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Sample records for resident major discrepancies

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

    Science.gov (United States)

    Shansky, Rebecca M

    2009-07-01

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

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

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    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

  3. Prefrontal cortex activation is associated with a discrepancy between self- and observer-rated depression severities of major depressive disorder: a multichannel near-infrared spectroscopy study.

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    Akashi, Hiroyuki; Tsujii, Noa; Mikawa, Wakako; Adachi, Toru; Kirime, Eiji; Shirakawa, Osamu

    2015-03-15

    Studies on major depressive disorder (MDD) show that the degree of correlation between the Beck Depression Inventory (BDI) and Hamilton Depression Rating Scale (HAMD) varies widely. We aimed to determine whether this discrepancy reflects specific functional abnormalities in the frontotemporal cortex. Mildly depressed or euthymic patients with MDD (n=52), including 21 patients with MDD with the discrepancy, i.e., those with low HAMD17 scores (≤13) but high BDI-II scores (>28), and 31 patients without the discrepancy, i.e., those with low HAMD17 scores and low BDI-II scores (≤28), participated in the study along with 48 control subjects. Regional changes of oxygenated hemoglobin (oxy-Hb) levels during a verbal fluency task (VFT) were monitored using a 52-channel near-infrared spectroscopy (NIRS) device. In the frontotemporal regions, mean oxy-Hb changes induced by the VFT were significantly smaller in patients with MDD than in control subjects. In 5 channels within frontal regions, the increase in mean oxy-Hb levels was significantly greater in MDD patients with the BDI-HAMD discrepancy than in those without the discrepancy. In 6 channels within the frontal region of the patients with MDD, significant positive correlations were observed between mean oxy-Hb changes and BDI total scores (ρ=0.38-0.59; Pdepressed patients, particularly those with melancholia. The distinct pattern of activation of the prefrontal cortex suggests that MDD with the BDI-HAMD discrepancy is pathophysiologically different from MDD without the discrepancy. Copyright © 2014 Elsevier B.V. All rights reserved.

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

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    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.

  5. Minerva: using a software program to improve resident performance during independent call

    Science.gov (United States)

    Itri, Jason N.; Redfern, Regina O.; Cook, Tessa; Scanlon, Mary H.

    2010-03-01

    We have developed an application called Minerva that allows tracking of resident discrepancy rates and missed cases. Minerva mines the radiology information system (RIS) for preliminary interpretations provided by residents during independent call and copies both the preliminary and final interpretations to a database. Both versions are displayed for direct comparison by Minerva and classified as 'in agreement', 'minor discrepancy' or 'major discrepancy' by the resident program director. Minerva compiles statistics comparing minor, major and total discrepancy rates for individual residents relative to the overall group. Discrepant cases are categorized according to date, modality and body part and reviewed for trends in missed cases. The rate of minor, major and total discrepancies for residents on-call at our institution was similar to rates previously published, including a 2.4% major discrepancy rate for second year radiology residents in the DePICTORS study and a 2.6% major discrepancy rate for resident at a community hospital. Trend analysis of missed cases was used to generate a topic-specific resident missed case conference on acromioclavicular (AC) joint separation injuries, which resulted in a 75% decrease in the number of missed cases related to AC separation subsequent to the conference. Using a software program to track of minor and major discrepancy rates for residents taking independent call using modified RadPeer scoring guidelines provides a competency-based metric to determine resident performance. Topic-specific conferences using the cases identified by Minerva can result in a decrease in missed cases.

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2013-10-01

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

  7. 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.

  8. Overnight shift work: factors contributing to diagnostic discrepancies.

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    Hanna, Tarek N; Loehfelm, Thomas; Khosa, Faisal; Rohatgi, Saurabh; Johnson, Jamlik-Omari

    2016-02-01

    The aims of the study are to identify factors contributing to preliminary interpretive discrepancies on overnight radiology resident shifts and apply this data in the context of known literature to draw parallels to attending overnight shift work schedules. Residents in one university-based training program provided preliminary interpretations of 18,488 overnight (11 pm–8 am) studies at a level 1 trauma center between July 1, 2013 and December 31, 2014. As part of their normal workflow and feedback, attendings scored the reports as major discrepancy, minor discrepancy, agree, and agree--good job. We retrospectively obtained the preliminary interpretation scores for each study. Total relative value units (RVUs) per shift were calculated as an indicator of overnight workload. The dataset was supplemented with information on trainee level, number of consecutive nights on night float, hour, modality, and per-shift RVU. The data were analyzed with proportional logistic regression and Fisher's exact test. There were 233 major discrepancies (1.26 %). Trainee level (senior vs. junior residents; 1.08 vs. 1.38 %; p performance. Increased workload affected more junior residents' performance, with R3 residents performing significantly worse on busier nights. Hour of the night was not significantly associated with performance, but there was a trend toward best performance at 2 am, with subsequent decreased accuracy throughout the remaining shift hours. Improved performance occurred after the first six night float shifts, presumably as residents acclimated to a night schedule. As overnight shift work schedules increase in popularity for residents and attendings, focused attention to factors impacting interpretative accuracy is warranted.

  9. 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.

  10. 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...

  11. Skin-resident CD4+ T cells protect against Leishmania major by recruiting and activating inflammatory monocytes

    Science.gov (United States)

    Glennie, Nelson D.; Volk, Susan W.

    2017-01-01

    Tissue-resident memory T cells are required for establishing protective immunity against a variety of different pathogens, although the mechanisms mediating protection by CD4+ resident memory T cells are still being defined. In this study we addressed this issue with a population of protective skin-resident, IFNγ-producing CD4+ memory T cells generated following Leishmania major infection. We previously found that resident memory T cells recruit circulating effector T cells to enhance immunity. Here we show that resident memory CD4+ T cells mediate the delayed-hypersensitivity response observed in immune mice and provide protection without circulating T cells. This protection occurs rapidly after challenge, and requires the recruitment and activation of inflammatory monocytes, which limit parasites by production of both reactive oxygen species and nitric oxide. Overall, these data highlight a novel role for tissue-resident memory cells in recruiting and activating inflammatory monocytes, and underscore the central role that skin-resident T cells play in immunity to cutaneous leishmaniasis. PMID:28419151

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

    Science.gov (United States)

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

    2011-10-01

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

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

    Science.gov (United States)

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

    2013-07-01

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

  14. 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.

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

    Directory of Open Access Journals (Sweden)

    Lana Salameh

    2018-01-01

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

  16. Discrepancy in abo blood grouping

    International Nuclear Information System (INIS)

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

    2013-01-01

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

  17. The mediation roles of discrepancy stress and self-esteem between masculine role discrepancy and mental health problems.

    Science.gov (United States)

    Yang, Xue; Lau, Joseph T F; Wang, Zixin; Ma, Yee-Ling; Lau, Mason C M

    2018-08-01

    Masculine role discrepancy and discrepancy stress occur when men perceive that they fail to live up to the ideal manhood derived from societal prescriptions. The present study examined the associations between masculine role discrepancy and two emotional and mental health problems (social anxiety and depressive symptoms), and potential mediation effects through discrepancy stress and self-esteem in a male general population. Based on random population-based sampling, 2000 male residents in Hong Kong were interviewed. Levels of masculine role discrepancy, discrepancy stress, self-esteem, social anxiety, and depressive symptoms were assessed by using validated scales. Results of structural equation modeling analysis indicated that the proposed model fit the sample well. (χ 2 (118) = 832.34, p masculine role discrepancy, discrepancy stress, and emotional/mental health problems. We found that discrepancy stress significantly mediated the association between masculine role discrepancy and social anxiety, while self-esteem significantly mediated the associations between masculine role discrepancy and both social anxiety and depression. Study limitations mainly included the cross-sectional design and reliance on self-reported questionnaires. The associations between masculine discrepancy and social anxiety/depressive symptoms among men may be explained by the increase in discrepancy stress and decrease in self-esteem. The findings suggest needs and directions for future research for the relationship between masculine role discrepancy and men's mental health, mechanisms involved, and interventions for improvement. Copyright © 2018. Published by Elsevier B.V.

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

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

    2013-03-01

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

  19. 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.

  20. A panorama of discrepancy theory

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    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.

  1. 235Cf anti ν discrepancy and the sulfur discrepancy

    International Nuclear Information System (INIS)

    Smith, J.R.

    1979-01-01

    The cantankerous discrepancy among measured values of anti ν for 235 Cf appears at last to be nearing a final resolution. A recent review has summarized the progress that has been achieved through revaluation upward by 0.5% of two manganese bath values anti ν and the performance of a new liquid scintillator measurement. A new manganese bath measurement at INEL is in reasonably good agreement with previous manganese bath values of 235 Cf anti ν. It now appears that the manganese bath values could still be systematically low by as much as 0.4% because the BNL-325 thermal absorption cross section for sulfur may be as much as 10% low. There is a bona fide discrepancy between measurements of the sulfur cross section by pile oscillators and the values derived from transmission measurements. The resolution of this discrepancy is a prerequisite to the final resolution of the 235 Cf anti ν discrepancy. 22 references

  2. 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

  3. 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

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

    Science.gov (United States)

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

    2010-08-01

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

  5. 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

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

    Directory of Open Access Journals (Sweden)

    Marios Argyrides

    2017-02-01

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

  7. 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)

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2010-08-15

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

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

    International Nuclear Information System (INIS)

    Abujudeh, Hani H.; Boland, Giles W.; Kaewlai, Rathachai; Rabiner, Pavel; Thrall, James H.; Halpern, Elkarn F.; Gazelle, G.S.

    2010-01-01

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

  10. 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

  11. 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.

  12. 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.

  13. Interdisciplinary Discrepancies Between Parenteral Nutrition Macronutrient Prescribing and Recommendations: Is Body Mass Index a Factor?

    Science.gov (United States)

    Elliott, Katie L; Kandiah, Jay; Walroth, Todd A

    2017-07-01

    Formal nutrition training in medical schools and residencies is lacking and needed. Registered dietitians (RDs) are formally trained in nutrition support and considered experts in the nutrition field. Our purpose was to examine prescribing and recommending discrepancies of parenteral nutrition macronutrients between medical residents (MRs) and RDs and compare results with the ASPEN clinical care guidelines. We also looked at discrepancies among obese patients, due to their increased risk of mortality. The primary end point of this retrospective review was discrepancies in nonprotein calories (NPCs) and grams of protein (PRO) between MRs and RDs. The secondary end point was discrepancies in NPCs and PRO between MRs and RDs among patients stratified by body mass index category. MRs prescribed 300 NPCs more versus RDs ( P < .001). When compared with RDs, MRs prescribed fewer NPCs for underweight patients and more for obese patients ( P < .001). The same analysis found that the PRO discrepancies significantly varied by body mass index classification as well ( P = .022). When these results were compared with the ASPEN clinical care guidelines, RDs adhered closer to the guidelines than did MRs in terms of permissive underfeeding of obese patients. It is widely accepted that MRs are in need of increased formal training, and the results of our study confirm this need and suggest a short-term solution of increasing order-writing privileges for the RD. RDs with this privilege may adhere more closely to clinical care guidelines and therefore increase patient safety.

  14. 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....

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

    International Nuclear Information System (INIS)

    Ullah, K.; Alamgir, W.

    2006-01-01

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

  16. 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

  17. 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…

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

    Science.gov (United States)

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

    2013-11-13

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

  19. 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

  20. 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.

  1. Discrepancies between Abstracts Presented at International Association for Dental Research Annual Sessions from 2004 to 2005 and Full-Text Publication.

    Science.gov (United States)

    Prasad, Soni; Lee, Damian J; Yuan, Judy Chia-Chun; Barao, Valentim A R; Shyamsunder, Nodesh; Sukotjo, Cortino

    2012-01-01

    Purpose. The purpose of this study was to evaluate the discrepancies between abstracts presented at the IADR meeting (2004-2005) and their full-text publication. Material and Methods. Abstracts from the Prosthodontic Section of IADR meeting were obtained. The following information was collected: abstract title, number of authors, study design, statistical analysis, outcome, and funding source. PubMed was used to identify the full-text publication of the abstracts. The discrepancies between the abstract and the full-text publication were examined, categorized as major and minor discrepancies, and quantified. The data were collected and analyzed using descriptive analysis. Frequency and percentage of major and minor discrepancies were calculated. Results. A total of 109 (95.6%) articles showed changes from their abstracts. Seventy-four (65.0%) and 105 (92.0%) publications had at least one major and one minor discrepancies, respectively. Minor discrepancies were more prevalent (92.0%) than major discrepancies (65.0%). The most common minor discrepancy was observed in the title (80.7%), and most common major discrepancies were seen in results (48.2%). Conclusion. Minor discrepancies were more prevalent than major discrepancies. The data presented in this study may be useful to establish a more comprehensive structured abstract requirement for future meetings.

  2. 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

  3. 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.

  4. 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.

  5. 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.

  6. 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.

  7. 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.

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

    Science.gov (United States)

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

    2016-06-01

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

  9. 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

  10. 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.

  11. 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.)

  12. 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.

  13. 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.

  14. 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.

  15. 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...

  16. 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)…

  17. Hospitalist career decisions among internal medicine residents.

    Science.gov (United States)

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

    2014-07-01

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

  18. 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

  19. 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.

  20. 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

  1. 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...

  2. 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.

  3. 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.

  4. 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 ...

  5. 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 ...

  6. 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...

  7. 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

  8. 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.

  9. 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)

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

    Directory of Open Access Journals (Sweden)

    Daniel Wittschieber

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

  11. 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

  12. 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.

  13. 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.

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

    Science.gov (United States)

    Nguyen, Hieu M

    2017-05-12

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

  15. 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.

  16. 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.

  17. 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

  18. 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.

  19. 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.

  20. 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

  1. 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.

  2. 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.

  3. 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.

  4. 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...

  5. 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

  6. 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.

  7. 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.

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

    Directory of Open Access Journals (Sweden)

    Carlos Martínez Ramos

    2004-12-01

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

  9. 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.

  10. 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 ...

  11. 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.

  12. 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…

  13. 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.

  14. 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

  15. 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.

  16. 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

  17. 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

  18. 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,…

  19. Major depression

    Science.gov (United States)

    Depression - major; Depression - clinical; Clinical depression; Unipolar depression; Major depressive disorder ... providers do not know the exact causes of depression. It is believed that chemical changes in the ...

  20. 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

  1. 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

  2. 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.

  3. [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.

  4. 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

  5. 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.

  6. [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.

  7. 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.

  8. 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.

  9. 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.

  10. 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.

  11. 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

  12. 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.

  13. 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.

  14. 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.

  15. 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...

  16. Major Links.

    Science.gov (United States)

    Henderson, Tona

    1995-01-01

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

  17. Major Roads

    Data.gov (United States)

    Minnesota Department of Natural Resources — This data set contains roadway centerlines for major roads (interstates and trunk highways) found on the USGS 1:24,000 mapping series. These roadways are current...

  18. 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.

  19. 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...

  20. Discrepancy between body surface area and body composition in cancer.

    Science.gov (United States)

    Stobäus, Nicole; Küpferling, Susanne; Lorenz, Marie-Luise; Norman, Kristina

    2013-01-01

    Calculation of cytostatic dose is typically based on body surface area (BSA) regardless of body composition. The aim of this study was to assess the discrepancy between BSA and low fat-free mass (FFM) by investigating the prevalence of low FFM with regard to BSA in 630 cancer patients. First, BSA was calculated according to DuBois and DuBois. Patients were divided into 6 categories with respect to their BSA. Each BSA category was further divided into 3 groups according to FFM: low (FFM), normal (-0.99 and 0.99 SD of mean FFM) or high (>1 SD of mean FFM), which was derived through bioelectric impedance analysis. FFM was reduced in 15.7% of patients, 69% had normal and 15.2% had high FFM. In patients with low FFM (i.e., more than-1 SD lower than the mean FFM within their BSA group), body mass index and fatigue were higher whereas functional status was reduced. Moreover, in the subcohort of patients receiving chemotherapy, absolute FFM [Hazard ratio (HR) = 0.970, P = 0.026] as well as the allocation to the low FFM group (HR = 1.644, P = 0.025) emerged as predictors of increased 1-yr mortality. In conclusion, there was a large discrepancy between FFM and BSA. Particularly women were affected by low FFM.

