigated the prevalence of C. sinensis infection among residents living along 5 major rivers in Korea. A total of 42,562 individual stool samples were collected from 37 localities and examined using the formalin-ether sedimentation technique. Helminth eggs were detected in 4,052 (9.5%) residents and 3,586 (8.4%) were infected with C. sinensis. The egg positive rate of C. sinensis in Nakdong, Seomjin, Geum, Yeongsan, and Han River was 11.7%, 9.9%, 6.5%, 3.1%, and 1.0%, respectively. The overall prevalence of clonorchiasis by sex was 11.2% in males and 6.2% in females. The age-prevalence was the highest in the 50-59 years band. It has been reconfirmed that the endemicity of clonorchiasis is higher in southern areas of Korea, especially along Nakdong and Seomjin Rivers. A combination of continuous control programs with health education initiatives is urgently required in these highly endemic areas of clonorchiasis in Korea.

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

A comparison of weather variables linked to infectious disease patterns using laboratory addresses and patient residence addresses.

Science.gov (United States)

Djennad, Abdelmajid; Lo Iacono, Giovanni; Sarran, Christophe; Fleming, Lora E; Kessel, Anthony; Haines, Andy; Nichols, Gordon L

2018-04-27

To understand the impact of weather on infectious diseases, information on weather parameters at patient locations is needed, but this is not always accessible due to confidentiality or data availability. Weather parameters at nearby locations are often used as a proxy, but the accuracy of this practice is not known. Daily Campylobacter and Cryptosporidium cases across England and Wales were linked to local temperature and rainfall at the residence postcodes of the patients and at the corresponding postcodes of the laboratory where the patient's specimen was tested. The paired values of daily rainfall and temperature for the laboratory versus residence postcodes were interpolated from weather station data, and the results were analysed for agreement using linear regression. We also assessed potential dependency of the findings on the relative geographic distance between the patient's residence and the laboratory. There was significant and strong agreement between the daily values of rainfall and temperature at diagnostic laboratories with the values at the patient residence postcodes for samples containing the pathogens Campylobacter or Cryptosporidium. For rainfall, the R-squared was 0.96 for the former and 0.97 for the latter, and for maximum daily temperature, the R-squared was 0.99 for both. The overall mean distance between the patient residence and the laboratory was 11.9 km; however, the distribution of these distances exhibited a heavy tail, with some rare situations where the distance between the patient residence and the laboratory was larger than 500 km. These large distances impact the distributions of the weather variable discrepancies (i.e. the differences between weather parameters estimated at patient residence postcodes and those at laboratory postcodes), with discrepancies up to ±10 °C for the minimum and maximum temperature and 20 mm for rainfall. Nevertheless, the distributions of discrepancies (estimated separately for minimum and maximum

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.

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

Science.gov (United States)

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

2010-10-01

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

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.

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...... for mobility inducing policies are especially found through the housing market parameters....

Discrepancy detection in the retrieval-enhanced suggestibility paradigm.

Science.gov (United States)

Butler, Brendon Jerome; Loftus, Elizabeth F

2018-04-01

Retrieval-enhanced suggestibility (RES) refers to the finding that immediately recalling the details of a witnessed event can increase susceptibility to later misinformation. In three experiments, we sought to gain a deeper understanding of the role that retrieval plays in the RES paradigm. Consistent with past research, initial testing did increase susceptibility to misinformation - but only for those who failed to detect discrepancies between the original event and the post-event misinformation. In all three experiments, subjects who retrospectively detected discrepancies in the post-event narratives were more resistant to misinformation than those who did not. In Experiments 2 and 3, having subjects concurrently assess the consistency of the misinformation narratives negated the RES effect. Interestingly, in Experiments 2 and 3, subjects who had retrieval practice and detected discrepancies were more likely to endorse misinformation than control subjects who detected discrepancies. These results call attention to limiting conditions of the RES effect and highlight the complex relationship between retrieval practice, discrepancy detection, and misinformation endorsement.

Consequences of discrepancies on verified material balances

International Nuclear Information System (INIS)

Jaech, J.L.; Hough, C.G.

1983-01-01

There exists a gap between the way item discrepancies that are found in an IAEA inspection are treated in practice and how they are treated in the IAEA Safeguards Technical Manual, Part F, Statistics. In the latter case, the existence of even a single item discrepancy is cause for rejection of the facility data. Probabilities of detection for given inspection plans are calculated based on this premise. In fact, although the existence of discrepancies may be so noted in inspection reports, they in no sense of the word lead to rejection of the facility data, i.e., to ''detection''. Clearly, however, discrepancies have an effect on the integrity of the material balance, and in fact, this effect may well be of dominant importance when compared to that of small measurement biases. This paper provides a quantitative evaluation of the effect of item discrepancies on the facility MUF. The G-circumflex statistic is introduced. It is analogous to the familiar D-circumflex statistic used to quantify the effects of small biases. Thus, just as (MUF-D-circumflex) is the facility MUF adjusted for the inspector's variables measurements, so is (MUF-D-circumflex-G-circumflex) the MUF adjusted for both the variables and attributes measurements, where it is the attributes inspection that detects item discrepancies. The distribution of (MUF-D-circumflex-G-circumflex) is approximated by a Pearson's distribution after finding the first four moments. Both the number of discrepancies and their size and sign distribution are treated as random variables. Assuming, then, that ''detection'' occurs when (MUF-D-circumflex-G-circumflex) differs significantly from zero, procedures for calculating effectiveness are derived. Some generic results on effectiveness are included. These results apply either to the case where (MUF-D-circumflex-G-circumflex) is treated as the single statistic, or to the two-step procedure in which the facility's data are first examined using (D-circumflex+G-circumflex) as

Preoperative learning goals set by surgical residents and faculty.

Science.gov (United States)

Pernar, Luise I M; Breen, Elizabeth; Ashley, Stanley W; Peyre, Sarah E

2011-09-01

The operating room (OR) remains the main teaching venue for surgical trainees. The OR is considered a pure-discovery learning environment; the downsides of this can be putatively overcome when faculty and trainee arrive at a shared understanding of learning. This study aimed to better understand preoperative learning goals to identify areas of commonalities and potential barrier to intraoperative teaching. Brief, structured preoperative interviews were conducted outside the OR with the resident and faculty member who were scheduled to operate together. Answers were analyzed and grouped using grounded theory. Twenty-seven resident-faculty pairs were interviewed. Nine residents (33.3%) were junior (PGY 1 and 2) and 18 (66.7%) were senior (PGY 3 through 5). Learning goal categories that emerged from the response analysis were anatomy, basic and advanced surgical skills, general and specific procedural tasks, technical autonomy, and pre-, intra-, and postoperative considerations. Residents articulated fewer learning goals than faculty (1.5 versus 2.4; P = 0.024). The most frequently identified learning goal by both groups was one classifiable under general procedural tasks; the greatest divergence was seen regarding perioperative considerations, which were identified frequently by faculty members but rarely by residents. Faculty articulate significantly more learning goals for the residents they will operate with than residents articulate for themselves. Our data suggest that residents and faculty align on some learning goals for the OR but residents tend to be more limited, focusing predominantly on technical aspects of the operation. Faculty members tend to hold a broader view of the learning potential of the OR. These discrepancies may present barriers to effective intraoperative teaching. Copyright © 2011 Elsevier Inc. All rights reserved.

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.

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...

Impact of the Primary Care Exception on Family Medicine Resident Coding.

Science.gov (United States)

Cawse-Lucas, Jeanne; Evans, David V; Ruiz, David R; Allcut, Elizabeth A; Andrilla, C Holly A; Thompson, Matthew; Norris, Thomas E

2016-03-01

The Medicare Primary Care Exception (PCE) allows residents to see and bill for less-complex patients independently in the primary care setting, requiring attending physicians only to see patients for higher-level visits and complete physical exams in order to bill for them as such. Primary care residencies apply the PCE in various ways. We investigated the impact of the PCE on resident coding practices. Family medicine residency directors in a five-state region completed a survey regarding interpretation and application of the PCE, including the number of established patient evaluation and management codes entered by residents and attending faculty at their institution. The percentage of high-level codes was compared between residencies using chi-square tests. We analyzed coding data for 125,016 visits from 337 residents and 172 faculty physicians in 15 of 18 eligible family medicine residencies. Among programs applying the PCE criteria to all patients, residents billed 86.7% low-mid complexity and 13.3% high-complexity visits. In programs that only applied the PCE to Medicare patients, residents billed 74.9% low-mid complexity visits and 25.2% high-complexity visits. Attending physicians coded more high-complexity visits at both types of programs. The estimated revenue loss over the 1,650 RRC-required outpatient visits was $2,558.66 per resident and $57,569.85 per year for the average residency in our sample. Residents at family medicine programs that apply the PCE to all patients bill significantly fewer high-complexity visits. This finding leads to compliance and regulatory concerns and suggests significant revenue loss. Further study is required to determine whether this discrepancy also reflects inaccuracy in coding.

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.

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.

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

Factors Influencing American Plastic Surgery Residents Toward an Academic Career.

Science.gov (United States)

Chetta, Matthew D; Sugg, Kristoffer B; Diaz-Garcia, Rafael J; Kasten, Steven J

2018-02-01

Plastic surgery residency program directors have an interest in recruiting applicants who show an interest in an academic practice. Medical school achievements (ie, United States Medical Licensing Examination® scores, publications, and Alpha Omega Alpha status) are metrics assessed to grade applicants but may not correlate with ultimately choosing an academic career. This study was designed to investigate factors influencing residents' choices for or against academic careers. A 25-item online questionnaire was designed to measure baseline interest in academic plastic surgery and factors that influence decisions to continue on or abandon that career path. This questionnaire was disseminated to the integrated/combined plastic surgery residents during the 2013 to 2014 academic year. One hundred twenty-five respondents indicated that they were currently interested in pursuing academic practice (n = 78) or had lost interest in academic practice (n = 47). Among all respondents, 92.8% (n = 116) stated they were interested in academic careers at the time of residency application, but one-third (n = 41) subsequently lost interest. Those residents who retained interest in academic careers indicated resident/medical student educational opportunities (57%) and complexity of patients (52%) as reasons. Those who lost interest cited a lack of autonomy (43%), publishing requirements (32%), and income discrepancy (26%) as reasons. Many residents report losing interest in academics during residency. Traditional metrics valued in the recruitment process may not serve as positive predictors of an academic career path. Reasons why residents lose interest are not easily correctable, but mentorship, adequate career counseling, and research opportunities during training remain factors that can be addressed across all residency programs.

Self-Discrepancy and Eating Disorder Symptoms Across Eating Disorder Diagnostic Groups.

Science.gov (United States)

Mason, Tyler B; Lavender, Jason M; Wonderlich, Stephen A; Crosby, Ross D; Engel, Scott G; Strauman, Timothy J; Mitchell, James E; Crow, Scott J; Le Grange, Daniel; Klein, Marjorie H; Smith, Tracey L; Peterson, Carol B

2016-11-01

This study examined self-discrepancy, a construct of theoretical relevance to eating disorder (ED) psychopathology, across different types of EDs. Individuals with anorexia nervosa (AN; n = 112), bulimia nervosa (BN; n = 72), and binge eating disorder (BED; n = 199) completed semi-structured interviews assessing specific types of self-discrepancies. Results revealed that actual:ideal (A:I) discrepancy was positively associated with AN, actual:ought (A:O) discrepancy was positively associated with BN and BED, and self-discrepancies did not differentiate BN from BED. Across diagnoses, A:O discrepancy was positively associated with severity of purging, binge eating, and global ED psychopathology. Further, there were significant interactions between diagnosis and A:O discrepancy for global ED psychopathology and between diagnosis and A:I discrepancy for binge eating and driven exercise. These results support the importance of self-discrepancy as a potential causal and maintenance variable in EDs that differentiates among different types of EDs and symptom severity. Copyright © 2016 John Wiley & Sons, Ltd and Eating Disorders Association. Copyright © 2016 John Wiley & Sons, Ltd and Eating Disorders Association.

Residents in difficulty

DEFF Research Database (Denmark)

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

2016-01-01

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

Effect of EHR user interface changes on internal prescription discrepancies.

Science.gov (United States)

Turchin, A; Sawarkar, A; Dementieva, Y A; Breydo, E; Ramelson, H

2014-01-01

To determine whether specific design interventions (changes in the user interface (UI)) of an electronic health record (EHR) medication module are associated with an increase or decrease in the incidence of contradictions between the structured and narrative components of electronic prescriptions (internal prescription discrepancies). We performed a retrospective analysis of 960,000 randomly selected electronic prescriptions generated in a single EHR between 01/2004 and 12/2011. Internal prescription discrepancies were identified using a validated natural language processing tool with recall of 76% and precision of 84%. A multivariable autoregressive integrated moving average (ARIMA) model was used to evaluate the effect of five UI changes in the EHR medication module on incidence of internal prescription discrepancies. Over the study period 175,725 (18.4%) prescriptions were found to have internal discrepancies. The highest rate of prescription discrepancies was observed in March 2006 (22.5%) and the lowest in March 2009 (15.0%). Addition of "as directed" option to the dropdown decreased prescription discrepancies by 195 / month (p = 0.0004). An non-interruptive alert that reminded providers to ensure that structured and narrative components did not contradict each other decreased prescription discrepancies by 145 / month (p = 0.03). Addition of a "Renew / Sign" button to the Medication module (a negative control) did not have an effect in prescription discrepancies. Several UI changes in the electronic medication module were effective in reducing the incidence of internal prescription discrepancies. Further research is needed to identify interventions that can completely eliminate this type of prescription error and their effects on patient outcomes.

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

Effect of EHR User Interface Changes on Internal Prescription Discrepancies

Science.gov (United States)

Sawarkar, A.; Dementieva, Y.A.; Breydo, E.; Ramelson, H.

2014-01-01

Summary Objective To determine whether specific design interventions (changes in the user interface (UI)) of an electronic health record (EHR) medication module are associated with an increase or decrease in the incidence of contradictions between the structured and narrative components of electronic prescriptions (internal prescription discrepancies). Materials and Methods We performed a retrospective analysis of 960,000 randomly selected electronic prescriptions generated in a single EHR between 01/2004 and 12/2011. Internal prescription discrepancies were identified using a validated natural language processing tool with recall of 76% and precision of 84%. A multivariable autoregressive integrated moving average (ARIMA) model was used to evaluate the effect of five UI changes in the EHR medication module on incidence of internal prescription discrepancies. Results Over the study period 175,725 (18.4%) prescriptions were found to have internal discrepancies. The highest rate of prescription discrepancies was observed in March 2006 (22.5%) and the lowest in March 2009 (15.0%). Addition of „as directed“ option to the dropdown decreased prescription discrepancies by 195 / month (p = 0.0004). An non-interruptive alert that reminded providers to ensure that structured and narrative components did not contradict each other decreased prescription discrepancies by 145 / month (p = 0.03). Addition of a „Renew / Sign“ button to the Medication module (a negative control) did not have an effect in prescription discrepancies. Conclusions Several UI changes in the electronic medication module were effective in reducing the incidence of internal prescription discrepancies. Further research is needed to identify interventions that can completely eliminate this type of prescription error and their effects on patient outcomes. PMID:25298811

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.

Discrepancies between self and observer ratings of depression. The relationship to demographic, clinical and personality variables.

Science.gov (United States)

Enns, M W; Larsen, D K; Cox, B J

2000-10-01

The observer-rated Hamilton depression scale (HamD) and the self-report Beck Depression Inventory (BDI) are among the most commonly used rating scales for depression, and both have well demonstrated reliability and validity. However, many depressed subjects have discrepant scores on these two assessment methods. The present study evaluated the ability of demographic, clinical and personality factors to account for the discrepancies observed between BDI and HamD ratings. The study group consisted of 94 SCID-diagnosed outpatients with a current major depressive disorder. Subjects were rated with the 21-item HamD and completed the BDI and the NEO-Five Factor Inventory. Younger age, higher educational attainment, and depressive subtype (atypical, non-melancholic) were predictive of higher BDI scores relative to HamD observer ratings. In addition, high neuroticism, low extraversion and low agreeableness were associated with higher endorsement of depressive symptoms on the BDI relative to the HamD. In general, these predictive variables showed a greater ability to explain discrepancies between self and observer ratings of psychological symptoms of depression compared to somatic symptoms of depression. The study does not determine which aspects of neuroticism and extraversion contribute to the observed BDI/HamD discrepancies. Depression ratings obtained with the BDI and HamD are frequently discordant and a number of patient characteristics robustly predict the discrepancy between these two rating methods. The value of multi-modal assessment in the conduct of research on depressive disorders is re-affirmed.

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.

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.

Skin-resident memory CD4+ T cells enhance protection against Leishmania major infection.

Science.gov (United States)

Glennie, Nelson D; Yeramilli, Venkata A; Beiting, Daniel P; Volk, Susan W; Weaver, Casey T; Scott, Phillip

2015-08-24

Leishmaniasis causes a significant disease burden worldwide. Although Leishmania-infected patients become refractory to reinfection after disease resolution, effective immune protection has not yet been achieved by human vaccines. Although circulating Leishmania-specific T cells are known to play a critical role in immunity, the role of memory T cells present in peripheral tissues has not been explored. Here, we identify a population of skin-resident Leishmania-specific memory CD4+ T cells. These cells produce IFN-γ and remain resident in the skin when transplanted by skin graft onto naive mice. They function to recruit circulating T cells to the skin in a CXCR3-dependent manner, resulting in better control of the parasites. Our findings are the first to demonstrate that CD4+ TRM cells form in response to a parasitic infection, and indicate that optimal protective immunity to Leishmania, and thus the success of a vaccine, may depend on generating both circulating and skin-resident memory T cells. © 2015 Glennie et al.

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.

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.

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.

Discrepancies Between Perceptions of the Parent-Adolescent Relationship and Early Adolescent Depressive Symptoms: An Illustration of Polynomial Regression Analysis.

Science.gov (United States)

Nelemans, S A; Branje, S J T; Hale, W W; Goossens, L; Koot, H M; Oldehinkel, A J; Meeus, W H J

2016-10-01

Adolescence is a critical period for the development of depressive symptoms. Lower quality of the parent-adolescent relationship has been consistently associated with higher adolescent depressive symptoms, but discrepancies in perceptions of parents and adolescents regarding the quality of their relationship may be particularly important to consider. In the present study, we therefore examined how discrepancies in parents' and adolescents' perceptions of the parent-adolescent relationship were associated with early adolescent depressive symptoms, both concurrently and longitudinally over a 1-year period. Our sample consisted of 497 Dutch adolescents (57 % boys, M age = 13.03 years), residing in the western and central regions of the Netherlands, and their mothers and fathers, who all completed several questionnaires on two occasions with a 1-year interval. Adolescents reported on depressive symptoms and all informants reported on levels of negative interaction in the parent-adolescent relationship. Results from polynomial regression analyses including interaction terms between informants' perceptions, which have recently been proposed as more valid tests of hypotheses involving informant discrepancies than difference scores, suggested the highest adolescent depressive symptoms when both the mother and the adolescent reported high negative interaction, and when the adolescent reported high but the father reported low negative interaction. This pattern of findings underscores the need for a more sophisticated methodology such as polynomial regression analysis including tests of moderation, rather than the use of difference scores, which can adequately address both congruence and discrepancies in perceptions of adolescents and mothers/fathers of the parent-adolescent relationship in detail. Such an analysis can contribute to a more comprehensive understanding of risk factors for early adolescent depressive symptoms.

Masculine Discrepancy Stress, Emotion-Regulation Difficulties, and Intimate Partner Violence.

Science.gov (United States)

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

2016-05-24

Research suggests that masculine socialization processes contribute to the perpetration of intimate partner violence (IPV) by men. Although this research has traditionally focused on men who strongly adhere to traditional gender norms, men who negatively evaluate themselves as falling short of these norms (a construct termed masculine discrepancy stress) have proven to be at increased risk of IPV perpetration. Likewise, men experiencing problems with emotion regulation, a multidimensional construct reflecting difficulties in effectively experiencing and responding to emotional states, are also at risk of IPV perpetration. In the present research, we tested the hypothesis that the link between discrepancy stress and IPV perpetration is mediated via difficulties in emotion regulation. Three hundred fifty-seven men completed online surveys assessing their experience of discrepancy stress, emotion-regulation difficulties, and history of IPV perpetration. Results indicated that discrepancy-stressed men's use of physical IPV was fully mediated by emotion-regulation difficulties. In addition, emotion-regulation difficulties partially mediated the association between discrepancy stress and sexual IPV. Findings are discussed in terms of the potential utility of emotion-focused interventions for modifying men's experience and expression of discrepancy stress and reducing perpetration of IPV. © The Author(s) 2016.

Masculine Discrepancy Stress, Emotion-Regulation Difficulties, and Intimate Partner Violence

Science.gov (United States)

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

2018-01-01

Research suggests that masculine socialization processes contribute to the perpetration of intimate partner violence (IPV) by men. Although this research has traditionally focused on men who strongly adhere to traditional gender norms, men who negatively evaluate themselves as falling short of these norms (a construct termed masculine discrepancy stress) have proven to be at increased risk of IPV perpetration. Likewise, men experiencing problems with emotion regulation, a multidimensional construct reflecting difficulties in effectively experiencing and responding to emotional states, are also at risk of IPV perpetration. In the present research, we tested the hypothesis that the link between discrepancy stress and IPV perpetration is mediated via difficulties in emotion regulation. Three hundred fifty-seven men completed online surveys assessing their experience of discrepancy stress, emotion-regulation difficulties, and history of IPV perpetration. Results indicated that discrepancy-stressed men's use of physical IPV was fully mediated by emotion-regulation difficulties. In addition, emotion-regulation difficulties partially mediated the association between discrepancy stress and sexual IPV. Findings are discussed in terms of the potential utility of emotion-focused interventions for modifying men's experience and expression of discrepancy stress and reducing perpetration of IPV. PMID:27226013

Learning about physical parameters: the importance of model discrepancy

International Nuclear Information System (INIS)

Brynjarsdóttir, Jenný; O'Hagan, Anthony

2014-01-01

Science-based simulation models are widely used to predict the behavior of complex physical systems. It is also common to use observations of the physical system to solve the inverse problem, that is, to learn about the values of parameters within the model, a process which is often called calibration. The main goal of calibration is usually to improve the predictive performance of the simulator but the values of the parameters in the model may also be of intrinsic scientific interest in their own right. In order to make appropriate use of observations of the physical system it is important to recognize model discrepancy, the difference between reality and the simulator output. We illustrate through a simple example that an analysis that does not account for model discrepancy may lead to biased and over-confident parameter estimates and predictions. The challenge with incorporating model discrepancy in statistical inverse problems is being confounded with calibration parameters, which will only be resolved with meaningful priors. For our simple example, we model the model-discrepancy via a Gaussian process and demonstrate that through accounting for model discrepancy our prediction within the range of data is correct. However, only with realistic priors on the model discrepancy do we uncover the true parameter values. Through theoretical arguments we show that these findings are typical of the general problem of learning about physical parameters and the underlying physical system using science-based mechanistic models. (paper)

Children's Recall and Recognition of Sex Role Stereotyped and Discrepant Information.

Science.gov (United States)

Trepanier-Street, Mary L.; Kropp, Jerri Jaudon

1987-01-01

Investigated the influence of differing levels of sex role stereotyped and discrepant information on immediate and delayed memory. Compared kindergarten and second-grade children's recall and recognition of stereotyped, moderately discrepant, and highly discrepant pictures. Results suggested significantly better recall of highly discrepant…

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

Retrospective analysis of forward and reverse ABO typing discrepancies among patients and blood donors in a tertiary care hospital.

Science.gov (United States)

Makroo, R N; Kakkar, B; Agrawal, S; Chowdhry, M; Prakash, B; Karna, P

2018-01-12

The aim of our study was to determine the incidence and causes of ABO typing discrepancies among patients and blood donors at our centre. An accurate interpretation of the ABO blood group of an individual is of utmost importance to ensure patient safety and good transfusion practices. A retrospective observational study was carried out in the Department of Transfusion Medicine in our hospital from March 2013 to December 2015. Records of all patient and blood donor samples were retrieved and analysed for ABO typing discrepancies. In total, 135 853 patient and 62 080 donor samples were analysed for ABO typing discrepancies. The incidence among patients and blood donors was found to be 0·1% (138/135853) and 0·02% (14/62080), respectively. The mean age for patients and blood donors was 48·4 and 29·2 years, respectively. The most common cause of ABO typing discrepancies was due to cold autoantibodies among the patients (50·7%) and blood donors (57%) causing discrepant results in reverse typing. The various other causes of reverse typing discrepancies among patients were weak/missing antibody (25·4%), cold-reacting alloantibody (4·3%), warm autoantibody (2·2%), anti-A1 antibody (2·2%), Bombay phenotype (1·5%), transplantation (0·7%) and rouleaux (0·7%), whereas in blood donors, the causes were cold-reacting antibody (7%) and weak antibody (7%). The major cause of forward typing discrepancies among patients (12·3%) and blood donors (29%) was ABO subgroups. The resolution of ABO typing discrepancy is essential to minimise the chance of transfusion of ABO-incompatible blood. © 2018 British Blood Transfusion Society.

Current integrated cardiothoracic surgery residents: a Thoracic Surgery Residents Association survey.

Science.gov (United States)

Tchantchaleishvili, Vakhtang; LaPar, Damien J; Stephens, Elizabeth H; Berfield, Kathleen S; Odell, David D; DeNino, Walter F

2015-03-01

After approval by the Thoracic Surgery Residency Review Committee in 2007, 6-year integrated cardiothoracic surgery (I-6) residency programs have gained in popularity. We sought to assess and objectively quantify the level of satisfaction I-6 residents have with their training and to identify areas of improvement for future curriculum development. A completely anonymous, electronic survey was created by the Thoracic Surgery Residents Association that asked the responders to provide demographic information, specialty interest, and lifestyle priorities, and to rate their experience and satisfaction with I-6 residency. The survey was distributed nationwide to all residents in I-6 programs approved by the Accreditation Council for Graduate Medical Education. Of a total of 88 eligible I-6 residents, 49 completed the survey (55.7%). Career choice satisfaction was high (75.5%), as was overall satisfaction with integrated training (83.7%). The majority (77.6%) were interested in cardiac surgery. Overall, the responders reported sufficient time for life outside of the hospital (57.1%), but experienced conflicts between work obligations and personal life at least sometimes (75.5%). Early exposure to cardiothoracic surgery was reported as the dominant advantage of the I-6 model, whereas variable curriculum structure and unclear expectations along with poor integration with general surgery training ranked highest among perceived disadvantages. Current I-6 residents are largely satisfied with the integrated training model and report a reasonable work/life balance. The focused nature of training is the primary perceived advantage of the integrated pathway. Curriculum variability and poor integration with general surgery training are identified by residents as primary areas of concern. Copyright © 2015 The Society of Thoracic Surgeons. Published by Elsevier Inc. All rights reserved.

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.

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.

The discrepancy between patients and informants on clinician-rated measures in major depressive disorder: implications for clinical trials and clinical practice.

Science.gov (United States)

Peselow, Eric D; Karamians, Reneh; Lord, Marie; Tobia, Gabriel; IsHak, Waguih William

2014-03-01

Clinician-rated measures are used in clinical trials and measurement-based clinical care settings to assess baseline symptoms and treatment outcomes of major depressive disorder (MDD), with a widely held dictum that they are sufficient in assessing the patient's clinical status. In this study, we examined clinician-rated measures of depressive and global symptom severity, obtained by interviewing patients as well as informants in an attempt to examine the potential difference or similarity between these two sources of information. The sample consisted of 89 treatment seeking, DSM-IV diagnosed MDD outpatients treated between 1995 and 2004. The clinician-rated measures used included the Montgomery Åsberg Depression Rating Scale (MADRS), and the Clinical Global Impression Scale (CGI) for Severity. The scores of the clinician-rated measures collected from patients' interviews were compared with those collected from informants' interviews. Clinician-rated scores, collected by interviewing patients, were significantly higher and indicative of greater symptom severity when compared with those collected by interviewing informants. This was true for both the MADRS before (Ppractical in MDD clinical trials or everyday clinical care. The discrepancies observed between the clinician-rated scores obtained from patients and informants emphasize the importance of incorporating collateral information during the assessment and rating of depressive symptom severity in both clinical trials as well as in clinical practice.

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.

Predicting Receptive-Expressive Vocabulary Discrepancies in Preschool Children With Autism Spectrum Disorder.

Science.gov (United States)

McDaniel, Jena; Yoder, Paul; Woynaroski, Tiffany; Watson, Linda R

2018-05-15

Correlates of receptive-expressive vocabulary size discrepancies may provide insights into why language development in children with autism spectrum disorder (ASD) deviates from typical language development and ultimately improve intervention outcomes. We indexed receptive-expressive vocabulary size discrepancies of 65 initially preverbal children with ASD (20-48 months) to a comparison sample from the MacArthur-Bates Communicative Development Inventories Wordbank (Frank, Braginsky, Yurovsky, & Marchman, 2017) to quantify typicality. We then tested whether attention toward a speaker and oral motor performance predict typicality of the discrepancy 8 months later. Attention toward a speaker correlated positively with receptive-expressive vocabulary size discrepancy typicality. Imitative and nonimitative oral motor performance were not significant predictors of vocabulary size discrepancy typicality. Secondary analyses indicated that midpoint receptive vocabulary size mediated the association between initial attention toward a speaker and end point receptive-expressive vocabulary size discrepancy typicality. Findings support the hypothesis that variation in attention toward a speaker might partially explain receptive-expressive vocabulary size discrepancy magnitude in children with ASD. Results are consistent with an input-processing deficit explanation of language impairment in this clinical population. Future studies should test whether attention toward a speaker is malleable and causally related to receptive-expressive discrepancies in children with ASD.

Majority and minority influence: A dual role interpretation

OpenAIRE

de Vries, N.K.; de Dreu, C.; Gordijn, E.; Schuurman, M.

1996-01-01

This chapter offers an analysis of majority vs. minority influence using the Heuristic-Systematic Model of persuasion (HSM). We evaluate evidence for and against leading perspectives such as Conversion Theory. Next, research and theory is reviewed suggesting that majority vs. minority influence differentially affect the processing of persuasive arguments. A dual-role interpretation of majority and minority influence is presented. First, numerical support for discrepant messages affects the de...

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 ...

Man enough? Masculine discrepancy stress and intimate partner violence.

