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Sample records for small group medical

  1. Deming, quality and the small medical group administrator.

    Science.gov (United States)

    Noll, D C

    1992-01-01

    As administrators, writes Douglas Noll, we can coordinate and implement quality measures affecting our practices and which impact the patient's total medical experience. Unfortunately, many smaller groups cannot hire an outside consultant or single employee whose sole purpose would be to monitor quality. Noll offers several simple practices that administrators can use to improve the quality of service in their groups.

  2. Factors Influencing Electronic Clinical Information Exchange in Small Medical Group Practices

    Science.gov (United States)

    Kralewski, John E.; Zink, Therese; Boyle, Raymond

    2012-01-01

    Purpose: The purpose of this study was to identify the organizational factors that influence electronic health information exchange (HIE) by medical group practices in rural areas. Methods: A purposive sample of 8 small medical group practices in 3 experimental HIE regions were interviewed to determine the extent of clinical information exchange…

  3. Evaluation of Small-Group Teaching in Human Gross Anatomy in a Caribbean Medical School

    Science.gov (United States)

    Chan, Lap Ki; Ganguly, Pallab K.

    2008-01-01

    Although there are a number of medical schools in the Caribbean islands, very few reports have come out so far in the literature regarding the efficacy of small-group teaching in them. The introduction of small-group teaching in the gross anatomy laboratory one and a half years ago at St. Matthew's University (SMU) on Grand Cayman appears to have…

  4. Small group effectiveness during pharmacology learning sessions in a Nepalese medical school.

    Science.gov (United States)

    Shankar, Pr; Gurung, Sb; Jha, N; Bajracharya, O; Karki, Bms; Thapa, Tp

    2011-01-01

    Small group learning sessions are used in pharmacology at the KIST Medical College, Lalitpur, Nepal. Feedback about student behaviours that enhance and hinder small group effectiveness was obtained. This will help us improve the small group sessions and will also be useful to educators using small groups in other medical schools. The small groups were self-managing with a group leader, time-keeper, recorder and presenter. Small group effectiveness was measured using the Tutorial Group Effectiveness Instrument (TGEI) developed by Singaram and co-authors. The instrument was administered in June 2010 and key findings obtained were shared with students and facilitators. The instrument was administered again in August. The mean cognitive, motivational, demotivational and overall scores were compared among different categories of respondents in June and August. Scores were also compared between June and August 2010. A total of 89 students participated in the study in June and 88 in August 2010. In June, females rated overall group productivity higher compared to males. The cognitive and motivational scores were higher in August 2010 while the demotivational score was lower. The small group effectiveness was higher in August after the educational intervention which utilised feedback about problems observed, theoretical considerations of effective small groups and how this information can be applied in practice.

  5. Medical Students Perceive Better Group Learning Processes when Large Classes Are Made to Seem Small

    Science.gov (United States)

    Hommes, Juliette; Arah, Onyebuchi A.; de Grave, Willem; Schuwirth, Lambert W. T.; Scherpbier, Albert J. J. A.; Bos, Gerard M. J.

    2014-01-01

    Objective Medical schools struggle with large classes, which might interfere with the effectiveness of learning within small groups due to students being unfamiliar to fellow students. The aim of this study was to assess the effects of making a large class seem small on the students' collaborative learning processes. Design A randomised controlled intervention study was undertaken to make a large class seem small, without the need to reduce the number of students enrolling in the medical programme. The class was divided into subsets: two small subsets (n = 50) as the intervention groups; a control group (n = 102) was mixed with the remaining students (the non-randomised group n∼100) to create one large subset. Setting The undergraduate curriculum of the Maastricht Medical School, applying the Problem-Based Learning principles. In this learning context, students learn mainly in tutorial groups, composed randomly from a large class every 6–10 weeks. Intervention The formal group learning activities were organised within the subsets. Students from the intervention groups met frequently within the formal groups, in contrast to the students from the large subset who hardly enrolled with the same students in formal activities. Main Outcome Measures Three outcome measures assessed students' group learning processes over time: learning within formally organised small groups, learning with other students in the informal context and perceptions of the intervention. Results Formal group learning processes were perceived more positive in the intervention groups from the second study year on, with a mean increase of β = 0.48. Informal group learning activities occurred almost exclusively within the subsets as defined by the intervention from the first week involved in the medical curriculum (E-I indexes>−0.69). Interviews tapped mainly positive effects and negligible negative side effects of the intervention. Conclusion Better group learning processes can be

  6. Medical students perceive better group learning processes when large classes are made to seem small.

    Science.gov (United States)

    Hommes, Juliette; Arah, Onyebuchi A; de Grave, Willem; Schuwirth, Lambert W T; Scherpbier, Albert J J A; Bos, Gerard M J

    2014-01-01

    Medical schools struggle with large classes, which might interfere with the effectiveness of learning within small groups due to students being unfamiliar to fellow students. The aim of this study was to assess the effects of making a large class seem small on the students' collaborative learning processes. A randomised controlled intervention study was undertaken to make a large class seem small, without the need to reduce the number of students enrolling in the medical programme. The class was divided into subsets: two small subsets (n=50) as the intervention groups; a control group (n=102) was mixed with the remaining students (the non-randomised group n∼100) to create one large subset. The undergraduate curriculum of the Maastricht Medical School, applying the Problem-Based Learning principles. In this learning context, students learn mainly in tutorial groups, composed randomly from a large class every 6-10 weeks. The formal group learning activities were organised within the subsets. Students from the intervention groups met frequently within the formal groups, in contrast to the students from the large subset who hardly enrolled with the same students in formal activities. Three outcome measures assessed students' group learning processes over time: learning within formally organised small groups, learning with other students in the informal context and perceptions of the intervention. Formal group learning processes were perceived more positive in the intervention groups from the second study year on, with a mean increase of β=0.48. Informal group learning activities occurred almost exclusively within the subsets as defined by the intervention from the first week involved in the medical curriculum (E-I indexes>-0.69). Interviews tapped mainly positive effects and negligible negative side effects of the intervention. Better group learning processes can be achieved in large medical schools by making large classes seem small.

  7. Small group effectiveness during pharmacology learning sessions in a Nepalese medical school

    Directory of Open Access Journals (Sweden)

    Shankar PR

    2011-06-01

    Full Text Available BackgroundSmall group learning sessions are used in pharmacology atthe KIST Medical College, Lalitpur, Nepal. Feedback aboutstudent behaviours that enhance and hinder small groupeffectiveness was obtained. This will help us improve thesmall group sessions and will also be useful to educatorsusing small groups in other medical schools.MethodThe small groups were self-managing with a group leader,time-keeper, recorder and presenter. Small groupeffectiveness was measured using the Tutorial GroupEffectiveness Instrument (TGEI developed by Singaram andco-authors. The instrument was administered in June 2010and key findings obtained were shared with students andfacilitators. The instrument was administered again inAugust. The mean cognitive, motivational, demotivationaland overall scores were compared among differentcategories of respondents in June and August. Scores werealso compared between June and August 2010.ResultsA total of 89 students participated in the study in June and88 in August 2010. In June, females rated overall groupproductivity higher compared to males. The cognitive andmotivational scores were higher in August 2010 while thedemotivational score was lower.ConclusionThe small group effectiveness was higher in August after theeducational intervention which utilised feedback aboutproblems observed, theoretical considerations of effectivesmall groups and how this information can be applied inpractice.

  8. Gender differences in leadership amongst first-year medical students in the small-group setting.

    Science.gov (United States)

    Wayne, Nancy L; Vermillion, Michelle; Uijtdehaage, Sebastian

    2010-08-01

    To investigate the extent of gender bias in the volunteerism of small-group leaders amongst first-year medical students, and whether bias could be eliminated with special instructions to the students. The gender of leaders in small-group sessions in a real academic setting was monitored under two conditions: control conditions, in which basic instructions were provided to participants, and intervention conditions, in which the same basic instructions were provided plus a brief "pep talk" on the importance of experiencing a leadership role in a safe environment. During the small-group sessions, an observer noted the gender and names of group leaders for later analysis. After a class debriefing, a subset of leaders and nonleaders from both the control and intervention groups were invited to be interviewed about their perceptions of the small-group experience. Interviews were tape recorded and transcribed for analysis. In 2007-2008 and 2008-2009, disproportionately fewer women than men volunteered to become small-group leaders under control conditions. This gender bias was eliminated under intervention conditions. The interviews illustrated how a subtle change in instructions helped some female students take on a leadership role. Gender bias in leadership in the small-group setting amongst medical students-even when women make up half of the class-may persist without targeted intervention. The authors suggest that frequent and consistent intervention during medical school could be an important factor in encouraging women to identify themselves as leaders, promoting confidence to consider leadership roles in medicine.

  9. Small group learning: effect on item analysis and accuracy of self-assessment of medical students.

    Science.gov (United States)

    Biswas, Shubho Subrata; Jain, Vaishali; Agrawal, Vandana; Bindra, Maninder

    2015-01-01

    Small group sessions are regarded as a more active and student-centered approach to learning. Item analysis provides objective evidence of whether such sessions improve comprehension and make the topic easier for students, in addition to assessing the relative benefit of the sessions to good versus poor performers. Self-assessment makes students aware of their deficiencies. Small group sessions can also help students develop the ability to self-assess. This study was carried out to assess the effect of small group sessions on item analysis and students' self-assessment. A total of 21 female and 29 male first year medical students participated in a small group session on topics covered by didactic lectures two weeks earlier. It was preceded and followed by two multiple choice question (MCQ) tests, in which students were asked to self-assess their likely score. The MCQs used were item analyzed in a previous group and were chosen of matching difficulty and discriminatory indices for the pre- and post-tests. The small group session improved the marks of both genders equally, but female performance was better. The session made the items easier; increasing the difficulty index significantly but there was no significant alteration in the discriminatory index. There was overestimation in the self-assessment of both genders, but male overestimation was greater. The session improved the self-assessment of students in terms of expected marks and expectation of passing. Small group session improved the ability of students to self-assess their knowledge and increased the difficulty index of items reflecting students' better performance.

  10. Basic steps in establishing effective small group teaching sessions in medical schools.

    Science.gov (United States)

    Meo, Sultan Ayoub

    2013-07-01

    Small-group teaching and learning has achieved an admirable position in medical education and has become more popular as a means of encouraging the students in their studies and enhance the process of deep learning. The main characteristics of small group teaching are active involvement of the learners in entire learning cycle and well defined task orientation with achievable specific aims and objectives in a given time period. The essential components in the development of an ideal small group teaching and learning sessions are preliminary considerations at departmental and institutional level including educational strategies, group composition, physical environment, existing resources, diagnosis of the needs, formulation of the objectives and suitable teaching outline. Small group teaching increases the student interest, teamwork ability, retention of knowledge and skills, enhance transfer of concepts to innovative issues, and improve the self-directed learning. It develops self-motivation, investigating the issues, allows the student to test their thinking and higher-order activities. It also facilitates an adult style of learning, acceptance of personal responsibility for own progress. Moreover, it enhances student-faculty and peer-peer interaction, improves communication skills and provides opportunity to share the responsibility and clarify the points of bafflement.

  11. Process factors facilitating and inhibiting medical ethics teaching in small groups.

    Science.gov (United States)

    Bentwich, Miriam Ethel; Bokek-Cohen, Ya'arit

    2017-11-01

    To examine process factors that either facilitate or inhibit learning medical ethics during case-based learning. A qualitative research approach using microanalysis of transcribed videotaped discussions of three consecutive small-group learning (SGL) sessions on medical ethics teaching (MET) for three groups, each with 10 students. This research effort revealed 12 themes of learning strategies, divided into 6 coping and 6 evasive strategies. Cognitive-based strategies were found to relate to Kamin's model of critical thinking in medical education, thereby supporting our distinction between the themes of coping and evasive strategies. The findings also showed that cognitive efforts as well as emotional strategies are involved in discussions of ethical dilemmas. Based on Kamin's model and the constructivist learning theory, an examination of the different themes within the two learning strategies-coping and evasive-revealed that these strategies may be understood as corresponding to process factors either facilitating or inhibiting MET in SGL, respectively. Our classification offers a more nuanced observation, specifically geared to pinpointing the desired and less desired process factors in the learning involved in MET in the SGL environment. Two key advantages of this observation are: (1) it brings to the forefront process factors that may inhibit and not merely facilitate MET in SGL and (2) it acknowledges the existence of emotional and not just cognitive process factors. Further enhancement of MET in SGL may thus be achieved based on these observations. 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/.

  12. Student perceptions of independent versus facilitated small group learning approaches to compressed medical anatomy education.

    Science.gov (United States)

    Whelan, Alexander; Leddy, John J; Mindra, Sean; Matthew Hughes, J D; El-Bialy, Safaa; Ramnanan, Christopher J

    2016-01-01

    The purpose of this study was to compare student perceptions regarding two, small group learning approaches to compressed (46.5 prosection-based laboratory hours), integrated anatomy education at the University of Ottawa medical program. In the facilitated active learning (FAL) approach, tutors engage students and are expected to enable and balance both active learning and progression through laboratory objectives. In contrast, the emphasized independent learning (EIL) approach stresses elements from the "flipped classroom" educational model: prelaboratory preparation, independent laboratory learning, and limited tutor involvement. Quantitative (Likert-style questions) and qualitative data (independent thematic analysis of open-ended commentary) from a survey of students who had completed the preclerkship curriculum identified strengths from the EIL (promoting student collaboration and communication) and FAL (successful progression through objectives) approaches. However, EIL led to student frustration related to a lack of direction and impaired completion of objectives, whereas active learning opportunities in FAL were highly variable and dependent on tutor teaching style. A "hidden curriculum" was also identified, where students (particularly EIL and clerkship students) commonly compared their compressed anatomy education or their anatomy learning environment with other approaches. Finally, while both groups highly regarded the efficiency of prosection-based learning and expressed value for cadaveric-based learning, student commentary noted that the lack of grade value dedicated to anatomy assessment limited student accountability. This study revealed critical insights into small group learning in compressed anatomy education, including the need to balance student active learning opportunities with appropriate direction and feedback (including assessment). © 2015 American Association of Anatomists.

  13. A trial of team-based versus small-group learning for second-year medical students: does the size of the small group make a difference?

    Science.gov (United States)

    Willett, Laura Rees; Rosevear, G Craig; Kim, Sarang

    2011-01-01

    Team-based learning is a large-group instructional modality intended to provide active learning with modest faculty resources. The goal is to determine if team-based learning could be substituted for small-group learning in case sessions without compromising test performance or satisfaction. One hundred and sixty-seven students were assigned to team-based or small-group learning for 6 case discussion sessions. Examination scores and student satisfaction were compared. Instruction modality had no meaningful effect on examination score, 81.7% team based versus 79.7% small-group, p=.56 after multivariate adjustment. Student satisfaction was lower with team-based learning, 2.45 versus 3.74 on a 5-point scale, pgroups influenced the preference for small-group learning. Team-based learning does not adversely affect examination performance. However, student satisfaction may be inferior, especially if compared to instruction in very small groups of 10 or fewer students.

  14. Small Group Research

    Science.gov (United States)

    McGrath, Joseph E.

    1978-01-01

    Summarizes research on small group processes by giving a comprehensive account of the types of variables primarily studied in the laboratory. These include group structure, group composition, group size, and group relations. Considers effects of power, leadership, conformity to social norms, and role relationships. (Author/AV)

  15. Preserving third year medical students' empathy and enhancing self-reflection using small group "virtual hangout" technology.

    Science.gov (United States)

    Duke, Pamela; Grosseman, Suely; Novack, Dennis H; Rosenzweig, Steven

    2015-01-01

    Medical student professionalism education is challenging in scope, purpose, and delivery, particularly in the clinical years when students in large universities are dispersed across multiple clinical sites. We initiated a faculty-facilitated, peer small group course for our third year students, creating virtual classrooms using social networking and online learning management system technologies. The course emphasized narrative self-reflection, group inquiry, and peer support. We conducted this study to analyze the effects of a professionalism course on third year medical students' empathy and self-reflection (two elements of professionalism) and their perceptions about the course. Students completed the Groningen Reflection Ability Scale (GRAS) and the Jefferson Scale of Empathy (JSE) before and after the course and provided anonymous online feedback. The results of the JSE before and after the course demonstrated preservation of empathy rather than its decline. In addition, there was a statistically significant increase in GRAS scores (p < 0.001), suggesting that the sharing of personal narratives may foster reflective ability and reflective practice among third year students. This study supports previous findings showing that students benefit from peer groups and discussion in a safe environment, which may include the use of a virtual group video platform.

  16. Implementing the patient-centered medical home model for chronic disease care in small medical practices: practice group characteristics and physician understanding.

    Science.gov (United States)

    Baxter, Louisa; Nash, David B

    2013-01-01

    Strengthening primary care may improve health outcomes and restrain spending. The patient-centered medical home (PCMH) model is endorsed as a tool to achieve this. Early evaluations in large group practices demonstrate improvements in some health outcomes. Evidence is lacking from small medical practices that deliver the majority of primary health care. This was a national survey of 200 physicians that explored perceptions of PCMH. There was considerable interest in adoption of the model; however, providing PCMH care was seen as an extension of traditional roles that requires additional reimbursement. No differentiation was made among a variety of payment models to do this. All joint principle components of the model were identified as important: extending access and information technology were the most contentious. There was consensus that PCMH might improve the quality of primary care; however, tension between wider societal benefits and rising costs for individual practices was a challenge to implementation.

  17. Evaluating effectiveness of small group information literacy instruction for Undergraduate Medical Education students using a pre- and post-survey study design.

    Science.gov (United States)

    McClurg, Caitlin; Powelson, Susan; Lang, Eddy; Aghajafari, Fariba; Edworthy, Steven

    2015-06-01

    The Undergraduate Medical Education (UME) programme at the University of Calgary is a three-year programme with a strong emphasis on small group learning. The purpose of our study was to determine whether librarian led small group information literacy instruction, closely integrated with course content and faculty participation, but without a hands on component, was an effective means to convey EBM literacy skills. Five 15-minute EBM information literacy sessions were delivered by three librarians to 12 practicing physician led small groups of 15 students. Students were asked to complete an online survey before and after the sessions. Data analysis was performed through simple descriptive statistics. A total of 144 of 160 students responded to the pre-survey, and 112 students answered the post-survey. Instruction in a small group environment without a mandatory hands on component had a positive impact on student's evidence-based information literacy skills. Students were more likely to consult a librarian and had increased confidence in their abilities to search and find relevant information. Our study demonstrates that student engagement and faculty involvement are effective tools for delivering information literacy skills when working with students in a small group setting outside of a computer classroom. © 2015 Health Libraries Group.

  18. Do medical students generate sound arguments during small group discussions in problem-based learning?: an analysis of preclinical medical students' argumentation according to a framework of hypothetico-deductive reasoning.

    Science.gov (United States)

    Ju, Hyunjung; Choi, Ikseon; Yoon, Bo Young

    2017-06-01

    Hypothetico-deductive reasoning (HDR) is an essential learning activity and a learning outcome in problem-based learning (PBL). It is important for medical students to engage in the HDR process through argumentation during their small group discussions in PBL. This study aimed to analyze the quality of preclinical medical students' argumentation according to each phase of HDR in PBL. Participants were 15 first-year preclinical students divided into two small groups. A set of three 2-hour discussion sessions from each of the two groups during a 1-week-long PBL unit on the cardiovascular system was audio-recorded. The arguments constructed by the students were analyzed using a coding scheme, which included four types of argumentation (Type 0: incomplete, Type 1: claim only, Type 2: claim with data, and Type 3: claim with data and warrant). The mean frequency of each type of argumentation according to each HDR phase across the two small groups was calculated. During small group discussions, Type 1 arguments were generated most often (frequency=120.5, 43%), whereas the least common were Type 3 arguments (frequency=24.5, 8.7%) among the four types of arguments. The results of this study revealed that the students predominantly made claims without proper justifications; they often omitted data for supporting their claims or did not provide warrants to connect the claims and data. The findings suggest instructional interventions to enhance the quality of medical students' arguments in PBL, including promoting students' comprehension of the structure of argumentation for HDR processes and questioning.

  19. Small Group Teaching in Epidemiology Courses

    Directory of Open Access Journals (Sweden)

    Azita Goshtasebi

    2009-02-01

    Full Text Available Background and purpose: small group teaching(SGT in is a known method for developing intellectual skills, changing attitudes and encouraging the taking of responsibilities for learning. This study was an attempt to compare students’ attitudes and knowledge scores on SGT and lecture -based teaching (LBT.Methods: 22 first year medical students were enrolled in a course using two methods (lecture- based and small group discussion for teaching basic epidemiology. Data about attitudes and knowledge scores of the two methods were collected at the end of the course and analyzed using a two-sided Wilcoxon test.Results: The students were satisfied and preferred SGT in terms of Evaluation method for the course, Participatory learning and team working, effectiveness and developing self learning skills (p<0.001,and scored higher on topics of SGT(p<0.01, but believed that they needed longer discussion of the topics.Conclusion: Better question design and course organization and creating a safe, comfortable environment is essential for good performance. Integrating this teaching strategy in medical education curricula with appropriate professional and organizational development is suggested.Key words: MEDICAL EDUCATION, SMALL GROUP TEACHING, COURSE EVALUATION

  20. The interprofessional team as a small group.

    Science.gov (United States)

    Kane, R A

    1975-01-01

    Conflicts in interprofessional teamwork may be as much explained by group process considerations as by the interaction of professional roles and statuses. This paper examines the interprofessional team as a small group, using a synthesis of sources from social psychology, social group work, T-group literature, management theory, and health team research. Eight issues are considered in relation to the team as a small group, namely, (a) the individual in the group, (b) team size, (c) group norms, (d) democracy, (e) decision making and conflict resolution, (f) communication and structure, (g) leadership, and (h) group harmony and its relationship to group productivity.

  1. Small Group Multitasking in Literature Classes

    Science.gov (United States)

    Baurain, Bradley

    2007-01-01

    Faced with the challenge of teaching American literature to large, multilevel classes in Vietnam, the writer developed a flexible small group framework called "multitasking". "Multitasking" sets up stable task categories which rotate among small groups from lesson to lesson. This framework enabled students to work cooperatively…

  2. LARGE AND SMALL GROUP TYPEWRITING PROJECT.

    Science.gov (United States)

    JEFFS, GEORGE A.; AND OTHERS

    AN INVESTIGATION WAS CONDUCTED TO DETERMINE IF GROUPS OF HIGH SCHOOL STUDENTS NUMERICALLY IN EXCESS OF 50 COULD BE AS EFFECTIVELY INSTRUCTED IN TYPEWRITING SKILLS AS GROUPS OF LESS THAN 30. STUDENTS ENROLLED IN 1ST-YEAR TYPEWRITING WERE RANDOMLY ASSIGNED TO TWO LARGE GROUPS AND THREE SMALL GROUPS TAUGHT BY THE SAME INSTRUCTOR. TEACHER-MADE,…

  3. Small Group Activities for Introductory Business Classes.

    Science.gov (United States)

    Mundrake, George

    1999-01-01

    Describes numerous small-group activities for the following areas of basic business education: consumer credit, marketing, business organization, entrepreneurship, insurance, risk management, economics, personal finance, business careers, global markets, and government regulation. (SK)

  4. Student leadership in small group science inquiry

    Science.gov (United States)

    Oliveira, Alandeom W.; Boz, Umit; Broadwell, George A.; Sadler, Troy D.

    2014-09-01

    Background: Science educators have sought to structure collaborative inquiry learning through the assignment of static group roles. This structural approach to student grouping oversimplifies the complexities of peer collaboration and overlooks the highly dynamic nature of group activity. Purpose: This study addresses this issue of oversimplification of group dynamics by examining the social leadership structures that emerge in small student groups during science inquiry. Sample: Two small student groups investigating the burning of a candle under a jar participated in this study. Design and method: We used a mixed-method research approach that combined computational discourse analysis (computational quantification of social aspects of small group discussions) with microethnography (qualitative, in-depth examination of group discussions). Results: While in one group social leadership was decentralized (i.e., students shared control over topics and tasks), the second group was dominated by a male student (centralized social leadership). Further, decentralized social leadership was found to be paralleled by higher levels of student cognitive engagement. Conclusions: It is argued that computational discourse analysis can provide science educators with a powerful means of developing pedagogical models of collaborative science learning that take into account the emergent nature of group structures and highly fluid nature of student collaboration.

  5. The electrocardiogram made (really) easy: Using small-group ...

    African Journals Online (AJOL)

    Medicine designed small-group tutorials using animations and analogies as methods to improve the ECG interpretation skills of students. Objectives. To improve students' ability to interpret ECGs and assess their perceptions of the tutorials. Methods. A questionnaire was administered to 67 final-year medical students after ...

  6. How do small groups make decisions?

    OpenAIRE

    Chahine, Saad; Cristancho, Sayra; Padgett, Jessica; Lingard, Lorelei

    2017-01-01

    In the competency-based medical education (CBME) approach, clinical competency committees are responsible for making decisions about trainees? competence. However, we currently lack a?theoretical model for group decision-making to inform this emerging assessment phenomenon. This paper proposes an organizing framework to study and guide the decision-making processes of clinical competency committees. This is an explanatory, non-exhaustive review, tailored to identify relevant theoretical and e...

  7. The Medicaid Medically Improved Group, Losing Disability...

    Data.gov (United States)

    U.S. Department of Health & Human Services — According to findings reported in, The Medicaid Medically Improved Group, Losing Disability Status and Growing Earnings, published in Volume 4, Issue 1 of the...

  8. Medical group mergers: strategies for success.

    Science.gov (United States)

    Latham, Will

    2014-01-01

    As consolidation sweeps over the healthcare industry, many medical groups are considering mergers with other groups as an alternative to employment. While mergers are challenging and fraught with risk, an organized approach to the merger process can dramatically increase the odds for success. Merging groups need to consider the benefits they seek from a merger, identify the obstacles that must be overcome to merge, and develop alternatives to overcome those obstacles. This article addresses the benefits to be gained and issues to be addressed, and provides a tested roadmap that has resulted in many successful medical group mergers.

  9. Dynamics of small groups of galaxies. I. Virialized groups

    International Nuclear Information System (INIS)

    Mamon, G.A.; New York Univ., NY)

    1987-01-01

    The dynamical evolution of small groups of galaxies from an initial virial equilibrium state is investigated by means of numerical simulations. The basic scheme is a gravitational N-body code in which galaxies and diffuse background are treated as single particles with both external parameters and internal structure; collisional and tidal stripping, dynamical friction, mergers, and orbital braking are taken into account. The results are presented in extensive tables and graphs and characterized in detail. Eight-galaxy groups with surface densities like those of compact groups (as defined by Hickson, 1982) are found to be unstable to rapid mergers after 1/30 to 1/8 Hubble time. The effects of dark-matter distribution (in galactic halos or in a common intergalactic background) are considered. 79 references

  10. Small group experience for socially withdrawn girls.

    Science.gov (United States)

    Houck, Gail M; Stember, Lisa

    2002-08-01

    Social competence is the effectiveness of social interaction behavior. Given its link to mental health outcomes, it is an important consideration in child and adolescent development. Social withdrawal is associated with depression. Socially withdrawn children make few social initiations and tend to be isolated in their play, further limiting their social involvement. To develop effective social behavior, experiences must be provided to learn relationship skills. This practice improvement project provided a small group experience for five socially withdrawn school-age girls. Weekly group meetings provided a social situation in which conversations could occur around a shared snack and craft project. The school nurse facilitated self-assertion and the expression of prosocial behavior in a socially safe (nonrejecting) environment and promoted social problem solving. On completion of the program, the participants not only showed more effective social reasoning and social skills, but developed friendships with each other that lasted beyond the life of the group.

  11. Structuring group medical practices: tax planning aspects.

    Science.gov (United States)

    Gassman, A S; Conetta, T F

    1992-01-01

    This article is the first in a series addressing the structuring of group medical practice entities, shareholder relationships, and general representation factors. In this article, a general background in federal tax planning is provided, including strategies for minimization of income tax payment and the potential problems that may be encountered when a group practice is not carefully structured.

  12. Marketing the academic medical center group practice.

    Science.gov (United States)

    Eudes, J A; Divis, K L

    1992-01-01

    From a marketing perspective, there are many differences between private and academic medical center (AMC) group practices. Given the growing competition between the two, write John Eudes and Kathy Divis, it is important for the AMC group practice to understand and use these differences to develop a competitive market advantage.

  13. Medical group management: a marketing orientation.

    Science.gov (United States)

    Bopp, K D; Allcorn, S

    1986-09-01

    This article considers the pragmatic aspects of conducting a situation/marketing audit for group medical practices. This audit is a key component in the formulation of a competitive strategy and the development of a marketing program. Given are a series of questions that may be used by medical groups to guide assessment of the opportunities and threats present in the environment as well as the strengths and weaknesses of the organization in meeting the environmental challenges. Furthermore, the article provides a framework for thinking about strategy and the variables that should be considered and aligned to achieve effective implementation of strategy. Finally, the parameters are outlined for deciding on a marketing program: the mix of marketing tools (service design, distribution channels, pricing and promotion) that should be employed to offensively and/or defensively position the medical group in the competitive marketplace.

  14. Small groups and long memories promote cooperation.

    Science.gov (United States)

    Stewart, Alexander J; Plotkin, Joshua B

    2016-06-01

    Complex social behaviors lie at the heart of many of the challenges facing evolutionary biology, sociology, economics, and beyond. For evolutionary biologists the question is often how group behaviors such as collective action, or decision making that accounts for memories of past experience, can emerge and persist in an evolving system. Evolutionary game theory provides a framework for formalizing these questions and admitting them to rigorous study. Here we develop such a framework to study the evolution of sustained collective action in multi-player public-goods games, in which players have arbitrarily long memories of prior rounds of play and can react to their experience in an arbitrary way. We construct a coordinate system for memory-m strategies in iterated n-player games that permits us to characterize all cooperative strategies that resist invasion by any mutant strategy, and stabilize cooperative behavior. We show that, especially when groups are small, longer-memory strategies make cooperation easier to evolve, by increasing the number of ways to stabilize cooperation. We also explore the co-evolution of behavior and memory. We find that even when memory has a cost, longer-memory strategies often evolve, which in turn drives the evolution of cooperation, even when the benefits for cooperation are low.

  15. Using social media to support small group learning.

    Science.gov (United States)

    Cole, Duncan; Rengasamy, Emma; Batchelor, Shafqat; Pope, Charles; Riley, Stephen; Cunningham, Anne Marie

    2017-11-10

    Medical curricula are increasingly using small group learning and less didactic lecture-based teaching. This creates new challenges and opportunities in how students are best supported with information technology. We explored how university-supported and external social media could support collaborative small group working on our new undergraduate medical curriculum. We made available a curation platform (Scoop.it) and a wiki within our virtual learning environment as part of year 1 Case-Based Learning, and did not discourage the use of other tools such as Facebook. We undertook student surveys to capture perceptions of the tools and information on how they were used, and employed software user metrics to explore the extent to which they were used during the year. Student groups developed a preferred way of working early in the course. Most groups used Facebook to facilitate communication within the group, and to host documents and notes. There were more barriers to using the wiki and curation platform, although some groups did make extensive use of them. Staff engagement was variable, with some tutors reviewing the content posted on the wiki and curation platform in face-to-face sessions, but not outside these times. A small number of staff posted resources and reviewed student posts on the curation platform. Optimum use of these tools depends on sufficient training of both staff and students, and an opportunity to practice using them, with ongoing support. The platforms can all support collaborative learning, and may help develop digital literacy, critical appraisal skills, and awareness of wider health issues in society.

  16. Student Leadership in Small Group Science Inquiry

    Science.gov (United States)

    Oliveira, Alandeom W.; Boz, Umit; Broadwell, George A.; Sadler, Troy D.

    2014-01-01

    Background: Science educators have sought to structure collaborative inquiry learning through the assignment of static group roles. This structural approach to student grouping oversimplifies the complexities of peer collaboration and overlooks the highly dynamic nature of group activity. Purpose: This study addresses this issue of…

  17. Facilitating small groups: how to encourage student learning.

    Science.gov (United States)

    Kitchen, Mark

    2012-02-01

    Many clinicians are involved in medical education, with small group teaching (SGT) forming a significant part of their work. Most facilitate these sessions by experience and common sense: less than one-third of them have received formal training in SGT. Evidence suggests small group productivity depends on good facilitation rather than on topic knowledge. Applying the fundamental concepts of SGT will lead to improvements in the quality of clinicians' teaching and in student learning. Good SGT creates the perfect environment for learning and discussion, without the need for didactic teaching. SGT emphasises the role of students in sharing and discussing their ideas in a safe learning environment, without domination by the tutor. This article provides clinicians with basic requirements for effective session design and planning, explains how to encourage student participation, how to manage students as a group, how to manage student learning, and how to recognise and deal with problems. Active facilitation and group management is the key to success in SGT, and consequently better learning outcomes. Improving the facilitation skills of clinical teachers makes teaching more effective, stimulating, and enjoyable for both tutors and students. © Blackwell Publishing Ltd 2012.

  18. Emergency Medicine Curriculum: Complications of Pregnancy Small Group Module

    Directory of Open Access Journals (Sweden)

    Linda L Herman

    2017-07-01

    Full Text Available Audience: This curriculum, created and implemented at Kaweah Delta HCD emergency medicine program, was designed to educate our emergency medicine (EM residents, PGY-1 to PGY-3, as well as medical students and attending physicians. Introduction: Obstetrical (OB emergencies pose a unique challenge to the EM physician. Given the relative rarity of these presentations within the Emergency Department (ED, it is important that residents are educated in a comprehensive manner to ensure understanding and retention.1 The exact prevalence of emergency department (ED visits that are associated with complications of pregnancy is unknown, but they are likely a sizeable portion of the patient population of the ED. Also, many hospitals in rural areas have closed their labor and delivery units due to higher operating costs and lack of available medical personnel.2 New models of high-quality teaching that ensure retention of clinically rare, but critical presentations are required. There is a body of research that suggests a small-group discussion model rather than traditional lecture-based content may improve learner engagement and retention. This model encourages active learning, which requires simultaneous instructor and learner engagement.3, 4, 5, 6, 7 Studies have revealed that the application of knowledge through case studies, personal interaction with content experts, and integrated questions are effective learning strategies for emergency medicine.3 The small group discussion classroom is facilitated by content experts with personal experience in the topic at hand. Objectives: We aim to teach the presentation and management of pregnancy complications through interactive teaching during small group discussions concerning patient cases. This curriculum utilizes resources chosen by education faculty, study questions, actual experience, and small group discussions in place of a traditional lecture-based format. In doing so, a goal of the curriculum is to

  19. Small diameter symmetric networks from linear groups

    Science.gov (United States)

    Campbell, Lowell; Carlsson, Gunnar E.; Dinneen, Michael J.; Faber, Vance; Fellows, Michael R.; Langston, Michael A.; Moore, James W.; Multihaupt, Andrew P.; Sexton, Harlan B.

    1992-01-01

    In this note is reported a collection of constructions of symmetric networks that provide the largest known values for the number of nodes that can be placed in a network of a given degree and diameter. Some of the constructions are in the range of current potential engineering significance. The constructions are Cayley graphs of linear groups obtained by experimental computation.

  20. Small group presentations for each session

    International Nuclear Information System (INIS)

    2011-01-01

    This section presents the results of the questionnaires with the recommendations from the 3 discussion groups. The questions approached are as follows: 1 - Discussion Group 1, 2 and 3 - Senior Management / Organizational Issues: Do Senior Managers understand the root cause analysis (RCA) process? Who in the organization is responsible for RCA? Are there regulatory requirements / influence? Does the culture of the organization affect the RCA process? Specific Recommendations. 2 - Discussion Group 1, 2 and 3 - Systematic Methodology / Tools: What are the challenges in using available analyses tools for identification of Human and Organisational Factors (HOF) in RCA? How do you 'handle' the perceived qualitative/subjective nature of HOF? Is the vocabulary used in RCA methodologies consistent? Will organizational issues be identified in analyses less intensive than RCA? Are you able to identify organizational issues from a single event? Is it difficult to make a clear link between RCA and CAs? What do you do if your scope expands? Recommendations. 3 - Discussion Group 1, 2 and 3 - Team Composition / Attributes: What are the challenges associated in team / individual competence? Is there management / HOF representation on the team? Does the level of the management sponsor affect the willingness of the organization to accept the HOF in RCA? Are RCA results presented to management? Who presents? Recommendations. 4 - Discussion Group 1, 2 and 3 - Learning: How many RCAs are done in a year? Is this sufficient? Could you identify organizational issues using an 'Apparent Cause Analysis' method? Are events with HOF issues trended in your organization? How do you know you have a learning organization? How can you measure the effectiveness of CAs?

  1. Effects of Group Size on Students Mathematics Achievement in Small Group Settings

    Science.gov (United States)

    Enu, Justice; Danso, Paul Amoah; Awortwe, Peter K.

    2015-01-01

    An ideal group size is hard to obtain in small group settings; hence there are groups with more members than others. The purpose of the study was to find out whether group size has any effects on students' mathematics achievement in small group settings. Two third year classes of the 2011/2012 academic year were selected from two schools in the…

  2. Teaching Small Group Communication: The Do Good Project

    Science.gov (United States)

    Minei, Elizabeth M.

    2016-01-01

    This paper focuses on the parameters of a semester-long project called the "Do Good" project, geared towards developing small group communication skills in undergraduate students. This project highlights participation in a social engagement project that allows students to bridge concepts learned in small group communication lectures…

  3. Differential impact of student behaviours on group interaction and collaborative learning: medical students' and tutors' perspectives.

    Science.gov (United States)

    Iqbal, Maha; Velan, Gary M; O'Sullivan, Anthony J; Balasooriya, Chinthaka

    2016-08-22

    Collaboration is of increasing importance in medical education and medical practice. Students' and tutors' perceptions about small group learning are valuable to inform the development of strategies to promote group dynamics and collaborative learning. This study investigated medical students' and tutors' views on competencies and behaviours which promote effective learning and interaction in small group settings. This study was conducted at UNSW Australia. Five focus group discussions were conducted with first and second year medical students and eight small group tutors were interviewed. Data were transcribed verbatim and thematic analysis was conducted. Students and tutors identified a range of behaviours that influenced collaborative learning. The main themes that emerged included: respectfulness; dominance, strong opinions and openness; constructiveness of feedback; active listening and contribution; goal orientation; acceptance of roles and responsibilities; engagement and enthusiasm; preparedness; self- awareness and positive personal attributes. An important finding was that some of these student behaviours were found to have a differential impact on group interaction compared with collaborative learning. This information could be used to promote higher quality learning in small groups. This study has identified medical students' and tutors' perceptions regarding interactional behaviours in small groups, as well as behaviours which lead to more effective learning in those settings. This information could be used to promote learning in small groups.

  4. Cooperative behavior evolution of small groups on interconnected networks

    International Nuclear Information System (INIS)

    Huang, Keke; Cheng, Yuan; Zheng, Xiaoping; Yang, Yeqing

    2015-01-01

    Highlights: • Small groups are modeled on interconnected networks. • Players face different dilemmas inside and outside small groups. • Impact of the ratio and strength of link on the behavioral evolution are studied. - Abstract: Understanding the behavioral evolution in evacuation is significant for guiding and controlling the evacuation process. Based on the fact that the population consists of many small groups, here we model the small groups which are separated in space but linked by other methods, such as kinship, on interconnected networks. Namely, the players in the same layer belong to an identical small group, while the players located in different layers belong to different small groups. And the players of different layers establish interaction by edge crossed layers. In addition, players face different dilemmas inside and outside small groups, in detail, the players in the same layer play prisoner’s dilemma, but players in different layers play harmony game. By means of numerous simulations, we study the impact of the ratio and strength of link on the behavioral evolution. Because the framework of this work takes the space distribution into account, which is close to the realistic life, we hope that it can provide a new insight to reveal the law of behavioral evolution of evacuation population.

  5. Integrating a Social Behavior Intervention during Small Group Academic Instruction Using a Total Group Criterion Intervention

    Science.gov (United States)

    Rodriguez, Billie Jo; Anderson, Cynthia M.

    2014-01-01

    Total group contingencies, a variation of interdependent group contingencies, provide educators with an efficient and effective mechanism to improve social behavior and increase academic skills. Their utility has not been examined in small educational groups. This is unfortunate as supplemental instruction frequently is delivered in small group…

  6. Adding Group Psychotherapy to Medication Treatment in Dysthymia

    Science.gov (United States)

    Hellerstein, David J.; Little, Suzanne A. S.; Samstag, Lisa Wallner; Batchelder, Sarai; Muran, J. Christopher; Fedak, Michael; Kreditor, David; Rosenthal, Richard N.; Winston, Arnold

    2001-01-01

    Patients with dysthymia have been shown to respond to treatment with antidepressant medications, and to some degree to psychotherapy. Even patients successfully treated with medication often have residual symptoms and impaired psychosocial functioning. The authors describe a prospective randomized 36-week study of dysthymic patients, comparing continued treatment with antidepressant medication (fluoxetine) alone and medication with the addition of group therapy treatment. After an 8-week trial of fluoxetine, medication-responsive subjects were randomly assigned to receive either continued medication only or medication plus 16 sessions of manualized group psychotherapy. Results provide preliminary evidence that group therapy may provide additional benefit to medication-responding dysthymic patients, particularly in interpersonal and psychosocial functioning. PMID:11264333

  7. Searching for Intertextual Connections in Small Group Text Discussion

    Science.gov (United States)

    Chi, Feng-ming

    2012-01-01

    This paper reports the sources for and intentions of intertextuality made by 10 groups of Taiwanese university students in the process of discussing two American stories. Two types of data, small group text discussions and oral interviews, were gathered. The results indicated that participants used diverse sources of intertextual links, and with…

  8. Teaching Small Group Communication: A Do Good Project

    Directory of Open Access Journals (Sweden)

    Elizabeth M. Minei, PhD

    2016-08-01

    Full Text Available This paper focuses on the parameters of a semester-long project called the “Do Good” project, geared towards developing small group communication skills in undergraduate students. This project highlights participation in a social engagement project that allows students to bridge concepts learned in small group communication lectures (e.g., team dynamics, project management, conflict resolution, decision making, leadership with community outreach. Included are an overview of the project, and examples for how each component both challenges students’ ability to communicate in groups and provides motivation that foster students’ ability to link in-class knowledge with practical, real world application.

  9. Small-Group Learning in Undergraduate STEM Disciplines: Effect of Group Type on Student Achievement

    Science.gov (United States)

    Micari, Marina; Pazos, Pilar; Streitwieser, Bernhard; Light, Gregory

    2010-01-01

    Small-group learning in the science, technology, engineering, and mathematics (STEM) disciplines has been widely studied, and it is clear that this method offers many benefits to students. Less attention has been paid to the ways in which small learning groups differ from one another, and how these differences may affect student learning and…

  10. Implement the medical group revenue function. Create competitive advantage.

    Science.gov (United States)

    Colucci, C

    1998-01-01

    This article shows medical groups how they can employ new financial management and information technology techniques to safeguard their revenue and income streams. These managerial techniques stem from the application of the medical group revenue function, which is defined herein. This article also describes how the medical group revenue function can be used to create value by employing a database and a decision support system. Finally, the article describes how the decision support system can be used to create competitive advantage. Through the wise use of internally generated information, medical groups can negotiate better contract terms, improve their operations, cut their costs, embark on capital investment programs and improve market share. As medical groups gain market power by improving in these areas, they will be more attractive to potential strategic allies, payers and investment bankers.

  11. Small Steps in Impacting Clinical Auscultation of Medical Students

    Directory of Open Access Journals (Sweden)

    Edem K. Binka MD

    2016-09-01

    Full Text Available The objective of this study was to determine if a training module improves the auscultation skills of medical students at the University of Maryland School of Medicine. Second-year medical students completed pretests on 12 heart sounds followed by a 45-minute training module on clinical auscultation, with retesting immediately after the intervention and during their third-year pediatrics clerkship. The control group consisted of third-year medical students who did not have the intervention. There was a 23% improvement in the identification of heart sounds postintervention (P < .001. Diastolic and valvular murmurs were poorly identified pre- and post intervention. There was a 6% decline in accuracy of the intervention group in the following academic year. The intervention group was superior to the control group at identifying the tested heart sounds (49% vs 43%, P = .04. The accuracy of second-year medical students in identifying heart sounds improved after a brief training module.

  12. Opportunity recognition for small businesses in medical tourism in Taiwan

    Directory of Open Access Journals (Sweden)

    Hung Ying-Hsun

    2018-01-01

    Full Text Available Medical tourism has become an investment focus for many Asian countries. For example, India, Singapore, Thailand, South Korea, and Malaysia have governmental projects to foster this emerging industry, and successfully attract millions of medical tourists each year. Medical tourism consists of diverse industries that can provide abundant opportunities of new businesses. Currently Taiwan is trying to catch up in this trend by making national development policies, setting up institutions, modifying laws and regulations, and encouraging investment of private sector. The purpose of this study is to analyze the status quo of international medical tourism in Taiwan, and identify several opportunities for small businesses to catch and to participate in forming a solid medical tourism industry for Taiwan.

  13. THE APPLICABILITY OF SMALL GROUP DISCUSSION IN ENGLISH READING CLASS

    Directory of Open Access Journals (Sweden)

    Kurniawan Yudhi Nugroho

    2017-04-01

    Full Text Available Success of learning is not only a matter of using an appropriate teaching resources, instead, the interference of teaching method is found to be essential to determine the students’ learning achievement. Teacher as a captain of class has the right to choose type of method used in the classroom for sake of students’ improvement. This study was designed as an attempt to help Master Students from a well established private university improve their reading comprehension skill through small group discussion. This study was participated by 30 students, later divided into two classes and served differently as an experimental group for the class A and a control group for the class B. Referring to the final data analysis of the study, it is found that there is an improving learning achievement in the experimental group, indicated by higher performance of posttest (20.333 than the pretest. Apart from this, further analysis was also conducted to find out whether or not small group discussion was able to show better performance than another teaching method applied in another different class. Based on the result of statistical calculation, it shows that small group discussion got better result 12.334 than that of another group. As a result, some suggestions were made by referring to result of the study.

  14. Metastable structures and size effects in small group dynamics.

    Science.gov (United States)

    Lauro Grotto, Rosapia; Guazzini, Andrea; Bagnoli, Franco

    2014-01-01

    In his seminal works on group dynamics Bion defined a specific therapeutic setting allowing psychoanalytic observations on group phenomena. In describing the setting he proposed that the group was where his voice arrived. This physical limit was later made operative by assuming that the natural dimension of a therapeutic group is around 12 people. Bion introduced a theory of the group aspects of the mind in which proto-mental individual states spontaneously evolve into shared psychological states that are characterized by a series of features: (1) they emerge as a consequence of the natural tendency of (both conscious and unconscious) emotions to combine into structured group patterns; (2) they have a certain degree of stability in time; (3) they tend to alternate so that the dissolution of one is rapidly followed by the emergence of another; (4) they can be described in qualitative terms according to the nature of the emotional mix that dominates the state, in structural terms by a kind of typical "leadership" pattern, and in "cognitive" terms by a set of implicit expectations that are helpful in explaining the group behavior (i.e., the group behaves "as if" it was assuming that). Here we adopt a formal approach derived from Socio-physics in order to explore some of the structural and dynamic properties of this small group dynamics. We will described data from an analytic DS model simulating small group interactions of agents endowed with a very simplified emotional and cognitive dynamic in order to assess the following main points: (1) are metastable collective states allowed to emerge in the model and if so, under which conditions in the parameter space? (2) can these states be differentiated in structural terms? (3) to what extent are the emergent dynamic features of the systems dependent of the system size? We will finally discuss possible future applications of the quantitative descriptions of the interaction structure in the small group clinical setting.

  15. Metastable structures and size effects in small group dynamics

    Directory of Open Access Journals (Sweden)

    Rosapia eLauro Grotto

    2014-07-01

    Full Text Available In his seminal works on group dynamics Bion defined a specific therapeutic setting allowing psychoanalytic observations on group phenomena. In describing the setting he proposed that the group was where his voice arrived. This physical limit was later made operative by assuming that the natural dimension of a therapeutic group is around 12 people. Bion introduced a theory of the group aspects of the mind in which proto-mental individual states spontaneously evolve into shared psychological states that are characterized by a series of features: 1 they emerge as a consequence of the natural tendency of (both conscious and unconscious emotions to combine into structured group patterns; 2 they have a certain degree of stability in time; 3 they tend to alternate so that the dissolution of one is rapidly followed by the emergence of another; 4 they can be described in qualitative terms according to the nature of the emotional mix that dominates the state, in structural terms by a kind of typical 'leadership’ pattern, and in 'cognitive’ terms by a set of implicit expectations that are helpful in explaining the group behavior (i.e. the group behaves 'as if’ it was assuming that…. Here we adopt a formal approach derived from Socio-physics in order to explore some of the structural and dynamic properties of this small group dynamics. We will described data from an analytic DS model simulating small group interactions of agents endowed with a very simplified emotional and cognitive dynamic in order to assess the following main points: 1 are metastable collective states allowed to emerge in the model and if so, under which conditions in the parameter space? 3 can these states be differentiated in structural terms? 3 to what extent are the emergent dynamic features of the systems dependent of the system size? We will finally discuss possible future applications of the quantitative descriptions of the interaction structure in the small group clinical

  16. Modernizing dermatology interest groups in medical school: Certificate programs.

    Science.gov (United States)

    Wang, Jordan V; Korta, Dorota Z; Keller, Matthew

    2017-11-15

    This commentary addresses the increasingly competitive nature of applying to dermatology residency programs and how both interest groups in medical schools and their dermatology departments can help to better prepare applicants. As previous literature argued that dermatology has been underemphasized in medical school curricula, we propose five fundamental options that interest groups can implement in order to offer increased exposure to our field in medical training. Furthermore, with therecent trend of many schools conferring certificates in various specialized concentrations, we also discuss interest groups pioneering certificate-grantingprograms in dermatology competency. The pros and cons of having a recognized certificate program in dermatology are presented.

  17. A prospective randomized trial of content expertise versus process expertise in small group teaching.

    Science.gov (United States)

    Peets, Adam D; Cooke, Lara; Wright, Bruce; Coderre, Sylvain; McLaughlin, Kevin

    2010-10-14

    Effective teaching requires an understanding of both what (content knowledge) and how (process knowledge) to teach. While previous studies involving medical students have compared preceptors with greater or lesser content knowledge, it is unclear whether process expertise can compensate for deficient content expertise. Therefore, the objective of our study was to compare the effect of preceptors with process expertise to those with content expertise on medical students' learning outcomes in a structured small group environment. One hundred and fifty-one first year medical students were randomized to 11 groups for the small group component of the Cardiovascular-Respiratory course at the University of Calgary. Each group was then block randomized to one of three streams for the entire course: tutoring exclusively by physicians with content expertise (n = 5), tutoring exclusively by physicians with process expertise (n = 3), and tutoring by content experts for 11 sessions and process experts for 10 sessions (n = 3). After each of the 21 small group sessions, students evaluated their preceptors' teaching with a standardized instrument. Students' knowledge acquisition was assessed by an end-of-course multiple choice (EOC-MCQ) examination. Students rated the process experts significantly higher on each of the instrument's 15 items, including the overall rating. Students' mean score (±SD) on the EOC-MCQ exam was 76.1% (8.1) for groups taught by content experts, 78.2% (7.8) for the combination group and 79.5% (9.2) for process expert groups (p = 0.11). By linear regression student performance was higher if they had been taught by process experts (regression coefficient 2.7 [0.1, 5.4], p teach first year medical students within a structured small group environment; preceptors with process expertise result in at least equivalent, if not superior, student outcomes in this setting.