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

    Science.gov (United States)

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

    2006-08-10

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

  2. 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.

  3. 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.

  4. 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...

  5. 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.

  6. 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

  7. Personal Therapy in Psychiatry Residency Training: A National Survey of Canadian Psychiatry Residents.

    Science.gov (United States)

    Hadjipavlou, George; Halli, Priyanka; Hernandez, Carlos A Sierra; Ogrodniczuk, John S

    2016-02-01

    The authors collected nationally representative data on Canadian residents' experiences with and perspectives on personal psychotherapy in their psychiatric training. A 43-item questionnaire was distributed electronically to all current psychiatry residents in Canada (N = 839). Four hundred residents from every program across Canada returned the survey (response rate 47.7%). The prevalence of personal therapy at any time was 55.3%, with 42.8% receiving personal therapy during residency. Of residents who undertook personal psychotherapy, 59.3% engaged in weekly therapy, 74.1% received psychodynamic psychotherapy, and 81.5% participated in long-term therapy (>1 year). Personal growth, self-understanding, and professional development were the most common reasons for engaging in personal therapy; however, one-third of residents did so to alleviate symptoms of depression, anxiety, or other mental health concerns. Time was the most important factor impeding residents from personal therapy; only 8.8% found stigma to act as a barrier. The vast majority of residents rated their experience with personal therapy as having a positive or very positive impact on their personal life (84.8%) and overall development as psychiatrists (81.8%). For 64% of respondents, personal therapy had an important or very important role in psychiatry residency training. Residents who received personal therapy rated themselves as better able to understand what happens moment by moment during therapy sessions, detect and deal with patients' emotional reactions, and constructively use their personal reactions to patients. Interest in personal therapy remains strong among psychiatry trainees in Canada. Residents who engaged in psychotherapy endorsed greater confidence in psychotherapy and rated their psychotherapy skills more favorably than those who had never been in the patient role, supporting the view of personal therapy as an important adjunct to psychotherapy training during residency.

  8. 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)

  9. 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)

  10. 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…

  11. Self-Reliance and Community Development: Intention-Outcome Discrepancy

    Science.gov (United States)

    Pomerleau, Raymond

    1970-01-01

    A case study among residents in the area of a water distribution project in the Philippines found that most respondents were willing in theory but reluctant in practice to contribute either funds of volunteered labor to self-help projects, and that they expected others (i.e. the government) to be responsible for project upkeep. (MF)

  12. Minimizing Barriers in Learning for On-Call Radiology Residents-End-to-End Web-Based Resident Feedback System.

    Science.gov (United States)

    Choi, Hailey H; Clark, Jennifer; Jay, Ann K; Filice, Ross W

    2018-02-01

    Feedback is an essential part of medical training, where trainees are provided with information regarding their performance and further directions for improvement. In diagnostic radiology, feedback entails a detailed review of the differences between the residents' preliminary interpretation and the attendings' final interpretation of imaging studies. While the on-call experience of independently interpreting complex cases is important to resident education, the more traditional synchronous "read-out" or joint review is impossible due to multiple constraints. Without an efficient method to compare reports, grade discrepancies, convey salient teaching points, and view images, valuable lessons in image interpretation and report construction are lost. We developed a streamlined web-based system, including report comparison and image viewing, to minimize barriers in asynchronous communication between attending radiologists and on-call residents. Our system provides real-time, end-to-end delivery of case-specific and user-specific feedback in a streamlined, easy-to-view format. We assessed quality improvement subjectively through surveys and objectively through participation metrics. Our web-based feedback system improved user satisfaction for both attending and resident radiologists, and increased attending participation, particularly with regards to cases where substantive discrepancies were identified.

  13. 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....

  14. 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.

  15. Management of bimaxillary transverse discrepancy with vertical excess

    Directory of Open Access Journals (Sweden)

    Dinesh C Chaudhary

    2015-01-01

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

  16. Discrepancies between parents' and children's attitudes toward TV advertising.

    Science.gov (United States)

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

    2009-06-01

    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 how TV commercials affect children's developmental stages and, particularly, their credence, behavioral intentions, and TV enjoyment. Regarding enjoyment and purchase dimensions, the group of 7-year-old children claimed that they enjoyed and are influenced in their consumer attitude more than did the groups of 8-11-year-old children. Credence decreased significantly with age. This study showed that parents tended to undervalue TV advertising's influence on their children. Parents' conformity was a significant predictor of children's attitude toward TV advertising. Results indicated that a high level of parental conformity was linked to the number of brands children claimed to possess.

  17. Some Properties of a Measure of Information Discrepancy

    Institute of Scientific and Technical Information of China (English)

    FANG Shun-lan; FANG Wei-wu

    2002-01-01

    Based on a group of axioms, a measure of information discrepancyamong multiple information sources has been introduced in [7,8, 10] and it possesses some peculiar properties compared with other measures of information discrepancy, so it can be used in some areas, where the traditional measures are not valid or not efficient, for example, in the study of DNA sequence comparison, prediction of protein structure class, evidence analysis, questionnaire analysis, and so on. In this paper, using the optimization techniques,we prove that it is a distance function and show that it is also an approximation of x2 function. These two properties will stimulate further applications of the measure to information processing and system analysis.

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

    Directory of Open Access Journals (Sweden)

    Taner AYDIN

    2015-12-01

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

  19. Linking Cognition to Cognitive Dissonance through Scientific Discrepant Events

    Directory of Open Access Journals (Sweden)

    Allen G. Rauch

    2010-10-01

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

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

    International Nuclear Information System (INIS)

    Ribon, P.; Tellier, H.

    1986-09-01

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

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

    International Nuclear Information System (INIS)

    Ribon, P.; Tellier, H.

    1986-01-01

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

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

    International Nuclear Information System (INIS)

    Prades Lopez, Ana; Gonzalez Reyes, Felisa

    1998-01-01

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

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

    International Nuclear Information System (INIS)

    Akella, J.

    1996-01-01

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

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

    Science.gov (United States)

    Messina, G; Verzì, P; Pappalardo, S

    1999-06-01

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

  5. Burnout Syndrome During Residency.

    Science.gov (United States)

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

    2016-10-01

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

  6. 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.

  7. Changes in medicine: residency

    Directory of Open Access Journals (Sweden)

    Robbins RA

    2011-07-01

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

  8. 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.

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

    Directory of Open Access Journals (Sweden)

    Evan Hy Einstein

    2017-04-01

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

  10. 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.

  11. 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.

  12. 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

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

    Science.gov (United States)

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

    2016-01-01

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

  14. Accuracy of digital American Board of Orthodontics Discrepancy Index measurements.

    Science.gov (United States)

    Dragstrem, Kristina; Galang-Boquiren, Maria Therese S; Obrez, Ales; Costa Viana, Maria Grace; Grubb, John E; Kusnoto, Budi

    2015-07-01

    A digital analysis that is shown to be accurate will ease the demonstration of initial case complexity. To date, no literature exists on the accuracy of the digital American Board of Orthodontics Discrepancy Index (DI) calculations when applied to pretreatment digital models. Plaster models were obtained from 45 previous patients with varying degrees of malocclusion. Total DI scores and the target disorders were computed manually with a periodontal probe on the original plaster casts (gold standard) and digitally using Ortho Insight 3D (Motion View Software, Hixson, Tenn) and OrthoCAD (Cadent, Carlstadt, NJ). Intrarater and interrater reliabilities were assessed for 15 subjects using the Spearman rho correlation test. Accuracies of the DI scores and target disorders were assessed for all 45 subjects using Wilcoxon signed ranks tests. Intrarater and interrater reliabilities were high for total DI scores and most target disorders (r > 0.8). No significant difference was found between total DI score when measured with OrthoCAD compared with manual calculations. The total DI scores calculated by Ortho Insight 3D were found to be significantly greater than those by manual calculation by 2.71 points. The findings indicate that a DI calculated by Ortho Insight 3D may lead the clinician to overestimate case complexity. OrthoCAD's DI module was demonstrated to be a clinically acceptable alternative to manual calculation of the total scores. Copyright © 2015 American Association of Orthodontists. Published by Elsevier Inc. All rights reserved.

  15. A statistical investigation of the mass discrepancy-acceleration relation

    Science.gov (United States)

    Desmond, Harry

    2017-02-01

    We use the mass discrepancy-acceleration relation (the correlation between the ratio of total-to-visible mass and acceleration in galaxies; MDAR) to test the galaxy-halo connection. We analyse the MDAR using a set of 16 statistics that quantify its four most important features: shape, scatter, the presence of a `characteristic acceleration scale', and the correlation of its residuals with other galaxy properties. We construct an empirical framework for the galaxy-halo connection in LCDM to generate predictions for these statistics, starting with conventional correlations (halo abundance matching; AM) and introducing more where required. Comparing to the SPARC data, we find that: (1) the approximate shape of the MDAR is readily reproduced by AM, and there is no evidence that the acceleration at which dark matter becomes negligible has less spread in the data than in AM mocks; (2) even under conservative assumptions, AM significantly overpredicts the scatter in the relation and its normalization at low acceleration, and furthermore positions dark matter too close to galaxies' centres on average; (3) the MDAR affords 2σ evidence for an anticorrelation of galaxy size and Hubble type with halo mass or concentration at fixed stellar mass. Our analysis lays the groundwork for a bottom-up determination of the galaxy-halo connection from relations such as the MDAR, provides concrete statistical tests for specific galaxy formation models, and brings into sharper focus the relative evidence accorded by galaxy kinematics to LCDM and modified gravity alternatives.

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

    Science.gov (United States)

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

    2015-01-01

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

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

    Directory of Open Access Journals (Sweden)

    Sébastien eTassy

    2013-05-01

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

  18. TLD DRD dose discrepancy: role of beta radiation fields

    International Nuclear Information System (INIS)

    Munish Kumar; Pradhan, S.M.; Bihari, R.R.; Bakshi, A.K.; Chougaonkar, M.P.; Babu, D.A.R.; Gupta, Anil

    2014-01-01

    Ionization chamber based direct reading/pocket dosimeters (DRDs), are used along with the legal dosimeters (thermoluminescent dosimeters-TLDs) for day to day monitoring and control of radiation doses received by radiation workers. The DRDs are routinely used along with the passive dosimeters (TLDs) in nuclear industry at different radiation installations where radiation levels could vary significantly and the possibility of receiving doses beyond investigation levels by radiation workers is not ruled out. Recently, recommendations for dealing with discrepancies between personal dosimeter systems used in parallel were issued by ISO. The present study was performed to measure the response of ionization chamber based pocket dosimeters to various beta sources having energy (E max ) ranging from 0.224 MeV-3.54 MeV. It is expected that the above study will be useful in resolving the disparity between TLD and DRD doses at those radiation installations where radiation workers are likely to be exposed simultaneously from photons and beta particles

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

    Directory of Open Access Journals (Sweden)

    Deokjae Lee

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

  20. 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

  1. 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.

  2. 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.

  3. 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.

  4. 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.

  5. 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.

  6. 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.

  7. 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.

  8. 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

  9. 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.

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

    Science.gov (United States)

    Howie, Alexander J; Owen-Casey, Mared P

    2010-09-01

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

  11. 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.

  12. 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.

  13. 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.

  14. 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/

  15. Lawful Permanent Residents - Annual Report

    Data.gov (United States)

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

  16. 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.

  17. 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

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

    Directory of Open Access Journals (Sweden)

    Patrícia Kanno

    2008-08-01

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

  19. 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...

  20. 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...

  1. 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...

  2. 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...

  3. 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…

  4. 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...

  5. 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

  6. 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...

  7. 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

  8. 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

  9. 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…

  10. 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…

  11. 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.

  12. 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.

  13. 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.

  14. 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

  15. 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.

  16. 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.

  17. 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.

  18. Resident Peritoneal NK cells

    Science.gov (United States)

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

    2011-01-01

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

  19. 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.

  20. 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)

  1. 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.

  2. 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.

  3. 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.

  4. 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.

  5. 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).

  6. 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.

  7. 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.

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

    Directory of Open Access Journals (Sweden)

    Taylor, Brian T.

    2014-11-01

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

  9. 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.

  10. 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...

  11. The pregnant female surgical resident

    Directory of Open Access Journals (Sweden)

    Shifflette V

    2018-05-01

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

  12. Second opinion and discrepancy in the diagnosis of soft tissue lesions at surgical pathology

    Directory of Open Access Journals (Sweden)

    Sharif Muhammad

    2010-07-01

    Full Text Available Objective: To determine the frequency and magnitude of discrepancies in the surgical pathological diagnosis of soft tissue lesions on review and second opinion in a histopathology center. Study Design: Cross-sectional, observational. Place and Duration of Study: Department of Histopathology, Armed Forces Institute of Pathology, Rawalpindi, from April 2006 to May 2007. Materials and Methods: All the cases of soft tissue as well as bone lesions, irrespective of age and gender, which were referred for second opinion or review after being reported elsewhere, were included in the study. A panel of antibodies of soft tissue, epithelial and lymphoid markers was applied according to the requirements of each case. The cases were categorized as category A where there was concurrence between initial diagnosis and diagnosis at review. Category B included cases where there was disagreement in the specific diagnostic entity as per WHO classifications without therapeutic implications. Category C was cases where the category of benign or malignant diagnosis remained the same but there was disagreement in the specific diagnosis with definite therapeutic implications. Category D had diagnosis of benign changed to malignant while category E had cases where diagnosis of malignancy was changed to a benign lesion. Results: During the study period, 34 cases of soft tissue lesions were received for review and second opinion. The mean age of the patients was 39 ΁ 22 years and immunohistochemistry was performed in 21 (62% of 34 cases. Concurrence between the review and initial diagnosis was seen in 18 (53% cases (category A. Discrepancy in the diagnosis at review and initial consultation was seen in 16 (47% cases. There were four (11.8% cases that were placed in category B as the diagnosis of benign and malignant remained the same but the specific diagnostic entity was changed. Category C included eight (23.5% cases where the review diagnosis changed the therapeutic

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

    Directory of Open Access Journals (Sweden)

    Mazhar F

    2017-03-01

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

  14. 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...

  15. 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 ...

  16. 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.

  17. 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

  18. [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.

  19. Education Research: Neurology resident education

    Science.gov (United States)

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

    2016-01-01

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

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

    International Nuclear Information System (INIS)

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

    1986-08-01

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

  1. Interpretation of images and discrepancy between osteoarthritic findings and symptomatology in temporomandibular joint

    Directory of Open Access Journals (Sweden)

    Tsukasa Sano

    2008-07-01

    Full Text Available The discrepancy between osteoarthritic findings on images and symptomatology can sometimes be problematic in clinical work. In this article, we focus on osteoarthritis and related entities on images, and especially on MR images.

  2. 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.

  3. 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.

  4. . 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

  5. Processing Discrepancy Reports Against Foreign Military Sales Shipments (Supplementation is Permitted at all Levels)

    National Research Council Canada - National Science Library

    Tucker, Gary

    1991-01-01

    ...) shipments are processed. It provides for the basic documents required to support adjustment of property and financial inventory accounting records, notification to shippers of the type of discrepancies, required corrective...

  6. 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...

  7. 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

  8. 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.

  9. 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...

  10. 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

  11. 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...

  12. 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

  13. 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.

  14. 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...

  15. 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.

  16. 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.

  17. 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

  18. 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.

  19. 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.