Science.gov (United States)

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

2014-10-01

Research on gender roles suggests that men who strongly adhere to traditional masculine gender norms are at increased risk for the perpetration of violent and abusive acts toward their female intimate partners. Yet, gender norms alone fail to provide a comprehensive explanation of the multifaceted construct of intimate partner violence (IPV) and there is theoretical reason to suspect that men who fail to conform to masculine roles may equally be at risk for IPV. In the present study, we assessed effect of masculine discrepancy stress , a form of distress arising from perceived failure to conform to socially-prescribed masculine gender role norms, on IPV. Six-hundred men completed online surveys assessing their experience of discrepancy stress, masculine gender role norms, and history of IPV. Results indicated that masculine discrepancy stress significantly predicted men's historical perpetration of IPV independent of other masculinity related variables. Findings are discussed in terms of potential distress engendered by masculine socialization as well as putative implications of gender role discrepancy stress for understanding and intervening in partner violence perpetrated by men.

Man enough? Masculine discrepancy stress and intimate partner violence☆

Science.gov (United States)

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

2018-01-01

Research on gender roles suggests that men who strongly adhere to traditional masculine gender norms are at increased risk for the perpetration of violent and abusive acts toward their female intimate partners. Yet, gender norms alone fail to provide a comprehensive explanation of the multifaceted construct of intimate partner violence (IPV) and there is theoretical reason to suspect that men who fail to conform to masculine roles may equally be at risk for IPV. In the present study, we assessed effect of masculine discrepancy stress, a form of distress arising from perceived failure to conform to socially-prescribed masculine gender role norms, on IPV. Six-hundred men completed online surveys assessing their experience of discrepancy stress, masculine gender role norms, and history of IPV. Results indicated that masculine discrepancy stress significantly predicted men’s historical perpetration of IPV independent of other masculinity related variables. Findings are discussed in terms of potential distress engendered by masculine socialization as well as putative implications of gender role discrepancy stress for understanding and intervening in partner violence perpetrated by men. PMID:29593368

Postoperative electrolyte management: Current practice patterns of surgeons and residents.

Science.gov (United States)

Angarita, Fernando A; Dueck, Andrew D; Azouz, Solomon M

2015-07-01

Managing postoperative electrolyte imbalances often is driven by dogma. To identify areas of improvement, we assessed the practice pattern of postoperative electrolyte management among surgeons and residents. An online survey was distributed among attending surgeons and surgical residents at the University of Toronto. The survey was designed according to a systematic approach for formulating self-administered questionnaires. Questions addressed workload, decision making in hypothetical clinical scenarios, and improvement strategies. Of 232 surveys distributed, 156 were completed (response rate: 67%). The majority stated that junior residents were responsible for managing electrolytes at 13 University of Toronto-affiliated hospitals. Supervision was carried out predominately by senior residents (75%). Thirteen percent reported management went unsupervised. Approximately 59% of residents were unaware how often attending surgeons assessed patients' electrolytes. Despite the majority of residents (53.7%) reporting they were never given tools or trained in electrolyte replacement, they considered themselves moderately or extremely confident. The management of hypothetical clinical scenarios differed between residents and attending surgeons. The majority (50.5%) of respondents considered that an electrolyte replacement protocol is the most appropriate improvement strategy. Electrolyte replacement represents an important component of surgeons' workload. Despite reporting that formal training in electrolyte management is limited, residents consider themselves competent; however, their practice is highly variable and often differs from pharmacologic-directed recommendations. Optimizing how postoperative electrolytes are managed in surgical wards requires building a framework that improves knowledge, training, and limits unnecessary interventions. Copyright © 2015 Elsevier Inc. All rights reserved.

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.

Resident perceptions of the impact of duty hour restrictions on resident-attending interactions: an exploratory study.

Science.gov (United States)

Gerjevic, Kristen A; Rosenbaum, Marcy E; Suneja, Manish

2017-07-18

The institution of duty hour reforms by the Accreditation Council for Graduate Medical Education in 2003 has created a learning environment where residents are consistently looking for input from attending physicians with regards to balancing duty hour regulations and providing quality patient care. There is a paucity of literature regarding resident perceptions of attending physician actions or attitudes towards work hour restrictions. The purpose of this study was to identify attending physician behaviors that residents perceived as supportive or unsupportive of their compliance with duty hour regulations. Focus group interviews were conducted with residents exploring their perceptions of how duty hour regulations impact their interactions with attending physicians. Qualitative analysis identified key themes in residents' experiences interacting with faculty in regard to duty hour regulations. Forty residents from five departments in two hospital systems participated. Discussion of these interactions highlighted that attending physicians demonstrate behaviors that explicitly or implicitly either lend their support and understanding of residents' need to comply with these regulations or imply a lack of support and understanding. Three major themes that contributed to the ease or difficulty in addressing duty hour regulations included attending physicians' explicit communication of expectations, implicit non-verbal and verbal cues and the program's organizational culture. Resident physicians' perception of attending physicians' explicit and implicit communication and residency programs organization culture has an impact on residents' experience with duty hour restrictions. Residency faculty and programs could benefit from explicitly addressing and supporting the challenges that residents perceive in complying with duty hour restrictions.

Cost and quality implications of discrepancies between admitting and discharge diagnoses.

Science.gov (United States)

McNutt, Robert; Johnson, Tricia; Kane, Jason; Ackerman, Mariel; Odwazny, Richard; Bardhan, Jaydeep

2012-01-01

Presenting and discharge diagnoses of hospitalized patients may differ as a result of patient complexity, diagnostic dilemmas, or errors in clinical judgment at the time of primary assessment. When diagnoses at admission and discharge are not in agreement, this discrepancy may indicate more complex processes of care and resultant costs. It is unclear whether surrogate measures reflecting quality of care are impacted by discrepant diagnoses. To assess whether an association exists between admitting and discharge International Classification of Diseases, Ninth Revision (ICD-9) diagnosis codes and other quality markers including hospital length of stay, total cost of care, and 30-day readmission rate. This was a retrospective, cross-sectional analysis of general internal medicine patients aged 18 years and older. Diagnosis discrepancy was defined as a difference between the 3-digit ICD-9 diagnosis code at admission and the principal 3-digit ICD-9 diagnosis code at discharge. Sixty-eight percent of patients had a diagnosis discrepancy. Diagnosis discrepancy was associated with a 0.41-day increase in length of stay (P < .001), $663 increase in direct costs (P < .001), and a 1.55 times greater odds of readmission within 30 days (P < .001). Diagnosis discrepancy was associated with hospital quality outcome measures. This finding likely reflects variations in patients' diagnostic complexity.

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

How do Locals in Finland Identify Resident Foreigners

Directory of Open Access Journals (Sweden)

Minna Säävälä

2008-01-01

Full Text Available This study examines the identi? cation by Finns of foreign residents in Finland by analyzing data from a representative sample survey carried out in 2002. When people were asked to name a group of foreigners residing in Finland, the majority ?rst mentioned Somalis, despite the fact that only 4 percent of foreign residents are Somali and 6 percent of foreign-language speakers speak Somali. The general tendency when identifying resident foreigners is to refer primarily to ethnic or national groups; references to status (e.g. refugee, return migrant, guest worker or religion (e.g. Muslim are rare in the survey. In terms of ethnicity, identifying foreign residents in Finland is inconsistent, particularly as Russians and Estonians, the two largest groups, are not readily seen as foreign residents. The prevalence of answering Somalis could be considered an outcome of the maximally visible difference between Finns and Somalis. A logistic regression analysis is used to examine whether identifying resident foreigners differs according to socio-economic and educational characteristics, age, gender, region, and attitude towards the number of resident foreigners in Finland. The variables that signi? cantly in? uence the probability of answering Somalis and Russians are the respondents region, age, attitude towards the number of foreign residents in Finland, and to some extent, gender and higher education. Respondents occupational status, vocational education or income does not have a signi? cant impact on the answers. Regional differences appear to be a major factor affecting how foreigners are identi? ed, which shows that although the need to consider resident foreigners as visibly, culturally and linguistically maximally different may be a nearly universal base line for creating difference and identity, identifying foreign residents in Finland is not entirely independent of demographic realities.

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

Orthopedic resident work-shift analysis: are we making the best use of resident work hours?

Science.gov (United States)

Hamid, Kamran S; Nwachukwu, Benedict U; Hsu, Eugene; Edgerton, Colston A; Hobson, David R; Lang, Jason E

2014-01-01

Surgery programs have been tasked to meet rising demands in patient surgical care while simultaneously providing adequate resident training in the midst of increasing resident work-hour restrictions. The purpose of this study was to quantify orthopedic surgery resident workflow and identify areas needing improved resident efficiency. We hypothesize that residents spend a disproportionate amount of time involved in activities that do not relate directly to patient care or maximize resident education. We observed 4 orthopedic surgery residents on the orthopedic consult service at a major tertiary care center for 72 consecutive hours (6 consecutive shifts). We collected minute-by-minute data using predefined work-task criteria: direct new patient contact, direct existing patient contact, communications with other providers, documentation/administrative time, transit time, and basic human needs. A seventh category comprised remaining less-productive work was termed as standby. In a 720-minute shift, residents spent on an average: 191 minutes (26.5%) performing documentation/administrative duties, 167.0 minutes (23.2%) in direct contact with new patient consults, 129.6 minutes (17.1%) in communication with other providers regarding patients, 116.2 (16.1%) minutes in standby, 63.7 minutes (8.8%) in transit, 32.6 minutes (4.5%) with existing patients, and 20 minutes (2.7%) attending to basic human needs. Residents performed an additional 130 minutes of administrative work off duty. Secondary analysis revealed residents were more likely to perform administrative work rather than directly interact with existing patients (p = 0.006) or attend to basic human needs (p = 0.003). Orthopedic surgery residents spend a large proportion of their time performing documentation/administrative-type work and their workday can be operationally optimized to minimize nonvalue-adding tasks. Formal workflow analysis may aid program directors in systematic process improvements to better align

12 CFR 41.82 - Duties of users regarding address discrepancies.

Science.gov (United States)

2010-01-01

... CREDIT REPORTING Duties of Users of Consumer Reports Regarding Address Discrepancies and Records Disposal... consumer reports (user) that receives a notice of address discrepancy from a consumer reporting agency... request the consumer report and the address(es) in the agency's file for the consumer. (c) Reasonable...

12 CFR 571.82 - Duties of users regarding address discrepancies.

Science.gov (United States)

2010-01-01

... CREDIT REPORTING Duties of Users of Consumer Reports Regarding Address Discrepancies and Records Disposal... consumer reports (user) that receives a notice of address discrepancy from a consumer reporting agency... consumer report and the address(es) in the agency's file for the consumer. (c) Reasonable belief—(1...

12 CFR 717.82 - Duties of users regarding address discrepancies.

Science.gov (United States)

2010-01-01

... CREDIT UNIONS FAIR CREDIT REPORTING Duties of Users of Consumer Reports Regarding Address Discrepancies... applies to a user of consumer reports (user) that receives a notice of address discrepancy from a consumer... consumer report and the address(es) in the agency's file for the consumer. (c) Reasonable belief—(1...

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)…

The stress of residency: recognizing the signs of depression and suicide in you and your fellow residents.

Science.gov (United States)

Hochberg, Mark S; Berman, Russell S; Kalet, Adina L; Zabar, Sondra R; Gillespie, Colleen; Pachter, H Leon

2013-02-01

Stress, depression, and suicide are universal but frequently unrecognized issues for women and men in residency training. Stress affects cognitive and psychomotor performance both inside and outside of the operating room. Stress impairs the 2 key components of a surgeon's responsibilities: intellectual judgment and technical skill. We hypothesized that the recognition of depression, substance abuse, failing personal relationships, and potential suicide is poor among surgeons. If residents can recognize the signs of stress, depression, and suicide among colleagues, we believe it will not only improve their quality of life but also may preserve it. We first determined baseline resident knowledge of the signs of surgical stress including fatigue; burn out; depression; physician suicide; drug and alcohol abuse; and their effects on family, friends, and relationships. We then developed a curriculum to identify these signs in first, second, third, and fourth year surgical residents were identified as the target learners. The major topics discussed were depression; physician suicide; drug and alcohol abuse; and the effects of stress on family, friends, and our goals. Secondary objectives included identifying major sources of stress, general self-awareness, understanding professional choices, and creating a framework to manage stress. Residents participated in an interactive seminar with a surgical facilitator. Before and after the seminar, a multiple-choice test was administered with questions to assess knowledge of the signs of stress (eg, fatigue, burn out, and depression). Twenty-one residents participated in this study. Seventeen completed the pretest, and 21 participated in the interactive seminar and completed the post-test. The pretest revealed that surgical residents were correct in 46.8% (standard deviation [SD] = 25.4%) of their responses. The postseminar test showed an improvement to 89.7% (SD = 6.1%, P abuse, divorce, and suicide, educating house staff about

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 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.

Cross-country discrepancies on public understanding of stress concepts: evidence for stress-management psychoeducational programs

OpenAIRE

Souza-Talarico, Juliana Nery; Wan, Nathalie; Santos, Sheila; Fialho, Patr?cia Paes Araujo; Chaves, Eliane Corr?a; Caramelli, Paulo; Bianchi, Estela Ferraz; Santos, Aline Talita; Lupien, Sonia J

2016-01-01

Background Negative effects of stress have pose one of the major threats to the health and economic well being of individuals independently of age and cultural background. Nevertheless, the term ?stress? has been globally used unlinked from scientificevidence-based meaning. The discrepancies between scientific and public stress knowledge are focus of concern and little is know about it. This is relevant since misconceptions about stress may influence the effects of stress-management psychoedu...

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.

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

Measurements in Los Alamos benchmark criticals and the central reactivity discrepancy

International Nuclear Information System (INIS)

Davey, W.G.; Hansen, G.E.; Koelling, J.J.; McLaughlin, T.P.

1978-01-01

Measurements in seven Los Alamos fast critical facilities are described; all are related to elucidating the causes of the central reactivity discrepancy in fast reactors. Specific capabilities of these specialized assemblies permit measurements well-above delayed critical and these confirm the validity of the delayed neutron data used for calibration; there is therefore no reactivity-scale error. Reactivity measurements in these homogeneous assemblies exhibit no discrepancy. It is concluded that nuclear data should not be adjusted to eliminate the discrepancy found in other, heterogeneous assemblies

Computing half-plane and strip discrepancy of planar point sets

NARCIS (Netherlands)

Berg, de M.

1996-01-01

We present efficient algorithms for two problems concerning the discrepancy of a set S of n points in the unit square in the plane. First, we describe an algorithm for maintaining the half-plane discrepancy of S under insertions and deletions of points. The algorithm runs in O(nlogn) worst-case time

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 insomnia. © 2014 European Sleep Research Society.

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; 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. 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/

Hospitalist career decisions among internal medicine residents.

Science.gov (United States)

Ratelle, John T; Dupras, Denise M; Alguire, Patrick; Masters, Philip; Weissman, Arlene; West, Colin P

2014-07-01

Hospital medicine is a rapidly growing field of internal medicine. However, little is known about internal medicine residents' decisions to pursue careers in hospital medicine (HM). To identify which internal medicine residents choose a career in HM, and describe changes in this career choice over the course of their residency education. Observational cohort using data collected from the annual Internal Medicine In-Training Examination (IM-ITE) survey. 16,781 postgraduate year 3 (PGY-3) North American internal medicine residents who completed the annual IM-ITE survey in 2009-2011, 9,501 of whom completed the survey in all 3 years of residency. Self-reported career plans for individual residents during their postgraduate year 1 (PGY-1), postgraduate year 2 (PGY-2) and PGY-3. Of the 16,781 graduating PGY-3 residents, 1,552 (9.3 %) reported HM as their ultimate career choice. Of the 951 PGY-3 residents planning a HM career among the 9,501 residents responding in all 3 years, 128 (13.5 %) originally made this decision in PGY-1, 192 (20.2 %) in PGY-2, and 631 (66.4 %) in PGY-3. Only 87 (9.1 %) of these 951 residents maintained a career decision of HM during all three years of residency education. Hospital medicine is a reported career choice for an important proportion of graduating internal medicine residents. However, the majority of residents do not finalize this decision until their final year.

Estimation of Tooth Size Discrepancies among Different Malocclusion Groups

OpenAIRE

Hasija, Narender; Bala, Madhu; Goyal, Virender

2014-01-01

ABSTRACT Regards and Tribute: Late Dr Narender Hasija was a mentor and visionary in the light of knowledge and experience. We pay our regards with deepest gratitude to the departed soul to rest in peace. Bolton’s ratios help in estimating overbite, overjet relationships, the effects of contemplated extractions on posterior occlusion, incisor relationships and identification of occlusal misfit produced by tooth size discrepancies. Aim: To determine any difference in tooth size discrepancy in a...

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.

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...

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.

Analysis of F-16 radar discrepancies

Science.gov (United States)

Riche, K. A.

1982-12-01

One hundred and eight aircraft were randomly selected from three USAF F-16 bases and examined. These aircraft included 63 single-seat F-16As and 45 two-seat F-16Bs and encompassed 8,525 sorties and 748 radar system write-ups. Programs supported by the Statistical Package for the Social Sciences (SPSS) were run on the data. Of the 748 discrepancies, over one-third of them occurred within three sorties of each other and half within six sorties. Sixteen percent of all aircraft which had a discrepancy within three sorties had another write-up within the next three sorties. Designated repeat/recurring write-ups represented one-third of all the instances in which the write-up separation interval was three sorties or less. This is an indication that maintenance is unable to correct equipment failures as they occur, most likely because the false alarm rate is too high and maintenance is unable to duplicate the error conditions on the ground for correct error diagnosis.

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.

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.

Culture-Led Discrepancies and Negotiating Conflicts in Strategic Outsourcing Alliances

DEFF Research Database (Denmark)

Gammelgaard, Jens; Kumar, Rajesh; Worm, Verner

2013-01-01

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...... 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...

Impacto da discrepância de desejo sexual e relacional masculina

OpenAIRE

Pereira, Tiago José da Costa

2017-01-01

Dissertação de mestrado integrado em Psicologia O desejo sexual é descrito como um dos fatores que mais contribui para a satisfação sexual e relacional. Num casal os níveis de desejo podem estar mais, ou menos, sincronizados, ou pode acontecer uma situação de discrepância. A discrepância de desejo existente pode ser suficiente para potenciar um problema, nomeadamente ao nível da satisfação sexual e relacional. Este estudo teve como objetivo perceber se a discrepância de desejo ...

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

In vitro analysis of the marginal adaptation and discrepancy of stainless steel crowns

Science.gov (United States)

Mulder, Riaan; Medhat, Rasha; Mohamed, Nadia

2018-01-01

Abstract Aim: The purpose of the study was to assess the marginal adaptation and discrepancy of SSC’s. Differences in adaptation and discrepancy between the four surfaces (mesial, lingual, distal, and buccal) were evaluated. Methods: The placement of stainless steel crowns were completed on a phantom head in accordance with the clinical technique. The ideal tooth preparation was made and this ‘master tooth’ duplicated to achieve a sample size of 15. The stainless steel crowns were placed, trimmed, and cemented as per the clinical technique. The cemented stainless crowns were analyzed under 100× stereomicroscope magnification. The marginal adaptation and discrepancy of each specimen was measured every 2 µm. Results: All the specimens showed marginal adaptation and discrepancy. The lingual margin had a significantly better adaptation (p steel crown adaptation and discrepancy is an essential clinical step. PMID:29536024

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.

Pediatric resident perceptions of family-friendly benefits.

Science.gov (United States)

Berkowitz, Carol D; Frintner, Mary Pat; Cull, William L

2010-01-01

The aim of this study was to examine the importance of family-friendly features in residency program selection, benefits offered to and used by residents, and importance of benefits in future job selection. A survey of a random, national sample of 1000 graduating pediatric residents in 2008 was mailed and e-mailed. Survey response rate for graduating resident respondents was 59%. Among the respondents, 76% were women. Thirty-seven percent of men and 32% of women were parents. Residents with children were more likely than residents without children to rate family-friendly characteristics as very important in their residency selection (P maternity leave (88%), paternity leave (59%), individual flexibility with schedule (63%), and lactation rooms (55%), but fewer reported on-site child care (24%), care for ill children (19%), and part-time residency positions (12%). Among residents reporting availability, 77% of women with children used maternity leave and lactation rooms. Few held part-time residency positions (2%), but many expressed interest (23% of women with children). The majority of residents with and without children reported that flexibility with schedule was important in their future job selection. Most women with children (71%) and many women without children (52%) considered part-time work to be very important in their job selection. Family-friendly benefits are important to residents, particularly those with children. The data provides a benchmark for the availability and use of family-friendly features at pediatric training programs. The data also shows that many residents are unaware if benefits are offered, which suggests a need to make available benefits more transparent to residents. Copyright 2010 Academic Pediatric Association. Published by Elsevier Inc. All rights reserved.

[Medical ethics in residency training].

Science.gov (United States)

Civaner, Murat; Sarikaya, Ozlem; Balcioğlu, Harun

2009-04-01

Medical ethics education in residency training is one of the hot topics of continuous medical education debates. Its importance and necessity is constantly stressed in declarations and statements on national and international level. Parallel to the major structural changes in the organization and the finance model of health care system, patient-physician relationship, identity of physicianship, social perception and status of profession are changing. Besides, scientific developments and technological advancements create possibilities that never exists before, and bring new ethical dilemmas along with. To be able to transplant human organs has created two major problems for instance; procurement of organs in sufficient numbers, and allocating them to the patients in need by using some prioritizing criteria. All those new and challenging questions force the health care workers to find authentic and justifiable solutions while keeping the basic professional values. In that sense, proper medical ethics education in undergraduate and postgraduate term that would make physician-to-be's and student-physicians acquire the core professional values and skill to notice, analyze and develop justifiable solutions to ethical problems is paramount. This article aims to express the importance of medical ethics education in residency training, and to propose major topics and educational methods to be implemented into. To this aim, first, undergraduate medical education, physician's working conditions, the exam of selection for residency training, and educational environment were revised, and then, some topics and educational methods, which are oriented to educate physicians regarding the professional values that they should have, were proposed.

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).

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

practitioner (GP) and the in-home care provider. A discrepancy was defined as any disagreement or omission of information between the four sources concerning name, form, strength and dose for each drug with which the patient was being treated. Main outcome measure The number of discrepancies between the data...

Asthma exacerbation and proximity of residence to major roads: a population-based matched case-control study among the pediatric Medicaid population in Detroit, Michigan

Directory of Open Access Journals (Sweden)

Wahl Robert

2011-04-01

Full Text Available Abstract Background The relationship between asthma and traffic-related pollutants has received considerable attention. The use of individual-level exposure measures, such as residence location or proximity to emission sources, may avoid ecological biases. Method This study focused on the pediatric Medicaid population in Detroit, MI, a high-risk population for asthma-related events. A population-based matched case-control analysis was used to investigate associations between acute asthma outcomes and proximity of residence to major roads, including freeways. Asthma cases were identified as all children who made at least one asthma claim, including inpatient and emergency department visits, during the three-year study period, 2004-06. Individually matched controls were randomly selected from the rest of the Medicaid population on the basis of non-respiratory related illness. We used conditional logistic regression with distance as both categorical and continuous variables, and examined non-linear relationships with distance using polynomial splines. The conditional logistic regression models were then extended by considering multiple asthma states (based on the frequency of acute asthma outcomes using polychotomous conditional logistic regression. Results Asthma events were associated with proximity to primary roads with an odds ratio of 0.97 (95% CI: 0.94, 0.99 for a 1 km increase in distance using conditional logistic regression, implying that asthma events are less likely as the distance between the residence and a primary road increases. Similar relationships and effect sizes were found using polychotomous conditional logistic regression. Another plausible exposure metric, a reduced form response surface model that represents atmospheric dispersion of pollutants from roads, was not associated under that exposure model. Conclusions There is moderately strong evidence of elevated risk of asthma close to major roads based on the results obtained

Asthma exacerbation and proximity of residence to major roads: a population-based matched case-control study among the pediatric Medicaid population in Detroit, Michigan

Science.gov (United States)

2011-01-01

Background The relationship between asthma and traffic-related pollutants has received considerable attention. The use of individual-level exposure measures, such as residence location or proximity to emission sources, may avoid ecological biases. Method This study focused on the pediatric Medicaid population in Detroit, MI, a high-risk population for asthma-related events. A population-based matched case-control analysis was used to investigate associations between acute asthma outcomes and proximity of residence to major roads, including freeways. Asthma cases were identified as all children who made at least one asthma claim, including inpatient and emergency department visits, during the three-year study period, 2004-06. Individually matched controls were randomly selected from the rest of the Medicaid population on the basis of non-respiratory related illness. We used conditional logistic regression with distance as both categorical and continuous variables, and examined non-linear relationships with distance using polynomial splines. The conditional logistic regression models were then extended by considering multiple asthma states (based on the frequency of acute asthma outcomes) using polychotomous conditional logistic regression. Results Asthma events were associated with proximity to primary roads with an odds ratio of 0.97 (95% CI: 0.94, 0.99) for a 1 km increase in distance using conditional logistic regression, implying that asthma events are less likely as the distance between the residence and a primary road increases. Similar relationships and effect sizes were found using polychotomous conditional logistic regression. Another plausible exposure metric, a reduced form response surface model that represents atmospheric dispersion of pollutants from roads, was not associated under that exposure model. Conclusions There is moderately strong evidence of elevated risk of asthma close to major roads based on the results obtained in this population

Intrahousehold discrepancy regarding food insecurity within intermarried couples of Vietnamese wives and Korean husbands in South Korea.

Science.gov (United States)

Choi, Ha Ney; Chung, Hye Won; Hwang, Ji-Yun; Chang, Namsoo

2011-10-01

Our previous studies have demonstrated the inadequate nutritional status of Vietnamese female marriage immigrants in Korea. Major possible reasons include food insecurity due to economic problems as well as a lack of adjustment to unfamiliar Korean foods and limited access to Vietnamese foods; however, no study has investigated food insecurity among such intermarried couples. This study was performed to investigate the prevalence of food insecurity in Korean-husband-Vietnamese-wife couples and to determine whether they exhibit an intrahousehold discrepancy regarding food insecurity. A cross-sectional analysis of the Cohort of Intermarried Women in Korea study was performed with 84 intermarried couples. Among the 84 Vietnamese immigrants, 48.8% and 41.7% had food insecurity due to economic problems and a lack of foods appealing to their appetite, respectively. There was a marked discrepancy in reporting food insecurity between Vietnamese wives (22.6-38.1%) and their Korean husbands (6.0-15.5%). Vietnamese wives were five and two times more food-insecure due to economic problems and no foods appealing to their appetite, respectively, than their Korean spouses. A follow-up study is needed to investigate the causes of this discrepancy and ways of reducing food insecurity among female marriage immigrants living in low-income, rural communities.

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.

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…

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.

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

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.

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.

Discrepancies between implicit and explicit motivation and unhealthy eating behavior.

Science.gov (United States)

Job, Veronika; Oertig, Daniela; Brandstätter, Veronika; Allemand, Mathias

2010-08-01

Many people change their eating behavior as a consequence of stress. One source of stress is intrapersonal psychological conflict as caused by discrepancies between implicit and explicit motives. In the present research, we examined whether eating behavior is related to this form of stress. Study 1 (N=53), a quasi-experimental study in the lab, showed that the interaction between the implicit achievement motive disposition and explicit commitment toward an achievement task significantly predicts the number of snacks consumed in a consecutive taste test. In cross-sectional Study 2 (N=100), with a sample of middle-aged women, overall motive discrepancy was significantly related to diverse indices of unsettled eating. Regression analyses revealed interaction effects specifically for power and achievement motivation and not for affiliation. Emotional distress further partially mediated the relationship between the overall motive discrepancy and eating behavior.

Evaluation of discrepancies between thermoluminescent dosimeter and direct-reading dosimeter results

International Nuclear Information System (INIS)

Shaw, K.R.

1993-07-01

Currently at Oak Ridge National Laboratory (ORNL), the responses of thermoluminescent dosimeters (TLDs) and direct-reading dosimeters (DRDs) are not officially compared or the discrepancies investigated. However, both may soon be required due to the new US Department of Energy (DOE) Radiological Control Manual. In the past, unofficial comparisons of the two dosimeters have led to discrepancies of up to 200%. This work was conducted to determine the reasons behind such discrepancies. For tests conducted with the TLDs, the reported dose was most often lower than the delivered dose, while DRDs most often responded higher than the delivered dose. Trends were identified in personnel DRD readings, and ft was concluded that more training and more control of the DRDs could improve their response. TLD responses have already begun to be improved; a new background subtraction method was implemented in April 1993, and a new dose algorithm is being considered. It was concluded that the DOE Radiological Control Manual requirements are reasonable for identifying discrepancies between dosimeter types, and more stringent administrative limits might even be considered

Early learning effect of residents for laparoscopic sigmoid resection.

Science.gov (United States)

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

2013-01-01

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

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

[Analysis on death causes of residents in Anhui province, 2013].

Science.gov (United States)

He, Qin; Chen, Yeji; Dai, Dan; Xu, Wei; Xing, Xiuya; Liu, Zhirong

2015-09-01

To analyze the demographic characteristics and the death causes of the residents in Anhui province, and provide evidence for the disease prevention and control. Using descriptive epidemiological analysis, the demographic characteristics and death data of the national disease surveillance points (DSPs) in Anhui province in 2013 were analyed by areas. The aging of the population was observed in all the areas in Anhui, which was most obvious in Jianghuai, followed by Wannan and Huaibei. The overall mortality was 627.10/100 000. The mortalities of diseases varied with sex, area and age. Among the 3 areas, the overall mortality, chronic disease mortality and injury mortality were highest in Huaibei and lowest in Wannan. The area specific difference in mortality of infectious diseases was small. Regardless of areas or the types of diseases, the mortality was higher in males than in females. Deaths caused by diseases with unknown origins were common in residents aged >65 years. The mortality of chronic diseases was higher in residents aged >45 years, especially in those aged 65-84 years. The mortality of injuries was higher in age groups >15 years and >45 years. The mortality of infectious diseases peaked at both young age group and old age group. The top five death causes were cerebrovascular diseases, malignant tumors, heart diseases, respiratory diseases and injuries. Regardless of sex or area, the major death causes were similar, but the ranks were slightly different. The major death causes varied in different age groups, but they were similar in same age group in different areas. The major death causes were diseases originated in perinatal period, and congenital malformations, deformations and chromosomal abnormalities in children aged death causes in children aged 1-14 years were injuries, diseases originated in perinatal period, congenital malformations, deformations and chromosomal abnormalities. Injuries and malignant tumors were the first and second death causes

Discrepancies in Communication Versus Documentation of Weight-Management Benchmarks

Directory of Open Access Journals (Sweden)

Christy B. Turer MD, MHS

2017-02-01

Full Text Available To examine gaps in communication versus documentation of weight-management clinical practices, communication was recorded during primary care visits with 6- to 12-year-old overweight/obese Latino children. Communication/documentation content was coded by 3 reviewers using communication transcripts and health-record documentation. Discrepancies in communication/documentation content codes were resolved through consensus. Bivariate/multivariable analyses examined factors associated with discrepancies in benchmark communication/documentation. Benchmarks were neither communicated nor documented in up to 42% of visits, and communicated but not documented or documented but not communicated in up to 20% of visits. Lowest benchmark performance rates were for laboratory studies (35% and nutrition/weight-management referrals (42%. In multivariable analysis, overweight (vs obesity was associated with 1.6 more discrepancies in communication versus documentation (P = .03. Many weight-management benchmarks are not met, not documented, or performed without being communicated. Enhanced communication with families and documentation in health records may promote lifestyle changes in overweight children and higher quality care for overweight children in primary care.