  18. Dynamical networks of influence in small group discussions.

    Science.gov (United States)

    Moussaïd, Mehdi; Noriega Campero, Alejandro; Almaatouq, Abdullah

    2018-01-01

    In many domains of life, business and management, numerous problems are addressed by small groups of individuals engaged in face-to-face discussions. While research in social psychology has a long history of studying the determinants of small group performances, the internal dynamics that govern a group discussion are not yet well understood. Here, we rely on computational methods based on network analyses and opinion dynamics to describe how individuals influence each other during a group discussion. We consider the situation in which a small group of three individuals engages in a discussion to solve an estimation task. We propose a model describing how group members gradually influence each other and revise their judgments over the course of the discussion. The main component of the model is an influence network-a weighted, directed graph that determines the extent to which individuals influence each other during the discussion. In simulations, we first study the optimal structure of the influence network that yields the best group performances. Then, we implement a social learning process by which individuals adapt to the past performance of their peers, thereby affecting the structure of the influence network in the long run. We explore the mechanisms underlying the emergence of efficient or maladaptive networks and show that the influence network can converge towards the optimal one, but only when individuals exhibit a social discounting bias by downgrading the relative performances of their peers. Finally, we find a late-speaker effect, whereby individuals who speak later in the discussion are perceived more positively in the long run and are thus more influential. The numerous predictions of the model can serve as a basis for future experiments, and this work opens research on small group discussion to computational social sciences.

  19. Integrating Academic Interventions into Small Group Counseling in Elementary School

    Science.gov (United States)

    Steen, Sam; Kaffenberger, Carol J.

    2007-01-01

    Professional school counselors face the challenge of delivering guidance and counseling services to students while connecting to the educational mission of schools. This article is a summary and evaluation of a small group counseling program that targets academic issues while addressing personal/social issues with elementary-aged children. Results…

  20. A Mindfulness Experiential Small Group to Help Students Tolerate Ambiguity

    Science.gov (United States)

    Bohecker, Lynn; Vereen, Linwood G.; Wells, Pamela C.; Wathen, Cristen C.

    2016-01-01

    This study explored the lived experiences of 20 counselors-in-training (CITs) in a mindfulness experiential small group. Using grounded theory, the authors described a 5-dimensional model for navigating ambiguity. Findings suggest mindfulness training provides CITs self-reflection skills and a greater ability to manage cognitive complexity.

  1. Listening--A New Priority In Small Group Process?

    Science.gov (United States)

    Brack, Harold A.

    Although listening is a major activity in small group communication, it has received minimal attention. Examination of several books and journals reveals a very sparse treatment of the subject. More attention should be given to listening because it is a key factor in a democratic leadership style and requires different skills than does listening…

  2. Small arms proliferation. Report on working group 2

    International Nuclear Information System (INIS)

    1998-01-01

    The working group reported on the proliferation of small arms, light weapons non-lethal weapons, which have traditionally been given little attention in international talks on peace on the contrary to nuclear weapons which have been tested during the Second World War but never used in war later

  3. Influence of Individual and Group Priming on Medical Students

    OpenAIRE

    McGeown, Helen Rosemary

    2009-01-01

    This study investigated the impact of information on level of prototypicality of the ingroup ‘medical students’, comparing self-esteem effects for those primed as individuals with self-esteem effects for those primed as group members. Indication of prototypicality was given by false feedback on purported individual levels of empathy, an important group norm for medical students. As well as priming type having interactive effects with prototypicality information, it was hypothesized that initi...

  4. Preparation of small group constants for calculation of shielding

    International Nuclear Information System (INIS)

    Khokhlov, V.F.; Shejno, I.N.; Tkachev, V.D.

    1979-01-01

    Studied is the effect of the shielding calculation error connected with neglect of the angular and spatial neutron flux dependences while determining the small-group constants on the basis of the many-group ones. The economical method allowing for dependences is proposed. The spatial dependence is substituted by the average value according to the zones singled out in the limits of the zones of the same content; the angular cross section dependence is substituted by the average values in the half-ranges of the angular variable. To solve the transfer equation the ALGOL-ROSA-M program using the method of characteristic interpolation and trial run method is developed. The program regards correctly for nonscattered and single scattered radiations. Compared are the calculation results of neutron transmission (10.5 MeV-0.01 eV) in the 21-group approximation with the 3-group calculations for water (the layer thickness is 30 cm) and 5-group calculations for heterogeneous shielding of alternating stainless steel layers (3 layers, each of the 16 cm thickness) and graphite layers (2 layers, each of the 20 cm thickness). The analysis shows that the method proposed permits to obtain rather accurate results in the course of preparation of the small-group cross sections, decreasing considerably the number of the groups (from 21 to 3-5) and saving the machine time

  5. Consolidation of medical groups into physician practice management organizations.

    Science.gov (United States)

    Robinson, J C

    1998-01-14

    Medical groups are growing and merging to improve efficiency and bargaining leverage in the competitive managed care environment. An increasing number are affiliating with physician practice management (PPM) firms that offer capital financing, expertise in utilization management, and global capitation contracts with health insurance entities. These physician organizations provide an alternative to affiliation with a hospital system and to individual physician contracting with health plans. To describe the growth, structure, and strategy of PPM organizations that coordinate medical groups in multiple markets and contract with health maintenance organizations (HMOs). Case studies, including interviews with administrative and clinical leaders, review of company documents, and analysis of documents from investment bankers, the Securities and Exchange Commission, and industry observers. Medical groups and independent practice associations (IPAs) in California and New Jersey affiliated with MedPartners, FPA Medical Management, and UniMed. Growth in number of primary care and specialty care physicians employed by and contracting with affiliated medical groups; growth in patient enrollment from commercial, Medicare, and Medicaid HMOs; growth in capitation and noncapitation revenues; structure and governance of affiliated management service organizations and professional corporations; and contracting strategies with HMOs. Between 1994 and 1996, medical groups and IPAs affiliated with 3 PPMs grew from 3787 to 25763 physicians; 65% of employed physicians provide primary care, while the majority of contracting physicians provide specialty care. Patient enrollment in HMOs grew from 285503 to 3028881. Annual capitation revenues grew from $190 million to $2.1 billion. Medical groups affiliated with PPMs are capitated for most professional, hospital, and ancillary clinical services and are increasingly delegated responsibility by HMOs for utilization management and quality

  6. The growth of medical groups paid through capitation in California.

    Science.gov (United States)

    Robinson, J C; Casalino, L P

    1995-12-21

    In California, it is common for health maintenance organizations (HMOs) to contract with large medical groups that are paid through capitation and are responsible for managing a full spectrum of medical services. We studied six large medical groups in California--Bristol Park Medical, Friendly Hills HealthCare Network, HealthCare Partners Medical Group, Mullikin Medical Centers, Palo Alto Medical Foundation, and San Jose Medical Group--that are paid through capitation and that are growing as a result of contracts with managed-care organizations. We conducted interviews and obtained data on factors such as patient enrollment, capitation and other revenue, numbers of days spent by enrollees in the hospital, and numbers of visits to physicians per enrollee. Between 1990 and 1994, the number of HMO enrollees whose care was paid for through capitation in the six medical groups increased by 91 percent, from 398,359 to 759,474. In 1994, the mean number of hospital days per 1000 HMO enrollees ranged from 120 to 149 for non-Medicare patients and from 643 to 936 days for Medicare patients. By comparison, in 1993 the mean numbers of hospital days per 1000 HMO enrollees not covered by Medicare were 232 for California and 297 for the United States; for HMO enrollees covered by Medicare, the numbers were 1337 for California and 1698 for the United States. In 1994, the average annual number of visits to physicians for HMO patients in the six groups not covered by Medicare ranged from 3.1 to 3.9; for Medicare patients, it ranged from 7.2 to 9.3; these rates were slightly lower than statewide and national rates. Four of the groups have sold their assets (such as facilities, supplies, equipment, and patients' charts) to outside investors; the physicians remain employed by physician-owned professional corporations. Medical groups paid through capitation offer a model for the status of physicians in managed-care systems that differs from the employee status offered by staff-model HMOs

  7. A RFID grouping proof protocol for medication safety of inpatient.

    Science.gov (United States)

    Huang, Hsieh-Hong; Ku, Cheng-Yuan

    2009-12-01

    In order to provide enhanced medication safety for inpatients, the medical mechanism which adopts the modified grouping proof protocol is proposed in this paper. By using the grouping proof protocol, the medical staffs could confirm the authentication and integrity of a group of Radio-Frequency Identification (RFID) tags which are embedded on inpatient bracelets and the containers of drugs. This mechanism is designed to be compatible with EPCglobal Class-1 Generation-2 standard which is the most popular specification of RFID tags. Due to the light-weight computational capacity of passive tags, only the pseudo-random number generator (PRNG) and cyclic redundancy code (CRC) are allowed to be used in the communication protocol. Furthermore, a practical scenario of using this proposed mechanism in hospital to examine the medication safety is also presented.

  8. Medication errors in home care: a qualitative focus group study.

    Science.gov (United States)

    Berland, Astrid; Bentsen, Signe Berit

    2017-11-01

    To explore registered nurses' experiences of medication errors and patient safety in home care. The focus of care for older patients has shifted from institutional care towards a model of home care. Medication errors are common in this situation and can result in patient morbidity and mortality. An exploratory qualitative design with focus group interviews was used. Four focus group interviews were conducted with 20 registered nurses in home care. The data were analysed using content analysis. Five categories were identified as follows: lack of information, lack of competence, reporting medication errors, trade name products vs. generic name products, and improving routines. Medication errors occur frequently in home care and can threaten the safety of patients. Insufficient exchange of information and poor communication between the specialist and home-care health services, and between general practitioners and healthcare workers can lead to medication errors. A lack of competence in healthcare workers can also lead to medication errors. To prevent these, it is important that there should be up-to-date information and communication between healthcare workers during the transfer of patients from specialist to home care. Ensuring competence among healthcare workers with regard to medication is also important. In addition, there should be openness and accurate reporting of medication errors, as well as in setting routines for the preparation, alteration and administration of medicines. To prevent medication errors in home care, up-to-date information and communication between healthcare workers is important when patients are transferred from specialist to home care. It is also important to ensure adequate competence with regard to medication, and that there should be openness when medication errors occur, as well as in setting routines for the preparation, alteration and administration of medications. © 2017 John Wiley & Sons Ltd.

  9. Building clinical data groups for electronic medical record in China.

    Science.gov (United States)

    Tu, Haibo; Yu, Yingtao; Yang, Peng; Tang, Xuejun; Hu, Jianping; Rao, Keqin; Pan, Feng; Xu, Yongyong; Liu, Danhong

    2012-04-01

    This article aims at building clinical data groups for Electronic Medical Records (EMR) in China. These data groups can be reused as basic information units in building the medical sheets of Electronic Medical Record Systems (EMRS) and serve as part of its implementation guideline. The results were based on medical sheets, the forms that are used in hospitals, which were collected from hospitals. To categorize the information in these sheets into data groups, we adopted the Health Level 7 Clinical Document Architecture Release 2 Model (HL7 CDA R2 Model). The regulations and legal documents concerning health informatics and related standards in China were implemented. A set of 75 data groups with 452 data elements was created. These data elements were atomic items that comprised the data groups. Medical sheet items contained clinical records information and could be described by standard data elements that exist in current health document protocols. These data groups match different units of the CDA model. Twelve data groups with 87 standardized data elements described EMR headers, and 63 data groups with 405 standardized data elements constituted the body. The later 63 data groups in fact formed the sections of the model. The data groups had two levels. Those at the first level contained both the second level data groups and the standardized data elements. The data groups were basically reusable information units that served as guidelines for building EMRS and that were used to rebuild a medical sheet and serve as templates for the clinical records. As a pilot study of health information standards in China, the development of EMR data groups combined international standards with Chinese national regulations and standards, and this was the most critical part of the research. The original medical sheets from hospitals contain first hand medical information, and some of their items reveal the data types characteristic of the Chinese socialist national health system

  10. Structuring group medical practices: shareholder and partnership agreements.

    Science.gov (United States)

    Gassman, A S

    1992-01-01

    This article is the second in a series addressing the structuring of group medical entities, shareholder relationships, and general representation factors. In this article, a number of the legal and business considerations for entering into shareholder and partnership agreements are discussed, and various types of practice structures and recommended group practice agreement provisions are described.

  11. A qualitative assessment of faculty perspectives of small group teaching experience in Iraq.

    Science.gov (United States)

    Saleh, Abubakir M; Shabila, Nazar P; Dabbagh, Ali A; Al-Tawil, Namir G; Al-Hadithi, Tariq S

    2015-02-15

    Although medical colleges in Iraq started recently to increasingly use small group teaching approach, there is limited research on the challenges, opportunities and needs of small group teaching in Iraq particularly in Kurdistan Region. Therefore, this study was aimed to assess the small group teaching experience in the 4(th) and 5(th) year of study in Hawler College of Medicine with a focus on characterizing the impressions of faculty members about how small group teaching is proceeding in the college. A qualitative study based on semi-structured interviews with 20 purposively selected faculty members was conducted. An interview guide was used for data collection that was around different issues related to small group teaching in medical education including planning, preparation, positive aspects, problems facing its implementation, factors related to it and recommendations for improvement. Qualitative data analysis comprised identifying themes that emerged from the review of transcribed interviews. Participants reported some positive experience and a number of positive outcomes related to this experience including better controlling the class, enhancing students' understanding of the subject, increasing interaction in the class, increasing the students' confidence, enhancing more contact between teachers and students, improving the presentation skills of the students and improving the teacher performance. The participants emphasized poor preparation and planning for application of this system and highlighted a number of problems and challenges facing this experience particularly in terms of poor infrastructure and teaching facilities, poor orientation of students and teachers, inadequate course time for some subjects and shortage of faculty members in a number of departments. The main suggestions to improve this experience included improving the infrastructure and teaching facilities, using more interactive teaching methods and better organization and management

  12. Group processes in medical education: learning from social identity theory.

    Science.gov (United States)

    Burford, Bryan

    2012-02-01

    The clinical workplace in which doctors learn involves many social groups, including representatives of different professions, clinical specialties and workplace teams. This paper suggests that medical education research does not currently take full account of the effects of group membership, and describes a theoretical approach from social psychology, the social identity approach, which allows those effects to be explored. The social identity approach has a long history in social psychology and provides an integrated account of group processes, from the adoption of group identity through a process of self-categorisation, to the biases and conflicts between groups. This paper outlines key elements of this theoretical approach and illustrates their relevance to medical education. The relevance of the social identity approach is illustrated with reference to a number of areas of medical education. The paper shows how research questions in medical education may be usefully reframed in terms of social identity in ways that allow a deeper exploration of the psychological processes involved. Professional identity and professionalism may be viewed in terms of self-categorisation rather than simply attainment; the salience of different identities may be considered as influences on teamwork and interprofessional learning, and issues in communication and assessment may be considered in terms of intergroup biases. Social identity theory provides a powerful framework with which to consider many areas of medical education. It allows disparate influences on, and consequences of, group membership to be considered as part of an integrated system, and allows assumptions, such as about the nature of professional identity and interprofessional tensions, to be made explicit in the design of research studies. This power to question assumptions and develop deeper and more meaningful research questions may be increasingly relevant as the nature and role of the medical profession change

  13. Using an electronic prescribing system to ensure accurate medication lists in a large multidisciplinary medical group.

    Science.gov (United States)

    Stock, Ron; Scott, Jim; Gurtel, Sharon

    2009-05-01

    Although medication safety has largely focused on reducing medication errors in hospitals, the scope of adverse drug events in the outpatient setting is immense. A fundamental problem occurs when a clinician lacks immediate access to an accurate list of the medications that a patient is taking. Since 2001, PeaceHealth Medical Group (PHMG), a multispecialty physician group, has been using an electronic prescribing system that includes medication-interaction warnings and allergy checks. Yet, most practitioners recognized the remaining potential for error, especially because there was no assurance regarding the accuracy of information on the electronic medical record (EMR)-generated medication list. PeaceHealth developed and implemented a standardized approach to (1) review and reconcile the medication list for every patient at each office visit and (2) report on the results obtained within the PHMG clinics. In 2005, PeaceHealth established the ambulatory medication reconciliation project to develop a reliable, efficient process for maintaining accurate patient medication lists. Each of PeaceHealth's five regions created a medication reconciliation task force to redesign its clinical practice, incorporating the systemwide aims and agreed-on key process components for every ambulatory visit. Implementation of the medication reconciliation process at the PHMG clinics resulted in a substantial increase in the number of accurate medication lists, with fewer discrepancies between what the patient is actually taking and what is recorded in the EMR. The PeaceHealth focus on patient safety, and particularly the reduction of medication errors, has involved a standardized approach for reviewing and reconciling medication lists for every patient visiting a physician office. The standardized processes can be replicated at other ambulatory clinics-whether or not electronic tools are available.

  14. Task Type and Group Motivation: Implications for a Behavioral Approach to Leadership in Small Groups.

    Science.gov (United States)

    Latham, Van M.

    1987-01-01

    Discusses a theory of leadership effectiveness in small discussion/decision making groups developed to facilitate discussion and goal efficacy. Develops four leadership styles (coordinator, inventor, enthusiast, and director) focusing on two critical questions the leader must address. Discusses implications of the model for leadership training and…

  15. Expanding Group Peer Review: A Proposal for Medical Education Scholarship.

    Science.gov (United States)

    Dumenco, Luba; Engle, Deborah L; Goodell, Kristen; Nagler, Alisa; Ovitsh, Robin K; Whicker, Shari A

    2017-02-01

    After participating in a group peer-review exercise at a workshop presented by Academic Medicine and MedEdPORTAL editors at the 2015 Association of American Medical Colleges Medical Education Meeting, the authors realized that the way their work group reviewed a manuscript was very different from the way by which they each would have reviewed the paper as an individual. Further, the group peer-review process yielded more robust feedback for the manuscript's authors than did the traditional individual peer-review process. This realization motivated the authors to reconvene and collaborate to write this Commentary to share their experience and propose the expanded use of group peer review in medical education scholarship.The authors consider the benefits of a peer-review process for reviewers, including learning how to improve their own manuscripts. They suggest that the benefits of a team review model may be similar to those of teamwork and team-based learning in medicine and medical education. They call for research to investigate this, to provide evidence to support group review, and to determine whether specific paper types would benefit most from team review (e.g., particularly complex manuscripts, those receiving widely disparate initial individual reviews). In addition, the authors propose ways in which a team-based approach to peer review could be expanded by journals and institutions. They believe that exploring the use of group peer review potentially could create a new methodology for skill development in research and scholarly writing and could enhance the quality of medical education scholarship.

  16. Competitive forces in the medical group industry: a stakeholder perspective.

    Science.gov (United States)

    Blair, J D; Buesseler, J A

    1998-01-01

    Applying Porter's model of competitive forces to health care, stakeholder concepts are integrated to analyze the future of medical groups. Using both quantitative survey and qualitative observational data, competitors, physician suppliers, integrated systems new entrants, patient and managed care buyers, and hospitals substitutes are examined.

  17. Opinion dynamics within a virtual small group: the stubbornness effect

    Science.gov (United States)

    Guazzini, Andrea; Cini, Alessandro; Bagnoli, Franco; Ramasco, José

    2015-09-01

    The modeling of opinion dynamics is social systems has attracted a good deal of attention in the last decade. Even though based on intuition and observation, the mechanisms behind many of these models need solid empirical grounding. In this work, we investigate the relation among subjective variables (such as the personality), the dynamics of the affinity network dynamics, the communication patterns emerging throughout the social interactions and the opinions dynamics in a series of experiments with five small groups of ten people each. In order to ignite the discussion, the polemic topic of animal experimentation was proposed. The groups essentially polarized in two factions with a set of stubborn individuals (those not changing their opinions in time) playing the role of anchors. Our results suggest that the different layers present in the group dynamics (i.e., individual level, group dynamics and meso-communication) are deeply intermingled, specifically the stubbornness effect appears to be related to the dynamical features of the network topologies, and only in an undirected way to the personality of the participants.

  18. Opinion dynamics within a virtual small group: the stubbornness effect

    Directory of Open Access Journals (Sweden)

    Andrea eGuazzini

    2015-09-01

    Full Text Available The modeling of opinion dynamics is social systems has attracted a good deal of attention in the last decade. Even though based on intuition and observation, the mechanisms behind many of these models need solid empirical grounding. In this work, we investigate the relation among subjective variables (such as the personality, the dynamics of the affinity network dynamics, the communication patterns emerging throughout the social interactions and the opinions dynamics in a series of experiments with five small groups of ten people each. In order to ignite the discussion, the polemic topic of animal experimentation was proposed. The groups essentially polarized in two factions with a set of stubborn individuals (those not changing their opinions in time playing the role of anchors. Our results suggest that the different layers present in the group dynamics (i.e., individual level, group dynamics and meso-communication are deeply intermingled, specifically the stubbornness effect appears to be related to the dynamical features of the network topologies, and only in an undirected way to the personality of the participants.

  19. SMALL GROUP LEARNING METHODS AND THEIR EFFECT ON LEARNERS’ RELATIONSHIPS

    Directory of Open Access Journals (Sweden)

    Radka Borůvková

    2016-04-01

    Full Text Available Building relationships in the classroom is an essential part of any teacher's career. Having healthy teacher-to-learner and learner-to-learner relationships is an effective way to help prevent pedagogical failure, social conflict and quarrelsome behavior. Many strategies are available that can be used to achieve good long-lasting relationships in the classroom setting. Successful teachers’ pedagogical work in the classroom requires detailed knowledge of learners’ relationships. Good understanding of the relationships is necessary, especially in the case of teenagers’ class. This sensitive period of adolescence demands attention of all teachers who should deal with the problems of their learners. Special care should be focused on children that are out of their classmates’ interest (so called isolated learners or isolates in such class and on possibilities to integrate them into the class. Natural idea how to do it is that of using some modern non-traditional teaching/learning methods, especially the methods based on work in small groups involving learners’ cooperation. Small group education (especially problem-based learning, project-based learning, cooperative learning, collaborative learning or inquire-based learning as one of these methods involves a high degree of interaction. The effectiveness of learning groups is determined by the extent to which the interaction enables members to clarify their own understanding, build upon each other's contributions, sift out meanings, ask and answer questions. An influence of this kind of methods (especially cooperative learning (CL on learners’ relationships was a subject of the further described research. Within the small group education, students work with their classmates to solve complex and authentic problems that help develop content knowledge as well as problem-solving, reasoning, communication, and self-assessment skills. The aim of the research was to answer the question: Can the

  20. Medical Student Perspectives of Active Learning: A Focus Group Study.

    Science.gov (United States)

    Walling, Anne; Istas, Kathryn; Bonaminio, Giulia A; Paolo, Anthony M; Fontes, Joseph D; Davis, Nancy; Berardo, Benito A

    2017-01-01

    Phenomenon: Medical student perspectives were sought about active learning, including concerns, challenges, perceived advantages and disadvantages, and appropriate role in the educational process. Focus groups were conducted with students from all years and campuses of a large U.S. state medical school. Students had considerable experience with active learning prior to medical school and conveyed accurate understanding of the concept and its major strategies. They appreciated the potential of active learning to deepen and broaden learning and its value for long-term professional development but had significant concerns about the efficiency of the process, the clarity of expectations provided, and the importance of receiving preparatory materials. Most significantly, active learning experiences were perceived as disconnected from grading and even as impeding preparation for school and national examinations. Insights: Medical students understand the concepts of active learning and have considerable experience in several formats prior to medical school. They are generally supportive of active learning concepts but frustrated by perceived inefficiencies and lack of contribution to the urgencies of achieving optimal grades and passing United States Medical Licensing Examinations, especially Step 1.

  1. Workplace learning through peer groups in medical school clerkships.

    Science.gov (United States)

    Chou, Calvin L; Teherani, Arianne; Masters, Dylan E; Vener, Margo; Wamsley, Maria; Poncelet, Ann

    2014-01-01

    When medical students move from the classroom into clinical practice environments, their roles and learning challenges shift dramatically from a formal curricular approach to a workplace learning model. Continuity among peers during clinical clerkships may play an important role in this different mode of learning. We explored students' perceptions about how they achieved workplace learning in the context of intentionally formed or ad hoc peer groups. We invited students in clerkship program models with continuity (CMCs) and in traditional block clerkships (BCs) to complete a survey about peer relationships with open-ended questions based on a workplace learning framework, including themes of workplace-based relationships, the nature of work practices, and selection of tasks and activities. We conducted qualitative content analysis to characterize students' experiences. In both BCs and CMCs, peer groups provided rich resources, including anticipatory guidance about clinical expectations of students, best practices in interacting with patients and supervisors, helpful advice in transitioning between rotations, and information about implicit rules of clerkships. Students also used each other as benchmarks for gauging strengths and deficits in their own knowledge and skills. Students achieve many aspects of workplace learning in clerkships through formal or informal workplace-based peer groups. In these groups, peers provide accessible, real-time, and relevant resources to help each other navigate transitions, clarify roles and tasks, manage interpersonal challenges, and decrease isolation. Medical schools can support effective workplace learning for medical students by incorporating continuity with peers in the main clinical clerkship year.

  2. Report of the Study Group on Medical Uses of Accelerators

    International Nuclear Information System (INIS)

    1978-01-01

    Medical uses of accelerators to raise the welfare of peoples are advancing rapidly due to the improvement of using technology. Under the situation, the Study Group on Medical Uses of Accelerators set up in the Science and Technology Agency has surveyed the status in Japan of radiation therapy of cancers and nuclear medicine with accelerators, and has studied on the future research and development in this field. The present report should contribute to the plans by the Government for the future. The results obtained by the study Group are described: the trends of medicine for the next ten years, especially the advances of cancer diagnosis and treatment and nuclear medicine; and medical radiation sources and the accelerators as their generators expected to be in practical utilization. As for the particles from accelerators used for medical purposes, there are fast neutrons, protons, helium particles, charged heavy particles, and π-mesons. For diagnosis and treatment, the radiation sources must be chosen according to the purposes, and their combination becomes necessary. (Mori, K.)

  3. Using Telestrations™ to Illustrate Small Group Communication Principles

    Science.gov (United States)

    Fedesco, Heather Noel

    2014-01-01

    This single class activity described here: (1) illustrates the importance of interdependence in groups; (2) can be used to measure group productivity and performance; (3) can encourage groups to engage in group learning; and (4) can facilitate group cohesion for newly formed groups. Students will be working in groups for the majority of their…

  4. Decommissioning of small medical, industrial and research facilities

    International Nuclear Information System (INIS)

    2003-01-01

    Most of the technical literature on decommissioning addresses the regulatory, organizational, technical and other aspects for large facilities such as nuclear power plants, reprocessing plants and relatively large prototype, research and test reactors. There are, however, a much larger number of licensed users of radioactive material in the fields of medicine, research and industry. Most of these nuclear facilities are smaller in size and complexity and may present a lower radiological risk during their decommissioning. Such facilities are located at research establishments, biological and medical laboratories, universities, medical centres, and industrial and manufacturing premises. They are often operated by users who have not been trained or are unfamiliar with the decommissioning, waste management and associated safety aspects of these types of facility at the end of their operating lives. Also, for many small users of radioactive material such as radiation sources, nuclear applications are a small part of the overall business or process and, although the operating safety requirements may be adhered to, concern or responsibility may not go much beyond this. There is concern that even the minimum requirements of decommissioning may be disregarded, resulting in avoidable delays, risks and safety implications (e.g. a loss of radioactive material and a loss of all records). Incidents have occurred in which persons have been injured or put at risk. It is recognized that the strategies and specific requirements for small facilities may be much less onerous than for large ones such as nuclear power plants or fuel processing facilities, but many of the same principles apply. There has been considerable attention given to nuclear facilities and many IAEA publications are complementary to this report. This report, however, attempts to give specific guidance for small facilities. 'Small' in this report does not necessarily mean small in size but generally modest in terms

  5. Effects of an additional small group discussion to cognitive achievement and retention in basic principles of bioethics teaching methods

    Directory of Open Access Journals (Sweden)

    Dedi Afandi

    2009-03-01

    Full Text Available Aim The place of ethics in undergraduate medical curricula is essential but the methods of teaching medical ethics did not show substantial changes. “Basic principles of bioethics” is the best knowledge to develop student’s reasoning analysis in medical ethics In this study, we investigate the effects of an additional small group discussion in basic principles of bioethics conventional lecture methods to cognitive achievement and retention. This study was a randomized controlled trial with parallel design. Cognitive scores of the basic principles of bioethics as a parameter was measured using basic principles of bioethics (Kaidah Dasar Bioetika, KDB test. Both groups were attending conventional lectures, then the intervention group got an additional small group discussion.Result Conventional lectures with or without small group discussion significantly increased cognitive achievement of basic principles of bioethics (P= 0.001 and P= 0.000, respectively, and there were significant differences in cognitive achievement and retention between the 2 groups (P= 0.000 and P= 0.000, respectively.Conclusion Additional small group discussion method improved cognitive achievement and retention of basic principles of bioethics. (Med J Indones 2009; 18: 48-52Keywords: lecture, specification checklist, multiple choice questions

  6. Job sharing as an employment alternative in group medical practice.

    Science.gov (United States)

    Vanek, E P; Vanek, J A

    2001-01-01

    Although physicians discuss quality-of-life and employment issues with their patients, they often fail to consider flexible scheduling and reduced employment options to lessen their own job stress. We examined one of these options by surveying two community-based, private practice groups with a combined 13-year experience with job sharing. We found that a majority of respondents rated job sharing as successful, and most wanted it to continue. Job sharers derived considerable personal benefit from the arrangement and had significantly more positive attitudes toward work than full-time physicians. Job sharing appeared to have little impact on practice parameters. Dependability, flexibility and willingness to cooperate were the most important attributes in choosing a job-sharing partner. Job sharing is an employment alternative worth exploring to retain physicians in medical group practice.

  7. Impact of a Social Media Group Page on Undergraduate Medical Physiology Learning.

    Science.gov (United States)

    Shakoori, Tania Ahmed; Mahboob, Usman; Strivens, Janet; Willis, Ian

    2017-07-01

    To investigate the impact of associating classroom learning of medical physiology with a Facebook group page in an all-women medical college of a conservative small city in Pakistan. Qualitative interpretivist study using semi-structured interviews. Women Medical College Abbottabad, Pakistan, from March to December 2014. Aclosed Facebook study group was established at a local medical college in Pakistan. It was used to upload learning resources and initiate discussions, coordinated with classroom lectures of physiology. Thirteen semistructured interviews were conducted with volunteer students according to a standard protocol. Five major themes were identified. Facebook group is something new and exciting; it motivated self-study, research, collaborative learning and improved class attendance. Convenience of easily accessible resources allowed the students to concentrate on the lecture rather than note taking. It was easier to communicate with the instructor through Facebook than face to face. Lurkers were also learning. High achievers who had adapted to the current didactic system of teaching were less receptive of the collaborative learning and favored teaching geared towards exam preparation. Using social media for e-learning in undergraduate medical education can enhance the student learning experience, especially in resource-limited regions where Information and communication technology is not an integrated part of the teaching process.

  8. The Decision-Making Process of a Small Task Group.

    Science.gov (United States)

    Roderick, Joan C.

    1985-01-01

    This article focuses on the following areas of group process: the nature of the task group, the steps taken to reach a decision, and the ways in which a leader can effectively manage the inevitable conflict that emerges within groups as the problem-solving process progresses. (CT)

  9. Palliative medicine Death Rounds: small group learning on a vital subject.

    Science.gov (United States)

    Kitzes, Judith A; Kalishman, Summers; Kingsley, Darra D; Mines, Jan; Lawrence, Elizabeth

    The medical student's experience with patients' dying and death has profound impact on personal and professional development. Death Rounds at the University of New Mexico School of Medicine is a small group educational model that promotes student self-reflection, metacognition, professional growth, and collegial support. To describe the implementation and evaluation activities of a third year clerkship Death Rounds which are a structured, institutionally supported resource for helping students to understand the clinical, ethical, legal, professional, cultural, and spiritual aspects of death. Medical students attend 2 to 3 small group palliative medicine Death Rounds sessions, facilitated by the attending clerkship director, chief residents, and a palliative care physician. The students' assessment of their palliative medicine knowledge and skills in 5 categories before and after participation in Death Rounds rated their skills after Death Rounds higher with effect sizes ranging from 0.9 to 1.9. Evidence from both the Death Rounds Questionnaire and Facilitators' Logs demonstrates that multiple issues and topics were addressed and all associated with the School of Medicine's 6 core competencies. Death Rounds minimally affect on clerkship time and faculty resources.

  10. Medical group affiliations: interorganizational relationships and organizational performance.

    Science.gov (United States)

    Rotarius, Timothy; Fottler, Myron D; Blair, John D

    2003-01-01

    The hyperturbulent health care environment is causing health care organizations to create interorganizational relationships (IORs). This article reports on a study of 686 medical groups that assessed how 11 types of IORs affected 7 dimensions of organizational performance. Organizational performance was ascertained through self-reported questions about performance relative to local market competitors. Respondents believed that, to varying degrees, all IORs lead to a competitive advantage over local competitors in all seven performance categories. There was no consistent pattern for either loose or tight linkages to be associated with superior performance. Consequently, loose linkages may be preferable to tighter linkages (i.e., membership in a fully integrated delivery system) that require higher levels of resource commitment.

  11. Small groups, contexts, and civic engagement: A multilevel analysis of United States Congregational Life Survey data.

    Science.gov (United States)

    Whitehead, Andrew L; Stroope, Samuel

    2015-07-01

    Prior research suggests that church-goers are more civically engaged than their non-church-going counterparts. Little is known, however, about how the popular phenomenon of small groups factors into this equation. In the present study, we examine relationships between small group participation at individual and congregation levels and civic engagement. Using multilevel modeling and national data on congregations and individuals from the U.S. Congregational Life Study (n=82,044), we find that: (1) individual-level small group involvement is associated with four measures of civic engagement; (2) congregation-level small group participation is associated with both lower and higher civic engagement in the case of two outcomes; and (3) in the case of three civic outcomes, congregation-level small group participation moderates individual-level small group involvement such that small group members' civic activity more closely resembles the lower civic engagement of small group nonparticipants. In the case of one civic outcome, at high levels of overall small group participation, small group members' civic engagement drops below that of small group nonparticipants. Explanations for these findings, including a "crowding out" effect, are examined including their complex implications for debates regarding small groups, religious involvement, and civic engagement. Copyright © 2014 Elsevier Inc. All rights reserved.

  12. Student Talk and Opportunities for Mathematical Learning in Small Group Interactions

    Science.gov (United States)

    Wood, Marcy B.; Kalinec, Crystal A.

    2012-01-01

    Small group interactions are an important tool for mathematical learning and yet researchers have neither examined small group talk across entire lessons nor have they focused on moments of mathematical learning in small groups. We examined such talk and identified kinds of interactions and connections between interactions and mathematical…

  13. Teaching as Interaction: Challenges in Transitioning Teachers' Instruction to Small Groups

    Science.gov (United States)

    Wyatt, Tasha; Chapman-DeSousa, Brook

    2017-01-01

    Although small group instruction is often endorsed in teaching young children, teachers are rarely given explicit instruction on how to move instruction into small groups where effective adult-child interactions can take place. This study examines how 14 early childhood educators transitioned their instruction from whole to small group teaching…

  14. Group-sparse representation with dictionary learning for medical image denoising and fusion.

    Science.gov (United States)

    Li, Shutao; Yin, Haitao; Fang, Leyuan

    2012-12-01

    Recently, sparse representation has attracted a lot of interest in various areas. However, the standard sparse representation does not consider the intrinsic structure, i.e., the nonzero elements occur in clusters, called group sparsity. Furthermore, there is no dictionary learning method for group sparse representation considering the geometrical structure of space spanned by atoms. In this paper, we propose a novel dictionary learning method, called Dictionary Learning with Group Sparsity and Graph Regularization (DL-GSGR). First, the geometrical structure of atoms is modeled as the graph regularization. Then, combining group sparsity and graph regularization, the DL-GSGR is presented, which is solved by alternating the group sparse coding and dictionary updating. In this way, the group coherence of learned dictionary can be enforced small enough such that any signal can be group sparse coded effectively. Finally, group sparse representation with DL-GSGR is applied to 3-D medical image denoising and image fusion. Specifically, in 3-D medical image denoising, a 3-D processing mechanism (using the similarity among nearby slices) and temporal regularization (to perverse the correlations across nearby slices) are exploited. The experimental results on 3-D image denoising and image fusion demonstrate the superiority of our proposed denoising and fusion approaches.

  15. Effects of longitudinal small-group learning on delivery and receipt of communication skills feedback.

    Science.gov (United States)

    Chou, Calvin L; Masters, Dylan E; Chang, Anna; Kruidering, Marieke; Hauer, Karen E

    2013-11-01

    Although feedback is a critical component of learning, recent data suggest that learners may discount feedback they receive. The emotional threat inherent in feedback can contribute to its ineffectiveness, particularly for sensitive topics like communication skills. Longitudinal relationships among peers may increase their sense of safety and soften the perceived threat of feedback to allow students to give, receive and potentially more effectively incorporate feedback. We studied the effects of prior shared learning experiences among medical students in the delivery and receipt of feedback on clinical (communication) skills. During a formative clinical skills examination, we divided Year 3 students at a US medical school into two subgroups comprising, respectively, small-group classmates from a 2-year longitudinal pre-clerkship clinical skills course (with prior peer-learning relationships), and peers with no prior shared small-group coursework. Students in both subgroups observed peers in a simulated clinical case and then provided feedback, which was videotaped, transcribed and coded. Feedback recipients also completed a survey on their perceptions of the feedback. Students valued the feedback they received and intended to enact it, regardless of whether they had prior peer-learning relationships. Coding of feedback revealed high specificity. Feedback providers who had prior peer-learning relationships with recipients provided more specific corrective feedback on communication skills than those with no such relationships (p = 0.014); there was no significant difference between subgroups in the provision of reinforcing feedback on communication skills. Year 3 medical student peers can deliver specific feedback on clinical skills; prior peer-learning relationships in pre-clerkship clinical skills courses enrich the provision of specific corrective feedback about communication skills. Feedback between peers with pre-existing peer-learning relationships represents

  16. mCell: Facilitating Mobile Communication of Small Groups

    OpenAIRE

    Mikko T. Tarkiainen; Jonna Häkkilä; Jan Blom; Merja Haveri; Jyri Virtanen

    2008-01-01

    Mobile communication technology offers a potential platform for new types of communication applications. Here, we describe the development and experiences with a mobile group communication application, mCell, that runs on a mobile phone. We present the underlying design implications, the application implementation, and a user study, where three groups used the application for one month. The findings of the user study reveal general user experiences with the application and show different patt...

  17. Behavioral and biological interactions with small groups in confined microsocieties

    Science.gov (United States)

    Brady, J. V.; Emurian, H. H.

    1982-01-01

    Requirements for high levels of human performance in the unfamiliar and stressful environments associated with space missions necessitate the development of research-based technological procedures for maximizing the probability of effective functioning at all levels of personnel participation. Where the successful accomplishment of such missions requires the coordinated contributions of several individuals collectively identified with the achievement of a common objective, the conditions for characterizing a team, crew, or functional group are operationally defined. For the most part, studies of group performances under operational conditions which emphasize relatively long exposure to extended mission environments have been limited by the constraints imposed on experimental manipulations to identify critical effectiveness factors. On the other hand, laboratory studies involving relatively brief exposures to contrived task situations have been considered of questionable generality to operational settings requiring realistic group objectives.

  18. Small-Group Discourse: Establishing a Communication-Rich Classroom

    Science.gov (United States)

    Quebec Fuentes, Sarah

    2013-01-01

    Establishing a communication-rich classroom can be difficult. This article describes the process and findings of a practitioner action research study addressing the question of how teachers can interact with their students while they are working in groups to encourage and enhance student-to-student communication. Recommended research-based teacher…

  19. Small Group Learning: Do Group Members' Implicit Theories of Ability Make a Difference?

    Science.gov (United States)

    Beckmann, Nadin; Wood, Robert E.; Minbashian, Amirali; Tabernero, Carmen

    2012-01-01

    We examined the impact of members' implicit theories of ability on group learning and the mediating role of several group process variables, such as goal-setting, effort attributions, and efficacy beliefs. Comparisons were between 15 groups with a strong incremental view on ability (high incremental theory groups), and 15 groups with a weak…

  20. French experience with Uranium compounds: conclusions of medical working group

    International Nuclear Information System (INIS)

    Berard, P.; Mazeyrat, C.; Auriol, B.; Montegue, A.; Estrabaud, M.; Grappin, L.; Giraud, J.M.

    2002-01-01

    The authors who represent several organisations and industrial firms, present observations conducted for some thirty years in France, including routine monitoring or special measurements following contamination by uranium compounds. They propose recommendations for radio toxicological monitoring of workers exposed to industrial uranium compounds and they comment on urine and faecal collections in relation to specific exposures. Our working group, set up by the CEA Medical Adviser in 1975, consists of French specialists in uranium radio toxicology. Their role is to propose recommendations for the monitoring of working conditions and exposed workers. The different plants process chemically and metallurgically, and machine large quantities of uranium with various 235U enrichments. Radio toxicological monitoring of workers exposed to uranium compounds requires examinations prescribed according to the kind of product manipulated and the industrial risk of the workplace. The range of examinations that are useful for this kind of monitoring includes lung monitoring, urine analyses and faecal sampling. The authors present the frequency of the monitoring for routine or special conditions according to industrial exposure, time and duration of collection of excreta (urine and faeces), the necessity of a work break, precautions for preservation of the samples and the ways in interpreting excretion analysis according to natural food intakes

  1. Large and small sets with respect to homomorphisms and products of groups

    Directory of Open Access Journals (Sweden)

    Riccardo Gusso

    2002-10-01

    Full Text Available We study the behaviour of large, small and medium subsets with respect to homomorphisms and products of groups. Then we introduce the definition af a P-small set in abelian groups and we investigate the relations between this kind of smallness and the previous one, giving some examples that distinguish them.

  2. Key Informant Models for Measuring Group-Level Variables in Small Groups: Application to Plural Subject Theory

    Science.gov (United States)

    Algesheimer, René; Bagozzi, Richard P.; Dholakia, Utpal M.

    2018-01-01

    We offer a new conceptualization and measurement models for constructs at the group-level of analysis in small group research. The conceptualization starts with classical notions of group behavior proposed by Tönnies, Simmel, and Weber and then draws upon plural subject theory by philosophers Gilbert and Tuomela to frame a new perspective…

  3. An Overview of medical solution business of Hitachi group

    International Nuclear Information System (INIS)

    Ninomiya, Ken; Tao, Ryuji; Umegaki, Kikuo; Hashizume, Akihide; Watanabe, Shigeru

    2006-01-01

    Hitachi is promoting the medicare business in the medical fields of imaging diagnosis, external diagnosis, medical information, treatment support and medical service with the concept that advancement of medical technology is essential for health and this paper describes its major details including research/development. In imaging diagnosis, Hitachi has apparatuses for MRI, X-ray radiography, X-CT, ultrasonography and PET, which are being subject to continuous technological improvement for patients (the principle, Patient Friendly). Clinical laboratory test equipments are in external diagnosis, where ''LABOSPECT series'', a support system for clinical chemistry, has been recently marketed. Medical information involves the total health-care system of people to connect the medical facilities (e.g., POMR, problem oriented medical record) and national medical institutions (e.g., IHE-J, integrating the healthcare enterprise-Japan). One of topics of Hitachi's res/dev is the molecular imaging like PET equipped with high magnetic field MRI and semi-conductor detector and, the other, targeting therapy with proton accelerator already operating in Tsukuba University and to be operated in The University of Texas. Hitachi is working for turning the dream of healthy and safe society into reality through technology. (T.I.)

  4. Medical Surveillance, Continuous Health Promotion and a Participatory Intervention in a Small Company

    Directory of Open Access Journals (Sweden)

    Nicola Magnavita

    2018-04-01

    Full Text Available The workplace is an ideal setting for health promotion. The regular medical examination of workers enables us to screen for numerous diseases, spread good practices and correct lifestyles, and obtain a favourable risk/benefit ratio. The continuous monitoring of the level of workers’ wellbeing using a holistic approach during medical surveillance enables us to promptly identify problems in work organisation and the company climate. Problems of this kind can be adequately managed by using a participatory approach. The aim of this paper is twofold: to signal this way of proceeding with medical surveillance, and to describe an organisational development intervention. Participatory groups were used to improve occupational life in a small company. After intervention we observed a reduction in levels of perceived occupational stress measured with the Effort/Reward Imbalance questionnaire, and an improvement in psychological wellbeing assessed by means of the Goldberg Anxiety/Depression scale. Although the limited size of the sample and the lack of a control group call for a cautious evaluation of this study, the participatory strategy proved to be a useful tool due to its cost-effectiveness.

  5. Medical Surveillance, Continuous Health Promotion and a Participatory Intervention in a Small Company.

    Science.gov (United States)

    Magnavita, Nicola

    2018-04-02

    The workplace is an ideal setting for health promotion. The regular medical examination of workers enables us to screen for numerous diseases, spread good practices and correct lifestyles, and obtain a favourable risk/benefit ratio. The continuous monitoring of the level of workers' wellbeing using a holistic approach during medical surveillance enables us to promptly identify problems in work organisation and the company climate. Problems of this kind can be adequately managed by using a participatory approach. The aim of this paper is twofold: to signal this way of proceeding with medical surveillance, and to describe an organisational development intervention. Participatory groups were used to improve occupational life in a small company. After intervention we observed a reduction in levels of perceived occupational stress measured with the Effort/Reward Imbalance questionnaire, and an improvement in psychological wellbeing assessed by means of the Goldberg Anxiety/Depression scale. Although the limited size of the sample and the lack of a control group call for a cautious evaluation of this study, the participatory strategy proved to be a useful tool due to its cost-effectiveness.

  6. Framing Negotiation: Dynamics of Epistemological and Positional Framing in Small Groups during Scientific Modeling

    Science.gov (United States)

    Shim, Soo-Yean; Kim, Heui-Baik

    2018-01-01

    In this study, we examined students' epistemological and positional framing during small group scientific modeling to explore their context-dependent perceptions about knowledge, themselves, and others. We focused on two small groups of Korean eighth-grade students who participated in six modeling activities about excretion. The two groups were…

  7. Student talk and opportunities for mathematical learning in small group interactions

    OpenAIRE

    Wood, M.; Kalinec, C.

    2012-01-01

    Small group interactions are an important tool for mathematical learning and yet researchers have neither examined small group talk across entire lessons nor have they focused on moments of mathematical learning in small groups. We examined such talk and identified kinds of interactions and connections between interactions and mathematical learning. We differentiated talk based upon its focus: mathematical objects (mathematizing), people (subjectifying), or more specifically, people’s attribu...

  8. Prospecting for customers in the small employer market: the experience of Arizona Health Care Group.

    Science.gov (United States)

    Christianson, J B; Liu, C F; Schroeder, C M

    1994-01-01

    The findings of this study provide an interesting profile of the small employer "prospects" for prepaid health plans, where a prospect is defined as an employer that responds to a mass mailing effort with a request for information and further contact. About 60% of these prospects already have insurance, with 40% having group insurance. Therefore, a substantial portion of prospects are seeking to replace their existing health benefit package with a different one. Of those who do not offer existing insurance, the most common reason is that it is "too expensive" or the employer is "not profitable." A very small proportion do not offer insurance because they do not qualify for it due to medical underwriting considerations. Prospects tend to be larger than non-prospects in terms of sales, but employ lower wage employees, on average. About half of prospects are in service industries, a proportion typical of small employers in general. Somewhat surprisingly, most prospects have been in operation for over five years. They are not new firms attempting to establish their benefit packages. This is consistent with the findings on gross sales, suggesting that some maturity is necessary before an employer considers offering group health insurance as a benefit. The prepaid plans in this study also appeared to target established employers for their marketing efforts. In responding to questions about their attitudes towards health insurance, over one-quarter of prospects indicated that they would be unwilling to offer insurance at rates so low that they would not normally apply to the coverages offered by prepaid plans. Thus, although they were "prospects" by the study's definition, they were unlikely to eventually contract with prepaid plans. Those prospects that had offered insurance previously, but had discontinued it, tended to cite premium increases as the reason. This suggests that prospects among small employers are likely to be very price sensitive, and that further

  9. Production of 123I for medical use with small accelerators

    International Nuclear Information System (INIS)

    Beyer, G.J.; Pimentel, G.; Solin, O.; Heselius, S.J.; Taka, T.

    1988-01-01

    The possibilities of 123 I production with small accelerators are discussed. Among the possible nuclear reactions the 122 Te(d,n) 123 I and the 123 Te(p,n) 123 I reaction are of particular interest for those institutions, who do not run a cyclotron with particle energies for protons above 18-20 MeV. The use of TeO 2 as target material is advantaged over Te. The 123 I preparations contain resonable amounts of 130 I and 124 I. The most 'dangerous' impurity is 130 I due to its high energy gamma radiation. Nevertheless, high quality imagings may be obtained using medium or high energy collimators loosing some of the advantages of 123 I. The proposed approach is the only way to make 123 I available for a number of institutions or countries running small cyclotrons and for which commercial 123 I is difficult or impossible to obtain for economical or geographical reasons. (author)

  10. The role of micro size computing clusters for small physics groups

    International Nuclear Information System (INIS)

    Shevel, A Y

    2014-01-01

    A small physics group (3-15 persons) might use a number of computing facilities for the analysis/simulation, developing/testing, teaching. It is discussed different types of computing facilities: collaboration computing facilities, group local computing cluster (including colocation), cloud computing. The author discuss the growing variety of different computing options for small groups and does emphasize the role of the group owned computing cluster of micro size.

  11. Peer-led small groups: Are we on the right track?

    Science.gov (United States)

    Moore, Fraser

    2017-10-01

    Peer tutor-led small group sessions are a valuable learning strategy but students may lack confidence in the absence of a content expert. This study examined whether faculty reinforcement of peer tutor-led small group content was beneficial. Two peer tutor-led small group sessions were compared with one faculty-led small group session using questionnaires sent to student participants and interviews with the peer tutors. One peer tutor-led session was followed by a lecture with revision of the small group content; after the second, students submitted a group report which was corrected and returned to them with comments. Student participants and peer tutors identified increased discussion and opportunity for personal reflection as major benefits of the peer tutor-led small group sessions, but students did express uncertainty about gaps in their learning following these sessions. Both methods of subsequent faculty reinforcement were perceived as valuable by student participants and peer tutors. Knowing in advance that the group report would be corrected reduced discussion in some groups, potentially negating one of the major benefits of the peer tutor-led sessions. Faculty reinforcement of peer-tutor led small group content benefits students but close attention should be paid to the method of reinforcement.