  20. Surgical residency: A tenant's view

    African Journals Online (AJOL)

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

  1. Burnout among Dutch medical residents

    NARCIS (Netherlands)

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

    2007-01-01

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

  2. Discrepancies between perceptions of students and deans regarding the consequences of restricting students' use of electronic medical records on quality of medical education.

    Science.gov (United States)

    Solarte, Ivan; Könings, Karen D

    2017-03-13

    Electronic medical records (EMR) are more used in university hospitals, but the use of EMR by medical students at the workplace is still a challenge, because the conflict of interest between medical accountability for hospitals and quality of medical education programs for students. Therefore, this study investigates the use of EMR from the perspective of medical school deans and students, and determines their perceptions and concerns about consequences of restricted use of EMR by students on quality of education and patient care. We administered a large-scale survey about the existence of EMR, existing policies, students' use for learning, and consequences on patient care to 42 deans and 789 Residency Physician Applicants in a private university in Colombia. Data from 26 deans and 442 former graduated students were compared with independent t tests and chi square tests. Only half of medical schools had learning programs and policies about the use of EMR by students. Deans did not realize that students have less access to EMR than to paper-based MR. Perceptions of non-curricular learning opportunities how to write in (E)MR were significantly different between deans and students. Limiting students use of EMR has negative consequences on medical education, according to both deans and students, while deans worried significantly more about impact on patient care than students. Billing issues and liability aspects were their major concerns. There is a need for a clear policy and educational program on the use of EMR by students. Discrepancies between the planned curriculum by deans and the real clinical learning environment as experienced by students indicate suboptimal learning opportunities for students. Creating powerful workplace-learning experiences and resolving concerns on students use of EMR has to be resolved in a constructive collaboration way between the involved stakeholders, including also EMR designers and hospital administrators. We recommend intense

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

    Science.gov (United States)

    Kansagra, Akash P

    2014-01-01

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

  4. 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.

  5. 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.

  6. 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.

  7. 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

  8. 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.

  9. 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.

  10. 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.

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

    Science.gov (United States)

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

    2005-09-01

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

  12. Diabetes Educators' Intended and Reported Use of Common Diabetes-Related Technologies: Discrepancies and Dissonance.

    Science.gov (United States)

    James, Steven; Perry, Lin; Gallagher, Robyn; Lowe, Julia

    2016-11-01

    Technology provides adjuvant and/or alternative approaches to care and may promote self-care, communication, and engagement with health care services. Common recent technologies for diabetes include continuous subcutaneous insulin infusions (insulin pumps), continuous glucose monitoring systems, smartphone and tablet applications, and telehealth (video conferencing). This study reports Australian diabetes educators' intentions and reported professional use of these technologies for people with type 1 diabetes, and factors predictive of this. An anonymous, web-based questionnaire based on the technology acceptance model was distributed to members of the Australian Diabetes Educators Association through their electronic newsletter. Exploratory factor analysis revealed a 5-factor solution comprising confidence and competence, improving clinical practice, preparation (intentions and training), ease of use, and subjective norms. Logistic regression analyses identified factors predicting intention and use of technology. Respondents (n = 228) had high intentions to use technology. The majority reported using continuous subcutaneous insulin infusions, continuous glucose monitoring systems, and applications with patients, but usage was occasional. Confidence and competence independently predicted both intentions and use of all 4 technologies. Preparation (intentions and training) independently predicted use of each technology also. Discrepancies and dissonance appear between diabetes educators' intentions and behavior (intentions to use and reported technology use). Intentions were higher than current use, which was relatively low and not likely to provide significant support to people with type 1 diabetes for disease management, communication, and engagement with health care services. Continuing education and experiential learning may be key in supporting diabetes educators to align their intentions with their practice. © 2016 Diabetes Technology Society.

  13. Personal finances of urology residents in Canada.

    Science.gov (United States)

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

    2000-12-01

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

  14. 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.

  15. 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

  16. 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.

  17. 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.)

  18. 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.

  19. 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.

  20. Minimum Data Set Active Resident Information Report

    Data.gov (United States)

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

  1. 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.

  2. Discrepancy between subjective autobiographical reliving and objective recall: The past as seen by Alzheimer's disease patients.

    Science.gov (United States)

    El Haj, Mohamad; Antoine, Pascal

    2017-03-01

    This paper investigated whether Alzheimer's disease (AD) patients may demonstrate a discrepancy between subjective autobiographical reliving and objective recall. To this end, 31 AD patients and 35 controls were asked to retrieve three autobiographical memories. For each memory, participants were asked to rate its subjective characteristics (e.g., reliving, travel in time, visual imagery…). Besides this subjective assessment, we analyzed recall objectively with regard to specificity. Results showed poorer subjective autobiographical reliving and objective recall in AD patients than in controls. A discrepancy (i.e., higher level of subjective reliving than of objective recall) was observed in AD but not in control participants. Despite a compromise in their objective recall, AD patients seemed to attribute a high value to their subjective autobiographical experience. This discrepancy can be attributed to a potential genuine consciousness experience in which mild AD patients can, to some extent, experience some subjective features of the past. Copyright © 2017 Elsevier Inc. All rights reserved.

  3. 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.

  4. 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.

  5. 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...

  6. 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

  7. 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.

  8. 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.

  9. 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.

  10. 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.

  11. 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.

  12. 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.

  13. 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.

  14. 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

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

    Directory of Open Access Journals (Sweden)

    Shweiki E

    2015-04-01

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

  16. 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

  17. 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.

  18. 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

  19. 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.

  20. [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

  1. 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.

  2. 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.

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

    Science.gov (United States)

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

    2016-01-01

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

  4. When Discrepant Events Change the Plans: An Unexpected Investigation of Physical Properties and Reactions

    Science.gov (United States)

    Madden, Lauren; Seifried, Joyce; Farnum, Kerry; D'Armiento, Angela

    2016-01-01

    Discrepant events are often used by science educators to incite interest and excitement in learners, yet sometimes their results are farther-reaching. The following article describes how one such event--dissolving packing peanuts in acetone--led to a change in the course of a college-level elementary science teaching methods class and to the…

  5. 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.

  6. 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...

  7. 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...

  8. 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…

  9. The Impact of Discrepant Verbal-Nonverbal Messages in the Teacher-Student Interaction.

    Science.gov (United States)

    Karr-Kidwell, PJ

    Noting that teachers' nonverbal behaviors are frequently inconsistent with their verbal messages, a situation that detracts from student learning, this paper offers an activity for focusing prospective teachers' attentions on the frequency and impact of discrepant verbal-nonverbal messages occurring in the classroom. The step-by-step process is…

  10. 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…

  11. 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.

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

    Directory of Open Access Journals (Sweden)

    Nan Nwe Win

    2017-01-01

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

  13. 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 ...

  14. 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.

  15. 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…

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

    DEFF Research Database (Denmark)

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

    2015-01-01

    Innovation literature mainly focuses on eliminating ambiguity and discrepancy from the early phases of innovation. This study questions this implicit assumption, as it may provide an oversimplified view on, how to attain proficiency. Instead of narrowly focusing on reducing ambiguity and discrepa...

  17. 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

  18. 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.

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

    Science.gov (United States)

    Icek Ajzen; Thomas C. Brown; Franklin Carvajal

    2004-01-01

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

  20. Loaded dice in Monte Carlo : importance sampling in phase space integration and probability distributions for discrepancies

    NARCIS (Netherlands)

    Hameren, Andreas Ferdinand Willem van

    2001-01-01

    Discrepancies play an important role in the study of uniformity properties of point sets. Their probability distributions are a help in the analysis of the efficiency of the Quasi Monte Carlo method of numerical integration, which uses point sets that are distributed more uniformly than sets of

  1. 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 ...

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

    Science.gov (United States)

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

    2011-01-01

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

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

    Directory of Open Access Journals (Sweden)

    Berta Schnettler

    2017-01-01

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

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

    Science.gov (United States)

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

    2016-01-01

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

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

    Directory of Open Access Journals (Sweden)

    Pinto João

    2011-08-01

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

  6. 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…

  7. 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…

  8. 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: ...

  9. 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.

  10. 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

  11. 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.

  12. 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

  13. 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.

  14. Plagiarism in residency application essays.

    Science.gov (United States)

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

    2010-07-20

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

  15. 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.

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

    African Journals Online (AJOL)

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

  17. 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.

  18. 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

  19. 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.

  20. Conversations with Holocaust survivor residents.

    Science.gov (United States)

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

    2011-03-01

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

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

    Science.gov (United States)

    Hoda, Syed T.; Crawford, James M.

    2016-01-01

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

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

    Directory of Open Access Journals (Sweden)

    Arvind Rishi MD

    2016-05-01

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

  3. 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.

  4. 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.

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

    Science.gov (United States)

    Lebastchi, Amir H; Yuh, David D

    2014-08-01

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

  6. 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 .

  7. 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.

  8. 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

  9. 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

  10. 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

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

    Science.gov (United States)

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

    2015-01-01

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

  12. From Residency to Lifelong Learning.

    Science.gov (United States)

    Brandt, Keith

    2015-11-01

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

  13. Machiavelli and the Chief Resident.

    Science.gov (United States)

    Raviglione, Mario C.

    1990-01-01

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

  14. 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

  15. 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…

  16. Predictors of Sunburn Risk Among Florida Residents.

    Science.gov (United States)

    Arutyunyan, Sergey; Alfonso, Sarah V; Hernandez, Nilda; Favreau, Tracy; Fernández, M Isabel

    2017-03-01

    The incidence of skin cancer, the most common type of cancer in the United States, is increasing. Sunburn is a major modifiable risk factor for skin cancer, and its prevalence among the US population is high. To identify predictors of having had a red or painful sunburn in the past 12 months among people living in Florida. Florida residents were recruited from public places and online. They were asked to complete an anonymous cross-sectional survey that assessed demographic information, dermatologic history, as well as knowledge, attitude, and behavior factors associated with sunburn. A total of 437 participants whose data were complete for all variables were included in the multivariate analysis. In multivariate logistic regression, younger age (18-29 years) was the most significant predictor of sunburn (OR, 15.26; 95% CI, 5.97-38.98; PSunburn prevention programs that osteopathic physicians can readily implement in clinical practice are urgently needed, particularly for young adult patients. This study identified 7 predictors of sunburn in Florida residents. With additional research findings, promoting attitude change toward sun protection may be a viable strategy.

  17. 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

  18. 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…

  19. 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…

  20. 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...

  1. 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.

  2. Corticotomy-assisted orthodontic camouflage in a class III adult patient with a severe transverse discrepancy.

    Science.gov (United States)

    Gracco, Antonio; Finotti, Marco; Bruno, Giovanni; de Stefani, Alberto

    2018-04-06

    A 25-year-old man presented with a maxillary transverse discrepancy, posterior cross bite, anterior open bite, molar and canine class III. Treatment included a corticotomy in the upper lateral and posterior teeth, a palatal expansor and a sectional archwire to assist the expansion. The following treatment phase included bonding with Incognito System lingual appliance, interproximal reduction to solve the crowding and bite blocks to control the verticality. Two months after the bonding intermaxillary class III elastics were used to solve the sagittal discrepancy and eight months after the bonding vertical elastics were used in order to solve the anterior open bite until the end of the treatment. A Boston splint was applied for the upper arch, an essix splint was applied for the lower arch. The patient compliance was an essential aspect in the success of the orthodontic treatment. Copyright © 2018. Published by Elsevier Masson SAS.

  3. Factors associated with diagnostic discrepancy for left ventricular hypertrophy between electrocardiography and echocardiography

    DEFF Research Database (Denmark)

    Sandager Petersen, Søren; Reinholdt Pedersen, Line; Pareek, Manan

    2017-01-01

    (absolute value/cut-off value for LVH) were used as outcome variables in order to identify explanatory variables associated with diagnostic discrepancies between ECG and echocardiography. RESULTS: Of the 1382 subjects included, 77% did not display any signs of LVH, 6% had LVH defined by ECG only, 13% had...... LVH defined by echocardiography only, and 5% had LVH on both ECG and echocardiography. Older subjects and those with higher blood pressure and RWT were more likely to have a relatively greater LVMI on echocardiography than that predicted on ECG (odds ratio: 1.65 per 10 years (95% confidence interval...... and odds ratio: 1.41 (95% CI: 1.06-1.87), p = .02), but FPG did not independently influence discrepancy between ECG and echocardiography. CONCLUSION: Age, blood pressure, female sex, greater RWT and use of antihypertensive medication were associated with a greater risk of non-consistency between LVH...

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

    Science.gov (United States)

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

    2018-02-09

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

  5. Analysis of discrepancies in Dalitz plot parameters in η→3π decay

    International Nuclear Information System (INIS)

    Kolesár, Marián

    2011-01-01

    We analyze the Dalitz plot parameters of η→3π decay in the framework of resummed chiral perturbation theory. This approach allows us to keep the uncertainties in the NNLO and higher orders under better control and estimate their influence. We cannot confirm the suspected discrepancy in the case of the charged decay parameter b, where even small uncertainties in higher orders could accommodate the difference. On the other hand, we find the experimental value of the neutral decay parameter α incompatible with an assumption of good convergence properties in the center of the Dalitz plot. We calculate ππ rescattering bubble corrections up to three loops and show that these might explain the discrepancy, especially for a low value of the pseudoscalar decay constant in the chiral limit. However, that could indicate a failure of convergence of the chiral series in this channel already at low energies around 500MeV.

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

    Science.gov (United States)

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

    2015-01-01

    This study examined the association between relationship adjustment and discrepant alcohol use among lesbian women and their same-sex intimate partners after controlling for verbal and physical aggression. Lesbian women (N = 819) who were members of online marketing research panels completed an online survey in which they reported both their own and same-sex intimate partner’s alcohol use, their relationship adjustment, and their own and their partner’s physical aggression and psychological aggression (i.e., verbal aggression and dominance/isolation). Partners’ alcohol use was moderately correlated. Discrepancy in alcohol use was associated with poorer relationship adjustment after controlling for psychological aggression and physical aggression. Results are discussed in terms of the similarity and differences with previous literature primarily focused on heterosexual couples. PMID:26478657

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

    Science.gov (United States)

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

    2015-11-01

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

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

    Science.gov (United States)

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

    2014-01-01

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

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

    Directory of Open Access Journals (Sweden)

    Yu TY

    2016-02-01

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

  10. 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.

  11. 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.

  12. 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.

  13. Discrepancies between calculated and observed Fe XVII and Ni XIX solar coronal lines

    Energy Technology Data Exchange (ETDEWEB)

    Loulergue, M [Observatoire de Paris, Section de Meudon, 92 (France); Nussbaumer, H [Eidgenoessische Technische Hochschule, Zurich (Switzerland)

    1975-12-01

    The 36-levels model atom Fe/sup +16/ of Loulergue and Nussbaumer (1973) is extended to a 51-levels atom including n=4 configuration. The earlier conclusion that relative intensities among the Fe XVII lines are not sufficiently sensitive to variations in electron densities and electron temperature to deduce these parameters from observed intensity ratios still holds. Discrepancies between calculated and observed relative intensities in Fe XVII and Ni XIX are attributed to blends or misidentifications.

  14. 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.

  15. Parent–Child Discrepancy on Children’s Body Weight Perception: The Role of Attachment Security

    Directory of Open Access Journals (Sweden)

    Arcangelo Uccula

    2017-09-01

    Full Text Available 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.

  16. Errors and discrepancies in the administration of intravenous infusions: a mixed methods multihospital observational study

    OpenAIRE

    Lyons, I.; Furniss, D.; Blandford, A.; Chumbley, G.; Iacovides, I.; Wei, L.; Cox, A.; Mayer, A.; Vos, J.; Galal-Edeen, G. H.; Schnock, K. O.; Dykes, P. C.; Bates, D. W.; Franklin, B. D.