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

Administrative organization in diagnostic radiology residency program leadership.

Science.gov (United States)

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

2012-04-01

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

An atlas-based multimodal registration method for 2D images with discrepancy structures.

Science.gov (United States)

Lv, Wenchao; Chen, Houjin; Peng, Yahui; Li, Yanfeng; Li, Jupeng

2018-06-04

An atlas-based multimodal registration method for 2-dimension images with discrepancy structures was proposed in this paper. Atlas was utilized for complementing the discrepancy structure information in multimodal medical images. The scheme includes three steps: floating image to atlas registration, atlas to reference image registration, and field-based deformation. To evaluate the performance, a frame model, a brain model, and clinical images were employed in registration experiments. We measured the registration performance by the squared sum of intensity differences. Results indicate that this method is robust and performs better than the direct registration for multimodal images with discrepancy structures. We conclude that the proposed method is suitable for multimodal images with discrepancy structures. Graphical Abstract An Atlas-based multimodal registration method schematic diagram.

Empathy, Sense of Power, and Personality: Do They Change During Pediatric Residency?

Science.gov (United States)

Greenberg, Larrie; Agrawal, Dewesh; Toto, Regina; Blatt, Benjamin

2015-08-01

Empathy is a critical competency in medicine. Prior studies demonstrate a longitudinal decrease in empathy during residency; however, they have not included pediatric residents. The relations among the expression of empathy, sense of power (ability to influence other's behavior), and personality traits in residents also have not been addressed. Lastly, there are no data on how residents compare with the general nonmedical population in their expression of empathy. The purposes of our study were to assess whether empathy, sense of power, and personality type were statistically correlated; if resident empathy declines over time; and how resident empathy compares with that of nonmedical peers. In 2010, a cohort of individuals entering pediatric residency were given three validated survey instruments at the beginning of their first and third years of training to explore longitudinal changes in empathy, sense of power, and major personality traits. We found no decrease in resident empathy in 2 years of pediatric training, no changes in their sense of power, and no statistically significant correlation between empathetic tendencies and sense of power. When compared with the general nonmedical population, pediatric residents rated themselves higher in empathy. As expected, the two components of empathy (empathic concern and perspective taking) were moderately correlated. Of the major personality traits, only agreeableness showed significant correlation with empathy. Pediatric resident empathy did not decrease longitudinally, unlike studies in other residents. There was no inverse relation between self-perceptions of sense of power and empathy as is present in the business literature. Finally, pediatric resident empathy was significantly higher when compared with a general nonmedical population.

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...

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

Survey of community pharmacy residents' perceptions of transgender health management.

Science.gov (United States)

Leach, Caitlin; Layson-Wolf, Cherokee

2016-01-01

1) To measure the general perceptions and attitudes of community pharmacy residents toward transgender patients and health; 2) to identify gaps in didactic education regarding transgender health care among residents; and 3) to evaluate residents' level of support for pharmacists receiving education in transgender health care. This study was a cross-sectional survey delivered online. Community residency directors were e-mailed a cover letter and a 34-question online survey. The directors were asked to forward the survey to their residents for completion within 4 weeks. Responses were anonymous with no identifiers collected on the survey. Survey responses used a combination of open-response, multiple-choice, and Likert-scale questions aimed at gathering respondents' demographic information, perceptions of managing transgender patients and the need for receiving additional education in transgender health care. Overall, the results of the survey indicated that community pharmacy residents support integrating transgender health management into pharmacy education and recognize that the overwhelming barriers to care for these patients include discrimination and lack of provider knowledge. Significant findings include: 82.7% of community residents think that community pharmacists play an important role in providing care for transgender patients; 98.2% think that they have a responsibility to treat transgender patients; and 71.4% were not educated about transgender patient issues in pharmacy school. Only 36.2% of community residents felt confident in their ability to treat transgender patients. Community pharmacy residents list discrimination and lack of provider knowledge as the major barriers to care for transgender patients. Residents do not feel confident in their ability to treat and manage transgender patients. The majority of residents were not educated about transgender patient issues while in pharmacy school and think that community pharmacists need more education

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.

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.

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.

Training, Research, and Working Conditions for Urology Residents in Germany: A Contemporary Survey.

Science.gov (United States)

Borgmann, Hendrik; Arnold, Hannah K; Meyer, Christian P; Bründl, Johannes; König, Justus; Nestler, Tim; Ruf, Christian; Struck, Julian; Salem, Johannes

2016-12-16

Excellent uniform training of urology residents is crucial to secure both high-quality patient care and the future of our specialty. Residency training has come under scrutiny following the demands of subspecialized care, economical aspects, and working hour regulations. To comprehensively assess the surgical training, research opportunities, and working conditions among urology residents in Germany. We sent a 29-item online survey via email to 721 members of the German Society of Residents in Urology. Descriptive analyses were conducted to describe the surveys' four domains: (1) baseline characteristics, (2) surgical training (cumulative completed case volume for all minor-, medium-, and major-complexity surgeries), (3) research opportunities, and (4) working conditions. Four hundred and seventy-two residents completed the online survey (response rate 65%). Surgical training: the median number of cumulative completed cases for postgraduate yr (PGY)-5 residents was 113 (interquartile range: 76-178). Minor surgeries comprised 57% of all surgeries and were performed by residents in all PGYs. Medium-complexity surgeries comprised 39% of all surgeries and were mostly performed by residents in PGYs 2-5. Major surgeries comprised 4% of all surgeries and were occasionally performed by residents in PGYs 3-5. Research opportunities: some 44% have attained a medical thesis (Dr. med.), and 39% are currently pursuing research. Working conditions: psychosocial work-related stress was high and for 82% of residents their effort exceeded their rewards. Some 44% were satisfied, 32% were undecided, and 24% were dissatisfied with their current working situation. Limitations include self-reported survey answers and a lack of validated assessment tools. Surgical exposure among German urology residents is low and comprises minor and medium-complex surgeries. Psychosocial work-related stress is high for the vast majority of residents indicating the need for structural improvements in

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.

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.

Collaborating with Public Housing Residents and Staff to Improve Health: A Mixed-Methods Analysis.

Science.gov (United States)

Noonan, Devon; Hartman, Ann Michelle; Briggs, Joyce; Biederman, Donna J

2017-01-01

This study described the health behaviors and barriers and facilitators of those behaviors in elderly and/or disabled residents of public housing. A mixed-methods design was used. Residents (N = 88) completed a survey with validated measures of health behaviors. A sub-sample (N = 16) participated in three focus groups. Residents scored worse than population norms on the majority of behaviors measured. Qualitative results framed in an ecological model indicated the majority of facilitators and barriers to health behaviors were perceived as occurring at the intrapersonal and interpersonal levels. Interventions to promote health should consider the unique barriers and facilitators to health behaviors among residents.

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

Depression among newly admitted Australian nursing home residents.

Science.gov (United States)

McSweeney, K; O'Connor, D W

2008-08-01

This research concerns the prevalence and course of depression in newly admitted nursing home residents. We attempted to recruit consecutive admissions into the study, irrespective of cognitive status, enabling a comparison of the prevalence and course of depression experienced by cognitively intact residents and those exhibiting all levels of cognitive impairment. Depression was assessed at one month, three months and six months post-admission. The assessment of mood in this study entailed the conduct of a semi-structured clinical interview, which encompassed DSM-IV criteria and Cornell Scale for Depression in Dementia (CSDD) items. Recruitment difficulties resulted in a sample of 51 newly admitted residents, drawn from six nursing homes located in Victoria, Australia. Of particular interest, throughout the duration of the study, only the cognitively impaired were diagnosed with major depression (MD). One month post-admission, 24% of the sample were diagnosed with MD, and a further 20% evidenced a non-major depressive disorder. At the second and third assessments, MD was observed in 14% and 15% of residents, respectively. For residents who completed all three assessments, there was no appreciable change in the proportion diagnosed with a depressive disorder, nor was there a change in the levels of depressive symptomatology. Although subject to limitations, the current study indicated that clinical depression in nursing home facilities most often occurs in residents who also exhibit pronounced cognitive impairment. These depressions are unlikely to remit spontaneously. Accordingly, care staff and general practitioners must be trained in the identification of depression in dementia, and any interventions implemented in these facilities should be tailored to meet the unique needs of this group.

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

Estimation of Tooth Size Discrepancies among Different Malocclusion Groups.

Science.gov (United States)

Hasija, Narender; Bala, Madhu; Goyal, Virender

2014-05-01

Regards and Tribute: Late Dr Narender Hasija was a mentor and visionary in the light of knowledge and experience. We pay our regards with deepest gratitude to the departed soul to rest in peace. Bolton's ratios help in estimating overbite, overjet relationships, the effects of contemplated extractions on posterior occlusion, incisor relationships and identification of occlusal misfit produced by tooth size discrepancies. To determine any difference in tooth size discrepancy in anterior as well as overall ratio in different malocclusions and comparison with Bolton's study. After measuring the teeth on all 100 patients, Bolton's analysis was performed. Results were compared with Bolton's means and standard deviations. The results were also subjected to statistical analysis. Results show that the mean and standard deviations of ideal occlusion cases are comparable with those Bolton but, when the mean and standard deviation of malocclusion groups are compared with those of Bolton, the values of standard deviation are higher, though the mean is comparable. How to cite this article: Hasija N, Bala M, Goyal V. Estimation of Tooth Size Discrepancies among Different Malocclusion Groups. Int J Clin Pediatr Dent 2014;7(2):82-85.

Exploring disadvantageous inequality aversion in children: How cost and discrepancy influence decision-making

Directory of Open Access Journals (Sweden)

Amanda eWilliams

2014-09-01

Full Text Available This research examined disadvantageous inequality aversion in 4- and 6-year-old children. Using the resource allocation paradigm, we explored how inequality aversion was influenced by whether a cost was associated with the equitable choice. We also investigated whether preferences for equality differed depending on whether the inequitable choice presented a small or large discrepancy between the payoff of the participant and their partner. The results demonstrated that cost plays a large role in decision-making, as children preferred equality more when there was no cost associated with it compared to when there was a cost. Interestingly, the effect of cost also affected discrepancy, with children more likely to choose equality when the discrepancy was large as opposed to small, in cost trials but not in no cost trials. Finally, the effect of discrepancy also interacted with age, with older children being more sensitive to the discrepancy between themselves and their partner Together, these results suggest that children’s behaviour is not indiscriminately guided by a generalized aversion to inequality or established fairness norms. Alternate motives for inequality aversion are discussed.

Teaching Residents to Teach: Do Program Directors and Trainees Agree on Format and Content?

Directory of Open Access Journals (Sweden)

Miriam Lacasse

2010-03-01

Methods: This needs assessment was an observational study with a cross-sectional design. Online or printed questionnaires were used to assess the preferred format and content for this curriculum among MS, residents from most postgraduate medical training programs, and PD from Faculté de médecine de l’Université Laval. Results: The questionnaires were completed by 26 PD (response rate 72.2%, 146 residents (response rate 21.9% and 154 MS (response rate 15.7%. Among the list of potential subjects that could be included in the curriculum, Learning styles, Working with students in difficulty and Self-directed learning were scored high by both residents and PD. MS favored Learning styles, Teaching in the ambulatory care setting, Teaching health promotion and prevention, Teaching with time constraints and Direct supervision strategies. PD also favored Teaching conflict management and Teaching professionalism, however these were both among the residents’ lower scores. The preferred formats were One half-day, One day and Online learning for PD and One day, Two consecutive days and A few one-day sessions over several months for residents. Conclusion: The PD and MS perception of the optimal format and content for residents’ teaching-skills training showed some discrepancies when compared with residents’ preferences. Since PD are largely involved in curriculum development for their respective specialties and since MS are also well positioned to assess residents’ teaching performance, we suggest that PD, residents and MS should all be consulted locally before organizing any intervention for teaching curricula.

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.

Discrepancy in Motivation for Weight Loss and Exercise in Rural Patients.

Science.gov (United States)

Warren, Jacob C; Smalley, K Bryant; Barefoot, K Nikki

2017-11-01

We explored the extent to which discrepancy between motivation for weight loss and exercise is related to obesity among rural patients with chronic disease, and identified the psychosocial correlates of this discrepancy. 497 patients with diabetes and/or hypertension were recruited from a network of Federally Qualified Health Centers in the rural South and completed a battery of assessments. Most persons in the sample (83.1%) were overweight and 65.0% were obese. For motivation for change, 70.8% reported being in the Action stage or higher for weight loss, whereas only 24.9% reported being in the Action stage or higher for motivation for exercise. When controlling for age, education level, income, sex, and race/ethnicity, individuals who were motivated for weight loss but not exercise were twice as likely to be obese (p = .005). Race and sex were significantly associated with this discrepancy, with African-American patients 1.7 times as likely (p = .05) and women 2.3 times as likely to be discrepant (p = .001). Findings underscore the importance of focusing not simply on weight loss among rural patients with chronic disease, but rather to incorporate specific activities designed to build simultaneous motivation for engaging in exercise.

Initial substantial reduction in air dose rates of Cs origin and personal doses for residents owing to the Fukushima nuclear accident

International Nuclear Information System (INIS)

Yoshida, Hiroko; Saito, Junko; Hirasawa, Noriyasu; Kobayashi, Ikuo

2013-01-01

The initial substantial reduction in the air dose rate and personal dose equivalent [Hp(10)] for residents were compared between the Marumori and Kosugo regions for the period from September 2011 to September 2012 after the occurrence of the Fukushima nuclear accident. Marumori is a rural settlement, and Kosugo is a suburban city along a freeway. A similar tendency was observed in the Hp(10) results for Marumori residents and in the air dose rates for both regions: values dropped during the heavy snow season and a faster reduction in the air dose rate than the radioactive decay of 134 Cs and 137 Cs was observed after the snow had thawed. These reductions are considered to be caused by the weathering and/or migration of radionuclides down the soil column. However, neither a drop due to an accumulation of snow nor faster reduction was observed in Hp(10) for Kosugo residents. This discrepancy between the air dose rate and Hp(10) for Marumori and Kosugo residents might be caused by differences in their living environment. (author)

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.

An attempt to explain the uranium 238 effective capture integral discrepancy

International Nuclear Information System (INIS)

Tellier, Henry; Grandotto-Biettoli, Marc; Vanuxeem, Jacqueline

1979-02-01

Up to now, there was a discrepancy between the computed value and the measured value of the uranium 238 effective capture integral. The former has been always greater than the latter. For this reason, the reactor physicists have used an adjustment of the computed value. Nowadays the accuracy of the cross sections knowledge is increased and the reactors computation codes are almost exact. Such an adjustment is no more justified. Recently several new measurements of the resonance parameters were carried out and the use of a multilevel formalism was suggested to compute the uranium 238 cross sections. It is shown in this work that the simultaneous use of recent parameters and Reich and Moore formalism explain the discrepancy. For the thermal neutron reactors, two thirds of this discrepancy are explained by the neutron data and the last third by the multilevel formalism [fr

Demographics, Interests, and Quality of Life of Canadian Neurosurgery Residents.

Science.gov (United States)

Iorio-Morin, Christian; Ahmed, Syed Uzair; Bigder, Mark; Dakson, Ayoub; Elliott, Cameron; Guha, Daipayan; Kameda-Smith, Michelle; Lavergne, Pascal; Makarenko, Serge; Taccone, Michael S; Tso, Michael K; Wang, Bill; Winkler-Schwartz, Alexander; Fortin, David

2018-03-01

Neurosurgical residents face a unique combination of challenges, including long duty hours, technically challenging cases, and uncertain employment prospects. We sought to assess the demographics, interests, career goals, self-rated happiness, and overall well-being of Canadian neurosurgery residents. A cross-sectional survey was developed and sent through the Canadian Neurosurgery Research Collaborative to every resident enrolled in a Canadian neurosurgery program as of April 1, 2016. We analyzed 76 completed surveys of 146 eligible residents (52% response rate). The median age was 29 years, with 76% of respondents being males. The most popular subspecialties of interest for fellowship were spine, oncology, and open vascular neurosurgery. The most frequent self-reported number of worked hours per week was the 80- to 89-hour range. The majority of respondents reported a high level of happiness as well as stress. Sense of accomplishment and fatigue were reported as average to high and overall quality of life was low for 19%, average for 49%, and high for 32%. Satisfaction with work-life balance was average for 44% of respondents and was the only tested domain in which significant dissatisfaction was identified (18%). Overall, respondents were highly satisfied with their choice of specialty, choice of program, surgical exposure, and work environment; however, intimidation was reported in 36% of respondents and depression by 17%. Despite a challenging residency and high workload, the majority of Canadian neurosurgery residents are happy and satisfied with their choice of specialty and program. However, work-life balance, employability, resident intimidation, and depression were identified as areas of active concern.

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

Discrepancy between Snack Choice Intentions and Behavior

Science.gov (United States)

Weijzen, Pascalle L. G.; de Graaf, Cees; Dijksterhuis, Garmt 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 1 week after the actual choice, they completed…

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...

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.

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.

L_p- and S_{p,q}^rB-discrepancy of (order 2) digital nets

OpenAIRE

Markhasin, Lev

2014-01-01

Dick proved that all order $2$ digital nets satisfy optimal upper bounds of the $L_2$-discrepancy. We give an alternative proof for this fact using Haar bases. Furthermore, we prove that all digital nets satisfy optimal upper bounds of the $S_{p,q}^r B$-discrepancy for a certain parameter range and enlarge that range for order $2$ digitals nets. $L_p$-, $S_{p,q}^r F$- and $S_p^r H$-discrepancy is considered as well.

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)

Impact of a pharmacy technician-centered medication reconciliation program on medication discrepancies and implementation of recommendations.

Science.gov (United States)

Kraus, Sarah K; Sen, Sanchita; Murphy, Michelle; Pontiggia, Laura

2017-01-01

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. 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. 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. A PTMR program with dedicated pharmacy technicians and pharmacists identifies many medication discrepancies at admission and provides opportunities for pharmacist reconciliation recommendations.

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.

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.

Perspective of ophthalmology residents in the United States about residency programs and competency in relation to the International Council of Ophthalmology guidelines.

Science.gov (United States)

Abdelfattah, Nizar Saleh; Radwan, Ahmed E; Sadda, Srinivas R

2016-09-01

To evaluate the perspective of ophthalmology residents in the US about their residency programs and compare the competency of residency programs to international competency levels set by the International Council of Ophthalmology (ICO). A cross-sectional web-based survey extracted from the ICO published competency standards was sent to program directors of ophthalmology residency programs in the US to forward it to current PGY-3, 4 residents, and residency graduates from 2011 to 2014. Eighty-seven responses were received, comprising 61 residents and 26 graduates. Most respondents were highly satisfied with their programs (93.6%). Clinic-based training was rated satisfactorily. Insufficient exposure to low-vision rehabilitation (38.5%), refraction and contact lenses prescription (38.5%), and vitreo-retinal surgeries (38.5%) was reported. Respondents were satisfied with their overall surgical experiences, with the vast majority (>83%) rating case volume, complexity, and variety as satisfactory or better. A significant group stated they had insufficient exposure to extra-capsular cataract extraction (26.3%), refractive surgery (19.7%), and orbital surgery (64.5%). All graduates surveyed passed their Ophthalmic Knowledge Assessment Program (OKAP) examinations, and 72% felt their residency programs adequately prepared them for the examinations. All respondents reported insufficient training in certain nonclinical areas, such as practice management, staffing, and administration skills. Ophthalmology residents in the US express high levels of satisfaction with their residency training programs. While most programs adequately address most ICO core objectives, certain curriculum modifications should be considered.

Scaling limits for the Lego discrepancy

International Nuclear Information System (INIS)

Hameren, Andre van; Kleiss, Ronald

1999-01-01

For the Lego discrepancy with M bins, which is equivalent with a χ 2 -statistic with M bins, we present a procedure to calculate the moment generating function of the probability distribution perturbatively if M and N, the number of uniformly and randomly distributed data points, become large. Furthermore, we present a phase diagram for various limits of the probability distribution in terms of the standardized variable if M and N become infinite

16 CFR 641.1 - Duties of users of consumer reports regarding address discrepancies.

Science.gov (United States)

2010-01-01

... 16 Commercial Practices 1 2010-01-01 2010-01-01 false Duties of users of consumer reports... CREDIT REPORTING ACT DUTIES OF USERS OF CONSUMER REPORTS REGARDING ADDRESS DISCREPANCIES § 641.1 Duties of users of consumer reports regarding address discrepancies. (a) Scope. This section applies to...

Resolving taxonmic discrepancies: Role of Electronic Catalogues of Known Organisms

Directory of Open Access Journals (Sweden)

Vishwas Chavan

2005-01-01

Full Text Available There is a disparity in availability of nomenclature change literature to the taxonomists of the developing world and availability of taxonomic papers published by developing world scientists to their counterparts in developed part of the globe. This has resulted in several discrepancies in the naming of organisms. Development of electronic catalogues of names of known organisms would help in pointing out these issues. We have attempted to highlight a few of such discrepancies found while developing IndFauna, an electronic catalogue of known Indian fauna and comparing it with existing global and regional databases.Full Text: PDF

Useful but Different: Resident Physician Perceptions of Interprofessional Feedback.

Science.gov (United States)

Vesel, Travis P; O'Brien, Bridget C; Henry, Duncan M; van Schaik, Sandrijn M

2016-01-01

Phenomenon: Based on recently formulated interprofessional core competencies, physicians are expected to incorporate feedback from other healthcare professionals. Based on social identity theory, physicians likely differentiate between feedback from members of their own profession and others. The current study examined residents' experiences with, and perceptions of, interprofessional feedback. In 2013, Anesthesia, Obstetrics-Gynecology, Pediatrics, and Psychiatry residents completed a survey including questions about frequency of feedback from different professionals and its perceived value (5-point scale). The authors performed an analysis of variance to examine interactions between residency program and profession of feedback provider. They conducted follow-up interviews with a subset of residents to explore reasons for residents' survey ratings. Fifty-two percent (131/254) of residents completed the survey, and 15 participated in interviews. Eighty percent of residents reported receiving written feedback from physicians, 26% from nurses, and less than 10% from other professions. There was a significant interaction between residency program and feedback provider profession, F(21, 847) = 3.82, p feedback provider profession, F(7, 847) = 73.7, p feedback from attending physicians higher than feedback from others, and anesthesia residents rated feedback from other professionals significantly lower than other residents. Ten major themes arose from qualitative data analysis, which revealed an overall positive attitude toward interprofessional feedback and clarified reasons behind residents' perceptions and identified barriers. Insights: Residents in our study reported limited exposure to interprofessional feedback and valued such feedback less than intraprofessional feedback. However, our data suggest opportunities exist for effective utilization of interprofessional feedback.

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.

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.

2016-01-01

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. PMID:27625721

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.

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.

Perceptions of orthodontic case complexity among orthodontists, general practitioners, orthodontic residents, and dental students.

Science.gov (United States)

Heath, Elizabeth M; English, Jeryl D; Johnson, Cleverick D; Swearingen, Elizabeth B; Akyalcin, Sercan

2017-02-01

Our aims were to assess the perceptions of orthodontic case complexity among orthodontists, general dentists, orthodontic residents, and dental students and to compare their perceptions with the American Board of Orthodontics Discrepancy Index (DI). Orthodontists, general dentists, orthodontic residents, and dental students (n = 343) participated in a Web-based survey. Pretreatment orthodontic records of 29 cases with varying DI scores were obtained. Respondents were asked to evaluate case complexity on a 100-point visual analog scale. Additional information was collected on participants' orthodontic education and orthodontic treatment preferences. Pearson correlation coefficients were used to assess the relationship between the average complexity score and the DI score. Repeated measures analysis with linear mixed models was used to assess the association between the average complexity score and the DI score and whether the association between the 2 scores varied by level of difficulty or panel group. The level of significance for all analyses was set at P clear aligners. DI score was significantly associated with complexity perceptions (P = 0.0168). Associations between average complexity and DI score varied significantly by provider group (P = 0.0033), with orthodontists and residents showing the strongest associations. When the DI score was greater than 15, orthodontists and residents perceived cases as more complex than did the other provider groups. Orthodontists and orthodontic residents had better judgments for evaluating orthodontic case complexity. The high correlation between orthodontic professionals' perceptions and DI scores suggested that additional orthodontic education and training have an influence on the ability to recognize case complexity. Copyright © 2017 American Association of Orthodontists. Published by Elsevier Inc. All rights reserved.

When do self-discrepancies predict negative emotions? Exploring formal operational thought and abstract reasoning skills as moderators.

Science.gov (United States)

Stevens, Erin N; Holmberg, Nicole J; Lovejoy, M Christine; Pittman, Laura D

2014-01-01

Individual differences in higher-order cognitive abilities may be an important piece to understanding how and when self-discrepancies lead to negative emotions. In the current study, three measures of reasoning abilities were considered as potential moderators of the relationship between self-discrepancies and depression and anxiety symptoms. Participants (N = 162) completed measures assessing self-discrepancies, depression and anxiety symptoms, and were administered measures examining formal operational thought, and verbal and non-verbal abstract reasoning skills. Both formal operational thought and verbal abstract reasoning were significant moderators of the relationship between actual:ideal discrepancies and depressive symptoms. Discrepancies predicted depressive symptoms for individuals with higher levels of formal operational thought and verbal abstract reasoning skills, but not for those with lower levels. The discussion focuses on the need to consider advanced reasoning skills when examining self-discrepancies.

Psychiatry chief resident opinions toward basic and clinical neuroscience training and practice.

Science.gov (United States)

Bennett, Jeffrey I; Handa, Kamna; Mahajan, Aman; Deotale, Pravesh

2014-04-01

The authors queried attendees to a chief resident conference on whether program education and training in neuroscience or in translating neuroscience research into practice is sufficient and what changes are needed. The authors developed and administered a 26-item voluntary questionnaire to each attendee at the Chief Residents' Leadership Conference at the American Psychiatric Association 2013 annual meeting in San Francisco, CA. Out of 94 attendees, 55 completed and returned questionnaires (58.5%). A majority of respondents stated that their program provided adequate training in neuroscience (61.8%); opportunities for neuroscience research existed for them (78.2%), but that their program did not prepare them for translating future neuroscience research findings into clinical practice (78.9%) or educate them on the NIMH Research Domain Criteria (83.3%). A majority of respondents stated that the ACGME should require a specific neuroscience curriculum (79.6%). Chief residents believe that curricular and cultural change is needed in psychiatry residency neuroscience education.

Computerized follow-up of discrepancies in image interpretation between emergency and radiology departments.

Science.gov (United States)

Siegel, E; Groleau, G; Reiner, B; Stair, T

1998-08-01

Radiographs are ordered and interpreted for immediate clinical decisions 24 hours a day by emergency physicians (EP's). The Joint Commission for Accreditation of Health Care Organizations requires that all these images be reviewed by radiologists and that there be some mechanism for quality improvement (QI) for discrepant readings. There must be a log of discrepancies and documentation of follow up activities, but this alone does not guarantee effective Q.I. Radiologists reviewing images from the previous day and night often must guess at the preliminary interpretation of the EP and whether follow up action is necessary. EP's may remain ignorant of the final reading and falsely assume the initial diagnosis and treatment were correct. Some hospitals use a paper system in which the EP writes a preliminary interpretation on the requisition slip, which will be available when the radiologist dictates the final reading. Some hospitals use a classification of discrepancies based on clinical import and urgency, and communicated to the EP on duty at the time of the official reading, but may not communicate discrepancies to the EP's who initial read the images. Our computerized radiology department and picture archiving and communications system have increased technologist and radiologist productivity, and decreased retakes and lost films. There are fewer face-to-face consultants of radiologists and clinicians, but more communication by telephone and electronic annotation of PACS images. We have integrated the QI process for emergency department (ED) images into the PACS, and gained advantages over the traditional discrepancy log. Requisitions including clinical indications are entered into the Hospital Information System and then appear on the PACS along with images on readings. The initial impression, time of review, and the initials of the EP are available to the radiologist dictating the official report. The radiologist decides if there is a discrepancy, and whether it

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…

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

Salary discrepancies between practicing male and female physician assistants.

Science.gov (United States)

Coplan, Bettie; Essary, Alison C; Virden, Thomas B; Cawley, James; Stoehr, James D

2012-01-01

Salary discrepancies between male and female physicians are well documented; however, gender-based salary differences among clinically practicing physician assistants (PAs) have not been studied since 1992 (Willis, 1992). Therefore, the objectives of the current study are to evaluate the presence of salary discrepancies between clinically practicing male and female PAs and to analyze the effect of gender on income and practice characteristics. Using data from the 2009 American Academy of Physician Assistants' (AAPA) Annual Census Survey, we evaluated the salaries of PAs across multiple specialties. Differences between men and women were compared for practice characteristics (specialty, experience, etc) and salary (total pay, base pay, on-call pay, etc) in orthopedic surgery, emergency medicine, and family practice. Men reported working more years as a PA in their current specialty, working more hours per month on-call, providing more direct care to patients, and more funding available from their employers for professional development (p pay, overtime pay, administrative pay, on-call pay, and incentive pay based on productivity and performance (p pay (p = .001) in orthopedic surgery, higher total income (p = .011) and base pay (p = .005) in emergency medicine, and higher base pay in family practice (p discrepancies remain between employed male and female PAs regardless of specialty, experience, or other practice characteristics. Copyright © 2012. Published by Elsevier Inc.