  12. Professional Development of Mathematics Teachers toward the Facilitation of Small-Group Collaboration

    Science.gov (United States)

    Tabach, Michal; Schwarz, Baruch B.

    2018-01-01

    Collaborative work in small groups is often a suitable context for yielding substantial individual learning outcomes. Indeed, small-group collaboration has recently become an educational goal rather than a means. Yet, this goal is difficult to attain, and students must be taught how to learn together. In this paper, we focus on how to prepare…

  13. Assessing the Internal Dynamics of Mathematical Problem Solving in Small Groups.

    Science.gov (United States)

    Artzt, Alice F.; Armour-Thomas, Eleanor

    The purpose of this exploratory study was to examine the problem-solving behaviors and perceptions of (n=27) seventh-grade students as they worked on solving a mathematical problem within a small-group setting. An assessment system was developed that allowed for this analysis. To assess problem-solving behaviors within a small group a Group…

  14. Intradermal vaccination against hepatitis B in a group of medical ...

    African Journals Online (AJOL)

    A prospective study of a low-dose (one-tenth) intradermal regimen using recombinant hepatitis B vaccine was undertaken during two consecutive years in 4th-year medical students. Eighty one per cent of the vaccinees (123/152) seroconverted with anti-HBs levels of > 10 lU/l. The lower titre of hepatitis B surface antibodies ...

  15. Medical Genetics at McGill: The History of a Pioneering Research Group.

    Science.gov (United States)

    Canning, Christopher; Weisz, George; Tone, Andrea; Cambrosio, Alberto

    2013-01-01

    The McGill Group in Medical Genetics was formed in 1972, supported by the Medical Research Council and successor Canadian Institutes for Health Research until September 2009, making it the longest active biomedical research group in the history of Canada. We document the history of the McGill Group and situate its research within a broader history of medical genetics. Drawing on original oral histories with the Group's members, surviving documents, and archival materials, we explore how the Group's development was structured around epistemological trends in medical genetics, policy choices made by research agencies, and the development of genetics at McGill University and its hospitals.

  16. Group music performance causes elevated pain thresholds and social bonding in small and large groups of singers

    Science.gov (United States)

    Weinstein, Daniel; Launay, Jacques; Pearce, Eiluned; Dunbar, Robin I. M.; Stewart, Lauren

    2016-01-01

    Over our evolutionary history, humans have faced the problem of how to create and maintain social bonds in progressively larger groups compared to those of our primate ancestors. Evidence from historical and anthropological records suggests that group music-making might act as a mechanism by which this large-scale social bonding could occur. While previous research has shown effects of music making on social bonds in small group contexts, the question of whether this effect ‘scales up’ to larger groups is particularly important when considering the potential role of music for large-scale social bonding. The current study recruited individuals from a community choir that met in both small (n = 20 – 80) and large (a ‘megachoir’ combining individuals from the smaller subchoirs n = 232) group contexts. Participants gave self-report measures (via a survey) of social bonding and had pain threshold measurements taken (as a proxy for endorphin release) before and after 90 minutes of singing. Results showed that feelings of inclusion, connectivity, positive affect, and measures of endorphin release all increased across singing rehearsals and that the influence of group singing was comparable for pain thresholds in the large versus small group context. Levels of social closeness were found to be greater at pre- and post-levels for the small choir condition. However, the large choir condition experienced a greater change in social closeness as compared to the small condition. The finding that singing together fosters social closeness – even in large contexts where individuals are not known to each other – is consistent with evolutionary accounts that emphasize the role of music in social bonding, particularly in the context of creating larger cohesive groups than other primates are able to manage. PMID:27158219

  17. Clinical diagnostic system using a small cyclotron for medical use

    International Nuclear Information System (INIS)

    Yonekura, Y.; Magata, Y.; Konishi, J.

    1990-01-01

    Since a small cyclotron and a positron emission tomography (PET) scanner have been installed at the Kyoto University Hospital in 1983, a great deal of effort has been directed to the clinical application of the PET-cyclotron system. This paper outlines the experience with PET in the clinical setting, including the facility, equipments and staff involved, weekly schedule, typical clinical protocols, and some results from the patients. The system consists of small cyclotron for production of the short-lived positron emitting radionuclides, fully automated synthesis system for labeling various compounds, scanning for measurement of radioactivities, and data analysis system for calculating physiological parameters. A resolving cylinder target system with eight smaller cylinders is equipped for production of C-11, N-13, O-15, and F-18. Labeled compounds are quickly delivered to the PET scanner room by two systems--the continuous delivery system for the labeled gas and the rapid delivery system for the liquid compounds by compressed air. A PET scanner devoted for clinical studies is a multislice whole-body PET scanner. Ten PET studies are performed weekly on the average for measuring blood flow and oxygen and glucose metabolism in the brain, blood flow and glucose and fatty acid metabolism in the heart, blood flow and amino acid uptake in the pancreas, lung ventilation, and tumor glucose metabolism. The availability of PET-cyclotron system is still limited in view of cost. The previous clinical studies suggest the contribution of PET to the the understanding of the mechanism of disease pathophysiology. (N.K.)

  18. Intradermal vaccination against hepatitis B in a group of medical ...

    African Journals Online (AJOL)

    A prospective study of a low-dose (one-tenth) intradermal regimen using recombinant hepatitis B vaccine was under- taken during two consecutive years in 4th-year medical stu- dents. Eightj;one per cent of the vaccinees (123/152) sero- converted with anti.HBs levels of> 10 lUll. The lower titre of hepatitis B surface ...

  19. Medical Team Training: Using Simulation as a Teaching Strategy for Group Work

    Science.gov (United States)

    Moyer, Michael R.; Brown, Rhonda Douglas

    2011-01-01

    Described is an innovative approach currently being used to inspire group work, specifically a medical team training model, referred to as The Simulation Model, which includes as its major components: (1) Prior Training in Group Work of Medical Team Members; (2) Simulation in Teams or Groups; (3) Multidisciplinary Teamwork; (4) Team Leader…

  20. Medical Managment of the Acute Radiation Syndrome: Recommendations of the Strategic National Stockpile Radiation Working Group

    National Research Council Canada - National Science Library

    Waselenka, Jamie K; MacVittie, Thomas J; Blakely, William F; Pesik, Nicki; Wiley, Albert L; Dickerson, William E; Tsu, Horace; Confer, Dennis L; Coleman, Norman; Seed, Thomas

    2004-01-01

    .... This consensus document was developed by the Strategic National Stockpile Radiation Working Group to provide a framework for physicians in internal medicine and the medical subspecialties to evaluate...

  1. Oral traditional Chinese medication for adhesive small bowel obstruction.

    Science.gov (United States)

    Suo, Tao; Gu, Xixi; Andersson, Roland; Ma, Huaixing; Zhang, Wei; Deng, Wei; Zhang, Boheng; Cai, Dingfang; Qin, Xinyu

    2012-05-16

    Small bowel obstruction (SBO) is one of the most common emergent complications of general surgery. Intra-abdominal adhesions are the leading cause of SBO. Because surgery can induce new adhesions, non-operative management is preferred in the absence of signs of peritonitis or strangulation. Oral traditional Chinese herbal medicine has long been used as a non-operative therapy to treat adhesive SBO in China. Many controlled trials have been conducted to investigate its therapeutic value in resolving adhesive SBO. The aim of this review was to assess the efficacy and safety of oral traditional Chinese medicine (TCM) for adhesive small bowel obstruction. We searched the following databases, without regard to language or publishing restrictions: the Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE, EMBASE, Chinese Biomedical Database (CBM), China National Knowledge Infrastructure/Chinese Academic Journals full-text Database (CNKI), and VIP (a full-text database of Chinese journals). The searches were conducted in November 2011. Randomised controlled trials and quasi-randomised controlled trials comparing Chinese medicines administered orally, via the gastric canal, or both with a placebo or conventional therapy in participants diagnosed with adhesive SBO were considered. We also considered trials of TCM (oral administration, gastric tube perfusion, or both) plus conventional therapy compared with conventional therapy alone for patients with adhesive SBO. Studies addressing the safety and efficacy of oral traditional Chinese medicinal agents in the treatment of adhesive SBO were also considered. Two authors collected the data independently. We assessed the risk of bias according to the following methodological criteria: random sequence generation, allocation concealment, blinding, incomplete outcome data, selective outcome reporting and other sources of bias. Dichotomous data are presented as risk ratios (OR) and 95% confidence intervals (CI

  2. Novel Emergency Medicine Curriculum Utilizing Self-Directed Learning and the Flipped Classroom Method: Genitourinary Emergencies Small Group Module

    Directory of Open Access Journals (Sweden)

    Andrew King

    2017-07-01

    Full Text Available Audience: This curriculum, created and implemented at The Ohio State University Wexner Medical Center, was designed to educate our emergency medicine (EM residents, PGY-1 to PGY-3, as well as medical students. Introduction: In 2013, there were over 6 million Emergency Department visits in the United States which resulted in a primary diagnosis of the genitourinary system. This represents 5.2% of all Emergency Department visits.1 Residents must be proficient in the differential diagnosis and management of the wide variety of genitourinary emergencies. This flipped classroom curricular model emphasizes self-directed learning activities completed by learners, followed by small group discussions pertaining to the topic reviewed. The active learning fostered by this curriculum increases faculty and learner engagement and interaction time typically absent in traditional lecture-based formats.2-4 Studies have revealed that the application of knowledge through case studies, personal interaction with content experts, and integrated questions are effective learning strategies for emergency medicine residents.4-6 The Ohio State University Wexner Medical Center EM Residency didactic curriculum recently transitioned to a “flipped classroom” approach.7-10 We created this innovative curriculum aimed to improve our residency education program and to share educational resources with other EM residency programs. Our curriculum utilizes an 18-month curricular cycle to cover the defined emergency medicine content. The flipped classroom curriculum maximizes didactic time and resident engagement, fosters intellectual curiosity and active learning, and meets the needs of today’s learners. 3,6,11 Objectives: We aim to teach the presentation and management of genitourinary emergencies through the creation of a flipped classroom design. This unique, innovative curriculum utilizes resources chosen by education faculty and resident learners, study questions, real

  3. Invented Spelling Activities in Small Groups and Early Spelling and Reading

    Science.gov (United States)

    Martins, Margarida Alves; Salvador, Liliana; Albuquerque, Ana; Silva, Cristina

    2016-01-01

    Our aim was to assess the impact of an invented spelling programme conducted in small groups on children's written language acquisition in Portuguese. We expected the experimental group to have better post-test results than the control group in spelling and reading. Participants were 160 preschool-age children who were randomly divided into an…

  4. Small, Task-Oriented Groups: Conflict, Conflict Management, Satisfaction, and Decision Quality.

    Science.gov (United States)

    Wall, Victor D., Jr.; And Others

    1987-01-01

    Examined relationship among amount of conflict experienced, the style of its management, individual satisfaction, and decision quality of small, task-oriented groups using 129 college student subjects in 24 groups. Data suggest a curvilinear relationship between the number of conflict episodes experienced by group members and the subsequent…

  5. Integrative and distributive negotiation in small groups : Effects of task structure, decision rule, and social motive

    NARCIS (Netherlands)

    Beersma, Bianca; De Dreu, Carsten K W

    2002-01-01

    This study examined the interactive effects of task structure, decision rule, and social motive on small-group negotiation processes and outcomes. Three-person groups negotiated either within an asymmetrical task structure (in which a majority of group members have compatible interests) or within a

  6. Secure Group Formation Protocol for a Medical Sensor Network Prototype

    DEFF Research Database (Denmark)

    Andersen, Jacob

    2009-01-01

    , and experience from user workshops and observations of clinicians at work on a hospital ward show that if the security mechanisms are not well designed, the technology is either rejected altogether, or they are circumvented leaving the system wide open to attacks. Our work targets the problem of designing......Designing security mechanisms such as privacy and access control for medical sensor networks is a challenging task; as such systems may be operated very frequently, at a quick pace, and at times in emergency situations. Understandably, clinicians hold extra unproductive tasks in low regard...... wireless sensors to be both secure and usable by exploring different solutions on a fully functional prototype platform. In this paper, we present an Elliptic Curve Cryptography (ECC) based protocol, which offers fully secure sensor set-up in a few seconds on standard (Telos) hardware. We evaluate...

  7. Pioneering small-group learning in Tanzanian emergency medicine: Investigating acceptability for physician learners

    Directory of Open Access Journals (Sweden)

    A G Lim

    2017-03-01

    Full Text Available Background. Emergency medicine (EM is a relatively new, but growing medical specialty in sub-Saharan Africa. African EM training programmes have used small-group learning (SGL modalities in their curricula. However, there is little knowledge of whether SGL modalities are perceived to be effective in these African EM training programmes. Objectives. To investigate the acceptability of SGL for physicians’ training in an academic Tanzanian emergency department using a novel EM curriculum. Methods. Using responses to a written questionnaire, we explored the perceived effectiveness of SGL compared with traditional didactic lectures among 38 emergency department physician learners in Dar es Salaam, Tanzania. Perceptions of SGL were identified from qualitative responses, and regression analyses were used to determine strength of association between quantitative outcomes. Results. Reported benefits of SGL included team building, simulation training, enhancement of procedural skills, and the opportunity to discuss opinions on clinical management. SGL scored more favourably with regard to improving clinical practice, enjoyment of learning, and building peer-to-peer relations. Lectures scored more favourably at improving medical knowledge. Preference towards SGL over lectures for overall training increased with years of clinical experience (95% confidence interval (CI 0.16 - 0.62, p=0.002, Spearman’s rho 0.51, and the perception that SGL reinforces learner-teacher relationships correlated with seniority within residency training (95% CI 0.14 - 0.86, p=0.007, Spearman’s rho 0.47. Conclusion. Techniques of SGL were perceived as effective at improving clinical practice in the emergency department setting. These modalities may be more favourably accepted by more experienced physician learners – therefore, new EM teaching programmes in Africa should consider these factors when targeting educational strategies for their respective regions and learner

  8. Final report of the group research. Advanced Technology for Medical Imaging Research. 1996-2000 FY

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    2002-03-01

    This report involves the organization of the research groups (4 units of radiopharmaceutical chemistry, radiotracer and radiopharmacology, clinical imaging, and molecular informative research), 5 research reports and 38 published research papers. The research reports concern Fundamental researches on the availability and production of PET radiopharmaceuticals using the National Institute of Radiological Sciences (NIRS) cyclotron, Design and evaluation of in vivo radiopharmaceuticals for PET measurement (kinetics and metabolism in small animals and primates), Fundamental studies on development of technique radiation measurement, Clinical application of medical imaging technology in the fields of neuroscience, cardiovascular, cancer diagnosis and others, and A study to establish and evaluate a lung cancer screening system using spiral CT units which is in pilot-progress in Kanto and Kansai regions. (N.I.)

  9. Managing medical groups: 21st century challenges and the impact of physician leadership styles.

    Science.gov (United States)

    Martin, William E; Keogh, Timothy J

    2004-01-01

    Physician group managers and administrators charged with leading medical groups in the 21st century face a set of old and new challenges and opportunities. Leadership is assumed to make the difference between a successful and not-so-successful medical group. Yet, there is little research about how physician manager leadership styles contribute to the success of medical group practices. This article is a study of physician leadership styles using the DiSC, based upon a sample of 232 physician managers. Dominance (D) and conscientiousness (C) were the two dominant styles found in this study. Moreover, the two dominant combination leadership styles fall under the categories of the "creative" and the 'perfectionist." The article formulates practical recommendations for both physician managers and administrators for leading medical groups to respond more effectively to the challenges and opportunities facing medical groups in the 21st century.

  10. Metastatic non-small cell lung cancer Current treatment based on evidence (ONCOL Group)

    International Nuclear Information System (INIS)

    Castro, Carlos; Cardona, Andres Felipe; Reveiz, Ludovic; Serrano, Silvia Juliana; Carranza, Hernan; Vargas, Carlos Alberto; Reguart, Noemi; Campo, Felipe; Ospina, Edgar Guillermo; Sanchez, Oswaldo; Torres, Diana; Otero, Jorge Miguel

    2010-01-01

    to perform a review of evidence about the treatment of non-small cell lung cancer (NSCLC). Source of data: the information was obtained from searches conducted in Medline, CCTR, Biosis, Embase, Lilacs and CINHAL. We also collected the most representative references presented during the last five years at Asco, ESMO and IASLC. Data extraction: data were extracted by associate members to the ONCOL Group. The collection of information did not follow a uniform strategy. Results of data synthesis: therapy for NSCLC can prolong survival and improve quality of life, but the majority of advanced stage patients dies due to disease progression within 2 years, meaning that there is room for improvement. The standard chemotherapy for NSCLC involves one of a number of platinum-based doublets that have been shown to improve survival when compared with single agents or best supportive care. These doublets are generally comparable in terms of efficacy, differing primarily in their toxicity profiles. However, encouraging new options may be approaching, including therapies targeted to specific patient subpopulations, and the use of combinations of current and new drugs to produce synergistic effects. This review present a detailed analysis of current evidence regarding the treatment of NSCLC based on a representative case series. This review didn't conduct a systematic evaluation of the evidence. Conclusion: medical therapy for NSCLC produces positive changes in main outcomes, including quality of life

  11. Small business groups enhance performance and promote stability, not expropriation. Evidence from French SMEs

    OpenAIRE

    Anaïs Hamelin

    2010-01-01

    This paper investigates the influence of a firm’s distance from control on its performance, using a unique firm level data set on small business ownership, as well as balance sheet information. This study fills a gap in the empirical governance literature by investigating whether or not there is an expropriation of minority shareholders in small business groups. Contrary to what is usually observed for large business groups, results show a positive relationship between the separation of contr...

  12. Medical mission to dominican republic: one dermatology group?s experiences.

    Science.gov (United States)

    Ahmed, Atif; Peine, Steven

    2013-01-01

    The intents of this article are to share our experiences during a medical mission in the Dominican Republic and to provide the reader with a cross-sectional view of conditions seen and an overview of interesting and challenging cases encountered. We also discuss treatments and techniques used and share lessons learned. 2013.

  13. Toward a social capital theory of competitive advantage in medical groups.

    Science.gov (United States)

    Hoelscher, Mark L; Hoffman, James J; Dawley, David

    2005-01-01

    Social capital can have a positive impact on medical group performance. We forward our theory based on the integration of theories in social capital, resource advantage, and the resource-based view of the firm. Further, we suggest specific ways in which medical groups can increase their levels of social capital. First, medical groups should design or redesign the workplace so that there is ample interaction among employees. Second, employee participation within the community should be encouraged. Third, medical groups should recognize that social capital becomes ingrained in organizational culture. Therefore, medical groups should take steps to ensure a culture that supports its social capital. Fourth, hiring procedures should be designed (or redesigned) to ensure that new employees add social capital to the organization. Finally, trust must be fostered at the employee level.

  14. Novel Emergency Medicine Curriculum Utilizing Self-Directed Learning and the Flipped Classroom Method: Gastrointestinal Emergencies Small Group Module

    Directory of Open Access Journals (Sweden)

    Andrew King

    2017-01-01

    Full Text Available Audience and type of curriculum: This curriculum created and implemented at The Ohio State University Wexner Medical Center was designed to educate our emergency medicine (EM residents, PGY-1 to PGY-3, as well as medical students and attending physicians. Introduction/Background: Gastrointestinal (GI emergencies comprise approximately 12% of emergency department (ED visits.1 Residents must be proficient in the differential diagnosis and management of the wide variety of GI emergencies. The flipped classroom curricular model emphasizes self-directed learning activities completed by learners, followed by small group discussions pertaining to the topic reviewed. The active learning fostered by this curriculum increases faculty and learner engagement and interaction time typically absent in traditional lecture-based formats.2-4 Studies have revealed that the application of knowledge through case studies, personal interaction with content experts, and integrated questions are effective learning strategies for emergency medicine residents.4-6 The Ohio State University EM Residency didactic curriculum recently transitioned to a “flipped classroom” approach.7-10 We created this innovative curriculum aimed to improve our residency education program and to share educational resources with other EM residency programs. This proposed curriculum utilizes an 18-month curricular cycle. The flipped classroom curriculum maximizes didactic time and resident engagement, fosters intellectual curiosity and active learning, and meets the needs of today’s learners. 3,6,11 Objectives: We aim to teach the presentation and management of GI emergencies through the creation of a flipped classroom design. This unique, innovative curriculum utilizes resources chosen by education faculty and resident learners, study questions, real-life experiences, and small group discussions in place of traditional lectures. In doing so, a goal of the curriculum is to encourage self

  15. Novel Emergency Medicine Curriculum Utilizing Self-Directed Learning and the Flipped Classroom Method: Psychiatric Emergencies Small Group Module

    Directory of Open Access Journals (Sweden)

    Andrew King

    2017-07-01

    Full Text Available Audience: This curriculum created and implemented at The Ohio State University Wexner Medical Center was designed to educate our emergency medicine (EM residents, PGY-1 to PGY-3, as well as medical students and attending physicians. Introduction: In 2007, there were 12 million adult Emergency Department visits for mental health and substance abuse complaints. This represents 12.5% of all adult emergency department visits.1 Residents must be proficient in the differential diagnosis and management of the wide variety of psychiatric emergencies. The flipped classroom curricular model emphasizes self-directed learning activities completed by learners, followed by small group discussions pertaining to the topic reviewed. The active learning fostered by this curriculum increases faculty and learner engagement and interaction time typically absent in traditional lecture-based formats.2-4 Studies have revealed that the application of knowledge through case studies, personal interaction with content experts, and integrated questions are effective learning strategies for emergency medicine residents.4-6 The Ohio State University EM Residency didactic curriculum recently transitioned to a “flipped classroom” approach.7-10 We created this innovative curriculum aimed to improve our residency education program and to share educational resources with other EM residency programs. Our curriculum utilizes an 18-month curricular cycle to cover the defined emergency medicine content. The flipped classroom curriculum maximizes didactic time and resident engagement, fosters intellectual curiosity and active learning, and meets the needs of today’s learners. 3,6,11 Objectives: We aim to teach the presentation and management of psychiatric emergencies through the creation of a flipped classroom design. This unique, innovative curriculum utilizes resources chosen by education faculty and resident learners, study questions, real-life experiences, and small group

  16. Responsive Guided Reading in Grades K-5: Simplifying Small-Group Instruction

    Science.gov (United States)

    Berne, Jennifer; Degener, Sophie C.

    2010-01-01

    Guided reading is a staple of elementary literacy instruction, yet planning and conducting reading groups can be time consuming and challenging. This hands-on book presents an innovative approach to guided reading that is manageable even for teachers who are new to small-group, differentiated reading instruction. Numerous classroom examples…

  17. Vocabulary Learning in Collaborative Tasks: A Comparison of Pair and Small Group Work

    Science.gov (United States)

    Dobao, Ana Fernández

    2014-01-01

    This study examined the opportunities that pair and small group interaction offer for collaborative dialogue and second language (L2) vocabulary learning. It compared the performance of the same collaborative writing task by learners working in groups of four (n = 60) and in pairs (n = 50), focusing on the occurrence of lexical language-related…

  18. Learning Science in Small Multi-Age Groups: The Role of Age Composition

    Science.gov (United States)

    Kallery, Maria; Loupidou, Thomais

    2016-01-01

    The present study examines how the overall cognitive achievements in science of the younger children in a class where the students work in small multi-age groups are influenced by the number of older children in the groups. The context of the study was early-years education. The study has two parts: The first part involved classes attended by…

  19. The small group subtlety of using ICT for participatory governance: A South African experience

    CSIR Research Space (South Africa)

    Twinomurinzi, H

    2012-04-01

    Full Text Available the necessity to re-design ICT to suit small groups as part of participative e-governance rather than the normative ICT design that suits individual work styles. Additionally, the research reveals that by working in groups, communities are more willing to accept...

  20. Building Children's Sense of Community in a Day Care Centre through Small Groups in Play

    Science.gov (United States)

    Koivula, Merja; Hännikäinen, Maritta

    2017-01-01

    This study examines the process through which children build a sense of community in small groups in a day care centre. The study asks the following: how does children's sense of community develop, and what are its key features? Data were collected by applying ethnographic methods in a group of three- to five-year-old children over eleven months.…

  1. Evaluation of a Small-Group Technique as a Teacher Training Instrument. Final Report.

    Science.gov (United States)

    Whipple, Babette S.

    An exploratory study was designed to determine whether the use of a new, small group technique adds significantly to the level of training in early childhood education. Two groups of five student teachers learned the technique and were then evaluated. The evaluation procedure was designed to measure changes in their educational objectives, their…

  2. Peer-Assisted History-Taking Groups: A Subjective Assessment of their Impact Upon Medical Students' Interview Skills

    Directory of Open Access Journals (Sweden)

    Keifenheim, Katharina Eva

    2017-08-01

    Full Text Available Background and Objectives: Among the clinical skills needed by all physicians, history taking is one of the most important. The teaching model for peer-assisted history-taking groups investigated in the present study consists of small-group courses in which students practice conducting medical interviews with real patients. The purpose of this pilot study was to investigate the expectations, experiences, and subjective learning progress of participants in peer-assisted history-taking groups.Methods: The 42 medical student participants completed a 4-month, peer-assisted, elective history-taking course, which both began and ended with a subjective assessment of their interview skills by way of a pseudonymized questionnaire. Measures comprised the students’ self-assessment of their interview skills, their expectations of, and their experiences with the course and especially with the peer tutors. Results: Medical students’ most important motivations in attending peer-assisted history-taking groups were becoming able to complete a structured medical interview, to mitigate difficult interviewing situations, and to address patients’ emotional demands appropriately. By the end of the course, students’ self-assessment of both their interview skills and management of emotional issues improved significantly. Students especially benefitted from individual feedback regarding interview style and relationship formation, as well as generally accepted and had their expectations met by peer tutors. Conclusions: To meet the important learning objectives of history-taking and management of emotional issues, as well as self-reflection and reflection of student–patient interactions, students in the field greatly appreciate practicing medical interviewing in small, peer-assisted groups with real patients. At the same time, peer tutors are experienced to be helpful and supportive and can help students to overcome inhibitions in making contact with patients.

  3. Involving postgraduate's students in undergraduate small group teaching promotes active learning in both

    Science.gov (United States)

    Kalra, Ruchi; Modi, Jyoti Nath; Vyas, Rashmi

    2015-01-01

    Background: Lecture is a common traditional method for teaching, but it may not stimulate higher order thinking and students may also be hesitant to express and interact. The postgraduate (PG) students are less involved with undergraduate (UG) teaching. Team based small group active learning method can contribute to better learning experience. Aim: To-promote active learning skills among the UG students using small group teaching methods involving PG students as facilitators to impart hands-on supervised training in teaching and managerial skills. Methodology: After Institutional approval under faculty supervision 92 UGs and 8 PGs participated in 6 small group sessions utilizing the jigsaw technique. Feedback was collected from both. Observations: Undergraduate Feedback (Percentage of Students Agreed): Learning in small groups was a good experience as it helped in better understanding of the subject (72%), students explored multiple reading resources (79%), they were actively involved in self-learning (88%), students reported initial apprehension of performance (71%), identified their learning gaps (86%), team enhanced their learning process (71%), informal learning in place of lecture was a welcome change (86%), it improved their communication skills (82%), small group learning can be useful for future self-learning (75%). Postgraduate Feedback: Majority performed facilitation for first time, perceived their performance as good (75%), it was helpful in self-learning (100%), felt confident of managing students in small groups (100%), as facilitator they improved their teaching skills, found it more useful and better identified own learning gaps (87.5%). Conclusions: Learning in small groups adopting team based approach involving both UGs and PGs promoted active learning in both and enhanced the teaching skills of the PGs. PMID:26380201

  4. Is the modernisation of postgraduate medical training in the Netherlands successful? Views of the NVMO Special Interest Group on Postgraduate Medical Education

    NARCIS (Netherlands)

    Scheele, Fedde; Van Luijk, Scheltus; Mulder, Hanneke; Baane, Coby; Den Rooyen, Corry; De Hoog, Matthijs; Fokkema, Joanne; Heineman, Erik; Sluiter, Henk

    Background: Worldwide, the modernisation of medical education is leading to the design and implementation of new postgraduate curricula. In this article, the Special Interest Group for postgraduate medical education of the Netherlands Association for Medical Education (NVMO) reports on the

  5. A Project Team Analysis Using Tuckman's Model of Small-Group Development.

    Science.gov (United States)

    Natvig, Deborah; Stark, Nancy L

    2016-12-01

    Concerns about equitable workloads for nursing faculty have been well documented, yet a standardized system for workload management does not exist. A project team was challenged to establish an academic workload management system when two dissimilar universities were consolidated. Tuckman's model of small-group development was used as the framework for the analysis of processes and effectiveness of a workload project team. Agendas, notes, and meeting minutes were used as the primary sources of information. Analysis revealed the challenges the team encountered. Utilization of a team charter was an effective tool in guiding the team to become a highly productive group. Lessons learned from the analysis are discussed. Guiding a diverse group into a highly productive team is complex. The use of Tuckman's model of small-group development provided a systematic mechanism to review and understand group processes and tasks. [J Nurs Educ. 2016;55(12):675-681.]. Copyright 2016, SLACK Incorporated.

  6. Physician Acceptance of a Computerized Outpatient Medication System in a Teaching Hospital Group Practice

    OpenAIRE

    Blish, Christi; Proctor, Rita; Fletcher, Suzanne W.; O'Malley, Michael

    1983-01-01

    As part of a new automated ambulatory medical record, a computerized outpatient medication system was developed for a teaching hospital general medicine group practice. Seven months after its implementation, the system was evaluated to determine physician acceptance and approval. Practice physicians were surveyed, and 94% of the respondents approved of the system. Over 90% thought that the computerized system had improved the completeness and accuracy of medication information as well as thei...

  7. Growing medicine: small-scale cannabis cultivation for medical purposes in six different countries.

    Science.gov (United States)

    Hakkarainen, Pekka; Frank, Vibeke Asmussen; Barratt, Monica J; Dahl, Helle Vibeke; Decorte, Tom; Karjalainen, Karoliina; Lenton, Simon; Potter, Gary; Werse, Bernd

    2015-03-01

    The production and consumption of cannabis for the treatment of medical conditions is of increasing importance internationally; however, research on different aspects of the phenomenon is still scarce. In this article, we report findings from a cross-cultural study of small-scale cannabis cultivation for medical purposes. This kind of comparative study has not been done previously. The data were gathered with a help of web surveys conducted by the Global Cannabis Cultivation Research Consortium (GCCRC) in Australia, Belgium, Denmark, Finland, Germany and the UK (N=5313). In the analysis we compare reports of medical motives, for what conditions cannabis is used, whether users have diagnoses for these conditions and whether the use of cannabis been recommended as a treatment of those conditions by a medical doctor. Descriptive statistics are used to show the main commonalities and noteworthy disparities across different countries. Findings from countries were quite similar, even though several national differences in details were found. Growing cannabis for medical purposes was widespread. The majority of medical growers reported cultivating cannabis for serious conditions. Most of them did have a formal diagnosis. One fifth had got a recommendation from their doctor, but in most cases cannabis use was self-medication which was not discussed with their doctors. There is a wider demand for licit access for medical cannabis than currently available in these countries. Ideologically, medical growers can be seen distancing themselves from both the legal and illicit drug markets. From a harm reduction perspective, it is worrying that, in the context of present health and control policies in these countries, many medical growers are using cannabis to treat serious medical conditions without proper medical advice and doctor's guidance. Copyright © 2014 Elsevier B.V. All rights reserved.

  8. Identification of mistakes and their correction by a small group discussion as a revision exercise at the end of a teaching module in biochemistry.

    Science.gov (United States)

    Bobby, Zachariah; Nandeesha, H; Sridhar, M G; Soundravally, R; Setiya, Sajita; Babu, M Sathish; Niranjan, G

    2014-01-01

    Graduate medical students often get less opportunity for clarifying their doubts and to reinforce their concepts after lecture classes. The Medical Council of India (MCI) encourages group discussions among students. We evaluated the effect of identifying mistakes in a given set of wrong statements and their correction by a small group discussion by graduate medical students as a revision exercise. At the end of a module, a pre-test consisting of multiple-choice questions (MCQs) was conducted. Later, a set of incorrect statements related to the topic was given to the students and they were asked to identify the mistakes and correct them in a small group discussion. The effects on low, medium and high achievers were evaluated by a post-test and delayed post-tests with the same set of MCQs. The mean post-test marks were significantly higher among all the three groups compared to the pre-test marks. The gain from the small group discussion was equal among low, medium and high achievers. The gain from the exercise was retained among low, medium and high achievers after 15 days. Identification of mistakes in statements and their correction by a small group discussion is an effective, but unconventional revision exercise in biochemistry. Copyright 2014, NMJI.

  9. Selected List of Books and Journals for the Small Medical Library

    Science.gov (United States)

    Brandon, Alfred N.

    2012-01-01

    This list of 358 books and 123 journals is intended as a selection aid for the small library of a hospital, medical society, clinic, or similar organization. Books and journals are arranged by subject, with the books followed by an author index, and the journals by an alphabetical title listing. PMID:23509428

  10. How do Small Groups Promote Behaviour Change? An Integrative Conceptual Review of Explanatory Mechanisms.

    Science.gov (United States)

    Borek, Aleksandra J; Abraham, Charles

    2018-03-01

    Small groups are used to promote health, well-being, and personal change by altering members' perceptions, beliefs, expectations, and behaviour patterns. An extensive cross-disciplinary literature has articulated and tested theories explaining how such groups develop, function, and facilitate change. Yet these theoretical understandings are rarely applied in the development, description, and evaluation of health-promotion, group-based, behaviour-change interventions. Medline database, library catalogues, search engines, specific journals and reference lists were searched for relevant texts. Texts were reviewed for explanatory concepts or theories describing change processes in groups, which were integrated into the developing conceptual structure. This was designed to be a parsimonious conceptual framework that could be applied to design and delivery. Five categories of interacting processes and concepts were identified and defined: (1) group development processes, (2) dynamic group processes, (3) social change processes, (4) personal change processes, and (5) group design and operating parameters. Each of these categories encompasses a variety of theorised mechanisms explaining individual change in small groups. The final conceptual model, together with the design issues and practical recommendations derived from it, provides a practical basis for linking research and theory explaining group functioning to optimal design of group-based, behaviour-change interventions. © 2018 The Authors. Applied Psychology: Health and Well-Being published by John Wiley & Sons Ltd on behalf of International Association of Applied Psychology.

  11. Differences in attitudes towards medication between population groups in the Durban Metropolitan Area of South Africa.

    Science.gov (United States)

    Suleman, Fatima; Ally, Shabnam; Bayat, Samirah; Essack, Razia; Moodley, Renalda; Mtembu, Thobekile; Ramalingham, Emily

    2009-08-01

    Personal factors, especially attitude, have been implicated in the utilization of health care services, and in access to medical treatment. There is little information on the attitudes of the general public in South Africa towards medications and whether attitudes differ across population groups or among the different users of the health care system. This study aimed to determine the general attitude of a local population to medications, self-care orientation and health professional contact, and whether differences existed between age groups, gender and race groups. METHODS We carried out a randomized, cross-sectional quantitative study via telephonic questionnaire survey (adapted from a previous study) of a sample of 1132 telephone numbers. The setting was the Durban Metropolitan Area, KwaZulu-Natal, South Africa. KEY FINDINGS A total of 500 (44.2%) people responded. The majority had a positive attitude towards medication. An increase in age resulted in increased medication use. Females were more likely than males to use medication and seek professional health care (P = 0.0406). Most of the respondents (86.0%) were self-care-orientated and displayed moderate medication knowledge (46.2%). Some 295 (59.0%) of the 500 respondents had visited a pharmacy within the last 6 months. Conclusions Health care professionals can adopt an informed approach to address the needs of the population with regard to medication, by targeting groups more likely to use medication (females and the older age group). In addition, gaps in medication knowledge were identified which could be used for health-promotion interventions by health care workers.

  12. DEVELOPMENT OF COORDINATION ABILITIES OF SPECIAL MEDICAL GROUPS STUDENTS IN PHYSICAL EDUCATION PROCESS

    Directory of Open Access Journals (Sweden)

    E. N. Dotsenko

    2013-08-01

    Full Text Available Purpose. To analyze the problem of motor abilities development and health of students of special medical group in the process of physical education in technical universities. Determine the major factors, characteristics, and the relationship of physical development, physical fitness and coordination abilities of female students in special medical group. Establish regularities in precise movements mastering of different coordination structure and develop model characteristics of the relationship of coordination abilities and motor characteristics of students in special medical group. To substantiate and verify efficiency of coordination abilities development method of female students with regard to their functional status in the course of physical education in higher school. Methodology. Theoretical and methodological argument, characteristic of the experimental program in physical education teaching process of students in special medical group was shown. Findings. Research is to develop the training content in special medical groups with the use of coordinating elements and exercises to enhance the motor abilities of female students. Their influence on the level of physical development, functional training, as well as regularities in mastering and movement control of different coordinating structure at the female students of special medical group was studied. The comparative characteristic of female students athletic ability in the dynamics of the educational process, differentiated into groups according to nosology was presented. The criterion of spare capacities upgrade of the motor system in controlling the movements of different coordination structure was determined. Originality. The method of coordination abilities development of female students in special medical group, that aims on the formation and correction of motor control system of different coordination structure, a sense of body position and its individual parts in space, improving

  13. Development of active learning modules in pharmacology for small group teaching.

    Science.gov (United States)

    Tripathi, Raakhi K; Sarkate, Pankaj V; Jalgaonkar, Sharmila V; Rege, Nirmala N

    2015-01-01

    Current teaching in pharmacology in undergraduate medical curriculum in India is primarily drug centered and stresses imparting factual knowledge rather than on pharmacotherapeutic skills. These skills would be better developed through active learning by the students. Hence modules that will encourage active learning were developed and compared with traditional methods within the Seth GS Medical College, Mumbai. After Institutional Review Board approval, 90 second year undergraduate medical students who consented were randomized into six sub-groups, each with 15 students. Pre-test was administered. The three sub-groups were taught a topic using active learning modules (active learning groups), which included problems on case scenarios, critical appraisal of prescriptions and drug identification. The remaining three sub-groups were taught the same topic in a conventional tutorial mode (tutorial learning groups). There was crossover for the second topic. Performance was assessed using post-test. Questionnaires with Likert-scaled items were used to assess feedback on teaching technique, student interaction and group dynamics. The active and tutorial learning groups differed significantly in their post-test scores (11.3 ± 1.9 and 15.9 ± 2.7, respectively, P active learning session as interactive (vs. 37/90 students in tutorial group) and enhanced their understanding vs. 56/90 in tutorial group), aroused intellectual curiosity (47/90 students of active learning group vs. 30/90 in tutorial group) and provoked self-learning (41/90 active learning group vs. 14/90 in tutorial group). Sixty-four students in the active learning group felt that questioning each other helped in understanding the topic, which was the experience of 25/90 students in tutorial group. Nevertheless, students (55/90) preferred tutorial mode of learning to help them score better in their examinations. In this study, students preferred an active learning environment, though to pass examinations, they

  14. Female peers in small work groups enhance women's motivation, verbal participation, and career aspirations in engineering

    OpenAIRE

    Dasgupta, Nilanjana; Scircle, Melissa McManus; Hunsinger, Matthew

    2015-01-01

    Advances in science, technology, engineering, and mathematics are critical to the American economy and require a robust workforce. The scarcity of women in this workforce is a well-recognized problem, but data-driven solutions to this problem are less common. We provide experimental evidence showing that gender composition of small groups in engineering has a substantial impact on undergraduate women’s persistence. Women participate more actively in engineering groups when members are mostly ...

  15. A Selective Group Authentication Scheme for IoT-Based Medical Information System.

    Science.gov (United States)

    Park, YoHan; Park, YoungHo

    2017-04-01

    The technology of IoT combined with medical systems is expected to support advanced medical services. However, unsolved security problems, such as misuse of medical devices, illegal access to the medical server and so on, make IoT-based medical systems not be applied widely. In addition, users have a high burden of computation to access Things for the explosive growth of IoT devices. Because medical information is critical and important, but users have a restricted computing power, IoT-based medical systems are required to provide secure and efficient authentication for users. In this paper, we propose a selective group authentication scheme using Shamir's threshold technique. The property of selectivity gives the right of choice to users to form a group which consists of things users select and access. And users can get an access authority for those Things at a time. Thus, our scheme provides an efficient user authentication for multiple Things and conditional access authority for safe IoT-based medical information system. To the best of our knowledge, our proposed scheme is the first in which selectivity is combined with group authentication in IoT environments.

  16. Student pharmacist experiences as inpatient psychiatry medication education group leaders during an early immersion program.

    Science.gov (United States)

    McLaughlin, Jacqueline E; Kennedy, Lindsey; Garris, Shauna; Harris, Suzanne C; Hillman, Ashley; Pinelli, Nicole R; Rhoney, Denise H

    2017-09-01

    While research suggests that pharmacists generally hold positive attitudes toward consumers of psychiatric medications, they often feel less comfortable talking about these medications and providing services for patients with mental illness. The purpose of this program was to train second and third year student pharmacists as psychiatry medication education groups leaders and to examine resulting student self-efficacy and mental health stigma. In partnership with the University of North Carolina (UNC) Eshelman School of Pharmacy, the inpatient psychiatry service at UNC Medical Center expanded weekly medication education groups with the help of trained student pharmacists. All second- and third-year student pharmacists were invited to participate. Pre/post surveys and reflection statements were collected from 13 students that received training, provided informed consent, and participated in one or more medication education groups. Data were analyzed with a mixed methods approach. Student responses revealed an increase in student self-efficacy (p appreciation for pharmacists and the workplace while developing self-efficacy and strategies for engaging with patients with mental illness as a part of medication education groups. Copyright © 2017 Elsevier Inc. All rights reserved.

  17. Taking It to the Classroom: Number Board Games as a Small Group Learning Activity

    Science.gov (United States)

    Ramani, Geetha B.; Siegler, Robert S.; Hitti, Aline

    2012-01-01

    We examined whether a theoretically based number board game could be translated into a practical classroom activity that improves Head Start children's numerical knowledge. Playing the number board game as a small group learning activity promoted low-income children's number line estimation, magnitude comparison, numeral identification, and…

  18. Information Problem-Solving Skills in Small Virtual Groups and Learning Outcomes

    Science.gov (United States)

    Garcia, Consuelo; Badia, Antoni

    2017-01-01

    This study investigated the frequency of use of information problem-solving (IPS) skills and its relationship with learning outcomes. During the course of the study, 40 teachers carried out a collaborative IPS task in small virtual groups in a 4-week online training course. The status of IPS skills was collected through self-reports handed in over…

  19. What Do We Want Small Group Activities For? Voices from EFL Teachers in Japan

    Science.gov (United States)

    Kato, Yoshitaka

    2016-01-01

    This paper discusses the fundamental issue of why small group activities are utilized in the language learning classroom. Although these activities have gained popularity in the field of Teaching English as a Second Language (TESL), supported by a sound theoretical base, few studies have so far examined the reasons why language teachers are…

  20. Ten-year diameter and basal area growth of trees surrounding small group selection openings

    Science.gov (United States)

    Philip M. McDonald; Martin W. Ritchie; Celeste S. Abbott

    1996-01-01

    The effects of small openings in forest stands has interested silviculturists and ecologists for years. Interest generally has centered on the vegetation in the openings, not on that immediately outside of them. Quantitative information on the growth of trees adjacent to group-selection openings, although often mentioned in forestry textbooks as contributing to cost...

  1. A cross-cultural comparative analysis of small group collaboration using mobile twitter

    NARCIS (Netherlands)

    Kyungsub Stephen Choi, Il Im; Hofstede, G.J.

    2016-01-01

    This study was undertaken to determine the distinctive user behaviors and patterns of participants communicating using Twitter on a mobile device in a small-group collaborative setting. Participants were from Western and Eastern cultures (the United States and Korea). Tweets were coded and

  2. Worrying about What Others Think: A Social-Comparison Concern Intervention in Small Learning Groups

    Science.gov (United States)

    Micari, Marina; Pazos, Pilar

    2014-01-01

    Small-group learning has become commonplace in education at all levels. While it has been shown to have many benefits, previous research has demonstrated that it may not always work to the advantage of every student. One potential problem is that less-prepared students may feel anxious about participating, for fear of looking "dumb" in…

  3. Exploring Young Children's Response to Three Genres of Literature in Small-Peer Groups

    Science.gov (United States)

    Griffin, Jennifer Adams

    2010-01-01

    This teacher research studied second graders' small-group, peer-led discussions about three genres of literature--realistic fiction, biography picture books, and science information books--across one school year (during three units in the fall, winter, and spring). It set out to explore how this peer talk, in general, mediated children's responses…

  4. Strong Teens: A School-Based Small Group Experience for African American Males

    Science.gov (United States)

    White, Nathan J.; Rayle, Andrea Dixon

    2007-01-01

    This article describes the school-based, small group adaptation of the existing Strong Teens Curriculum (STC) for African American male adolescents in high schools. The STC was created to equip adolescents with skills that promote more effective social interaction and enhance personal emotional and psychological wellness. The authors present a…

  5. Coaching Paraprofessionals to Promote Engagement and Social Interactions during Small Group Activities

    Science.gov (United States)

    Ledford, Jennifer R.; Zimmerman, Kathleen N.; Chazin, Kate T.; Patel, Natasha M.; Morales, Vivian A.; Bennett, Brittany P.

    2017-01-01

    Paraprofessionals need adequate training and supports to assist young children with autism spectrum disorders to engage in appropriate social interactions during small group activities with their peers. In this study, we used in situ coaching and brief post-session feedback to improve the use of environmental arrangement, prompting, and praise by…

  6. Developing Reflective Dispositions through Collaborative Knowledge-Building during Small Group Bible Study

    Science.gov (United States)

    Toh, Tze Keong; Koh, Joyce Hwee Ling; Chai, Ching Sing

    2017-01-01

    This article explores the use of a constructivist pedagogical approach to cultivate reflective dispositions during small group Bible study. Conducted in a local church Bible class setting (n = 12), the instructional design emulated the reflective thinking process, while adopting collaborative knowledge-building as its pedagogical framework.…

  7. Developing Employment Interview and Interviewing Skills in Small-group Project Work.

    Science.gov (United States)

    Hindle, Paul

    2000-01-01

    Discusses the value of communications skills in geographical education. Describes the use of realistic interviews that were a part of small-group project work. Explains that students wrote job specifications, a curriculum vitae, a cover letter, and conducted interview panels. (CMK)

  8. Creating in the Collective: Dialogue, Collaboration, and the Search for Understanding in the Jazz Small Group

    Science.gov (United States)

    Branker, Anthony Daniel John

    2010-01-01

    What would happen if college students involved in jazz small group performance were given the opportunity to be musically independent and self-directed while working in their own collaborative space? What sorts of things would they experience? What kind of learning space would they create for themselves? The purpose of this study was to…

  9. Teaching Play Skills to Children with Autism through Video Modeling: Small Group Arrangement and Observational Learning

    Science.gov (United States)

    Ozen, Arzu; Batu, Sema; Birkan, Binyamin

    2012-01-01

    The purpose of the present study was to examine if video modeling was an effective way of teaching sociodramatic play skills to individuals with autism in a small group arrangement. Besides maintenance, observational learning and social validation data were collected. Three 9 year old boys with autism participated in the study. Multiple probe…

  10. Promoting Pre-Service Elementary Students' Understanding of Chemical Equilibrium through Discussions in Small Groups

    Science.gov (United States)

    Bilgin, Ibrahim

    2006-01-01

    The purpose of this study was to investigate the effectiveness of small group discussion on students' conceptual understanding of chemical equilibrium. Students' understanding of chemical equilibrium concepts was measured using the Misconception Identification Test. The test consisted of 30 items and administered as pre-posttests to a total of 81…

  11. An empirical assessment of high-performing medical groups: results from a national study.

    Science.gov (United States)

    Shortell, Stephen M; Schmittdiel, Julie; Wang, Margaret C; Li, Rui; Gillies, Robin R; Casalino, Lawrence P; Bodenheimer, Thomas; Rundall, Thomas G

    2005-08-01

    The performance of medical groups is receiving increased attention. Relatively little conceptual or empirical work exists that examines the various dimensions of medical group performance. Using a national database of 693 medical groups, this article develops a scorecard approach to assessing group performance and presents a theory-driven framework for differentiating between high-performing versus low-performing medical groups. The clinical quality of care, financial performance, and organizational learning capability of medical groups are assessed in relation to environmental forces, resource acquisition and resource deployment factors, and a quality-centered culture. Findings support the utility of the performance scorecard approach and identification of a number of key factors differentiating high-performing from low-performing groups including, in particular, the importance of a quality-centered culture and the requirement of outside reporting from third party organizations. The findings hold a number of important implications for policy and practice, and the framework presented provides a foundation for future research.

  12. Too much small talk? Medical students' pelvic examination skills falter with pleasant patients.

    Science.gov (United States)

    Posner, Glenn D; Hamstra, Stanley J

    2013-12-01

    The competent performance of a female pelvic examination requires both technical proficiency and superlative communication skills. However, the ideal medium with which to assess these skills remains to be elucidated. Part-task trainers (PTTs) offer an effective and affordable means of testing technical skills, but may not allow students to demonstrate their communication skills. Hybrids involving standardised patients (SPs) (SP-PTT) offer a more realistic assessment of communication, but students may feel awkward when examining the female genitalia. The objective of this study was to compare the use of PTTs with that of SP-PTT hybrids in the assessment of technical and communication skills in the female pelvic examination. A total of 145 medical students were randomised to one of three conditions during their summative objective structured clinical examination (OSCE) at the completion of clerkship. Students performed the female pelvic examination on: (i) a PTT alone ('plastic' condition); (ii) an SP-PTT hybrid with an SP who did not engage in any superfluous conversation ('perfunctory' condition), or (iii) an SP-PTT hybrid with an SP who was trained to offer small talk and banter, which was judged to better reflect the typical doctor-patient interaction ('pleasant' condition). Communication skills did not differ significantly among the three groups (p = 0.354). There was a significant difference among groups in technical skills scores (p = 0.0018). Students in the 'plastic' condition performed best, followed by those in the 'perfunctory' and 'pleasant' conditions, respectively. Medical students demonstrate equivalent communication skills whether they work with a PTT or an SP-PTT hybrid, but their technical skills suffer in the presence of an SP. Working with the PTT alone does not appear to disadvantage students in terms of communication skills, but may offer better conditions for performing technical aspects of the procedure. Whether the 'plastic patient' is

  13. Response to: 'Why medical professionals have no moral claim to conscientious objection accommodation in liberal democracies' by Schuklenk and Smalling.