    2018-01-01

    INTRODUCTION: Intravenous medication administration has traditionally been regarded as error prone, with high potential for harm. A recent US multisite study revealed few potentially harmful errors despite a high overall error rate. However, there is limited evidence about infusion practices in England and how they relate to prevalence and types of error. OBJECTIVES: To determine the prevalence, types and severity of errors and discrepancies in infusion administration in English hospitals, an...

  17. 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.

  18. An Analysis of the Discrepancies between MODIS and INSAT-3D LSTs in High Temperatures

    Directory of Open Access Journals (Sweden)

    Seyed Kazem Alavipanah

    2017-04-01

    Full Text Available In many disciplines, knowledge on the accuracy of Land Surface Temperature (LST as an input is of great importance. One of the most efficient methods in LST evaluation is cross validation. Well-documented and validated polar satellites with a high spatial resolution can be used as references for validating geostationary LST products. This study attempted to investigate the discrepancies between a Moderate Resolution Imaging Spectro-radiometer (MODIS and Indian National Satellite (INSAT-3D LSTs for high temperatures, focusing on six deserts with sand dune land cover in the Middle East from 3 March 2015 to 24 August 2016. Firstly, the variability of LSTs in the deserts of the study area was analyzed by comparing the mean, Standard Deviation (STD, skewness, minimum, and maximum criteria for each observation time. The mean value of the LST observations indicated that the MYD-D observation times are closer to those of diurnal maximum and minimum LSTs. At all times, the LST observations exhibited a negative skewness and the STD indicated higher variability during times of MOD-D. The observed maximum LSTs from MODIS collection 6 showed higher values in comparison with the last versions of LSTs for hot spot regions around the world. After the temporal, spatial, and geometrical matching of LST products, the mean of the MODIS—INSAT LST differences was calculated for the study area. The results demonstrated that discrepancies increased with temperature up to +15.5 K. The slopes of the mean differences were relatively similar for all deserts except for An Nafud, suggesting an effect of View Zenith Angle (VZA. For modeling the discrepancies between two sensors in continuous space, the Diurnal Temperature Cycles (DTC of both sensors were constructed and compared. The sample DTC models approved the results from discrete LST subtractions and proposed the uncertainties within MODIS DTCs. The authors proposed that the observed LST discrepancies in high

  19. Psychotherapy role expectations and experiences - discrepancy and therapeutic alliance among patients with substance use disorders.

    Science.gov (United States)

    Frankl, My; Philips, Björn; Wennberg, Peter

    2014-12-01

    The main aim of the study was to examine how the discrepancy between role expectations prior to psychotherapy and experiences of ongoing psychotherapy related to therapeutic alliance. We hypothesized that a similarity between patient role expectations and experiences would be associated with a stronger alliance. The study also examined whether different dimensions of psychotherapy role expectations predicted retention in psychotherapy. A naturalistic study design was used with data collected prior to therapy and during the first 6 months of therapy. Patients with substance use disorders completed the Psychotherapy Expectation Questionnaire-short version (PEX-S) at the time of therapy assessment. A subsample of these patients (n = 41; n = 24 in individual therapy and n = 17 in group therapy) provided data from therapy including psychotherapy experiences (also measured with PEX-S) and therapeutic alliance, measured with Working Alliance Questionnaire-short version. For patients in group therapy, discrepancy between role expectations and experiences correlated negatively with alliance. Expectations prior to psychotherapy characterized by defensiveness correlated negatively with therapy retention. The finding that disconfirmation of patients' role expectations in group therapy were associated with weaker therapeutic alliance highlights the importance of discussing psychotherapy expectations at an early stage in treatment. Expectations characterized by defensiveness predicted worse retention in psychotherapy, which indicates that the PEX-S can be helpful in detecting patients at risk for dropout. In targeting a patient's role expectancies prior to treatment, possible discrepancies between patient and therapist are made visible and possible to examine. Clarifying the patient's role expectations and the therapist's rationale might be a first step towards establishing a strong working alliance. Surveying the patient's defensiveness tendencies at the beginning of therapy

  20. 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

  1. 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.

  2. Limb lengthening in Africa: tibial lengthening indicated for limb length discrepancy and postosteomyelitis pseudarthrosis

    OpenAIRE

    Ibrahima F; Fokam P; Mouafo Tambo FF

    2014-01-01

    Farikou Ibrahima,1,2 Pius Fokam,2 Félicien Faustin Mouafo Tambo11Department of Surgery and Specialties, Faculty of Medicine and Biomedical Sciences, University of Yaoundé I, Yaoundé, 2Department of Surgery, Douala General Hospital, Douala, CameroonBackground: We present a case of lengthening of a tibia to treat postosteomyelitis pseudarthrosis and limb length discrepancy by the Ilizarov device.Objective: The objective was to treat the pseudarthrosis and correc...

  3. Response to discrepancies in publications related to HMB-FA and ATP supplementation.

    Science.gov (United States)

    Wilson, Jacob M

    2017-01-01

    Gentles and Phillips have submitted questions regarding three recent papers investigating ATP, HMB and the combination. The questions pertaining to the homogeneity of subjects' characteristics between the three different published papers, and why there appears to be differences in the number of subjects in placebo groups across studies. This response addresses each of these issues and demonstrates that there are no discrepancies between papers but rather a misunderstanding of the papers previously published.

  4. 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.

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

    Science.gov (United States)

    Leeuwis, Franca H; Koot, Hans M; Creemers, Daan H M; van Lier, Pol A C

    2015-07-01

    Discrepancies between implicit and explicit self-esteem have been linked with internalizing problems among mainly adolescents and adults. Longitudinal research on this association in children is lacking. This study examined the longitudinal link between self-esteem discrepancies and the development of internalizing problems in children. It furthermore examined the possible mediating role of self-esteem discrepancies in the longitudinal link between experiences of peer victimization and internalizing problems development. Children (N = 330, M(age) = 11.2 year; 52.5 % female) were followed over grades five (age 11 years) and six (age 12 years). Self-report measures were used annually to test for victimization and internalizing problems. Implicit self-esteem was assessed using an implicit association test, while explicit self-esteem was assessed via self-reports. Self-esteem discrepancies represented the difference between implicit and explicit self-esteem. Results showed that victimization was associated with increases in damaged self-esteem (higher levels of implicit than explicit self-esteem. Additionally, damaged self-esteem at age 11 years predicted an increase in internalizing problems in children over ages 11 to 12 years. Furthermore, damaged self-esteem mediated the relationship between age 11 years victimization and the development of internalizing problems. No impact of fragile self-esteem (lower levels of implicit than explicit self-esteem) on internalizing problems was found. The results thus underscore that, as found in adolescent and adult samples, damaged self-esteem is a predictor of increases in childhood internalizing problems. Moreover, damaged self-esteem might explain why children who are victimized develop internalizing problems. Implications are discussed.

  6. 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

  7. Bolton's tooth size discrepancy in malaysian orthodontic patients: Are occlusal characteristics such as overjet, overbite, midline, and crowding related to tooth size discrepancy in specific malocclusions and ethnicities?

    Directory of Open Access Journals (Sweden)

    Priti Subhash Mulimani

    2018-01-01

    Full Text Available Introduction: Tooth size, occlusal traits, and ethnicity are closely interrelated, and their impact on desirable orthodontic treatment outcome cannot be underestimated. This study was undertaken to assess the occlusal characteristics and ethnic variations in occlusion of Malaysian orthodontic patients and evaluate their correlation with Bolton's tooth size discrepancy. Materials and Methods: On 112 pretreatment study models of orthodontic patients, molar relationship, overjet, overbite, spacing, crowding, midline shift, and Bolton's ratios were assessed. ANOVA, one-sample t-test, Chi-squared test, and Spearman's rho correlation coefficient were used for statistical analysis. Results: Significant difference between anterior ratio of our study and Bolton's ideal values was found, for the entire study sample and Chinese ethnic group. Differences between races and malocclusion groups were not statistically significant (P > 0.05. Significant correlations were found as follows – in Angle's Class I malocclusion between 1 anterior ratio and overbite, 2 overall ratio and maxillary crowding and spacing; in Angle's Class II malocclusion between 1 anterior ratio and overjet and midline shift, 2 overall ratio and mandibular crowding; in Angle's Class III malocclusion between 1 anterior ratio and mandibular crowding and both maxillary and mandibular spacing 2 overall ratio and mandibular crowding. Conclusions: Significant differences in anterior ratio and Bolton's ideal values for the Malaysian population were found, indicating variations in anterior tooth size as compared to Caucasians. Statistically significant correlations existed between Bolton's ratios and occlusal traits. These findings can be applied clinically in diagnosis and treatment planning by keeping in mind the specific discrepancies that can occur in certain malocclusions and addressing them accordingly.

  8. 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.

  9. Health risk behaviors and depressive symptoms among Hispanic adolescents: Examining acculturation discrepancies and family functioning.

    Science.gov (United States)

    Cano, Miguel Ángel; Schwartz, Seth J; Castillo, Linda G; Unger, Jennifer B; Huang, Shi; Zamboanga, Byron L; Romero, Andrea J; Lorenzo-Blanco, Elma I; Córdova, David; Des Rosiers, Sabrina E; Lizzi, Karina M; Baezconde-Garbanati, Lourdes; Soto, Daniel W; Villamar, Juan Andres; Pattarroyo, Monica; Szapocznik, José

    2016-03-01

    Drawing from a theory of bicultural family functioning 2 models were tested to examine the longitudinal effects of acculturation-related variables on adolescent health risk behaviors and depressive symptoms (HRB/DS) mediated by caregiver and adolescent reports of family functioning. One model examined the effects of caregiver-adolescent acculturation discrepancies in relation to family functioning and HRB/DS. A second model examined the individual effects of caregiver and adolescent acculturation components in relation to family functioning and HRB/DS. A sample of 302 recently immigrated Hispanic caregiver-child dyads completed measures of Hispanic and U.S. cultural practices, values, and identities at baseline (predictors); measures of family cohesion, family communications, and family involvement 6 months postbaseline (mediators); and only adolescents completed measures of smoking, binge drinking, inconsistent condom use, and depressive symptoms 1 year postbaseline (outcomes). Measures of family cohesion, family communications, and family involvement were used to conduct a confirmatory factor analysis to estimate the fit of a latent construct for family functioning. Key findings indicate that (a) adolescent acculturation components drove the effect of caregiver-adolescent acculturation discrepancies in relation to family functioning; (b) higher levels of adolescent family functioning were associated with less HRB/DS, whereas higher levels of caregiver family functioning were associated with more adolescent HRB/DS; (c) and only adolescent reports of family functioning mediated the effects of acculturation components and caregiver-adolescent acculturation discrepancies on HRB/DS. (c) 2016 APA, all rights reserved).

  10. Micro-macro-discrepancies in nonlinear microrheology: I. Quantifying mechanisms in a suspension of Brownian ellipsoids

    International Nuclear Information System (INIS)

    DePuit, Ryan J; Squires, Todd M

    2012-01-01

    Active and nonlinear microrheology experiments involve a colloidal probe that is forced to move within a material, with the goal of recovering the nonlinear rheological response properties of the material. Various mechanisms cause discrepancies between the nonlinear rheology measured microrheologically and macroscopically, including direct probe-bath collisions, the Lagrangian unsteadiness experienced by the material elements, and the spatially inhomogeneous and rheologically mixed strain field set up around the probe. Here, we perform computational nonlinear microrheology experiments, in which a colloidal probe translates through a dilute suspension of Brownian ellipsoids, whose results we compare against analogous computational experiments on the macroscopic shear rheology of the same model material. The quantitative impact of each of the mechanisms for micro-macro-discrepancy can thus be computed directly, with additional computational experiments performed where the processes in question are ‘turned off’. We show that all three discrepancy mechanisms impact the microrheological measurement quantitatively, and that none can be neglected. This motivates a search for microrheological probes whose geometry or forcing is optimized to minimize these impacts, which we present in a companion article.

  11. Limb lengthening in Africa: tibial lengthening indicated for limb length discrepancy and postosteomyelitis pseudarthrosis

    Directory of Open Access Journals (Sweden)

    Ibrahima F

    2014-05-01

    Full Text Available Farikou Ibrahima,1,2 Pius Fokam,2 Félicien Faustin Mouafo Tambo11Department of Surgery and Specialties, Faculty of Medicine and Biomedical Sciences, University of Yaoundé I, Yaoundé, 2Department of Surgery, Douala General Hospital, Douala, CameroonBackground: We present a case of lengthening of a tibia to treat postosteomyelitis pseudarthrosis and limb length discrepancy by the Ilizarov device.Objective: The objective was to treat the pseudarthrosis and correct the consequent limb length discrepancy of 50 mm.Materials and methods: The patient was a 5-year-old boy. Osteotomy of the tibia, excision of fibrosis, and decortications were carried out. After a latency period of 5 days, the lengthening started at a rate of 1 mm per day.Results: The pseudarthrosis healed and the gained correction was 21.73%. The index consolidation was 49 days/cm. Minor complications were reported.Discussion: Osteomyelitis of long bones is a common poverty-related disease in Africa. The disease usually is diagnosed at an advanced stage with complications. In these conditions, treatment is much more difficult. Most surgical procedures treating this condition use the Ilizarov device. The most common reported surgical complications are refractures and recurrence of infection.Conclusion: This technique should be popularized in countries with limited resources because it would be an attractive alternative to the amputations that are sometimes performed.Keywords: Limb length discrepancy (LLD, bone gap, Ilizarov device

  12. 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.

  13. Diversity in Dermatology Residency Programs.

    Science.gov (United States)

    Van Voorhees, Abby S; Enos, Clinton W

    2017-10-01

    Given the change in our population to one that is more racially and ethnically diverse, the topic of diversity in dermatology residency programs has gained attention. In a field that has become highly competitive, diversity is lagging behind. What are the reasons for this? The existing diversity among medical school matriculants is reflective of the applicant pool, and although modest, there has been an increase in applications and acceptances from minority populations. However, these proportions do not carry through to the population applying to dermatology residency. Making sense of this and planning how to recruit a more diverse applicant pool will improve the quality and cultural competency of future dermatologists. Copyright © 2017 The Authors. Published by Elsevier Inc. All rights reserved.

  14. Redesigning journal club in residency.

    Science.gov (United States)

    Al Achkar, Morhaf

    2016-01-01

    The gap between production and implementation of knowledge is the main reason for the suboptimal quality of health care. To eliminate this gap and improve the quality of patient care, journal club (JC) in graduate medical education provides an opportunity for learning the skills of evidence-based medicine. JC, however, continues to face many challenges mainly due to poorly defined goals, inadequate preparation, and lack of interest. This article presents an innovative model to prepare and present JC based on three pillars: dialogical learning through group discussion, mentored residents as peer teachers, and including JC as part of a structured curriculum to learn evidence-based medicine. This engaging model has the potential to transform JC from a moribund session that is daunting for residents into a lively discussion to redefine clinical practice using the most current evidence.

  15. 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.

  16. Redesigning journal club in residency

    Directory of Open Access Journals (Sweden)

    Al Achkar M

    2016-05-01

    Full Text Available Morhaf Al Achkar Department of Family Medicine, Indiana University, Indianapolis, IN, USA Abstract: The gap between production and implementation of knowledge is the main reason for the suboptimal quality of health care. To eliminate this gap and improve the quality of patient care, journal club (JC in graduate medical education provides an opportunity for learning the skills of evidence-based medicine. JC, however, continues to face many challenges mainly due to poorly defined goals, inadequate preparation, and lack of interest. This article presents an innovative model to prepare and present JC based on three pillars: dialogical learning through group discussion, mentored residents as peer teachers, and including JC as part of a structured curriculum to learn evidence-based medicine. This engaging model has the potential to transform JC from a moribund session that is daunting for residents into a lively discussion to redefine clinical practice using the most current evidence. Keywords: journal club, residents, peer teaching, evidence-based medicine, dialogical learning

  17. 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

  18. 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.