Impact of Residency Training Redesign on Residents' Clinical Knowledge.

Science.gov (United States)

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

2017-10-01

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

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)

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)

Numerical discrepancy between serial and MPI parallel computations

Directory of Open Access Journals (Sweden)

Sang Bong Lee

2016-09-01

Full Text Available Numerical simulations of 1D Burgers equation and 2D sloshing problem were carried out to study numerical discrepancy between serial and parallel computations. The numerical domain was decomposed into 2 and 4 subdomains for parallel computations with message passing interface. The numerical solution of Burgers equation disclosed that fully explicit boundary conditions used on subdomains of parallel computation was responsible for the numerical discrepancy of transient solution between serial and parallel computations. Two dimensional sloshing problems in a rectangular domain were solved using OpenFOAM. After a lapse of initial transient time sloshing patterns of water were significantly different in serial and parallel computations although the same numerical conditions were given. Based on the histograms of pressure measured at two points near the wall the statistical characteristics of numerical solution was not affected by the number of subdomains as much as the transient solution was dependent on the number of subdomains.

Intravenous fluid prescription practices among pediatric residents in Korea.

Science.gov (United States)

Lee, Jiwon M; Jung, Younghwa; Lee, Se Eun; Lee, Jun Ho; Kim, Kee Hyuck; Koo, Ja Wook; Park, Young Seo; Cheong, Hae Il; Ha, Il-Soo; Choi, Yong; Kang, Hee Gyung

2013-07-01

Recent studies have established the association between hypotonic fluids administration and hospital-acquired hyponatremia in children. The present paper investigated the pattern of current practice in intravenous fluid prescription among Korean pediatric residents, to underscore the need for updated education. A survey-based analysis was carried out. Pediatric residents at six university hospitals in Korea completed a survey consisting of four questions. Each question proposed a unique scenario in which the respondents had to prescribe either a hypotonic or an isotonic fluid for the patient. Ninety-one responses were collected and analyzed. In three of the four scenarios, a significant majority prescribed the hypotonic fluids (98.9%, 85.7%, and 69.2%, respectively). Notably, 69.2% of the respondents selected the hypotonic fluids for postoperative management. Almost all (96.7%) selected the isotonic fluids for hydration therapy. In the given scenarios, the majority of Korean pediatric residents would prescribe a hypotonic fluid, except for initial hydration. The current state of pediatric fluid management, notably, heightens the risk of hospital-acquired hyponatremia. Updated clinical practice education on intravenous fluid prescription, therefore, is urgently required.

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

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.

Impact of aldosterone-producing cell clusters on diagnostic discrepancies in primary aldosteronism

Science.gov (United States)

Kometani, Mitsuhiro; Yoneda, Takashi; Aono, Daisuke; Karashima, Shigehiro; Demura, Masashi; Nishimoto, Koshiro; Yamagishi, Masakazu; Takeda, Yoshiyu

2018-01-01

Adrenocorticotropic hormone (ACTH) stimulation is recommended in adrenal vein sampling (AVS) for primary aldosteronism (PA) to improve the AVS success rate. However, this method can confound the subtype diagnosis. Gene mutations or pathological characteristics may be related to lateralization by AVS. This study aimed to compare the rate of diagnostic discrepancy by AVS pre- versus post-ACTH stimulation and to investigate the relationship between this discrepancy and findings from immunohistochemical and genetic analyses of PA. We evaluated 195 cases of AVS performed in 2011–2017. All surgical specimens were analyzed genetically and immunohistochemically. Based on the criteria, AVS was successful in 158 patients both pre- and post-ACTH; of these patients, 75 showed diagnostic discrepancies between pre- and post-ACTH. Thus, 19 patients underwent unilateral adrenalectomy, of whom 16 had an aldosterone-producing adenoma (APA) that was positive for CYP11B2 immunostaining. Of them, 10 patients had discordant lateralization between pre- and post-ACTH. In the genetic analysis, the rate of somatic mutations was not significantly different between APA patients with versus without a diagnostic discrepancy. In the immunohistochemical analysis, CYP11B2 levels and the frequency of aldosterone-producing cell clusters (APCCs) in APAs were almost identical between patients with versus without a diagnostic discrepancy. However, both the number and summed area of APCCs in APAs were significantly smaller in patients with concordant results than in those whose diagnosis changed to bilateral PA post-ACTH stimulation. In conclusion, lateralization by AVS was affected by APCCs in the adjacent gland, but not by APA-related factors such as somatic gene mutations. PMID:29899838

Resident Preferences for Program Director Role in Wellness Management.

Science.gov (United States)

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

2018-05-01

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

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

2018-06-01

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 .

Gender Discrepancies and Victimization of Students with Disabilities

Science.gov (United States)

Simpson, Cynthia G.; Rose, Chad A.; Ellis, Stephanie K.

2016-01-01

Students with disabilities have been recognized as disproportionately involved within the bullying dynamic. However, few studies have examined the interaction between disability status, gender, and grade level. The current study explored the gender discrepancies among students with and without disabilities in middle and high school on bullying,…

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.

Helicopter emergency medical services (HEMS) over-triage and the financial implications for major trauma centres in NSW, Australia.

Science.gov (United States)

Taylor, Colman B; Curtis, Kate; Jan, Stephen; Newcombe, Mark

2013-07-01

In NSW Australia, a formal trauma system including the use of helicopter emergency medical services (HEMS) has existed for over 20 years. Despite providing many advantages in NSW, HEMS patients are frequently over-triaged; leading to financial implications for major trauma centres that receive HEMS patients. The aim of this study was to investigate the financial implications of HEMS over-triage from the perspective of major trauma centres in NSW. The study sample included all trauma patients transported via HEMS to 12 major trauma centres in NSW during the period: 1 July 2008 to 30 June 2009. Clinical data were gathered from individual hospital trauma registries and merged with financial information obtained from casemix units at respective hospitals. HEMS over-triage was estimated based on the local definition of minor to moderate trauma (ISS≤12) and hospital length of stay of less than 24 hrs. The actual treatment costs were determined and compared to state-wide peer group averages to obtain estimates of potential funding discrepancies. A total of 707 patients transported by HEMS were identified, including 72% pre-hospital (PH; n=507) and 28% inter-hospital (IH; n=200) transports. Over-triage was estimated at 51% for PH patients and 29% for IH patients. Compared to PH patients, IH patients were more costly to treat on average (IH: $42,604; PH: $25,162), however PH patients were more costly overall ($12,329,618 [PH]; $8,265,152 [IH]). When comparing actual treatment costs to peer group averages we found potential funding discrepancies ranging between 4% and 32% across patient groups. Using a sensitivity analysis, the potential funding discrepancy increased with increasing levels of over-triage. HEMS patients are frequently over-triaged in NSW, leading to funding implications for major trauma centres. In general, HEMS patient treatment costs are higher than the peer group average and the potential funding discrepancy varies by injury severity and the type of

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

Science.gov (United States)

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

2015-01-01

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

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.

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.

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

African Journals Online (AJOL)

Nekky Umera

essence, the research sought to determine the prevalence of gender discrepancies in .... that the proportion of women Internet users in developing countries is much smaller than that of ..... equality: a contradiction in terminis? Computers in ...

Medical Resident Workload at a Multidisciplinary Hospital in Iran

Directory of Open Access Journals (Sweden)

Anahita Sadeghi

2014-12-01

Full Text Available Introduction: Medical resident workload has been shown to be associated with learning efficiency and patient satisfaction. However, there is limited evidence about it in developing countries. This study aimed to evaluate the medical resident workload in a multidisciplinary teaching hospital in Tehran, Iran.Methods: All medical residents at Shariati Hospital, a teaching hospital affiliated with Tehran University of Medical Science, who were working between November and December 2011 were enrolled in this cross-sectional study. A self–reported questionnaire was used to gather information about their duty hours (including daily activities and shifts and financial issues.Results:135 (52.5% out of 257 residents responded to the questionnaire. 72 (53.3% residents were in surgical departments and 63 (46.7% were in non-surgical departments. Mean duty hours per month were significantly higher in surgical (350.8 ±76.7 than non-surgical (300.6±74.2 departments (p=0.001. Three cardiology (a non-surgical group residents (5.7% and 30 residents (41% in surgical groups (p<0.001 declared a number of “on-calls in the hospital” more than the approved number in the curriculum. The majority of residents (97.8% declared that their salary was not sufficient to manage their lives and they needed other financial resources. Conclusion: Medical residents at teaching hospitals in Iran suffer from high workloads and low income. There is a need to reduce medical resident workload and increase salary to improve worklife balance and finances.

Toward resolving model-measurement discrepancies of radon entry into houses

International Nuclear Information System (INIS)

Garbesi, K.

1993-01-01

My dissertation research 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 (Chapter II) 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 measurement 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 (0.1-0.5 m) 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. In Chapter III, I describe the development of a dual-probe dynamic pressure technique to measure soil permeability to air (and anisotropy of permeability) at various length scales. Preliminary field tests of the apparatus indicated that soil permeability was indeed scale dependent

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

Body self-discrepancies and women's social physique anxiety: the moderating role of the feared body.

Science.gov (United States)

Woodman, Tim; Steer, Rebecca

2011-05-01

We explored ideal, ought, and feared body image self-discrepancies as predictors of social physique anxiety within Carver, Lawrence, and Scheier's and Woodman and Hemmings' interaction frameworks. One hundred women completed actual, ideal, ought, and feared body self-discrepancy visual analogue scales, the Social Physique Anxiety Scale and the Beck Depression Inventory-II. Moderated hierarchical regression analyses indicated that the relationship between ought body fat discrepancies and social physique anxiety was moderated by proximity to the feared fat self. Specifically, the positive relationship between ought fat discrepancies and social physique anxiety was stronger when women were far from their feared body self. The results highlight the importance of considering the feared self in order to more fully understand the relationship between body image and social physique anxiety. ©2010 The British Psychological Society.

Discrepancy and Disliking Do Not Induce Negative Opinion Shifts

Science.gov (United States)

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. PMID:27333160

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.

Residents’ Support in Major Local Events: Leeds Pride.

OpenAIRE

Pappas, Nikolaos

2016-01-01

This article examines the extent to which community participation and perceived impacts have an influence on residents' support of major events, more specifically, the Leeds Pride celebration. The research examines the perspectives of 400 Leeds permanent residents. The study tests a structural equation model, which has its theoretical basis in social exchange theory. It examines the constructs of community participation, perceived positive and negative impacts, and community support, includin...

Resident complaints about the nursing home food service: relationship to cognitive status.

Science.gov (United States)

Simmons, Sandra F; Cleeton, Patrick; Porchak, Tracy

2009-05-01

Most nursing home (NH) residents are not interviewed about their satisfaction with the food service due to cognitive impairment. The purpose of this study was to determine the proportion of NH residents able to complete a structured interview to assess food complaints when no cognitive status criteria were used to exclude residents from interview. Eighty-nine percent of 163 residents were able and willing to complete the interview, and 65% expressed complaints about the NH food service. Residents who expressed complaints ate less of their meals, had less cognitive impairment, and had more depressive symptoms than those who did not. This study shows that the majority of NH residents are able to reliably answer questions about their satisfaction with the food service, regardless of cognitive status, and the presence of complaints is related to poor meal intake and depressive symptoms.

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

19 CFR 125.34 - Countersigning of documents and notation of bad order or discrepancy.

Science.gov (United States)

2010-04-01

... 19 Customs Duties 1 2010-04-01 2010-04-01 false Countersigning of documents and notation of bad... and Receipt § 125.34 Countersigning of documents and notation of bad order or discrepancy. When a... and shall note thereon any bad order or discrepancy. When available, the importing carrier's tally...

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.

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.

Identifying nursing home residents at risk for falling.

Science.gov (United States)

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

1998-05-01

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

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.

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...

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.

Evaluating Coding Accuracy in General Surgery Residents' Accreditation Council for Graduate Medical Education Procedural Case Logs.

Science.gov (United States)

Balla, Fadi; Garwe, Tabitha; Motghare, Prasenjeet; Stamile, Tessa; Kim, Jennifer; Mahnken, Heidi; Lees, Jason

.0043). The survey response rate was 100%. Survey results indicated that inability to find the precise code within the ACGME search interface and unfamiliarity with available CPT codes were by far the most common perceived barriers to accuracy. Survey results also indicated that most residents (74%) believe that they code accurately most of the time and agree that their case log would accurately represent their operative experience (66.6%). This is the first study to evaluate correctness of residents' ACGME case logs in general surgery. The degree of inaccuracy found here necessitates further investigation into the etiology of these discrepancies. Instruction on coding practices should also benefit the residents after graduation. Optimizing communication among attendings and residents, improving ACGME coding search interface, and implementing consistent coding practices could improve accuracy giving a more realistic view of residents' operative experience. Published by Elsevier Inc.

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.

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

NARCIS (Netherlands)

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

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

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

Intravenous fluid prescription practices among pediatric residents in Korea

Directory of Open Access Journals (Sweden)

Jiwon M. Lee

2013-07-01

Full Text Available Purpose: Recent studies have established the association between hypotonic fluids administration and hospital-acquired hyponatremia in children, and have contended that hypotonic fluids be removed from routine practice. To assess current intravenous fluid prescription practices among Korean pediatric residents and to call for updated clinical-practice education Methods: A survey-based analysis was carried out. Pediatric residents at six university hospitals in Korea completed a survey consisting of four questions. Each question supposed a unique scenario in which the respondents were to prescribe either a hypotonic or an isotonic fluid for the patient. Results: Ninety-one responses were collected and analyzed. In three of the four scenarios, a significant majority prescribed the hypotonic fluids (98.9%, 85.7%, and 69.2%, respectively. Notably, 69.2% of the respondents selected the hypotonic fluids for postoperative management. Almost all (96.7% selected the isotonic fluids for hydration therapy. Conclusion: In the given scenarios, the majority of Korean pediatric residents would prescribe a hypotonic fluid, except for initial hydration. The current state of pediatric fluid management, notably, heightens the risk of hospital-acquired hyponatremia. Updated clinical practice education on intravenous fluid prescription, therefore, is urgently required.

Discrepancies in the half-lives of 90Sr, 137Cs and 252Cf

International Nuclear Information System (INIS)

Rajput, M.U.; Mac Mahon, T.D.

1990-01-01

Recent reports have pointed out that significant discrepancies exist in published half-life data for 90 Sr, 137 Cs and 252 Cr, amongst others. These discrepancies make the estimation of evaluated half-lives for these isotopes difficult and contentious. This paper reviews the current situation, takes into account recently available data and attempts to derive recommended half-lives and associated uncertainties for the three isotopes. 37 refs, 3 tabs

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...

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.

Media education in pediatric residencies: a national survey.

Science.gov (United States)

Christakis, Dimitri A; Frintner, Mary Pat; Mulligan, Deborah A; Fuld, Gilbert L; Olson, Lynn M

2013-01-01

Little is known about the current state of residency education with respect to counseling parents about media usage and whether trainees consider it to be adequate. A national survey of graduating pediatric residents was conducted in the United States to determine the amount of training they receive on traditional and new media, their perceptions of its quality, and their self-reported practices regarding talking to families about media usage. A 58% response rate was achieved with no evidence of response bias based on age or gender. Only 38% rated their residency program as "very good" or "excellent" in preparing them to provide anticipatory guidance on the effects of media on children and adolescents. In logistic regression analyses, controlling for demographic characteristics, more training on media issues was a significant predictor for usually/always advising families on traditional, passive media (adjusted odds ratio = 3.29; 95% confidence interval 2.26-4.81) and usually/always advising families on new, interactive media use (adjusted odds ratio = 3.96; 95% confidence interval 2.61-6.00) during well-child visits. The majority of residents believe their training on children in media is inadequate. Enhanced training on media is needed in US pediatric residencies. Copyright © 2013 Academic Pediatric Association. Published by Elsevier Inc. All rights reserved.

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

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

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.

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

Science.gov (United States)

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

2018-04-17

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

Residents' barometer 2010. Residents' survey on residential environments in Finland; Asukasbarometri 2010. Asukaskysely suomalaisista asuinympaeristoeistae

Energy Technology Data Exchange (ETDEWEB)

Strandell, A.

2011-12-15

The Residents' Barometer 2010 is a survey on the quality of Finnish residential environments in settlements with a population of 10,000 or more. The survey was carried out in cooperation with Statistics Finland. Implemented for the third time, the Residents' Barometer is used by the environmental administration to monitor the quality of the living environment. The first Residents' Barometer survey was conducted in 1998, and the second in 2004. While the majority of questions remained the same, new topical questions were included, such as those on the environmental friendliness of housing choices. In general, residents are highly satisfied with their living environment: of the respondents, 97 per cent find their residential area pleasant and the degree of satisfaction has increased. Key factors in this include peacefulness, natural environment, location and transport connections, alongside the supply of services and leisure activities. Factors causing most discomfort are traffic-related disturbances and problems. The supply of basic services in residential areas remained largely unchanged in large, densely populated areas targeted by the survey. The most sought-after additional services include a grocery store, other shops and public transport. There was a considerable decline in the number of people wishing for banking and postal services, whereas the number of those expressing the desire for public transport almost doubled. In general, people are satisfied with parks and outdoor recreation areas and more dissatisfied with the condition of their yards. Residents of densely built areas with blocks of flats, particularly residents of rented apartments, are most dissatisfied with their yard. Car ownership, the possibility to use a car, and using a car for commuting to work and shops has become more common, as the share of walking and public transport has decreased. The average distance commuted to work has increased. Dissatisfaction with public

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.)

Further Investigations of NIST Water Sphere Discrepancies

International Nuclear Information System (INIS)

Broadhead, B.L.

2001-01-01

Measurements have been performed on a family of water spheres at the National Institute of Standards and Technology (NIST) facilities. These measurements are important for criticality safety studies in that, frequently, difficulties have arisen in predicting the reactivity of individually subcritical components assembled in a critical array. It has been postulated that errors in the neutron leakage from individual elements in the array could be responsible for these problems. In these NIST measurements, an accurate determination of the leakage from a fission spectrum, modified by water scattering, is available. Previously, results for 3-, 4-, and 5-in. diam. water-filled spheres, both with and without cadmium covers over the fission chambers, were presented for four fissionable materials: 235 U, 238 U, 237 Np, and 239 Pu. Results were also given for ''dry'' systems, in which the water spheres were drained of water, with the results corresponding to essentially measurements of unmoderated 252 Cf spontaneous-fission neutrons. The calculated-to-experimental (C/E) values ranged from 0.94 to 1.01 for the dry systems and 0.93 to 1.05 for the wet systems, with experimental uncertainties ranging from 1.5 to 1.9%. These results indicated discrepancies that were clearly outside of the experimental uncertainties, and further investigation was suggested. This work updates the previous calculations with a comparison of the predicted C/E values with ENDF/B-V and ENDF/B-VI transport cross sections. Variations in the predicted C/E values that arise from the use of ENDF/B-V, ENDF/B-VI, ENDL92, and LLLDOS for the response fission cross sections are also tabulated. The use of both a 45-group NIST fission spectrum and a continuous-energy fission spectrum for 252 Cf are evaluated. The use of the generalized-linear-least-squares (GLLSM) procedures to investigate the reported discrepancies in the water sphere results for 235 U, 238 U, 239 Pu, and 237 Np is reported herein. These studies

Computerized follow-up of discrepancies in image interpretation between emergency and radiology departments

OpenAIRE

Siegel, Eliot; Groleau, Georgina; Reiner, Bruce; Stair, Thomas

1998-01-01

Radiographs are ordered and interpreted for immediate clinical decisions 24 hours a day by emergency physicians (EP’s). The Joint Commission for Accreditation of Health Care Organizations requires that all these images be reviewed by radiologists and that there be some mechanism for quality improvement (QI) for discrepant readings. There must be a log of discrepancies and documentation of follow up activities, but this alone does not guarantee effective Q.I. Radiologists reviewing images from...

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 ...

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

Science.gov (United States)

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

1996-06-01

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

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.

Problems and Proposals of Their Solutions in Dermatology Residency Training: A Survey of Residents’ Opinions in Turkey

Directory of Open Access Journals (Sweden)

Sadık Yılmaz

2009-03-01

Full Text Available Background and Design: There are many problems in dermatology residency training. The purpose of this study was to describe dermatology residents’ opinions about problems and proposals of their solutions of dermatology residency training programs in Turkey. In addition, by means of these estimations to propose efficient and standard curriculum components are aimed. Material and Method: A descriptive pilot study was designed and a questionnaire was prepared to describe the problems and suggestions for the solution in dermatology residency education. The survey was conducted between 20 June 2006 and 09 August 2006. The questions were prepared in accordance with a 1 to 5 Likert-type scale to evaluate the level of importance and sufficiency of the residents’ opinions. Results: Sixty seven (52 female, 15 male residents responded to the survey. Based on the importance evaluation, although clinical-pathological meetings were the most important educational component, all other educational components were also indicated as important. Based on the sufficiency evaluation, the least sufficient educational components were photodermatology/laser therapy training (score, 1,82 of 5,0 and cosmetic dermatology (1,83. Sufficiency levels of educational components such as textbook review, translation and discussion (3,86 journal club (4,04, preparation of seminar (4,03 and allergy training (2,95 were evaluated as sufficient. All other educational components were determined as insufficient. Overall, the greatest discrepancies between the importance and sufficiency for all educational components were observed in cosmetic dermatology education (2,50.Conclusion: This is the first study to assess dermatology residency education based on the residents’ perspectives, in Turkey. These results show the necessity for review and revise of some of the elements and the necessity to prepare a standard curriculum of dermatology residency education. It is appropriate to

Medical professionalism from a socio-cultural perspective: evaluating medical residents communicative attitudes during the medical encounter in malaysia.

Science.gov (United States)

Ganasegeran, K; Al-Dubai, S A R

2014-01-01

The practice of medicine requires good communication skills to foster excellent rapport in doctor patient relationship. Reports on communication skills learning attitude among medical professionals are key essentials toward improving patient safety and quality of care. We aimed to determine factors affecting communication skills learning attitudes among medical residents in Malaysia. Cross-sectional survey, in a Malaysian public health hospital. A total of 191 medical residents across medical and surgical based rotations were included. We assessed the validated communication skills attitude scale among medical residents from different rotations. Statistical Package of Social Sciences (SPSS®) (version 16.0, IBM, Armonk, NY) was used. Cronbach's alpha was used to test the internal consistency of the scale. Descriptive analysis was conducted for all variables. Bivariate analysis was employed across the socio-demographic variables. Majority of the residents believed that communication skills training should be made compulsory in Malaysia (78.5%). Medical residents agreed that acquiring good communication skills is essential to be a good doctor. However, the majority cited time pressures for not being able to learn communication skills. Significant differences in communication skills learning attitude scores were found between Malays and Chinese. The majority of medical residents had a positive attitude toward communication skills learning. Socio-demographic factors influenced communication skills learning attitude among medical residents. Incorporating communicative skills modules during hospital Continuous Medical Education for medical residents is essential to cultivate communicative skills attitudes for effective doctor-patient relationship during the routine medical encounters.

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

Science.gov (United States)

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

2012-11-01

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

Management of Obstetric Perineal Tears: Do Obstetrics and Gynaecology Residents Receive Adequate Training? Results of an Anonymous Survey

Directory of Open Access Journals (Sweden)

A. Cornet

2012-01-01

Full Text Available Background/Aim. To evaluate the obstetrics and gynaecology residents' perspective of their training and experience in the management of perineal tears that occur during assisted vaginal delivery. We hypothesised that residents would perceive room for improvement in their knowledge of pelvic floor anatomy and the training received in tears repair. Design. Descriptive cross-sectional study. Population/Setting. Seventy-two major residents from all teaching hospitals in Catalonia. Methods. A questionnaire was designed to evaluate experience, perception of the training and supervision provided. Results. The questionnaire was sent to all residents (=72, receiving 46 responses (64%. The participants represented 15 out of the 16 teaching hospitals included in the study (94% of the hospitals represented. Approximately, 52% of residents were in their third year while 48% were in their fourth. The majority of them thought that their knowledge of pelvic floor anatomy was poor (62%, although 98% felt confident that they would know when an episiotomy was correctly indicated. The survey found that they lacked experience in the repair of major degree tears (70% had repaired fewer than ten, and most did not carry out followup procedures. Conclusion. The majority of them indicated that more training in this specific area is necessary (98%.

Opinion of residents from the Gold Coast, Queensland, on community water fluoridation.

Science.gov (United States)

Kroon, Jeroen; Reid, Kate Emily; Cutting, Jenna Renae; Lalloo, Ratilal; Chiu, Kandy Chien

2014-02-01

To investigate opinions and concerns of Gold Coast residents regarding fluoridation of community water supplies. Anonymous data were collected in four major shopping centers from approximately 500 Gold Coast residents. Eighty-one percent of participants were aware of the addition of fluoride to the water supply. More than half obtained information on water fluoridation through the print and electronic media. Sixty percent of respondents supported water fluoridation. The majority preferred the public and/or health professionals to have made the decision on water fluoridation rather than the government. The percentage of residents supporting water fluoridation was lower than that found in other Queensland, Australian, and worldwide surveys. In this study, only age and the highest level of education attained were factors significantly related to levels of support for water fluoridation. The Queensland Government's decision to implement water fluoridation without a referendum caused disquiet amongst some Gold Coast residents. Future public health initiatives therefore may be assisted by more consultation with, and involvement from, health professionals in the relevant fields. Public health campaigns may benefit more from interaction with the community in order to address their specific concerns. © 2012 Wiley Publishing Asia Pty Ltd.

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 ...

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 ...

Resident Involvement in Professional Otolaryngology Organizations: Current Trends in the United States.

Science.gov (United States)

Wong, Kevin; Jang, Minyoung; Gilad, Amir; Levi, Jessica R

2017-08-01

Involvement by residents in professional medical organizations can enrich their training, but little data exist regarding the number and types of involvement opportunities available to otolaryngology residents. We sought to fill this gap in knowledge by quantifying the extent to which major otolaryngology-related organizations in the United States provide involvement opportunities to otolaryngology residents. Our analysis included 23 organizations and subspecialty societies. Results showed that many opportunities exist for residents to attend conferences and present research; however, fewer involvement and funding opportunities existed in any other leadership, health policy, or service-learning experiences. These findings were consistent across general and subspecialty societies. Given the many purported benefits of resident involvement in otolaryngology outside of the standard training environment, future efforts may be warranted to increase the number and type of involvement opportunities currently available in professional societies.

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.

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.

Measuring resident well-being: impostorism and burnout syndrome in residency.

Science.gov (United States)

Legassie, Jenny; Zibrowski, Elaine M; Goldszmidt, Mark A

2008-07-01

Assessing resident well-being is becoming increasingly important from a programmatic standpoint. Two measures that have been used to assess this are the Clance Impostor Scale (CIS) and the Maslach Burnout Inventory-Human Services Survey (MBI-HSS). However, little is known about the relationship between the two phenomena. To explore the prevalence and association between impostorism and burnout syndrome in a sample of internal medicine residents. Anonymous, cross-sectional postal survey. Forty-eight internal medicine residents (postgraduate year [PGY] 1-3) at the Schulich School of Medicine & Dentistry (62.3% response rate). Short demographic questionnaire, CIS and MBI-HSS. Impostorism and burnout syndrome were identified in 43.8% and 12.5% of residents, respectively. With the exception of a negative correlation between CIS scores and the MBI's personal accomplishment subscale (r = -.30; 95% CI -.54 to -.02), no other significant relations were identified. Foreign-trained residents were more likely to score as impostors (odds ratio [OR] 10.7; 95% CI 1.2 to 98.2) while senior residents were more likely to experience burnout syndrome (OR 16.5 95% CI 1.6 to 168.5). Both impostorism and burnout syndrome appear to be threats to resident well-being in our program. The lack of relationship between the two would suggest that programs and researchers wishing to address the issue of resident distress should consider using both measures. The finding that foreign-trained residents appear to be more susceptible to impostorism warrants further study.

The attitude-behavior discrepancy in medical decision making.

Science.gov (United States)

He, Fei; Li, Dongdong; Cao, Rong; Zeng, Juli; Guan, Hao

2014-12-01

In medical practice, the dissatisfaction of patients about medical decisions made by doctors is often regarded as the fuse of doctor-patient conflict. However, a few studies have looked at why there are such dissatisfactions. This experimental study aimed to explore the discrepancy between attitude and behavior within medical situations and its interaction with framing description. A total of 450 clinical undergraduates were randomly assigned to six groups and investigated using the classic medical decision making problem, which was described either in a positive or a negative frame (2) × decision making behavior\\attitude to risky plan\\attitude to conservative plan (3). A discrepancy between attitude and behavior did exist in medical situations. Regarding medical dilemmas, if the mortality rate was described, subjects had a significant tendency to choose a conservative plan (t = 3.55, P 0.05). However, regardless of the plan chosen by the doctor, the subjects had a significant opposing attitude (P Framing description had a significant impact on both decision making behavior and attitude (t behavior = -3.24, P framing of a description has an impact on medical decision-making.

Resident perception of volcanic hazards and evacuation procedures

Directory of Open Access Journals (Sweden)

D. K. Bird

2009-02-01

Full Text Available Katla volcano, located beneath the Mýrdalsjökull ice cap in southern Iceland, is capable of producing catastrophic jökulhlaup. The Icelandic Civil Protection (ICP, in conjunction with scientists, local police and emergency managers, developed mitigation strategies for possible jökulhlaup produced during future Katla eruptions. These strategies were tested during a full-scale evacuation exercise in March 2006. A positive public response during a volcanic crisis not only depends upon the public's knowledge of the evacuation plan but also their knowledge and perception of the possible hazards. To improve the effectiveness of residents' compliance with warning and evacuation messages it is important that emergency management officials understand how the public interpret their situation in relation to volcanic hazards and their potential response during a crisis and apply this information to the ongoing development of risk mitigation strategies. We adopted a mixed methods approach in order to gain a broad understanding of residents' knowledge and perception of the Katla volcano in general, jökulhlaup hazards specifically and the regional emergency evacuation plan. This entailed field observations during the major evacuation exercise, interviews with key emergency management officials and questionnaire survey interviews with local residents. Our survey shows that despite living within the hazard zone, many residents do not perceive that their homes could be affected by a jökulhlaup, and many participants who perceive that their homes are safe, stated that they would not evacuate if an evacuation warning was issued. Alarmingly, most participants did not receive an evacuation message during the exercise. However, the majority of participants who took part in the exercise were positive about its implementation. This assessment of resident knowledge and perception of volcanic hazards and the evacuation plan is the first of its kind in

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…

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.