    Science.gov (United States)

    Glick, Shimon M; Jotkowitz, Alan

    2017-04-01

    The recent essay by Schuklenk and Smalling opposing respect for physicians' conscientious objections to providing patients with medical services that are legally permitted in liberal democracies is based on several erroneous assumptions. Acting in this manner would have serious harmful effects on the ethos of medicine and of bioethics. A much more nuanced and balanced position is critical in order to respect physicians' conscience with minimal damage to patients' rights. 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/.

  14. Female peers in small work groups enhance women's motivation, verbal participation, and career aspirations in engineering

    Science.gov (United States)

    Dasgupta, Nilanjana; Scircle, Melissa McManus; Hunsinger, Matthew

    2015-01-01

    For years, public discourse in science education, technology, and policy-making has focused on the “leaky pipeline” problem: the observation that fewer women than men enter science, technology, engineering, and mathematics fields and more women than men leave. Less attention has focused on experimentally testing solutions to this problem. We report an experiment investigating one solution: we created “microenvironments” (small groups) in engineering with varying proportions of women to identify which environment increases motivation and participation, and whether outcomes depend on students’ academic stage. Female engineering students were randomly assigned to one of three engineering groups of varying sex composition: 75% women, 50% women, or 25% women. For first-years, group composition had a large effect: women in female-majority and sex-parity groups felt less anxious than women in female-minority groups. However, among advanced students, sex composition had no effect on anxiety. Importantly, group composition significantly affected verbal participation, regardless of women’s academic seniority: women participated more in female-majority groups than sex-parity or female-minority groups. Additionally, when assigned to female-minority groups, women who harbored implicit masculine stereotypes about engineering reported less confidence and engineering career aspirations. However, in sex-parity and female-majority groups, confidence and career aspirations remained high regardless of implicit stereotypes. These data suggest that creating small groups with high proportions of women in otherwise male-dominated fields is one way to keep women engaged and aspiring toward engineering careers. Although sex parity works sometimes, it is insufficient to boost women’s verbal participation in group work, which often affects learning and mastery. PMID:25848061

  15. Female peers in small work groups enhance women's motivation, verbal participation, and career aspirations in engineering.

    Science.gov (United States)

    Dasgupta, Nilanjana; Scircle, Melissa McManus; Hunsinger, Matthew

    2015-04-21

    For years, public discourse in science education, technology, and policy-making has focused on the "leaky pipeline" problem: the observation that fewer women than men enter science, technology, engineering, and mathematics fields and more women than men leave. Less attention has focused on experimentally testing solutions to this problem. We report an experiment investigating one solution: we created "microenvironments" (small groups) in engineering with varying proportions of women to identify which environment increases motivation and participation, and whether outcomes depend on students' academic stage. Female engineering students were randomly assigned to one of three engineering groups of varying sex composition: 75% women, 50% women, or 25% women. For first-years, group composition had a large effect: women in female-majority and sex-parity groups felt less anxious than women in female-minority groups. However, among advanced students, sex composition had no effect on anxiety. Importantly, group composition significantly affected verbal participation, regardless of women's academic seniority: women participated more in female-majority groups than sex-parity or female-minority groups. Additionally, when assigned to female-minority groups, women who harbored implicit masculine stereotypes about engineering reported less confidence and engineering career aspirations. However, in sex-parity and female-majority groups, confidence and career aspirations remained high regardless of implicit stereotypes. These data suggest that creating small groups with high proportions of women in otherwise male-dominated fields is one way to keep women engaged and aspiring toward engineering careers. Although sex parity works sometimes, it is insufficient to boost women's verbal participation in group work, which often affects learning and mastery.

  16. Charge transfer through amino groups-small molecules interface improving the performance of electroluminescent devices

    Science.gov (United States)

    Havare, Ali Kemal; Can, Mustafa; Tozlu, Cem; Kus, Mahmut; Okur, Salih; Demic, Şerafettin; Demirak, Kadir; Kurt, Mustafa; Icli, Sıddık

    2016-05-01

    A carboxylic group functioned charge transporting was synthesized and self-assembled on an indium tin oxide (ITO) anode. A typical electroluminescent device [modified ITO/TPD (50 nm)/Alq3 (60 nm)/LiF (2 nm)/(120 nm)] was fabricated to investigate the effect of the amino groups-small molecules interface on the characteristics of the device. The increase in the surface work function of ITO is expected to facilitate the hole injection from the ITO anode to the Hole Transport Layer (HTL) in electroluminescence. The modified electroluminescent device could endure a higher current and showed a much higher luminance than the nonmodified one. For the produced electroluminescent devices, the I-V characteristics, optical characterization and quantum yields were performed. The external quantum efficiency of the modified electroluminescent device is improved as the result of the presence of the amino groups-small molecules interface.

  17. Health insurance reform and HMO penetration in the small group market.

    Science.gov (United States)

    Buchmueller, Thomas C; Liu, Su

    This study uses data from several national employer surveys conducted between the late 1980s and the mid-1990s to investigate the effect of state-level underwriting reforms on HMO penetration in the small group health insurance market. We identify reform effects by exploiting cross-state variation in the timing and content of reform legislation and by using mid-sized and large employers, which were not affected by the legislation, as within-state control groups. While it is difficult to disentangle the effect of state reforms from other factors affecting HMO penetration in the small group markets, the results suggest a positive relationship between insurance market regulations and HMO penetration.

  18. Acute care in Tanzania: Epidemiology of acute care in a small community medical centre

    Directory of Open Access Journals (Sweden)

    Rachel M. Little

    2013-12-01

    Discussion: Respiratory infections, malaria, and skin or soft tissue infections are leading reasons for seeking medical care at a small community medical centre in Arusha, Tanzania, highlighting the burden of infectious diseases in this type of facility. Males may be more likely to present with trauma, burns, and laceration injuries than females. Many patients required one or no procedures to determine their diagnosis, most treatments administered were inexpensive, and most patients were discharged home, suggesting that providing acute care in this setting could be accomplished with limited resources.

  19. Technology of forming a positive attitude to physical training students of special medical group

    Directory of Open Access Journals (Sweden)

    Mukhamediarov N.N.

    2013-04-01

    Full Text Available Defined effective technology stages of forming a positive attitude towards physical education of students in special medical groups, stimulate motivation, epistemologically, informative, content-procedural, analytical and adjustment. For each stage technology offered special tools: lectures, seminars, analysis articles, mini conference on improving technique, racing games, mini-competitions, diagnostic interviews, questionnaires, analysis of log data on attendance. Selected criteria forming positive attitudes towards physical education: theoretical and practical, formed groups for research: experimental and control, analyzed results introduction of technology, efficiency of the proposed technology and means forming a positive attitude towards physical education students in special medical groups.

  20. TIME DISTRIBUTIONS OF LARGE AND SMALL SUNSPOT GROUPS OVER FOUR SOLAR CYCLES

    International Nuclear Information System (INIS)

    Kilcik, A.; Yurchyshyn, V. B.; Abramenko, V.; Goode, P. R.; Cao, W.; Ozguc, A.; Rozelot, J. P.

    2011-01-01

    Here we analyze solar activity by focusing on time variations of the number of sunspot groups (SGs) as a function of their modified Zurich class. We analyzed data for solar cycles 20-23 by using Rome (cycles 20 and 21) and Learmonth Solar Observatory (cycles 22 and 23) SG numbers. All SGs recorded during these time intervals were separated into two groups. The first group includes small SGs (A, B, C, H, and J classes by Zurich classification), and the second group consists of large SGs (D, E, F, and G classes). We then calculated small and large SG numbers from their daily mean numbers as observed on the solar disk during a given month. We report that the time variations of small and large SG numbers are asymmetric except for solar cycle 22. In general, large SG numbers appear to reach their maximum in the middle of the solar cycle (phases 0.45-0.5), while the international sunspot numbers and the small SG numbers generally peak much earlier (solar cycle phases 0.29-0.35). Moreover, the 10.7 cm solar radio flux, the facular area, and the maximum coronal mass ejection speed show better agreement with the large SG numbers than they do with the small SG numbers. Our results suggest that the large SG numbers are more likely to shed light on solar activity and its geophysical implications. Our findings may also influence our understanding of long-term variations of the total solar irradiance, which is thought to be an important factor in the Sun-Earth climate relationship.

  1. Small group gender ratios impact biology class performance and peer evaluations.

    Science.gov (United States)

    Sullivan, Lauren L; Ballen, Cissy J; Cotner, Sehoya

    2018-01-01

    Women are underrepresented in science, technology, engineering, and mathematics (STEM) disciplines. Evidence suggests the microclimate of the classroom is an important factor influencing female course grades and interest, which encourages retention of women in STEM fields. Here, we test whether the gender composition of small (8-9 person) learning groups impacts course performance, sense of social belonging, and intragroup peer evaluations of intellectual contributions. Across two undergraduate active learning courses in introductory biology, we manipulated the classroom microclimate by varying the gender ratios of learning groups, ranging from 0% female to 100% female. We found that as the percent of women in groups increased, so did overall course performance for all students, regardless of gender. Additionally, women assigned higher peer- evaluations in groups with more women than groups with less women. Our work demonstrates an added benefit of the retention of women in STEM: increased performance for all, and positive peer perceptions for women.

  2. Directions for new developments on statistical design and analysis of small population group trials.

    Science.gov (United States)

    Hilgers, Ralf-Dieter; Roes, Kit; Stallard, Nigel

    2016-06-14

    Most statistical design and analysis methods for clinical trials have been developed and evaluated where at least several hundreds of patients could be recruited. These methods may not be suitable to evaluate therapies if the sample size is unavoidably small, which is usually termed by small populations. The specific sample size cut off, where the standard methods fail, needs to be investigated. In this paper, the authors present their view on new developments for design and analysis of clinical trials in small population groups, where conventional statistical methods may be inappropriate, e.g., because of lack of power or poor adherence to asymptotic approximations due to sample size restrictions. Following the EMA/CHMP guideline on clinical trials in small populations, we consider directions for new developments in the area of statistical methodology for design and analysis of small population clinical trials. We relate the findings to the research activities of three projects, Asterix, IDeAl, and InSPiRe, which have received funding since 2013 within the FP7-HEALTH-2013-INNOVATION-1 framework of the EU. As not all aspects of the wide research area of small population clinical trials can be addressed, we focus on areas where we feel advances are needed and feasible. The general framework of the EMA/CHMP guideline on small population clinical trials stimulates a number of research areas. These serve as the basis for the three projects, Asterix, IDeAl, and InSPiRe, which use various approaches to develop new statistical methodology for design and analysis of small population clinical trials. Small population clinical trials refer to trials with a limited number of patients. Small populations may result form rare diseases or specific subtypes of more common diseases. New statistical methodology needs to be tailored to these specific situations. The main results from the three projects will constitute a useful toolbox for improved design and analysis of small

  3. Individual and small group interactions in learning to teach with a hypermedia case

    Science.gov (United States)

    Chung, Mi-Lee Ahn

    The purpose of this study was to investigate the similarities and differences of individual and small group preservice teachers' interactions with a hypermedia case. Preservice teachers' interactions with a hypermedia case were defined in terms of their (1) goals and perception of accomplishments of the goals, (2) use of features of the hypermedia case, and (3) types of questions and conflicts raised. Two individuals and two small groups of three preservice teachers participated by interacting with the hypermedia case which was developed to illustrate conceptual change science teaching in an elementary classroom. Most of the previous studies in this area have addressed large group use of hypermedia cases, and this study attempted to address the gap in the literature related to different social contexts, individuals and small groups, from the constructivist perspective. The assumptions of symbolic interactionism guided data collection from think-alouds and interviews. These multiple sources of data were used to understand the participants' construction of knowledge; data were analyzed and interpreted by a process of analytic induction. The major assertion was that the preservice teachers perceived the hypermedia case to be like a tool to link theory and practice of teaching. Three sub-assertions, and several supporting categories, also emerged from the data. These findings indicated that group learning experiences with the hypermedia case were more valuable than those of individuals. In general, preservice teachers benefited from learning how to teach with the hypermedia case in both settings. However, the individuals were not as satisfied as those in small groups, and the members of small groups interacted more actively with the hypermedia case as well as with the peers. The results of this study suggest that effective use of hypermedia cases takes place in a community of learners where the learners share the context and can draw upon the resources afforded by the

  4. Open-Source Medical Devices (OSMD) Design of a Small Animal Radiotherapy System

    Science.gov (United States)

    Prajapati, S.; Mackie, T. R.; Jeraj, R.

    2014-03-01

    Open-Source Medical Devices (OSMD) was initiated with the goal of facilitating medical research by developing medical technologies including both hardware and software on an open-source platform. Our first project was to develop an integrated imaging and radiotherapy device for small animals that includes computed tomography (CT), positron emission tomography (PET) and radiation therapy (RT) modalities for which technical specifications were defined in the first OSMD conference held in Madison, Wisconsin, USA in December 2011. This paper specifically focuses on the development of a small animal RT (micro-RT) system by designing a binary micro multileaf collimator (bmMLC) and a small animal treatment planning system (SATPS) to enable intensity modulated RT (IMRT). Both hardware and software projects are currently under development and their current progresses are described. After the development, both bmMLC and TPS will be validated and commissioned for a micro-RT system. Both hardware design and software development will be open-sourced after completion.

  5. The good and bad of group conformity: a call for a new programme of research in medical education.

    Science.gov (United States)

    Beran, Tanya N; Kaba, Alyshah; Caird, Jeff; McLaughlin, Kevin

    2014-09-01

    Given that a significant portion of medical education occurs in various social settings (small groups, large classes, clinical environments), it is critical to examine how group members interact. One type of influence on these interactions is conformity, whereby an individual changes his or her own behaviour to match incorrect responses of others in a group. Conformity to peer pressure has been replicated in experimental research conducted in many countries over the last 60 years. There is newly emerging empirical evidence of this effect in medical education, suggesting that subtle motivations and pressures within a group may prevent students from challenging or questioning information that seems incorrect. This narrative review aims to present an overview of theory and findings in research into conformity in the fields of social psychology, business, sociology and aviation theory to demonstrate its direct relevance to medical education and the health professions. We searched online databases (MEDLINE, PubMed, PsycINFO and ProQuest) from the University of Calgary catalogue. We also searched citations in articles reviewed and references provided by colleagues. We limited our narrative review to publications released between 1950 and 2012. Group conformity behaviour may be one of a number of communication challenges associated with interprofessional care, and may represent a factor contributing to the burden of adverse events. This paper calls for a new programme of research into conformity in medical education that provides systematic empirical evidence of its relevance and applications in education, health care and practice. This review reveals decades of anecdotal and empirical evidence that conformity is a pervasive phenomenon across disciplines. Further research is needed to elucidate which situations pose the greatest risk for the occurrence of conformity, how to manage it in practice and its implications for patient safety. © 2014 John Wiley & Sons Ltd.

  6. Literacy and Technology: Integrating Technology with Small Group, Peer-led Discussions of Literature

    Directory of Open Access Journals (Sweden)

    Genya Coffey

    2012-03-01

    Full Text Available This review examines research of computer-mediated small group discussion of literature. The goal of this review is to explore several instructional formats for integrating print-based and new literacies skills. First, the theoretical foundations for the shift from teacher-led to student led discussion are outlined. Research exploring ways in which technology has been infused into several common elements of literature discussion groups are presented next. Benefits and challenges of such integration are highlighted and suggestions for future research are presented.

  7. The Lp Spectrum of Locally Symmetric Spaces with Small Fundamental Group

    International Nuclear Information System (INIS)

    Weber, Andreas

    2009-01-01

    We determine the L p spectrum of the Laplace-Beltrami operator on certain complete locally symmetric spaces M whose universal covering X is a symmetric space of non-compact type with rank one. More precisely, we show that the L p spectra of M and X coincide if the fundamental group of M is small and if the injectivity radius of M is bounded away from zero. In the L 2 case, the restriction on the injectivity radius is not needed

  8. Small Groups, Big Change: Preliminary Findings from the Sparks for Change Institute

    Science.gov (United States)

    Kirsch, R.; Batchelor, R. L.; Habtes, S. Y.; King, B.; Crockett, J.

    2017-12-01

    The geoscience professoriate continues to under represent women and minorities, yet the value of diversity, both for science as well as recruiting and retaining diverse students, is well known. While there are growing numbers of early career tenure-track minority faculty, low retention rates pose a challenge for sustained diversity in the professoriate. Part of this challenge is the lack of institutional support and recognition in tenure and promotion pathways for faculty who undertake broadening participation efforts. Sparks for Change is a NSF Geoscience Opportunities for Leadership in Diversity (GOLD)-funded project that aims to change departmental culture to better value and reward inclusion and broadening participation efforts. By encouraging, recognizing, and rewarding diversity, equity, and inclusion (DEI) efforts at the department level, we aim to support and retain underrepresented minority (URM) faculty, who often disproportionately undertake these efforts, and to build more inclusive environments for faculty, staff and students alike. Sparks for Change utilizes a small group theory of change, arguing that the effort of a small group of committed individuals inside the organization is the best way to overcome the institutional inertia of academic departments that makes them resistant to change. For this effort, we propose that the ideal composition of these small groups is a junior faculty URM who is interested in DEI in the geosciences, a senior member of that same department who can lend weight to efforts and is positioned to help enact department policy, and an external broadening participation expert who can share best practices and provide accountability for the group. Eleven of these small groups, representing a range of institutions, will be brought together at the Sparks for Change Institute in Boulder, CO, in September. There they will receive leadership training on adaptive, transformative, and solidarity practices, share DEI experiences and

  9. Evaluation of an Ongoing Diabetes Group Medical Visit in a Family Medicine Practice.

    Science.gov (United States)

    Cunningham, Amy T; Delgado, David J; Jackson, Joseph D; Crawford, Albert G; Jabbour, Serge; Lieberthal, Robert D; Diaz, Victor; LaNoue, Marianna

    2018-01-01

    Group medical visits (GMVs), which combine 1-on-1 clinical consultations and group self-management education, have emerged as a promising vehicle for supporting type 2 diabetes management in primary care. However, few evaluations exist of ongoing diabetes GMVs embedded in medical practices. This study used a quasi-experimental design to evaluate diabetes GMV at a large family medicine practice. We examined program attendance and attrition, used propensity score matching to create a matched comparison group, and compared participants and the matched group on clinical, process of care, and utilization outcomes. GMV participants (n = 230) attended an average of 1 session. Participants did not differ significantly from the matched comparison group (n = 230) on clinical, process of care or utilization outcomes. The diabetes GMV was not associated with improvements in outcomes. Further studies should examine diabetes GMV implementation challenges to enhance their effectiveness in everyday practice. © Copyright 2018 by the American Board of Family Medicine.

  10. Small functional groups for controlled differentiation of hydrogel-encapsulated human mesenchymal stem cells

    Science.gov (United States)

    Benoit, Danielle S. W.; Schwartz, Michael P.; Durney, Andrew R.; Anseth, Kristi S.

    2008-10-01

    Cell-matrix interactions have critical roles in regeneration, development and disease. The work presented here demonstrates that encapsulated human mesenchymal stem cells (hMSCs) can be induced to differentiate down osteogenic and adipogenic pathways by controlling their three-dimensional environment using tethered small-molecule chemical functional groups. Hydrogels were formed using sufficiently low concentrations of tether molecules to maintain constant physical characteristics, encapsulation of hMSCs in three dimensions prevented changes in cell morphology, and hMSCs were shown to differentiate in normal growth media, indicating that the small-molecule functional groups induced differentiation. To our knowledge, this is the first example where synthetic matrices are shown to control induction of multiple hMSC lineages purely through interactions with small-molecule chemical functional groups tethered to the hydrogel material. Strategies using simple chemistry to control complex biological processes would be particularly powerful as they could make production of therapeutic materials simpler, cheaper and more easily controlled.

  11. Patterns of Relating Between Physicians and Medical Assistants in Small Family Medicine Offices

    Science.gov (United States)

    Elder, Nancy C.; Jacobson, C. Jeffrey; Bolon, Shannon K.; Fixler, Joseph; Pallerla, Harini; Busick, Christina; Gerrety, Erica; Kinney, Dee; Regan, Saundra; Pugnale, Michael

    2014-01-01

    PURPOSE The clinician-colleague relationship is a cornerstone of relationship-centered care (RCC); in small family medicine offices, the clinician–medical assistant (MA) relationship is especially important. We sought to better understand the relationship between MA roles and the clinician-MA relationship within the RCC framework. METHODS We conducted an ethnographic study of 5 small family medicine offices (having informed by clinicians’ roles in hiring and managing MAs and the social familiarity of MAs and clinicians. Within the RCC framework, these findings can be seen as previously undefined constraints and freedoms in what is known as the Complex Responsive Process of Relating between clinicians and MAs. CONCLUSIONS Improved understanding of clinician-MA relationships will allow a better appreciation of how clinicians and MAs function in family medicine teams. Our findings may assist small offices undergoing practice transformation and guide future research to improve the education, training, and use of MAs in the family medicine setting. PMID:24615311

  12. Performance Anxiety at English PBL Groups Among Taiwanese Medical Students: A Preliminary Study

    Directory of Open Access Journals (Sweden)

    Cheng-Sheng Chen

    2008-03-01

    Full Text Available Students' performance anxiety can impact negatively on the effectiveness of medical education reform, including performance in problem-based learning (PBL and in using English in discussion. This study aimed to investigate the nature of performance anxiety among Taiwanese medical students in an English-language PBL group. Eighteen Taiwanese, one American and four Asian medical students who were attending an international PBL workshop were enrolled. A questionnaire seeking demographic data and experience in use of PBL and eight questions evaluating performance anxiety were administered. The performance anxiety of Taiwanese medical students was compared to that of the Asians and the one American. Frequencies of each performance anxiety were calculated. The results suggested that the Taiwanese students showed more anxiety than the one student from the United States, but less than other Asian students. The acts of giving a report, being the center of attention, and talking in the PBL group were the most common situations related to anxiety in PBL groups. Using English and working in a new PBL environment are possible sources of anxiety. The presence of anxiety among the Taiwanese medical students in English PBL groups implies the necessity for developing an effective strategy to deal with students' performance anxiety.

  13. How do small groups make decisions? : A theoretical framework to inform the implementation and study of clinical competency committees.

    Science.gov (United States)

    Chahine, Saad; Cristancho, Sayra; Padgett, Jessica; Lingard, Lorelei

    2017-06-01

    In the competency-based medical education (CBME) approach, clinical competency committees are responsible for making decisions about trainees' competence. However, we currently lack a theoretical model for group decision-making to inform this emerging assessment phenomenon. This paper proposes an organizing framework to study and guide the decision-making processes of clinical competency committees.This is an explanatory, non-exhaustive review, tailored to identify relevant theoretical and evidence-based papers related to small group decision-making. The search was conducted using Google Scholar, Web of Science, MEDLINE, ERIC, and PsycINFO for relevant literature. Using a thematic analysis, two researchers (SC & JP) met four times between April-June 2016 to consolidate the literature included in this review.Three theoretical orientations towards group decision-making emerged from the review: schema, constructivist, and social influence. Schema orientations focus on how groups use algorithms for decision-making. Constructivist orientations focus on how groups construct their shared understanding. Social influence orientations focus on how individual members influence the group's perspective on a decision. Moderators of decision-making relevant to all orientations include: guidelines, stressors, authority, and leadership.Clinical competency committees are the mechanisms by which groups of clinicians will be in charge of interpreting multiple assessment data points and coming to a shared decision about trainee competence. The way in which these committees make decisions can have huge implications for trainee progression and, ultimately, patient care. Therefore, there is a pressing need to build the science of how such group decision-making works in practice. This synthesis suggests a preliminary organizing framework that can be used in the implementation and study of clinical competency committees.

  14. Perceptions of problem-based learning (PBL) group effectiveness in a socially-culturally diverse medical student population.

    Science.gov (United States)

    Singaram, V S; Dolmans, D H J M; Lachman, N; van der Vleuten, C P M

    2008-07-01

    A key aspect of the success of a PBL curriculum is the effective implementation of its small group tutorials. Diversity among students participating in tutorials may affect the effectiveness of the tutorials and may require different implementation strategies. To determine how students from diverse backgrounds perceive the effectiveness of the processes and content of the PBL tutorials. This study also aims to explore the relationship between students' perceptions of their PBL tutorials and their gender, age, language, prior educational training, and secondary schooling. Data were survey results from 244 first-year student-respondents at the Nelson Mandela School of Medicine at the University of KwaZulu-Natal in South Africa. Exploratory factor analysis was conducted to verify scale constructs in the questionnaire. Relationships between independent and dependent variables were investigated in an analysis of variance. The average scores for the items measured varied between 3.3 and 3.8 (scale value 1 indicated negative regard and 5 indicated positive regard). Among process measures, approximately two-thirds of students felt that learning in a group was neither frustrating nor stressful and that they enjoyed learning how to work with students from different social and cultural backgrounds. Among content measures, 80% of the students felt that they learned to work successfully with students from different social and cultural groups and 77% felt that they benefited from the input of other group members. Mean ratings on these measures did not vary with students' gender, age, first language, prior educational training, and the types of schools they had previously attended. Medical students of the University of KwaZulu-Natal, regardless of their backgrounds, generally have positive perceptions of small group learning. These findings support previous studies in highlighting the role that small group tutorials can play in overcoming cultural barriers and promoting unity and

  15. What Factors Influence Well-being of Students on Performing Small Group Discussion?

    Science.gov (United States)

    Wulanyani, N. M. S.; Vembriati, N.

    2018-01-01

    Generally, Faculty of Medicine of Udayana University applied Small Group Discussion (SGD) in its learning process. If group problem solving succeeds, each individual of the group will individually succeed. However, the success is also determined by each individual’s level of psychological well-being. When the students are in the high level of wellbeing, they will feel comfortable in small group discussion, and teamwork will be effective. Therefore, it is needed to conduct a research which investigates how psychological factors, such as traits, needs, cognitive, and social intelligence, influence students’ wellbeing in performing SGD. This research is also initiated by several cases of students who prefer individual learning and take SGD merely to fulfill attendance requirement. If the students have good wellbeing, they will take the SGD process optimally. The subject of this research was 100 students of Faculty of Medicine of Udayana University. This survey research used psychological test assessment, Psychological well-being scale, and Social Intelligence scale to gain data analyzed quantitatively. The results showed that all aspects of traits together with aspects ‘need for rules and supervision’ affect social intelligence. Furthermore, social intelligence factor with cognitive factors influence wellbeing of the students in the process of SGD.

  16. Analysis of multidrug resistant group B streptococci with reduced penicillin susceptibility forming small, less hemolytic colonies.

    Directory of Open Access Journals (Sweden)

    Hirotsugu Banno

    Full Text Available Group B streptococci (GBS; Streptococcus agalactiae are the leading cause of neonatal invasive diseases and are also important pathogens for elderly adults. Until now, nearly all GBS with reduced penicillin susceptibility (PRGBS have shown β-hemolytic activity and grow on sheep blood agar. However, we have previously reported three PRGBS clinical isolates harboring a CylK deletion that form small less hemolytic colonies. In this study, we examined the causes of small, less hemolytic colony formation in these clinical isolates. Isogenic strains were sequenced to identify the mutation related to a small colony size. We identified a 276_277insG nucleic acid insertion in the thiamin pyrophosphokinase (tpk gene, resulting in premature termination at amino acid 103 in TPK, as a candidate mutation responsible for small colony formation. The recombinant strain Δtpk, which harbored the 276_277insG insertion in the tpk gene, showed small colony formation. The recombinant strain ΔcylK, which harbored the G379T substitution in cylK, showed a reduction in hemolytic activity. The phenotypes of both recombinant strains were complemented by the expression of intact TPK or CylK, respectively. Moreover, the use of Rapid ID 32 API and VITEK MS to identify strains as GBS was evaluated clinical isolates and recombinant strains. VITEK MS, but not Rapid ID 32 API, was able to accurately identify the strains as GBS. In conclusion, we determined that mutations in tpk and cylK caused small colonies and reduced hemolytic activity, respectively, and characterized the clinical isolates in detail.

  17. Modifying the ECC-based grouping-proof RFID system to increase inpatient medication safety.

    Science.gov (United States)

    Ko, Wen-Tsai; Chiou, Shin-Yan; Lu, Erl-Huei; Chang, Henry Ker-Chang

    2014-09-01

    RFID technology is increasingly used in applications that require tracking, identification, and authentication. It attaches RFID-readable tags to objects for identification and execution of specific RFID-enabled applications. Recently, research has focused on the use of grouping-proofs for preserving privacy in RFID applications, wherein a proof of two or more tags must be simultaneously scanned. In 2010, a privacy-preserving grouping proof protocol for RFID based on ECC in public-key cryptosystem was proposed but was shown to be vulnerable to tracking attacks. A proposed enhancement protocol was also shown to have defects which prevented proper execution. In 2012, Lin et al. proposed a more efficient RFID ECC-based grouping proof protocol to promote inpatient medication safety. However, we found this protocol is also vulnerable to tracking and impersonation attacks. We then propose a secure privacy-preserving RFID grouping proof protocol for inpatient medication safety and demonstrate its resistance to such attacks.

  18. Evolution of project-based learning in small groups in environmental engineering courses

    Directory of Open Access Journals (Sweden)

    Jesús M. Requies

    2018-03-01

    Full Text Available This work presents the assessment of the development and evolution of an active methodology (Project-Based Learning –PBL- implemented on the course “Unit Operations in Environmental Engineering”, within the bachelor’s degree in Environmental Engineering, with the purpose of decreasing the dropout rate in this course. After the initial design and implementation of this methodology during the first academic year (12/13, different modifications were adopted in the following ones (13-14, 14-15 & 15-16 in order to optimize the student’s and professor’s work load as well as correct some malfunctions observed in the initial design of the PBL. This active methodology seeks to make students the main architects of their own learning processes. Accordingly, they have to identify their learning needs, which is a highly motivating approach both for their curricular development and for attaining the required learning outcomes in this field of knowledge. The results obtained show that working in small teams (cooperative work enhances each group member’s self–learning capabilities. Moreover, academic marks improve when compared to traditional learning methodologies. Nevertheless, the implementation of more active methodologies, such as project-based learning, in small groups has certain specific characteristics. In this case it has been implemented simultaneously in two different groups of 10 students each one. Such small groups are more heterogeneoussince the presence of two highly motivated students or not can vary or affect the whole group’s attitude and academic results.

  19. The method for detecting small lesions in medical image based on sliding window

    Science.gov (United States)

    Han, Guilai; Jiao, Yuan

    2016-10-01

    At present, the research on computer-aided diagnosis includes the sample image segmentation, extracting visual features, generating the classification model by learning, and according to the model generated to classify and judge the inspected images. However, this method has a large scale of calculation and speed is slow. And because medical images are usually low contrast, when the traditional image segmentation method is applied to the medical image, there is a complete failure. As soon as possible to find the region of interest, improve detection speed, this topic attempts to introduce the current popular visual attention model into small lesions detection. However, Itti model is mainly for natural images. But the effect is not ideal when it is used to medical images which usually are gray images. Especially in the early stages of some cancers, the focus of a disease in the whole image is not the most significant region and sometimes is very difficult to be found. But these lesions are prominent in the local areas. This paper proposes a visual attention mechanism based on sliding window, and use sliding window to calculate the significance of a local area. Combined with the characteristics of the lesion, select the features of gray, entropy, corner and edge to generate a saliency map. Then the significant region is segmented and distinguished. This method reduces the difficulty of image segmentation, and improves the detection accuracy of small lesions, and it has great significance to early discovery, early diagnosis and treatment of cancers.

  20. Memory Transmission in Small Groups and Large Networks: An Agent-Based Model.

    Science.gov (United States)

    Luhmann, Christian C; Rajaram, Suparna

    2015-12-01

    The spread of social influence in large social networks has long been an interest of social scientists. In the domain of memory, collaborative memory experiments have illuminated cognitive mechanisms that allow information to be transmitted between interacting individuals, but these experiments have focused on small-scale social contexts. In the current study, we took a computational approach, circumventing the practical constraints of laboratory paradigms and providing novel results at scales unreachable by laboratory methodologies. Our model embodied theoretical knowledge derived from small-group experiments and replicated foundational results regarding collaborative inhibition and memory convergence in small groups. Ultimately, we investigated large-scale, realistic social networks and found that agents are influenced by the agents with which they interact, but we also found that agents are influenced by nonneighbors (i.e., the neighbors of their neighbors). The similarity between these results and the reports of behavioral transmission in large networks offers a major theoretical insight by linking behavioral transmission to the spread of information. © The Author(s) 2015.

  1. Recommendations on vaccination for Asian small animal practitioners: a report of the WSAVA Vaccination Guidelines Group.

    Science.gov (United States)

    Day, M J; Karkare, U; Schultz, R D; Squires, R; Tsujimoto, H

    2015-02-01

    In 2012 and 2013, the World Small Animal Veterinary Association (WSAVA) Vaccination Guidelines Group (VGG) undertook fact-finding visits to several Asian countries, with a view to developing advice for small companion animal practitioners in Asia related to the administration of vaccines to dogs and cats. The VGG met with numerous first opinion practitioners, small animal association leaders, academic veterinarians, government regulators and industry representatives and gathered further information from a survey of almost 700 veterinarians in India, China, Japan and Thailand. Although there were substantial differences in the nature and magnitude of the challenges faced by veterinarians in each country, and also differences in the resources available to meet those challenges, overall, the VGG identified insufficient undergraduate and postgraduate training in small companion animal microbiology, immunology and vaccinology. In most of the countries, there has been little academic research into small animal infectious diseases. This, coupled with insufficient laboratory diagnostic support, has limited the growth of knowledge concerning the prevalence and circulating strains of key infectious agents in most of the countries visited. Asian practitioners continue to recognise clinical infections that are now considered uncommon or rare in western countries. In particular, canine rabies virus infection poses a continuing threat to animal and human health in this region. Both nationally manufactured and international dog and cat vaccines are variably available in the Asian countries, but the product ranges are small and dominated by multi-component vaccines with a licensed duration of immunity (DOI) of only 1 year, or no description of DOI. Asian practitioners are largely unaware of current global trends in small animal vaccinology or of the WSAVA vaccination guidelines. Consequently, most practitioners continue to deliver annual revaccination with both core and non

  2. Facebook Groups as a Powerful and Dynamic Tool in Medical Education: Mixed-Method Study

    Science.gov (United States)

    Schmidbauer, Moritz; Gradel, Maximilian; Ferch, Sabine; Antón, Sofía; Hoppe, Boj; Pander, Tanja; von der Borch, Philip; Pinilla, Severin; Fischer, Martin; Dimitriadis, Konstantinos

    2017-01-01

    Background Social networking sites, in particular Facebook, are not only predominant in students’ social life but are to varying degrees interwoven with the medical curriculum. Particularly, Facebook groups have been identified for their potential in higher education. However, there is a paucity of data on user types, content, and dynamics of study-related Facebook groups. Objective The aim of this study was to identify the role of study-related Facebook group use, characterize medical students that use or avoid using Facebook groups (demographics, participation pattern, and motivation), and analyze student posting behavior, covered topics, dynamics, and limitations in Facebook groups with regards to educational usage. Methods Using a multi-method approach (interviews, focus groups, and qualitative and quantitative analysis of Facebook posts), we analyzed two representative Facebook groups of medical preclinical semesters at Ludwig-Maximilians-University (LMU) Munich. Facebook primary posts and replies over one semester were extracted and evaluated by using thematic content analysis. We developed and applied a coding scheme for studying the frequency and distribution of these posts. Additionally, we interviewed students with various degrees of involvement in the groups, as well as “new minorities,” students not registered on Facebook. Results Facebook groups seem to have evolved as the main tool for medical students at LMU to complement the curriculum and to discuss study-related content. These Facebook groups are self-organizing and quickly adapt to organizational or subject-related challenges posed by the curriculum. A wide range of topics is covered, with a dominance of organization-related posts (58.35% [6916/11,853] of overall posts). By measuring reply rates and comments per category, we were able to identify learning tips and strategies, material sharing, and course content discussions as the most relevant categories. Rates of adequate replies in these

  3. Cohesion assessment of student groups from the faculty of dentistry at Burdenko Voronezh State Medical University

    Directory of Open Access Journals (Sweden)

    Pashkov A. N.

    2017-10-01

    Full Text Available the article presents data on the study of the cohesion of 115 students from the faculty of dentistry at Burdenko Voronezh State Medical University. The study revealed that students have high and medium favorable psychological climate. 99 of them have the average level of group cohesion, and 16 revealed a low level of this indicator. To improve the educational process and interpersonal relations, these results must be taken into account when forming groups.

  4. Writing for publication in medical education: the benefits of a faculty development workshop and peer writing group.

    Science.gov (United States)

    Steinert, Yvonne; McLeod, Peter J; Liben, Stephen; Snell, Linda

    2008-01-01

    Although educational innovations in medical education are increasing in number, many educators do not submit their ideas for publication. The goal of this initiative was to assist faculty members write about their educational innovations. Twenty-four faculty members participated in this intervention, which consisted of a half-day workshop, three peer writing groups, and independent study. We assessed the impact of this intervention through post-workshop evaluations, a one-year follow-up questionnaire, tracking of manuscript submissions, and an analysis of curriculum vitae. The workshop evaluations and one-year follow-up demonstrated that participants valued the workshop small groups, self-instructional workbook, and peer support and feedback provided by the peer writing groups. One year later, nine participants submitted a total of 14 manuscripts, 11 of which were accepted for publication. In addition, 10 participants presented a total of 38 abstracts at educational meetings. Five years later, we reviewed the curriculum vitae of all participants who had published or presented their educational innovation. Although the total number of publications remained the same, the number of educationally-related publications and presentations at scientific meetings increased considerably. A faculty development workshop and peer writing group can facilitate writing productivity and presentations of scholarly work in medical education.

  5. Comparison of micelle structure of glycolipids with different head groups by small angle neutron scattering

    International Nuclear Information System (INIS)

    He, Lizhong; Middelberg, Anton; Hartmann, Thorsten; Niemeyer, Bernd; Garamus, V.M.; Willumeit, Regine

    2005-01-01

    Full text: Glycolipids such as n-alkyl- beta-D-glucopyranoside and n-alkyl- beta-D-maltopyranoside can self-assemble into different structures depending on solution conditions. Their amphiphilic properties enable them to serve as biosurfactants in biology and biotechnology, especially for solubilizing membrane proteins. The physicochemical properties of glycolipids have attracted attentions from several research groups, aiming to better understand their application in biological and environmental processes. For example, small angle neutron and X-ray scattering have been used to study micelle structures formed by glycolipids. Our previous work has shown that n-octyl-beta- D-glucopyranoside and n-octyl- beta-D-maltopyranoside form micelles with different structure, suggesting an important role of the sugar head group in micelle formation. In the present work, we further compare micelle structures of n-octyl- beta-Dglucopyranoside and n-octyl- beta-D-galactopyranoside. These two glycolipids have the same hydrophobic tail and their head sugar groups differ only in the conformation with one hydroxyl group pointing to different direction. Our SANS data together with phase behaviours reported by other group have suggested that a slight alteration of head group conformation can significantly affect self-assembly of glycolipids. (authors)

  6. Effects of communication strategy training on EFL students’ performance in small-group discussions

    Directory of Open Access Journals (Sweden)

    Stuart Benson

    2013-10-01

    Full Text Available In recent years, a number of studies have been conducted with regard to communication strategy training and performance on communicative tasks (Lam, 2009; Nakatani, 2010; Naughton, 2006. This study aims to add to the literature by examining how two strategies, clarifying/confirming and extending a conversation, and two methods of teaching the strategies, affected the interactional sequences and overall group discussion performance of EFL students at a university in Japan. Pre and posttreatment small-group discussions were recorded for assessment, and a stimulated recall interview was administered to determine the participants’ perceptions of their learning and language use. Posttest results reveal that the experimental groups that were taught predetermined phrases aimed at clarifying/confirming and extending a conversation employed such phrases more frequently than the control group. However, this employment of phrases did not lead to higher gains in group discussion skills as the control group enjoyed the largest gains from pre to posttest. The researchers consider the findings in light of previous research, and conclude with recommendations for future research on the topic with special regard to research design.

  7. Testing an empirically derived mental health training model featuring small groups, distributed practice and patient discussion.

    Science.gov (United States)

    Murrihy, Rachael C; Byrne, Mitchell K; Gonsalvez, Craig J

    2009-02-01

    Internationally, family doctors seeking to enhance their skills in evidence-based mental health treatment are attending brief training workshops, despite clear evidence in the literature that short-term, massed formats are not likely to improve skills in this complex area. Reviews of the educational literature suggest that an optimal model of training would incorporate distributed practice techniques; repeated practice over a lengthy time period, small-group interactive learning, mentoring relationships, skills-based training and an ongoing discussion of actual patients. This study investigates the potential role of group-based training incorporating multiple aspects of good pedagogy for training doctors in basic competencies in brief cognitive behaviour therapy (BCBT). Six groups of family doctors (n = 32) completed eight 2-hour sessions of BCBT group training over a 6-month period. A baseline control design was utilised with pre- and post-training measures of doctors' BCBT skills, knowledge and engagement in BCBT treatment. Family doctors' knowledge, skills in and actual use of BCBT with patients improved significantly over the course of training compared with the control period. This research demonstrates preliminary support for the efficacy of an empirically derived group training model for family doctors. Brief CBT group-based training could prove to be an effective and viable model for future doctor training.

  8. Conceptual foundations of classes with the disciples of special medical group in secondary schools

    Directory of Open Access Journals (Sweden)

    Y. V. Vaskov

    2014-09-01

    Full Text Available Purpose: study and scientific rationale for new approaches to the organization of educational work with students of special medical group in secondary schools. Material : analyzed 15 scientific sources regarding the approaches of different authors to develop educational programs for students of special medical group. Results : focuses on the outstanding issues in a substantive, logistical and human aspects. Found that the selection of the content of educational material for special medical groups is an empirical question. Selection is carried out by copying the existing curriculum of physical culture for healthy children with an indication of the load reduction and exemption of complex elements. Established a complete absence of evaluation of educational achievements of pupils. Based on modern approaches to teaching students based on biomedical and didactic aspects: Leading defined function of each stage of training, fleshed main goals and objectives of the educational process, substantiated various kinds of sports activity, taking into account the diagnosis of diseases and the needs of students of different ages and gender. Conclusions : the main controversy in the decision of the designated problem. Substantiated leading features of each stage of training in special medical groups. A system of assessment of students' achievements.

  9. Estimating morbidity rates from electronic medical records in general practice: evaluation of a grouping system.

    NARCIS (Netherlands)

    Biermans, M.C.J.; Verheij, R.A.; Bakker, D.H. de; Zielhuis, G.A.; Vries Robbé, P.F. de

    2008-01-01

    Objectives: In this study, we evaluated the internal validity of EPICON, an application for grouping ICPCcoded diagnoses from electronic medical records into episodes of care. These episodes are used to estimate morbidity rates in general practice. Methods: Morbidity rates based on EPICON were

  10. [The Positionality of Caring Action: Small Group Dialogue in a Course on Nursing Ethics].

    Science.gov (United States)

    Chiang, Hsien-Hsien

    2016-12-01

    The content of nursing-ethics education has typically focused on the external standards of caring behavior and neglected the relationship between the ethical attitudes and internal experiences of caregivers. To explore the embodied experience in order to define the positionality of caring action, which is necessary to enrich the content of nursing ethics through small-group-learning-based dialogue. The researcher, as a participant observer, teaches a course on nursing ethics. Reflective analysis was used to analyze the data from the process of small group learning, a reflective group of faculty members, and 30 reflective journals submitted by 10 students. The results identified three items that were related to the positionality of caring action: the attitudes of belief, including the choice to belief and deep understanding; articulating the value system, including exploring affectivity and positionality; and cultivating the self through self-dialogues and dialogues with others. The attitudes of belief promote trust in interpersonal relationships. Articulating the value system deepens the meaning of caring. Cultivating the self may facilitate the ethical self.

  11. Benefits of Group Foraging Depend on Prey Type in a Small Marine Predator, the Little Penguin.

    Science.gov (United States)

    Sutton, Grace J; Hoskins, Andrew J; Arnould, John P Y

    2015-01-01

    Group foraging provides predators with advantages in over-powering prey larger than themselves or in aggregating small prey for efficient exploitation. For group-living predatory species, cooperative hunting strategies provide inclusive fitness benefits. However, for colonial-breeding predators, the benefit pay-offs of group foraging are less clear due to the potential for intra-specific competition. We used animal-borne cameras to determine the prey types, hunting strategies, and success of little penguins (Eudyptula minor), a small, colonial breeding air-breathing marine predator that has recently been shown to display extensive at-sea foraging associations with conspecifics. Regardless of prey type, little penguins had a higher probability of associating with conspecifics when hunting prey that were aggregated than when prey were solitary. In addition, success was greater when individuals hunted schooling rather than solitary prey. Surprisingly, however, success on schooling prey was similar or greater when individuals hunted on their own than when with conspecifics. These findings suggest individuals may be trading-off the energetic gains of solitary hunting for an increased probability of detecting prey within a spatially and temporally variable prey field by associating with conspecifics.

  12. Handling limited datasets with neural networks in medical applications: A small-data approach.

    Science.gov (United States)

    Shaikhina, Torgyn; Khovanova, Natalia A

    2017-01-01

    Single-centre studies in medical domain are often characterised by limited samples due to the complexity and high costs of patient data collection. Machine learning methods for regression modelling of small datasets (less than 10 observations per predictor variable) remain scarce. Our work bridges this gap by developing a novel framework for application of artificial neural networks (NNs) for regression tasks involving small medical datasets. In order to address the sporadic fluctuations and validation issues that appear in regression NNs trained on small datasets, the method of multiple runs and surrogate data analysis were proposed in this work. The approach was compared to the state-of-the-art ensemble NNs; the effect of dataset size on NN performance was also investigated. The proposed framework was applied for the prediction of compressive strength (CS) of femoral trabecular bone in patients suffering from severe osteoarthritis. The NN model was able to estimate the CS of osteoarthritic trabecular bone from its structural and biological properties with a standard error of 0.85MPa. When evaluated on independent test samples, the NN achieved accuracy of 98.3%, outperforming an ensemble NN model by 11%. We reproduce this result on CS data of another porous solid (concrete) and demonstrate that the proposed framework allows for an NN modelled with as few as 56 samples to generalise on 300 independent test samples with 86.5% accuracy, which is comparable to the performance of an NN developed with 18 times larger dataset (1030 samples). The significance of this work is two-fold: the practical application allows for non-destructive prediction of bone fracture risk, while the novel methodology extends beyond the task considered in this study and provides a general framework for application of regression NNs to medical problems characterised by limited dataset sizes. Copyright © 2017 The Authors. Published by Elsevier B.V. All rights reserved.

  13. Sharing a Personal Trainer: Personal and Social Benefits of Individualized, Small-Group Training.

    Science.gov (United States)

    Wayment, Heidi A; McDonald, Rachael L

    2017-11-01

    Wayment, HA and McDonald, RL. Sharing a personal trainer: personal and social benefits of individualized, small-group training. J Strength Cond Res 31(11): 3137-3145, 2017-We examined a novel personal fitness training program that combines personal training principles in a small-group training environment. In a typical training session, exercisers warm-up together but receive individualized training for 50 minutes with 1-5 other adults who range in age, exercise experience, and goals for participation. Study participants were 98 regularly exercising adult members of a fitness studio in the southwestern United States (64 women and 32 men), aged 19-78 years (mean, 46.52 years; SD = 14.15). Average membership time was 2 years (range, 1-75 months; mean, 23.54 months; SD = 20.10). In collaboration with the program directors, we developed a scale to assess satisfaction with key features of this unique training program. Participants completed an online survey in Fall 2015. Hypotheses were tested with a serial mediator model (model 6) using the SPSS PROCESS module. In support of the basic tenets of self-determination theory, satisfaction with small-group, individualized training supported basic psychological needs, which in turn were associated with greater autonomous exercise motivation and life satisfaction. Satisfaction with this unique training method was also associated with greater exercise self-efficacy. Autonomous exercise motivation was associated with both exercise self-efficacy and greater self-reported health and energy. Discussion focuses on why exercise programs that foster a sense of social belonging (in addition to motivation and efficacy) may be helpful for successful adherence to an exercise program.

  14. Replacing Lectures with Small Groups: The Impact of Flipping the Residency Conference Day

    Science.gov (United States)

    King, Andrew M.; Mayer, Chad; Barrie, Michael; Greenberger, Sarah; Way, David P.

    2018-01-01

    The flipped classroom, an educational alternative to the traditional lecture, has been widely adopted by educators at all levels of education and across many disciplines. In the flipped classroom, learners prepare in advance of the face-to-face meeting by learning content material on their own. Classroom time is reserved for application of the learned content to solving problems or discussing cases. Over the past year, we replaced most residency program lectures with small-group discussions using the flipped-classroom model, case-based learning, simulation and procedure labs. In the new model, residents prepared for conference by reviewing a patient case and studying suggested learning materials. Conference day was set aside for facilitated small-group discussions about the case. This is a cross-cohort study of emergency medicine residents who experienced the lecture-based curriculum to residents in the new flipped-classroom curriculum using paired comparisons (independent t-tests) on in-training exam scores while controlling for program year level. We also compared results of the evaluation of various program components. We observed no differences between cohorts on in-training examination scores. Small-group methods were rated the same across program years. Two program components in the new curriculum, an updated format of both adult and pediatric case conferences, were rated significantly higher on program quality. In preparation for didactics, residents in the new curriculum report spending more time on average with outside learning materials, including almost twice as much time reviewing textbooks. Residents found the new format of the case conferences to be of higher quality because of the inclusion of rapid-fire case discussions with targeted learning points. PMID:29383050

  15. Direct production of 99mTc using a small medical cyclotron

    Energy Technology Data Exchange (ETDEWEB)

    Lapi, Suzanne [Washington Univ., St. Louis, MO (United States)

    2017-10-03

    This project describes an investigation towards the production of 99mTc with a small medical cyclotron. This endeavor addresses the current urgent problem of availability of 99mTc due to the ongoing production reactor failures and the upcoming Canadian reactor shut down. Currently, 99mTc is produced via nuclear fission using highly enriched uranium which is a concern due to nuclear proliferation risks. In addition to this, the United States is dependent solely on currently unreliable foreign sources of this important medical isotope. Clearly, a need exists to probe alternative production routes of 99mTc. In the first year, this project measured cross-sections and production yields of potential pathways to 99mTc and associated radionuclidic impurities produced via these pathways using a small 15 MeV medical cyclotron. During the second and third years target systems for the production of 99mTc via the most promising reaction routes were developed and separation techniques for the isolation of 99mTc from the irradiated target material will be investigated. Systems for the recycling of the enriched target isotopes as well as automated target processing systems were examined in years four and five. This project has the potential to alleviate some of the current crisis in the medical community by developing a technique to produce 99mTc on location at a university hospital. This technology will be applicable at many other sites in the United States as many other similar, low energy (<20 MeV) cyclotrons (currently used for a few hours per day for the production of [18F]fluorodeoxyglucose) are available for production of 99mTc though this method, thus leading to job creation and preservation.

  16. Assessment of a Group Activity Based Educational Method to Teach Research Methodology to Undergraduate Medical Students of a Rural Medical College in Gujarat, India.