  19. 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.

  20. 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...

  1. 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.

  2. 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.

  3. 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.

  4. Lawful Permanent Residents Fiscal Year 2014 Country

    Data.gov (United States)

    Department of Homeland Security — Lawful permanent residents (LPRs) are foreign nationals who have been granted the right to reside permanently in the United States. LPRs are also known as 'permanent...

  5. Lawful Permanent Residents Fiscal Year 2011 State

    Data.gov (United States)

    Department of Homeland Security — Lawful permanent residents (LPRs) are foreign nationals who have been granted the right to reside permanently in the United States. LPRs are also known as 'permanent...

  6. Lawful Permanent Residents Fiscal Year 2015 Country

    Data.gov (United States)

    Department of Homeland Security — Lawful permanent residents (LPRs) are foreign nationals who have been granted the right to reside permanently in the United States. LPRs are also known as 'permanent...

  7. Lawful Permanent Residents Fiscal Year 2011 Country

    Data.gov (United States)

    Department of Homeland Security — Lawful permanet residents (LPRs) are foreign nationals who have been gratned the right to reside permanently in the United States. LPRs are also known as 'permanent...

  8. Lawful Permanent Residents Fiscal Year 2016 State

    Data.gov (United States)

    Department of Homeland Security — Lawful permanent residents (LPRs) are foreign nationals who have been granted the right to reside permanently in the United States. LPRs are also known as 'permanent...

  9. Lawful Permanent Residents Fiscal Year 2014 State

    Data.gov (United States)

    Department of Homeland Security — Lawful permanent residents (LPRs) are foreign nationals who have been granted the right to reside permanently in the United States. LPRs are also known as 'permanent...

  10. Lawful Permanent Residents Fiscal Year 2015 State

    Data.gov (United States)

    Department of Homeland Security — Lawful permanent residents (LPRs) are foreign nationals who have been granted the right to reside permanently in the United States. LPRs are also known as 'permanent...

  11. Major Sport Venues

    Data.gov (United States)

    Department of Homeland Security — The Major Public Venues dataset is composed of facilities that host events for the National Association for Stock Car Auto Racing, Indy Racing League, Major League...

  12. Major Depression Among Adults

    Science.gov (United States)

    ... Depressive Episode Among Adolescents Data Sources Share Major Depression Definitions Major depression is one of the most ... Bethesda, MD 20892-9663 Follow Us Facebook Twitter YouTube Google Plus NIMH Newsletter NIMH RSS Feed NIMH ...

  13. Neurocritical care education during neurology residency: AAN survey of US program directors.

    Science.gov (United States)

    Sheth, K N; Drogan, O; Manno, E; Geocadin, R G; Ziai, W

    2012-05-29

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

  14. 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.

  15. 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.

  16. 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.

  17. 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.

  18. 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.

  19. Discrepant Views of Oncologists and Cancer Patients on Complementary and Alternative Medicine in a Chinese General Hospital.

    Science.gov (United States)

    Yang, Geliang; Zhang, Huiqing; Gan, Zheng; Fan, Yifu; Gu, Wei; Ling, Changquan

    2018-06-01

    Complementary and alternative medicine (CAM) has been widely used by cancer patients but rarely discussed by oncologists. This study was designed to evaluate the communication gap between China's oncologists and cancer patients on CAM. Two parallel cross-sectional studies assessed 83 oncologists and 402 cancer patients on CAM communication between patients and oncologists, and attitudes toward CAM use and clinical decisions about CAM. A majority (75.1%) of the cancer patients (302/402) were identified as CAM users within the most recent three months while 77.6% of the cancer patients (312/402) were identified as CAM users since diagnosis of cancer. Oncologists and patients responded differently ( P effectiveness of CAM, cancer patients were more likely to believe that CAM was effective while oncologists had more concerns about adverse effects of CAM use. CAM use by patients was predicted by disease duration (≥9 months) in the multivariable logistic regression model. China's oncologists and cancer patients may hold discrepant views on CAM. China's oncologists are encouraged to improve their knowledge on CAM and to initiate more discussions with their patients regarding effective and the safe use of CAM.

  20. Concordances and discrepancies between ICD-10 and DSM-IV criteria for anxiety disorders in childhood and adolescence

    Science.gov (United States)

    2012-01-01

    Background Mental disorders are classified by two major nosological systems, the ICD-10 and the DSM-IV-TR, consisting of different diagnostic criteria. The present study investigated the diagnostic concordance between the two systems for anxiety disorders in childhood and adolescence, in particular for separation anxiety disorder (SAD), specific phobia, social phobia, and generalized anxiety disorder (GAD). Methods A structured clinical interview, the Kinder-DIPS, was administered to 210 children and 258 parents. The percentage of agreement, kappa, and Yule’s Y coefficients were calculated for all diagnoses. Specific criteria causing discrepancies between the two classification systems were identified. Results DSM-IV-TR consistently classified more children than ICD-10 with an anxiety disorder, with a higher concordance between DSM-IV-TR and the ICD-10 child section (F9) than with the adult section (F4) of the ICD-10. This result was found for all four investigated anxiety disorders. The results revealed low to high levels of concordance and poor to good agreement between the classification systems, depending on the anxiety disorder. Conclusions The two classification systems identify different children with an anxiety disorder. However, it remains an open question, whether the research results can be generalized to clinical practice since DSM-IV-TR is mainly used in research while ICD-10 is widely established in clinical practice in Europe. Therefore, the population investigated by the DSM (research population) is not identical with the population examined using the ICD (clinical population). PMID:23267678

  1. Our House Is Burning: Discrepancy in Climate Change vs. Biodiversity Coverage in the Media as Compared to Scientific Literature

    Directory of Open Access Journals (Sweden)

    Pierre Legagneux

    2018-01-01

    Full Text Available Scientists, policy makers, and journalists are three key, interconnected players involved in prioritizing and implementing solutions to mitigate the consequences of anthropogenic pressures on the environment. The way in which information is framed and expertise is communicated by the media is crucial for political decisions and for the integrated management of environmental issues. Here we present a comparative study of scientific literature and press articles addressing climate change and biodiversity. We extensively scrutinized the scientific literature, research funding, and press articles from the USA, Canada, and United Kingdom addressing climate change and biodiversity issues between 1991 and 2016. We found that media coverage of climate change was up to eight times higher compared to biodiversity. This discrepancy could not be explained by different scientific output between the two issues. Moreover, climate change media coverage was often related to specific events whereas no such indication of a connection was found in the case of biodiversity. An international communication strategy is urgently required to raise public awareness on biodiversity issues. We discussed several initiatives that scientists could undertake to better communicate major discoveries to the public and policy makers.

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

    Science.gov (United States)

    Souza-Talarico, Juliana Nery; Wan, Nathalie; Santos, Sheila; Fialho, Patrícia Paes Araujo; Chaves, Eliane Corrêa; Caramelli, Paulo; Bianchi, Estela Ferraz; Santos, Aline Talita; Lupien, Sonia J

    2016-06-03

    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 psychoeducational programs and the development of best practices for interventions. The study aimed to analyze stress knowledge among the Canadian and Brazilian general public and to determine the extent to which scientific and popular views of stress differ between those countries. We evaluated 1156 healthy participants between 18 and 88 years of age recruited from Canada (n = 502) and Brazil (n = 654). To assess stress knowledge, a questionnaire composed of questions regarding stress concepts ("stress is bad" versus "stress-free life is good") and factors capable of triggering the stress response ("novelty, unpredictability, low sense of control and social evaluative threat versus "time pressure,work overload, conflict, unbalance and children") was used. Both Canadian and Brazilian participants showed misconceptions about stress and the factors capable of triggering a stress response. However, the rate of misconceptions was higher in Brazil than in Canada (p stress science and its variance according to a country's society. Psychoeducational programs and vulnerability of stress-related disorder are discussed.

  3. Concordances and discrepancies between ICD-10 and DSM-IV criteria for anxiety disorders in childhood and adolescence

    Directory of Open Access Journals (Sweden)

    Adornetto Carmen

    2012-12-01

    Full Text Available Abstract Background Mental disorders are classified by two major nosological systems, the ICD-10 and the DSM-IV-TR, consisting of different diagnostic criteria. The present study investigated the diagnostic concordance between the two systems for anxiety disorders in childhood and adolescence, in particular for separation anxiety disorder (SAD, specific phobia, social phobia, and generalized anxiety disorder (GAD. Methods A structured clinical interview, the Kinder-DIPS, was administered to 210 children and 258 parents. The percentage of agreement, kappa, and Yule’s Y coefficients were calculated for all diagnoses. Specific criteria causing discrepancies between the two classification systems were identified. Results DSM-IV-TR consistently classified more children than ICD-10 with an anxiety disorder, with a higher concordance between DSM-IV-TR and the ICD-10 child section (F9 than with the adult section (F4 of the ICD-10. This result was found for all four investigated anxiety disorders. The results revealed low to high levels of concordance and poor to good agreement between the classification systems, depending on the anxiety disorder. Conclusions The two classification systems identify different children with an anxiety disorder. However, it remains an open question, whether the research results can be generalized to clinical practice since DSM-IV-TR is mainly used in research while ICD-10 is widely established in clinical practice in Europe. Therefore, the population investigated by the DSM (research population is not identical with the population examined using the ICD (clinical population.

  4. Suicidal Thoughts Among Medical Residents with Burnout

    NARCIS (Netherlands)

    van der Heijden, Frank; Dillingh, Gea; Bakker, Arnold; Prins, Jelle

    2008-01-01

    Objectives: Recent research showed that medical residents have a high risk for developing burnout. The present study investigates the prevalence of burnout and its relationship with suicidal thoughts among medical residents. Methods: All Dutch medical residents (n = 5126) received a self-report

  5. Pioneering partnerships: Resident involvement from multiple perspectives

    NARCIS (Netherlands)

    Baur, V.E.; Abma, T.A.; Boelsma, F.; Woelders, S.

    2013-01-01

    Resident involvement in residential care homes is a challenge due to shortcomings of consumerist and formal approaches such as resident councils. The PARTNER approach aims to involve residents through collective action to improve their community life and wellbeing. The purpose of this article is to

  6. 45 CFR 233.40 - Residence.

    Science.gov (United States)

    2010-10-01

    .... For purposes of this section: (1) A resident of a State is one: (i) Who is living in the State... resident of the State in which he or she is living other than on a temporary basis. Residence may not depend upon the reason for which the individual entered the State, except insofar as it may bear upon...

  7. 24 CFR 964.140 - Resident training.

    Science.gov (United States)

    2010-04-01

    ... TENANT PARTICIPATION AND TENANT OPPORTUNITIES IN PUBLIC HOUSING Tenant Participation § 964.140 Resident... Resident Management Corporations and duly elected Resident Councils; (3) Public housing policies, programs... colleges, vocational schools; and (4) HUD and other Federal agencies and other local public, private and...

  8. 38 CFR 51.110 - Resident assessment.

    Science.gov (United States)

    2010-07-01

    ...) PER DIEM FOR NURSING HOME CARE OF VETERANS IN STATE HOMES Standards § 51.110 Resident assessment. The... physician orders for the resident's immediate care and a medical assessment, including a medical history and...) Review of assessments. The nursing facility management must examine each resident no less than once every...

  9. Sexual Health Education: A Psychiatric Resident's Perspective

    Science.gov (United States)

    Waineo, Eva; Arfken, Cynthia L.; Morreale, Mary K.

    2010-01-01

    Objective: This report discusses psychiatric residents' perceptions of sexual health education and their opinions regarding curricular improvements. Methods: An anonymous, web-based survey was sent to residents in one general psychiatry program (N = 33). The response rate was 69.7%. Results: Residents reported inadequate experience in multiple…

  10. Hepatectomy simulation discrepancy between radionuclide receptor imaging and CT volumetry. Influence of decreased unilateral portal venous flow

    International Nuclear Information System (INIS)

    Akaki, Shiro; Okumura, Yoshihiro; Sasai, Nobuya; Sato, Shuhei; Tsunoda, Masatoshi; Kuroda, Masahiro; Kanazawa, Susumu; Hiraki, Yoshio

    2003-01-01

    Regional dysfunction demonstrated by Tc-99m-diethylenetriamine-penta-acetic acid-galactosyl human serum albumin (GSA) scintigraphy due to regional decrease in the portal venous flow has previously been reported. In this study, we call attention to the significance of unilateral portal venous flow decrease for preoperative hepatectomy simulation, and evaluate the hepatectomy simulation discrepancy between Tc-99m-GSA single-photon emission computed tomography (SPECT) and CT volumetry. Twenty-four hepatectomy candidates underwent preoperative hepatectomy simulation by both Tc-99m-GSA SPECT and CT volumetry. Both anatomical and functional resection ratios were calculated by means of CT volumetry and Tc-99m-GSA SPECT, respectively. The differences and ratios between anatomical and functional resection ratios were calculated in all patients, and compared in patients with and without unilateral portal venous flow decrease. Anatomical resection ratios were 28.0±11.7 (mean±standard deviation) in patients with unilateral portal venous flow decrease, and 42.1±15.7 in patients without unilateral portal venous flow decrease (p=0.0127). Functional resection ratios were 14.7±12.8 in patients with unilateral portal venous flow decrease and 40.5±14.6 in patients without (p=0.0004). The differences between anatomical and functional resection ratios were 13.0±7.9 in patients with unilateral portal venous flow decrease and 5.6±3.1 in patients without (p=0.0099). The ratios between anatomical and functional resection ratios were 0.48±0.29 in patients with unilateral portal venous flow decrease and 0.86±0.10 in patients without (p=0.0018). In 12 of the 13 patients with unilateral portal venous flow decrease, anatomical resection ratios were found to be larger than functional resection ratios, whereas this happened in only 6 of 11 patients without unilateral portal venous flow decrease (p=0.0063). Unilateral portal venous flow decrease is suspected to be a major factor in the

  11. Psychotherapy Training: Residents' Perceptions and Experiences.

    Science.gov (United States)

    Kovach, Jessica G; Dubin, William R; Combs, Christopher J

    2015-10-01

    This survey examined actual training hours in psychotherapy modalities as reported by residents, residents' perceptions of training needs, and residents' perceptions of the importance of different aspects of psychotherapy training. A brief, voluntary, anonymous, Internet-based survey was developed. All 14 program directors for Accreditation Council for Graduate Medical Education accredited programs in Pennsylvania, New Jersey, and Delaware provided email addresses for current categorical residents. The survey inquired about hours of time spent in various aspects of training, value assigned to aspects of training, residents' involvement in their own psychotherapy, and overall resident wellness. The survey was e-mailed to 328 residents. Of the 328 residents contacted, 133 (40.5%) responded. Median reported number of PGY 3 and 4 performed versus perceived ideal hours of supportive therapy, cognitive behavioral therapy (CBT), and psychodynamic therapy did not differ. Answers for clinical time utilizing these modalities ranged from "none or less than 1 h" per month to 20+ h per month. PGY 3 and 4 residents reported a median of "none or less than 1 h" per month performed of interpersonal, dialectical behavior therapy, couples/family/group, and child therapies but preferred more time using these therapies. Residents in all years of training preferred more hours of didactic instruction for all psychotherapies and for medication management. Residents ranked teaching modalities in the following order of importance: supervision, hours of psychotherapy performed, personal psychotherapy, readings, and didactic instruction. Residents engaged in their own psychotherapy were significantly more likely to rank the experiential aspects of psychotherapy training (personal psychotherapy, supervision, and hours performed) higher than residents not in psychotherapy. Current psychotherapy training for psychiatry residents is highly variable, but overall, residents want more

  12. How do urology residents manage personal finances?

    Science.gov (United States)

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

    2001-05-01

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

  13. Peer observation and feedback of resident teaching.

    Science.gov (United States)

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

    2013-02-01

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

  14. Lamb shift in muonic hydrogen-II. Analysis of the discrepancy of theory and experiment

    International Nuclear Information System (INIS)

    Jentschura, U.D.