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

Prevalence of burnout syndrome among medical residents: experience of a developing country.

Science.gov (United States)

Ashkar, Khalil; Romani, Maya; Musharrafieh, Umayya; Chaaya, Monique

2010-05-01

It has been well established that burnout, defined as emotional exhaustion (EE), de-personalisation (DP), and a 'decreased sense of personal accomplishment (PA) due to work related stress', is prevalent to a great extent among medical residents. This has been implicated in the delivery of suboptimal patient care. Residents in developing countries work under difficult working and social conditions and therefore examining burnout is important when addressing quality of care and working conditions. The objectives of the study were to assess the point prevalence of burnout among residents in Lebanon and investigate some of the work and non-work related factors associated with burnout. A cross sectional study of all medical residents was carried out in two major hospitals in the capital city. A total of 155 residents responded, representing all specialities. Maslach Burnout Inventory for Health Services Workers (MBI-HSS) was used. Burnout in three domains was dichotomised into high versus not high burnout. The prevalence of burnout was high in all the domains with the highest in the domain of emotional exhaustion (67.7%). 80% of the sample had a high level of burnout in at least one domain. Being female, experiencing a major stress, working for more than 80 h per week, and having more than eight calls per month increased the odds of burnout in at least one domain. The high burnout level calls for action. This could be addressed by re-examining workload and other working conditions of residents as well as attending to their psychological wellbeing. The limitations of the study are also discussed.

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).

Discrepancies between parent and adolescent beliefs about daily life topics and performance on an emotion recognition task.

Science.gov (United States)

De Los Reyes, Andres; Lerner, Matthew D; Thomas, Sarah A; Daruwala, Samantha; Goepel, Katherine

2013-08-01

Parents and children and adolescents commonly disagree in their perceptions of a variety of behaviors, including the family relationship and environment, and child and adolescent psychopathology. To this end, numerous studies have examined to what extent increased discrepant perceptions-particularly with regard to perceptions of the family relationship and environment-predict increased child and adolescent psychopathology. Parents' and children and adolescents' abilities to decode and identify others' emotions (i.e., emotion recognition) may play a role in the link between discrepant perceptions and child and adolescent psychopathology. We examined parents' and adolescents' emotion recognition abilities in relation to discrepancies between parent and adolescent perceptions of daily life topics. In a sample of 50 parents and adolescents ages 14-to-17 years (M = 15.4 years, 20 males, 54 % African-American), parents and adolescents were each administered a widely used performance-based measure of emotion recognition. Parents and adolescents were also administered a structured interview designed to directly assess each of their perceptions of the extent to which discrepancies existed in their beliefs about daily life topics (e.g., whether adolescents should complete their homework and carry out household chores). Interestingly, lower parent and adolescent emotion recognition performance significantly related to greater parent and adolescent perceived discrepant beliefs about daily life topics. We observed this relation whilst accounting for adolescent age and gender and levels of parent-adolescent conflict. These findings have important implications for understanding and using informant discrepancies in both basic developmental psychopathology research and applied research in clinic settings (e.g., discrepant views on therapeutic goals).

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.)

Does Residency Selection Criteria Predict Performance in Orthopaedic Surgery Residency?

Science.gov (United States)

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

2016-04-01

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

Verbal-spatial IQ discrepancies impact brain activation associated with the resolution of cognitive conflict in children and adolescents.

Science.gov (United States)

Margolis, Amy E; Davis, Katie S; Pao, Lisa S; Lewis, Amy; Yang, Xiao; Tau, Gregory; Zhao, Guihu; Wang, Zhishun; Marsh, Rachel

2018-03-01

Verbal-spatial discrepancies are common in healthy individuals and in those with neurodevelopmental disorders associated with cognitive control deficits including: Autism Spectrum Disorder, Non-Verbal Learning Disability, Fragile X, 22q11 deletion, and Turner Syndrome. Previous data from healthy individuals suggest that the magnitude of the difference between verbal IQ (VIQ) and performance IQ (PIQ) scores (the VIQ>PIQ discrepancy) is associated with reduced thickness in frontal and parietal cortices (inferior frontal, anterior cingulate, inferior parietal lobule, and supramarginal gyrus) that support cognitive control. Unknown is whether the VIQ>PIQ discrepancy is associated with functional deficits in these areas in healthy or ill children and adolescents. We assessed the effects of the VIQ>PIQ discrepancy on fMRI BOLD response during the resolution of cognitive conflict in 55 healthy children and adolescents during performance of a Simon Spatial Incompatibility task. As the magnitude of the VIQ>PIQ discrepancy increased, activation of fronto-striatal, limbic, and temporal regions decreased during conflict resolution (p PIQ discrepancy was associated with reduced functional connectivity from right inferior frontal gyrus to right thalamus and increased functional connectivity to right supramarginal gyrus (ps PIQ discrepancy may be an important aspect of an individual's cognitive profile and likely contributes to, or is associated with, deficient cognitive control processes characteristic of many childhood disorders. © 2017 John Wiley & Sons Ltd.

Barriers and Facilitators to Effective Feedback: A Qualitative Analysis of Data From Multispecialty Resident Focus Groups.

Science.gov (United States)

Reddy, Shalini T; Zegarek, Matthew H; Fromme, H Barrett; Ryan, Michael S; Schumann, Sarah-Anne; Harris, Ilene B

2015-06-01

Despite the importance of feedback, the literature suggests that there is inadequate feedback in graduate medical education. We explored barriers and facilitators that residents in anesthesiology, emergency medicine, obstetrics and gynecology, and surgery experience with giving and receiving feedback during their clinical training. Residents from 3 geographically diverse teaching institutions were recruited to participate in focus groups in 2012. Open-ended questions prompted residents to describe their experiences with giving and receiving feedback, and discuss facilitators and barriers. Data were transcribed and analyzed using the constant comparative method associated with a grounded theory approach. A total of 19 residents participated in 1 of 3 focus groups. Five major themes related to feedback were identified: teacher factors, learner factors, feedback process, feedback content, and educational context. Unapproachable attendings, time pressures due to clinical work, and discomfort with giving negative feedback were cited as major barriers in the feedback process. Learner engagement in the process was a major facilitator in the feedback process. Residents provided insights for improving the feedback process based on their dual roles as teachers and learners. Time pressures in the learning environment may be mitigated by efforts to improve the quality of teacher-learner relationships. Forms for collecting written feedback should be augmented by faculty development to ensure meaningful use. Efforts to improve residents' comfort with giving feedback and encouraging learners to engage in the feedback process may foster an environment conducive to increasing feedback.

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.

Attitudes of surgical residents toward trauma care: a Canadian-based study.

Science.gov (United States)

Girotti, M J; Leslie, K; Chinnick, B; Butcher, C; Holliday, R L

1994-01-01

Surgical residents (n = 330) registered in training programs in the province of Ontario, Canada were surveyed about their attitudes toward trauma care related issues. Questionnaires were returned by 48%. Overall, 84% felt that their clinical exposure to trauma was adequate; 78% noted that the emphasis placed on trauma topics in their educational programs was appropriate; 50% spend > 10% of their current clinical time in trauma care. Orthopedic residents (n = 43) were different; 79% devoted > 10% and 29% > or = 30% of their time to trauma. Future clinical activity in trauma as practicing surgeons was expressed by 83% of the trainees: 31% intended 30% of their future practices to be related to trauma. The major positive factors of trauma were the scope and excitement of trauma care. The major negative factors were the night/weekend activity and the time away from family. We are encouraged by the results of this survey in that a significant number of residents perceive trauma as a clinical endeavor to be incorporated into their future surgical practices.

Mother-father informant discrepancies regarding diabetes management: associations with diabetes-specific family conflict and glycemic control.

Science.gov (United States)

Sood, Erica D; Pendley, Jennifer Shroff; Delamater, Alan M; Rohan, Jennifer M; Pulgaron, Elizabeth R; Drotar, Dennis

2012-09-01

To examine the relationship of mother-father informant discrepancies regarding diabetes management to diabetes-specific family conflict and glycemic control. One hundred thirty-six mothers and fathers of youth with Type 1 diabetes reported on the youth's diabetes management, diabetes-specific family conflict, and amount of paternal involvement in diabetes care. Glycosylated hemoglobin A1c (HbA1c) was used to measure glycemic control. As hypothesized, mother-father discrepancies regarding diabetes management were positively associated with frequency of diabetes-specific family conflict. Contrary to hypotheses, mother-father discrepancies regarding diabetes management predicted poorer glycemic control for youth with less involved fathers only. Results highlight the importance of caregivers being consistent about pediatric illness management and support the idea that informant discrepancies represent an important window into the functioning of the family system. PsycINFO Database Record (c) 2012 APA, all rights reserved.

Medical professionalism from a socio-cultural perspective: Evaluating medical residents communicative attitudes during the medical encounter in Malaysia

Directory of Open Access Journals (Sweden)

K Ganasegeran

2014-01-01

Full Text Available Context: The practice of medicine requires good communication skills to foster excellent rapport in doctor patient relationship. Reports on communication skills learning attitude among medical professionals are key essentials toward improving patient safety and quality of care. Aims: We aimed to determine factors affecting communication skills learning attitudes among medical residents in Malaysia. Settings and Design: Cross-sectional survey, in a Malaysian public health hospital. Materials and Methods: A total of 191 medical residents across medical and surgical based rotations were included. We assessed the validated communication skills attitude scale among medical residents from different rotations. Statistical Analysis: Statistical Package of Social Sciences (SPSS® (version 16.0, IBM, Armonk, NY was used. Cronbach′s alpha was used to test the internal consistency of the scale. Descriptive analysis was conducted for all variables. Bivariate analysis was employed across the socio-demographic variables. Results: Majority of the residents believed that communication skills training should be made compulsory in Malaysia (78.5%. Medical residents agreed that acquiring good communication skills is essential to be a good doctor. However, the majority cited time pressures for not being able to learn communication skills. Significant differences in communication skills learning attitude scores were found between Malays and Chinese. Conclusion: The majority of medical residents had a positive attitude toward communication skills learning. Socio-demographic factors influenced communication skills learning attitude among medical residents. Incorporating communicative skills modules during hospital Continuous Medical Education for medical residents is essential to cultivate communicative skills attitudes for effective doctor-patient relationship during the routine medical encounters.

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.

Self vs. Other Focus: Predicting Professionalism Remediation of Emergency Medicine Residents.

Science.gov (United States)

Thaxton, Robert E; Jones, Woodson S; Hafferty, Fred W; April, Carolyn W; April, Michael D

2018-01-01

Unprofessionalism is a major reason for resident dismissal from training. Because of the high stakes involved, residents and educators alike would benefit from information predicting whether they might experience challenges related to this competency. Our objective was to correlate the outcome of professionalism-related remedial actions during residency with the predictor variable of resident response to a standardized interview question: "Why is Medicine important to you?" We conducted a professional development quality improvement (QI) initiative to improve resident education and mentorship by achieving a better understanding of each resident's reasons for valuing a career in medicine. This initiative entailed an interview administered to each resident beginning emergency medicine training at San Antonio Military Medical Center during 2006-2013. The interviews uniformly began with the standardized question "Why is Medicine important to you?" The residency program director documented a free-text summary of each response to this question, the accuracy of which was confirmed by the resident. We analyzed the text of each resident's response after a review of the QI data suggested an association between responses and professionalism actions (retrospective cohort design). Two associate investigators blinded to all interview data, remedial actions, and resident identities categorized each text response as either self-focused (e.g., "I enjoy the challenge") or other-focused (e.g., "I enjoy helping patients"). Additional de-identified data collected included demographics, and expressed personal importance of politics and religion. The primary outcome was a Clinical Competency Committee professionalism remedial action. Of 114 physicians starting residency during 2006-2013, 106 (93.0%) completed the interview. There was good inter-rater reliability in associate investigator categorization of resident responses as either self-focused or other-focused (kappa coefficient 0

Skipping of meals has a significant impact on dietary intake and nutritional status of old (65+ y) nursing home residents.

Science.gov (United States)

Beck, A M; Ovesen, L

2004-01-01

In spite of a high prevalence of undernutrition among old nursing home residents, studies have generally reported a mean intake of energy sufficient to cover the mean estimated energy requirement. This discrepancy could be due to skipping of meals and hence periods of insufficient energy intake too intermittent to be identified, when mean results are presented. To examine the significance of skipping of (part of) meals on dietary intake and nutritional status of old (65+y) nursing home residents. Participants were 132 nursing home residents (84 (82-85) y). They were characterised according to activity of daily living-functions (ADL-functions), cognitive performance, intake of energy and protein (4-days dietary record), skipping of meals, energy and protein balance, and nutritional status (body mass index (BMI)). The participants had an energy intake, which was significantly higher than the estimated energy requirement (p eat or only had desert at one or more meals during the 4-day registration period. Participants who were skipping meals had a lower BMI, energy and protein intake (all p <0.001) and a higher prevalence of negative protein balance (p <0.01), than the other residents. More focus should be given to individualized nutritional assessment in order to discover the cause to this problem and target individuals who could be helped by nutritional intervention.

Self-Discrepancies and Involvement Moderate the Effects of Positive and Negative Message Framing in Persuasive Communication

NARCIS (Netherlands)

Dijkstra, Arie; Schakenraad, Roos; Menninga, Karin; Buunk, Abraham P.; Siero, Frans

2009-01-01

One individual difference that is conceptually closely related to the positive and negative framing of outcomes in persuasive communications is the person's self-discrepancy. It was expected that a match between a person's self-discrepancy and framing will lead to more persuasion, under the

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.

Digital evaluation of absolute marginal discrepancy: A comparison of ceramic crowns fabricated with conventional and digital techniques.

Science.gov (United States)

Liang, Shanshan; Yuan, Fusong; Luo, Xu; Yu, Zhuoren; Tang, Zhihui

2018-04-05

Marginal discrepancy is key to evaluating the accuracy of fixed dental prostheses. An improved method of evaluating marginal discrepancy is needed. The purpose of this in vitro study was to evaluate the absolute marginal discrepancy of ceramic crowns fabricated using conventional and digital methods with a digital method for the quantitative evaluation of absolute marginal discrepancy. The novel method was based on 3-dimensional scanning, iterative closest point registration techniques, and reverse engineering theory. Six standard tooth preparations for the right maxillary central incisor, right maxillary second premolar, right maxillary second molar, left mandibular lateral incisor, left mandibular first premolar, and left mandibular first molar were selected. Ten conventional ceramic crowns and 10 CEREC crowns were fabricated for each tooth preparation. A dental cast scanner was used to obtain 3-dimensional data of the preparations and ceramic crowns, and the data were compared with the "virtual seating" iterative closest point technique. Reverse engineering software used edge sharpening and other functional modules to extract the margins of the preparations and crowns. Finally, quantitative evaluation of the absolute marginal discrepancy of the ceramic crowns was obtained from the 2-dimensional cross-sectional straight-line distance between points on the margin of the ceramic crowns and the standard preparations based on the circumferential function module along the long axis. The absolute marginal discrepancy of the ceramic crowns fabricated using conventional methods was 115 ±15.2 μm, and 110 ±14.3 μm for those fabricated using the digital technique was. ANOVA showed no statistical difference between the 2 methods or among ceramic crowns for different teeth (P>.05). The digital quantitative evaluation method for the absolute marginal discrepancy of ceramic crowns was established. The evaluations determined that the absolute marginal discrepancies were

Discrepancies between perceptions of real and ideal yoga teachers and their relationship to emotional well-being.

Science.gov (United States)

Park, Crystal L; Riley, Kristen E; Besedin, Elena Y; Stewart, V Michelle

2013-01-01

Although more individuals are adopting yoga into their lives, little research has examined practitioners' expectations and experiences of their yoga instructor's behavior. Discrepancies between real and ideal behaviors of yoga instructors may lead to unsatisfactory experiences and decrease the potential impact of yoga practice. This study investigated differences between yoga practitioners' real and ideal perceptions of their yoga teacher's behavior and the relationship between discrepant beliefs and students' symptoms of depression, anxiety,and stress. The Perceptions of Yoga Teacher Questionnaire (PYTQ), a recently developed survey of student attitudes regarding yoga teachers' behavior, was administered ina national online survey of yoga students and teachers. Greater discrepancy between real and idea yoga teacher behavior was anticipated to be positively associated with practitioners' symptoms of depression, anxiety, and stress. Pearson correlations corrected for multiple comparisons revealed that yoga students and teachers are generally satisfied with their teacher's behaviors. Significant discrepancies between real and ideal teacher behavior were found for both groups. Higher discrepancy scores were associated with symptoms of stress and anxiety but not depression for students, but not for teachers. These preliminary findings provide insight into the relationship between expectancies and real yoga teacher behaviors and their links to student emotional adjustment.More research in this area is warranted.

eLearning among Canadian anesthesia residents: a survey of podcast use and content needs.

Science.gov (United States)

Matava, Clyde T; Rosen, Derek; Siu, Eric; Bould, Dylan M

2013-04-23

Podcasts are increasingly being used in medical education. In this study, we conducted a survey of Canadian anesthesia residents to better delineate the content needs, format preferences, and usage patterns among anesthesia residents. 10/16 Canadian anesthesia program directors, representing 443/659 Canadian anesthesia residents, allowed their residents to be included in the study. 169/659 (24%) residents responded to our survey. A 17-item survey tool developed by the investigators was distributed by email eliciting information on patterns of podcast use, preferred content, preferred format, and podcast adjuncts perceived to increase knowledge retention. 60% (91/151) had used medical podcasts with 67% of these users spending up to 1 hour per week on podcasts. 72.3% of respondents selected 'ability to review materials whenever I want' was selected by the majority of respondents (72%) as the reason they found podcasts to be valuable. No clear preference was shown for audio, video, or slidecast podcasts. Physiology (88%) and pharmacology (87%) were the most requested basic science topics while regional anesthesia (84%), intensive care (79%) and crisis resource management (86%) were the most requested for procedural, clinical and professional topics respectively. Respondents stated they would most likely view podcasts that contained procedural skills, journal article summaries and case presentations and that were between 5-15 minutes in duration A significantly greater proportion of senior residents (81%) requested podcasts on 'pediatric anesthesia' compared to junior residents 57% (P = 0.007). The majority of respondents are using podcasts. Anesthesia residents have preferred podcast content, types, length and format that educators should be cognizant of when developing and providing podcasts.

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.

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.

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…

Competencies "plus": the nature of written comments on internal medicine residents' evaluation forms.

Science.gov (United States)

Ginsburg, Shiphra; Gold, Wayne; Cavalcanti, Rodrigo B; Kurabi, Bochra; McDonald-Blumer, Heather

2011-10-01

Comments on residents' in-training evaluation reports (ITERs) may be more useful than scores in identifying trainees in difficulty. However, little is known about the nature of comments written by internal medicine faculty on residents' ITERs. Comments on 1,770 ITERs (from 180 residents in postgraduate years 1-3) were analyzed using constructivist grounded theory beginning with an existing framework. Ninety-three percent of ITERs contained comments, which were frequently easy to map onto traditional competencies, such as knowledge base (n = 1,075 comments) to the CanMEDs Medical Expert role. Many comments, however, could be linked to several overlapping competencies. Also common were comments completely unrelated to competencies, for instance, the resident's impact on staff (813), or personality issues (450). Residents' "trajectory" was a major theme (performance in relation to expected norms [494], improvement seen [286], or future predictions [286]). Faculty's assessments of residents are underpinned by factors related and unrelated to traditional competencies. Future evaluations should attempt to capture these holistic, integrated impressions.

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.

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.

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…

Phenological differences among selected residents and long-distance migrant bird species in central Europe

Science.gov (United States)

Bartošová, Lenka; Trnka, Miroslav; Bauer, Zdeněk; Možný, Martin; Štěpánek, Petr; Žalud, Zdeněk

2014-07-01

The phenological responses to climate of residents and migrants (short- and long-distance) differ. Although few previous studies have focussed on this topic, the agree that changes in phenology are more apparent for residents than for long-distance migrants. We analysed the breeding times of two selected residents ( Sitta europaea, Parus major) and one long-distance migrant ( Ficedula albicollis) from 1961 to 2007 in central Europe. The timing of the phenophases of all three bird species showed a significant advance to earlier times. Nevertheless, the most marked shift was observed for the long-distance migrant (1.9 days per decade on average in mean laying date with linearity at the 99.9 % confidence level). In contrast, the shifts shown by the residents were smaller (1.6 days for S. europaea and 1.5 days for P. major also on average in mean laying date for both, with linearity at the 95 % confidence level). Spearman rank correlation coefficients calculated for pairs of phenophases of given bird species in 20-year subsamples (e.g. 1961-1980, 1962-1981) showed higher phenological separation between the residents and the migrant. This separation is most apparent after the 1980s. Thus, our results indicate that the interconnections between the studied phenological stages of the three bird species are becoming weaker.

Factors influencing resident's decision to reside in gated and guarded community

Science.gov (United States)

Shamsudin, Zarina; Shamsudin, Shafiza; Zainal, Rozlin

2017-10-01

Gated communities are residential areas developed with restricted access with strictly controlled entrances and surrounded by a close perimeter of wall or fences. Developers, conscious of the need to fulfill the requirement of living in modern and sophisticated lifestyle and gated properties become the trend and mushroomed over the past decade. Nowadays, it is obvious that gated and guarded communities become almost a dominant feature of Malaysia housing development projects. The focus of this paper is to identify the factors contribute resident's decision to reside in gated and guarded community and to study social interaction among gated communities' residents. 150 questionnaires were distributed to the residents of selected gated and guarded community area in order to achieve the objectives and analyzed by using Statistical Package for Social Science (SPSS) and descriptive analysis. The result was tabulated and presented in charts and graphs for a clear and better understanding. The five main factors contribute to resident decision to reside in gated communities were identified and ranked; there are privacy, security, location, lifestyle and prestige. Besides, the residents are feeling neutral towards the facilities and services provided in their gated and guarded residential area. A comprehensive improvement towards the facilities and services is needed to reach higher satisfaction from the residents.

Parent-Child Acculturation Discrepancy, Perceived Parental Knowledge, Peer Deviance, and Adolescent Delinquency in Chinese Immigrant Families

Science.gov (United States)

Wang, Yijie; Kim, Su Yeong; Anderson, Edward R.; Chen, Angela Chia-Chen; Yan, Ni

2012-01-01

Parent-child acculturation discrepancy has been considered a risk factor for child maladjustment. The current study examined parent-child acculturation discrepancy as an ongoing risk factor for delinquency, through the mediating pathway of parental knowledge of the child's daily experiences relating to contact with deviant peers. Participants were…

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…

Relationship between parenting stress and informant discrepancies on symptoms of ADHD/ODD and internalizing behaviors in preschool children

Science.gov (United States)

Ni, Hsing-Chang; Liang, Sophie Hsin-Yi; Lin, Hsiang-Yuan; Lin, Chiao-Fan; Tseng, Yu-Han

2017-01-01

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. PMID:29016602

Patterns of serum PCDD/Fs affected by vegetarian regime, consumption of locally produced food, and resident places of residents living near incinerators

Energy Technology Data Exchange (ETDEWEB)

Chen Hsiu-Ling; Lee Chang-Ching; Su Hue-Jen; Liao Pao-Chi [Inst. of Basic Medical Science, Medical Coll., National Cheng Kung Univ., Tainan (Taiwan)

2004-09-15

Previous reports have been estimated that more than 90% of serum PCDD/Fs can be accounted for by the consumption of various food groups. Nouwen et al. suggested residents living near incinerators with the elevated dioxin exposure while they ate locally produced food compared to the general population from other areas. PCDD/Fs usually abound in fatty meats and marine foods, and consumption of which is the major pathway of human expose to PCDD/Fs. However, no distinct association was shown between vegetarian regime of human and their corresponding serum PCDD/Fs concentration. In addition, the resident region is associated to their corresponding dietary consumption and ambient exposure of PCDD/Fs, especially for subjects consumed the local foods with special dioxin-like contamination. The current study, therefore, was set to examine how dietary habits, including vegetarian regime and consumption of local food original for residents living near the incinerators are associated to serum PCDD/F concentrations. In addition, the further aim is to assess the influence on the serum PCDD/Fs levels resulting from subjects living in the alternative resident regions, even all of them exposed to PCDD/Fs emission from incinerators.

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.

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: ...

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.

Identifying Gaps and Launching Resident Wellness Initiatives: The 2017 Resident Wellness Consensus Summit.

Science.gov (United States)

Zaver, Fareen; Battaglioli, Nicole; Denq, William; Messman, Anne; Chung, Arlene; Lin, Michelle; Liu, Emberlynn L

2018-03-01

Burnout, depression, and suicidality among residents of all specialties have become a critical focus for the medical education community, especially among learners in graduate medical education. In 2017 the Accreditation Council for Graduate Medical Education (ACGME) updated the Common Program Requirements to focus more on resident wellbeing. To address this issue, one working group from the 2017 Resident Wellness Consensus Summit (RWCS) focused on wellness program innovations and initiatives in emergency medicine (EM) residency programs. Over a seven-month period leading up to the RWCS event, the Programmatic Initiatives workgroup convened virtually in the Wellness Think Tank, an online, resident community consisting of 142 residents from 100 EM residencies in North America. A 15-person subgroup (13 residents, two faculty facilitators) met at the RWCS to develop a public, central repository of initiatives for programs, as well as tools to assist programs in identifying gaps in their overarching wellness programs. An online submission form and central database of wellness initiatives were created and accessible to the public. Wellness Think Tank members collected an initial 36 submissions for the database by the time of the RWCS event. Based on general workplace, needs-assessment tools on employee wellbeing and Kern's model for curriculum development, a resident-based needs-assessment survey and an implementation worksheet were created to assist residency programs in wellness program development. The Programmatic Initiatives workgroup from the resident-driven RWCS event created tools to assist EM residency programs in identifying existing initiatives and gaps in their wellness programs to meet the ACGME's expanded focus on resident wellbeing.

The impact of a medical procedure service on patient safety, procedure quality and resident training opportunities.

Science.gov (United States)

Tukey, Melissa H; Wiener, Renda Soylemez

2014-03-01

At some academic hospitals, medical procedure services are being developed to provide supervision for residents performing bedside procedures in hopes of improving patient safety and resident education. There is limited knowledge of the impact of such services on procedural complication rates and resident procedural training opportunities. To determine the impact of a medical procedure service (MPS) on patient safety and resident procedural training opportunities. Retrospective cohort analysis comparing characteristics and outcomes of procedures performed by the MPS versus the primary medical service. Consecutive adults admitted to internal medicine services at a large academic hospital who underwent a bedside medical procedure (central venous catheterization, thoracentesis, paracentesis, lumbar puncture) between 1 July 2010 and 31 December 2011. The primary outcome was a composite rate of major complications. Secondary outcomes included resident participation in bedside procedures and use of "best practice" safety process measures. We evaluated 1,707 bedside procedures (548 by the MPS, 1,159 by the primary services). There were no differences in the composite rate of major complications (1.6 % vs. 1.9 %, p = 0.71) or resident participation in bedside procedures (57.0 % vs. 54.3 %, p = 0.31) between the MPS and the primary services. Procedures performed by the MPS were more likely to be successfully completed (95.8 % vs. 92.8 %, p = 0.02) and to use best practice safety process measures, including use of ultrasound guidance when appropriate (96.8 % vs. 90.0 %, p = 0.0004), avoidance of femoral venous catheterization (89.5 vs. 82.7 %, p = 0.02) and involvement of attending physicians (99.3 % vs. 57.0 %, p < 0.0001). Although use of a MPS did not significantly affect the rate of major complications or resident opportunities for training in bedside procedures, it was associated with increased use of best practice safety process measures.

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.

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.

Smoking history, knowledge, and attitudes among older residents of a long-term care facility.

Science.gov (United States)

Carosella, Ann Marie; Ossip-Klein, Deborah J; Watt, Celia A; Podgorski, Carol

2002-05-01

In the absence of empirical literature from the resident perspective, this study provided a first assessment of smoking history, knowledge of the risks of smoking, the risks of environmental tobacco exposure, and the benefits of quitting among older (age 50+) nursing home unit residents, as well as readiness to quit, barriers to quitting, frequency of cessation advice by healthcare givers, and quit-attempt history of residents who smoke. Subjects were 25 smokers and 70 non-smokers housed on long-term nursing home units in a county hospital. Results indicated that smoking status for the majority of residents was similar to when they were admitted, although smokers smoked fewer cigarettes (M = 11.6, SD = 9.2) than prior to admission (M = 18.6, SD = 11.8). Smokers were less likely than non-smokers to agree that smoking is harmful to their health. Both smokers and non-smokers were not well informed of the dangers of passive smoke exposure. The majority of smokers were in precontemplation (no interest in quitting within the next 6 months). Fewer than half of residents who smoked reported receiving cessation advice from physicians (40%) or nurses (36%), and no in-house cessation programs were available. These results suggest gaps in knowledge and resources for smoking cessation in this setting and an opportunity for intervention. This study begins to build an evidence base from the residents' perspective that can be used by healthcare providers, administrators, and policy makers in addressing smoking in the nursing home.

Resident and attending physician perception of maladaptive response to stress in residents

Directory of Open Access Journals (Sweden)

Lee Ann Riesenberg

2014-11-01

Full Text Available Background: Residency stress has been shown to interfere with resident well-being and patient safety. We developed a survey research study designed to explore factors that may affect perception of a maladaptive response to stress. Methods: A 16-item survey with 12 Likert-type perception items was designed to determine how often respondents agreed or disagreed with statements regarding the resident on the trigger tape. A total of 438 respondents from multiple institutions completed surveys. Results: Attending physicians were more likely than residents to agree that the resident on the trigger tape was impaired, p<0.0001; needed to seek professional counseling, p=0.0003; should be removed from the service, p=0.002; was not receiving adequate support from the attending physician, p=0.007; and was a risk to patient safety, p=0.02. Attending physicians were also less likely to agree that the resident was a good role model, p=0.001, and that the resident should be able to resolve these issues herself/himself, p<0.0001. Conclusion: Our data suggest that resident physicians may not be able to adequately detect maladaptive responses to stress and that attending physicians may be more adept at recognizing this problem. More innovative faculty and resident development workshops should be created to teach and encourage physicians to better observe and detect residents who are displaying maladaptive responses to stress.