    Science.gov (United States)

    Kumar, Dinesh; Singh, Uday Shankar; Solanki, Rajanikant

    2015-07-01

    Early undergraduate exposure to research helps in producing physicians who are better equipped to meet their professional needs especially the analytical skills. To assess the effectiveness and acceptability of small group method in teaching research methodology. Sixth semester medical undergraduates (III MBBS-part1) of a self-financed rural medical college. The workshop was of two full days duration consisting of daily two sessions by faculty for 30 minutes, followed by group activity of about four hours and presentation by students at the end of the day. A simple 8 steps approach was used. These steps are Identify a Problem, Refine the Problem, Determine a Solution, Frame the Question, Develop a Protocol, Take Action, Write the Report and Share your Experience. A Pre-test and post-test assessment was carried out using a questionnaire followed by anonymous feedback at the end of the workshop. The responses were evaluated by blinded evaluator. There were 95 (94.8%) valid responses out of the 99 students, who attended the workshop. The mean Pre-test and post-test scores were 4.21 and 10.37 respectively and the differences were found to be significant using Wilcoxon Sign Rank test (presearch methodology workshop can play a significant role in teaching research to undergraduate students in an interesting manner. However, the long term effect of such workshops needs to be evaluated.

  17. Treatment results of radiotherapy for medically inoperable stage I/II non-small cell lung cancer

    International Nuclear Information System (INIS)

    Zhang Li; Wang Lvhua; Zhang Hongxing; Chen Dongfu; Xiao Zefen; Wang Mei; Feng Qinfu; Liang Jun; Zhou Zongmei; Ou Guangfei; Lv Jima; Yin Weibo

    2008-01-01

    Objective: To retrospectively analyze treatment results of radiotherapy for medically inoperable stage I/II non-small cell lung cancer. Methods: Between Jan. 2000 and Dec. 2005, fifty-eight such patients were enrolled into the database analysis, including 37 with clinical stage I and 21 with stage II disease. Fifty patients received radiotherapy alone and eight with radiotherapy and chemotherapy. Forty- three patients were treated with 3-D conformal radiotherapy (3D-CRT) and 15 with conventional radiotherapy. Results: The 1-, 2- and 3-year overall survival rates were 85%, 54% and 30%, and the median survival time was 26.2 months for the whole group. The corresponding figures were 88%, 60%, 36% and 30.8 months for cancer-specific survival; 84%, 64%, 31% and 30.8 months for Stage I disease; 81%, 47%, 28% and 18.8 months for Stage II disease; 95%, 57%, 33% and 30.8 months for 3D-CRT group and 53%, 44%, 24% and 15.3 months for conventional radiotherapy group. By logrank test, tumor volume, pneumonitis of Grade II or higher and weight loss more than 5% showed statistically significant impact on overall survival. Tumor volume was the only independent prognostic factor in Cox multivariable regression. Pneumonitis and esophagitis of Grade II or higher were 16% and 2%, respectively. Age and lung function before treatment had a significant relationship with pneumonitis. Failure included the local recurrence (33%) and distant metastasis (21%). There was no difference between the treatment modalities and failure sites. Conclusions: For medically inoperable early stage non-small cell lung cancer patients, tumor volume is the most important prognostic factor for overall survival. The conformal radiotherapy marginally improves the survival. The age and pulmonary function are related to the incidence of treatment induced pneumonitis. (authors)

  18. Comparison of small-group training with self-directed internet-based training in inhaler techniques.

    Science.gov (United States)

    Toumas, Mariam; Basheti, Iman A; Bosnic-Anticevich, Sinthia Z

    2009-08-28

    To compare the effectiveness of small-group training in correct inhaler technique with self-directed Internet-based training. Pharmacy students were randomly allocated to 1 of 2 groups: small-group training (n = 123) or self-directed Internet-based training (n = 113). Prior to intervention delivery, all participants were given a placebo Turbuhaler and product information leaflet and received inhaler technique training based on their group. Technique was assessed following training and predictors of correct inhaler technique were examined. There was a significant improvement in the number of participants demonstrating correct technique in both groups (small group training, 12% to 63%; p training, 9% to 59%; p groups in the percent change (n = 234, p > 0.05). Increased student confidence following the intervention was a predictor for correct inhaler technique. Self-directed Internet-based training is as effective as small-group training in improving students' inhaler technique.

  19. A CORRELATION BETWEEN ABO BLOOD GROUPS AND BODY MASS INDEX AMONG MEDICAL STUDENTS

    Directory of Open Access Journals (Sweden)

    Sarbjit Singh

    2017-11-01

    Full Text Available BACKGROUND ABO blood groups are associated with some important chronic diseases, obesity being the major risk factor is rising rapidly globally. The present study seeks to determine if there is any association between ABO blood groups and body mass index. MATERIALS AND METHODS The present study involve 200 medical students, 102 boys and 98 girls in the age group of 18-23 years in the Government Medical College, Amritsar. Weight, height for BMI and blood groups were determined in order to find any association between ABO blood group and BMI. RESULTS Overweight and obesity was found more prevalent in boys than girls, 22.5% students were overweight and 15.5% were obese. The prevalence of overweight was (24.52% boys and 20.40% girls and prevalence of obesity was (25.49% boys and 5.10% girls. Blood group B was reported the most common blood groups (37.5% followed by blood group O (32.0%, while blood groups A and AB were found 19.5% and 11% of participants, respectively. The prevalence of overweight (BMI 25-29.9 among participants based on blood group O, A, AB and B was 29.69%, 25.64%, 18.18%, 16.00%, while obesity (BMI >30 among participants based on blood groups B, O, A and AB was 24.00%, 10.94%, 10.26% and 9.09%. CONCLUSION Prevalence of overweight and obesity was more in blood group O and B respectively and was more in males than females

  20. Is the modernisation of postgraduate medical training in the Netherlands successful? Views of the NVMO Special Interest Group on Postgraduate Medical Education

    NARCIS (Netherlands)

    Scheele, Fedde; van Luijk, Scheltus; Mulder, Hanneke; Baane, Coby; den Rooyen, Corry; de Hoog, Matthijs; Fokkema, Joanne; Heineman, Erik; Sluiter, Henk

    2014-01-01

    Worldwide, the modernisation of medical education is leading to the design and implementation of new postgraduate curricula. In this article, the Special Interest Group for postgraduate medical education of the Netherlands Association for Medical Education (NVMO) reports on the experiences in the

  1. A study of grouphate in a course on small group communication.

    Science.gov (United States)

    Myers, Scott A; Goodboy, Alan K

    2005-10-01

    This study explored the relationship between grouphate and cohesion, consensus, relational satisfaction, affective learning, and cognitive learning. Participants were 83 undergraduate students enrolled in an introductory course on small group communication. Participants completed the Grouphate scale, the Classroom Cohesion scale, the Consensus scale, the Relational Satisfaction scale, three subscales of the Instructional Affect Assessment Instrument, and the Cognitive Learning Loss measure. Mean grouphate significantly increased during the semester, and negative correlations were found between scores for grouphate and cohesion (-.50), consensus (-.45), relational satisfaction (-.58), attitude toward the behaviors recommended in the course (-.23), the likelihood of developing an appreciation for the course content (-.33), and cognitive learning (-.32). Results may imply that students' grouphate is not associated with prosocial outcomes of the group work in this course.

  2. How groups co-ordinate their concepts and terminology: implications for medical informatics.

    Science.gov (United States)

    Garrod, S

    1998-11-01

    Conceptual and terminological systems are established and maintained by the communities who use them. This paper reports experiments which investigate the role of communication and interaction in the process. The experiments show that isolated pairs of communicators and virtual communities of interacting pairs naturally converge on their own conceptual and terminological systems when confronted with a common task. The results also indicate that the system converged on is optimal for that particular group engaged in that particular task. These findings are discussed in relation to the increasing use of tightly coordinated medical teams and its implications for getting them to adopt standardized medical terminologies.

  3. A Comparison of Web-based and Small-Group Palliative and End-of-Life Care Curricula: A Quasi-Randomized Controlled Study at One Institution

    Science.gov (United States)

    Day, Frank C.; Srinivasan, Malathi; Der-Martirosian, Claudia; Griffin, Erin; Hoffman, Jerome R.; Wilkes, Michael S.

    2014-01-01

    Purpose Few studies have compared the effect of web-based eLearning versus small-group learning on medical student outcomes. Palliative and end-of-life (PEOL) education is ideal for this comparison, given uneven access to PEOL experts and content nationally. Method In 2010, the authors enrolled all third-year medical students at the University of California, Davis School of Medicine into a quasi-randomized controlled trial of web-based interactive education (eDoctoring) compared to small-group education (Doctoring) on PEOL clinical content over two months. All students participated in three 3-hour PEOL sessions with similar content. Outcomes included a 24-item PEOL-specific self-efficacy scale with three domains (diagnosis/treatment [Cronbach’s alpha = 0.92, CI: 0.91–0.93], communication/prognosis [alpha = 0.95; CI: 0.93–0.96], and social impact/self-care [alpha = 0.91; CI: 0.88–0.92]); eight knowledge items; ten curricular advantage/disadvantages, and curricular satisfaction (both students and faculty). Results Students were randomly assigned to web-based eDoctoring (n = 48) or small-group Doctoring (n = 71) curricula. Self-efficacy and knowledge improved equivalently between groups: e.g., prognosis self-efficacy, 19%; knowledge, 10–42%. Student and faculty ratings of the web-based eDoctoring curriculum and the small group Doctoring curriculum were equivalent for most goals, and overall satisfaction was equivalent for each, with a trend towards decreased eDoctoring student satisfaction. Conclusions Findings showed equivalent gains in self-efficacy and knowledge between students participating in a web-based PEOL curriculum, in comparison to students learning similar content in a small-group format. Web-based curricula can standardize content presentation when local teaching expertise is limited, but may lead to decreased user satisfaction. PMID:25539518

  4. Technical Note: Harmonizing met-ocean model data via standard web services within small research groups

    Science.gov (United States)

    Signell, Richard; Camossi, E.

    2016-01-01

    Work over the last decade has resulted in standardised web services and tools that can significantly improve the efficiency and effectiveness of working with meteorological and ocean model data. While many operational modelling centres have enabled query and access to data via common web services, most small research groups have not. The penetration of this approach into the research community, where IT resources are limited, can be dramatically improved by (1) making it simple for providers to enable web service access to existing output files; (2) using free technologies that are easy to deploy and configure; and (3) providing standardised, service-based tools that work in existing research environments. We present a simple, local brokering approach that lets modellers continue to use their existing files and tools, while serving virtual data sets that can be used with standardised tools. The goal of this paper is to convince modellers that a standardised framework is not only useful but can be implemented with modest effort using free software components. We use NetCDF Markup language for data aggregation and standardisation, the THREDDS Data Server for data delivery, pycsw for data search, NCTOOLBOX (MATLAB®) and Iris (Python) for data access, and Open Geospatial Consortium Web Map Service for data preview. We illustrate the effectiveness of this approach with two use cases involving small research modelling groups at NATO and USGS.

  5. A Small-Group Activity Introducing the Use and Interpretation of BLAST

    Directory of Open Access Journals (Sweden)

    Peter D. Newell

    2013-08-01

    Full Text Available As biological sequence data are generated at an ever increasing rate, the role of bioinformatics in biological research also grows. Students must be trained to complete and interpret bioinformatic searches to enable them to effectively utilize the trove of sequence data available. A key bioinformatic tool for sequence comparison and genome database searching is BLAST (Basic Local Alignment Search Tool. BLAST identifies sequences in a database that are similar to the entered query sequence, and ranks them based on the length and quality of the alignment. Our goal was to introduce sophomore and junior level undergraduate students to the basic functions and uses of BLAST with a small group activity lasting a single class period. The activity provides students an opportunity to perform a BLAST search, interpret the data output, and use the data to make inferences about bacterial cell envelope structure. The activity consists of two parts. Part 1 is a handout to be completed prior to class, complete with video tutorial, that reviews cell envelope structure, introduces key terms, and allows students to familiarize themselves with the mechanics of a BLAST search. Part 2 consists of a hands-on, web-based small group activity to be completed during the class period. Evaluation of the activity through student performance assessments suggests that students who complete the activity can better interpret the BLAST output parameters % query coverage and % max identity. While the topic of the activity is bacterial cell wall structure, it could be adapted to address other biological concepts.

  6. Small Marine Protected Areas in Fiji Provide Refuge for Reef Fish Assemblages, Feeding Groups, and Corals

    Science.gov (United States)

    Pires, Mathias M.; Guimarães, Paulo Roberto; Hoey, Andrew S.; Hay, Mark E.

    2017-01-01

    The establishment of no-take marine protected areas (MPAs) on coral reefs is a common management strategy for conserving the diversity, abundance, and biomass of reef organisms. Generally, well-managed and enforced MPAs can increase or maintain the diversity and function of the enclosed coral reef, with some of the benefits extending to adjacent non-protected reefs. A fundamental question in coral reef conservation is whether these benefits arise within small MPAs (fish assemblages, composition of fish feeding groups, benthic cover, and key ecosystem processes (grazing, macroalgal browsing, and coral replenishment) in three small (0.5–0.8 km2) no-take MPAs and adjacent areas where fisheries are allowed (non-MPAs) on coral reefs in Fiji. The MPAs exhibited greater species richness, density, and biomass of fishes than non-MPAs. Furthermore, MPAs contained a greater abundance and biomass of grazing herbivores and piscivores as well as a greater abundance of cleaners than fished areas. We also found differences in fish associations when foraging, with feeding groups being generally more diverse and having greater biomass within MPAs than adjacent non-MPAs. Grazing by parrotfishes was 3–6 times greater, and macroalgal browsing was 3–5 times greater in MPAs than in non-MPAs. On average, MPAs had 260–280% as much coral cover and only 5–25% as much macroalgal cover as their paired non-MPA sites. Finally, two of the three MPAs had three-fold more coral recruits than adjacent non-MPAs. The results of this study indicate that small MPAs benefit not only populations of reef fishes, but also enhance ecosystem processes that are critical to reef resilience within the MPAs. PMID:28122006

  7. Capacity of small groups of muscles to accomplish precision grasping tasks.

    Science.gov (United States)

    Towles, Joseph D; Valero-Cuevas, Francisco J; Hentz, Vincent R

    2013-01-01

    An understanding of the capacity or ability of various muscle groups to generate endpoint forces that enable grasping tasks could provide a stronger biomechanical basis for the design of reconstructive surgery or rehabilitation for the treatment of the paralyzed or paretic hand. We quantified two-dimensional endpoint force distributions for every combination of the muscles of the index finger, in cadaveric specimens, to understand the capability of muscle groups to produce endpoint forces that accomplish three common types of grasps-tripod, tip and lateral pinch-characterized by a representative level of Coulomb friction. We found that muscle groups of 4 or fewer muscles were capable of generating endpoint forces that enabled performance of each of the grasping tasks examined. We also found that flexor muscles were crucial to accomplish tripod pinch; intrinsic muscles, tip pinch; and the dorsal interosseus muscle, lateral pinch. The results of this study provide a basis for decision making in the design of reconstructive surgeries and rehabilitation approaches that attempt to restore the ability to perform grasping tasks with small groups of muscles.

  8. Clinical course teaching in transport of critically ill patients: Small group methods

    Directory of Open Access Journals (Sweden)

    Mohammad Taghi Beigmohammadi

    2016-10-01

    Full Text Available Critically ill patient transfer is potentially risky and may be lead to morbidity and mortality. Physicians' skill is very important for safe transport. We want to evaluate the effect of clinical course teaching on the promotion of physicians' abilities in the transport of critically ill patients. In an interventional study, 320 interns, male and female, were taught about patient transfer in two groups include in one day clinical course as the small group system (n=160 and other group the lecture base learning (n=160. In the clinical course, each participant under observation of an anesthesiologist in the operation room and ICU was acquainted with mask ventilation, intubation and learned to work with a defibrillator, infusion pump, portable ventilator and pulse oximeter. In lecture group, the anesthesiologist explained the topics by video and dummy. At the end of education course, the interns’ abilities were evaluated based on checklist method and scored by the project colleague in all educational items. Three hundred twenty interns, 122 males, and 198 females; were enrolled, two groups. The clinical course training caused improvements in the interns’ knowledge and abilities in intubation and use of the defibrillator and portable ventilator vs.lecture group significantly (P<0.005. The males were better than females in laryngoscopy, but the progress of the females was significantly better than males (P=0.003. The rate of adverse events was reduced significantly after clinical course teaching (P=0.041 Clinical course teaching could promote interns' clinical competencies in the transport of critically ill patients.

  9. The use of computer simulations in whole-class versus small-group settings

    Science.gov (United States)

    Smetana, Lara Kathleen

    This study explored the use of computer simulations in a whole-class as compared to small-group setting. Specific consideration was given to the nature and impact of classroom conversations and interactions when computer simulations were incorporated into a high school chemistry course. This investigation fills a need for qualitative research that focuses on the social dimensions of actual classrooms. Participants included a novice chemistry teacher experienced in the use of educational technologies and two honors chemistry classes. The study was conducted in a rural school in the south-Atlantic United States at the end of the fall 2007 semester. The study took place during one instructional unit on atomic structure. Data collection allowed for triangulation of evidence from a variety of sources approximately 24 hours of video- and audio-taped classroom observations, supplemented with the researcher's field notes and analytic journal; miscellaneous classroom artifacts such as class notes, worksheets, and assignments; open-ended pre- and post-assessments; student exit interviews; teacher entrance, exit and informal interviews. Four web-based simulations were used, three of which were from the ExploreLearning collection. Assessments were analyzed using descriptive statistics and classroom observations, artifacts and interviews were analyzed using Erickson's (1986) guidelines for analytic induction. Conversational analysis was guided by methods outlined by Erickson (1982). Findings indicated (a) the teacher effectively incorporated simulations in both settings (b) students in both groups significantly improved their understanding of the chemistry concepts (c) there was no statistically significant difference between groups' achievement (d) there was more frequent exploratory talk in the whole-class group (e) there were more frequent and meaningful teacher-student interactions in the whole-class group (f) additional learning experiences not measured on the assessment

  10. 75 FR 43557 - TA-W-73,682, Hartford Financial Services Group, Incorporated, Medical Bill Processing and...

    Science.gov (United States)

    2010-07-26

    ... Leased Workers From Beeline: Aurora, IL; TA-W-73,682A, Hartford Financial Services Group, Incorporated..., applicable to workers of Hartford Financial Services Group, Incorporated, Medical Bill Processing and Production Center Support, Aurora, Illinois and Hartford Financial Services Group, Incorporated, Medical Bill...

  11. Perspectives on Research Participation and Facilitation Among Dialysis Patients, Clinic Personnel, and Medical Providers: A Focus Group Study.

    Science.gov (United States)

    Flythe, Jennifer E; Narendra, Julia H; Dorough, Adeline; Oberlander, Jonathan; Ordish, Antoinette; Wilkie, Caroline; Dember, Laura M

    2017-12-19

    Most prospective studies involving individuals receiving maintenance dialysis have been small, and many have had poor clinical translatability. Research relevance can be enhanced through stakeholder engagement. However, little is known about dialysis clinic stakeholders' perceptions of research participation and facilitation. The objective of this study was to characterize the perspectives of dialysis clinic stakeholders (patients, clinic personnel, and medical providers) on: (1) research participation by patients and (2) research facilitation by clinic personnel and medical providers. We also sought to elucidate stakeholder preferences for research communication. Qualitative study. 7 focus groups (59 participants: 8 clinic managers, 14 nurses/patient care technicians, 8 social workers/dietitians, 11 nephrologists/advanced practice providers, and 18 patients/care partners) from 7 North Carolina dialysis clinics. Clinics and participants were purposively sampled. Focus groups were recorded and transcribed. Thematic analysis. We identified 11 themes that captured barriers to and facilitators of research participation by patients and research facilitation by clinic personnel and medical providers. We collapsed these themes into 4 categories to create an organizational framework for considering stakeholder (narrow research understanding, competing personal priorities, and low patient literacy and education levels), relationship (trust, buy-in, and altruistic motivations), research design (convenience, follow-up, and patient incentives), and dialysis clinic (professional demands, teamwork, and communication) aspects that may affect stakeholder interest in participating in or facilitating research. These themes appear to shape the degree of research readiness of a dialysis clinic environment. Participants preferred short research communications delivered in multiple formats. Potential selection bias and inclusion of English-speaking participants only. Our findings

  12. Effects of Chinese Medicine as Adjunct Medication for Adjuvant Chemotherapy Treatments of Non-Small Cell Lung Cancer Patients

    Science.gov (United States)

    Jiao, Lijing; Dong, Changsheng; Liu, Jiaxiang; Chen, Zhiwei; Zhang, Lei; Xu, Jianfang; Shen, Xiaoyong; Che, Jiaming; Yang, Yi; Huang, Hai; Li, Hegen; Sun, Jianli; Jiang, Yi; Mao, Zhujun; Chen, Peiqi; Gong, Yabin; Jin, Xiaolin; Xu, Ling

    2017-01-01

    The aim was to evaluate the effects of traditional Chinese medicine (TCM) as a combination medication with adjuvant chemotherapy on postoperative early stage non-small cell lung cancer (NSCLC) patients. The 314 patients with completely resected stage IB, II or IIIA cancers were assigned into vinorelbine plus cisplatin/carboplatin (NP/NC) (control, n = 158) and NP/NC with additional TCM (intervention, n = 156) groups. The primary endpoint was QOL scores; secondary endpoints were the toxicity and safety of the regimens. The NP/NC regimen caused mild (grade 1 or 2) non-hematologic toxic effects in the patients comprising vomiting (43.6%), fatigue (36.9%), pain (23%), dry mouth (27.6%) and diarrhea (7.9%). The incidence of adverse events was significantly lower in the intervention group than in the control group (0.57% vs 4.02%, P = 0.037). Transient severe (grade 3 or 4) hematological toxic effects occurred less often (hemoglobin reduction (11.9 vs 22.5 percent) and total bilirubin increased (to 42.1 vs 46.2%) in the intervention compared to the control group during the 2nd chemotherapy cycle. When combined with adjuvant chemotherapy, TCM led to partial relief of symptoms in addition to a reduction of side-effects and adverse events caused by the NP/NC regimens. PMID:28436479

  13. Pedagogical Conditions of Shaping Motor Competence in Physical Education of Students of Special Medical Groups

    Directory of Open Access Journals (Sweden)

    В. М. Корягін

    2016-09-01

    Full Text Available Study objective. To define the pedagogical conditions of shaping motor competence in students of special medical groups during physical education at higher educational institutions. Study methods: theoretical analysis, systematization, comparison of different views on the issue under study, methodological and special literature collation, general scientific methods of theoretical level: analogy, analysis, synthesis, abstraction, induction. Study results. The study addresses the issues of indicating the pedagogical conditions necessary for the effective shaping of the motor competence in students of special medical groups during their physical education at higher educational institutions. The data analysis and collation of the data collected from the scientific, methodological and special literature helped outline and organize their index, which is a pre-requisite for ensuring the process effectiveness. We recommend using the study results as a major foundation for re-organization of the scientific and methodological aspects of physical education of students with health problems to ensure their motor competence effectively shaped.

  14. Facebook Groups as a Powerful and Dynamic Tool in Medical Education: Mixed-Method Study.

    Science.gov (United States)

    Nicolai, Leo; Schmidbauer, Moritz; Gradel, Maximilian; Ferch, Sabine; Antón, Sofía; Hoppe, Boj; Pander, Tanja; von der Borch, Philip; Pinilla, Severin; Fischer, Martin; Dimitriadis, Konstantinos

    2017-12-22

    Social networking sites, in particular Facebook, are not only predominant in students' social life but are to varying degrees interwoven with the medical curriculum. Particularly, Facebook groups have been identified for their potential in higher education. However, there is a paucity of data on user types, content, and dynamics of study-related Facebook groups. The aim of this study was to identify the role of study-related Facebook group use, characterize medical students that use or avoid using Facebook groups (demographics, participation pattern, and motivation), and analyze student posting behavior, covered topics, dynamics, and limitations in Facebook groups with regards to educational usage. Using a multi-method approach (interviews, focus groups, and qualitative and quantitative analysis of Facebook posts), we analyzed two representative Facebook groups of medical preclinical semesters at Ludwig-Maximilians-University (LMU) Munich. Facebook primary posts and replies over one semester were extracted and evaluated by using thematic content analysis. We developed and applied a coding scheme for studying the frequency and distribution of these posts. Additionally, we interviewed students with various degrees of involvement in the groups, as well as "new minorities," students not registered on Facebook. Facebook groups seem to have evolved as the main tool for medical students at LMU to complement the curriculum and to discuss study-related content. These Facebook groups are self-organizing and quickly adapt to organizational or subject-related challenges posed by the curriculum. A wide range of topics is covered, with a dominance of organization-related posts (58.35% [6916/11,853] of overall posts). By measuring reply rates and comments per category, we were able to identify learning tips and strategies, material sharing, and course content discussions as the most relevant categories. Rates of adequate replies in these categories ranged between 78% (11/14) and

  15. Quality of life, treatment adherence, and locus of control: multiple family groups for chronic medical illnesses.

    Science.gov (United States)

    López-Larrosa, Silvia

    2013-12-01

    The Multiple Family Groups (MFGs) approach for patients with a chronic medical illness and their families is a structured psychoeducational program that unfolds in six weekly 90-minute sessions. In the MFGs, patients and family members explore new ways to balance illness and nonillness priorities in family life (Steinglass, 1998; Steinglass, 2000 Cuadernos de Terapia Familiar, 44-45, 11; Steinglass, Ostroff, & Steinglass, 2011 Family Process, 50, 393). © FPI, Inc.

  16. The Use of the Delphi and Other Consensus Group Methods in Medical Education Research: A Review.

    Science.gov (United States)

    Humphrey-Murto, Susan; Varpio, Lara; Wood, Timothy J; Gonsalves, Carol; Ufholz, Lee-Anne; Mascioli, Kelly; Wang, Carol; Foth, Thomas

    2017-10-01

    Consensus group methods, such as the Delphi method and nominal group technique (NGT), are used to synthesize expert opinions when evidence is lacking. Despite their extensive use, these methods are inconsistently applied. Their use in medical education research has not been well studied. The authors set out to describe the use of consensus methods in medical education research and to assess the reporting quality of these methods and results. Using scoping review methods, the authors searched the Medline, Embase, PsycInfo, PubMed, Scopus, and ERIC databases for 2009-2016. Full-text articles that focused on medical education and the keywords Delphi, RAND, NGT, or other consensus group methods were included. A standardized extraction form was used to collect article demographic data and features reflecting methodological rigor. Of the articles reviewed, 257 met the inclusion criteria. The Modified Delphi (105/257; 40.8%), Delphi (91/257; 35.4%), and NGT (23/257; 8.9%) methods were most often used. The most common study purpose was curriculum development or reform (68/257; 26.5%), assessment tool development (55/257; 21.4%), and defining competencies (43/257; 16.7%). The reporting quality varied, with 70.0% (180/257) of articles reporting a literature review, 27.2% (70/257) reporting what background information was provided to participants, 66.1% (170/257) describing the number of participants, 40.1% (103/257) reporting if private decisions were collected, 37.7% (97/257) reporting if formal feedback of group ratings was shared, and 43.2% (111/257) defining consensus a priori. Consensus methods are poorly standardized and inconsistently used in medical education research. Improved criteria for reporting are needed.

  17. Medical care of hepatitis B among Asian American populations: perspectives from three provider groups.

    Science.gov (United States)

    Hwang, Jessica P; Roundtree, Aimee K; Engebretson, Joan C; Suarez-Almazor, Maria E

    2010-03-01

    Physicians can play a significant role in helping to decrease the hepatitis B virus (HBV) burden among Asian Americans. Few studies have described knowledge and practice patterns in the medical community among different provider types regarding HBV and liver cancer. Our study explores the HBV beliefs, attitudes and practice patterns of medical providers serving Asian American communities. We conducted three focus groups with primary care providers, liver specialists, and other providers predominantly serving Asian American community. We asked about practices and barriers to appropriate medical care and outreach. We moderated three focus groups with 23 participants, 18 of whom completed and returned demographic surveys. Twelve were of Asian ethnicity and 13 spoke English as a second language. Only eight screened at least half of their patients, most (72%) using the hepatitis B surface antigen test. We used grounded theory methods to analyze focus group transcripts. Participants frequently discussed cultural and financial barriers to hepatitis care. They admitted reluctance to screen for HBV because patients might be unwilling or unable to afford treatment. Cultural differences were discussed most by primary care providers; best methods of outreach were discussed most by liver specialists; and alternative medicine was discussed most by acupuncturists and other providers. More resources are needed to lower financial barriers complicating HBV care and encourage providing guideline-recommended screenings. Other providers can help promote HBV screening and increase community and cultural awareness.

  18. Social Transmission of False Memory in Small Groups and Large Networks.

    Science.gov (United States)

    Maswood, Raeya; Rajaram, Suparna

    2018-05-21

    Sharing information and memories is a key feature of social interactions, making social contexts important for developing and transmitting accurate memories and also false memories. False memory transmission can have wide-ranging effects, including shaping personal memories of individuals as well as collective memories of a network of people. This paper reviews a collection of key findings and explanations in cognitive research on the transmission of false memories in small groups. It also reviews the emerging experimental work on larger networks and collective false memories. Given the reconstructive nature of memory, the abundance of misinformation in everyday life, and the variety of social structures in which people interact, an understanding of transmission of false memories has both scientific and societal implications. © 2018 Cognitive Science Society, Inc.

  19. Implementation of small group discussion as a teaching method in earth and space science subject

    Science.gov (United States)

    Aryani, N. P.; Supriyadi

    2018-03-01

    In Physics Department Universitas Negeri Semarang, Earth and Space Science subject is included in the curriculum of the third year of physics education students. There are various models of teaching earth and space science subject such as textbook method, lecturer, demonstrations, study tours, problem-solving method, etc. Lectures method is the most commonly used of teaching earth and space science subject. The disadvantage of this method is the lack of two ways interaction between lecturers and students. This research used small group discussion as a teaching method in Earth and Space science. The purpose of this study is to identify the conditions under which an efficient discussion may be initiated and maintained while students are investigating properties of earth and space science subjects. The results of this research show that there is an increase in student’s understanding of earth and space science subject proven through the evaluation results. In addition, during the learning process, student’s activeness also increase.

  20. Savings and Loans Program, The Revenue of Small Micro Enterprises and Poverty Reduction among Women Groups

    Directory of Open Access Journals (Sweden)

    Ana Zahrotun Nihayah

    2017-04-01

    Full Text Available This research aims to understand the micro small medium business income both before and after receiving the program, to find out the number of poverty reduction, and to see the application of Islamic economic values on the women’s saving and loans program.The population of this research are members of the women’s saving and loans program, which is 215 people in total and scattered in 16 business group. Using random sampling techniques, there are 70 people that was taken into consideration. The method analysis used in in this research is using Wilcoxon rank test analysis, the poverty reduction analysis, and the Islamic economics values. Based on data analysis is(1 founded that the women’s saving and loans program affecting the micro small medium enterprises income. (2 Due to the women’s saving and loans program there are decreasing number of poverty rate about 20 percent. (3 It is realized that there are some applications of Islamic economics values upon the women’s saving and loans program, they are time extensions, fine replacement, social activities, and the improvement of society welfare.

  1. Scientifically speaking: Identifying, analyzing, and promoting science talk in small groups

    Science.gov (United States)

    Holthuis, Nicole Inamine

    In this dissertation I define, document, and analyze the nature of students' science talk as they work in cooperative learning groups. Three questions form the basis of this research. First, what is science talk? Second, how much and what kind of science talk did students do? And, third, what conditions help promote or inhibit students' science talk? This study was conducted in a total of six classrooms in three high schools. I videotaped and audiotaped students as they worked in small groups during the course of an ecology unit. I analyzed this videotape data and field notes using both quantitative and qualitative methods. I define science talk as talk that serves to move students along in terms of the science (both content and process) required or suggested by the activity. More specifically, I identified five epistemological characteristics that delineate what counts as scientific knowledge and, subsequently, science talk. From this definition, I developed an analytic framework and science talk observation instrument to document the quantity and level of student and teacher talk during groupwork. Analysis of the data from this instrument indicates that the overall level of students' science talk is considerable and students do significantly more science talk than school talk. I also found that while the overall level and type of science talk does not vary by class or by school, it does vary by activity type. Finally, my analysis suggests that science talk does not vary by gender composition of the group. I explored the classroom conditions that promote or inhibit science talk during groupwork. My findings suggest that, among other things, teachers can promote science talk by delegating authority to students, by emphasizing content and the big idea, by implementing open-ended tasks, and by modeling science talk. In conclusion, the findings described in this dissertation point teachers and researchers toward ways in which they may improve practice in order to

  2. Transformational leadership and group potency in small military units: The mediating role of group identification and cohesion

    Directory of Open Access Journals (Sweden)

    Carlos García-Guiu

    2016-12-01

    Full Text Available In the present study, we examined an exploratory model to assess the relationship between transformational leadership and group potency and analyze the mediating role of group identification and cohesion. The research was conducted with squads of the Spanish Army. The sample was composed of 243 members of 51 squads of operational units. Our findings highlighted the importance of the transformational leadership style of command of non-commissioned officers (NCOs due to its positive relationship with the group potency of the squad. We also analyzed the indirect relationships between transformational leadership and group identification and group cohesion and found that the latter variables played a mediating role between transformational leadership and group potency. The conclusions of this study are relevant due to the growing importance of transformational leadership and actions implemented at lower levels of the command chain for the success of missions of security organizations and defense.

  3. The Effect of Functional Roles on Group Efficiency : Using Multilevel Modeling and Content Analysis to Investigate Computer-Supported Collaboration in Small Groups

    NARCIS (Netherlands)

    Strijbos, J.W.; Martens, R.L.; Jochems, W.M.G.; Broers, N.J.

    2004-01-01

    The usefulness of roles to support small group performance can often be read; however, their effect is rarely empirically assessed. This article reports the effects of functional roles on group performance, efficiency, and collaboration during computer-supported collaborative learning. A comparison

  4. Role modelling of clinical tutors: a focus group study among medical students.

    Science.gov (United States)

    Burgess, Annette; Goulston, Kerry; Oates, Kim

    2015-02-14

    Role modelling by clinicians assists in development of medical students' professional competencies, values and attitudes. Three core characteristics of a positive role model include 1) clinical attributes, 2) teaching skills, and 3) personal qualities. This study was designed to explore medical students' perceptions of their bedside clinical tutors as role models during the first year of a medical program. The study was conducted with one cohort (n = 301) of students who had completed Year 1 of the Sydney Medical Program in 2013. A total of nine focus groups (n = 59) were conducted with medical students following completion of Year 1. Data were transcribed verbatim. Thematic analysis was used to code and categorise data into themes. Students identified both positive and negative characteristics and behaviour displayed by their clinical tutors. Characteristics and behaviour that students would like to emulate as medical practitioners in the future included: 1) Clinical attributes: a good knowledge base; articulate history taking skills; the ability to explain and demonstrate skills at the appropriate level for students; and empathy, respect and genuine compassion for patients. 2) Teaching skills: development of a rapport with students; provision of time towards the growth of students academically and professionally; provision of a positive learning environment; an understanding of the student curriculum and assessment requirements; immediate and useful feedback; and provision of patient interaction. 3) Personal qualities: respectful interprofessional staff interactions; preparedness for tutorials; demonstration of a passion for teaching; and demonstration of a passion for their career choice. Excellence in role modelling entails demonstration of excellent clinical care, teaching skills and personal characteristics. Our findings reinforce the important function of clinical bedside tutors as role models, which has implications for faculty development and

  5. Emergency preparedness: medical management of nuclear accidents involving large groups of victims

    International Nuclear Information System (INIS)

    Parmentier, N.; Nenot, J.C.

    1988-01-01

    The treatment of overexposed individuals implies hospitalisation in a specialized unit applying hematological intense care. If the accident results in a small number of casualties, the medical management does not raise major problems in most of the countries, where specialized units exist, as roughly 7% of the beds are available at any time. But an accident which would involved tens or hundreds of people raises much more problems for hospitalization. Such problems are also completely different and will involve steps in the medical handling, mainly triage, (combined injuries), determination of whole body dose levels, transient hospitalization. In this case, preplanning is necessary, adapted to the system of medical care in case of a catastrophic event in the given Country, with the main basic principles : emergency concerns essentially the classical injuries (burns and trauma) - and contamination problems in some cases - treatment of radiation syndrome is not an emergency during the first days but some essential actions have to be taken such as early blood sampling for biological dosimetry and for HLa typing

  6. Medical Students' Empathy for Vulnerable Groups: Results From a Survey and Reflective Writing Assignment.

    Science.gov (United States)

    Wellbery, Caroline; Saunders, Pamela A; Kureshi, Sarah; Visconti, Adam

    2017-12-01

    As medical education curricula increasingly acknowledge the contributions of the social determinants of health to individual health, new methods of engaging students in the care of vulnerable groups are needed. Empathy is one way to connect students with patients, but little is known about how to nurture students' empathy on behalf of populations. This study examined the relationship between individual and social empathy as groundwork for cultivating students' empathy for vulnerable groups. In 2014-2015, first-year medical students completed the Social Empathy Index at the start and end of a two-semester population health course, and they completed a reflective writing assignment exploring the challenges of caring for vulnerable patients. Pre- and posttest mean survey scores were compared, and reflective writing assignments were analyzed for themes concerning social empathy. Data from 130 students were analyzed. Scores for the contextual understanding of systemic barriers domain increased significantly. There was a trend toward increased cumulative social empathy scores that did not reach statistical significance. Students' essays revealed three themes relating to individual empathy as the foundation for social empathy; civic and moral obligations; and the role of institutional practices in caring for vulnerable groups. This study extends understanding of empathy beyond care for the individual to include care for vulnerable groups. Thus, social empathy may function as a valuable concept in developing curricula to support students' commitment to care for the underserved. Educators first need to address the many barriers students cited that impede both individual and social empathy.

  7. Using Small Group Debates to Actively Engage Students in an Introductory Microbiology Course†

    Science.gov (United States)

    Shaw, Joyce A.

    2012-01-01

    Debates stimulate critical thinking and can be a highly effective way to actively engage students in the classroom. This paper describes a small group debate format in which groups of four to six students debated preassigned topics in microbiology in front of the rest of the class. Rapid advancements in science, especially in microbiology, provide the scaffolding for students to locate and share evidence-based information from a plethora of complex and often conflicting sources. Student-generated debate presentations can be a welcome respite from the lecture format. Debates were scheduled throughout the course to coincide with topics being covered. Questionnaires distributed immediately after each debate revealed that the debates were well received by students and were effective in changing student attitudes and misconceptions. Debate preparation provided students the opportunity to gain proficiency in accessing information from electronic databases, to use resources from professional organizations, and to synthesize and analyze information. In addition, the debate process gave students experience in developing oral communication skills. PMID:23653803

  8. Novel Emergency Medicine Curriculum Utilizing Self-Directed Learning and the Flipped Classroom Method: Obstetric and Gynecologic Emergencies Small Group Module

    Directory of Open Access Journals (Sweden)

    Jillian McGrath

    2017-09-01

    Full Text Available Audience: This curriculum, created and implemented at The Ohio State University Wexner Medical Center, was primarily designed to educate our emergency medicine (EM residents (PGY1-3 and emergency medicine/internal medicine (EM/IM residents (PGY1-5 on core obstetrics and gynecology topics in EM. Additional audience members include medical students and faculty physicians. Introduction: In 2013, there were over 1 million emergency department visits in the United States which resulted in primary obstetric or gynecologic diagnoses.1 EM Residents must be proficient in the differential diagnosis and management of the wide variety of obstetric and gynecologic emergencies. To do this, we developed a flipped classroom curricular model, which consists of self-directed learning activities completed by learners, followed by small group discussions pertaining to the topic reviewed. The active learning fostered by this type of curriculum increases faculty and learner engagement and interaction time typically absent in traditional lecture-based formats.2-4 Studies have revealed that the application of knowledge through case studies, personal interaction with content experts, and integrated questions are effective learning strategies for EM residents.4-6 The Ohio State University Wexner Medical Center EM residency didactic curriculum recently transitioned to a “flipped classroom” approach.7-10 Our didactic curriculum is delivered over the course of 18 months; however, it could easily be adapted to other academic calendar cycles. The flipped classroom curriculum maximizes didactic time and resident engagement, fosters intellectual curiosity and active learning, and meets the needs of today’s learners. 3,6,11 Objectives: We aim to teach the presentation and management of obstetric and gynecologic emergencies through the creation of a flipped classroom design. This unique, innovative curriculum utilizes resources chosen by education faculty and resident

  9. Loads on small muscle groups as a risk of hypertensive conditions

    Directory of Open Access Journals (Sweden)

    Olga G. Kourova

    2017-12-01

    Full Text Available Background ― Hypertension is a widespread condition nowadays. Changes in physical activity patterns of the population, namely, sedentary lifestyle and increased loads on small muscle groups, are the key factors behind the development of hypertension. Although science has amassed sufficient amounts of facts about a hypertensive effect of local loads, the very mechanisms underlying adaptive reactions of the circulatory system have not received comprehensive study. Material and Methods ― We studied adaptive reactions to local muscle work in 108 adult subjects groups aged between 18 and 20, 30 and 35, and 60 and 74 respectively by means of a Mosso’s ergograph until the onset of fatigue with all the three age groups receiving medium loads. We have analyzed their work performance, including static and dynamic stamina. We took blood pressure measurements, electrocardiograms (ECGs and electroencephalograms (EEGs before and after the test. Results ― We discovered increased heartbeat rates, systolic blood pressure, and diastolic blood pressure in all of the subjects, as they were doing local load tests, while their ECGs showed shortened electric diastole time, which was indicative of heart functional tension, especially in the subjects aged between 18 and, and 60 and 74. Adverse heart reactions were more pronounced while the subjects were doing static tests rather than dynamic tests, and their EEGs showed increased slow-wave activity within alpha- and theta-ranges, with regularly recurrent alpha wave synchronizations. Conclusion ― Our research shows that central mechanisms underlie hypertensive reactions of the cardiovascular system to local loads with the participation of metabolic receptors of muscles. We have also justified the necessity of preventive campaigns against hypertensions in individuals receiving increased amounts of local muscle work in the motor mode.

  10. An Audit of the Effectiveness of Large Group Neurology Tutorials for Irish Undergraduate Medical Students

    LENUS (Irish Health Repository)

    Kearney, H

    2016-07-01

    The aim of this audit was to determine the effectiveness of large group tutorials for teaching neurology to medical students. Students were asked to complete a questionnaire rating their confidence on a ten point Likert scale in a number of domains in the undergraduate education guidelines from the Association of British Neurologists (ABN). We then arranged a series of interactive large group tutorials for the class and repeated the questionnaire one month after teaching. In the three core domains of neurological: history taking, examination and differential diagnosis, none of the students rated their confidence as nine or ten out of ten prior to teaching. This increased to 6% for history taking, 12 % in examination and 25% for differential diagnosis after eight weeks of tutorials. This audit demonstrates that in our centre, large group tutorials were an effective means of teaching, as measured by the ABN guidelines in undergraduate neurology.

  11. Enhancing medical students' reflectivity in mentoring groups for professional development - a qualitative analysis.

    Science.gov (United States)

    Lutz, Gabriele; Pankoke, Nina; Goldblatt, Hadass; Hofmann, Marzellus; Zupanic, Michaela

    2017-07-14

    Professional competence is important in delivering high quality patient care, and it can be enhanced by reflection and reflective discourse e.g. in mentoring groups. However, students are often reluctant though to engage in this discourse. A group mentoring program involving all preclinical students as well as faculty members and co-mentoring clinical students was initiated at Witten-Herdecke University. This study explores both the attitudes of those students towards such a program and factors that might hinder or enhance how students engage in reflective discourse. A qualitative design was applied using semi-structured focus group interviews with preclinical students and semi-structured individual interviews with mentors and co-mentors. The interview data were analyzed using thematic content analysis. Students' attitudes towards reflective discourse on professional challenges were diverse. Some students valued the new program and named positive outcomes regarding several features of professional development. Enriching experiences were described. Others expressed aversive attitudes. Three reasons for these were given: unclear goals and benefits, interpersonal problems within the groups hindering development and intrapersonal issues such as insecurity and traditional views of medical education. Participants mentioned several program setup factors that could enhance how students engage in such groups: explaining the program thoroughly, setting expectations and integrating the reflective discourse in a meaningful way into the curriculum, obliging participation without coercion, developing a sense of security, trust and interest in each other within the groups, randomizing group composition and facilitating group moderators as positive peer and faculty role models and as learning group members. A well-designed and empathetic setup of group mentoring programs can help raise openness towards engaging in meaningful reflective discourse. Reflection on and communication of

  12. Design of small-animal thermal neutron irradiation facility at the Brookhaven Medical Research Reactor

    International Nuclear Information System (INIS)

    Liu, H.B.

    1996-01-01

    The broad beam facility (BBF) at the Brookhaven Medical Research Reactor (BMRR) can provide a thermal neutron beam with flux intensity and quality comparable to the beam currently used for research on neutron capture therapy using cell-culture and small-animal irradiations. Monte Carlo computations were made, first, to compare with the dosimetric measurements at the existing BBF and, second, to calculate the neutron and gamma fluxes and doses expected at the proposed BBF. Multiple cell cultures or small animals could be irradiated simultaneously at the so-modified BBF under conditions similar to or better than those individual animals irradiated at the existing thermal neutron irradiation Facility (TNIF) of the BMRR. The flux intensity of the collimated thermal neutron beam at the proposed BBF would be 1.7 x 10 10 n/cm 2 ·s at 3-MW reactor power, the same as at the TNIF. However, the proposed collimated beam would have much lower gamma (0.89 x 10 -11 cGy·cm 2 /n th ) and fast neutron (0.58 x 10 -11 cGy·cm 2 /n th ) contaminations, 64 and 19% of those at the TNIF, respectively. The feasibility of remodeling the facility is discussed

  13. Malaria problem in Afghanistan: malaria scanning results of the Turkish medical aid group after the war.

    Science.gov (United States)

    Oner, Yaşar Ali; Okutan, Salih Erkan; Artinyan, Elizabeth; Kocazeybek, Bekir

    2005-04-01

    Malaria is a parasitic infection caused by Plasmodium species and it is especially seen in tropical and subtropical areas. We aimed to evaluate the effects of the infection in Afghanistan, which is an endemic place for malaria and had severe socio-economical lost after the war. We also compared these data with the ones that were recorded before the war. Blood samples were taken from 376 malaria suspected patients who come to the health center, established by the medical group of Istanbul Medical Faculty in 2002, Afghanistan. Blood samples were screened using the OPTIMAL Rapid Malaria Test and Giemsa staining method. In 95 (25.3%) patients diagnosis was malaria. In 65 patients (17.3%) the agent of the infection was P. falciparum and in 30 patients (8%) agents were other Plasmodium species.

  14. The medical exposures in UNSCEAR 2000 and the data of Spanish Group

    International Nuclear Information System (INIS)

    Vano, E.

    2001-01-01

    Last year 2000, UNSCEAR published the document Sources and Effects of Ionizing Radiation which is composed of two volumes. Within Volume I: Sources, the Annex D is about medical radiation exposures. The present article summarises the more relevant data presented in this Annex, pointing out the changes that have taken places since the previous UNSCEAR report of 1993. Besides, the actions and results obtained by the Spanish UNSCEAR Working Group are presented. Some of the more relevant data presented in the last UNSCEAR report are: most of the medical applications are performed in developed countries (25% of the world-wide population); the mean effective dose (in developed countries) is approximately 1 mSv/year; the mean world-wide dose is around 0.4 mSv/year and more than 90% of this dose derives from medical diagnosis. In June 1999, the Spanish Ministry of Health and Consumption (Ministerio de Sanidad y consumo) created the UNSCEAR Working Group in which the author of the present article acts as technical coordinator. The objective of the group was to systematically compile the necessary information to edit a periodic report on the estimation of doses to the population due to medical exposures, which additionally could be used by the Health Administration as a complementary element for planning the installations and in the radiation protection programmes of the patients. The final report of the Spanish group, published in February 2000, was elaborated with the data provided by nine Autonomic Communities ( the total number of Autonomic Communities is seventeen) including 44% of the Spanish population (17.4 millions of inhabitants from the nine Autonomic Communities in relation to a total population of 39.9 millions; population data in 01.01.98). The final values in the Spanish report are rather reasonable, although in few cases deviations can appear due to the scarce information available The data provided are validated in origin due to the direct participation of

  15. Understanding Medical Students' Experience with Stress and Its Related Constructs: A Focus Group Study from Singapore.

    Science.gov (United States)

    Farquhar, Julia; Lie, Desiree; Chan, Angelique; Ow, Mandy; Vidyarthi, Arpana

    2018-02-01

    In order to protect medical students from burnout and its untoward psychiatric effects, it is imperative to understand their stress, burnout, coping, and resilience experiences. This study aimed to derive collective definitions from the medical student perspective, to identify common themes of students' experiences, and to distinguish pre-clinical and clinical year students' experiences relating to these four constructs. The authors conducted focus groups of medical students in Singapore across 4 years using a semi-structured question guide. Participants shared their understanding, experiences, and the relationships between stress, burnout, coping, and resilience. Coders independently evaluated construct definitions and derived common themes through an iterative process, and compared transcripts of pre-clinical and clinical year students to determine differences in experience over time. Nine focus groups (54 students, 28 females, mean age 24.3) were conducted. Students identified common definitions for each construct. Nine themes emerged within three domains: (1) relating constructs to personal experience, (2) interrelating stress, burnout, coping, and resilience, and (3) understanding the necessity of stress. Compared to clinical students, pre-clinical students reported theory-based rather than reality-based experiences and exam-induced stress, defined constructs using present rather than future situations, and described constructs as independent rather than interrelated. This sample of medical students in Singapore shares a common understanding of stress, burnout, coping, and resilience, but experiences these uniquely. They perceive a positive role for stress. These findings build upon prior literature, suggesting an interrelationship between stress and its related constructs and adding the novel perspective of students from an Asian country.

  16. The exploration of medical resources utilization among inguinal hernia repair in Taiwan diagnosis-related groups.

    Science.gov (United States)

    Yan, Yu-Hua; Kung, Chih-Ming; Chen, Yi

    2017-11-09

    This study centered on differences in medical costs, using the Taiwan diagnosis-related groups (Tw-DRGs) on medical resource utilization in inguinal hernia repair (IHR) in hospitals with different ownership to provide suitable reference information for hospital administrators. The 2010-2011 data for three hospitals under different ownership were extracted from the Taiwan National Health Insurance claims database. A retrospective method was applied to analyze the age, sex, length of stay, diagnosis and surgical procedure code, and the change in financial risk of medical costs in IHR cases after introduction of Tw-DRGs. The study calculated the cost using Tw-DRG payment principles, and compared it with estimated inpatient medical costs calculated using the fee-for-service policy. There were 723 IHR cases satisfying the Tw-DRGs criteria. Cost control in the medical care corporation hospital (US$764.2/case) was more efficient than that in the public hospital (US$902.7/case) or nonprofit proprietary hospital (US$817.1/case) surveyed in this study. For IHR, anesthesiologists in the public hospital preferred to use general anesthesia (86%), while those in the two other hospitals tended to administer spinal anesthesia. We also discovered the difference in anesthesia cost was high, at US$80.2/case on average. Because the Tw-DRG-based reimbursement system produces varying hospital costs, hospital administrators should establish a financial risk assessment system as early as possible to improve healthcare quality and financial management efficiency. This would then benefit the hospital, patient, and Bureau of National Health Insurance.