    2011-01-01

    Research highlights: → Various theoretical explanation for the recently observed experimental-theoretical discrepancy in the muonic hydrogen Lamb shift are explored. → These include a dip in the proton form factor slope, nonperturbative vacuum polarization and millicharged virtual particles, as well as process-dependent screening corrections. → Screening corrections may need to be explored further. → The need for an alternative determination of the Rydberg constant is highlighted. - Abstract: Currently, both the g factor measurement of the muon as well as the Lamb shift 2S-2P measurement in muonic hydrogen are in disagreement with theory. Here, we investigate possible theoretical explanations, including proton structure effects and small modifications of the vacuum polarization potential. In particular, we investigate a conceivable small modification of the spectral function of vacuum polarization in between the electron and muon energy scales due to a virtual millicharged particle and due to an unstable vector boson originating from a hidden sector of an extended standard model. We find that a virtual millicharged particle which could explain the muonic Lamb shift discrepancy alters theoretical predictions for the muon anomalous magnetic moment by many standard deviations and therefore is in conflict with experiment. Also, we find no parameterizations of an unstable virtual vector boson which could simultaneously explain both 'muonic' discrepancies without significantly altering theoretical predictions for electronic hydrogen, where theory and experiment currently are in excellent agreement. A process-dependent correction involving electron screening is evaluated to have the right sign and order-of-magnitude to explain the observed effect in muonic hydrogen. Additional experimental evidence from light muonic atoms and ions is needed in order to reach further clarification.

  15. The morpho/functional discrepancy in the cerebellar cortex: Looks alone are deceptive.

    Directory of Open Access Journals (Sweden)

    Dan Rokni

    2008-12-01

    Full Text Available In a recent report we demonstrated that stimulation of cerebellar mossy fibers synchronously activates Purkinje cells that are located directly above the site of stimulation. We found that the activated Purkinje cells are arranged in a radial patch on the cerebellar surface and that this organization is independent of the integrity of the inhibitory system. This arrangement of activity is counterintuitive. The anatomical structure with the extensive parallel fiber system implies that mossy fiber stimulation will activate Purkinje cells along a beam of parallel fibers. In this short review we highlight this discrepancy between anatomical structure and functional dynamics and suggest a plausible underlying mechanism.

  16. Gender discrepancies in the outcomes of schedule control on overtime hours and income in Germany

    OpenAIRE

    Lott, Yvonne; Chung, Heejung

    2016-01-01

    Schedule control can have both positive – e.g., increased income – but also negative outcomes – e.g., increased overtime. Here our core interest is whether there are gender discrepancies in these outcomes. Given the different ways in which schedule control can be used, and perceived to be used by men and women, their outcomes are also expected to be different. This is examined using the German Socio-Economic Panel Study (2003-2011), and panel regression models. The results show that schedule ...

  17. 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

  18. A study in the use of the position of discrepant events in the teaching of science

    Science.gov (United States)

    Frassinelli, John James

    The purpose of this study was to determine whether alternative placement of discrepant events would impact affective and cognitive outcomes of ninth-grade physical science students grouped into intact classes and classified as either "high" or "low" in prior academic achievement. Although researchers have found discrepant events to be effective in terms of cognition and recall, their chronological placement within science lessons had not been empirically researched. In this study, discrepant events were presented before, during, and after specific science lessons involving thermodynamics and heat. Discrepant events were withheld from the control group. To measure affective outcomes, the "enjoyment" and "motivation" scales taken from Sandman's (1973) Attitudes Towards Science Inventory (ATSI) were used to index subjects' global feelings about studying science, while a 20-item set of Semantic Differential (SD) scales was employed to determine their attitudes regarding the specific subject matter taught. To measure cognitive outcomes, a 20-item, selected response test was constructed by the researcher, with 6 items intended to assess subjects' knowledge of unit materials, and 14 items designed to query their understanding of unit concepts. Each subject (N = 131) was administered identical forms of each test in both pre-and post-test formats, both before and after the four-week study. Analyzed using a 4 x 2 mixed Analysis of Variance (ANOVA) model, data pertinent to the ATSI suggested neither between- nor within-group differences in subjects' global attitudes about studying science, although data pertinent to the SD scales indicated generally improved attitudes about studying thermodynamics and heat (F (1,122) = 2.759, p < .10). On the cognitive pretests and posttests, significant two-way interactions were observed for the overall test and experimental condition (F (3,121) = 4.068, p < .01), as well as for the overall test and higher prior achievement in physical

  19. Perioperative self-reflection among surgical residents.

    Science.gov (United States)

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

    2017-09-01

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

  20. Operative Landscape at Canadian Neurosurgery Residency Programs.

    Science.gov (United States)

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

    2017-07-01

    Background Currently, the literature lacks reliable data regarding operative case volumes at Canadian neurosurgery residency programs. Our objective was to provide a snapshot of the operative landscape in Canadian neurosurgical training using the trainee-led Canadian Neurosurgery Research Collaborative. Anonymized administrative operative data were gathered from each neurosurgery residency program from January 1, 2014, to December 31, 2014. Procedures were broadly classified into cranial, spine, peripheral nerve, and miscellaneous procedures. A number of prespecified subspecialty procedures were recorded. We defined the resident case index as the ratio of the total number of operations to the total number of neurosurgery residents in that program. Resident number included both Canadian medical and international medical graduates, and included residents on the neurosurgery service, off-service, or on leave for research or other personal reasons. Overall, there was an average of 1845 operative cases per neurosurgery residency program. The mean numbers of cranial, spine, peripheral nerve, and miscellaneous procedures were 725, 466, 48, and 193, respectively. The nationwide mean resident case indices for cranial, spine, peripheral nerve, and total procedures were 90, 58, 5, and 196, respectively. There was some variation in the resident case indices for specific subspecialty procedures, with some training programs not performing carotid endarterectomy or endoscopic transsphenoidal procedures. This study presents the breadth of neurosurgical training within Canadian neurosurgery residency programs. These results may help inform the implementation of neurosurgery training as the Royal College of Physicians and Surgeons residency training transitions to a competence-by-design curriculum.

  1. 2003 survey of Canadian radiation oncology residents

    International Nuclear Information System (INIS)

    Yee, Don; Fairchild, Alysa; Keyes, Mira; Butler, Jim; Dundas, George

    2005-01-01

    Purpose: Radiation oncology's popularity as a career in Canada has surged in the past 5 years. Consequently, resident numbers in Canadian radiation oncology residencies are at all-time highs. This study aimed to survey Canadian radiation oncology residents about their opinions of their specialty and training experiences. Methods and Materials: Residents of Canadian radiation oncology residencies that enroll trainees through the Canadian Resident Matching Service were identified from a national database. Residents were mailed an anonymous survey. Results: Eight of 101 (7.9%) potential respondents were foreign funded. Fifty-two of 101 (51.5%) residents responded. A strong record of graduating its residents was the most important factor residents considered when choosing programs. Satisfaction with their program was expressed by 92.3% of respondents, and 94.3% expressed satisfaction with their specialty. Respondents planning to practice in Canada totaled 80.8%, and 76.9% plan to have academic careers. Respondents identified job availability and receiving adequate teaching from preceptors during residency as their most important concerns. Conclusions: Though most respondents are satisfied with their programs and specialty, job availability and adequate teaching are concerns. In the future, limited time and resources and the continued popularity of radiation oncology as a career will magnify the challenge of training competent radiation oncologists in Canada

  2. Current perspectives on chief residents in psychiatry.

    Science.gov (United States)

    Warner, Christopher H; Rachal, James; Breitbach, Jill; Higgins, Michael; Warner, Carolynn; Bobo, William

    2007-01-01

    The authors examine qualitative data from outgoing chief residents in psychiatry from the 2004-2005 academic year to 1) determine common characteristics between programs, 2) examine the residents' perspectives on their experiences, and 3) determine their common leadership qualities. The authors sent out self-report surveys via e-mail to 89 outgoing chief residents who attended the APA/Lilly Chief Resident Executive Leadership Program. Fifty-three (60%) chief residents responded. Although most chief residents are senior residents, over 20% are in their third postgraduate year. Two-thirds of programs have more than one chief resident each year. Most chief residents believe that their "participating" leadership style, existing leadership skills, and interpersonal skills contributed to their overall positive experiences. Successfully performing duties as a chief resident entails functioning in a variety of roles and demands attention to leadership qualities of the individual. Developing existing leadership skills, clarifying expectations, and providing mentorship to chief residents will ensure successful transition into practice, and the advancement of the field of psychiatry.

  3. Creating a Culture of Wellness in Residency.

    Science.gov (United States)

    Edmondson, Emma K; Kumar, Anupam A; Smith, Stephanie M

    2018-04-17

    Despite increased awareness and recognition of the prevalence of physician burnout and the associated risks of depression and suicide, there is a paucity of actionable guidelines for residency programs to mitigate these risks for their residents. In this Invited Commentary, the authors acknowledge that, although there are inherent barriers to resident wellness, there are numerous modifiable barriers that present opportunities for programs to enable culture change and improve resident wellbeing. The authors frame the discussion with a personal narrative written by a resident in their internal medicine program who experienced burnout, depression, and suicidality during his intern year. They aim to inspire residency programs and hospital leadership to identify and intervene upon the modifiable barriers to wellness for residents in their programs in order to shape meaningful cultural change.

  4. 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

  5. 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

  6. Psychiatry Training in Canadian Family Medicine Residency Programs

    OpenAIRE

    Kates, Nick; Toews, John; Leichner, Pierre

    1985-01-01

    Family physicians may spend up to 50% of their time diagnosing and managing mental disorders and emotional problems, but this is not always reflected in the training they receive. This study of the teaching of psychiatry in the 16 family medicine residency programs in Canada showed that although the majority of program directors are reasonably satisfied with the current training, they see room for improvement—particularly in finding psychiatrists with a better understanding of family practice...

  7. [Part-time residency training in Israel].

    Science.gov (United States)

    Fishbain, Dana; Levi, Baruch; Borow, Malke; Ashkenazi, Shai; Lindner, Arie

    2012-08-01

    Full-time work has long been perceived as a cornerstone of medical residency, the consensus being that a resident must apply the bulk of his time and attention to his professional training. Demographic and cultural changes that have taken place over the last several years, specifically the rise in the number of female doctors and the importance of leisure time to the younger generation, have intensified the need to find new and innovative ways to deal with the plight of the resident population. One idea, already in effect in many Western countries, is the institution of part-time residency programs. The possibility of fulfilling residency requirements on a part-time basis is intended to assist medical residents in integrating their professional development with their personal and family life, without compromising the quality of their training. A number of research studies conducted over the last several years in countries that allow part-time residency, among them the United States, England and Switzerland, aimed to examine the quality of part-time training. The various studies evinced a high level of satisfaction from the program both by the residents themselves and their supervisors, and in many aspects those doing residency part-time received higher appraisals than their full-time colleagues. Some of the residents polled noted that they would have totally foregone the practice of medicine had there not been an option to complete residency part-time. In light of the experience throughout the world and the changing landscape in Israel, the Scientific Council of the Israeli Medical Association decided to examine the issue and its various aspects, and weighed all the considerations in favor and against part-time residency. Recently, the Scientific Council approved the launch of a pilot program to allow part-time residency in several fields that were carefully selected according to specific criteria. Once the Ministry of Health completes the LegisLation process, part

  8. 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.

  9. 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.

  10. Reducing discrepancies of personal goals in the context of cancer : A longitudinal study on the relation with well-being, psychological characteristics, and goal progress

    NARCIS (Netherlands)

    Pama, Marlous R.; Janse, Moniek; Sprangers, Mirjam A. G.; Fleer, Joke; Ranchor, Adelita V.

    OBJECTIVES: To (1) examine whether reducing discrepancies between goal importance and goal attainability is an adaptive predictor of well-being, (2) investigate intrusion, awareness, optimism, and pessimism as determinants of reducing discrepancies between goal importance and goal attainability, and

  11. 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

  12. 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.

  13. Gender and Depression: Analysis of the Effects of Sex Roles, Sex-Role Self-Discrepancy, and Attributional Style

    OpenAIRE

    Cutler, Scott V.

    1995-01-01

    The purpose of this study was to examine the influence of attributional style, sex roles, and sex-role self-discrepancy in the relationship between gender and depression. Epidemiological studies report a higher incidence of depression among women then men (approximately 2:1). Among the various theories suggested to explain this gender difference, sex roles, attributional style, and self-discrepancy have been conceived as possible explanations. The relationship between gender and depression ma...

  14. 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.

  15. Assessment of crown angulations, crown inclinations, and tooth size discrepancies in a South Indian population

    Directory of Open Access Journals (Sweden)

    Geeta Maruti Doodamani

    2011-01-01

    Full Text Available Aims and Objective: The aim of this study was to assess crown angulations, crown inclinations, and tooth size discrepancy in a sample population from Davangere, South India. Materials and Methods: One hundred adults (50 male and 50 female of age 18-30 years, with Angle′s class I ideal occlusion and balanced profiles, were selected for the study. Study models were prepared and crown angulations and crown inclinations were measured using a customized protractor device. Bolton′s analysis was used to measure the tooth size discrepancies. Results: Maxillary and mandibular teeth had less crown angulations. Maxillary and mandibular incisors and maxillary molars showed increased crown inclinations, whereas mandibular molars and premolars had less crown inclinations than the original Andrews sample. The mean maxillary and mandibular tooth size ratios, overall and anterior, were similar to Bolton′s ratios. Conclusions: The finding of this study indicates that there are possible racial and ethnic factors contributing to variations in crown angulations and crown inclinations.

  16. Masculine Discrepancy Stress and Psychosocial Maladjustment: Implications for Behavioral and Mental Health of Adolescent Boys.

    Science.gov (United States)

    Reidy, Dennis E; Smith-Darden, Joanne P; Vivolo-Kantor, Alana M; Malone, Carolyn A; Kernsmith, Poco D

    2017-01-01

    Gender role discrepancy (GRD), or nonconformity to socially prescribed gender roles, has been linked to a multitude of adverse mental and behavioral health outcomes. Masculine discrepancy stress (MDS), stress about being perceived not to conform to one's gender role, may explain the relationship between GRD and deleterious health outcomes. However, research on MDS has primarily been restricted to adult males. This leaves a critical gap pertaining to the potential effect of MDS on adolescent boys, who may be more malleable and susceptible to the influence and pressures of gender socialization. In the current study, data are drawn from a sample of adolescent male students ( N = 592) who completed self-report questionnaires. We employed structural equation modeling to test the effects of GRD and MDS on psychosocial maladjustment measured via sexual behavior, substance use, violence, mood disorder symptoms, and hopelessness. In addition, we controlled for critical risk factors including sociodemographic characteristics, adverse childhood experiences, trauma symptoms, and neighborhood disorganization. Findings indicate significant potentiating effects of MDS on maladjustment while there were direct protective effects of GRD. These data suggest that developing prevention strategies that incorporate social norms pertaining to gender socialization may have an impact on multiple behavioral and mental health problems.