ON range searching in the group model and combinatorial discrepancy

DEFF Research Database (Denmark)

Larsen, Kasper Green

2014-01-01

In this paper we establish an intimate connection between dynamic range searching in the group model and combinatorial discrepancy. Our result states that, for a broad class of range searching data structures (including all known upper bounds), it must hold that $t_u t_q=\\Omega(\\mbox{disc}^2......)$, where $t_u$ is the worst case update time, $t_q$ is the worst case query time, and disc is the combinatorial discrepancy of the range searching problem in question. This relation immediately implies a whole range of exceptionally high and near-tight lower bounds for all of the basic range searching...... problems. We list a few of them in the following: (1) For $d$-dimensional halfspace range searching, we get a lower bound of $t_u t_q=\\Omega(n^{1-1/d})$. This comes within an lg lg $n$ factor of the best known upper bound. (2) For orthogonal range searching, we get a lower bound of $t_u t...

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.

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.

Identifying Gaps and Launching Resident Wellness Initiatives: The 2017 Resident Wellness Consensus Summit

Directory of Open Access Journals (Sweden)

Nicole Battaglioli

2018-02-01

Full Text Available Introduction: Burnout, depression, and suicidality among residents of all specialties have become a critical focus for the medical education community, especially among learners in graduate medical education. In 2017 the Accreditation Council for Graduate Medical Education (ACGME updated the Common Program Requirements to focus more on resident wellbeing. To address this issue, one working group from the 2017 Resident Wellness Consensus Summit (RWCS focused on wellness program innovations and initiatives in emergency medicine (EM residency programs. Methods: Over a seven-month period leading up to the RWCS event, the Programmatic Initiatives workgroup convened virtually in the Wellness Think Tank, an online, resident community consisting of 142 residents from 100 EM residencies in North America. A 15-person subgroup (13 residents, two faculty facilitators met at the RWCS to develop a public, central repository of initiatives for programs, as well as tools to assist programs in identifying gaps in their overarching wellness programs. Results: An online submission form and central database of wellness initiatives were created and accessible to the public. Wellness Think Tank members collected an initial 36 submissions for the database by the time of the RWCS event. Based on general workplace, needs-assessment tools on employee wellbeing and Kern’s model for curriculum development, a resident-based needs-assessment survey and an implementation worksheet were created to assist residency programs in wellness program development. Conclusion: The Programmatic Initiatives workgroup from the resident-driven RWCS event created tools to assist EM residency programs in identifying existing initiatives and gaps in their wellness programs to meet the ACGME’s expanded focus on resident wellbeing.

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.

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 CFR 222.82 - Duties of users regarding address discrepancies.

Science.gov (United States)

2010-01-01

... FEDERAL RESERVE SYSTEM FAIR CREDIT REPORTING (REGULATION V) Duties of Users of Consumer Reports Regarding... a user of consumer reports (user) that receives a notice of address discrepancy from a consumer... consumer report and the address(es) in the agency's file for the consumer. (c) Reasonable belief—(1...

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.

Training future surgeons for management roles: the resident-surgeon-manager conference.

Science.gov (United States)

Hanna, Waël C; Mulder, David S; Fried, Gerald M; Elhilali, Mostafa; Khwaja, Kosar A

2012-10-01

OBJECTIVE To demonstrate that senior surgical residents would benefit from focused training by professionals with management expertise. Although managerial skills are recognized as necessary for the successful establishment of a surgical practice, they are not often emphasized in traditional surgical residency curricula. DESIGN Senior residents from all surgical subspecialties at McGill University were invited to participate in a 1-day management seminar. Precourse questionnaires aimed at evaluating the residents' perceptions of their own managerial knowledge and preparedness were circulated. The seminar was then given in the form of interactive lectures and case-based discussions. The questionnaires were readministered at the end of the course, along with an evaluation form. Precourse and postcourse data were compared using the Freeman-Halton extension of the Fisher exact test to determine statistical significance (P < .05). SETTING McGill University Health Centre in Montreal, Quebec, Canada. PARTICIPANTS A total of 43 senior residents. RESULTS Before the course, the majority of residents (27 of 43 [63%]) thought that management instruction only happened "from time to time" in their respective programs. After the course, 15 residents (35%) felt that management topics were "well addressed," and 19 (44%) felt that management topics have been "very well addressed" (P < .01). Residents noted a significant improvement in their ability to perform the following skills after the course: giving feedback, delegating duties, coping with stress, effective learning, and effective teaching. On the ensemble of all managerial skills combined, 26 residents (60%) rated their performance as "good" or "excellent" after the course vs only 21 (49%) before the course (P = .02). Residents also noted a statistically significant improvement in their ability to perform the managerial duties necessary for the establishment of a surgical practice. CONCLUSIONS Surgical residency programs

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.

Residency Training in Robotic General Surgery: A Survey of Program Directors.

Science.gov (United States)

George, Lea C; O'Neill, Rebecca; Merchant, Aziz M

2018-01-01

Robotic surgery continues to expand in minimally invasive surgery; however, the literature is insufficient to understand the current training process for general surgery residents. Therefore, the objectives of this study were to identify the current approach to and perspectives on robotic surgery training. An electronic survey was distributed to general surgery program directors identified by the Accreditation Council for Graduate Medical Education website. Multiple choice and open-ended questions regarding current practices and opinions on robotic surgery training in general surgery residency programs were used. 20 program directors were surveyed, a majority being from medium-sized programs (4-7 graduating residents per year). Most respondents (73.68%) had a formal robotic surgery curriculum at their institution, with 63.16% incorporating simulation training. Approximately half of the respondents believe that more time should be dedicated to robotic surgery training (52.63%), with simulation training prior to console use (84.21%). About two-thirds of the respondents (63.16%) believe that a formal robotic surgery curriculum should be established as a part of general surgery residency, with more than half believing that exposure should occur in postgraduate year one (55%). A formal robotics curriculum with simulation training and early surgical exposure for general surgery residents should be given consideration in surgical residency training.

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.

Attitudes of Canadian psychiatry residents if mentally ill: awareness, barriers to disclosure, and help-seeking preferences

Directory of Open Access Journals (Sweden)

Tariq Mahmood Hassan

2016-10-01

Conclusions: At the level of residency training, psychiatrists are reporting barriers to disclosure and help-seeking if they were to experience mental illness. A majority of psychiatry residents would only disclose to informal supports. Those with a history of mental illness would prefer formal treatment services over informal services.

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…

Assessing Residents' Readiness for OR Autonomy: A Qualitative Descriptive Study of Expert Surgical Teachers' Best Practices.

Science.gov (United States)

Chen, Xiaodong Phoenix; Sullivan, Amy M; Alseidi, Adnan; Kwakye, Gifty; Smink, Douglas S

Providing resident autonomy in the operating room (OR) is one of the major challenges for surgical educators today. The purpose of this study was to explore what approaches expert surgical teachers use to assess residents' readiness for autonomy in the OR. We particularly focused on the assessments that experts make prior to conducting the surgical time-out. We conducted semistructured in-depth interviews with expert surgical teachers from March 2016 to September 2016. Purposeful sampling and snowball sampling were applied to identify and recruit expert surgical teachers from general surgery residency programs across the United States to represent a range of clinical subspecialties. All interviews were audio-recorded, deidentified, and transcribed. We applied the Framework Method of content analysis, discussed and reached final consensus on the themes. We interviewed 15 expert teachers from 9 institutions. The majority (13/15) were Program or Associate Program Directors; 47% (7/15) primarily performed complex surgical operations (e.g., endocrine surgery). Five themes regarding how expert surgical teachers determine residents' readiness for OR autonomy before the surgical time-out emerged. These included 3 domains of evidence elicited about the resident (resident characteristics, medical knowledge, and beyond the current OR case), 1 variable relating to attending characteristics, and 1 variable composed of contextual factors. Experts obtained one or more examples of evidence, and adjusted residents' initial autonomy using factors from the attending variable and the context variable. Expert surgical teachers' assessments of residents' readiness for OR autonomy included 5 key components. Better understanding these inputs can contribute to both faculty and resident development, enabling increased resident autonomy and preparation for independent practice. Copyright © 2017 Association of Program Directors in Surgery. Published by Elsevier Inc. All rights reserved.

[Motivation and satisfaction of residents in urology].

Science.gov (United States)

Enzmann, T; Buxel, H; Benzing, F

2010-08-01

To address the increasing shortage of qualified residents, which leads to further discontent and additional on-call rotations for the remaining physicians, an analysis of the current situation was performed. Stress in the daily working routine, not enough free time, too little pay, or too little compensatory time off for overtime as well as inadequate options for continuing education were reported to be the main elements of dissatisfaction. The economic pressure of day-to-day work continues to define the physician's role and places demands on the medical staff by burdening them with nonmedical and administrative tasks.The major causes mentioned were staff shortage and lack of support provided by supervisors and the administration. For this reason, human resource development should be considered a strategic and central goal. This requires a normative, cross-functional approach at all levels of management and inclusion of personnel departments in the strategic processes of the hospital. The most important aspects for resident satisfaction were the work environment, acceptable work-life balance and remuneration, compensation for overtime, and quality of available continuing education, which is often rated as being insufficient.Effective strategies to improve the motivation of residents comprise offering opportunities for structured continuing education, optimizing the everyday work processes, and involving employees in social networks. The establishment of feedback strategies, including recognition of residents' achievements, will help to ensure their loyalty and identification with their clinic. This can serve as a preventive measure to offset any potential willingness to change jobs.

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.

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…

PATTERNS OF CONTACT AND INVOLVEMENT BETWEEN ADOLESCENTS AND THEIR NON-RESIDENT FATHERS

Directory of Open Access Journals (Sweden)

De Wit, Estelle

2014-04-01

Full Text Available This study examined the patterns of contact and involvement between adolescents and their non-resident fathers after divorce. The data were analysed to determine the role of Lamb, Pleck and Levine’s (1986 three constructs in the involvement of non-resident fathers, i.e. interaction, availability and responsibility. The results indicated that the majority of male and female adolescents reported continued direct and indirect contact with their fathers, regardless of paternal remarriage and the lapse of time since the divorce. Boys reported higher levels of communication and feelings of emotional closeness than girls. Overall, the study postulates that non-resident fathers play a less significant role in providing parental guidance to their children.

12 CFR 334.82 - Duties of users regarding address discrepancies.

Science.gov (United States)

2010-01-01

... STATEMENTS OF GENERAL POLICY FAIR CREDIT REPORTING Duties of Users of Consumer Reports Regarding Address... section applies to a user of consumer reports (user) that receives a notice of address discrepancy from a... consumer report and the address(es) in the agency's file for the consumer. (c) Reasonable belief. (1...

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

Science.gov (United States)

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

2016-03-01

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

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

Directory of Open Access Journals (Sweden)

James Ahn, MD

2016-03-01

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

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.

Pregnancy among residents enrolled in general surgery: a nationwide survey of attitudes and experiences.

Science.gov (United States)

Merchant, Shaila J; Hameed, S Morad; Melck, Adrienne L

2013-10-01

Medical student interest in general surgery has declined, and the lack of adequate accommodation for pregnancy and parenting during residency training may be a deterrent. We explored resident and program director experiences with these issues in general surgery programs across Canada. Using a web-based tool, residents and program directors from 16 Canadian general surgery programs were surveyed regarding their attitudes toward and experiences with pregnancy during residency. One hundred seventy-six of 600 residents and 8 of 16 program directors completed the survey (30% and 50% response rate, respectively). Multiple issues pertaining to pregnancy during surgical residency were reported including the lack of adequate policies for maternity/parenting, the major obstacles to breast-feeding, and the increased workload for fellow resident colleagues. All program directors reported the lack of a program-specific maternity/parenting policy. General surgery programs lack program-specific maternity/parenting policies. Several issues have been highlighted in this study emphasizing the importance of creating and implementing such a policy. Copyright © 2013 Elsevier Inc. All rights reserved.

Confidence, knowledge, and skills at the beginning of residency. A survey of pathology residents.

Science.gov (United States)

Hsieh, Cindy M; Nolan, Norris J

2015-01-01

To document the pathology learning experiences of pathology residents prior to residency and to determine how confident they were in their knowledge and technical skills. An online survey was distributed to all pathology residency program directors in the United States, who were requested to forward the survey link to their residents. Data were obtained on pathology electives, grossing experience, and frozen section experience. Likert scale questions assessed confidence level in knowledge and skills. In total, 201 pathology residents responded (8% of residents in the United States). Prior to starting residency, most respondents had exposure to anatomic pathology through elective rotations. Few respondents had work-related experience. Most did not feel confident in their pathology-related knowledge or skills, and many did not understand what pathology resident duties entail. Respondents gained exposure to pathology primarily through elective rotations, and most felt the elective experience prepared them for pathology residency. However, elective time may be enhanced by providing opportunities for students to increase hands-on experience and understanding of resident duties. Copyright© by the American Society for Clinical Pathology.

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

Science.gov (United States)

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

2009-09-01

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

The Quality of Written Feedback by Attendings of Internal Medicine Residents.

Science.gov (United States)

Jackson, Jeffrey L; Kay, Cynthia; Jackson, Wilkins C; Frank, Michael

2015-07-01

Attending evaluations are commonly used to evaluate residents. Evaluate the quality of written feedback of internal medicine residents. Retrospective. Internal medicine residents and faculty at the Medical College of Wisconsin from 2004 to 2012. From monthly evaluations of residents by attendings, a randomly selected sample of 500 written comments by attendings were qualitatively coded and rated as high-, moderate-, or low-quality feedback by two independent coders with good inter-rater reliability (kappa: 0.94). Small group exercises with residents and attendings also coded the utterances as high, moderate, or low quality and developed criteria for this categorization. In-service examination scores were correlated with written feedback. There were 228 internal medicine residents who had 6,603 evaluations by 334 attendings. Among 500 randomly selected written comments, there were 2,056 unique utterances: 29% were coded as nonspecific statements, 20% were comments about resident personality, 16% about patient care, 14% interpersonal communication, 7% medical knowledge, 6% professionalism, and 4% each on practice-based learning and systems-based practice. Based on criteria developed by group exercises, the majority of written comments were rated as moderate quality (65%); 22% were rated as high quality and 13% as low quality. Attendings who provided high-quality feedback rated residents significantly lower in all six of the Accreditation Council for Graduate Medical Education (ACGME) competencies (p service examination scores. Most attending written evaluation was of moderate or low quality. Attendings who provided high-quality feedback appeared to be more discriminating, providing significantly lower ratings of residents in all six ACGME core competencies, and across a greater range. Attendings' negative written comments on medical knowledge correlated with lower in-service training scores.

Evaluation of resident attitudes and self-reported competencies in health advocacy

Directory of Open Access Journals (Sweden)

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

The efficacy of a modified general hip technique in the treatment of leg length discrepancies

OpenAIRE

2015-01-01

M.Dip.Tech. Functional leg length discrepancies, as distinct from anatomical discrepancies, are often associated with sacroiliac joint dysfunction. This may result in back pain and discomfort. Chiropractors usually treat this condition using a side posture sacroiliac adjustment, but in some cases, an adjustment may not be indicated. This study aims to determine whether a Modified General Hip technique would be an acceptable alternative treatment. For this study, 30 patients who suffered fr...

Autologous bone marrow-derived stem cell therapy in heart disease: discrepancies and contradictions.

Science.gov (United States)

Francis, Darrel P; Mielewczik, Michael; Zargaran, David; Cole, Graham D

2013-10-09

Autologous bone marrow stem cell therapy is the greatest advance in the treatment of heart disease for a generation according to pioneering reports. In response to an unanswered letter regarding one of the largest and most promising trials, we attempted to summarise the findings from the most innovative and prolific laboratory. Amongst 48 reports from the group, there appeared to be 5 actual clinical studies ("families" of reports). Duplicate or overlapping reports were common, with contradictory experimental design, recruitment and results. Readers cannot always tell whether a study is randomised versus not, open-controlled or blinded placebo-controlled, or lacking a control group. There were conflicts in recruitment dates, criteria, sample sizes, million-fold differences in cell counts, sex reclassification, fractional numbers of patients and conflation of competitors' studies with authors' own. Contradictory results were also common. These included arithmetical miscalculations, statistical errors, suppression of significant changes, exaggerated description of own findings, possible silent patient deletions, fractional numbers of coronary arteries, identical results with contradictory sample sizes, contradictory results with identical sample sizes, misrepresented survival graphs and a patient with a negative NYHA class. We tabulate over 200 discrepancies amongst the reports. The 5 family-flagship papers (Strauer 2002, STAR, IACT, ABCD, BALANCE) have had 2665 citations. Of these, 291 citations were to the pivotal STAR or IACT-JACC papers, but 97% of their eligible citing papers did not mention any discrepancies. Five meta-analyses or systematic reviews covered these studies, but none described any discrepancies and all resolved uncertainties by undisclosed methods, in mutually contradictory ways. Meta-analysts disagreed whether some studies were randomised or "accepter-versus-rejecter". Our experience of presenting the discrepancies to journals is that readers may

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...

Subjective-Objective Sleep Discrepancy Is Associated With Alterations in Regional Glucose Metabolism in Patients With Insomnia and Good Sleeper Controls.

Science.gov (United States)

Kay, Daniel B; Karim, Helmet T; Soehner, Adriane M; Hasler, Brant P; James, Jeffrey A; Germain, Anne; Hall, Martica H; Franzen, Peter L; Price, Julie C; Nofzinger, Eric A; Buysse, Daniel J

2017-11-01

Sleep discrepancies are common in primary insomnia (PI) and include reports of longer sleep onset latency (SOL) than measured by polysomnography (PSG) or "negative SOL discrepancy." We hypothesized that negative SOL discrepancy in PI would be associated with higher relative glucose metabolism during nonrapid eye movement (NREM) sleep in brain networks involved in conscious awareness, including the salience, left executive control, and default mode networks. PI (n = 32) and good sleeper controls (GS; n = 30) completed [18F]fluorodeoxyglucose positron emission tomography (FDG-PET) scans during NREM sleep, and relative regional cerebral metabolic rate for glucose (rCMRglc) was measured. Sleep discrepancy was calculated by subtracting PSG-measured SOL on the PET night from corresponding self-report values the following morning. We tested for interactions between group (PI vs. GS) and SOL discrepancy for rCMRglc during NREM sleep using both a region of interest mask and exploratory whole-brain analyses. Significant group by SOL discrepancy interactions for rCMRglc were observed in several brain regions (pcorrected PSG-measured SOL) was associated with significantly higher relative rCMRglc in the right anterior insula and middle/posterior cingulate during NREM sleep. In GS, more positive SOL discrepancy (self-reported Sleep Research Society 2017. Published by Oxford University Press on behalf of the Sleep Research Society. All rights reserved. For permissions, please e-mail journals.permissions@oup.com.

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.

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

Science.gov (United States)

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

2012-01-01

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

Parent-Child Discrepancy on Children's Body Weight Perception: The Role of Attachment Security.

Science.gov (United States)

Uccula, Arcangelo; Nuvoli, Gianfranco

2017-01-01

The discrepancies between parents and their children on the description of the behavior and representations of their children have been shown in various studies. Other researchers have reported the parents' difficulty in correctly identifying the weight status of their children. The purpose of our study was to investigate the parent's attributional accuracy on their children's body weight perception in relation to the children attachment security. It was hypothesized that insecure children's parents have a greater discrepancy with their children compared to secure children with their parents. The research participants were 217 children, aged between 5 and 11 years of both genders, and their parents. The attachment pattern was measured by the SAT of Klagsbrun and Bowlby, with the Italian version of Attili. The children were also shown a set of figure body-drawings with which to measure the perception of their weight status. Parents answered a questionnaire to find out the parental attribution of their children's perception. The results show that the body weight perception of insecure children's parents have a greater discrepancy with their children's body weight perception compared with parentally secure children. In particular, parents of insecure children tend to underestimate the perception of their children. This result is most evident in disorganized children. In addition, the perception of insecure children's parents show a greater correlation with children's actual weight rather than with their children's perception. These results suggest that the discrepancies on the perception of children's body weight between parents and children may be influenced by the poor parental attunement to their children's internal states, which characterizes the insecure parent-child attachment relationship.

Digital microscopic evaluation of vertical marginal discrepancies of CAD/CAM fabricated zirconia cores.

Science.gov (United States)

Habib, Syed Rashid

2018-05-18

The aim of this in vitro research study was to evaluate the vertical marginal discrepancies of zirconia (Zr) cores fabricated by five different computer-aided design and manufacturing (CAD/CAM) systems using a digital microscope. A total of 60 specimens were prepared and randomly divided into five groups (n=12 each) using the following systems: Ceramill Motion 2 (CM, Amanngirrbach, Germany); Weiland (WI, Ivoclar Vivadent, USA); Cerec (CS, Sirona Dental, USA); Zirkonzahn (ZZ, Gmbh Bruneck, Italy) and Cad4dent (CD, Canada). The specimens were numbered and the vertical marginal discrepancies were evaluated with a digital microscope at 50× magnification. A one-way analysis of variance showed a statistically significant difference (p=0.002) between the groups. The CM group exhibited the lowest values for the marginal gaps (31.30±15.12 μm), while the ZZ group exhibited the highest values for the marginal gaps (44.83±28.76 μm) compared to other groups. A post hoc Tukey's test for multiple comparisons between the experimental groups showed a statistically significant difference (p<0.05) between the group CM and group CD with group ZZ. The rest of the groups showed no significant differences between them. Variations in the values were observed for the four sites measured with the highest and the least mean marginal gap value of 43.19±23.84 μm and 32.49±12.21 μm for buccal and lingual sites, respectively. Variations existed in the marginal discrepancy values for the CAD/CAM systems investigated in the study. Vertical marginal discrepancy values observed for various systems investigated in the study were well within the clinically acceptable range.

Well-being in residency training: a survey examining resident physician satisfaction both within and outside of residency training and mental health in Alberta

Directory of Open Access Journals (Sweden)

Patten Scott

2005-06-01

Full Text Available Abstract Background Despite the critical importance of well-being during residency training, only a few Canadian studies have examined stress in residency and none have examined well-being resources. No recent studies have reported any significant concerns with respect to perceived stress levels in residency. We investigated the level of perceived stress, mental health and understanding and need for well-being resources among resident physicians in training programs in Alberta, Canada. Methods A mail questionnaire was distributed to the entire resident membership of PARA during 2003 academic year. PARA represents each of the two medical schools in the province of Alberta. Results In total 415 (51 % residents participated in the study. Thirty-four percent of residents who responded to the survey reported their life as being stressful. Females reported stress more frequently than males (40% vs. 27%, p Residents highly valued their colleagues (67%, program directors (60% and external psychiatrist/psychologist (49% as well-being resources. Over one third of residents wished to have a career counselor (39% and financial counselor (38%. Conclusion Many Albertan residents experience significant stressors and emotional and mental health problems. Some of which differ among genders. This study can serve as a basis for future resource application, research and advocacy for overall improvements to well-being during residency training.

Sources of Stress and Support for the Pregnant Resident.

Science.gov (United States)

Phelan, Sharon T.

1992-01-01

A survey of women physicians elicited 373 responses from women who had experienced pregnancy during residency. Respondents indicated that major sources of stress included frequency of call, fatigue, long hours, and too little time with partner. Women medical staff were perceived as supportive. Maternity leave of less than 6 weeks was felt to be…

Rural Villagers and Urban Residents Exposure to Poultry in China

Science.gov (United States)

Shi, Ying; Liao, Qiaohong; Zhou, Hang; Zhou, Lei; Li, Leilei; Wu, Jiabing; Zhang, Shunxiang; Yu, Zhangda; Wu, Xiaomin; Ma, Hanwu; Lu, Jianhua; Cowling, Benjamin J.; Yu, Hongjie

2014-01-01

Patterns of poultry exposure in rural and urban areas in China have not been systematically evaluated and compared. The objective of our study is to investigate patterns in human exposure to poultry in rural and urban China. We conducted a two-stage household-based clustered survey on population exposure to live/sick/dead poultry in Xiuning and Shenzhen. Half of the rural households (51%) in Xiuning raised poultry, mostly (78%) free-range. Around half of those households (40%) allowed poultry to stay in their living areas. One quarter of villagers reported having contact with sick or dead poultry. In Shenzhen, 37% urban residents visited live poultry markets. Among these, 40% purchased live poultry and 16% touched the poultry or cages during purchase. Our findings indicated that human exposure to poultry was different in rural and urban areas in China. This discrepancy could contribute to the observed differences in epidemiologic characteristics between urban and rural cases of influenza A(H7N9) and A(H5N1) virus infection. PMID:24769673

Residents' Perspectives on Careers in Academic Medicine: Obstacles and Opportunities.

Science.gov (United States)

Lin, Steven; Nguyen, Cathina; Walters, Emily; Gordon, Paul

2018-03-01

Worsening faculty shortages in medical schools and residency programs are threatening the US medical education infrastructure. Little is known about the factors that influence the decision of family medicine residents to choose or not choose academic careers. Our study objective was to answer the following question among family medicine residents: "What is your greatest concern or fear about pursuing a career in academic family medicine?" Participants were family medicine residents who attended the Faculty for Tomorrow Workshop at the Society of Teachers of Family Medicine Annual Spring Conference in 2016 and 2017. Free responses to the aforementioned prompt were analyzed using a constant comparative method and grounded theory approach. A total of 156 participants registered for the workshops and 95 (61%) answered the free response question. Eight distinct themes emerged from the analysis. The most frequently recurring theme was "lack of readiness or mentorship," which accounted for nearly one-third (31%) of the codes. Other themes included work-life balance and burnout (17%), job availability and logistics (15%), lack of autonomy or flexibility (11%), competing pressures/roles (10%), lower financial rewards (4%), politics and bureaucracy (4%), and research (3%). To our knowledge, this is the first study to identify barriers and disincentives to pursuing a career in academic medicine from the perspective of family medicine residents. There may be at least eight major obstacles, for which we summarize and consider potential interventions. More research is needed to understand why residents choose, or don't choose, academic careers.

Self vs. Other Focus: Predicting Professionalism Remediation of Emergency Medicine Residents

Directory of Open Access Journals (Sweden)

Robert E. Thaxton

2017-12-01

Full Text Available Introduction Unprofessionalism is a major reason for resident dismissal from training. Because of the high stakes involved, residents and educators alike would benefit from information predicting whether they might experience challenges related to this competency. Our objective was to correlate the outcome of professionalism-related remedial actions during residency with the predictor variable of resident response to a standardized interview question: “Why is Medicine important to you?” Methods We conducted a professional development quality improvement (QI initiative to improve resident education and mentorship by achieving a better understanding of each resident’s reasons for valuing a career in medicine. This initiative entailed an interview administered to each resident beginning emergency medicine training at San Antonio Military Medical Center during 2006–2013. The interviews uniformly began with the standardized question “Why is Medicine important to you?” The residency program director documented a free-text summary of each response to this question, the accuracy of which was confirmed by the resident. We analyzed the text of each resident’s response after a review of the QI data suggested an association between responses and professionalism actions (retrospective cohort design. Two associate investigators blinded to all interview data, remedial actions, and resident identities categorized each text response as either self-focused (e.g., “I enjoy the challenge” or other-focused (e.g., “I enjoy helping patients”. Additional de-identified data collected included demographics, and expressed personal importance of politics and religion. The primary outcome was a Clinical Competency Committee professionalism remedial action. Results Of 114 physicians starting residency during 2006–2013, 106 (93.0% completed the interview. There was good inter-rater reliability in associate investigator categorization of resident

Training Family Medicine Residents to Perform Home Visits: A CERA Survey.

Science.gov (United States)

Sairenji, Tomoko; Wilson, Stephen A; D'Amico, Frank; Peterson, Lars E

2017-02-01

Home visits have been shown to improve quality of care, save money, and improve outcomes. Primary care physicians are in an ideal position to provide these visits; of note, the Accreditation Council for Graduate Medical Education no longer requires home visits as a component of family medicine residency training. To investigate changes in home visit numbers and expectations, attitudes, and approaches to training among family medicine residency program directors. This research used the Council of Academic Family Medicine Educational Research Alliance (CERA) national survey of family medicine program directors in 2015. Questions addressed home visit practices, teaching and evaluation methods, common types of patient and visit categories, and barriers. There were 252 responses from 455 possible respondents, representing a response rate of 55%. At most programs, residents performed 2 to 5 home visits by graduation in both 2014 (69% of programs, 174 of 252) and 2015 (68%, 172 of 252). The vast majority (68%, 172 of 252) of program directors expect less than one-third of their graduates to provide home visits after graduation. Scheduling difficulties, lack of faculty time, and lack of resident time were the top 3 barriers to residents performing home visits. There appeared to be no decline in resident-performed home visits in family medicine residencies 1 year after they were no longer required. Family medicine program directors may recognize the value of home visits despite a lack of few formal curricula.

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

Science.gov (United States)

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.

Quasirandom geometric networks from low-discrepancy sequences

Science.gov (United States)

Estrada, Ernesto

2017-08-01

We define quasirandom geometric networks using low-discrepancy sequences, such as Halton, Sobol, and Niederreiter. The networks are built in d dimensions by considering the d -tuples of digits generated by these sequences as the coordinates of the vertices of the networks in a d -dimensional Id unit hypercube. Then, two vertices are connected by an edge if they are at a distance smaller than a connection radius. We investigate computationally 11 network-theoretic properties of two-dimensional quasirandom networks and compare them with analogous random geometric networks. We also study their degree distribution and their spectral density distributions. We conclude from this intensive computational study that in terms of the uniformity of the distribution of the vertices in the unit square, the quasirandom networks look more random than the random geometric networks. We include an analysis of potential strategies for generating higher-dimensional quasirandom networks, where it is know that some of the low-discrepancy sequences are highly correlated. In this respect, we conclude that up to dimension 20, the use of scrambling, skipping and leaping strategies generate quasirandom networks with the desired properties of uniformity. Finally, we consider a diffusive process taking place on the nodes and edges of the quasirandom and random geometric graphs. We show that the diffusion time is shorter in the quasirandom graphs as a consequence of their larger structural homogeneity. In the random geometric graphs the diffusion produces clusters of concentration that make the process more slow. Such clusters are a direct consequence of the heterogeneous and irregular distribution of the nodes in the unit square in which the generation of random geometric graphs is based on.

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.