  17. The exploration of medical resources utilization among inguinal hernia repair in Taiwan diagnosis-related groups

    Directory of Open Access Journals (Sweden)

    Yu-Hua Yan

    2017-11-01

    Full Text Available Abstract Background This study centered on differences in medical costs, using the Taiwan diagnosis-related groups (Tw-DRGs on medical resource utilization in inguinal hernia repair (IHR in hospitals with different ownership to provide suitable reference information for hospital administrators. Methods The 2010–2011 data for three hospitals under different ownership were extracted from the Taiwan National Health Insurance claims database. A retrospective method was applied to analyze the age, sex, length of stay, diagnosis and surgical procedure code, and the change in financial risk of medical costs in IHR cases after introduction of Tw-DRGs. The study calculated the cost using Tw-DRG payment principles, and compared it with estimated inpatient medical costs calculated using the fee-for-service policy. Results There were 723 IHR cases satisfying the Tw-DRGs criteria. Cost control in the medical care corporation hospital (US$764.2/case was more efficient than that in the public hospital (US$902.7/case or nonprofit proprietary hospital (US$817.1/case surveyed in this study. For IHR, anesthesiologists in the public hospital preferred to use general anesthesia (86%, while those in the two other hospitals tended to administer spinal anesthesia. We also discovered the difference in anesthesia cost was high, at US$80.2/case on average. Conclusions Because the Tw-DRG-based reimbursement system produces varying hospital costs, hospital administrators should establish a financial risk assessment system as early as possible to improve healthcare quality and financial management efficiency. This would then benefit the hospital, patient, and Bureau of National Health Insurance.

  18. Radiotherapy alone for medically inoperable Stage I non-small-cell lung cancer: The Duke experience

    International Nuclear Information System (INIS)

    Sibley, Gregory S.; Jamieson, Timothy A.; Marks, Lawrence B.; Anscher, Mitchell S.; Prosnitz, Leonard R.

    1998-01-01

    Purpose: To review our experience treating clinical Stage I non-small-cell lung carcinoma with radiotherapy alone using modern techniques and staging. The effect of dose and volume on outcome is to be analyzed. Methods: Between January 1980 and December 1995, 156 patients with Stage I medically inoperable non-small-cell lung cancer were irradiated at Duke University Medical Center and the Durham Veterans Administration Medical Center. Fifteen patients were excluded from analysis (7 treated with palliative intent, and 8 lost to follow-up immediately following radiation). Characteristics of the 141 evaluable patients were as follows: Median age 70 years (range 46-95); gender: male 83%, female 17%; institution: DUMC 65%, DVAMC 35%; T1N0 54%, T2N0 46%; median size 3 cm (range 0.5 to 8); pathology: squamous cell carcinoma 52%, adenocarcinoma 18%, large cell carcinoma 19%, not otherwise specified 11%; presenting symptoms: weight loss 26%, cough 23%, none (incidental diagnosis) 57%. All patients underwent simulation prior to radiotherapy using linear accelerators of ≥4 MV. No patients received surgery or chemotherapy as part of their initial treatment. The median dose of radiotherapy (not reflecting lung inhomogeneity corrections) was 64 Gy (50 to 80 Gy) given in 1.2 bid to 3 Gy qid fractionation. The majority of cases included some prophylactic nodal regions (73%). Results: Of the 141 patients, 108 have died; 33% of intercurrent death, 35% of cancer, and 7% of unknown causes. At last follow-up, 33 patients were alive (median 24 months, range 7-132 months). The 2- and 5-year overall survival was 39% and 13%, respectively (median 18 months). The corresponding cause-specific survival was 60%, and 32% (median 30 months). On multivariate analysis, significant factors influencing overall and/or cause-specific survival were age, squamous cell histology, incidental diagnosis, and pack-years of smoking. There was a nonsignificant trend towards improved cause-specific survival

  19. Evolution of Facebook groups: Informal e-learning among medical laboratory scientists in Nigeria

    Directory of Open Access Journals (Sweden)

    Jarret Cassaniti

    2014-09-01

    Full Text Available Most people think of online courses when they talk about e-learning, but aspects of social media can also be considered e-learning. In 2011 the Knowledge for Health Project (K4Health began work with local partners to implement an e-learning and professional development policy for Medical Laboratory Scientists based on the needs identified by United States Agency for International Development (USAID/Nigeria. Six e-learning courses were developed and promoted through several channels including social media. A Facebook Group was created to share information about accessing and navigating the courses and attracted 8,500 members in 18 months. As the Group grew, the topics discussed evolved to include trade union news, employment opportunities and technical resources. Another Facebook Group provided insights that Facebook Groups could be used to facilitate interactions focused on continuing professional development. The findings show that Facebook Groups accommodate an informal learning style, allowing individuals to learn through peer support in flexible ways. It has also shown that the use of Facebook Groups is associated with high levels of engagement with e-learning courses.

  20. Faculty Development for Small-Group-Teaching with Simulated Patients (SP) - Design and Evaluation of a Competency-based Workshop.

    Science.gov (United States)

    Hölzer, Henrike; Freytag, Julia; Sonntag, Ulrike

    2017-01-01

    Objective: The introduction of innovative teaching formats and methods in medical education requires a specific didactic training for teachers to use complicated formats effectively. This paper describes preliminary considerations, design, implementation and evaluation of a skills-based workshop (7,5 hours long) for teaching with simulated patients. The aim is to describe the essential components for a lasting effect of the workshop so that the concept can be adapted to other contexts. Method: We present the theoretical framework, the objectives, the didactic methodology and the implementation of the workshop. The evaluation of the workshop was carried out using questionnaires. First the participants (teachers of the faculty of medicine, clinical and science subjects) were asked to estimate how well they felt prepared for small group teaching immediately after workshop. Later, after some teaching experience of their own, they gave feedback again as a part of the general evaluation of the semester. Results: In the course of three years 27 trainings were conducted and evaluated with a total of 275 participants. In the context of semester evaluation 452 questionnaires were evaluated on the quality of training. Conclusion: The evaluation shows that participants appreciate the concept of the workshop and also feel sufficiently well prepared. As a limitation it must be said that this is so far only the lecturers' self-assessment. Nevertheless, it can be stated that even a one-day workshop with a stringent teaching concept shows long term results regarding innovative teaching methods.

  1. Medical Record Clerk Training Program, Course of Study; Student Manual: For Medical Record Personnel in Small Rural Hospitals in Colorado.

    Science.gov (United States)

    Community Health Service (DHEW/PHS), Arlington, VA. Div. of Health Resources.

    The manual provides major topics, objectives, activities and, procedures, references and materials, and assignments for the training program. The topics covered are hospital organization and community role, organization and management of a medical records department, international classification of diseases and operations, medical terminology,…

  2. Spontaneous mass generation and the small dimensions of the Standard Model gauge groups U(1, SU(2 and SU(3

    Directory of Open Access Journals (Sweden)

    Guillermo García Fernández

    2017-02-01

    The result follows from strong antiscreening of the running coupling for those larger groups (with an appropriately small number of flavors together with scaling properties of the Dyson–Schwinger equation for the fermion mass.

  3. A Review and Annotated Bibliography of the Literature Pertaining to Team and Small Group Performance (1989 to 1999)

    National Research Council Canada - National Science Library

    LaJoie, Andrew

    1999-01-01

    .... Training and military doctrine has been evolving to reflect this emphasis on teamwork. The purpose of this annotated bibliography is to review literature published over the last ten years concerning team and small group performance...

  4. Gender differences and similarities in medical students' experiences of mistreatment by various groups of perpetrators.

    Science.gov (United States)

    Siller, Heidi; Tauber, Gloria; Komlenac, Nikola; Hochleitner, Margarethe

    2017-08-14

    Mistreatment of medical students during medical education is a widespread concern. Studies have shown that medical students report the most mistreatment compared to students of other study programs and that the prevalence of mistreatment peaks during clinical training. For this reason, a study was conducted to assess prevalence of mistreatment among medical students committed by various groups of people. The focus was to identify whether gender was associated with the experience of mistreatment. Additionally, students' perception of university climate for reporting sexual harassment was assessed. In the study 88 medical students (45 women, 43 men) participated. A modified version of the Questionnaire on Student Abuse was used to assess students' experience of various types of mistreatment and associated distress during medical education. To explore factors that could be associated with this experience the organizational climate for reporting sexual harassment was assessed with the Psychological Climate for Sexual Harassment. The most often cited perpetrators of mistreatment were strangers (79.5%), friends (75.0%) and university staff (68.2%). Strangers mostly committed psychological mistreatment and sexual harassment, whereas friends additionally engaged in physical mistreatment of medical students. The most common form of mistreatment conducted by university staff was humiliation of students. These kinds of psychological mistreatment were reported to be distressing (43%). Gender differences were found in the prevalence of mistreatment. Women experienced more sexual harassment and humiliation than did men. On the other hand, men experienced more physical mistreatment than did women. Women reported experiencing more distress from mistreatment experiences than did men and also more often reported being mistreated by university staff than did men. Women perceived a greater risk in reporting sexual harassment to the organization than did men. Mistreatment of female and

  5. Oregon department of transportation small business group twice-monthly payments pilot project : summary report.

    Science.gov (United States)

    2008-07-01

    Oregon Department of Transportation (ODOT) recently completed a pilot study on small business payment practices. In the study, three pilot projects were tested where payments to small business contractors were changed from a monthly payment to twice-...

  6. The Effect of Student Working Group Establishment on Teaching General Embryology Course to Medical Students

    Directory of Open Access Journals (Sweden)

    Mozafar Khazaei

    2012-11-01

    Full Text Available Introduction: Quantitative and qualitative enhancement of educational activities is an essential issue. Learners’ cooperation in the teaching process in order to increase teaching effectiveness and promotion is considered significant. The aim of the present study was to determine the effect of establishment of student working group on the teaching general embryology course to medical students.Methods: Ten students (1% of medical embryology course were selected to analyze the topics to be taught before each session according to lesson plan, and observe the whole teaching process during lesson presentation. Then, having asked the other students’ viewpoints and discussing with one another, they provided the teacher with a written report on the strengths and weaknesses of the teaching and its problems. The teacher analyzed the problems proposed by the working group to improve teaching process in the next session. At the end of the semester, a questionnaire was administered to all the participants. Data were analyzed using descriptive statistics.Results: The mean of students’ scores was 74.26%. The most important findings obtained in this study included positive role of film projection in teaching the materials (95.34%, significance of presentation of various pictures from different books (88.4%, changing students’ attitude toward application of embryology in different diseases (86%, and repetition of previous session’s pictures (83.75%. The weak points mentioned, however, were physical problems of the classroom and deficiency of audio visual equipment.Conclusion: Student working group has a positive impact on the teaching medical general embryology.

  7. Are medical treatments for individuals and groups like single-play and multiple-play gambles?

    Directory of Open Access Journals (Sweden)

    Michael L. DeKay

    2006-11-01

    Full Text Available People are often more likely to accept risky monetary gambles with positive expected values when the gambles will be played more than once. We investigated whether this distinction between single-play and multiple-play gambles extends to medical treatments for individual patients and groups of patients. Resident physicians and medical students (extit{n} = 69 and undergraduates (extit{n} = 99 ranked 9 different flu shots and a no-flu-shot option in 1 of 4 combinations of perspective (individual patient vs. group of 1000 patients and uncertainty frame (probability vs. frequency. The rank of the no-flu-shot option (a measure of preference for treatment vs. no treatment was not significantly related to perspective or participant population. The main effect of uncertainty frame and the interaction between perspective and uncertainty frame approached significance (0.1 {extgreater} extit{p} {extgreater} 0.05, with the no-flu-shot option faring particularly poorly (treatment faring particularly well when decisions about many patients were based on frequency information. Undergraduate participants believed that the no-flu-shot option would be less attractive (treatment would be more attractive in decisions about many patients, but these intuitions were inconsistent with the actual ranks. These results and those of other studies suggest that medical treatments for individuals and groups are not analogous to single-play and multiple-play monetary gambles, perhaps because many people are unwilling to aggregate treatment outcomes over patients in the same way that they would compute net gains or losses over monetary gambles.

  8. Effectiveness of a group-based intervention to change medication beliefs and improve medication adherence in patients with rheumatoid arthritis: a randomized controlled trial.

    NARCIS (Netherlands)

    Zwikker, H.E.; Ende, C.H. van den; Lankveld, W.G. van; Broeder, A.A. den; Hoogen, F.H. van den; Mosselaar, B. van de; Dulmen, S. van; Bemt, B.J. van den

    2014-01-01

    Objective: To assess the effect of a group-based intervention on the balance between necessity beliefs and concern beliefs about medication and on medication non-adherence in patients with rheumatoid arthritis (RA). Methods: Non-adherent RA patients using disease-modifying anti-rheumatic drugs

  9. Experiences of sickness absence, marginality and Medically Unexplained Physical Symptoms - A focus group study

    DEFF Research Database (Denmark)

    E.L., Werner; A, Aamland; Malterud, Kirsti

    2013-01-01

    PURPOSE: Medically unexplained physical symptoms (MUPS) form a major cause of sickness absence. The purpose of this study was to explore factors which may influence further marginalization among patients with MUPS on long-term sickness absence. METHODS: Two focus-group discussions were conducted...... of objective findings were perceived as an additional burden to the sickness absence itself. Factors that could counteract further marginalization were a supportive social network, positive coping strategies such as keeping to the daily schedule and physical activity, and positive attention and confidence from...

  10. Salary survey of the Medical Library Group of Southern California and Arizona.

    Science.gov (United States)

    Smith, J L; Connolly, B F; Davis, M; Graham, E; Wheeler, S

    1984-01-01

    The 1982 salary survey of the Medical Library Group of Southern California and Arizona (MLGSCA) indicates that 211 health sciences librarians in Southern California and Arizona earned a mean annual salary of $20,910 for 1982. Data analysis shows a positive correlation between salary and educational level. Other factors found to affect salary were job history, number of positions held, MLA certification, and professional responsibility. Age, gender, and MLA certification did not have a consistent positive correlation with salary. Results indicate that the salaries of hospital librarians are, on the average, roughly comparable to those of academic librarians in Southern California and Arizona. PMID:6743878

  11. The networked minority: How a small group prevailed in a local windfarm conflict

    International Nuclear Information System (INIS)

    Anderson, Carmel

    2013-01-01

    This paper aims to explain through a qualitative case study how a small protest group prevailed during a local windfarm conflict in south-eastern Australia. A social capital analytical framework was developed to analyse the data. The analysis found that two communities inhabited the area for which the windfarm development was proposed. The public participation process failed to address the concerns of both communities and led to the emergence of a social network of resistance. The network had high stocks of bridging social capital, which enabled an effective protest that led to the abandonment of the development. Their effectiveness was inadvertently aided by the windfarm supporters who were unable to act collectively to defend their interests because socio-economic changes in the community among other factors had led to a depletion of their social capital. In this context, different democratic participatory processes were needed to address the concerns of the two communities. Guidance and tools for researching and developing the types of participatory processes needed for vulnerable communities with low social capital and those similar to the social network with high social capital are provided. These will inform community-appropriate public participation processes and participatory planning policy. - Highlights: ► A case study of a local social network's resistance to a windfarm is undertaken. ► The link between high social capital and resistance is confirmed. ► Successful protest groups can be aided by passive windfarm supporters. ► Protesters are likely to participate in well-designed participatory processes. ► Guidance for developing community-specific participatory processes is provided

  12. Perspectives on Troubled Interactions:What Happened When a Small Group

    Directory of Open Access Journals (Sweden)

    Sara Ross

    2006-06-01

    Full Text Available This study investigated fostering political development (as defined in the report through an integration of adult development, public issues analysis, and structured public discourse. Entitled The Integral Process For Working On Complex Issues (TIP, that multi-session discourse methodology includes issue analysis and framing, deliberation, and organizing systemic action. Its issue-framing template helps users generate multiple approaches to issues that reflect different levels of complexity and incorporate the conceivable human and institutional perspectives and environmental life conditions. The small group used the discourse process to select a public issue of concern and to begin to address it. It was about how to change the community’s adversarial political culture. They conducted a deliberative action inquiry into their own tones and intentions toward that issue as the starting point to address it, and did deliberative decision-making on that basis. The political reasoning and culture of the group developed during the study, evidenced by the group’s work and changes that participants experienced. The study is the first of its kind in several respects, which are: (a to use this public discourse process as part of the research methodology, (b to perform this kind of empirical research on public discourse and deliberation, and (c to foster political and adult development while addressing complex issues. This extended length research report departs from traditional journal article formats not only by its length but also by integrating its report of findings with analyses of the processes that resulted in the findings. It is complemented by a shorter article in this issue of Integral Review, which describes the steps of the process and the major themes evident in participants’ experience.

  13. Risk transfer formula for individual and small group markets under the Affordable Care Act.

    Science.gov (United States)

    Pope, Gregory C; Bachofer, Henry; Pearlman, Andrew; Kautter, John; Hunter, Elizabeth; Miller, Daniel; Keenan, Patricia

    2014-01-01

    The Affordable Care Act provides for a program of risk adjustment in the individual and small group health insurance markets in 2014 as Marketplaces are implemented and new market reforms take effect. The purpose of risk adjustment is to lessen or eliminate the influence of risk selection on the premiums that plans charge. The risk adjustment methodology includes the risk adjustment model and the risk transfer formula. This article is the third of three in this issue of the Medicare & Medicaid Research Review that describe the ACA risk adjustment methodology and focuses on the risk transfer formula. In our first companion article, we discussed the key issues and choices in developing the methodology. In our second companion paper, we described the risk adjustment model that is used to calculate risk scores. In this article we present the risk transfer formula. We first describe how the plan risk score is combined with factors for the plan allowable premium rating, actuarial value, induced demand, geographic cost, and the statewide average premium in a formula that calculates transfers among plans. We then show how each plan factor is determined, as well as how the factors relate to each other in the risk transfer formula. The goal of risk transfers is to offset the effects of risk selection on plan costs while preserving premium differences due to factors such as actuarial value differences. Illustrative numerical simulations show the risk transfer formula operating as anticipated in hypothetical scenarios.

  14. Metagenomics uncovers a new group of low GC and ultra-small marine Actinobacteria

    Science.gov (United States)

    Ghai, Rohit; Mizuno, Carolina Megumi; Picazo, Antonio; Camacho, Antonio; Rodriguez-Valera, Francisco

    2013-01-01

    We describe a deep-branching lineage of marine Actinobacteria with very low GC content (33%) and the smallest free living cells described yet (cell volume ca. 0.013 μm3), even smaller than the cosmopolitan marine photoheterotroph, ‘Candidatus Pelagibacter ubique'. These microbes are highly related to 16S rRNA sequences retrieved by PCR from the Pacific and Atlantic oceans 20 years ago. Metagenomic fosmids allowed a virtual genome reconstruction that also indicated very small genomes below 1 Mb. A new kind of rhodopsin was detected indicating a photoheterotrophic lifestyle. They are estimated to be ~4% of the total numbers of cells found at the site studied (the Mediterranean deep chlorophyll maximum) and similar numbers were estimated in all tropical and temperate photic zone metagenomes available. Their geographic distribution mirrors that of picocyanobacteria and there appears to be an association between these microbial groups. A new sub-class, ‘Candidatus Actinomarinidae' is proposed to designate these microbes. PMID:23959135

  15. Defining quality criteria for online continuing medical education modules using modified nominal group technique.

    Science.gov (United States)

    Shortt, S E D; Guillemette, Jean-Marc; Duncan, Anne Marie; Kirby, Frances

    2010-01-01

    The rapid increase in the use of the Internet for continuing education by physicians suggests the need to define quality criteria for accredited online modules. Continuing medical education (CME) directors from Canadian medical schools and academic researchers participated in a consensus process, Modified Nominal Group Technique, to develop agreement on the most important quality criteria to guide module development. Rankings were compared to responses to a survey of a subset of Canadian Medical Association (CMA) members. A list of 17 items was developed, of which 10 were deemed by experts to be important and 7 were considered secondary. A quality module would: be needs-based; presented in a clinical format; utilize evidence-based information; permit interaction with content and experts; facilitate and attempt to document practice change; be accessible for later review; and include a robust course evaluation. There was less agreement among CMA members on criteria ranking, with consensus on ranking reached on only 12 of 17 items. In contrast to experts, members agreed that the need to assess performance change as a result of an educational experience was not important. This project identified 10 quality criteria for accredited online CME modules that representatives of Canadian organizations involved in continuing education believe should be taken into account when developing learning products. The lack of practitioner support for documentation of change in clinical behavior may suggest that they favor traditional attendance- or completion-based CME; this finding requires further research.

  16. Basis of integrated approach to sports and recreational activities of students of special medical groups

    Directory of Open Access Journals (Sweden)

    L.V. Zaharova

    2014-02-01

    Full Text Available Purpose : to prove the superiority of techniques integrated approach to sports and recreational activities of students of special medical groups in the educational institution. Material / methods : the annual pedagogical experiment conducted on three groups that have been formed based on the results of preliminary studies based on diagnosis. Learning process based on the principle of improving training. Results : the advantages of an integrated approach to sports and recreational activities of students with disorders of the musculoskeletal system. Recommended approaches to increase physical and functional training. Also - the formation of a stable demand of motor activity, leading healthy lifestyles, in the acquisition of social status in the educational activity. Conclusions : the integrated approach will meet the educational needs of students to form a cultural competence of the individual in the preservation and conservation of health, ability to adapt and successfully implement their professional activities.

  17. The regulatory framework of special medical group students' physical education: identifying the problem.

    Directory of Open Access Journals (Sweden)

    Mazur Valerij Anatol'evich

    2011-09-01

    Full Text Available The question of regulatory framework for special medical group students' physical education, and their physical condition in particular is elaborated. It is found that in the current program the identified question is missing, although the assessment of individual performance standards for the physical condition of the students was envisaged in the programs of 1977 and 1982. The need for such an assessment is indicated by the large number of Ukrainian and foreign pediatricians and specialists in therapeutic physical culture. At the same time the standards for assessing these indicators are not developed. It complicates the formation of positive motivation of students to regular classes, and does not promote their self-confidence, capabilities and effectiveness of monitoring the effectiveness of exercise in various forms. The findings suggest the need to define the optimal composition of the bulk of tests and functional tests to assess the physical condition of special medical group students with various diseases and to develop appropriate indicators for their evaluation standards.

  18. Task Performance in Small Group Settings: The Role of Group Members' Self-Efficacy And Collective Efficacy and Group's Characteristics

    Science.gov (United States)

    Khong, Jerrine Z. N.; Liem, Gregory Arief D.; Klassen, Robert M.

    2017-01-01

    The present study extends the literature by investigating the relative salience of self- and collective efficacy in predicting group performance among early adolescents in Indonesia. A total of 435 early adolescents (mean age 11.70 years, 53% female) were randomly assigned to groups of three to four and completed three group tasks (task 1:…

  19. Interprofessional communication skills training for serious illness: evaluation of a small-group, simulated patient intervention.

    Science.gov (United States)

    Bays, Alison M; Engelberg, Ruth A; Back, Anthony L; Ford, Dee W; Downey, Lois; Shannon, Sarah E; Doorenbos, Ardith Z; Edlund, Barbara; Christianson, Phyllis; Arnold, Richard W; O'Connor, Kim; Kross, Erin K; Reinke, Lynn F; Cecere Feemster, Laura; Fryer-Edwards, Kelly; Alexander, Stewart C; Tulsky, James A; Curtis, J Randall

    2014-02-01

    Communication with patients and families is an essential component of high-quality care in serious illness. Small-group skills training can result in new communication behaviors, but past studies have used facilitators with extensive experience, raising concerns this is not scalable. The objective was to investigate the effect of an experiential communication skills building workshop (Codetalk), led by newly trained facilitators, on internal medicine trainees' and nurse practitioner students' ability to communicate bad news and express empathy. Trainees participated in Codetalk; skill improvement was evaluated through pre- and post- standardized patient (SP) encounters. The subjects were internal medicine residents and nurse practitioner students at two universities. The study was carried out in anywhere from five to eight half-day sessions over a month. The first and last sessions included audiotaped trainee SP encounters coded for effective communication behaviors. The primary outcome was change in communication scores from pre-intervention to post-intervention. We also measured trainee characteristics to identify predictors of performance and change in performance over time. We enrolled 145 trainees who completed pre- and post-intervention SP interviews-with participation rates of 52% for physicians and 14% for nurse practitioners. Trainees' scores improved in 8 of 11 coded behaviors (p<0.05). The only significant predictors of performance were having participated in the intervention (p<0.001) and study site (p<0.003). The only predictor of improvement in performance over time was participating in the intervention (p<0.001). A communication skills intervention using newly trained facilitators was associated with improvement in trainees' skills in giving bad news and expressing empathy. Improvement in communication skills did not vary by trainee characteristics.

  20. Using Cooperative Small Groups in Introductory Accounting Classes: A Practical Approach.

    Science.gov (United States)

    Miglietti, Cynthia

    2002-01-01

    Effective use of cooperative learning groups requires the following: attention to group formation, orientation that sets clear expectations and guidelines, activities to develop teamwork skills, peer evaluation, and other assessments that recognize and measure individual effort on group projects. (SK)

  1. Small-scale medical waste incinerators - experiences and trials in South Africa

    International Nuclear Information System (INIS)

    Rogers, David E.C.; Brent, Alan C.

    2006-01-01

    Formal waste management services are not accessible for the majority of primary healthcare clinics on the African continent, and affordable and practicable technology solutions are required in the developing country context. In response, a protocol was established for the first quantitative and qualitative evaluation of relatively low cost small-scale incinerators for use at rural primary healthcare clinics. The protocol comprised the first phase of four, which defined the comprehensive trials of three incineration units. The trials showed that all of the units could be used to render medical waste non-infectious, and to destroy syringes or render needles unsuitable for reuse. Emission loads from the incinerators are higher than large-scale commercial incinerators, but a panel of experts considered the incinerators to be more acceptable compared to the other waste treatment and disposal options available in under-serviced rural areas. However, the incinerators must be used within a safe waste management programme that provides the necessary resources in the form of collection containers, maintenance support, acceptable energy sources, and understandable operational instructions for the incinerators, whilst minimising the exposure risks to emissions through the correct placement of the units in relation to the clinic and the surrounding communities. On-going training and awareness building are essential in order to ensure that the incinerators are correctly used as a sustainable waste treatment option

  2. 77 FR 9882 - Arsenic Small Systems Compliance and Alternative Affordability Criteria Working Group; public...

    Science.gov (United States)

    2012-02-21

    ... affordability criteria that give extra weight to small, rural, and lower income communities. This meeting will... held via the Internet using a Webcast and teleconference. Registrants will receive an Internet access... affordability criteria that give extra weight to small, rural, and lower income communities. Based upon input...

  3. Collaborative-group testing improves learning and knowledge retention of human physiology topics in second-year medical students.

    Science.gov (United States)

    Vázquez-García, Mario

    2018-06-01

    The present study examined the relationship between second-year medical students' group performance and individual performance in a collaborative-learning environment. In recent decades, university professors in the scientific and humanistic disciplines have successfully put into practice different modalities of collaborative approaches to teaching. Essentially, collaborative approach refers to a variety of techniques that involves the joint intellectual effort of a small group of students, which encourages interaction and discussion among students and professors. The present results show the efficacy of collaborative learning, which, furthermore, allowed students to participate actively in the physiology class. Average student's grades were significantly higher when they engaged in single-best-response, multiple-choice tests as a student team, compared with taking the same examinations individually. The method improved notably knowledge retention, as learning is more effective when performed in the context of collaborative partnership. A selected subset of questions answered wrongly in an initial test, both individually and collectively, was used on a second test to examine student retention of studied material. Grade averages were significantly improved, both individually and groupwise, when students responded to the subset of questions a second time, 1, 2, or 3 wk after the first attempt. These results suggest that the collaborative approach to teaching allowed a more effective understanding of course content, which meant an improved capacity for retention of human physiology knowledge.

  4. THINKING ALOUD, TALKING, AND LEAThinking aloud, talking, and learning to read: esl reading comprehension training in small cooperative groups Thinking aloud, talking, and learning to read: esl reading comprehension training in small cooperative groups

    Directory of Open Access Journals (Sweden)

    Yael Bejanaro

    2008-04-01

    Full Text Available Training students to become independent skillful readers is a major concern of the EFL reading teacher. How can we best train students in selecting and applying reading strategies so that they become more efficient readers? Can we ensure that an increase in students’ awareness of the need to use strategies will help them become more skillful readers? These questions served as a trigger for this study. The aim of this study was to investigate whether verbal articulation of reading behavior in a small group will improve foreign language comprehension. It is our contention that using verbalization in small groups will raise metacognitive awareness which will in turn enhance effective use of skills and strategies and result in improvement in reading comprehension. We assume that the special features that characterize small group interactions can provide an appropriate setting for raising metacognitive awareness. Training students to become independent skillful readers is a major concern of the EFL reading teacher. How can we best train students in selecting and applying reading strategies so that they become more efficient readers? Can we ensure that an increase in students’ awareness of the need to use strategies will help them become more skillful readers? These questions served as a trigger for this study. The aim of this study was to investigate whether verbal articulation of reading behavior in a small group will improve foreign language comprehension. It is our contention that using verbalization in small groups will raise metacognitive awareness which will in turn enhance effective use of skills and strategies and result in improvement in reading comprehension. We assume that the special features that characterize small group interactions can provide an appropriate setting for raising metacognitive awareness.

  5. Effectiveness of a group-based intervention to change medication beliefs and improve medication adherence in patients with rheumatoid arthritis: a randomized controlled trial.

    Science.gov (United States)

    Zwikker, Hanneke E; van den Ende, Cornelia H; van Lankveld, Wim G; den Broeder, Alfons A; van den Hoogen, Frank H; van de Mosselaar, Birgit; van Dulmen, Sandra; van den Bemt, Bart J

    2014-03-01

    To assess the effect of a group-based intervention on the balance between necessity beliefs and concern beliefs about medication and on medication non-adherence in patients with rheumatoid arthritis (RA). Non-adherent RA patients using disease-modifying anti-rheumatic drugs (DMARDs) were randomized to an intervention or control arm. The intervention consisted, amongst others, of two motivational interviewing-guided group sessions led by the same pharmacist. Control patients received brochures about their DMARDs. Questionnaires were completed up to 12 months follow-up. 123 patients (mean age: 60 years, female: 69%) were randomized. No differences in necessity beliefs and concern beliefs about medication and in medication non-adherence were detected between the intervention and control arm, except at 12 months' follow-up: participants in the intervention arm had less strong necessity beliefs about medication than participants in the control arm (b: -1.0 (95% CI: -2.0, -0.1)). This trial did not demonstrate superiority of our intervention over the control arm in changing beliefs about medication or in improving medication adherence over time. Absent intervention effects might have been due to, amongst others, selection bias and a suboptimal treatment integrity level. Hence, targeting beliefs about medication in clinical practice should not yet be ruled out. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.

  6. Sickness absence, marginality, and medically unexplained physical symptoms: a focus-group study of patients' experiences.

    Science.gov (United States)

    Aamland, Aase; Werner, Erik L; Malterud, Kirsti

    2013-06-01

    Medically unexplained physical symptoms (MUPS) form a major cause of sickness absence. The purpose of this study was to explore factors which may influence further marginalization among patients with MUPS on long-term sickness absence. Two focus-group discussions were conducted with a purposive sample of 12 participants, six men and six women, aged 24-59 years. Their average duration of sickness absence was 10.5 months. Participants were invited to share stories about experiences from the process leading to the ongoing sickness absence, with a focus on the causes being medically unexplained. Systematic text condensation was applied for analysis. Inspired by theories of marginalization and coping, the authors searched for knowledge of how patients' positive resources can be mobilized to counteract processes of marginality. Analysis revealed how invisible symptoms and lack of objective findings were perceived as an additional burden to the sickness absence itself. Factors that could counteract further marginalization were a supportive social network, positive coping strategies such as keeping to the daily schedule and physical activity, and positive attention and confidence from professionals. Confidence from both personal and professional contacts is crucial. GPs have an important and appreciated role in this aspect.

  7. Reducing legal fees in medical group practices. The role of health care alternative dispute resolution.

    Science.gov (United States)

    Joseph, D M

    1995-01-01

    Conflict is a growth industry, particularly in an increasingly complex health care system. Litigation is the most common, and most costly, method of settling health care disputes. Highly adversarial, the process of litigation often generates as much, if not more, hostility than the original dispute. In addition, satisfaction with the outcome is very low. The challenge that has arisen is to manage the conflicts so that the underlying needs and interests of all the parties can best be met. Often the techniques and processes of alternative dispute resolution (ADR) can be successfully used in resolving these sorts of conflicts quickly, cheaply and with greater satisfaction for all parties. Various applications of ADR are currently being used or tested in a variety of health care disputes in the United States and Canada. Tremendous success has been achieved in mediating medical malpractice claims, medical staff disputes, economic credentialing conflicts, insurer relations issues and denial of coverage disputes. Professional relations and departmental staff disputes, partnership and employee conflicts, and organizational disputes within clinics, HMOs and large group practices have all been found particularly amenable to ADR. These are all situations in which everyone benefits from quick, non-hostile resolutions and on-going relationships can continue.

  8. The ways of teaching process optimization in physical education of the students’ special medical group

    Directory of Open Access Journals (Sweden)

    U.A. Bukov

    2013-06-01

    Full Text Available Purpose – to identify the effectiveness of the use of innovative approaches in physical education teaching process of special medical group students. The study involved 15 boys aged 13-14 years. The lesson include exercises consisting of the elements of Pilates, yoga and static body-oriented therapy. The proposed program of physical exercises performed by students in the main part of the lesson and took the volume to 80% of the time. Set to increase the functionality of the skeletal muscles, the adaptive capacity of cardio-respiratory system, the health and strength of the nervous system, optimization of anthropometric indices, improved spinal mobility. A high degree of efficiency in the learning process of innovation of general preventive and therapeutic intervention is identified. Proposed to use in the educational process modern methods of prevention and correction

  9. Utility of a dermatology interest group blog: the impact of medical student interest groups and Web 2.0 tools as educational resources

    Directory of Open Access Journals (Sweden)

    Jalalat SZ

    2014-09-01

    Full Text Available Sheila Z Jalalat, Richard F Wagner Jr Department of Dermatology, University of Texas Medical Branch, Galveston, TX, USA Abstract: The open access University of Texas Dermatology Interest Group blog was established in 2004 for the purposes of increasing communication and collaboration between medical students and dermatology faculty, residents, and alumni, as well as to promote educational opportunities and the missions for which the interest group was created. This blog is unique because of its longevity and continuous postings directed toward the educational and professional needs of medical students and residents. A blog user survey was performed to assess viewers' thoughts, purpose of viewing, demographic profile, subscriber status, usage of the blog and other Web 2.0 tools (forums, Facebook, blogs, Twitter, podcasts, and perceived usefulness. Sixty-one anonymous online surveys were completed during a 1-month period. Statistical analyses of the responses demonstrated that the utilization of web-based tools and the blog were valuable resources for students, especially for blog subscribers, those more involved in an interest group, and those reading the blog for a longer period of time. The usefulness and impact of this method of communication and dissemination of information in medical education may encourage other student groups, faculty advisors, and educators to implement similar educational tools at their institutions. Keywords: education, medical student, dermatology, blog

  10. Medical malpractice in the management of small bowel obstruction: A 33-year review of case law.

    Science.gov (United States)

    Choudhry, Asad J; Haddad, Nadeem N; Rivera, Mariela; Morris, David S; Zietlow, Scott P; Schiller, Henry J; Jenkins, Donald H; Chowdhury, Naadia M; Zielinski, Martin D

    2016-10-01

    Annually, 15% of practicing general surgeons face a malpractice claim. Small bowel obstruction accounts for 12-16% of all surgical admissions. Our objective was to analyze malpractice related to small bowel obstruction. Using the search terms "medical malpractice" and "small bowel obstruction," we searched through all jury verdicts and settlements for Westlaw. Information was collected on case demographics, alleged reasons for malpractice, and case outcomes. The search criteria yielded 359 initial case briefs; 156 met inclusion criteria. The most common reason for litigation was failure to diagnose and timely manage the small bowel obstruction (69%, n = 107). Overall, 54% (n = 84) of cases were decided in favor of the defendant (physician). Mortality was noted in 61% (n = 96) of cases. Eighty-six percent (42/49) of cases litigated as a result of failing to diagnose and manage the small bowel obstruction in a timely manner, resulting in patient mortality, had a verdict with an award payout for the plaintiff (patient). The median award payout was $1,136,220 (range, $29,575-$12,535,000). A majority of malpractice cases were decided in favor of the defendants; however, cases with an award payout were costly. Timely intervention may prevent a substantial number of medical malpractice lawsuits in small bowel obstruction, arguing in favor of small bowel obstruction management protocols. Copyright © 2016 Elsevier Inc. All rights reserved.

  11. Small Group Conflict: A Look at Equity, Satisfaction, and Styles of Conflict Management.

    Science.gov (United States)

    Wall, Victor D., Jr.; Nolan, Linda L.

    1987-01-01

    Study of 71 task-oriented groups revealed that perceived inequity was negatively related to amount of expressed satisfaction with the group and positively related to amount of perceived conflict within the group. Inequity was associated more strongly with conflict centered around people than with conflict centered around task; least associated…

  12. Estimating cohesion in small groups using audio-visual nonverbal behavior

    NARCIS (Netherlands)

    Hung, H.; Gatica-Perez, D.

    2010-01-01

    Cohesiveness in teams is an essential part of ensuring the smooth running of task-oriented groups. Research in social psychology and management has shown that good cohesion in groups can be correlated with team effectiveness or productivity, so automatically estimating group cohesion for team

  13. An Analysis of Small Group Interactions of Vietnamese Students under the Bourdieusian Theoretical Lens

    Science.gov (United States)

    Pham, Thanh; Pham, Lam

    2018-01-01

    Group work has been increasingly encouraged and applied in Vietnamese universities. However, very little has been known about how Vietnamese university students work in a group and what the conditions are that help establish an effective group. This study attempted to redress this gap. The research applied Bourdieu's social field theory to examine…

  14. Small groups, large profits: Calculating interest rates in community-managed microfinance

    DEFF Research Database (Denmark)

    Rasmussen, Ole Dahl

    2012-01-01

    Savings groups are a widely used strategy for women’s economic resilience – over 80% of members worldwide are women, and in the case described here, 72.5%. In these savings groups it is common to see the interest rate on savings reported as "20-30% annually". Using panel data from 204 groups...... in Malawi, I show that the right figure is likely to be at least twice this figure. For these groups, the annual return is 62%. The difference comes from sector-wide application of a non-standard interest rate calculations and unrealistic assumptions about the savings profile in the groups. As a result......, it is impossible to compare returns in savings groups with returns elsewhere. Moreover, the interest on savings is incomparable to the interest rate on loans. I argue for the use of a standardized comparable metric and suggest easy ways to implement it. Developments of new tools and standard along these lines...

  15. Health Technology Assessment for Molecular Diagnostics: Practices, Challenges, and Recommendations from the Medical Devices and Diagnostics Special Interest Group.

    Science.gov (United States)

    Garfield, Susan; Polisena, Julie; S Spinner, Daryl; Postulka, Anne; Y Lu, Christine; Tiwana, Simrandeep K; Faulkner, Eric; Poulios, Nick; Zah, Vladimir; Longacre, Michael

    2016-01-01

    Health technology assessments (HTAs) are increasingly used to inform coverage, access, and utilization of medical technologies including molecular diagnostics (MDx). Although MDx are used to screen patients and inform disease management and treatment decisions, there is no uniform approach to their evaluation by HTA organizations. The International Society for Pharmacoeconomics and Outcomes Research Devices and Diagnostics Special Interest Group reviewed diagnostic-specific HTA programs and identified elements representing common and best practices. MDx-specific HTA programs in Europe, Australia, and North America were characterized by methodology, evaluation framework, and impact. Published MDx HTAs were reviewed, and five representative case studies of test evaluations were developed: United Kingdom (National Institute for Health and Care Excellence's Diagnostics Assessment Programme, epidermal growth factor receptor tyrosine kinase mutation), United States (Palmetto's Molecular Diagnostic Services Program, OncotypeDx prostate cancer test), Germany (Institute for Quality and Efficiency in Healthcare, human papillomavirus testing), Australia (Medical Services Advisory Committee, anaplastic lymphoma kinase testing for non-small cell lung cancer), and Canada (Canadian Agency for Drugs and Technologies in Health, Rapid Response: Non-invasive Prenatal Testing). Overall, the few HTA programs that have MDx-specific methods do not provide clear parameters of acceptability related to clinical and analytic performance, clinical utility, and economic impact. The case studies highlight similarities and differences in evaluation approaches across HTAs in the performance metrics used (analytic and clinical validity, clinical utility), evidence requirements, and how value is measured. Not all HTAs are directly linked to reimbursement outcomes. To improve MDx HTAs, organizations should provide greater transparency, better communication and collaboration between industry and HTA

  16. Teaching self-control to small groups of dually diagnosed adults.

    OpenAIRE

    Dixon, M R; Holcomb, S

    2000-01-01

    The present study examined the use of a progressive delay procedure to teach self-control to two groups of dually diagnosed adults. When given a choice between an immediate smaller reinforcer and a larger delayed reinforcer, both groups chose the smaller reinforcer during baseline. During treatment, progressive increases in work requirements for gaining access to a larger reinforcer resulted in both groups selecting larger delayed reinforcers. The results are discussed with respect to increas...

  17. Implementation of modified team-based learning within a problem based learning medical curriculum: a focus group study.

    Science.gov (United States)

    Burgess, Annette; Roberts, Chris; Ayton, Tom; Mellis, Craig

    2018-04-10

    While Problem Based Learning (PBL) has long been established internationally, Team-based learning (TBL) is a relatively new pedagogy in medical curricula. Both PBL and TBL are designed to facilitate a learner-centred approach, where students, in interactive small groups, use peer-assisted learning to solve authentic, professionally relevant problems. Differences, however, exist between PBL and TBL in terms of preparation requirements, group numbers, learning strategies, and class structure. Although there are many similarities and some differences between PBL and TBL, both rely on constructivist learning theory to engage and motivate students in their learning. The aim of our study was to qualitatively explore students' perceptions of having their usual PBL classes run in TBL format. In 2014, two iterations in a hybrid PBL curriculum were converted to TBL format, with two PBL groups of 10 students each, being combined to form one TBL class of 20, split into four groups of five students. At the completion of two TBL sessions, all students were invited to attend one of two focus groups, with 14 attending. Thematic analysis was used to code and categorise the data into themes, with constructivist theory used as a conceptual framework to identify recurrent themes. Four key themes emerged; guided learning, problem solving, collaborative learning, and critical reflection. Although structured, students were attracted to the active and collaborative approach of TBL. They perceived the key advantages of TBL to include the smaller group size, the preparatory Readiness Assurance Testing process, facilitation by a clinician, an emphasis on basic science concepts, and immediate feedback. The competitiveness of TBL was seen as a spur to learning. These elements motivated students to prepare, promoted peer assisted teaching and learning, and focussed team discussion. An important advantage of PBL over TBL, was the opportunity for adequate clinical reasoning within the problem

  18. 45 CFR 146.150 - Guaranteed availability of coverage for employers in the small group market.

    Science.gov (United States)

    2010-10-01

    ... SERVICES REQUIREMENTS RELATING TO HEALTH CARE ACCESS REQUIREMENTS FOR THE GROUP HEALTH INSURANCE MARKET... (and their dependents) or any health status-related factor relating to those employees and dependents... status-related factor relating to those employees and dependents. (2) An issuer that denies group health...

  19. Need for Cognition and Active Information Search in Small Student Groups

    Science.gov (United States)

    Curseu, Petru Lucian

    2011-01-01

    In a sample of 213 students organized in 44 groups this study tests the impact of need for cognition on active information search by using a multilevel analysis. The results show that group members with high need for cognition seek more advice in task related issues than those with low need for cognition and this pattern of information exchange is…

  20. "Explain to Your Partner": Teachers' Instructional Practices and Students' Dialogue in Small Groups

    Science.gov (United States)

    Webb, Noreen M.; Franke, Megan L.; De, Tondra; Chan, Angela G.; Freund, Deanna; Shein, Pat; Melkonian, Doris K.

    2009-01-01

    Collaborative group work has great potential to promote student learning, and increasing evidence exists about the kinds of interaction among students that are necessary to achieve this potential. Less often studied is the role of the teacher in promoting effective group collaboration. This article investigates the extent to which teachers'…

  1. Examining the Effect of Small Group Discussions and Question Prompts on Vicarious Learning Outcomes

    Science.gov (United States)

    Lee, Yekyung; Ertmer, Peggy A.

    2006-01-01

    This study investigated the effect of group discussions and question prompts on students' vicarious learning experiences. Vicarious experiences were delivered to 65 preservice teachers via VisionQuest, a Web site that provided examples of successful technology integration. A 2x2 factorial research design employed group discussions and question…

  2. Administrative Leadership in Three Small, Private Tennessee Colleges: Working Groups, Real Teams, or Both?

    Science.gov (United States)

    Nichols, Michael E.

    2010-01-01

    Diversity of knowledge and multiple perspectives are characteristic advantages of group leadership as compared to transactional or bureaucratic forms of leadership. When groups are engaged in administrative functions, they are more likely to realize a higher level of performance and more relevant and innovative solutions than may be achieved by a…

  3. Testing the Efficacy of a Kindergarten Mathematics Intervention by Small Group Size

    Directory of Open Access Journals (Sweden)

    Ben Clarke

    2017-04-01

    Full Text Available This study used a randomized controlled trial design to investigate the ROOTS curriculum, a 50-lesson kindergarten mathematics intervention. Ten ROOTS-eligible students per classroom (n = 60 were randomly assigned to one of three conditions: a ROOTS five-student group, a ROOTS two-student group, and a no-treatment control group. Two primary research questions were investigated as part of this study: What was the overall impact of the treatment (the ROOTS intervention as compared with the control (business as usual? Was there a differential impact on student outcomes between the two treatment conditions (two- vs. five-student group? Initial analyses for the first research question indicated a significant impact on three outcomes and positive but nonsignificant impacts on three additional measures. Results for the second research question, comparing the two- and five-student groups, indicated negligible and nonsignificant differences. Implications for practice are discussed.

  4. The Effect of the Student Success Skills Small Group Counseling Intervention on Factors Associated with Dropout Potential in High School

    Science.gov (United States)

    Weinstein, Jodie

    2013-01-01

    The focus of this study is to add to the outcome research on effective school counseling interventions and to specifically evaluate the effectiveness of the Student Success Skills (SSS) small group intervention with students identified as having drop out potential in the 9th grade. This study analyzed two years of pre-existing, non-identifiable…

  5. A Meta-Analytic Review of Studies of the Effectiveness of Small-Group Learning Methods on Statistics Achievement

    Science.gov (United States)

    Kalaian, Sema A.; Kasim, Rafa M.

    2014-01-01

    This meta-analytic study focused on the quantitative integration and synthesis of the accumulated pedagogical research in undergraduate statistics education literature. These accumulated research studies compared the academic achievement of students who had been instructed using one of the various forms of small-group learning methods to those who…

  6. Among Friends: The Role of Academic-Preparedness Diversity in Individual Performance within a Small-Group STEM Learning Environment

    Science.gov (United States)

    Micari, Marina; Van Winkle, Zachary; Pazos, Pilar

    2016-01-01

    In this study, we investigate the relationship between academic-preparedness diversity within small learning groups and individual academic performance in science, technology, engineering, and mathematics (STEM) university courses. We further examine whether academic-preparedness diversity impacts academically more- and less-prepared students…

  7. The Nature of Students' Efferent or Aesthetic Responses to Nonfiction Texts in Small, Peer-Led Literature Discussion Groups

    Science.gov (United States)

    Khieu, Tema Leah

    2014-01-01

    The purpose of this study was to provide an in-depth exploration and describe the nature of fourth graders' responses to nonfiction text in the context of small, peer-led literature discussion groups. This study took place in the teacher researcher's daily, forty-five minute, pull-out intervention time. The participants for this study consisted of…

  8. On the use of the Lie group technique for differential equations with a small parameter: Approximate solutions and integrable equations

    International Nuclear Information System (INIS)

    Burde, G.I.

    2002-01-01

    A new approach to the use of the Lie group technique for partial and ordinary differential equations dependent on a small parameter is developed. In addition to determining approximate solutions to the perturbed equation, the approach allows constructing integrable equations that have solutions with (partially) prescribed features. Examples of application of the approach to partial differential equations are given

  9. A Model of Small-Group Problem-Based Learning in Pharmacy Education: Teaching in the Clinical Environment

    Science.gov (United States)

    Khumsikiew, Jeerisuda; Donsamak, Sisira; Saeteaw, Manit

    2015-01-01

    Problem-based Learning (PBL) is an alternate method of instruction that incorporates basic elements of cognitive learning theory. Colleges of pharmacy use PBL to aid anticipated learning outcomes and practice competencies for pharmacy student. The purpose of this study were to implement and evaluate a model of small group PBL for 5th year pharmacy…

  10. Children's Behaviors and Emotions in Small-Group Argumentative Discussion: Explore the Influence of Big Five Personality Factors

    Science.gov (United States)

    Dong, Ting

    2009-01-01

    The assessment and structure of personality traits and small group learning during classroom discussions are both research fields that have undergone fast development in the past few decades. However, very few studies have investigated the relationship between individual personality characteristics and performance in discussions, especially with…

  11. Power and status within small groups: An analysis of students' verbal and nonverbal behavior and responses to one another

    Science.gov (United States)

    Morris, Lynnae Carol

    The purpose of this research has been to determine the influence of verbal and nonverbal behavior on power and status within small groups. The interactions which took place within five small groups of students in a middle school spatial reasoning elective were analyzed. Verbal responses to requests for help were analyzed using sequential analysis techniques. Results indicated that the identity of the student asking a question or requesting help in some form or another is a better predictor of whether he/she will receive help than the type of questions he/she asks. Nonverbal behavior was analyzed for social gestures, body language, and shifts in possession of tools. Each nonverbal act was coded as either "positive" (encouraging participation) or "negative" (discouraging participation); and, the researchers found that in groups in which there was unequal participation and less "help" provided among peers (according to the verbal analysis results) there tended to be more "negative" nonverbal behavior demonstrated than in groups in which "shared talk time" and "helping behavior" were common characteristics of the norm. The combined results from the analyses of the verbal and nonverbal behavior of students within small groups were then reviewed through the conflict, power, status perspective of small group interactions in order to determine some common characteristics of high functioning (collaborative) and low functioning (non-collaborative) groups. Some common characteristics of the higher functioning groups include: few instances of conflict, shared "talk time" and decision making, inclusive leadership, frequent use of encouraging social gestures and body language, and more sharing of tools than seizing. Some shared traits among the lower functioning groups include: frequent occurrences of interpersonal conflict, a focus on process (rather than content), persuasive or alienating leadership, unequal participation and power, frequent use of discouraging social gestures

  12. Recognition of patients with medically unexplained physical symptoms by family physicians: results of a focus group study

    NARCIS (Netherlands)

    Boeft, M. den; Huisman, D.; Wouden, J.C. van der; Numans, M.E.; Horst, H.E. van der; Lucassen, P.L.B.J.; Olde Hartman, T.C.