  17. Discrepancies in general surgery medical terminology between South and North Korea.

    Science.gov (United States)

    Hur, Keunyoung; Park, Do-Eon; Oh, Heung-Kwon; Yang, Hyun Hui; Ko, Dayoung; Kim, Min-Hyun; Kim, Myung Jo; Kang, Sung Il; Kim, Duck-Woo; Kang, Sung-Bum

    2018-03-01

    The purpose of this study was to categorize surgery-related medical terminologies used in South and North Korea and to compare and analyze discrepancies observed in the terms. This study collected medical terminology used in the North Korean medical book "Surgery" and compared it to medical terminology found in the medical glossary of South Korea. The order of the subtitle was described according to the Instruction to Authors. In total, there were 2,168 individual medical terms, of which only 1,004 words (46.3%) were identical to South Korean medical terms. There were 581 similar terms (26.8%), 265 different terms (12.2%), and 318 terms that are nonexistent in South Korea (14.7%). Less than half of the medical terms used in North Korea match those used in South Korea. It is expected that the prolongation of the current division of South and North Korea will only worsen this discrepancy. Further efforts to bridge the gap through academic exchange between South Korea and North Korea are required in preparation for an era of reunification.

  18. 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.

  19. Stellar oxygen abundances. I - A resolution to the 7774 A O I abundance discrepancy

    Science.gov (United States)

    King, Jeremy R.

    1993-09-01

    We investigate the discrepancy between O/Fe abundance ratios of metal-poor stars derived from the 7774 A O I triplet and O/Fe ratios determined from other oxygen lines. We propose a possible resolution to this discrepancy which also eliminates the correlation of O/Fe and T(eff) found in a recent 7774 A O I analysis. The equivalent widths of Abia & Rebolo (1989) are found to be systematically too high by 25 percent. Arguments are presented that current temperature estimates for halo stars are 150-200 K too low. Using the guidance of both model atmospheres and other empirical color-T(eff) relations, we construct new color temperature relations for metal-poor stars. These relations are tied to the temperature scale of Saxner & Hammarback (1985) for metal-rich stars. We use (b-y) and (V-K) indices to redetermine values of T(eff) for a handful of halo stars. (B-V)-T(eff) relations which do not take into account the effects of metallicity are found to be inadequate. Revised O/Fe ratios are determined using the new temperature scale. The mean abundance ratio of the reanalyzed halo dwarfs is about +0.52. There is no trend of O/Fe with Fe/H or T(eff).

  20. Comparison of radioassay and microbiological assay for serum folate, with clinical assessment of discrepant results

    International Nuclear Information System (INIS)

    Baril, L.; Carmel, R.

    1978-01-01

    Folate assays by use of radiolabeled folate provide obvious practical advantages over the standard microbiological assay, but remain incompletely tested. We therefore compared results for 415 sera with a kit involving 3 H-labeled folate and the Lactobacillus casei microbiological method. We examined the patients' data when there were discrepancies between the two methods. Although the correlation overall was satisfactory, results were discrepant in 25% of cases. In 74% of the latter, the radioassay result appeared to be the correct one, primarily because L. casei results were suppressed by antibiotics being taken by the patient. The radioassay occasionally gave falsely high values for patients with liver disease and falsely low ones for patients who had received isotopes for scanning purposes. Several assay kits that make use of 125 I- or 75 Se-labeled folate were also tested. Although these results correlated with the results of 3 H-labeled folate assay, various problems appeared, including the possible need for serum-supernate control tubes in one kit. Answers to these and other questions and careful clinical correlation of results are needed for any folate radioassays before their adoption for routine clinical use

  1. Effects of creatine supplementation on high-intensity intermittent exercise: discrepancies and methodological appraisals

    Directory of Open Access Journals (Sweden)

    Bruno Gualano

    2008-07-01

    Full Text Available http://dx.doi.org/10.5007/1980-0037.2008v10n2p189 After a brief review of the literature on the effects of creatine supplementation on high-intensity intermittent exercise performance, the main aim of this study was to discuss methodological differences between studies which could explain the discrepancies observed in the literature. The effects of creatine supplementation on high-intensity intermittent exercise performance have been investigated in depth. Although the results of much research demonstrates the effi cacy of this supplement, there is just as much evidence that does not support this ergogenic effect. The explanation for this divergence appears to be multifactorial, although it is always linked to methodological characteristics. Study design (crossover or parallel groups, individual variability of muscular creatine content, chronic high meat intake, sample size, exercise protocol characteristics (body weight dependence and time between series, and gender and age all differ between studies and are potentially the variables responsible, to differing extents, for the discrepancies observed in the literature. Studies involving young males, with parallel group design, adequate statistical power, control of the incorporation of creatine into muscles, food intake assessment and intermittent exercise protocols in which performance is independent of body weight and with rest-recovery intervals of 1 to 6 minutes, usually produce positive results. The many methodological factors which can contribute to divergence on the ergogenic effects of creatine should be considered in futures studies, as well as when prescribing creatine supplementation.

  2. A comparison of cancer burden and research spending reveals discrepancies in the distribution of research funding

    Directory of Open Access Journals (Sweden)

    Carter Ashley JR

    2012-07-01

    Full Text Available Abstract Background Ideally, the distribution of research funding for different types of cancer should be equitable with respect to the societal burden each type of cancer imposes. These burdens can be estimated in a variety of ways; “Years of Life Lost” (YLL measures the severity of death in regard to the age it occurs, "Disability-Adjusted Life-Years" (DALY estimates the effects of non-lethal disabilities incurred by disease and economic metrics focus on the losses to tax revenue, productivity or direct medical expenses. We compared research funding from the National Cancer Institute (NCI to a variety of burden metrics for the most common types of cancer to identify mismatches between spending and societal burden. Methods Research funding levels were obtained from the NCI website and information for societal health and economic burdens were collected from government databases and published reports. We calculated the funding levels per unit burden for a wide range of different cancers and burden metrics and compared these values to identify discrepancies. Results Our analysis reveals a considerable mismatch between funding levels and burden. Some cancers are funded at levels far higher than their relative burden suggests (breast cancer, prostate cancer, and leukemia while other cancers appear underfunded (bladder, esophageal, liver, oral, pancreatic, stomach, and uterine cancers. Conclusions These discrepancies indicate that an improved method of health care research funding allocation should be investigated to better match funding levels to societal burden.

  3. Mate Value Discrepancy and Mate Retention Behaviors of Self and Partner.

    Science.gov (United States)

    Sela, Yael; Mogilski, Justin K; Shackelford, Todd K; Zeigler-Hill, Virgil; Fink, Bernhard

    2017-10-01

    This study investigated the relationship between perceived mate value discrepancy (i.e., the difference between an individual's mate value and their partner's mate value) and perceived frequency of mate retention performed by an individual relative to his or her partner. In two studies, participants in long-term, exclusive, sexual, heterosexual relationships reported their own, and their partner's, mate value and mate retention. Samples included 899 community members (Study 1) and 941 students and community members (Study 2). In Study 1, we documented that individuals with higher self-perceived short-term mate value, and who perceive their partner to have lower (vs. higher) short-term mate value, perform less frequent Benefit-Provisioning mate retention, controlling for the partner's Benefit-Provisioning mate retention. In Study 2, we documented that individuals who perceive that they could less easily replace their partner, and who perceive their partner could more (vs. less) easily replace them, perform more frequent mate retention (Benefit-Provisioning and Cost-Inflicting), controlling for the partner's mate retention. These results highlight the importance of assessing perceived discrepancies in mate value (notably, regarding the replaceability of self and partner with another long-term mate) and perceived mate retention behaviors of self, relative to partner, between men and women in long-term relationships. © 2016 Wiley Periodicals, Inc.

  4. Neurohospitalists enhance resident perception of the educational and clinical value of a night float rotation.

    Science.gov (United States)

    Greene, James G

    2013-10-01

    Neurology residency training programs have been profoundly impacted by recent changes in resident duty hours, workloads, and supervisory requirements. In response, many programs have adopted a night float coverage system to minimize the requirements for overnight call. The majority involves residents working a block of night shifts in what is typically a service-oriented rotation. Recently, concerns have arisen regarding the impact of this design on resident education and patient care. We have developed a novel on-site nighttime neurohospitalist model for the explicit purpose of steepening the initial learning curve for neurology residents in an effort to rapidly improve their neurological skills and, in conjunction, overnight patient care. We surveyed residents after the initiation of this system to assess their perception of the impact of direct overnight supervision on education and patient care. As part of ongoing quality improvement efforts, surveys were administered to neurology house staff at a tertiary academic medical center after they had completed service on the night float rotation both with and without an attending in the hospital using a retrospective pre/postdesign. There was a robust positive impact on resident's perception of overall quality, educational value, and clinical quality on the night float rotation with an attending on-site. Despite an overall perception that their autonomy was maintained, residents believed barriers to contact the attending were lower, and attending interaction during critical decision making was more frequent. Direct overnight supervision by a neurohospitalist enhances the educational value and care quality on overnight resident rotations.

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

    Science.gov (United States)

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

    2013-10-01

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

  6. Night shift preparation, performance, and perception: are there differences between emergency medicine nurses, residents, and faculty?

    Science.gov (United States)

    Richards, John R; Stayton, Taylor L; Wells, Jason A; Parikh, Aman K; Laurin, Erik G

    2018-04-30

    Determine differences between faculty, residents, and nurses regarding night shift preparation, performance, recovery, and perception of emotional and physical health effects. Survey study performed at an urban university medical center emergency department with an accredited residency program in emergency medicine. Forty-seven faculty, 37 residents, and 90 nurses completed the survey. There was no difference in use of physical sleep aids between groups, except nurses utilized blackout curtains more (69%) than residents (60%) and faculty (45%). Bedroom temperature preference was similar. The routine use of pharmacologic sleep aids differed: nurses and residents (both 38%) compared to faculty (13%). Residents routinely used melatonin more (79%) than did faculty (33%) and nurses (38%). Faculty preferred not to eat (45%), whereas residents (24%) preferred a full meal. The majority (>72%) in all groups drank coffee before their night shift and reported feeling tired despite their routine, with 4:00 a.m. as median nadir. Faculty reported a higher rate (41%) of falling asleep while driving compared to residents (14%) and nurses (32%), but the accident rate (3% to 6%) did not differ significantly. All had similar opinions regarding night shift-associated health effects. However, faculty reported lower level of satisfaction working night shifts, whereas nurses agreed less than the other groups regarding increased risk of drug and alcohol dependence. Faculty, residents, and nurses shared many characteristics. Faculty tended to not use pharmacologic sleep aids, not eat before their shift, fall asleep at a higher rate while driving home, and enjoy night shift work less.

  7. 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.

  8. Comparison of stress and burnout among anesthesia and surgical residents in a tertiary care teaching hospital in North India.

    Science.gov (United States)

    Gandhi, K; Sahni, N; Padhy, S K; Mathew, P J

    2017-10-23

    The residents undergoing training at hospitals in our country face challenges in terms of infrastructure and high workload with undefined working hours. The aim of the study was to compare the stress and burnout levels in trainee doctors doing residency in surgical fields and anesthesia at a tertiary care academic center in North India. A comparative, observational study was conducted in a tertiary care teaching hospital in North India. After Ethics Committee approval, 200 residents (100 each from surgical branches and anesthesia) were required to fill a questionnaire with information about age, sex, year of residency, marital status, and the Perceived Stress Scale-10, and Burnout Clinical Subtype Questionnaire-12. Burnout and perceived stress were compared between residents of anesthesia and surgical specialties. Residents of both surgical and anesthesia branches scored high in perceived stress, namely 21 and 18, respectively. The score was significantly higher in surgical residents (P = 0.03) and increased progressively with the year of residency. The majority of residents (90% surgical, 80% anesthesia) felt that they were being overloaded with work. However, only 20%-30% of respondents felt that there was lack of development of individual skills and still fewer (<10%) reported giving up in view of difficulties. There is high level of stress and overload dimension of burnout among the residents of anesthesia and surgical branches at our tertiary care academic institution and the surgical residents score marginally higher than anesthesia residents.

  9. Prospects after Major Trauma

    NARCIS (Netherlands)

    Holtslag, H.R.

    2007-01-01

    Introduction. After patients survived major trauma, their prospects, in terms of the consequences for functioning, are uncertain, which may impact severely on patient, family and society. The studies in this thesis describes the long-term outcomes of severe injured patients after major trauma. In

  10. 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.

  11. 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.

  12. 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.

  13. 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

  14. 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.

  15. Automated data mining: an innovative and efficient web-based approach to maintaining resident case logs.

    Science.gov (United States)

    Bhattacharya, Pratik; Van Stavern, Renee; Madhavan, Ramesh

    2010-12-01

    Use of resident case logs has been considered by the Residency Review Committee for Neurology of the Accreditation Council for Graduate Medical Education (ACGME). This study explores the effectiveness of a data-mining program for creating resident logs and compares the results to a manual data-entry system. Other potential applications of data mining to enhancing resident education are also explored. Patient notes dictated by residents were extracted from the Hospital Information System and analyzed using an unstructured mining program. History, examination and ICD codes were obtained and compared to the existing manual log. The automated data History, examination, and ICD codes were gathered for a 30-day period and compared to manual case logs. The automated method extracted all resident dictations with the dates of encounter and transcription. The automated data-miner processed information from all 19 residents, while only 4 residents logged manually. The manual method identified only broad categories of diseases; the major categories were stroke or vascular disorder 53 (27.6%), epilepsy 28 (14.7%), and pain syndromes 26 (13.5%). In the automated method, epilepsy 114 (21.1%), cerebral atherosclerosis 114 (21.1%), and headache 105 (19.4%) were the most frequent primary diagnoses, and headache 89 (16.5%), seizures 94 (17.4%), and low back pain 47 (9%) were the most common chief complaints. More detailed patient information such as tobacco use 227 (42%), alcohol use 205 (38%), and drug use 38 (7%) were extracted by the data-mining method. Manual case logs are time-consuming, provide limited information, and may be unpopular with residents. Data mining is a time-effective tool that may aid in the assessment of resident experience or the ACGME core competencies or in resident clinical research. More study of this method in larger numbers of residency programs is needed.

  16. 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.

  17. 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

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

    Science.gov (United States)

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

    2007-01-01

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

  19. 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.

  20. Social media in the emergency medicine residency curriculum: social media responses to the residents' perspective article.

    Science.gov (United States)

    Hayes, Bryan D; Kobner, Scott; Trueger, N Seth; Yiu, Stella; Lin, Michelle

    2015-05-01

    In July to August 2014, Annals of Emergency Medicine continued a collaboration with an academic Web site, Academic Life in Emergency Medicine (ALiEM), to host an online discussion session featuring the 2014 Annals Residents' Perspective article "Integration of Social Media in Emergency Medicine Residency Curriculum" by Scott et al. The objective was to describe a 14-day worldwide clinician dialogue about evidence, opinions, and early relevant innovations revolving around the featured article and made possible by the immediacy of social media technologies. Six online facilitators hosted the multimodal discussion on the ALiEM Web site, Twitter, and YouTube, which featured 3 preselected questions. Engagement was tracked through various Web analytic tools, and themes were identified by content curation. The dialogue resulted in 1,222 unique page views from 325 cities in 32 countries on the ALiEM Web site, 569,403 Twitter impressions, and 120 views of the video interview with the authors. Five major themes we identified in the discussion included curriculum design, pedagogy, and learning theory; digital curation skills of the 21st-century emergency medicine practitioner; engagement challenges; proposed solutions; and best practice examples. The immediacy of social media technologies provides clinicians the unique opportunity to engage a worldwide audience within a relatively short time frame. Copyright © 2015 American College of Emergency Physicians. Published by Elsevier Inc. All rights reserved.

  1. PNEUMONIA IN NURSING HOME RESIDENTS

    Directory of Open Access Journals (Sweden)

    Renato Eržen

    2002-10-01

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

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

    Science.gov (United States)

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

    2017-06-01

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

  3. 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.

  4. 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

  5. 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

  6. 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

  7. 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.

  8. 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.

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

    Science.gov (United States)

    Serrano, Karen

    2007-08-01

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

  10. Major operations and activities

    Energy Technology Data Exchange (ETDEWEB)

    Black, D.G.

    1995-06-01

    This section of the 1994 Hanford Site Environmental Report summarizes the major operations and activities on the site. These operations and activities include site management, waste management, environmental restoration and corrective actions, and research and technology development.