The impact of ethnic concentration on prejudice: The role of cultural and socioeconomic differences between ethnic neighbourhood residents

NARCIS (Netherlands)

Havekes, Esther; Coenders, Marcel; Dekker, Karien; van der Lippe, Tanja

2014-01-01

Many studies have examined the impact of the size of the neighborhood minority population on prejudicial attitudes of majority residents. However, few studies have investigated how residents of different ethnic origins evaluate different ethnic outgroups based on the shares of these particular

Lifestyle medicine curriculum for a preventive medicine residency program: implementation and outcomes.

Science.gov (United States)

Nawaz, Haq; Petraro, Paul V; Via, Christina; Ullah, Saif; Lim, Lionel; Wild, Dorothea; Kennedy, Mary; Phillips, Edward M

2016-01-01

The vast majority of the healthcare problems burdening our society today are caused by disease-promoting lifestyles (e.g., physical inactivity and unhealthy eating). Physicians report poor training and lack of confidence in counseling patients on lifestyle changes. To evaluate a new curriculum and rotation in lifestyle medicine for preventive medicine residents. Training included didactics (six sessions/year), distance learning, educational conferences, and newly developed lifestyle medicine rotations at the Institute of Lifestyle Medicine, the Yale-Griffin Prevention Research Center, and the Integrative Medicine Center. We used a number of tools to assess residents' progress including Objective Structured Clinical Examinations (OSCEs), self-assessments, and logs of personal health habits. A total of 20 residents participated in the lifestyle medicine training between 2010 and 2013. There was a 15% increase in residents' discussions of lifestyle issues with their patients based on their baseline and follow-up surveys. The performance of preventive medicine residents on OSCEs increased each year they were in the program (average OSCE score: PGY1 73%, PGY2 83%, PGY3 87%, and PGY4 91%, p=0.01). Our internal medicine and preliminary residents served as a control, since they did participate in didactics but not in lifestyle medicine rotations. Internal medicine and preliminary residents who completed the same OSCEs had a slightly lower average score (76%) compared with plural for resident, preventive medicine residents (80%). However, this difference did not reach statistical significance (p=0.11). Incorporating the lifestyle medicine curriculum is feasible for preventive medicine training allowing residents to improve their health behavior change discussions with patients as well as their own personal health habits.

Performance criteria for emergency medicine residents: a job analysis.

Science.gov (United States)

Blouin, Danielle; Dagnone, Jeffrey Damon

2008-11-01

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

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.

Residency programs and the outlook for occupational and environmental medicine in Korea.

Science.gov (United States)

Lee, Youngil; Kim, Jungwon; Chae, Yoomi

2015-01-01

This study investigated the implementation of training courses and the overall outlook for occupational and environmental medicine (OEM) in Korea. We described the problems facing OEM residency programs in Korea, and reviewed studies dealing with the specialty of occupational health in developed countries in order to suggest directions of improvement for the OEM training courses. We surveyed 125 OEM residents using a questionnaire in August 2012. A total of 23 questions about the training environment, residency programs, preferred institutions for post-licensure employment, and the outlook for OEM specialists were included in the questionnaire and analyzed according to the type of training institution and residency year. Responses from 88 residents (70.4 %) were analyzed. The major responsibilities of OEM residents were found to vary depending on whether they were trained in research institutes or in hospitals. OEM residents had a lower level of satisfaction with the following training programs: toxicology practice (measurements of biological markers, metabolites, and working environments), and OEM practice (environmental diseases and clinical training involving surgery). When asked about their eventual place of employment, OEM residents preferred institutions providing special health examinations or health management services. OEM residents reported a positive outlook for OEM over the next 5 years, but a negative outlook for the next 10 years. Although a standardized training curriculum for OEM residents exists, this study found differences in the actual training courses depending on the training institution. We plan to standardize OEM training by holding a regional conference and introducing open training methods, such as an open hospital system. Use of Korean-language OEM textbook may also reduce differences in the educational programs of each training institution. Toxicology practice, environmental diseases, and clinical training in surgery are areas that

The current and ideal state of mental health training: pediatric resident perspectives.

Science.gov (United States)

Hampton, Elisa; Richardson, Joshua E; Bostwick, Susan; Ward, Mary J; Green, Cori

2015-01-01

PHENOMENON: Mental health (MH) problems are prevalent in the pediatric population, and in a setting of limited resources, pediatricians need to provide MH care in the primary medical home yet are uncomfortable doing so citing a lack of training during residency as one barrier. The purpose of this study is to describe pediatric residents' experiences and perspectives on the current and ideal states of MH training and ideas for curriculum development to bridge this gap. A qualitative study using focus groups of pediatric residents from an urban academic medical center was performed. Audio recordings were transcribed and analyzed using a grounded theory approach. Twenty-six residents participated in three focus groups, which is when thematic saturation was achieved. The team generated five major themes: capabilities, comfort, organizational capacity, coping, and education. Residents expressed uncertainty at every step of an MH visit. Internal barriers identified included low levels of comfort and negative emotional responses. External barriers included a lack of MH resources and mentorship in MH care, or an inadequate organizational capacity. These internal and external barriers resulted in a lack of perceived capability in handling MH issues. In response, residents reported inadequate coping strategies, such as ignoring MH concerns. To build knowledge and skills, residents prefer educational modalities including didactics, experiential learning through collaborations with MH specialists, and tools built into patient care flow. Insights: Pediatric residency programs need to evolve in order to improve resident training in MH care. The skills and knowledge requested by residents parallel the American Academy of Pediatrics statement on MH competencies. Models of collaborative care provide similar modalities of learning requested by residents. These national efforts have not been operationalized in training programs yet may be useful for curriculum development and

Career Interests of Canadian Psychiatry Residents: What Makes Residents Choose a Research Career?

Science.gov (United States)

Laliberté, Vincent; Rapoport, Mark J.; Andrew, Melissa; Davidson, Marla

2016-01-01

Objectives: Training future clinician-researchers remains a challenge faced by Canadian psychiatry departments. Our objectives were to determine the prevalence of residents interested in pursuing research and other career options as part of their practice, and to identify the factors associated with interest in research. Method: Data from a national online survey of 207 Canadian psychiatry residents from a total of 853 (24.3% response rate) were examined. The main outcome was interest in research as part of residents’ future psychiatrist practice. Bivariate and multivariate analyses were performed to identify demographic and vocational variables associated with research interest. Results: Interest in research decreases by 76% between the first and fifth year of psychiatry residency (OR 0.76 per year, 95% CI 0.60 to 0.97). Training in a department with a residency research track did not correlate with increased research interest (χ2 = 0.007, df = 1, P = 0.93). Conclusions: Exposing and engaging psychiatry residents in research as early as possible in residency training appears key to promoting future research interest. Psychiatry residency programs and research tracks could consider emphasizing research training initiatives and protected research time early in residency. PMID:27253699

Residency Training in Robotic General Surgery: A Survey of Program Directors

Directory of Open Access Journals (Sweden)

Lea C. George

2018-01-01

Full Text Available Objective. Robotic surgery continues to expand in minimally invasive surgery; however, the literature is insufficient to understand the current training process for general surgery residents. Therefore, the objectives of this study were to identify the current approach to and perspectives on robotic surgery training. Methods. An electronic survey was distributed to general surgery program directors identified by the Accreditation Council for Graduate Medical Education website. Multiple choice and open-ended questions regarding current practices and opinions on robotic surgery training in general surgery residency programs were used. Results. 20 program directors were surveyed, a majority being from medium-sized programs (4–7 graduating residents per year. Most respondents (73.68% had a formal robotic surgery curriculum at their institution, with 63.16% incorporating simulation training. Approximately half of the respondents believe that more time should be dedicated to robotic surgery training (52.63%, with simulation training prior to console use (84.21%. About two-thirds of the respondents (63.16% believe that a formal robotic surgery curriculum should be established as a part of general surgery residency, with more than half believing that exposure should occur in postgraduate year one (55%. Conclusion. A formal robotics curriculum with simulation training and early surgical exposure for general surgery residents should be given consideration in surgical residency training.

Resident evaluation of clinical teachers based on teachers' certification.

Science.gov (United States)

Steiner, Ivan P; Yoon, Philip W; Kelly, Karen D; Diner, Barry M; Donoff, Michel G; Mackey, Duncan S; Rowe, Brian H

2003-07-01

To examine the influence of emergency medicine (EM) certification of clinical teaching faculty on evaluations provided by residents. A prospective cohort analysis was conducted of assessments between July 1994 and July 2000 on residents' evaluations of EM faculty at the University of Alberta, Edmonton, Canada. Resident- and faculty-related variables were entered anonymously using the validated evaluation tool (ER Scale). Credentialing and demographic information on EM faculty was supplemented by data obtained through a nine-question survey. Groups were compared using ANOVA. The 562 residents returned 705 (91%) valid evaluation sheets on 115 EM faculty members. The four domains of didactic teaching, clinical teaching, approachability, and helpfulness were assessed. The majority of ratings were in the very good or superb categories for each domain. Instructors with certification in EM had higher scores in didactic, clinical teaching compared with others, and teachers without national certification scored lower in the helpful and approachable categories (p certifications either through training or practice eligibility did not affect scores. Instructors under the age of 40 years had higher scores than the older age groups in three of four categories (p certification in EM, academic track, rotation year, and site are all correlated with better teaching performance.

Resident iPad use: has it really changed the game?

Science.gov (United States)

Berkowitz, Seth J; Kung, Justin W; Eisenberg, Ronald L; Donohoe, Kevin; Tsai, Leo L; Slanetz, Priscilla J

2014-02-01

The purpose of this study was to assess residents' usage patterns and opinions of the iPad as a tool for radiology education and clinical practice at an academic medical center. All 38 radiology residents in our radiology program (postgraduate years 2 to 5) were provided with iPad 2 tablets and subscriptions to e-Anatomy and STATdx. After 6 months of device use, residents were surveyed to assess their opinions regarding the technology as a tool for education and clinical practice. A total of 36 residents (95%) completed the survey. Eighty-six percent reported daily iPad use. Radiology-specific applications, particularly e-Anatomy, were used weekly or daily by 88% of respondents. Most preferred to read journal articles on the iPad (70%), but the number of respondents preferring to read textbooks on the iPad (48.5%) compared with the traditional bound form (48.5%) was evenly divided. Residents were also divided on the clinical utility of the iPad. Most had not used the iPad to view radiologic examinations (75%). Fewer than half (47%) used their iPads during readout. Finally, only 12% had used the iPad to edit dictated reports. The iPad has generated excitement within the radiology community, particularly among resident educators, who are increasingly recognizing the unique needs of "millennial learners." This study showed that the majority of residents at the authors' institution have incorporated the iPad as an educational tool and use it as a learning aid. Incorporation of the iPad into clinical workflow has been less pronounced. Copyright © 2014 American College of Radiology. Published by Elsevier Inc. All rights reserved.

Ontario Radiation Oncology Residents' Needs in the First Postgraduate Year-Residents' Perspective Survey

International Nuclear Information System (INIS)

Szumacher, Ewa; Warner, Eiran; Zhang Liying; Kane, Gabrielle; Ackerman, Ida; Nyhof-Young, Joyce; Agboola, Olusegun; Metz, Catherine de; Rodrigues, George; Voruganti, Sachi; Rappolt, Susan

2007-01-01

Purpose: To assess radiation oncology residents' needs and satisfaction in their first postgraduate year (PGY-1) in the province of Ontario. Methods and Materials: Of 62 radiation oncology residents, 58 who had completed their PGY-1 and were either enrolled or had graduated in 2006 were invited to participate in a 31-item survey. The questionnaire explored PGY-1 residents' needs and satisfaction in four domains: clinical workload, faculty/learning environment, stress level, and discrimination/harassment. The Fisher's exact and Wilcoxon nonparametric tests were used to determine relationships between covariate items and summary scores. Results: Of 58 eligible residents, 44 (75%) responded. Eighty-four percent of residents felt that their ward and call duties were appropriate. More than 50% of respondents indicated that they often felt isolated from their radiation oncology program. Only 77% agreed that they received adequate feedback, and 40% received sufficient counseling regarding career planning. More than 93% of respondents thought that faculty members had contributed significantly to their learning experience. Approximately 50% of residents experienced excessive stress and inadequate time for leisure or for reading the medical literature. Less than 10% of residents indicated that they had been harassed or experienced discrimination. Eighty-three percent agreed or strongly agreed that their PGY-1 experience had been outstanding. Conclusions: Most Ontario residents were satisfied with their PGY-1 training program. More counseling by radiation oncology faculty members should be offered to help residents with career planning. The residents might also benefit from more exposure to 'radiation oncology' and an introduction to stress management strategies

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...

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.

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.

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 subtest ( F =3.37-4.38, p motor skills than were children with even IQD and those with discrepantly higher VIQ, and vice versa. IQD (PIQ - VIQ) had significant positive correlations with the fine motor domain and fine motor subtests of the CDIIT ( r =0.18-0.29, p motor skills in preschool-aged children with ASD. This study suggests important implications for clinicians, therapists, and researchers: discrepantly higher PIQ could be related to better visual-motor coordination, and discrepantly higher VIQ could be related to poor visual-motor coordination. Furthermore, the results support that when therapists are working with preschool-aged children with ASD who are developing fine motor skills or undertaking fine motor tasks related to visual-motor coordination, they may need to pay attention to the children's IQD.

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

Science.gov (United States)

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

2017-12-01

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

When the Reading Room Meets the Team Room: Resident Perspectives From Radiology and Internal Medicine on the Effect of Personal Communication After Implementing a Resident-Led Radiology Rounds.

Science.gov (United States)

Klobuka, Andrew J; Lee, John; Buranosky, Raquel; Heller, Matthew

2018-02-13

Current radiology and internal medicine (IM) residents have trained to varying degrees depending on program in the post picture archiving and communication systems implementation era and thus have largely missed out on the benefits of in-person, 2-way communication between radiologists and consulting clinicians. The purpose of this study is to broadly explore resident perspectives from these groups on the desire for personal contact between radiologists and referring physicians and the effect of improved contact on clinical practice. A radiology rounds was implemented in which radiology residents travel to the IM teaching service teams to discuss their inpatients and review ordered imaging biweekly. Surveys were given to both cohorts following 9 months of implementation. A total of 23/49 diagnostic radiology (DR) and 72/197 IM residents responded. In all, 83% of DR and 96% of IM residents desired more personal contact between radiologists and clinicians. Of all, 92% of DR residents agree that contact with referring clinicians changes their approach to a study, 96% of IM residents agree that personal contact with a radiologist has changed patient management in a way that they otherwise would not have done having simply read a report, 85% of DR residents report that more clinician contact will improve resource use, and 96% report that it will improve care quality. Furthermore, 99% of IM residents report that increased access to a radiologist would make selecting the most appropriate imaging study easier in various clinical scenarios. A majority of IM residents prefer radiology reports that provide specific next-step recommendations and that include arrows/key-image series. We conclude that the newest generation of physicians is already attuned to the value of a radiologist who plays an active, in-person role in the clinical decision-making process. Copyright © 2018 Elsevier Inc. All rights reserved.

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

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...

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.

Effectiveness of a 2-year menopause medicine curriculum for obstetrics and gynecology residents.

Science.gov (United States)

Christianson, Mindy S; Washington, Chantel I; Stewart, Katherine I; Shen, Wen

2016-03-01

Previous work has shown American obstetrics and gynecology (OB/GYN) residents are lacking in menopause training. Our objective was to assess the effectiveness of a 2-year menopause medicine curriculum in improving OB/GYN residents' knowledge and self-assessed competency in menopause topics. We developed a menopause medicine-teaching curriculum for OB/GYN residents at our academic hospital-based residency program. The 2-year curriculum was composed of year 1: four 1-hour lectures and one 2-hour lab with cases presentations, and year 2: three 1-hour lectures and one 2-hour lab. Core topics included menopause physiology, hormone therapy, breast health, bone health, cardiovascular disease, and autoimmune disease. Pre- and posttests assessed resident knowledge and comfort in core topics, and a pre- and postcurriculum survey assessed utility and learning satisfaction. From July 2011 to June 2013, 34 OB/GYN residents completed the menopause curriculum annually with an average attendance at each module of 23 residents. Pre-/posttest scores improved from a mean pretest score of 57.3% to a mean posttest score of 78.7% (P menopause patients with 75.8% reporting feeling "barely comfortable" and 8.4% feeling "not at all comfortable." After the 2-year curriculum, 85.7% reported feeling "comfortable/very comfortable" taking care of menopause patients. The majority of residents (95.2%) reported the menopause curriculum was "extremely useful." A 2-year menopause medicine curriculum for OB/GYN residents utilizing lectures and a lab with case studies is an effective modality to improve resident knowledge required to manage menopause patients.

The Impact of Library Resources and Services on the Scholarly Activity of Medical Faculty and Residents.

Science.gov (United States)

Quesenberry, Alexandria C; Oelschlegel, Sandy; Earl, Martha; Leonard, Kelsey; Vaughn, Cynthia J

2016-01-01

Librarians at an academic medical center library gathered data to determine if library services and resources impacted scholarly activity. A survey was developed and sent out to faculty and residents asking how they used the library during scholarly activity. Sixty-five faculty members and residents responded to the survey. The majority of respondents involved with scholarly activity use the library's services and resources. PubMed is the most frequently used database. The positive results show the library impacts the scholarly activity of medical faculty and residents.

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

Science.gov (United States)

Einstein, Evan Hy; Klepacz, Lidia

2017-01-01

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. 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 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. 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.

Linking Informant Discrepancies to Observed Variations in Young Children's Disruptive Behavior

Science.gov (United States)

De Los Reyes, Andres; Henry, David B.; Tolan, Patrick H.; Wakschlag, Lauren S.

2009-01-01

Prior work has not tested the basic theoretical notion that informant discrepancies in reports of children's behavior exist, in part, because different informants observe children's behavior in different settings. We examined patterns of observed preschool disruptive behavior across varying social contexts in the laboratory and whether they…

Global health training and international clinical rotations during residency: current status, needs, and opportunities.

Science.gov (United States)

Drain, Paul K; Holmes, King K; Skeff, Kelley M; Hall, Thomas L; Gardner, Pierce

2009-03-01

Increasing international travel and migration have contributed to globalization of diseases. Physicians today must understand the global burden and epidemiology of diseases, the disparities and inequities in global health systems, and the importance of cross-cultural sensitivity. To meet these needs, resident physicians across all specialties have expressed growing interest in global health training and international clinical rotations. More residents are acquiring international experience, despite inadequate guidance and support from most accreditation organizations and residency programs. Surveys of global health training, including international clinical rotations, highlight the benefits of global health training as well as the need for a more coordinated approach. In particular, international rotations broaden a resident's medical knowledge, reinforce physical examination skills, and encourage practicing medicine among underserved and multicultural populations. As residents recognize these personal and professional benefits, a strong majority of them seek to gain international clinical experience. In conclusion, with feasible and appropriate administrative steps, all residents can receive global health training and be afforded the accreditation and programmatic support to participate in safe international rotations. The next steps should address accreditation for international rotations and allowance for training away from continuity clinics by residency accreditation bodies, and stipend and travel support for six or more weeks of call-free elective time from residency programs.

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.

Affective Evaluations of Exercising: The Role of Automatic-Reflective Evaluation Discrepancy.

Science.gov (United States)

Brand, Ralf; Antoniewicz, Franziska

2016-12-01

Sometimes our automatic evaluations do not correspond well with those we can reflect on and articulate. We present a novel approach to the assessment of automatic and reflective affective evaluations of exercising. Based on the assumptions of the associative-propositional processes in evaluation model, we measured participants' automatic evaluations of exercise and then shared this information with them, asked them to reflect on it and rate eventual discrepancy between their reflective evaluation and the assessment of their automatic evaluation. We found that mismatch between self-reported ideal exercise frequency and actual exercise frequency over the previous 14 weeks could be regressed on the discrepancy between a relatively negative automatic and a more positive reflective evaluation. This study illustrates the potential of a dual-process approach to the measurement of evaluative responses and suggests that mistrusting one's negative spontaneous reaction to exercise and asserting a very positive reflective evaluation instead leads to the adoption of inflated exercise goals.

Enhancing DSN Operations Efficiency with the Discrepancy Reporting Management System (DRMS)

Science.gov (United States)

Chatillon, Mark; Lin, James; Cooper, Tonja M.

2003-01-01

The DRMS is the Discrepancy Reporting Management System used by the Deep Space Network (DSN). It uses a web interface and is a management tool designed to track and manage: data outage incidents during spacecraft tracks against equipment and software known as DRs (discrepancy Reports), to record "out of pass" incident logs against equipment and software in a Station Log, to record instances where equipment has be restarted or reset as Reset records, and to electronically record equipment readiness status across the DSN. Tracking and managing these items increases DSN operational efficiency by providing: the ability to establish the operational history of equipment items, data on the quality of service provided to the DSN customers, the ability to measure service performance, early insight into processes, procedures and interfaces that may need updating or changing, and the capability to trace a data outage to a software or hardware change. The items listed above help the DSN to focus resources on areas of most need.

[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.

Skeletal anteroposterior discrepancy and vertical type effects on lower incisor preoperative decompensation and postoperative compensation in skeletal Class III patients.

Science.gov (United States)

Ahn, Hyo-Won; Baek, Seung-Hak

2011-01-01

To determine the initial compensation, preoperative decompensation, and postoperative compensation of the lower incisors according to the skeletal anteroposterior discrepancy and vertical type in skeletal Class III patients. The samples consisted of 68 skeletal Class III patients treated with two-jaw surgery and orthodontic treatment. Lateral cephalograms were taken before preoperative orthodontic treatment (T0) and before surgery (T1) and after debonding (T2). According to skeletal anteroposterior discrepancy/vertical type (ANB, criteria  =  -4°; SN-GoMe, criteria  =  35°) at the T0 stage, the samples were allocated into group 1 (severe anteroposterior discrepancy/hypodivergent vertical type, N  =  17), group 2 (moderate anteroposterior discrepancy/hypodivergent vertical type, N  =  17), group 3 (severe anteroposterior discrepancy/hyperdivergent vertical type, N  =  17), or group 4 (moderate anteroposterior discrepancy/hyperdivergent vertical type, N  =  17). After measurement of variables, one-way analysis of variance with Duncan's multiple comparison test, crosstab analysis, and Pearson correlation analysis were performed. At T0, groups 3 and 2 exhibited the most and least compensated lower incisors. In group 2, good preoperative decompensation and considerable postoperative compensation resulted in different values for T0, T1, and T2 (IMPA, T0 lower incisors in Class III patients.

Longitudinal linkages among parent-child acculturation discrepancy, parenting, parent-child sense of alienation, and adolescent adjustment in Chinese immigrant families.

Science.gov (United States)

Kim, Su Yeong; Chen, Qi; Wang, Yijie; Shen, Yishan; Orozco-Lapray, Diana

2013-05-01

Parent-child acculturation discrepancy is a risk factor in the development of children in immigrant families. Using a longitudinal sample of Chinese immigrant families, the authors of the current study examined how unsupportive parenting and parent-child sense of alienation sequentially mediate the relationship between parent-child acculturation discrepancy and child adjustment during early and middle adolescence. Acculturation discrepancy scores were created using multilevel modeling to take into account the interdependence among family members. Structural equation models showed that during early adolescence, parent-child American orientation discrepancy is related to parents' use of unsupportive parenting practices; parents' use of unsupportive parenting is related to increased sense of alienation between parents and children, which in turn is related to more depressive symptoms and lower academic performance in Chinese American adolescents. These patterns of negative adjustment established in early adolescence persist into middle adolescence. This mediating effect is more apparent among father-adolescent dyads than among mother-adolescent dyads. In contrast, parent-child Chinese orientation discrepancy does not demonstrate a significant direct or indirect effect on adolescent adjustment, either concurrently or longitudinally. The current findings suggest that during early adolescence, children are more susceptible to the negative effects of parent-child acculturation discrepancy; they also underscore the importance of fathering in Chinese immigrant families.

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

Reproductive Psychiatry Residency Training: A Survey of Psychiatric Residency Program Directors.

Science.gov (United States)

Osborne, Lauren M; MacLean, Joanna V; Barzilay, Erin Murphy; Meltzer-Brody, Samantha; Miller, Laura; Yang, Sarah Nagle

2018-04-01

The reproductive life cycle has unique influences on the phenotypic expression of mental illness in women. Didactic and clinical training focused on these sex-specific influences should be a vital component of the education of future psychiatrists. The authors sought to determine the current state of and attitudes toward reproductive psychiatry in resident education. The authors administered a web-based survey to psychiatry residency training directors. They assessed the availability of both mandated and optional didactic and clinical training experiences in reproductive psychiatry. Fifty residency program directors answered the survey, for a response rate of 28%. More than half of residency program directors (59%) reported requiring some training in reproductive psychiatry. Both the breadth and depth of topics covered varied greatly among programs. Lack of time (48%) and lack of qualified faculty (26%) were the most frequently cited barriers to more training. Only 40% of residency directors surveyed agreed that all residents should be competent in reproductive psychiatry. These findings suggest that specific training in reproductive psychiatry is inconsistent in US residency programs, and that training that does exist varies considerably in clinical time and content. Given that women comprise more than 50% of all psychiatric patients and most women will menstruate, give birth, and undergo menopause, future psychiatrists would benefit from more systematic instruction in this area. The authors propose the development of a national, standardized reproductive psychiatry curriculum to address this gap and aid in producing psychiatrists competent to treat women at all stages of life.

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

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.

Military Internal Medicine Resident Decision to Apply to Fellowship and Extend Military Commitment.

Science.gov (United States)

Barsoumian, Alice E; Hartzell, Joshua D; Bonura, Erin M; Ressner, Roseanne A; Whitman, Timothy J; Yun, Heather C

2018-02-06

Nationally, the number of internal medicine physicians practicing in primary care has decreased amidst increasing interest in hospitalist medicine. Current priorities in the Military Health System include access to primary care and retention of trained personnel. Recently, we have conducted a study of military internal medicine residents' decision to enter infectious disease. As part of our larger effort, we saw an opportunity to characterize factors impacting decision making of internal medicine residents' desire to apply for subspecialty training and to extend active duty service obligations. Questions were developed after discussion with various military graduate medical education and internal medicine leaders, underwent external review, and were added to a larger question set. The survey link was distributed electronically to all U.S. military affiliated residencies' graduating internal medicine residents in December 2016-January 2017. Data were analyzed by decision to apply to fellowship and decision to extend military obligation using Fisher's exact test or Pearon's chi-square test. Sixty-eight residents from 10 of 11 military residency programs responded, for a response rate of 51%. The majority (62%) applied to fellowship to start after residency completion. Reasons cited for applying to fellowship included wanting to become a specialist as soon as possible (74%), wishing to avoid being a general internist (57%), and because they are unable to practice as a hospitalist in the military (52%). Fellowship applicants were more likely to plan to extend their military obligation than non-applicants, as did those with longer duration of military commitments. No other factors, including Uniformed Services University attendance or participation in undergraduate military experiences, were found to impact plan to extend active duty service commitment. The majority of graduating internal medicine residents apply for fellowship and report a desire to avoid being a

What Is Asthma Control? Discrepancies between Parents' Perceptions and Official Definitions

Science.gov (United States)

Dozier, Ann; Aligne, C. Andrew; Schlabach, Mary Beth

2006-01-01

National guidelines define asthma control as the prevention of asthma symptoms rather than the treatment of asthma exacerbations. We hypothesized that we would find a discrepancy between what parents consider adequate control compared to what health care professionals mean by "control." Data from a telephone survey conducted for the…

Development and Factor Structure of the Helping Professional Wellness Discrepancy Scale

Science.gov (United States)

Blount, Ashley J.; Lambie, Glenn W.

2018-01-01

The authors present the development of the Helping Professional Wellness Discrepancy Scale (HPWDS). The purpose of this article is threefold: (a) present a rationale for the HPWDS; (b) review statistical analyses procedures used to develop the HPWDS; and (c) offer implications for counselors, other helping professionals, and future research.

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

Science.gov (United States)

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

2018-04-01

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

Post-prior discrepancies in the continuum distorted wave-eikonal initial state approximation for ion-helium ionization

Energy Technology Data Exchange (ETDEWEB)

Ciappina, M F [CONICET and Departamento de Fisica, Universidad Nacional del Sur, 8000 Bahia Blanca (Argentina); Cravero, W R [CONICET and Departamento de Fisica, Universidad Nacional del Sur, 8000 Bahia Blanca (Argentina); Garibotti, C R [CONICET and Division Colisiones Atomicas, Centro Atomico Bariloche, 8400 Bariloche (Argentina)

2003-09-28

We have explored post-prior discrepancies within continuum distorted wave-eikonal initial state theory for ion-atom ionization. Although there are no post-prior discrepancies when electron-target initial and final states are exact solutions of the respective Hamiltonians, discrepancies do arise for multielectronic targets, when a hydrogenic continuum with effective charge is used for the final electron-residual target wavefunction. We have found that the prior version calculations give better results than the post version, particularly for highly charged projectiles. We have explored the reasons for this behaviour and found that the prior version shows less sensitivity to the choice of the final state. The fact that the perturbation potentials operate upon the initial state suggests that the selection of the initial bound state is relatively more important than the final continuum state for the prior version.

The pregnant female surgical resident

Directory of Open Access Journals (Sweden)

Shifflette V

2018-05-01

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

Use and utility of Web-based residency program information: a survey of residency applicants.

Science.gov (United States)

Embi, Peter J; Desai, Sima; Cooney, Thomas G

2003-01-01

The Internet has become essential to the residency application process. In recent years, applicants and residency programs have used the Internet-based tools of the National Residency Matching Program (NRMP, the Match) and the Electronic Residency Application Service (ERAS) to process and manage application and Match information. In addition, many residency programs have moved their recruitment information from printed brochures to Web sites. Despite this change, little is known about how applicants use residency program Web sites and what constitutes optimal residency Web site content, information that is critical to developing and maintaining such sites. To study the use and perceived utility of Web-based residency program information by surveying applicants to an internal medicine program. Our sample population was the applicants to the Oregon Health & Science University Internal Medicine Residency Program who were invited for an interview. We solicited participation using the group e-mail feature available through the Electronic Residency Application Service Post-Office application. To minimize the possibility for biased responses, the study was confined to the period between submission of National Residency Matching Program rank-order lists and release of Match results. Applicants could respond using an anonymous Web-based form or by reply to the e-mail solicitation. We tabulated responses, calculated percentages for each, and performed a qualitative analysis of comments. Of the 431 potential participants, 218 responded (51%) during the study period. Ninety-nine percent reported comfort browsing the Web; 52% accessed the Web primarily from home. Sixty-nine percent learned about residency Web sites primarily from residency-specific directories while 19% relied on general directories. Eighty percent found these sites helpful when deciding where to apply, 69% when deciding where to interview, and 36% when deciding how to rank order programs for the Match. Forty

Toward a Resident Personal Finance Curriculum: Quantifying Resident Financial Circumstances, Needs, and Interests.