    2016-01-01

    BACKGROUND: Patients with medically unexplained physical symptoms (MUPS) form a heterogeneous group and frequently attend their family physician (FP). Little is known about how FPs recognize MUPS in their patients. We conducted a focus group study to explore how FPs recognize MUPS and whether they

  13. A Validation of the Group-Based Medical Mistrust Scale in Formerly Incarcerated Black and Latino Men.

    Science.gov (United States)

    Valera, Pamela; Boyas, Javier F; Bernal, Camila; Chiongbian, Victoria Briones; Chang, Yvonne; Shelton, Rachel C

    2016-05-04

    While there is a growing body of literature on medical mistrust and its relevance to public health, research on formerly incarcerated Black and Latino men and their perception of mistrust toward medical providers and medical institutions remains scant. Very little is known about whether formerly incarcerated Black and Latino men mistrust medical and clinical providers given their previous experiences with the criminal justice system. It is important to determine whether medical mistrust play a key role in the health and health behaviors of released Black and Latino men. The purpose of this study is to validate and assess the psychometric properties of the Group-Based Medical Mistrust Scale for use among formerly incarcerated Black and Latino men in New York City. The findings of the exploratory and confirmatory factor analyses state that a two-factor structure fit the data best. Two dimensions emerged as important subscales: discrimination and suspicion. The current findings suggest the two-factor Group-Based Medical Mistrust Scale is a valid and reliable assessment tool to discern medical mistrust levels among formerly incarcerated Black and Latino men. © The Author(s) 2016.

  14. Group integration for lattice gauge theory at large and at small coupling

    International Nuclear Information System (INIS)

    Brower, R.C.; Nauenberg, M.

    1981-01-01

    We consider the fundamental SU(N) invariant integrals encountered in Wilson's lattice QCD with an eye to analytical results for N → infinite and approximations for small g 2 at fixed N. We develop a new semiclassical technique starting from the Schwinger-Dyson equations cast in differential form to give an exact solution to the single-link integral for N → infinite. The third-order phase transition discovered by Gross and Witten for two-dimensional QCD occurs here for any dimension. Alternatively we parametrize directly the integral over the Haar measure and obtain approximate results for SU(N) using stationary phase at small g 2 . Remarkably the single-loop correction gives the exact answer at N = infinite. We show that the naive lattice string of Weingarten is obtained from N → infinite QCD in the limit of dimensions d → infinite. We discuss applications of our techniques to the 1/N expansion. (orig.)

  15. Report of the advisory group meeting on elemental analysis of extremely small samples

    International Nuclear Information System (INIS)

    2002-01-01

    This publication contains summary of discussions held at the meeting with brief description and comparative characteristics of most common nuclear analytical techniques used for analysis of very small samples as well as the conclusions of the meeting. Some aspect of reference materials and quality control are also discussed. The publication also contains individual contributions made by the participants, each of these papers haven provided with an abstract and indexed separately

  16. Learning science in small groups: The relationship of conversation to conceptual understanding

    Science.gov (United States)

    McDonald, James Tarleton

    The purpose of this study was to investigate the relationship between conversation and conceptual understanding of erosion. The objective of this study was to investigate how fifth grade students' conceptions of erosion changed while they used stream tables and worked in groups of four within an inquiry-based curriculum. This study used symbolic interactionism and sociocognitive frameworks to interpret science learning in the elementary classroom. The research focused on the conceptual understanding of the focal group students, their use of classroom discourse to talk about their understandings of erosion, and the expertise that emerged while using stream tables. This study took place over a one-semester long study on erosion. Key informants were eight fifth graders. The data sources consisted of children's journals; transcripts of audiotaped interviews with the key informants before, during, and after the erosion unit; transcripts of videotapes of the students using the stream tables; and field notes recording children's discourse and activity. Individual and group cases were constructed during the study. The knowledge of the eight focal group children was placed on a hierarchy of conceptual understanding that contained 8 components of the erosion process. All four of the students whose ideas were examined in depth gained in their conceptual understanding of erosion. Students' individual expertise enhanced their own conceptual understanding. The contribution of classroom discourse and expertise to conceptual understanding differed between the two focal groups. Group 1 used essential expertise to sustain generative conversations, maximizing their learning opportunities. Students in Group 1 got along with one another, rotated assigned roles and jobs, and were able to start their own generative conversations. Members of Group 1 asked generative questions, connected stream table events to real life situations, and involved everyone in the group. Group 2 engaged in a

  17. Efficacy of an internet-based learning module and small-group debriefing on trainees' attitudes and communication skills toward patients with substance use disorders: results of a cluster randomized controlled trial.

    Science.gov (United States)

    Lanken, Paul N; Novack, Dennis H; Daetwyler, Christof; Gallop, Robert; Landis, J Richard; Lapin, Jennifer; Subramaniam, Geetha A; Schindler, Barbara A

    2015-03-01

    To examine whether an Internet-based learning module and small-group debriefing can improve medical trainees' attitudes and communication skills toward patients with substance use disorders (SUDs). In 2011-2012, 129 internal and family medicine residents and 370 medical students at two medical schools participated in a cluster randomized controlled trial, which assessed the effect of adding a two-part intervention to the SUDs curricula. The intervention included a self-directed, media-rich Internet-based learning module and a small-group, faculty-led debriefing. Primary study outcomes were changes in self-assessed attitudes in the intervention group (I-group) compared with those in the control group (C-group) (i.e., a difference of differences). For residents, the authors used real-time, Web-based interviews of standardized patients to assess changes in communication skills. Statistical analyses, conducted separately for residents and students, included hierarchical linear modeling, adjusted for site, participant type, cluster, and individual scores at baseline. The authors found no significant differences between the I- and C-groups in attitudes for residents or students at baseline. Compared with those in the C-group, residents, but not students, in the I-group had more positive attitudes toward treatment efficacy and self-efficacy at follow-up (Pcommunication skills toward patients with SUDs among residents. Enhanced attitudes and skills may result in improved care for these patients.

  18. Evaluation of receptivity of the medical students in a lecture of a large group

    Directory of Open Access Journals (Sweden)

    Vidyarthi SurendraK, Nayak RoopaP, GuptaSandeep K

    2014-04-01

    Full Text Available Background: Lecturing is widely used teaching method in higher education. Instructors of large classes may have only option to deliver lecture to convey informations to large group students.Aims and Objectives: The present study was to evaluate the effectiveness/receptivity of interactive lecturing in a large group of MBBS second year students. Material and Methods: The present study was conducted in the well-equipped lecture theater of Dhanalakshmi Srinivasan Medical College and Hospital (DSMCH, Tamil Nadu. A fully prepared interactive lecture on the specific topic was delivered by using power point presentation for second year MBBS students. Before start to deliver the lecture, instructor distributed multiple choice 10 questionnaires to attempt within 10 minutes. After 30 minutes of delivering lecture, again instructor distributed same 10 sets of multiple choice questionnaires to attempt in 10 minutes. The topic was never disclosed to the students before to deliver the lecture. Statistics: We analyzed the pre-lecture & post-lecture questions of each student by applying the paired t-test formula by using www.openepi.com version 3.01 online/offline software and by using Microsoft Excel Sheet Windows 2010. Results: The 31 male, 80 female including 111 students of average age 18.58 years baseline (pre-lecture receptivity mean % was 30.99 ± 14.64 and post-lecture receptivity mean % was increased upto 53.51± 19.52. The only 12 students out of 111 post-lecture receptivity values was less (mean % 25.8± 10.84 than the baseline (mean % 45± 9.05 receptive value and this reduction of receptivity was more towards negative side. Conclusion: In interactive lecture session with power point presentation students/learners can learn, even in large-class environments, but it should be active-learner centered.

  19. Internet addiction in a group of medical students: a cross sectional study.

    Science.gov (United States)

    Pramanik, T; Sherpa, M T; Shrestha, R

    2012-03-01

    The use of Internet for education, recreation and communication is increasing day by day. Nevertheless, the possibility of exploitation and addiction leading to impairment in academic performance and emotional balance cannot be denied, especially among young population. The study was aimed to measure the degree of Internet addiction among a group of medical students. Internet addiction test questionnaire developed by Young was used to assess mild, moderate and severe addiction. Amongst the study population (n=130, age 19-23 years), 40% had mild addiction. Moderate and severe addiction was found in 41.53% and 3.07% of the participants respectively. The study revealed that 24% often and 19.2% always found themselves using Internet longer than they had planned or thought. Late night Internet surfing leading to sleep deprivation was found in 31.53% of the participants. Almost one fourth of them (25.38%) occasionally tried to cut down the time they spent on the Internet but failed and 31.53% sometimes experienced restlessness when deprived of Internet access. Results reflected that a significant number of participants suffered from mild to moderate addiction. The role of counseling and education should be emphasized for prevention of Internet addiction.

  20. [Personal resources and negative and positive effects of traumatic events in a group of medical rescuers].

    Science.gov (United States)

    Ogińska-Bulik, Nina

    The purpose of the research was to investigate the role of personal resources, such as optimism and sense of selfefficacy in both negative (posttraumatic stress disorder (PTSD) symptoms) and positive (posttraumatic growth - PTG) effects of experienced trauma in a group of emergency service representatives. Data of 100 medical rescue workers, mostly men (59%) who have experienced traumatic events in their worksite were analyzed. The age of the participants ranged from 24 to 60 years (mean = 37.43; standard deviation = 8.73). Polish versions of the Impact of Event Scale - Revised and the Posttraumatic Growth Inventory were used to assess the negative and positive effects of experienced events. Optimism was assessed by the Life Orientation Test and sense of self-efficacy by the Generalized Self-Efficacy Scale. The obtained results revealed that optimism is negatively associated with symptoms of PTSD in men, and sense of self-efficacy - positively with the severity of growth after trauma in women. The analyzed personal resources play a diverse role in the emergence of negative and positive effects of experienced traumatic events, depending on the gender of the respondents. Med Pr 2016;67(5):635-644. This work is available in Open Access model and licensed under a CC BY-NC 3.0 PL license.

  1. Personal resources and negative and positive effects of traumatic events in a group of medical rescuers

    Directory of Open Access Journals (Sweden)

    Nina Ogińska-Bulik

    2016-10-01

    Full Text Available Background: The purpose of the research was to investigate the role of personal resources, such as optimism and sense of selfefficacy in both negative (posttraumatic stress disorder (PTSD symptoms and positive (posttraumatic growth – PTG effects of experienced trauma in a group of emergency service representatives. Material and Methods: Data of 100 medical rescue workers, mostly men (59% who have experienced traumatic events in their worksite were analyzed. The age of the participants ranged from 24 to 60 years (mean = 37.43; standard deviation = 8.73. Polish versions of the Impact of Event Scale – Revised and the Posttraumatic Growth Inventory were used to assess the negative and positive effects of experienced events. Optimism was assessed by the Life Orientation Test and sense of self-efficacy by the Generalized Self-Efficacy Scale. Results: The obtained results revealed that optimism is negatively associated with symptoms of PTSD in men, and sense of self-efficacy – positively with the severity of growth after trauma in women. Conclusions: The analyzed personal resources play a diverse role in the emergence of negative and positive effects of experienced traumatic events, depending on the gender of the respondents. Med Pr 2016;67(5:635–644

  2. MAAGs (Medical Audit Advisory Groups): the Eli Lilly National Clinical Audit Centre.

    Science.gov (United States)

    Baker, R; Fraser, R

    1993-01-01

    Outlines the framework for promoting audit in general practice, created as one part of the health service reforms. Medical Audit Advisory Groups (MAAGs) were set up in each district with the aim of participation in audit of all general practitioners by April 1992. The activities undertaken have included those recommended by the Department of Health; the most significant of these being the appointment of lay facilitators who are able to assist general practitioners and primary care teams co-operate over efforts to improve the quality of care, and may offer one means of introducing some of the methods of total quality management into general practice. Discusses the problems which remain: audit is not yet sufficiently systematic, interface audit with secondary care is at a very early stage, the ways to involve managers and patients in audit remain to be clarified, and there is little evidence of the consequences of audit in terms of improved care. The Eli Lilly National Clinical Audit Centre has been set up within the Department of General Practice, University of Leicester, in order to address these issues.

  3. Quantitative Modeling of Membrane Transport and Anisogamy by Small Groups Within a Large-Enrollment Organismal Biology Course

    Directory of Open Access Journals (Sweden)

    Eric S. Haag

    2016-12-01

    Full Text Available Quantitative modeling is not a standard part of undergraduate biology education, yet is routine in the physical sciences. Because of the obvious biophysical aspects, classes in anatomy and physiology offer an opportunity to introduce modeling approaches to the introductory curriculum. Here, we describe two in-class exercises for small groups working within a large-enrollment introductory course in organismal biology. Both build and derive biological insights from quantitative models, implemented using spreadsheets. One exercise models the evolution of anisogamy (i.e., small sperm and large eggs from an initial state of isogamy. Groups of four students work on Excel spreadsheets (from one to four laptops per group. The other exercise uses an online simulator to generate data related to membrane transport of a solute, and a cloud-based spreadsheet to analyze them. We provide tips for implementing these exercises gleaned from two years of experience.

  4. Educational Outcomes of Small-Group Discussion Versus Traditional Lecture Format in Dental Students' Learning and Skills Acquisition.

    Science.gov (United States)

    Arias, Ana; Scott, Raymond; Peters, Ove A; McClain, Elizabeth; Gluskin, Alan H

    2016-04-01

    The aim of this prospective quantitative study was to compare the effect of different instructional formats on dental students' skills and knowledge acquisition for access cavity preparation. All first-year dental students were invited to participate in this study conducted during the four consecutive two-week endodontic rotation courses at the University of the Pacific Arthur A. Dugoni School of Dentistry in spring semester 2015. Four alphabetically distributed intact groups of students were randomly allocated to two groups (n=70 each) that participated in either small-group discussion or a traditional lecture on access preparation. The first outcome measure was skill acquisition, measured by the quality of access cavities prepared in extracted teeth at the conclusion of the session. Two blinded raters scored direct observations on a continuous scale. Knowledge, the second outcome measure, was scored with a multiple-choice and open-ended question test at the end of each two-week session. Data were obtained for 134 of the 140 students, for a 96% response rate. The results showed that students in the small-group discussion groups scored significantly higher than those in the lecture groups when skill performance was tested (p=8.9 × 10(-7)). However, no significant differences were found in the acquisition of knowledge between the two groups on the written test. Active student participation was significantly related to improved manual skill acquisition, but the format of the session does not seem to have had a direct influence on acquired knowledge.

  5. Utility of a dermatology interest group blog: the impact of medical student interest groups and Web 2.0 tools as educational resources.

    Science.gov (United States)

    Jalalat, Sheila Z; Wagner, Richard F

    2014-01-01

    The open access University of Texas Dermatology Interest Group blog was established in 2004 for the purposes of increasing communication and collaboration between medical students and dermatology faculty, residents, and alumni, as well as to promote educational opportunities and the missions for which the interest group was created. This blog is unique because of its longevity and continuous postings directed toward the educational and professional needs of medical students and residents. A blog user survey was performed to assess viewers' thoughts, purpose of viewing, demographic profile, subscriber status, usage of the blog and other Web 2.0 tools (forums, Facebook, blogs, Twitter, podcasts), and perceived usefulness. Sixty-one anonymous online surveys were completed during a 1-month period. Statistical analyses of the responses demonstrated that the utilization of web-based tools and the blog were valuable resources for students, especially for blog subscribers, those more involved in an interest group, and those reading the blog for a longer period of time. The usefulness and impact of this method of communication and dissemination of information in medical education may encourage other student groups, faculty advisors, and educators to implement similar educational tools at their institutions.

  6. Definitive radiation therapy for medically inoperable patients with stage I and II non-small cell lung cancer

    International Nuclear Information System (INIS)

    Hayakawa, K.; Mitsuhashi, N.; Saito, Y.; Nakayama, Y.; Katano, S.; Furuta, M.; Sakurai, H.; Takahashi, T.; Niibe, H.

    1995-01-01

    Purpose: To evaluate the role of definitive radiation therapy (RT) in the treatment for medically inoperable patients with stage I-II non-small cell lung cancer (NSCLC). Materials and Methods: From 1976 through 1989, 84 patients with clinical stage I and II NSCLC were treated with definitive RT alone at Gunma University hospital. All patients were treated with 10 MV X-rays using antero-posterior parallel opposed fields. The total dose ranged from 60 Gy to 90 Gy (35 pts; 60-69 Gy, 39 pts; 70-74 Gy, 10 pts; ≥ 80 Gy) with once-daily standard fractionation. Results: The two and five-year survival rates were 74% and 31% for 28 patients with stage I disease, as compared with 40% and 19% for 56 patients with stage II respectively (p<0.05). Although there was no significant difference of survival rates by the histologic subtypes, in the patients with squamous cell carcinoma there were more long-term survivors. Fifty-three patients with tumors less than 5 cm in diameter had an infield progression rate of 14% at two years, in comparison with 38% of 31 patients with tumors greater than 5 cm (p<0.05). Overall distant failure occurred in 57% of the patients with smaller tumors and in 80% of the patients with larger tumors (p<0.05). The difference of survival rates for these two groups was statistically significant (p<0.005). Ten patients given a total dose of 80Gy or over had only 17% local progression at the time of last follow-up, however they had not been alive beyond three years because they developed pulmonary insufficiency due to severe stenosis of the proximal bronchus. For age and sex, there were no significant differences in survival, however, patients with performance status of 0-1 lived longer than those with a status of 2 or more (MST 24 versus 13 months; p=0.06). Conclusion: The tumor size was the most important factor not only for local control but also for distant failure. It was also suggested that the optimal radiation dose for medically inoperable stage I

  7. Small Group Teaching in Undergraduate Science. Higher Education Learning Project (h.e.l.p.) - Physics.

    Science.gov (United States)

    Ogborn, Jon, Ed.; And Others

    While this book is focused primarily on the tutorials held in the British universities, it offers many insights that can improve the teaching in the discussion sections so common in our large universities. Introductions to analyses of group processes of technical language, and of questions are given. Lesson plans for skill building sessions are…

  8. Lurking on the Internet: A Small-Group Assignment that Puts a Human Face on Psychopathology

    Science.gov (United States)

    Lowman, Joseph; Judge, Abigail M.; Wiss, Charles

    2010-01-01

    Lurking on the Internet aims to put a human face on psychopathology for the abnormal psychology course. Student groups are assigned major diagnostic categories and instructed to search the Internet for discussion forums, individual blogs, or YouTube videos where affected individuals discuss their symptoms and lives. After discussing the ethics of…

  9. Distribution of Feedback among Teacher and Students in Online Collaborative Learning in Small Groups

    Science.gov (United States)

    Coll, Cesar; Rochera, Maria Jose; de Gispert, Ines; Diaz-Barriga, Frida

    2013-01-01

    This study explores the characteristics and distribution of the feedback provided by the participants (a teacher and her students) in an activity organized inside a collaborative online learning environment. We analyse 853 submissions made by two groups of graduate students and their teacher (N1 = 629 & N2 = 224) involved in the collaborative…

  10. Can't You Just Talk to Them? Small Group Work in a Senior Thesis Course.

    Science.gov (United States)

    Nance, Teresa; Mackey-Kallis, Susan

    At Villanova University, the Senior Projects Course is designed to serve as a capstone course. Students are required to integrate the pieces of the discipline acquired from previous course work into a comprehensive, fully developed research project. This paper looks critically at one aspect of effectively managing a group project course: conflict…

  11. Informal Cooperative Learning in Small Groups: The Effect of Scaffolding on Participation

    Science.gov (United States)

    Lange, Christopher; Costley, Jamie; Han, Seung Lock

    2016-01-01

    This study examines the effect of group work scaffolding on participation. The procedural scaffolding of two cooperative learning techniques, Numbered Heads Together and Think-Pair-Share, are compared based on levels of participation, learning, and satisfaction they elicit. Aspects of participation that are examined include levels of group…

  12. The economic efficiency of investment in the development of reserves of small groups of geographically contiguous gold deposits

    Directory of Open Access Journals (Sweden)

    Evdokimov S.I.

    2017-01-01

    Full Text Available The object of the research is a group of geographically contiguous low volume gold deposits. The subject of the study is an economic justification for a way to involve economic turnover to get a positive commercial result on a specially formed group of gold deposits, in which individual field development is unprofitable. A small production volume, combined with high capital and operating costs are objective reasons for the reduction in investment attractiveness of the deposits which have reserves of gold of 50%, equipped with a mobile processing complex with deep processing technology on highly liquid commodity products on site. An economic-mathematical model was devised to determine the rational placement of the processing capacity of the group.A simulation was conducted and an economic evaluation was performed on the effectiveness of investments in individual and group mining projects. The simulation results show that the joint exploitation of the reserves of the group of deposits, the internal rate of return on investments exceed the rate of return of funds to the bank deposit, the return on investment is above the level of inflation. The group project complies with the strategic line of small mining companies in terms of cost recovery terms, availability of financial sources to cover expenses, provision of stable means of income and obtaining competitive advantage.

  13. Simulation Suggests that medical group mergers won't undermine the potential utility of health information exchanges.

    Science.gov (United States)

    Rudin, Robert S; Schneider, Eric C; Volk, Lynn A; Szolovits, Peter; Salzberg, Claudia A; Simon, Steven R; Bates, David W

    2012-03-01

    Federal and state agencies are investing substantial resources in the creation of community health information exchanges, which are consortia that enable independent health care organizations to exchange clinical data. However, under pressure to form accountable care organizations, medical groups may merge and support private health information exchanges. Such activity could reduce the potential utility of community exchanges-that is, the exchanges' capacity to share patient data across hospitals and physician practices that are independent. Simulations of care transitions based on data from ten Massachusetts communities suggest that there would have to be many such mergers to undermine the potential utility of health information exchanges. At the same time, because hospitals and the largest medical groups account for only 10-20 percent of care transitions in a community, information exchanges will still need to recruit a large proportion of the medical groups in a given community for the exchanges to maintain their usefulness in fostering information exchange across independent providers.

  14. Applying information theory to small groups assessment: emotions and well-being at work.

    Science.gov (United States)

    García-Izquierdo, Antonio León; Moreno, Blanca; García-Izquierdo, Mariano

    2010-05-01

    This paper explores and analyzes the relations between emotions and well-being in a sample of aviation personnel, passenger crew (flight attendants). There is an increasing interest in studying the influence of emotions and its role as psychosocial factors in the work environment as they are able to act as facilitators or shock absorbers. The contrast of the theoretical models by using traditional parametric techniques requires a large sample size to the efficient estimation of the coefficients that quantify the relations between variables. Since the available sample that we have is small, the most common size in European enterprises, we used the maximum entropy principle to explore the emotions that are involved in the psychosocial risks. The analyses show that this method takes advantage of the limited information available and guarantee an optimal estimation, the results of which are coherent with theoretical models and numerous empirical researches about emotions and well-being.

  15. SUITABILITY OF MEDICATIONS USED BY THE ELDERLY PARTICIPANTS OF A SOCIAL GROUP, ACCORDING TO THE BEERS CRITERIA

    Directory of Open Access Journals (Sweden)

    Geysa Donária de Miranda Mascarenhas

    2014-09-01

    Full Text Available The dynamic process defined as aging progressively reduces the functional capacity of the elderly and added to the lifestyle, they can to testify to the high number of pathologies. Thus, pharmacotherapy for this age group requires special care, keeping in view its peculiarities. Given this need, a group of researchers has developed criteria that allowed the identification of inappropriate medications. Thus, the aim of this study was to investigate the suitability of medications used by the elderly participants of a social group, in Vitória da Conquista, BA, according to the Beers criteria. This research was an exploratory descriptive study and data collection conducted through semi - structured interviews. It was asked to bring all the elderly who were using medications and / or prescriptions. It was found that 12.7% of the drugs used by the elderly appeared in the list of inappropriate medicines and 42% of respondents make use of polypharmacy. Among the most prescribed inappropriate medications, there is acetylsalicylic acid, diclofenac, diazepam, piroxicam, ibuprofen and amitriptyline. The class of inappropriate drugs most used by seniors was anti - inflammatory drugs. Given this, all health professionals need to put into practice the criteria for selecting medications this age group as the reality of existing drugs in Brazil.

  16. Suitability of medications used by the elderly participants of a social group, according to the Beers criteria

    Directory of Open Access Journals (Sweden)

    Geysa Donária de Miranda Mascarenhas

    2014-07-01

    Full Text Available The dynamic process defined as aging progressively reduces the functional capacity of the elderly and added to the lifestyle, they can to testify to the high number of pathologies. Thus, pharmacotherapy for this age group requires special care, keeping in view its peculiarities. Given this need, a group of researchers has developed criteria that allowed the identification of inappropriate medications. Thus, the aim of this study was to investigate the suitability of medications used by the elderly participants of a social group, in Vitória da Conquista, BA, according to the Beers criteria. This research was an exploratory descriptive study and data collection conducted through semi - structured interviews. It was asked to bring all the elderly who were using medications and / or prescriptions. It was found that 12.7% of the drugs used by the elderly appeared in the list of inappropriate medicines and 42% of respondents make use of polypharmacy. Among the most prescribed inappropriate medications, there is acetylsalicylic acid, diclofenac, diazepam, piroxicam, ibuprofen and amitriptyline. The class of inappropriate drugs most used by seniors was anti - inflammatory drugs. Given this, all health professionals need to put into practice the criteria for selecting medications this age group as the reality of existing drugs in Brazil.

  17. How does the culture of medical group practices influence the types of programs used to assure quality of care?

    Science.gov (United States)

    Kaissi, Amer; Kralewski, John; Curoe, Ann; Dowd, Bryan; Silversmith, Janet

    2004-01-01

    It is widely acknowledged that the culture of medical group practices greatly influences the quality of care, but little is known about how cultures are translated into specific types of programs focused on quality. This study explores this issue by assessing the influence of the organizational culture on these types of programs in medical group practices in the upper Midwest. Data were obtained from two surveys of medical group practices. The first survey was designed to assess the culture of the practice using a nine-dimension instrument developed previously. The second survey was designed to obtain organizational structure data including the programs identified by the literature as important to the quality of care in medical practices. Completed surveys were obtained from eighty-eight medical groups. The relationship of the group practice culture to structural programs focused on quality of care was analyzed using logistic regression equations. Several interesting patterns emerged. As expected, practices with a strong information culture favor electronic data systems and formal programs that provide comparative or evidence-based data to enhance their clinical practices. However, those with a quality-centered culture appear to prefer patient satisfaction surveys to assess the quality of their care, while practices that are more business-oriented rely on bureaucratic strategies such as benchmarking and physician profiling. Cultures that emphasize the autonomy of physician practice were negatively (but not at a statistically significant level) associated with all the programs studied. Practices with a highly collegial culture appear to rely on informal peer review mechanisms to assure quality rather than any of the structural programs included in this analysis. This study suggests that the types of quality programs that group practices develop differ according to their cultures. Consequently, it is important for practice administrators and medical directors to

  18. Medical Assistant-based care management for high risk patients in small primary care practices

    DEFF Research Database (Denmark)

    Freund, Tobias; Peters-Klimm, Frank; Boyd, Cynthia M.

    2016-01-01

    Background: Patients with multiple chronic conditions are at high risk of potentially avoidable hospital admissions, which may be reduced by care coordination and self-management support. Medical assistants are an increasingly available resource for patient care in primary care practices. Objective......: To determine whether protocol-based care management delivered by medical assistants improves patient care in patients at high risk of future hospitalization in primary care. Design: Two-year cluster randomized clinical trial. Setting: 115 primary care practices in Germany. Patients: 2,076 patients with type 2......, and monitoring delivered by medical assistants with usual care. Measurements: All-cause hospitalizations at 12 months (primary outcome) and quality of life scores (Short Form 12 Health Questionnaire [SF-12] and the Euroqol instrument [EQ-5D]). Results: Included patients had, on average, four co-occurring chronic...

  19. Medical student perceptions of factors affecting productivity of problem-based learning tutorial groups: does culture influence the outcome?

    Science.gov (United States)

    Das Carlo, Mandira; Swadi, Harith; Mpofu, Debbie

    2003-01-01

    The popularization of problem-based learning (PBL) has drawn attention to the motivational and cognitive skills necessary for medical students in group learning. This study identifies the effect of motivational and cognitive factors on group productivity of PBL tutorial groups. A self-administered questionnaire was completed by 115 students at the end of PBL tutorials for 4 themes. The questionnaire explored student perceptions about effect of motivation, cohesion, sponging, withdrawal, interaction, and elaboration on group productivity. We further analyzed (a) differences in perceptions between male and female students, (b) effect of "problems," and (c) effect of student progress over time on group productivity. There were linear relations between a tutorial group's success and the factors studied. Significant differences were noted between male and female student groups. Students and tutors need to recognize symptoms of ineffective PBL groups. Our study emphasizes the need to take into account cultural issues in setting ground rules for PBL tutorials.

  20. Novel Emergency Medicine Curriculum Utilizing Self-Directed Learning and the Flipped Classroom Method: Head, Eyes, Ears, Nose and Throat Emergencies Small Group Module

    Directory of Open Access Journals (Sweden)

    Andrew King

    2017-09-01

    Full Text Available Audience: This curriculum created and implemented at The Ohio State University Wexner Medical Center was designed to educate our emergency medicine (EM residents, PGY-1 to PGY-3, as well as medical students and attending physicians. Introduction: Head, Eyes, Ears, Nose and Throat (HEENT complaints are very commonly seen in the Emergency Department. Numbers vary as to exact prevalence, but sources show that there are about 2 million annual emergency department (ED visits in the United States for non-traumatic dental problems, representing 1.5% of all ED visits.1 Other sources show that symptoms referable to the throat encompass 2,496,000 visits or 1.9% of total visits.2 Notably, about 8% of the written exam in emergency medicine covers the topic of head and neck complaints, making it the second most tested topic behind cardiovascular.3 Residents must be proficient in the differential diagnosis and management of the wide variety of HEENT emergencies. The flipped classroom curricular model emphasizes self-directed learning activities completed by learners, followed by small group discussions pertaining to the topic reviewed. The active learning fostered by this curriculum increases faculty and learner engagement and interaction time typically absent in traditional lecture-based formats.4-6 Studies have revealed that the application of knowledge through case studies, personal interaction with content experts, and integrated questions are effective learning strategies for emergency medicine residents.6-8 The Ohio State University EM Residency didactic curriculum recently transitioned to a “flipped classroom” approach.9-13 We created this innovative curriculum aimed to improve our residency education program and to share educational resources with other EM residency programs. Our curriculum utilizes an 18-month curricular cycle to cover the defined emergency medicine content. The flipped classroom curriculum maximizes didactic time and resident

  1. RETHINKING THE ROLE OF SMALL-GROUP COLLABORATORS AND ADVERSARIES IN THE LONDON KLEINIAN DEVELOPMENT (1914-1968).

    Science.gov (United States)

    Aguayo, Joseph; Regeczkey, Agnes

    2016-07-01

    The authors historically situate the London Kleinian development in terms of the small-group collaborations and adversaries that arose during the course of Melanie Klein's career. Some collaborations later became personally adversarial (e.g., those Klein had with Glover and Schmideberg); other adversarial relationships forever remained that way (with A. Freud); while still other long-term collaborations became theoretically contentious (such as with Winnicott and Heimann). After the Controversial Discussions in 1944, Klein marginalized one group of supporters (Heimann, Winnicott, and Riviere) in favor of another group (Rosenfeld, Segal, and Bion). After Klein's death in 1960, Bion maintained loyalty to Klein's ideas while quietly distancing his work from the London Klein group, immigrating to the United States in 1968. © 2016 The Psychoanalytic Quarterly, Inc.

  2. Production of a small-circulation medical journal using desktop publishing methods.

    Science.gov (United States)

    Peters, B A

    1994-07-01

    Since its inception in January 1988, the Baylor University Medical Center Proceedings, a quarterly medical journal, has been published by the few staff of the Scientific Publications Office (Baylor Research Institute, Dallas, Texas, USA) using microcomputers and page-makeup software in conjunction with a commercial printing company. This article outlines the establishment of the journal; the steps used in the publication process; the software and hardware used; and the changes in design, content, and circulation that have taken place as the journal and the technology used to create it have evolved.

  3. Just forest governance: how small learning groups can have big impact

    Energy Technology Data Exchange (ETDEWEB)

    Mayers, James; Bhattacharya, Prodyut; Diaw, Chimere [and others

    2009-10-15

    Forests are power bases, but often for the wrong people. As attention turns from making an international deal on REDD to making it work on the ground, the hunt will be on for practical ways of shifting power over forests towards those who enable and pursue sustainable forest-linked livelihoods. The Forest Governance Learning Group – an alliance active in Cameroon, Ghana, India, Indonesia, Malawi, Mozambique, South Africa, Uganda and Vietnam – has developed practical tactics for securing safe space, provoking dialogue, building constituencies, wielding evidence and interacting politically. It has begun to have significant impacts. To deepen and widen those impacts, FGLG seeks allies.

  4. Learning global health: a pilot study of an online collaborative intercultural peer group activity involving medical students in Australia and Indonesia.

    Science.gov (United States)

    Ambrose, Mark; Murray, Linda; Handoyo, Nicholas E; Tunggal, Deif; Cooling, Nick

    2017-01-13

    There is limited research to inform effective pedagogies for teaching global health to undergraduate medical students. Theoretically, using a combination of teaching pedagogies typically used in 'international classrooms' may prove to be an effective way of learning global health. This pilot study aimed to explore the experiences of medical students in Australia and Indonesia who participated in a reciprocal intercultural participatory peer e-learning activity (RIPPLE) in global health. Seventy-one third year medical students (49 from Australia and 22 from Indonesia) from the University of Tasmania (Australia) and the University of Nusa Cendana (Indonesia) participated in the RIPPLE activity. Participants were randomly distributed into 11 intercultural 'virtual' groups. The groups collaborated online over two weeks to study a global health topic of their choice, and each group produced a structured research abstract. Pre- and post-RIPPLE questionnaires were used to capture students' experiences of the activity. Descriptive quantitative data were analysed with Microsoft Excel and qualitative data were thematically analysed. Students' motivation to volunteer for this activity included: curiosity about the innovative approach to learning; wanting to expand knowledge of global health; hoping to build personal and professional relationships; and a desire to be part of an intercultural experience. Afer completing the RIPPLE program, participants reported on global health knowledge acquisition, the development of peer relationships, and insight into another culture. Barriers to achieving the learning outcomes associated with RIPPLE included problems with establishing consistent online communication, and effectively managing time to simultaneously complete RIPPLE and other curricula activities. Medical students from both countries found benefits in working together in small virtual groups to complement existing teaching in global health. However, our pilot study

  5. A model for warfare in stratified small-scale societies: The effect of within-group inequality

    Science.gov (United States)

    Pandit, Sagar; van Schaik, Carel

    2017-01-01

    In order to predict the features of non-raiding human warfare in small-scale, socially stratified societies, we study a coalitionary model of war that assumes that individuals participate voluntarily because their decisions serve to maximize fitness. Individual males join the coalition if war results in a net economic and thus fitness benefit. Within the model, viable offensive war ensues if the attacking coalition of males can overpower the defending coalition. We assume that the two groups will eventually fuse after a victory, with ranks arranged according to the fighting abilities of all males and that the new group will adopt the winning group’s skew in fitness payoffs. We ask whether asymmetries in skew, group size and the amount of resources controlled by a group affect the likelihood of successful war. The model shows, other things being equal, that (i) egalitarian groups are more likely to defeat their more despotic enemies, even when these are stronger, (ii) defection to enemy groups will be rare, unless the attacked group is far more despotic than the attacking one, and (iii) genocidal war is likely under a variety of conditions, in particular when the group under attack is more egalitarian. This simple optimality model accords with several empirically observed correlations in human warfare. Its success underlines the important role of egalitarianism in warfare. PMID:29228014

  6. Frequency of different blood groups and its association with BMI and blood pressure among the female medical students of Faisalabad.

    Science.gov (United States)

    Jawed, Shireen; Zia, Sadaf; Tariq, Sundus

    2017-08-01

    To determine the frequency of different blood groups among female medical students and to find the association of blood groups and body mass index with blood pressure. This cross-sectional study was performed at the University Medical and Dental College, Faisalabad, Pakistan, from March to April 2016, and comprised female medical students. Participants were divided into groups on the basis of their ABO blood groups and on body mass index criteria. Blood groups were determined by simple conventional slide method. Blood pressure was estimated by manual auscultatory technique with a mercury sphygmomanometer. Data was analysed usingSPSS20. There were 145 students with an overall mean age of18.4±0.75 years (range: 17-23 years). Blood group B was the predominant group 65(44.8%). Besides, 130(89.6%) subjects were rhesus positive and 23(53%) subjects of blood group O were pre-hypertensive. Multiple regression analysis indicated significant positive association of blood group O with both systolic and diastolic blood pressure (p=0.002, 0.001). However, subsequent logistic regression showed significant association only with diastolic blood pressure (p=0.001). Relative risk of pre-hypertension for obese (p=0.001) was greater than non-obese subjects. Body mass index was significantly associated with both systolic and diastolic blood pressure (p=0.004, 0.042). Blood group B was the most common blood group. Blood group O was associated with diastolic pre-hypertension, while body mass index was associated with both systolic and diastolic pre-hypertension.

  7. Diffuse X-ray emission from the NGC 2300 group of galaxies - Implications for dark matter and galaxy evolution in small groups

    Science.gov (United States)

    Mulchaey, John S.; Davis, David S.; Mushotzky, Richard F.; Burstein, David

    1993-01-01

    The discovery of diffuse X-ray emission from the NGC 2300 group of galaxies using the ROSAT Position Sensitive Proportional Counter is reported. The gas distributions is roughly symmetric and extends to a radius of at least 0.2/h(50) Mpc. A Raymond-Smith hot plasma model provides an excellent fit the X-ray spectrum with a best-fit value temperature of 0.9 + -/15 or - 0.14 keV and abundance 0.06 + 0/.12 or - 0.05 solar. The assumption of gravitational confinement leads to a total mass of the group of 3.0 + 0.4 or - 0.5 x 10 exp 13 solar. Baryons can reasonably account for 4 percent of this mass, and errors could push this number not higher than 10-15 percent. This is one of the strongest pieces of evidence that dark matter dominates small groups such as this one. The intragroup medium in this system has the lowest metal abundance yet found in diffuse gas in a group or cluster.

  8. Radiographic quality and radiation protection in general medical practice and small hospitals

    International Nuclear Information System (INIS)

    Williamson, B.D.P.; Le Heron, J.C.

    1988-01-01

    Radiation protection and image quality were assessed in a survey of 22 general medical practices (GP) and the 24 smallest hospitals with x-ray facilities. Limited radiography, usually of extremities for trauma, was being performed in these facilities since access to regular radiology services was restricted, mainly for geographic reasons. An anthropomorphic phantom foot and ankle with two simulated fractures of the lateral and medical malleoli was presented at each facility for radiography, and the resulting films assessed for radiographic technique and basic diagnostic usefulness. The x-ray equipment was adequate for the range of procedures performed. While the standard of radiographic techniques was lower than in regular x-ray departments, most films of the phantom ankle were still diagnostically useful and only four were rejected entirely. The principal deficiency in general practice x-ray was in darkrooms and x-ray film processing. Consultation in this regard with registered medical radiation technologists is recommended. Generally, the x-ray equipment and working procedures complied with the National Radiation Laboratory Code of Safe Practice for the Use of X-rays in Diagnosis (Medical). Radiation doses to the phantom ankle ranged widely for effectively the same procedure, although none was excessive. Improved x-ray film processing, and tighter x-ray beam collimation, would result in a narrower range of doses to patients. Personnel exposures to radiation were satisfactorily low and special shieldings are not required in general practice. (author). 7 refs., 4 figs., 2 tabs

  9. Small-scale medical waste incinerators: experiences and trials in South Africa

    CSIR Research Space (South Africa)

    Rogers, DEC

    2006-01-01

    Full Text Available incineration units. The trials showed that all of the units could be used to render medical waste non-infectious, and to destroy syringes or render needles unsuitable for reuse. Emission loads from the incinerators are higher than large-scale commercial...

  10. Knowledge, group-based medical mistrust, future expectations, and perceived disadvantages of medical genetic testing: perspectives of Black African immigrants/refugees.

    Science.gov (United States)

    Buseh, A; Kelber, S; Millon-Underwood, S; Stevens, P; Townsend, L

    2014-01-01

    Reasons for low participation of ethnic minorities in genetic studies are multifactorial and often poorly understood. Based on published literature, participation in genetic testing is low among Black African immigrants/refugees although they are purported to bear disproportionate disease burden. Thus, research involving Black African immigrant/refugee populations that examine their perspectives on participating in genetic studies is needed. This report examines and describes the knowledge of medical genetics, group-based medical mistrust, and future expectations of genetic research and the influence of these measures on the perceived disadvantages of genetic testing among Black African immigrants/refugees. Using a cross-sectional survey design, a nonprobability sample (n = 212) of Black African immigrants/refugees was administered a questionnaire. Participants ranged in age from 18 to 61 years (mean = 38.91, SD = 9.78). The questionnaire consisted of 5 instruments: (a) sociodemographic characteristics, (b) Knowledge of Medical Genetics scale, (c) Group-Based Medical Mistrust Scale, (d) Future Expectations/Anticipated Consequences of Genetics Research scale, and (e) Perceived Disadvantages of Genetic Testing scale. Participants were concerned that genetic research may result in scientists 'playing God,' interfering with the natural order of life. In multivariate analyses, the perceived disadvantages of genetic testing increased as medical mistrust and anticipated negative impacts of genetic testing increased. Increase in genetic knowledge contributed to a decrease in perceived disadvantages. Our findings suggest that recruitment of Black African immigrants/refugees in genetic studies should address potential low knowledge of genetics, concerns about medical mistrust, the expectations/anticipated consequences of genetic research, and the perceived disadvantages of genetic testing.

  11. Petit bourgeois health care? The big small-business of private complementary medical practice.

    Science.gov (United States)

    Andrews, Gavin J; Phillips, David R

    2005-05-01

    Although small business private complementary medicine (CAM) has grown to be a significant provider of health care in many Western societies, there has been relatively little research on the sector in business terms and on its wider socio-economic position and role. Using a combined questionnaire and interview survey, and the concept of small business petit bourgeoisie as a framework, this paper considers the character of therapists and their businesses in England and Wales. The findings suggest that typical of the core characteristics of both the petit bourgeoisie and therapists are the selling of goods with a considerable market viability, at the same time financial insecurity; the modest size of businesses; small amounts of direct employment generation and business owners undertaking everyday 'hands-on' work themselves. Certain of the therapists' and business characteristics depart from the stereotypical image of a small businesses class, such as the high incidence of part-time self-employment and incomes being supplemented often by unrelated waged employment. However, given the acknowledged diversity of the petit bourgeoisie between societies and over time, the framework is arguably appropriate in this context, and private CAM a latest guise. Indeed, just as the petit bourgeoisie have traditionally found market niches either neglected or rejected by bigger business, small business CAM has provided the forms of health care neglected and sometimes rejected by orthodox medicine.

  12. Introduction of small and medium reactors in developing countries. Proceedings of two advisory group meetings

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1998-02-01

    This publication presents material submitted both by vendor and interested buyer organizations and conclusions drawn from the discussions of these contributions at two Advisory Group meetings on the SMR introduction in developing countries. A few papers were prepared as follow-up contributions to the proceedings. The summary presents a review of the main areas related to SMR introduction and of relevant situations and activities in both industrialized and developing countries. It includes an assessment of the expected potential market and of relevant experience that may help developing countries in their efforts to introduce SMRs. Owing to the inclusion of several new designs, this TECDOC provides an update of the SMR status report (IAEA-TECDOC-881) published in 1996. It also reviews real time compact nuclear power plant simulators. Refs, figs, tabs.

  13. Introduction of small and medium reactors in developing countries. Proceedings of two advisory group meetings

    International Nuclear Information System (INIS)

    1998-02-01

    This publication presents material submitted both by vendor and interested buyer organizations and conclusions drawn from the discussions of these contributions at two Advisory Group meetings on the SMR introduction in developing countries. A few papers were prepared as follow-up contributions to the proceedings. The summary presents a review of the main areas related to SMR introduction and of relevant situations and activities in both industrialized and developing countries. It includes an assessment of the expected potential market and of relevant experience that may help developing countries in their efforts to introduce SMRs. Owing to the inclusion of several new designs, this TECDOC provides an update of the SMR status report (IAEA-TECDOC-881) published in 1996. It also reviews real time compact nuclear power plant simulators

  14. Is the modernisation of postgraduate medical training in the Netherlands successful? Views of the NVMO Special Interest Group on Postgraduate Medical Education.

    Science.gov (United States)

    Scheele, Fedde; Van Luijk, Scheltus; Mulder, Hanneke; Baane, Coby; Rooyen, Corry Den; De Hoog, Matthijs; Fokkema, Joanne; Heineman, Erik; Sluiter, Henk

    2014-02-01

    Worldwide, the modernisation of medical education is leading to the design and implementation of new postgraduate curricula. In this article, the Special Interest Group for postgraduate medical education of the Netherlands Association for Medical Education (NVMO) reports on the experiences in the Netherlands. To provide insight into the shift in the aims of postgraduate training, as well as into the diffusion of distinct curricular activities, introduced during the process of modernisation. Based on three levels of training described by Frenk et al., the process of modernisation in the Netherlands is reviewed in a narrative way, using the expert views of the NVMO-SIG on PGME as a source of information. Educational science has effectively been incorporated and has until now mainly been applied on the level of informative learning to create 'medical expertise'. Implementing change on the level of formative learning for 'professional performance' has until now been a slow and arduous process, but the concept of reflection on practice has been firmly embraced. The training on the level of transformative learning is still in its early stages. The discussion about the aims of modern medical education could benefit from a more structured and transdisciplinary approach. Research is warranted on the interface between health care provision and those sciences that specialise in generic professional skills and in the societal context. Training professionals and educating 'enlightened change agents' for transformation in health care requires more governance and support from academic leaders with a broader perspective on the future of health care.

  15. [Medical terminology and lay users. A quali-quantitative survey of a group of young motivated graduates].

    Science.gov (United States)

    Conti, A A

    2013-01-01

    Medical terms occupy growing spaces in dictionaries and the media daily propose a great number of medical words. Nevertheless scientific data regarding the actual degree of comprehension of medical terminology on the part of lay users are scanty. Aim of this study was the evaluation, in a group of young motivated graduates, of the degree of understanding of a set of medical terms normally adopted by physicians in specialistic language, and also used when speaking with patients. Nine medical terms used by physicians in daily practice were selected (“aphasia”, “edema”, “erythema”, “fibrillation”, “fibroma”, “jaundice”, “paraplegia”, “polypus”, “sclerosis”) and they were administered in paper form to eighteen young graduates, non-health operators who were asked to furnish one definition for each of the terms. A subsequent structured oral discussion integrated the recorded written findings. Erythema and fibrillation were the most well-known and understood terms. Among the selected medical terms, the more difficult ones to understand were sclerosis and jaundice. Interesting features emerged from the characterization of the site attributed to some of the investigated terms, in particular edema was mainly perceived as the pulmonary one, fibroma was more often interpreted as a benign tumor localized in the uterus and polypus was more frequently associated with its collocation in the nose. The participants involved in this quali-quantitative survey demonstrated a general good knowledge and comprehension of the medical terms proposed. Some limits in knowledge documented in this group, however, indicate that the use of medical terminology needs more clarification within the doctor-patient context. Such clarification appears even more mandatory in subjects with low scholastic-education levels.

  16. Collaborative-Group Testing Improves Learning and Knowledge Retention of Human Physiology Topics in Second-Year Medical Students

    Science.gov (United States)

    Vázquez-García, Mario

    2018-01-01

    The present study examined the relationship between second-year medical students' group performance and individual performance in a collaborative-learning environment. In recent decades, university professors in the scientific and humanistic disciplines have successfully put into practice different modalities of collaborative approaches to…

  17. 76 FR 19174 - In the Matter of Circuit Systems, Inc., Global Energy Group, Inc., Integrated Medical Resources...

    Science.gov (United States)

    2011-04-06

    ... SECURITIES AND EXCHANGE COMMISSION File No. 500-1 In the Matter of Circuit Systems, Inc., Global Energy Group, Inc., Integrated Medical Resources, Inc., iNTELEFILM Corp., and Lot$off Corp.; Order of... lack of current and accurate information concerning the securities of Circuit Systems, Inc. because it...

  18. ssDNA Pairing Accuracy Increases When Abasic Sites Divide Nucleotides into Small Groups.

    Directory of Open Access Journals (Sweden)

    Alexandra Peacock-Villada

    Full Text Available Accurate sequence dependent pairing of single-stranded DNA (ssDNA molecules plays an important role in gene chips, DNA origami, and polymerase chain reactions. In many assays accurate pairing depends on mismatched sequences melting at lower temperatures than matched sequences; however, for sequences longer than ~10 nucleotides, single mismatches and correct matches have melting temperature differences of less than 3°C. We demonstrate that appropriately grouping of 35 bases in ssDNA using abasic sites increases the difference between the melting temperature of correct bases and the melting temperature of mismatched base pairings. Importantly, in the presence of appropriately spaced abasic sites mismatches near one end of a long dsDNA destabilize the annealing at the other end much more effectively than in systems without the abasic sites, suggesting that the dsDNA melts more uniformly in the presence of appropriately spaced abasic sites. In sum, the presence of appropriately spaced abasic sites allows temperature to more accurately discriminate correct base pairings from incorrect ones.

  19. Level of 90Sr in the urine of a small group of Finnish people

    International Nuclear Information System (INIS)

    Puhakainen, M.; Suomela, M.; Rahola, T.

    1999-01-01

    The aim of the study was to test the feasibility of the applied analysis method for 90 Sr and if possible to estimate the current level of the 90 Sr concentration in the urine. Urine samples were collected from seven Finnish volunteers in connection with studies of 137 Cs body burdens. The activity measurements of urine samples were performed 14 - 18 days after chemical separation of 90 Sr to allow ingrowing of 90 Y. The 90 Sr and 90 Y activities were measured simultaneously using a Quantulus liquid scintillation spectrometer. The detection limit for 90 Sr was 0.0033 Bq per sample, or 0.0007-0.0015 Bq 1 -1 . The 90 Sr activities in urine varied between 0.006 and 0.046 Bq 1 1 . The daily urinary excretion was found to be 0.007-0.018 Bq for the five volunteers that collected three-day urine samples. Assuming that the daily 90 Sr intake was constant and that 18% of the ingested activity was excreted in urine, the mean intake in the investigated group would vary between 0.039 and 0.1 Bq d -1 . Based on these estimated intake values the respective annual effective internal doses from 90 Sr and 90 Y varied from 0.4 to 1 Sv during the sampling period. (au)

  20. Small-group learning in an upper-level university biology class enhances academic performance and student attitudes toward group work.