  11. A major safety overhaul

    CERN Multimedia

    2003-01-01

    A redefined policy, a revamped safety course, an environmental project... the TIS (Technical Inspection and Safety) Division has begun a major safety overhaul. Its new head, Wolfgang Weingarten, explains to the Bulletin why and how this is happening.

  12. Allegheny County Major Rivers

    Data.gov (United States)

    Allegheny County / City of Pittsburgh / Western PA Regional Data Center — This dataset contains locations of major rivers that flow through Allegheny County. These shapes have been taken from the Hydrology dataset. The Ohio River,...

  13. Major operations and activities

    International Nuclear Information System (INIS)

    Black, D.G.

    1995-01-01

    This section of the 1994 Hanford Site Environmental Report summarizes the major operations and activities on the site. These operations and activities include site management, waste management, environmental restoration and corrective actions, and research and technology development

  14. 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.

  15. Motherhood during residency training: challenges and strategies.

    Science.gov (United States)

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

    2005-07-01

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

  16. Stress and burnout among Swiss dental residents

    OpenAIRE

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

    2012-01-01

    Stress and burnout have been well-documented in graduate medical and undergraduate dental education, but studies among dental graduate students and residents are sparse. The purpose of this investigation was to examine perceived stressors and three dimensions of burnout among dental residents enrolled in the University of Bern, Switzerland. Thirty-six residents enrolled in five specialty programmes were administered the Graduate Dental Environment Stress (GDES30) questionnaire and the Maslach...

  17. Radiology residents' experience with intussusception reduction

    International Nuclear Information System (INIS)

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

    2011-01-01

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

  18. Ophthalmology resident surgical competency: a national survey.

    Science.gov (United States)

    Binenbaum, Gil; Volpe, Nicholas J

    2006-07-01

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

  19. 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).

  20. 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).

  1. Structure-function discrepancy in Clostridium botulinum C3 toxin for its rational prioritization as a subunit vaccine.

    Science.gov (United States)

    Prathiviraj, R; Prisilla, A; Chellapandi, P

    2016-06-01

    Clostridium botulinum is anaerobic pathogenic bacterium causing food-born botulism in human and animals by producing botulinum neurotoxins A-H, C2, and C3 cytotoxins. Physiological group III strains (type C and D) of this bacterium are capable of producing C2 and C3 toxins in cattle and avian. Herein, we have revealed the structure-function disparity of C3 toxins from two different C. botulinum type C phage (CboC) and type D phage (CboD) to design avirulent toxins rationally. Structure-function discrepancy of the both toxins was computationally evaluated from their homology models based on the conservation in sequence-structure-function relationships upon covariation and point mutations. It has shown that 8 avirulent mutants were generated from CboC of 34 mutants while 27 avirulent mutants resulted from CboD mutants. No major changes were found in tertiary structure of these toxins; however, some structural variations appeared in the coiled and loop regions. Correlated mutation on the first residue would disorder or revolutionize the hydrogen bonding pattern of the coevolved pairs. It suggested that the residues coupling in the local structural environments were compensated with coevolved pairs so as to preserve a pseudocatalytic function in the avirulent mutants. Avirulent mutants of C3 toxins have shown a stable structure with a common blue print of folding process and also attained a near-native backrub ensemble. Thus, we concluded that selecting the site-directed mutagenesis sites are very important criteria for designing avirulent toxins, in development of rational subunit vaccines, to cattle and avian, but the vaccine specificity can be determined by the C3 toxins of C. botulinum harboring phages.

  2. Strengths, Limitations, and Geographical Discrepancies in the Eligibility Criteria for Sport Participation in Young Patients With Congenital Heart Disease.

    Science.gov (United States)

    Cantinotti, Massimiliano; Giordano, Raffaele; Assanta, Nadia; Murzi, Bruno; Melo, Manuel; Franchi, Eliana; Crocetti, Maura; Iervasi, Giorgio; Kutty, Shelby

    2017-07-21

    Benefits of physical activity has been shown in children with congenital heart disease (CHD). In several forms of CHD, the risk of sudden death remains a major concern both for parents and clinicians, who in turn will have to consider the risk-benefit ratio of sport participation versus restriction. A literature search was performed within the National Library of Medicine using the keywords: Sport, CHD, and Eligibility. The search was further refined by adding the keywords: Children, Adult, and Criteria. Fifteen published studies evaluating sport eligibility criteria in CHD were included. Seven documents from various scientific societies have been published in the past decade but which of them should be adopted remains unclear. Our research highlighted accuracy and consistency of the latest documents; however, differences have emerged between the US and European recommendations. Eligibility criteria were consistent between countries for simple congenital heart defects, whereas there are discrepancies for borderline conditions including moderate valvular lesions and mild or moderate residual defects after CHD repair. Furthermore, some of the more severe defects were not evaluated. Multiple recommendations have been made for the same CHD, and cut-off values used to define disease severity have varied. Published eligibility criteria have mainly focused on competitive sports. Little attention was paid to recreational activities, and the psychosocial consequences of activity restriction were seldom evaluated. Comprehensive consensus recommendations for sport eligibility evaluating all CHD types and stages of repair are needed. These should include competitive and recreational activities, use standardized classifications to grade disease severity, and address the consequences of restriction.

  3. 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

  4. Consistencies and Discrepancies in Communication Between Parents and Teenage Children About Sexuality

    Directory of Open Access Journals (Sweden)

    Teresita María Sevilla

    2016-08-01

    Full Text Available Abstract The family is one of the most important socializing agents in adolescent sex education. However, multiple barriers to communication within families have been identified. Therefore, this study aimed to characterize and understand the processes by which parents and their adolescent children communicate about sexuality. Two questionnaires were completed by 711 fathers/mothers and 566 male/female students in 21 schools in Cali (Colombia, and 15 discussion groups were formed. The results showed that conversations about sexuality focused on protection for women and on sexuality promotion for men. Furthermore, it was found that greater fluency exists in father/son and mother/daughter conversations. The largest discrepancy between parents and teenagers was the adults' belief that it is sufficient to mention certain topics in a directive manner and the children's expectations that parents will discuss the value and dynamics of the sexual experience. Embarrassment and lack of communication tools hinder communication processes.

  5. Discrepancies between explicit and implicit self-esteem: implications for mate retention strategies and perceived infidelity.

    Science.gov (United States)

    Zeigler-Hill, Virgil; Fulton, Jessica J; McLemore, Chandler

    2012-01-01

    The purpose of the present study was to examine whether the association between explicit self-esteem and relationship outcomes was moderated by implicit self-esteem. This was accomplished by asking 210 undergraduates who were currently involved in romantic relationships to complete measures of their explicit self-esteem, implicit self-esteem, mate retention strategies, and likelihood of future infidelity. Implicit self-esteem was found to moderate the association between high explicit self-esteem and relationship outcomes for male participants such that men with discrepant high self-esteem (i.e., high explicit self-esteem but low implicit self-esteem) reported less use of mate retention strategies and perceived a greater likelihood of future infidelity in their relationships during the next year. These findings provide additional support for the idea that fragile self-esteem may have consequences for the manner in which individuals perceive their relationships.

  6. From Sexual Desire Discrepancies to Desirable Sex: Creating the Optimal Connection.

    Science.gov (United States)

    Kleinplatz, Peggy J; Paradis, Nicolas; Charest, Maxime; Lawless, Shannon; Neufeld, Marlene; Neufeld, Robert; Pratt, Danielle; Ménard, A Dana; Buduru, Bogdan; Rosen, Lianne

    2017-11-21

    Beginning in 2005, our team conducted a series of studies on optimal sexual experiences. We have applied our findings to develop a group therapy intervention for couples presenting with low sexual desire/frequency and sexual desire discrepancy. The goal was to improve the quality of erotic intimacy by focusing on such elements as being fully embodied during sex, increasing authenticity, trustworthiness, and vulnerability. Twenty-eight heterosexual individuals (14 couples) were seen in 16 hours of couples group therapy. Each completed the New Sexual Satisfaction Scale in pretests, posttests and six-month follow-ups. Significant differences in satisfaction (p creating just enough safety to enable couples to take erotic risks and thereby create desirable sexual intimacy.

  7. Discrepancies in Adolescents’ and their Mothers’ Perceptions of the Family and Adolescent Anxiety Symptomatology

    Science.gov (United States)

    Ohannessian, Christine McCauley; De Los Reyes, Andres

    2014-01-01

    SYNOPSIS Objective This study examines relations between adolescents’ and their mothers’ perceptions of the family and adolescent anxiety symptomatology. Design Surveys were administered to 145 15- to 18-year-old adolescents and their mothers. Results Adolescents viewed the family more negatively than did their mothers. In addition, adolescent girls’ perceptions of the family (satisfaction and communication) negatively predicted later adolescent anxiety symptomatology. Significant interactions between adolescent and mother reports of family satisfaction and communication also were found for girls, but not for boys. For girls, discrepant family perceptions with their mothers appeared to protect them from anxiety if their mothers had negative perceptions of the family. Conclusions Understanding the similarities and differences among family members’ perspectives yields useful predictive information that cannot be obtained from studying these perspectives in isolation from one another. PMID:24634608

  8. Self-discrepancy and regulatory fit in avatar-based exergames.

    Science.gov (United States)

    Jin, Seung-A Annie

    2012-12-01

    Drawing from Higgins's self-discrepancy theory and regulatory focus theory, this study examined the use of activated selves and regulatory foci in health games. Utilizing the Wii's avatar-creating and exergaming features, a 2 (activated self: actual self versus ideal self) x 2 (regulatory focus: promotion versus prevention) x 2 (efficacy appeals: self-efficacy versus response-efficacy) between-subjects experiment tested the interactions of activated selves, regulatory foci, and efficacy appeals on low-calorie dieting intentions after health game playing. Results from an experiment with 156 participants demonstrated that a fit between regulatory focus and efficacy appeals induced greater dieting intentions when the actual self was activated while the opposite effect occurred when the ideal self was activated. Theoretical contributions to basic and applied social psychology as well as managerial implications for consumer behavior research are considered.

  9. Does Mother Know Best? Parental Discrepancies in Assessing Child Behavioral and Educational Outcomes

    DEFF Research Database (Denmark)

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

    2018-01-01

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

  10. 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.

  11. Apsidal motion of the eccentric eclipsing binary DI Herculis: An apparent discrepancy with general relativity

    International Nuclear Information System (INIS)

    Guinan, E.F.; Maloney, F.P.

    1985-01-01

    In 1959, Rudkjobing called attention to the 8th magnitude, eccentric eclipsing binary DI Herculis as an important test case for studying relativistic apsidal motion, since the theoretical relativistic apsidal motion is greater than that expected from the classical effects (i.e., from the tidal and rotational deformation of the stellar components). Excellent determinations of the orbital and stellar parameters of the system have been made by Popper (1982) from the combined analysis of the system's radial-velocity data and UBV light curves of Martynov and Khaliullin (1980), which permit the theoretical relativistic and classical components of the apsidal motion to be determined with reasonable certainty: omega-dot/sup theor//sub GR/ = 2X34/100 yr and omega-dot/sup theor//sub CL/ = 1X93/100 yr. Least-squares solutions of the timings of primary and secondary minima, extending over an 84-yr interval, and including eclipse timings obtained as recently as 1984, yield a small advance of periastron omega-dot/sup obs/ = 0X65/100 yr +- 0X18/100 yr. The observed advance of the periastron is about one-seventh the theoretical value of omega-dot/sup theor//sub GR+CL/ = 4X27/100 yr that is expected from the combined relativistic and classical effects, and results in a discrepancy of -3X62/100 yr, a value which has a magnitude of approx.20 sigma. Classical mechanisms that can possibly explain this apparent discrepancy are discussed, along with the possibility that there may be problems with general relativity

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

    Science.gov (United States)

    Jensen, Janni; Mussmann, Bo R; Hjarbæk, John; Al-Aubaidi, Zaid; Pedersen, Niels W; Gerke, Oke; Torfing, Trine

    2017-09-01

    Background Children with leg length discrepancy often undergo repeat imaging. Therefore, every effort to reduce radiation dose is important. Using low dose preview images and noise reduction software rather than diagnostic images for length measurements might contribute to reducing dose. Purpose To compare leg length measurements performed on diagnostic images and low dose preview images both acquired using a low-dose bi-planar imaging system. Material and Methods Preview and diagnostic images from 22 patients were retrospectively collected (14 girls, 8 boys; mean age, 12.8 years; age range, 10-15 years). All images were anonymized and measured independently by two musculoskeletal radiologists. Three sets of measurements were performed on all images; the mechanical axis lines of the femur and the tibia as well as the anatomical line of the entire extremity. Statistical significance was tested with a paired t-test. Results No statistically significant difference was found between measurements performed on the preview and on the diagnostic image. The mean tibial length difference between the observers was -0.06 cm (95% confidence interval [CI], -0.12 to 0.01) and -0.08 cm (95% CI, -0.21 to 0.05), respectively; 0.10 cm (95% CI, 0.02-0.17) and 0.06 cm (95% CI, -0.02 to 0.14) for the femoral measurements and 0.12 cm (95% CI, -0.05 to 0.26) and 0.08 cm (95% CI, -0.02 to 0.19) for total leg length discrepancy. ICCs were >0.99 indicating excellent inter- and intra-rater reliability. Conclusion The data strongly imply that leg length measurements performed on preview images from a low-dose bi-planar imaging system are comparable to measurements performed on diagnostic images.

  13. Adolescent Loneliness and Social Skills: Agreement and Discrepancies Between Self-, Meta-, and Peer-Evaluations.

    Science.gov (United States)

    Lodder, G M A; Goossens, L; Scholte, R H J; Engels, R C M E; Verhagen, M

    2016-12-01

    Lonely adolescents report that they have poor social skills, but it is unknown whether this is due to an accurate perception of a social skills deficit, or a biased negative perception. This is an important distinction, as actual social skills deficits require different treatments than biased negative perceptions. In this study, we compared self-reported social skills evaluations with peer-reported social skills and meta-evaluations of social skills (i.e., adolescents' perceptions of how they believe their classmates evaluate them). Based on the social skills view, we expected negative relations between loneliness and these three forms of social skills evaluations. Based on the bias view, we expected lonely adolescents to have more negative self- and meta-evaluations compared to peer-evaluations of social skills. Participants were 1342 adolescents (48.64 % male, M age  = 13.95, SD = .54). All classmates rated each other in a round-robin design to obtain peer-evaluations. Self- and meta-evaluations were obtained using self-reports. Data were analyzed using polynomial regression analyses and response surface modeling. The results indicated that, when self-, peer- and meta-evaluations were similar, a greater sense of loneliness was related to poorer social skills. Loneliness was also related to larger discrepancies between self- and peer-evaluations of loneliness, but not related to the direction of these discrepancies. Thus, for some lonely adolescents, loneliness may be related to an actual social skills deficit, whereas for others a biased negative perception of one's own social skills or a mismatch with the environment may be related to their loneliness. This implies that different mechanisms may underlie loneliness, which has implications for interventions.

  14. The biological basis of treating jaw discrepancies: An interplay of mechanical forces and skeletal configuration.

    Science.gov (United States)

    Karamesinis, Konstantinos; Basdra, Efthimia K

    2018-05-01

    Jaw discrepancies and malrelations affect a large proportion of the general population and their treatment is of utmost significance for individuals' health and quality of life. The aim of their therapy is the modification of aberrant jaw development mainly by targeting the growth potential of the mandibular condyle through its cartilage, and the architectural shape of alveolar bone through a suture type of structure, the periodontal ligament. This targeted treatment is achieved via external mechanical force application by using a wide variety of intraoral and extraoral appliances. Condylar cartilage and sutures exhibit a remarkable plasticity due to the mechano-responsiveness of the chondrocytes and the multipotent mesenchy