Science.gov (United States)

McKillip, Ryan; Ernst, Michael; Ahn, James; Tekian, Ara; Shappell, Eric

2018-04-26

Introduction Resident financial health has been linked to wellness and resiliency, yet financial literacy among residents is highly variable. While some medical school curricula include budgeting and student loan education, content on managing finances as a resident is usually lacking. We sought to quantitatively assess residents' financial circumstances, needs, and interests to inform the design of a resident personal finance curriculum. Methods Surveys were sent to residents in eight specialties at an academic medical center. Likert-type responses allowed respondents to rate their level of comfort (1 = Very Uncomfortable, 7 = Very Comfortable) and interest (1 = Very Uninterested, 7 = Very Interested) in various personal finance topics including budgeting, loan repayment, disability insurance, life insurance, home buying, and retirement planning. Details regarding financial circumstances, including assets, liabilities, and insurance, were also collected. Results of questions that utilized a Likert-type scale are reported as median (interquartile range). Results Of 346 residents surveyed, 144 (41.6%) responded. Residents were from Internal Medicine (56, 38.9%), Pediatrics (34, 23.6%), Emergency Medicine (18, 12.5%), and other specialties (36, 25.0%). Ninety-one (63.2%) reported educational loans, with an average balance of $191,730. Credit card balances exceeding $3,000 were reported by 11 (7.6%) respondents. One-hundred-two (70.1%) reported emergency savings, but only 65 (45.1%) reported having a retirement account (average balance $27,608). Respondents rated highest comfort levels with budgeting (5[4-6]), and lowest level of comfort with disability insurance (2[2-4]) and home buying (2[2-5]). Interest in learning each topic was high (6[5-7]), with retirement planning (6[5-7]), investing (6[5-7]), and home buying (6[5-7]) the topics of highest interest. Conclusion These results highlight the deficits in personal finance literacy among residents. Future work should

Perspectives of Residents of Mashhad School of Dentistry about the Curriculum of Residency Program

Directory of Open Access Journals (Sweden)

Javad Sarabadani

2015-09-01

Full Text Available Introduction: This study was carried out to analyze the viewpoint of the residents of school of dentistry about the curriculum presented in the residency program to students of Mashhad School of Dentistry. Methods: To evaluate the perspectives of residents of dental school about the curriculum and regulations of residency program, a questionnaire was designed whose validity and reliability were confirmed by the authorities of School of Dentistry and test-retest reliability, respectively. The questionnaire was distributed among 100 residents and 80 of them completed the questionnaires. The data were analyzed by SPSS software (version 11.5. Results: A total of 43% of residents were informed of the curriculum (e.g. academic leave, transfer, removal of semester, etc.. As for the ability to write research proposal, 42.7% of residents were reported to have a favorable status, i.e. they were able to write more than 80% of their proposal. From among the residents, 30.4% had specialized English language certificate. Most of them (77% were satisfied with the professional staff, faculty members, of the faculty. Many students liked to participate in the teaching method courses of the residency program. Conclusion: Residents maintained that the curriculum in such domains as educational and research issues and special capabilities had some weak points. Thus, appropriate strategies are recommended to be applied to revise the curriculum using the residents’ views on these programs.

No Correlation Between Work-Hours and Operative Volumes--A Comparison Between United States and Danish Operative Volumes Achieved During Surgical Residency.

Science.gov (United States)

Kjærgaard, Jane; Sillesen, Martin; Beier-Holgersen, Randi

2016-01-01

Since 2003, United States residents have been limited to an 80-hour workweek. This has prompted concerns of reduced educational quality, especially inadequate operating exposure. In contrast, the Danish surgical specialty-training program mandates a cap on working hours of 37 per week. We hypothesize that there is no direct correlation between work-hours and operative volume achieved during surgical residency. To test the hypothesis, we compare Danish and US operative volumes achieved during surgical residency training. Retrospective comparative study. The data from the US population was extracted from the Accreditation Council for Graduate Medical Education database for General Surgery residents from 2012 to 2013. For Danish residents, a questionnaire with case categories matching the Accreditation Council for Graduate Medical Education categories were sent to all Danish surgeons graduating the national surgical residency program in 2012 or 2013, 54 in total. In all, 30 graduated residents (55%) responded to the Danish survey. We found no significant differences in mean total major procedures (1002.4 vs 976.9, p = 0.28) performed during residency training, but comparing average major procedures per year, the US residents achieve significantly more (132.3 vs 195.4, p work-hours and operative volumes achievable. Factors other than work-hours seem to effect on operative volumes achieved during training. Copyright © 2016 Association of Program Directors in Surgery. Published by Elsevier Inc. All rights reserved.

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

Facebook Use between College Resident Advisors' and Their Residents: A Mixed Methods Approach.

Science.gov (United States)

Kacvinsky, Lauren E; Moreno, Megan A

2014-01-01

Facebook use is nearly ubiquitous among college students. Studies have shown links between Facebook displays of depression or problem drinking and risk of these problems. This project aimed to determine whether Facebook could be used to help Resident Advisors (RAs) identify college students at risk for depression or problem drinking. Interviews were conducted with college freshmen to investigate whether they were Facebook "friends" with their RA. Focus groups were conducted with RAs to determine their views on Facebook friending their dormitory residents and using Facebook to help identify at-risk students. 72 freshmen were interviewed and 25 RAs participated in focus groups; both agreed it is common for RAs and residents to be Facebook friends. RAs commonly noted references to depression and problem drinking on residents' Facebook pages, which often led to in-person discussions with the resident. This study provides support that RAs use Facebook to identify issues that may impact their student residents. RAs emphasized benefits of in-person interactions in order to provide support and obtain additional details about the situation. Universities could consider whether providing RA education about Facebook interactions with residents merits encouragement within their existing RA training programs.

Self-Esteem and Locus of Causality as Vulnerability Factors for the Development of Actual/Ideal Self-Discrepancies in Late Childhood

OpenAIRE

Di Blas, Lisa; Cepollaro, Annunziata

2017-01-01

Self-discrepancies influence psychological well-being and self-acceptance across several domains. Middle to late childhood is a critical age for the development of self-discrepancies (SD). The present study was aimed at investigating antecedents of actual/ideal self-discrepancies in 9- to 11-year-old children by adopting a repeated measure design, with two measurement occasions. At the baseline (T1), children (N=261) completed a self-esteem questionnaire, a measure of actual/ideal SDs we deve...

The anticoagulation choices of internal medicine residents for stroke prevention in non-valvular atrial fibrillation.

Science.gov (United States)

Moulson, Nathaniel; McIntyre, William F; Oqab, Zardasht; Yazdan-Ashoori, Payam; Quinn, Kieran L; van Oosten, Erik; Hopman, Wilma M; Baranchuk, Adrian

2017-06-01

To explore the oral anticoagulation (OAC) prescribing choices of Canadian internal medicine residents, at different training levels, in comparison with the Canadian Cardiovascular Society (CCS) guidelines for non-valvular atrial fibrillation (NVAF). Cross-sectional, web-based survey, involving clinical scenarios designed to favour the use of non-vitamin K antagonists (NOACs) as per the 2014 CCS NVAF guidelines. Additional questions were also designed to determine resident attitudes towards OAC prescribing. A total of 518 internal medicine responses were analysed, with 196 postgraduate year (PGY)-1s, 169 PGY-2s and 153 PGY-3s. The majority of residents (81%) reported feeling comfortable choosing OAC, with 95% having started OAC in the past 3 months. In the initial clinical scenario involving an uncomplicated patient with a CHADS2 score of 3, warfarin was favoured over any of the NOACs by PGY-1s (81.6% vs 73.9%), but NOACs were favoured by PGY-3s (88.3% vs 83.7%). This was the only scenario where OAC choices varied by PGY year, as each of the subsequent clinical scenarios residents generally favoured warfarin over NOACs irrespective of level of training. The majority of residents stated that they would no longer prescribe warfarin once NOAC reversal agents are available, and residents felt risk of adverse events was the most important factor when choosing OAC. Canadian internal medicine residents favoured warfarin over NOACs for patients with NVAF, which is in discordance with the evidence-based CCS guidelines. This finding persisted throughout the 3 years of core internal medicine training. 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/.

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

Science.gov (United States)

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

2013-09-01

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

The influence of the residency application process on the online social networking behavior of medical students: a single institutional study.

Science.gov (United States)

Strausburg, Matthew B; Djuricich, Alexander M; Carlos, W Graham; Bosslet, Gabriel T

2013-11-01

To evaluate medical students' behavior regarding online social networks (OSNs) in preparation for the residency matching process. The specific aims were to quantify the use of OSNs by students to determine whether and how these students were changing OSN profiles in preparation for the residency application process, and to determine attitudes toward residency directors using OSNs as a screening method to evaluate potential candidates. An e-mail survey was sent to 618 third- and fourth-year medical students at Indiana University School of Medicine over a three-week period in 2012. Statistical analysis was completed using nonparametric statistical tests. Of the 30.1% (183/608) who responded to the survey, 98.9% (181/183) of students reported using OSNs. More than half, or 60.1% (110/183), reported that they would (or did) alter their OSN profile before residency matching. Respondents' opinions regarding the appropriateness of OSN screening by residency directors were mixed; however, most respondents did not feel that their online OSN profiles should be used in the residency application process. The majority of respondents planned to (or did) alter their OSN profile in preparation for the residency match process. The majority believed that residency directors are screening OSN profiles during the matching process, although most did not believe their OSN profiles should be used in the residency application process. This study implies that the more medical students perceive that residency directors use social media in application screening processes, the more they will alter their online profiles to adapt to protect their professional persona.

Discrepant feeling rules and unscripted emotion work: women coping with termination for fetal anomaly.

Science.gov (United States)

McCoyd, Judith L M

2009-10-01

The sociology of emotion is rapidly evolving and has implications for medical settings. Advancing medical technologies create new contexts for decision-making and emotional reaction that are framed by "feeling rules." Feeling rules guide not only behavior, but also how one believes one should feel, thereby causing one to attempt to bring one's authentic feelings into line with perceived feeling rules. Using qualitative data, the theoretical existence of feeling rules in pregnancy and prenatal testing is confirmed. Further examination extends this analysis: at times of technological development feeling rules are often discrepant, leaving patients with unscripted emotion work. Data from a study of women who interrupted anomalous pregnancies indicate that feeling rules are unclear when competing feeling rules are operating during times of societal and technological change. Because much of this occurs below the level of consciousness, medical and psychological services providers need to be aware of potential discrepancies in feeling rules and assist patients in identifying the salient feeling rules. Patients' struggles ease when they can recognize the discrepancies and assess their implications for decision-making and emotional response. (c) 2009 APA, all rights reserved.

Clinimetric testing in Mexican elders: associations with age, gender and place of residence

Directory of Open Access Journals (Sweden)

Lorena eTavano-Colaizzi

2014-10-01

Full Text Available Aim. To evaluate the ability of five clinimetric instruments to discriminate between subjects >60 years of age living at home versus those living in a residency.Methods. Trained nutritionists applied five instruments (Cognition/ Depression/ Functionality/ Nutrition/ Appetite to 285 subjects with majorities of women (64%, aged <80y (61% and home residents (54%.Results. Multivariable regression models were generated for each instrument using age, gender and residency as independent variables. Age was associated with worsening scores in the five instruments whereas residency showed association in three instruments, and gender in two. Score-age regressions by place of residency showed differences suggesting that Mundet residents had increasingly worse scores with increasing age, than home dwellers for Cognition, Depression and Nutrition. Also, living at home prevented the worsening of Depression with increasing age. In contrast, Functionality and Appetite deteriorated at a similar rate for home and Mundet residents suggesting an inhability of these two instruments to dicriminate between settings. Score-age regressions by gender suggested males have less cognitive problems at 60 and 80 years of age but not at 100, and better appetite than women at all ages.Conclusions. Increasing age proved to be associated to worsening scores in the five instruments but only three were able to detect differences according to setting. An interesting observation was that living at home appeared to prevent the Depression increase with increasing age seen in Mundet residents.

Resident Perception of Technical Skills Education and Preparation for Independent Practice.

Science.gov (United States)

Odell, David D; Macke, Ryan A; Tchantchaleishvili, Vakhtang; Loor, Gabriel; Nelson, Jennifer S; LaPar, Damien J; LaZar, John F; Wei, Benjamin; DeNino, Walter F; Berfield, Kathleen; Stein, William; Youssef, Samuel J; Nguyen, Tom C

2015-12-01

Surgical skills are traditionally taught and practiced in the operating room. However, changes in health care policy and outcome-based evaluation have decreased trainee operative autonomy. We examined cardiothoracic residents' perceptions of operative experience and the role of simulation. The In-Training Examination (ITE) is taken each year by all residents. Completion of a 30-question preexamination survey is mandatory, ensuring a 100% response rate. Survey data related to operative experience, career preparedness, and surgical simulation were analyzed. Opinion questions were asked on a 5-point Likert scale. Respondents were grouped into three cohorts by training paradigm (2-year versus 3-year traditional programs and 6-year integrated programs). In all, 314 respondents (122 2-year, 96 3-year, and 96 6-year integrated) completed the survey. Of the three groups, residents in 3-year programs had the highest levels of satisfaction. Advanced training was most common among residents in 6-year integrated programs (66%, versus 49% for 2-year and 26% for 3-year programs; p = 0.63). Desire to specialize drove further training (97%), with 2% stating further training was needed owing to inadequacy and 1% owing to a poor job market. In all assessed categories, the majority of residents believed that simulation did not completely replicate the educational value of an operative case. Cardiothoracic residents largely feel well prepared for the transition to practice under the current educational paradigm. Although many residents seek advanced training, it seems driven by the desire for specialization. Residents view simulation as an adjunct to traditional intraoperative education, but not as a viable replacement. Further study is necessary to better understand how best to integrate simulation with operative experience. Copyright © 2015 The Society of Thoracic Surgeons. Published by Elsevier Inc. All rights reserved.

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.

. 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

Effects of a Short Video-Based Resident-as-Teacher Training Toolkit on Resident Teaching.

Science.gov (United States)

Ricciotti, Hope A; Freret, Taylor S; Aluko, Ashley; McKeon, Bri Anne; Haviland, Miriam J; Newman, Lori R

2017-10-01

To pilot a short video-based resident-as-teacher training toolkit and assess its effect on resident teaching skills in clinical settings. A video-based resident-as-teacher training toolkit was previously developed by educational experts at Beth Israel Deaconess Medical Center, Harvard Medical School. Residents were recruited from two academic hospitals, watched two videos from the toolkit ("Clinical Teaching Skills" and "Effective Clinical Supervision"), and completed an accompanying self-study guide. A novel assessment instrument for evaluating the effect of the toolkit on teaching was created through a modified Delphi process. Before and after the intervention, residents were observed leading a clinical teaching encounter and scored using the 15-item assessment instrument. The primary outcome of interest was the change in number of skills exhibited, which was assessed using the Wilcoxon signed-rank test. Twenty-eight residents from two academic hospitals were enrolled, and 20 (71%) completed all phases of the study. More than one third of residents who volunteered to participate reported no prior formal teacher training. After completing two training modules, residents demonstrated a significant increase in the median number of teaching skills exhibited in a clinical teaching encounter, from 7.5 (interquartile range 6.5-9.5) to 10.0 (interquartile range 9.0-11.5; P<.001). Of the 15 teaching skills assessed, there were significant improvements in asking for the learner's perspective (P=.01), providing feedback (P=.005), and encouraging questions (P=.046). Using a resident-as-teacher video-based toolkit was associated with improvements in teaching skills in residents from multiple specialties.

Attending Physician Remote Access of the Electronic Health Record and Implications for Resident Supervision: A Mixed Methods Study.

Science.gov (United States)

Martin, Shannon K; Tulla, Kiara; Meltzer, David O; Arora, Vineet M; Farnan, Jeanne M

2017-12-01

Advances in information technology have increased remote access to the electronic health record (EHR). Concurrently, standards defining appropriate resident supervision have evolved. How often and under what circumstances inpatient attending physicians remotely access the EHR for resident supervision is unknown. We described a model of attending remote EHR use for resident supervision, and quantified the frequency and magnitude of use. Using a mixed methods approach, general medicine inpatient attendings were surveyed and interviewed about their remote EHR use. Frequency of use and supervisory actions were quantitatively examined via survey. Transcripts from semistructured interviews were analyzed using grounded theory to identify codes and themes. A total of 83% (59 of 71) of attendings participated. Fifty-seven (97%) reported using the EHR remotely, with 54 (92%) reporting they discovered new clinical information not relayed by residents via remote EHR use. A majority (93%, 55 of 59) reported that this resulted in management changes, and 54% (32 of 59) reported making immediate changes by contacting cross-covering teams. Six major factors around remote EHR use emerged: resident, clinical, educational, personal, technical, and administrative. Attendings described resident and clinical factors as facilitating "backstage" supervision via remote EHR use. In our study to assess attending remote EHR use for resident supervision, attendings reported frequent remote use with resulting supervisory actions, describing a previously uncharacterized form of "backstage" oversight supervision. Future work should explore best practices in remote EHR use to provide effective supervision and ultimately improve patient safety.

Efficacy of neurosurgery resident education in the new millennium: the 2008 Council of State Neurosurgical Societies post-residency survey results.

Science.gov (United States)

Mazzola, Catherine A; Lobel, Darlene A; Krishnamurthy, Satish; Bloomgarden, Gary M; Benzil, Deborah L

2010-08-01

Neurosurgical residency training paradigms have changed in response to Accreditation Council for Graduate Medical Education mandates and demands for quality patient care. Little has been done to assess resident education from the perspective of readiness to practice. To assess the efficacy of resident training in preparing young neurosurgeons for practice. In response to Resolution V-2007F of the Council of State Neurosurgical Societies, a survey was developed for neurosurgeons who applied for oral examination, Part II of the American Board of Neurological Surgery boards, in 2002 through 2007 (N = 800). The survey was constructed in "survey monkey" format and sent to 775 of 800 (97%) neurosurgeons for whom e-mail addresses were available. The response rate was 30% (233/775). Most neurosurgeons were board certified (n = 226, 97%). General neurosurgical training was judged as adequate by a large majority (n = 188, 80%). Sixty-percent chose to pursue at least 1 additional year of fellowship training (n = 138, 60%). Surgical skills training was acceptable, but 6 skill-technique areas were reported to be inadequate (endovascular techniques, neurosurgical treatment of pain, stereotactic radiosurgery, epilepsy surgery, cranial base surgery, and stereotactic neurosurgery). Respondents also noted inadequate education in contract negotiation, practice evaluation, and management. The study suggests that neurosurgeons believed that they were well trained in their surgical skills except for some areas of subspecialization. However, there is a significant need for improvement of resident training in the areas of socioeconomic and medicolegal education. Continued evaluation of the efficacy of neurosurgical education is important.

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

OpenAIRE

Jorm Anthony F; Christensen Helen; Griffiths Kathleen M

2009-01-01

Abstract Background Although there have been many population studies of mental health literacy, little is known about the mental health literacy of people who reside in rural areas. This study sought to determine the impact of remoteness on public knowledge of depression and schizophrenia. Methods The mental health literacy of residents of major cities, inner regional, and outer-remote (including outer regional, remote, and very remote) regions were compared using data from a 2003–04 Australi...

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

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

Science.gov (United States)

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

2011-12-01

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

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

Science.gov (United States)

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

2017-07-05

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

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

Science.gov (United States)

Gersten, D

1978-11-01

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

The association between automatic thoughts about eating, the actual-ideal weight discrepancies, and eating disorders symptoms: a longitudinal study in late adolescence.

Science.gov (United States)

Zarychta, Karolina; Luszczynska, Aleksandra; Scholz, Urte

2014-06-01

This study tested the reciprocal relationships between automatic thoughts about eating and the actual-ideal weight discrepancies, and their role in the formation and maintenance of eating disorders (ED) symptoms in a non-clinical sample of adolescents. In particular, we investigated whether thoughts about eating mediated the effects of weight discrepancies on ED formation and whether weight discrepancies mediated the effects of thoughts about eating on ED formation were investigated. Data were collected three times, with a 2-month interval between Time 1 (T1) and Time 2 (T2), and a 9-month interval between T2 and Time 3 (T3). Adolescents (N = 55) aged 15-18 filled out the SCOFF Questionnaire, assessing eating disorders symptoms, and the Eating Disorder Thoughts Questionnaire, evaluating automatic thoughts. To assess weight discrepancies questions about actual (subjectively reported) and ideal body weight were asked followed by objective measurement of height and weight. Negative thoughts about eating (T2) mediated the relation between weight discrepancies (T1) and symptoms of anorexia and bulimia (T3). In addition, the association between negative thoughts (T1) and eating disorders symptoms (T3) was mediated by weight discrepancies (T2). The negative thoughts and the actual (both subjectively reported and objectively measured)-ideal weight discrepancies constitute a vicious cycle, related to higher ED symptoms. Prevention of eating disorders should be directed to adolescents who manifest large weight discrepancies or high levels of negative thoughts about eating, as they are at risk for developing eating disorder symptoms.

Evidence-based practice in radiology: Knowledge, attitude and perceived barriers to practice among residents in radiology

Energy Technology Data Exchange (ETDEWEB)

Anuradha, Chandramohan, E-mail: anuradhachandramohan@gmail.com [Department of Radiology, Christian Medical College, Vellore, Tamil Nadu 632 004 (India); Jacob, K.S., E-mail: ksjacob@cmcvellore.ac.in [Department of Psychiatry, Christian Medical College, Vellore, Tamil Nadu 632 004 (India); Specialist Mental Health Service for Older People, Suite 106, 64–68 Derby Street, Kingswood, Penrith 2750 (Australia); Shyamkumar, N.K., E-mail: aparnashyam@gmail.com [Department of Radiology, Christian Medical College, Vellore, Tamil Nadu 632 004 (India); Sridhar, Gibikote, E-mail: gibikote@cmcvellore.ac.in [Department of Radiology, Christian Medical College, Vellore, Tamil Nadu 632 004 (India)

2013-05-15

Aim: We examinted the attitude, knowledge and perceived barriers to evidence-based practice of radiology (EBPR) among residents in radiology. Study design and setting: We used the McColl questionnaire (1) and the BARRIERS scale (2) to assess the issues among radiology trainees attending an annual refresher course. Ninety six residents from 32 medical colleges from Southern India attended the course. Results: Eighty (83.3%) residents, 55 male and 25 female of age range 24–34 years, consented and returned the questionnaire. The majority of the participants had a positive attitude towards EBPR. However, 45% were unaware of sources for evidence based literature although many had access to Medline (45%) and the internet (80%). The majority (70%) were aware of the common technical terms (e.g. odds ratio, absolute and relative risk) but other complex details (e.g. meta-analysis, clinical effectiveness, confidence interval, publication bias and number needed to treat) were poorly understood. Though majority of residents (59%) were currently following guidelines and protocols laid by colleagues within their departments, 70% of residents were interested in learning the skills of EBPR and were willing to appraise primary literature or systematic reviews by themselves. Insufficient time on the job to implement new ideas (70.1%); relevant literature is not being complied in one place (68.9%); not being able to understand statistical methods (68.5%) were considered to be the major barriers to EBPR. Training in critical appraisal significantly influence usage of bibliographic databases (p < 0.0001). Attitude of collegues (p = 0.006) influenced attitude of the trainees towards EBPR. Those with higher knowledge scores (p = 0.02) and a greater awareness of sources for seeking evidence based literature (p = 0.05) held stronger beliefs that EBPR significantly improved patient care. Conclusions: The large knowledge gap related to EBPR suggests the need to incorporate structured

Evidence-based practice in radiology: Knowledge, attitude and perceived barriers to practice among residents in radiology

International Nuclear Information System (INIS)

Anuradha, Chandramohan; Jacob, K.S.; Shyamkumar, N.K.; Sridhar, Gibikote

2013-01-01

Aim: We examinted the attitude, knowledge and perceived barriers to evidence-based practice of radiology (EBPR) among residents in radiology. Study design and setting: We used the McColl questionnaire (1) and the BARRIERS scale (2) to assess the issues among radiology trainees attending an annual refresher course. Ninety six residents from 32 medical colleges from Southern India attended the course. Results: Eighty (83.3%) residents, 55 male and 25 female of age range 24–34 years, consented and returned the questionnaire. The majority of the participants had a positive attitude towards EBPR. However, 45% were unaware of sources for evidence based literature although many had access to Medline (45%) and the internet (80%). The majority (70%) were aware of the common technical terms (e.g. odds ratio, absolute and relative risk) but other complex details (e.g. meta-analysis, clinical effectiveness, confidence interval, publication bias and number needed to treat) were poorly understood. Though majority of residents (59%) were currently following guidelines and protocols laid by colleagues within their departments, 70% of residents were interested in learning the skills of EBPR and were willing to appraise primary literature or systematic reviews by themselves. Insufficient time on the job to implement new ideas (70.1%); relevant literature is not being complied in one place (68.9%); not being able to understand statistical methods (68.5%) were considered to be the major barriers to EBPR. Training in critical appraisal significantly influence usage of bibliographic databases (p < 0.0001). Attitude of collegues (p = 0.006) influenced attitude of the trainees towards EBPR. Those with higher knowledge scores (p = 0.02) and a greater awareness of sources for seeking evidence based literature (p = 0.05) held stronger beliefs that EBPR significantly improved patient care. Conclusions: The large knowledge gap related to EBPR suggests the need to incorporate structured

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.

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

Science.gov (United States)

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

2016-01-01

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

Discrepância e acordo entre informadores na avaliação da ansiedade em crianças em idade escolar : discrepância e acordo mãe criança

OpenAIRE

Oliveira, Patrícia Isabel Simões

2011-01-01

Tese de mestrado, Psicologia (Secção de Psicologia Clínica e da Saúde - Núcleo de Psicologia Clínica da Saúde e da Doença), Universidade de Lisboa, Faculdade de Psicologia, 2011 As Perturbações de Ansiedade têm uma elevada prevalência na infância e na adolescência. Na sua avaliação são verificadas discrepâncias na informação recolhida aos vários informadores. Este trabalho teve por objectivo o estudo da discrepância e acordo mãe-criança na avaliação da ansiedade nas crianças atrav...

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

Weight-related actual and ideal self-states, discrepancies, and shame, guilt, and pride: examining associations within the process model of self-conscious emotions.

Science.gov (United States)

Castonguay, Andree L; Brunet, Jennifer; Ferguson, Leah; Sabiston, Catherine M

2012-09-01

The aim of this study was to examine the associations between women's actual:ideal weight-related self-discrepancies and experiences of weight-related shame, guilt, and authentic pride using self-discrepancy (Higgins, 1987) and self-conscious emotion (Tracy & Robins, 2004) theories as guiding frameworks. Participants (N=398) completed self-report questionnaires. Main analyses involved polynomial regressions, followed by the computation and evaluation of response surface values. Actual and ideal weight self-states were related to shame (R2 = .35), guilt (R2 = .25), and authentic pride (R2 = .08). When the discrepancy between actual and ideal weights increased, shame and guilt also increased, while authentic pride decreased. Findings provide partial support for self-discrepancy theory and the process model of self-conscious emotions. Experiencing weight-related self-discrepancies may be important cognitive appraisals related to shame, guilt, and authentic pride. Further research is needed exploring the relations between self-discrepancies and a range of weight-related self-conscious emotions. Copyright © 2012 Elsevier Ltd. All rights reserved.

The Glass Half Empty: How Emotional Exhaustion Affects the State-Trait Discrepancy in Self-Reports of Teaching Emotions.

Science.gov (United States)

Goetz, Thomas; Becker, Eva S; Bieg, Madeleine; Keller, Melanie M; Frenzel, Anne C; Hall, Nathan C

2015-01-01

Following from previous research on intensity bias and the accessibility model of emotional self-report, the present study examined the role of emotional exhaustion in explaining the discrepancy in teachers' reports of their trait (habitual) versus state (momentary, "real") emotions. Trait reports (habitual emotions, exhaustion) were assessed via trait questionnaires, and state reports (momentary emotions) were assessed in real time via the experience sampling method by using personal digital assistants (N = 69 high school teachers; 1,089 measures within teachers). In line with our assumptions, multi-level analyses showed that, as compared to the state assessment, teachers reported higher levels of habitual teaching-related emotions of anger, anxiety, shame, boredom, enjoyment, and pride. Additionally, the state-trait discrepancy in self-reports of negative emotions was accounted for by teachers' emotional exhaustion, with high exhaustion levels corresponding with a greater state-trait discrepancy. Exhaustion levels did not moderate the state-trait discrepancy in positive emotions indicating that perceived emotional exhaustion may reflect identity-related cognitions specific to the negative belief system. Implications for research and educational practice are discussed.

The Glass Half Empty: How Emotional Exhaustion Affects the State-Trait Discrepancy in Self-Reports of Teaching Emotions

Science.gov (United States)

Goetz, Thomas; Becker, Eva S.; Bieg, Madeleine; Keller, Melanie M.; Frenzel, Anne C.; Hall, Nathan C.

2015-01-01

Following from previous research on intensity bias and the accessibility model of emotional self-report, the present study examined the role of emotional exhaustion in explaining the discrepancy in teachers’ reports of their trait (habitual) versus state (momentary, “real”) emotions. Trait reports (habitual emotions, exhaustion) were assessed via trait questionnaires, and state reports (momentary emotions) were assessed in real time via the experience sampling method by using personal digital assistants (N = 69 high school teachers; 1,089 measures within teachers). In line with our assumptions, multi-level analyses showed that, as compared to the state assessment, teachers reported higher levels of habitual teaching-related emotions of anger, anxiety, shame, boredom, enjoyment, and pride. Additionally, the state-trait discrepancy in self-reports of negative emotions was accounted for by teachers’ emotional exhaustion, with high exhaustion levels corresponding with a greater state-trait discrepancy. Exhaustion levels did not moderate the state-trait discrepancy in positive emotions indicating that perceived emotional exhaustion may reflect identity-related cognitions specific to the negative belief system. Implications for research and educational practice are discussed. PMID:26368911

IQ discrepancy differentiates levels of fine motor skills and their relationship in children with autism spectrum disorders

Directory of Open Access Journals (Sweden)

Yu TY