    Science.gov (United States)

    Gaudet, Andrew D; Ramer, Leanne M; Nakonechny, Joanne; Cragg, Jacquelyn J; Ramer, Matt S

    2010-12-29

    To improve science learning, science educators' teaching tools need to address two major criteria: teaching practice should mirror our current understanding of the learning process; and science teaching should reflect scientific practice. We designed a small-group learning (SGL) model for a fourth year university neurobiology course using these criteria and studied student achievement and attitude in five course sections encompassing the transition from individual work-based to SGL course design. All students completed daily quizzes/assignments involving analysis of scientific data and the development of scientific models. Students in individual work-based (Individualistic) sections usually worked independently on these assignments, whereas SGL students completed assignments in permanent groups of six. SGL students had significantly higher final exam grades than Individualistic students. The transition to the SGL model was marked by a notable increase in 10th percentile exam grade (Individualistic: 47.5%; Initial SGL: 60%; Refined SGL: 65%), suggesting SGL enhanced achievement among the least prepared students. We also studied student achievement on paired quizzes: quizzes were first completed individually and submitted, and then completed as a group and submitted. The group quiz grade was higher than the individual quiz grade of the highest achiever in each group over the term. All students--even term high achievers--could benefit from the SGL environment. Additionally, entrance and exit surveys demonstrated student attitudes toward SGL were more positive at the end of the Refined SGL course. We assert that SGL is uniquely-positioned to promote effective learning in the science classroom.

  1. Who is the competent physics student? A study of students' positions and social interaction in small-group discussions

    Science.gov (United States)

    Due, Karin

    2014-06-01

    This article describes a study which explored the social interaction and the reproduction and challenge of gendered discourses in small group discussions in physics. Data for the study consisted of video recordings of eight upper secondary school groups solving physics problems and 15 audiotaped individual interviews with participating students. The analysis was based on gender theory viewing gender both as a process and a discourse. Specifically discursive psychology analysis was used to examine how students position themselves and their peers within discourses of physics and gender. The results of the study reveal how images of physics and of "skilled physics student" were constructed in the context of the interviews. These discourses were reconstructed in the students' discussions and their social interactions within groups. Traditional gendered positions were reconstructed, for example with boys positioned as more competent in physics than girls. These positions were however also resisted and challenged.

  2. Big hearts, small hands: a focus group study exploring parental food portion behaviours

    Directory of Open Access Journals (Sweden)

    Kristina Curtis

    2017-09-01

    Full Text Available Abstract Background The development of healthy food portion sizes among families is deemed critical to childhood weight management; yet little is known about the interacting factors influencing parents’ portion control behaviours. This study aimed to use two synergistic theoretical models of behaviour: the COM-B model (Capability, Opportunity, Motivation – Behaviour and Theoretical Domains Framework (TDF to identify a broad spectrum of theoretically derived influences on parents’ portion control behaviours including examination of affective and habitual influences often excluded from prevailing theories of behaviour change. Methods Six focus groups exploring family weight management comprised of one with caseworkers (n = 4, four with parents of overweight children (n = 14 and one with parents of healthy weight children (n = 8. A thematic analysis was performed across the dataset where the TDF/COM-B were used as coding frameworks. Results To achieve the target behaviour, the behavioural analysis revealed the need for eliciting change in all three COM-B domains and nine associated TDF domains. Findings suggest parents’ internal processes such as their emotional responses, habits and beliefs, along with social influences from partners and grandparents, and environmental influences relating to items such as household objects, interact to influence portion size behaviours within the home environment. Conclusion This is the first study underpinned by COM-B/TDF frameworks applied to childhood weight management and provides new targets for intervention development and the opportunity for future research to explore the mediating and moderating effects of these variables on one another.

  3. Barriers to Medication Decision Making in Women with Lupus Nephritis: A Formative Study using Nominal Group Technique.

    Science.gov (United States)

    Singh, Jasvinder A; Qu, Haiyan; Yazdany, Jinoos; Chatham, Winn; Dall'era, Maria; Shewchuk, Richard M

    2015-09-01

    To assess the perspectives of women with lupus nephritis on barriers to medication decision making. We used the nominal group technique (NGT), a structured process to elicit ideas from participants, for a formative assessment. Eight NGT meetings were conducted in English and moderated by an expert NGT researcher at 2 medical centers. Participants responded to the question: "What sorts of things make it hard for people to decide to take the medicines that doctors prescribe for treating their lupus kidney disease?" Patients nominated, discussed, and prioritized barriers to decisional processes involving medications for treating lupus nephritis. Fifty-one women with lupus nephritis with a mean age of 40.6 ± 13.3 years and disease duration of 11.8 ± 8.3 years participated in 8 NGT meetings: 26 African Americans (4 panels), 13 Hispanics (2 panels), and 12 whites (2 panels). Of the participants, 36.5% had obtained at least a college degree and 55.8% needed some help in reading health materials. Of the 248 responses generated (range 19-37 responses/panel), 100 responses (40%) were perceived by patients as having relatively greater importance than other barriers in their own decision-making processes. The most salient perceived barriers, as indicated by percent-weighted votes assigned, were known/anticipated side effects (15.6%), medication expense/ability to afford medications (8.2%), and the fear that the medication could cause other diseases (7.8%). Women with lupus nephritis identified specific barriers to decisions related to medications. Information relevant to known/anticipated medication side effects and medication cost will form the basis of a patient guide for women with systemic lupus erythematosus, currently under development.

  4. Design and rationale of the medical students learning weight management counseling skills (MSWeight) group randomized controlled trial.

    Science.gov (United States)

    Ockene, Judith K; Ashe, Karen M; Hayes, Rashelle B; Churchill, Linda C; Crawford, Sybil L; Geller, Alan C; Jolicoeur, Denise; Olendzki, Barbara C; Basco, Maria Theresa; Pendharkar, Jyothi A; Ferguson, Kristi J; Guck, Thomas P; Margo, Katherine L; Okuliar, Catherine A; Shaw, Monica A; Soleymani, Taraneh; Stadler, Diane D; Warrier, Sarita S; Pbert, Lori

    2018-01-01

    Physicians have an important role addressing the obesity epidemic. Lack of adequate teaching to provide weight management counseling (WMC) is cited as a reason for limited treatment. National guidelines have not been translated into an evidence-supported, competency-based curriculum in medical schools. Weight Management Counseling in Medical Schools: A Randomized Controlled Trial (MSWeight) is designed to determine if a multi-modal theoretically-guided WMC educational intervention improves observed counseling skills and secondarily improve perceived skills and self-efficacy among medical students compared to traditional education (TE). Eight U.S. medical schools were pair-matched and randomized in a group randomized controlled trial to evaluate whether a multi-modal education (MME) intervention compared to traditional education (TE) improves observed WMC skills. The MME intervention includes innovative components in years 1-3: a structured web-course; a role play exercise, WebPatientEncounter, and an enhanced outpatient internal medicine or family medicine clerkship. This evidence-supported curriculum uses the 5As framework to guide treatment and incorporates patient-centered counseling to engage the patient. The primary outcome is a comparison of scores on an Objective Structured Clinical Examination (OSCE) WMC case among third year medical students. The secondary outcome compares changes in scores of medical students from their first to third year on an assessment of perceived WMC skills and self-efficacy. MSWeight is the first RCT in medical schools to evaluate whether interventions integrated into the curriculum improve medical students' WMC skills. If this educational approach for teaching WMC is effective, feasible and acceptable it can affect how medical schools integrate WMC teaching into their curriculum. Copyright © 2017 Elsevier Inc. All rights reserved.

  5. Exploratory study of the characteristics of feedback in the reflective dialogue group given to medical students in a clinical clerkship

    Directory of Open Access Journals (Sweden)

    Chin-Chen Wen

    2015-02-01

    Full Text Available Purpose: Structured narrative reflective writing combined with guided feedback is an efficient teaching method for enhancing medical students’ reflective capacity. However, what kinds of feedback offered and reflection presented in a reflective group remain unclear. The aim of this study was to investigate the characteristics of feedback in a reflective dialogue group. Methods: Fifth-year medical students on a monthly interval rotation at the pediatric department of a medical center in eastern Taiwan during the 2012 academic year completed their reflective writing regarding patient and family psychosocial issues, and were subsequently debriefed in a 2-h group discussion session to receive feedback from a clinical tutor and peers. Content analysis was conducted to explore the characteristics of feedback and reflection presented in the reflective dialogue. The evaluative questionnaire regarding the benefits of reflection with others was administrated following the group session. Results: Forty students participated in five reflective groups and 108 psychosocial issues were discussed and identified. The tutor played an initiating role in the group discussion by providing six equal feedback types involving exploring new knowledge, initiating advanced discussion, highlighting the issues, and encouraging the students. The students provided eight types of feedback that involved a substantial deep discussion on psychosocial issues and action plans based on the complex interactive ecological network of clinical encounters. Each student attained 1.25 times the depth or breadth of reflection after receiving feedback and experienced the benefits of reflection with others. Conclusion: Through structured narrative reflective writing combined with pluralistic group discussion with a tutor and peers, the medical students had time to think deeply and broadly about psychosocial issues among patients and their family members. Facilitative feedback providing new

  6. Utilization and perceived problems of online medical resources and search tools among different groups of European physicians.

    Science.gov (United States)

    Kritz, Marlene; Gschwandtner, Manfred; Stefanov, Veronika; Hanbury, Allan; Samwald, Matthias

    2013-06-26

    There is a large body of research suggesting that medical professionals have unmet information needs during their daily routines. To investigate which online resources and tools different groups of European physicians use to gather medical information and to identify barriers that prevent the successful retrieval of medical information from the Internet. A detailed Web-based questionnaire was sent out to approximately 15,000 physicians across Europe and disseminated through partner websites. 500 European physicians of different levels of academic qualification and medical specialization were included in the analysis. Self-reported frequency of use of different types of online resources, perceived importance of search tools, and perceived search barriers were measured. Comparisons were made across different levels of qualification (qualified physicians vs physicians in training, medical specialists without professorships vs medical professors) and specialization (general practitioners vs specialists). Most participants were Internet-savvy, came from Austria (43%, 190/440) and Switzerland (31%, 137/440), were above 50 years old (56%, 239/430), stated high levels of medical work experience, had regular patient contact and were employed in nonacademic health care settings (41%, 177/432). All groups reported frequent use of general search engines and cited "restricted accessibility to good quality information" as a dominant barrier to finding medical information on the Internet. Physicians in training reported the most frequent use of Wikipedia (56%, 31/55). Specialists were more likely than general practitioners to use medical research databases (68%, 185/274 vs 27%, 24/88; χ²₂=44.905, Presources on the Internet and frequent reliance on general search engines and social media among physicians require further attention. Possible solutions may be increased governmental support for the development and popularization of user-tailored medical search tools and open

  7. Setting the question for inquiry: The effects of whole class vs small group on student achievement in elementary science

    Science.gov (United States)

    Cavagnetto, Andy Roy

    This study was conducted to determine the effects of two different student-centered approaches to setting the question for inquiry. The first approach (whole class) consisted of students setting a single question for inquiry after which students worked in small groups during an investigation phase of the activity with all groups exploring the same question. The second approach (small group) consisted of each group of students setting a question resulting in numerous questions being explored per class. A mixed method quasi-experimental design was utilized. Two grade five teachers from a small rural school district in the Midwestern United States participated, each teaching two sections of science (approximately 25 students per section). Results indicate three major findings. Instructional approach (whole class vs. small group) did not effect student achievement in science or language arts. Observational data indicated the actions and skills teachers utilized to implement the approaches were similar. Specifically, the pedagogical skills of dialogical interaction (which was found to be influenced by teacher level of control of learning and teacher content knowledge) and effective rather than efficient use of time were identified as key factors in teachers' progression toward a student-centered, teacher-managed instructional approach. Unit exams along with qualitative and quantitative teacher observation data indicated that these factors do have an impact on student achievement. Specifically increased dialogical interaction in the forms of greater student voice, and increased cognitive demands placed on students by embedding and emphasizing science argument within the student inquiry corresponded to positive gains in student achievement. Additionally, teacher's perception of student abilities was also found to influence professional growth. Finally, allowing students to set the questions for inquiry and design the experiments impact the classroom environment as teacher

  8. OPTICAL STUDIES OF PENICILLIN GROUP IN RELATION TO THEIR MEDICAL ACTIVITY

    Directory of Open Access Journals (Sweden)

    R. Jeevan Kumar

    2017-11-01

    Full Text Available The study of Medical activity of antibiotics is gaining momentum now a days owing to the importance of their curative values.  The Medical Activity correlated to molecular interactions,can be studied by various physical techniques, at present optical methods like Refractometry and Polarization are used to study the activity of a few antibiotics like Penicillin.  The Refractive Indices Mean Molecular Polarizability Diamagnetic Susceptibilities and Electron Ionisation Cross Section are interpreted in terms of dosages and the toxic effects if any due to over dosages are discussed critically.

  9. Psychotropic medication in a randomly selected group of citizens receiving residential or home care

    DEFF Research Database (Denmark)

    Futtrup, Tina Bergmann; Schultz, Hanne; Jensen, Margit Bak

    2014-01-01

    INTRODUCTION: Treatment with one or more psychotropic medications (PMs), especially in the elderly, is associated with risk, and the effects of treatment are poorly validated. The aim of this article was to describe the use of PM in a population of citizens receiving either residential care or home...... care with focus on the prevalence of drug use, the combination of different PMs and doses in relation to current recommendations. METHODS: The medication lists of 214 citizens receiving residential care (122) and home care (92) were collected together with information on age, gender and residential...

  10. Decay of references to Web sites in articles published in general medical journals: mainstream vs small journals.

    Science.gov (United States)

    Habibzadeh, P

    2013-01-01

    Over the last decade, Web sites (URLs) have been increasingly cited in scientific articles. However, the contents of the page of interest may change over the time. To investigate the trend of citation to URLs in five general medical journals since January 2006 to June 2013 and to compare the trends in mainstream journals with small journals. References of all original articles and review articles published between January 2006 and June 2013 in three regional journals - Archives of Iranian Medicine (AIM), Eastern Mediterranean Health Journal (EMHJ), and Journal of Postgraduate Medical Institute (JPMI) - and two mainstream journals - The Lancet and British Medical Journal (BMJ) - were reviewed. The references were checked to determine the frequency of citation to URLs as well as the rate of accessibility of the URLs cited. A total of 2822 articles was studied. Since January 2006 onward, the number of citations to URLs increased in the journals (doubling time ranged from 4.2 years in EMHJ to 13.9 years in AIM). Overall, the percentage of articles citing at least one URL has increased from 24% in 2006 to 48.5% in 2013. Accessibility to URLs decayed as the references got old (half life ranged from 2.2 years in EMHJ to 5.3 years in BMJ). The ratio of citation to URLs in the studied mainstream journals, as well as the ratio of URLs accessible were significantly (pjournals. URLs are increasingly cited, but their contents decay with time. The trend of citing and decaying URLs are different in mainstream journals compared to small medical journals. Decay of URL contents would jeopardize the accuracy of the references and thus, the body of evidence. One way to tackle this important obstacle is to archive URLs permanently.

  11. Making a business case for small medical practices to maintain quality while addressing racial healthcare disparities.

    Science.gov (United States)

    Dunston, Frances J; Eisenberg, Andrew C; Lewis, Evelyn L; Montgomery, John M; Ramos, Diana; Elster, Arthur

    2008-11-01

    Various reports have documented variations in quality of care that occur among racial and ethnic populations, even after accounting for socioeconomic factors and health insurance status. Although quality improvement initiatives are often touted as the answer to healthcare disparities, researchers have questioned whether a business case exists that supports this notion. We assess various barriers and incentives for using quality improvement to address racial and ethnic healthcare disparities in small-to-medium-sized practices. We believe that although both indirect and direct cost incentives may exist, a favorable business case for small private practices cannot be made unless there are additional financial incentives. The business community can work with health plans to provide these incentives.

  12. Simulation Suggests That Medical Group Mergers Won’t Undermine The Potential Utility Of Health Information Exchanges

    Science.gov (United States)

    Schneider, Eric C.; Volk, Lynn A.; Szolovits, Peter; Salzberg, Claudia A.; Simon, Steven R.; Bates, David W.

    2013-01-01

    Substantial resources are being invested in health information exchanges (HIE), community-based consortia that enable independent health-care organizations to exchange clinical data. However, under pressure to form accountable care organizations, medical groups may merge and support private HIE, reducing the potential utility of community HIEs. Simulations of “care transitions” based on data from 10 Massachusetts communities suggest that mergers would have to be considerable to substantially reduce the potential utility of an HIE. Nonetheless, simulations also suggest that HIEs will need to recruit a large proportion of the medical groups in a community, as hospitals and the largest groups account for only 10 to 20% of care transitions in communities. PMID:22392665

  13. An equivalence study of interview platform: Does videoconference technology impact medical school acceptance rates of different groups?

    Science.gov (United States)

    Ballejos, Marlene P; Oglesbee, Scott; Hettema, Jennifer; Sapien, Robert

    2018-02-14

    Web-based interviewing may be an effective element of a medical school's larger approach to promotion of holistic review, as recommended by the Association of American Medical Colleges, by facilitating the feasibility of including rural and community physicians in the interview process. Only 10% of medical schools offer videoconference interviews to applicants and little is known about the impact of this interview modality on the admissions process. This study investigated the impact of overall acceptance rates using videoconference interviews and face-to-face interviews in the medical school selection process using an equivalence trial design. The University of New Mexico School of Medicine integrated a videoconferencing interview option for community and rural physician interviewers in a pseudo-random fashion during the 2014-2016 admissions cycles. Logistic regression was conducted to examine whether videoconference interviews impacted acceptance rates or the characteristics of accepted students. Demographic, admissions and diversity factors were analyzed that included applicant age, MCAT score, cumulative GPA, gender, underrepresented in medicine, socioeconomic status and geographic residency. Data from 752 interviews were analyzed. Adjusted rates of acceptance for face-to-face (37.0%; 95% CI 28.2, 46.7%) and videoconference (36.1%; 95% CI 17.8, 59.5%) interviews were within an a priori ± 5% margin of equivalence. Both interview conditions yielded highly diverse groups of admitted students. Having a higher medical college admission test score, grade point average, and self-identifying as disadvantaged increased odds of admission in both interview modalities. Integration of the videoconference interview did not impact the overall acceptance of a highly diverse and qualified group of applicants, and allowed rural and community physicians to participate in the medical school interview process as well as allowed campus faculty and medical student committee members

  14. Barriers to the medication error reporting process within the Irish National Ambulance Service, a focus group study.

    Science.gov (United States)

    Byrne, Eamonn; Bury, Gerard

    2018-02-08

    Incident reporting is vital to identifying pre-hospital medication safety issues because literature suggests that the majority of errors pre-hospital are self-identified. In 2016, the National Ambulance Service (NAS) reported 11 medication errors to the national body with responsibility for risk management and insurance cover. The Health Information and Quality Authority in 2014 stated that reporting of clinical incidents, of which medication errors are a subset, was not felt to be representative of the actual events occurring. Even though reporting systems are in place, the levels appear to be well below what might be expected. Little data is available to explain this apparent discrepancy. To identify, investigate and document the barriers to medication error reporting within the NAS. An independent moderator led four focus groups in March of 2016. A convenience sample of 18 frontline Paramedics and Advanced Paramedics from Cork City and County discussed medication errors and the medication error reporting process. The sessions were recorded and anonymised, and the data was analysed using a process of thematic analysis. Practitioners understood the value of reporting errors. Barriers to reporting included fear of consequences and ridicule, procedural ambiguity, lack of feedback and a perceived lack of both consistency and confidentiality. The perceived consequences for making an error included professional, financial, litigious and psychological. Staff appeared willing to admit errors in a psychologically safe environment. Barriers to reporting are in line with international evidence. Time constraints prevented achievement of thematic saturation. Further study is warranted.

  15. Medical risk factors for small-bowel adenocarcinoma with focus on Crohn's disease

    DEFF Research Database (Denmark)

    Kærlev, Linda; Teglbjaerg, P.S.; Sabroe, Svend

    2001-01-01

    the 3-year period preceding the SBA diagnosis. Previous gallstone surgery, which may be a sign of severe gallstone disease, was not associated with SBA. Liver cirrhosis, hepatitis or medical treatments with radioactive substances or corticosteroid tablets were not associated with this disease. Cases...... with SBA had an increased prevalence of anaemia; OR 15.3 (2.5-92.1). An association between low educational level and SBA was found; OR 1.75 (1.0-3.0). CONCLUSION: This study supports Crohn disease and coeliac disease being strong but rare risk factors for SBA. Previous gallstones were unrelated to SBA...

  16. The role of medical group practice administrators in the adoption and implementation of Medicare's physician quality reporting system.

    Science.gov (United States)

    Coulam, Robert; Kralewski, John; Dowd, Bryan; Gans, David

    2016-01-01

    Although there are numerous studies of the factors influencing the adoption of quality assurance (QA) programs by medical group practices, few have focused on the role of group practice administrators. To gain insights into the role these administrators play in QA programs, we analyzed how medical practices adopted and implemented the Medicare Physician Quality Reporting System (PQRS), the largest physician quality reporting system in the United States. We conducted focus group interviews in 2011 with a national convenience sample of 76 medical group practice administrators. Responses were organized and analyzed using the innovation decision framework of Van de Ven and colleagues. Administrators conducted due diligence on PQRS, influenced how the issue was presented to physicians for adoption, and managed implementation thereafter. Administrators' recommendations were heavily influenced by practice characteristics, financial incentives, and practice commitments to early adoption of quality improvement innovations. Virtually, all who attempted it agreed that PQRS was straightforward to implement. However, the complexities of Medicare's PQRS reports impeded use of the data by administrators to support quality management. Group practice administrators are playing a prominent role in activities related to the quality of patient care--they are not limited to the business side of the practice. Especially, as PQRS becomes more nearly universal after 2014, Medicare should take account of the role that administrators play, by more actively engaging administrators in shaping these programs and making it easier for administrators to use the results. More research is needed on the rapidly evolving role of nonphysician administration in medical group practices. Practice administrators have a larger role than commonly understood in how quality reporting initiatives are adopted and used and are in an exceptional position to influence the more appropriate use of these resources if

  17. Identifying Risk of Future Asthma Attacks Using UK Medical Record Data : A Respiratory Effectiveness Group Initiative

    NARCIS (Netherlands)

    Blakey, John D.; Price, David B.; Pizzichini, Emilio; Popov, Todor A.; Dimitrov, Borislav D.; Postma, Dirkje S.; Josephs, Lynn K.; Kaplan, Alan; Papi, Alberto; Kerkhof, Marjan; Hillyer, Elizabeth V.; Chisholm, Alison; Thomas, Mike

    BACKGROUND: Asthma attacks are common, serious, and costly. Individual factors associated with attacks, such as poor symptom control, are not robust predictors. OBJECTIVE: We investigated whether the rich data available in UK electronic medical records could identify patients at risk of recurrent

  18. Leukaemia following childhood radiation exposure in the Japanese atomic bomb survivors and in medically exposed groups

    International Nuclear Information System (INIS)

    Little, M. P.

    2008-01-01

    Incidence and mortality risks of radiation-associated leukaemia are surveyed in the Japanese atomic bomb (A-bomb) survivors exposed in early childhood and in utero. Leukaemia incidence and mortality risks are also surveyed in 16 other studies of persons who received appreciable doses of ionizing radiation in the course of treatment in childhood and for whom there is adequate dosimetry and cancer incidence or mortality follow-up. Relative risks tend to be lower in the medical series than in the Japanese A-bomb survivors. The relative risks in the medical studies tend to diminish with increasing average therapy dose. After taking account of cell sterilisation and dose fractionation, the apparent differences between the relative risks for leukaemia in the Japanese A-bomb survivors and in the medical series largely disappear. This suggests that cell sterilisation largely accounts for the discrepancy between the relative risks in the Japanese data and the medical studies. Excess absolute risk has also been assessed in four studies, and there is found to be more variability in this measure than in excess relative risk. In particular, there is a substantial difference between the absolute risk in the Japanese atomic bomb survivor data and those in three other (European) populations. In summary, the relative risks of leukaemia in studies of persons exposed to appreciable doses of ionizing radiation in the course of treatment for a variety of malignant and non-malignant conditions in childhood are generally less than those in the Japanese A-bomb survivor data. The effects of cell sterilisation can largely explain the discrepancy between the Japanese and the medical series. (authors)

  19. Increasing medical student exposure to musculoskeletal medicine: the initial impact of the Orthopaedic Surgery and Sports Medicine Interest Group

    Directory of Open Access Journals (Sweden)

    Mickelson DT

    2017-07-01

    Full Text Available Dayne T Mickelson,1 Philip K Louie,2 Kenneth R Gundle,3 Alex W Farnand,4 Douglas P Hanel5 1Department of Orthopedic Surgery and Sports Medicine, Duke University, Durham, NC, USA; 2Department of Orthopedic Surgery, Rush University Medical Center, Chicago, IL, USA; 3Department of Orthopedics and Rehabilitation, Oregon Health and Science University, Portland, OR, USA; 4Department of General Surgery, Presence Saint Joseph Hospital – Chicago, Chicago, IL, USA; 5Department of Orthopedic Surgery and Sports Medicine, University of Washington, Harborview Medical Center, Seattle, WA, USA Purpose: To investigate the impact of the Orthopaedic Surgery and Sports Medicine Interest Group (OSSMIG on medical student interest and confidence in core musculoskeletal (MSK concepts through supplemental education and experiences at a single tertiary, academic institution.Methods: Medical student OSSMIG members at various levels of training were anonymously surveyed at the beginning and end of the 2014–2015 academic year.Results: Eighteen (N=18 medical student interest group members completed the survey. Significant improvement in their level of training was observed with regard to respondents’ self-assessed competence and confidence in MSK medicine (p<0.05. Additionally, respondents’ attitudes toward exposure and support from the interest group were significantly higher than those provided by the institution (p<0.05. Members believed OSSMIG increased interest in MSK medicine, improved confidence in their ability to perform orthopedics-related physical exams, strengthened mentorship with residents and attendings, and developed a connection with the Department of Orthopedic Surgery and its residents (median “Strongly Agree”, interquartile range one and two scale items.Conclusion: Since its inception 8 years ago, OSSMIG has been well received and has positively impacted University of Washington School of Medicine students through various interventions

  20. Small Ubiquitin-like Modifier (SUMO) Conjugation Impedes Transcriptional Silencing by the Polycomb Group Repressor Sex Comb on Midleg*

    OpenAIRE

    Smith, Matthew; Mallin, Daniel R.; Simon, Jeffrey A.; Courey, Albert J.

    2011-01-01

    The Drosophila protein Sex Comb on Midleg (Scm) is a member of the Polycomb group (PcG), a set of transcriptional repressors that maintain silencing of homeotic genes during development. Recent findings have identified PcG proteins both as targets for modification by the small ubiquitin-like modifier (SUMO) protein and as catalytic components of the SUMO conjugation pathway. We have found that the SUMO-conjugating enzyme Ubc9 binds to Scm and that this interaction, which requires the Scm C-te...

  1. Use of smokeless tobacco among groups of Pakistani medical students – a cross sectional study

    Directory of Open Access Journals (Sweden)

    Ilyas Mahwish

    2007-09-01

    Full Text Available Abstract Background Use of smokeless tobacco is common in South Asia. Tobacco is a major preventable cause of morbidity and mortality. Doctors make one of the best avenues to influence patients' tobacco use. However, medical students addicted to tobacco are likely to retain this habit as physicians and are unlikely to counsel patients against using tobacco. With this background, this study was conducted with the objective of determining the prevalence of smokeless tobacco among Pakistani medical students. Methods A cross sectional study was carried out in three medical colleges of Pakistan – one from the north and two from the southern region. 1025 students selected by convenient sampling completed a peer reviewed, pre-tested, self-administered questionnaire. Questions were asked regarding lifetime use (at least once or twice in their life, current use (at least once is the last 30 days, and established use (more than 100 times in their life of smokeless tobacco. Chi square and logistic regression analyses were used. Results Two hundred and twenty (21.5% students had used tobacco in some form (smoked or smokeless in their lifetime. Sixty six (6.4% students were lifetime users of smokeless tobacco. Thirteen (1.3% were daily users while 18 (1.8% fulfilled the criterion for established users. Niswar was the most commonly used form of smokeless tobacco followed by paan and nass. Most naswar users belonged to NWFP while most paan users studied in Karachi. On univariate analysis, lifetime use of smokeless tobacco showed significant associations with the use of cigarettes, student gender (M > F, student residence (boarders > day scholars and location of the College (NWFP > Karachi. Multivariate analysis showed independent association of lifetime use of smokeless tobacco with concomitant cigarette smoking, student gender and location of the medical college. Conclusion The use of smokeless tobacco among medical students cannot be ignored. The

  2. Occupational Safety and Health Conditions Aboard Small- and Medium-Size Fishing Vessels: Differences among Age Groups.

    Science.gov (United States)

    Zytoon, Mohamed A; Basahel, Abdulrahman M

    2017-02-24

    Although marine fishing is one of the most hazardous occupations, research on the occupational safety and health (OSH) conditions aboard marine fishing vessels is scarce. For instance, little is known about the working conditions of vulnerable groups such as young and aging fishermen. The objective of the current paper is to study the OSH conditions of young and aging fishermen compared to middle-aged fishermen in the small- and medium-size (SM) marine fishing sector. A cross-sectional study was designed, and 686 fishermen working aboard SM fishing vessels were interviewed to collect information about their safety and health. The associations of physical and psychosocial work conditions with safety and health outcomes, e.g., injuries, illnesses and job satisfaction, are presented. The results of the current study can be utilized in the design of effective accident prevention and OSH training programs for the three age groups and in the regulation of working conditions aboard fishing vessels.

  3. Medical error identification, disclosure, and reporting: do emergency medicine provider groups differ?

    Science.gov (United States)

    Hobgood, Cherri; Weiner, Bryan; Tamayo-Sarver, Joshua H

    2006-04-01

    To determine if the three types of emergency medicine providers--physicians, nurses, and out-of-hospital providers (emergency medical technicians [EMTs])--differ in their identification, disclosure, and reporting of medical error. A convenience sample of providers in an academic emergency department evaluated ten case vignettes that represented two error types (medication and cognitive) and three severity levels. For each vignette, providers were asked the following: 1) Is this an error? 2) Would you tell the patient? 3) Would you report this to a hospital committee? To assess differences in identification, disclosure, and reporting by provider type, error type, and error severity, the authors constructed three-way tables with the nonparametric Somers' D clustered on participant. To assess the contribution of disclosure instruction and environmental variables, fixed-effects regression stratified by provider type was used. Of the 116 providers who were eligible, 103 (40 physicians, 26 nurses, and 35 EMTs) had complete data. Physicians were more likely to classify an event as an error (78%) than nurses (71%; p = 0.04) or EMTs (68%; p error to the patient (59%) than physicians (71%; p = 0.04). Physicians were the least likely to report the error (54%) compared with nurses (68%; p = 0.02) or EMTs (78%; p error types, identification, disclosure, and reporting increased with increasing severity. Improving patient safety hinges on the ability of health care providers to accurately identify, disclose, and report medical errors. Interventions must account for differences in error identification, disclosure, and reporting by provider type.

  4. Awareness and distribution of ABO, Rhesus blood groups and haemoglobin phenotypes among medical undergraduates in a Nigerian university.

    Science.gov (United States)

    Akingbola, T S; Yuguda, S; Akinyemi, O O; Olomu, S

    2016-09-01

    In the past two decades the Nigerian government and religious organisations have put more emphasis on knowing the haemoglobin electrophoresis of school children and intending couples respectively. Knowledge of the distribution of blood groups and haemoglobin electrophoretic patterns among young people is vital for the prevention of haemoglobinopathies in the population and for providing effective blood banking services. Therefore, this study was designed to assess the frequency and awareness of blood group and haemoglobinphenotypes among a new set of fourth year clinical medical and dental students of the University of Ibadan, Nigeria. Data, including socio-demographics, self- reported blood group and haemoglobin phenotypes, were obtained from 155 students using a self-administered questionnaire. The ABO, Rhesus (Rh) blood groups and haemoglobin electrophoresis were determined by the tile (slide) technique and cellulose acetate at alkaline phrespectively. Only 43.9% of the participants knew their blood groups while less than a third (29.7%) knew their haemoglobin phenotypes. knowledge of both their blood groups and haemoglobin phenotypes was documented in as low as 20.6% of the respondents. The frequency of haemoglobin AA, AS, AC and. CC were 78.0%, 16.8%, 3.9% and 1.3% respectively. Similarly, the distribution of blood groups were: 0 RhD positive - 47.8%;0 RhD negative- 1.9%;ARhD positive- 21.9%; A RhD negative - 1.3%; B RhD positive - 23.2%; B RhD negative -1.3% and AB RhD positive - 2.6%. No participant was AB RhD negative. Participants who bad previously donated blood and those who were females were more likely to know their blood groups and haemoglobin phenotypes respectively (pblood groups and haemoglobin phenotypes among the medical and dental students was poor. Documentation and routine screening for haemoglobinphenotypes as well as blood grouping, accompanied by appropriate counseling should be institutionalised in Nigeriantertiary institutions.

  5. Group dynamics and social interaction in a South Asian online learning forum for faculty development of medical teachers.

    Science.gov (United States)

    Anshu; Sharma, M; Burdick, W P; Singh, T

    2010-04-01

    Group dynamics of online medical faculty development programs have not been analyzed and reported in literature. Knowledge of the types of content of posted messages will help to understand group dynamics and promote participation in an asynchronous learning environment. This paper assesses group dynamics and social interactivity in an online learning environment for medical teachers in the South Asian context. Participants of a medical education fellowship program conducted by the Foundation for Advancement of International Medical Education and Research (FAIMER) Regional Institute at Christian Medical College, Ludhiana (CMCL) in India interact on a listserv called the Mentoring-Learning Web (ML-Web). Monthly topics for online discussion are chosen by fellows through a standard tool called "multi-voting". Fellows volunteer to moderate sessions and direct the pace of the discussion. We analyzed the content and process of the discussion of one particular month. The emails were categorized as those that reflected cognitive presence (dealing with construction and exploration of knowledge), teacher presence (dealing with instructional material and learning resources), and social presence, or were administrative in nature. Social emails were further classified as: affective, cohesive and interactive. Social emails constituted one-third of the total emails. Another one-quarter of the emails dealt with sharing of resources and teacher presence, while cognitive emails comprised 36.2% of the total. More than half of the social emails were affective, while a little less than one-third were cohesive. Social posts are an inevitable part of online learning. These posts promote bonding between learners and contribute to better interaction and collaboration in online learning. Moderators should be aware of their presence and use them as tools to promote interactivity.

  6. The role of prophylactic cranial irradiation in regionally advanced non-small cell lung cancer. A Southwest Oncology Group Study

    Energy Technology Data Exchange (ETDEWEB)

    Rusch, V.W.; Griffin, B.R.; Livingston, R.B. (Univ. of Washington, Seattle (USA))

    1989-10-01

    Lung cancer is the most common malignant disease in the United States. Only the few tumors detected very early are curable, but there has been some progress in the management of more advanced non-small cell lung cancer, particularly in regionally inoperable disease. Prevention of central nervous system relapse is an important issue in this group of patients because brain metastases ultimately develop in 20% to 25% of them. Seventy-three patients with regionally advanced non-small cell lung cancer were entered into a Phase II trial of neutron chest radiotherapy sandwiched between four cycles of chemotherapy including cisplatin, vinblastine, and mitomycin C. Prophylactic cranial irradiation was administered concurrently with chest radiotherapy (3000 cGy in 10 fractions in 15 patients; 3600 cGy in 18 fractions in the remaining 50 patients). Patients underwent computed tomographic scan of the brain before treatment and every 3 months after treatment. The initial overall response rate was 79%, but 65 of the 73 patients have subsequently died of recurrent disease. Median follow-up is 9 months for all 73 patients and 26 months for eight long-term survivors. No patient who completed the prophylactic cranial irradiation program had clinical or radiologic brain metastases. Toxic reactions to prophylactic cranial irradiation included reversible alopecia in all patients, progressive dementia in one patient, and possible optic neuritis in one patient. Both of these patients received 300 cGy per fraction of irradiation. The use of prophylactic cranial irradiation has been controversial, but its safety and efficacy in this trial supports its application in a group of patients at high risk for central nervous system relapse. Further evaluation of prophylactic cranial irradiation in clinical trials for regionally advanced non-small cell lung cancer is warranted.

  7. The Importance of End Groups for Solution-Processed Small-Molecule Bulk-Heterojunction Photovoltaic Cells.

    Science.gov (United States)

    Duan, Ruomeng; Cui, Yong; Zhao, Yanfei; Li, Chen; Chen, Long; Hou, Jianhui; Wagner, Manfred; Baumgarten, Martin; He, Chang; Müllen, Klaus

    2016-05-10

    End groups in small-molecule photovoltaic materials are important owing to their strong influence on molecular stability, solubility, energy levels, and aggregation behaviors. In this work, a series of donor-acceptor pentads (D2 -A-D1 -A-D2 ) were designed and synthesized, aiming to investigate the effect of the end groups on the materials properties and photovoltaic device performance. These molecules share identical central A-D1 -A triads (with benzodithiophene as D1 and 6-carbonyl-thieno[3,4-b]thiophene as A), but with various D2 end groups composed of alkyl-substituted thiophene (T), thieno[3,2-b]thiophene (TT), and 2,2'-bithiophene (BT). The results indicate a relationship between conjugated segment/alkyl chain length of the end groups and the photovoltaic performance, which contributes to the evolving molecular design principles for high efficiency organic solar cells. © 2016 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.

  8. Medication withdrawal may be an option for a select group of patients in relapsing-remitting multiple sclerosis

    Directory of Open Access Journals (Sweden)

    Guilherme Sciascia do Olival

    2013-08-01

    Full Text Available This article describes the clinical and radiological evolution of a stable group of patients with relapsing-remitting multiple sclerosis that had their disease-modifying therapy (DMT withdrawn. Forty patients, which had made continuous use of one immunomodulator and had remained free of disease for at least 5 years, had their DMT withdrawn and were observed from 13 to 86 months. Out of the followed patients, 4 (10% patients presented with new attacks. In addition to these patients, 2 (5% patients had new lesions revealed by magnetic resonance imaging that did not correspond to clinical attacks. Despite these results, the difficult decision to withdraw medication requires careful analysis. Withdrawal, however, should not be viewed as simply the suspension of treatment because these patients should be evaluated periodically, and the immunomodulators should be readily reintroduced if new attacks occur. Nonetheless, medication withdrawal is an option for a select group of patients.

  9. Comparison of the Effectiveness and Efficiency of Text Previewing and Preteaching Keywords as Small-Group Reading Comprehension Strategies with Middle-School Students

    Science.gov (United States)

    Burns, Matthew K.; Hodgson, Jennifer; Parker, David C.; Fremont, Kathryn

    2011-01-01

    Reading instruction for middle- and high-school students is focused on vocabulary and comprehension, yet research suggests that comprehension skills among these students are alarmingly low. Small-group reading interventions are becoming more prevalent in schools, but there are few studies regarding small-group reading comprehension interventions.…

  10. One-Way Functions and Composition of Conjugacy and Discrete Logarithm Problems in the Small Cancellation Groups

    Directory of Open Access Journals (Sweden)

    N. V. Bezverkhniy

    2015-01-01

    Full Text Available The paper considers the possibility for building a one-way function in the small cancellation group. Thus, it uses the algorithm to solve the problem for a cyclic subgroup, also known as a discrete logarithm problem, and the algorithm to solve the word problem in this class of groups.Research is conducted using geometric methods of combinatorial group theory (the method of diagrams in groups.In public channel exchange of information are used one-way functions, direct calculation of which should be much less complicated than the calculation of the inverse function. The paper considers the combination of two problems: discrete logarithms and conjugacy. This leads to the problem of conjugate membership for a cyclic subgroup. The work proposes an algorithm based on this problem, which can be used as a basis in investigation of the appropriate one-way function for its fitness to build a public key distribution scheme.The study used doughnut charts of word conjugacy, and for one special class of such charts has been proven a property of the layer-based periodicity. The presence of such properties is obviously leads to a solution of the power conjugacy of words in the considered class of groups. Unfortunately, this study failed to show any periodicity of a doughnut chart, but for one of two possible classes this periodicity has been proven.The building process of one-way function considered in the paper was studied in terms of possibility to calculate both direct and inverse mappings. The computational complexity was not considered. Thus, the following two tasks were yet unresolved: determining the quality of one-way function in the above protocol of the public key distribution and completing the study of the periodicity of doughnut charts of word conjugacy, leading to a positive solution of the power conjugacy of words in the class groups under consideration.

  11. Team-Based Learning for Nursing and Medical Students: Focus Group Results From an Interprofessional Education Project.

    Science.gov (United States)

    Feather, Rebecca A; Carr, Doug E; Reising, Deanna L; Garletts, Derrick M

    2016-01-01

    Past research indicates that inadequacies in health care delivery create substantial preventable quality issues that can be addressed through improving relationships among clinicians to decrease the negative effects on patient outcomes. The purpose of this article is to describe the implementation of an interprofessional education project with senior nursing and third-year medical students working in teams in a clinical setting. Results include data from focus groups conducted at the conclusion of the project.

  12. Parental illness perceptions and medication perceptions in childhood asthma, a focus group study

    NARCIS (Netherlands)

    Klok, Ted; Brand, Paul L.; Bomhof-Roordink, Hanna; Duiverman, Eric J.; Kaptein, Adrian A.

    Aim: Asthma treatment according to guidelines fails frequently, through patients' nonadherence to doctors' advice. This study aimed to explore how differences in asthma care influence parents' perceptions to inhaled corticosteroids (ICS). Methods: We conducted six semistructured focus groups,

  13. The Impact of a Group Communication Course on Veterinary Medical Students' Perceptions of Communication Competence and Communication Apprehension.

    Science.gov (United States)

    Kedrowicz, April A

    2016-01-01

    This paper explores the impact of a group communication course on veterinary medical students' perceptions of communication competence and communication anxiety. Students enrolled in the Group Communication in Veterinary Medicine course completed the Personal Report of Communication Apprehension and the Communicative Competence Scale at the beginning (Time 1) and end (Time 2) of the semester. Results show that first-year veterinary students' self-perceptions of communication competence increased and their self-reported levels of communication apprehension decreased across multiple contexts from Time 1 to Time 2. This research provides support for experiential communication training fostering skill development and confidence.

  14. Many large medical groups will need to acquire new skills and tools to be ready for payment reform.

    Science.gov (United States)

    Mechanic, Robert; Zinner, Darren E

    2012-09-01

    Federal and state policy makers are now experimenting with programs that hold health systems accountable for delivering care under predetermined budgets to help control health care spending. To assess how well prepared medical groups are to participate in these arrangements, we surveyed twenty-one large, multispecialty groups. We evaluated their participation in risk contracts such as capitation and the degree of operational support associated with these arrangements. On average, about 25 percent of the surveyed groups' patient care revenue stemmed from global capitation contracts and 9 percent from partial capitation or shared risk contracts. Groups with a larger share of revenue from risk contracts were more likely than others to have salaried physicians, advanced data management capabilities, preferred relationships with efficient specialists, and formal programs to coordinate care for high-risk patients. Our findings suggest that medical groups that lack risk contracting experience may need to develop new competencies and infrastructure to successfully navigate federal payment reform programs, including information systems that track performance and support clinicians in delivering good care; physician-level reward systems that are aligned with organizational goals; sound physician leadership; and an organizational commitment to supporting performance improvement. The difficulty of implementing these changes in complex health care organizations should not be underestimated.

  15. Risk perception about medication sharing among patients: a focus group qualitative study on borrowing and lending of prescription analgesics

    Directory of Open Access Journals (Sweden)

    Markotic F

    2017-02-01

    Full Text Available Filipa Markotic,1 Davorka Vrdoljak,2 Marijana Puljiz,3 Livia Puljak,4 1Centre for Clinical Pharmacology, University Clinical Hospital Mostar, Mostar, Bosnia and Herzegovina; 2Department of Family Medicine, University of Split School of Medicine, Split, 3Family Medicine Clinic, Health Centre Imotski, Kamenmost, 4Laboratory for Pain Research, University of Split School of Medicine, Split, Croatia Background: One form of self-medication is sharing of medications, defined as borrowing or lending medications in situations where the receiver of these drugs is not the individual to whom the medications were allocated. Objective: To explore experiences and opinions of patients about sharing prescription analgesics, reasons for sharing prescription analgesics, the way in which patients choose to share those medications, their awareness of risk regarding sharing prescription analgesics, and how they estimated the potential risk.Methods: This qualitative study was conducted by focus group discussions with 40 participants led by a moderator trained in focus group methodology using a semi-structured moderator guide. Adults aged ≥18 years who had received a prescription for an analgesic at least once in a lifetime were included. Six separate focus groups were conducted to discuss participants’ perception of risks associated with sharing of prescription analgesics among patients. Additionally, participants filled out two questionnaires on demographic data, their own behavior regarding sharing analgesics, and their attitudes about risks associated with sharing prescription analgesics.Results: In a questionnaire, 55% of the participants indicated that they personally shared prescription analgesics, while subsequently in the focus group discussions, 76% confessed to such behavior. Participants recognized certain risks related to sharing of prescription analgesics, mentioned a number of reasons for engaging in such behavior, and indicated certain positive

  16. Multiple group I introns in the small-subunit rDNA of Botryosphaeria dothidea: implication for intraspecific genetic diversity.

    Directory of Open Access Journals (Sweden)

    Chao Xu

    Full Text Available Botryosphaeria dothidea is a widespread and economically important pathogen on various fruit trees, and it often causes die-back and canker on limbs and fruit rot. In characterizing intraspecies genetic variation within this fungus, group I introns, rich in rDNA of fungi, may provide a productive region for exploration. In this research, we analysed complete small subunit (SSU ribosomal DNA (rDNA sequences of 37 B. dothidea strains, and found four insertions, designated Bdo.S943, Bdo.S1199-A, Bdo.S1199-B and Bdo.S1506, at three positions. Sequence analysis and structure prediction revealed that both Bdo.S943 and Bdo.S1506 belonged to subgroup IC1 of group I introns, whereas Bdo.S1199-A and Bdo.S1199-B corresponded to group IE introns. Moreover, Bdo.S1199-A was found to host an open reading frame (ORF for encoding the homing endonuclease (HE, whereas Bdo.S1199-B, an evolutionary descendant of Bdo.S1199-A, included a degenerate HE. The above four introns were novel, and were the first group I introns observed and characterized in this species. Differential distribution of these introns revealed that all strains could be separated into four genotypes. Genotype III (no intron and genotype IV (Bdo.S1199-B were each found in only one strain, whereas genotype I (Bdo.S1199-A and genotype II (Bdo.S943 and Bdo.S1506 occurred in 95% of the strains. There is a correlation between B. dothidea genotypes and hosts or geographic locations. Thus, these newly discovered group I introns can help to advance understanding of genetic differentiation within B. dothidea.

  17. Negotiating the Inquiry Question: A Comparison of Whole Class and Small Group Strategies in Grade Five Science Classrooms

    Science.gov (United States)

    Cavagnetto, Andy R.; Hand, Brian; Norton-Meier, Lori

    2011-03-01

    The purpose of this study is to examine the effect of two strategies for negotiating the question for exploration during science inquiry on student achievement and teachers' perceptions. The study is set in the context of the Science Writing Heuristic. The first strategy (small group) consisted of each group of four students negotiating a question for inquiry with the teacher while the second strategy (whole class) consisted of the entire class negotiating a single question for inquiry with the teacher. The study utilized a mixed-method approach. A quasi-experimental repeated measures design was used to determine the effect of strategy on student achievement and semi-structured teacher interviews were used to probe the question of teacher perceptions of the two strategies. Teacher observations were conducted using the Reformed Teaching Observation Protocol (RTOP) to check for variation in implementation of the two strategies. Iowa Test of Basic Skills Science (ITBSS) (2005 and 2006) and teacher/researcher developed unit exams (pre and post) were used as student achievement measures. No statistically significant differences were found among students in the two treatment groups on the ITBSS or unit exams. RTOP observations suggest that teacher implementation was consistent across the two treatment strategies. Teachers disclosed personal preferences for the two strategies, indicating the whole class treatment was easier to manage (at least at the beginning of the school year) as students gained experience with science inquiry and the associated increased responsibility. Possible mechanisms linking the two strategies, negotiated questions, and student outcomes are discussed.

  18. Review of medical discharge summaries and medical documentation in a metropolitan hospital: impact on diagnostic-related groups and Weighted Inlier Equivalent Separation.

    Science.gov (United States)

    Chin, N; Perera, P; Roberts, A; Nagappan, R

    2013-07-01

    Accurate and comprehensive clinical documentation is crucial for effective ongoing patient care, follow up and to optimise case mix-based funding. Each Diagnostic Related Group (DRG) is assigned a 'weight', leading to Weighted Inlier Equivalent Separation (WIES), a system many public and private hospitals in Australia subscribe to. To identify the top DRG in a general medical inpatient service, the completeness of medical discharge documentation, commonly missed comorbidities and system-related issues and subsequent impact on DRG and WIES allocation. One hundred and fifty completed discharge summaries were randomly selected from the top 10 medical DRG in our health service. From a detailed review of the clinical documentation, principal diagnoses, associated comorbidities and complications, where appropriate, the DRG and WIES were modified. Seventy-two (48%) of the 150 reviewed admissions resulted in a revision of DRG and WIES equivalent to an increase of AUD 142,000. Respiratory-based DRG generated the largest revision of DRG and WIES, while 'Cellulitis' DRG had the largest relative change. Twenty-seven per cent of summaries reviewed necessitated a change in coding with no subsequent change in DRG allocation or WIES. Acute renal failure, anaemia and electrolyte disturbances were the most commonly underrepresented entities in clinical discharge documentation. Seven patients had their WIES downgraded. Comprehensive documentation of principal diagnosis/diagnoses, comorbidities and their complications is imperative to optimal DRG and WIES allocation. Regular meetings between clinical and coding staff improve the quality and timeliness of medical documentation, ensure adequate communication with general practitioners and lead to appropriate funding. © 2013 The Authors; Internal Medicine Journal © 2013 Royal Australasian College of Physicians.

  19. Sustained impact of a short small group course with systematic feedback in addition to regular clinical clerkship activities on musculoskeletal examination skills--a controlled study.

    Science.gov (United States)

    Perrig, Martin; Berendonk, Christoph; Rogausch, Anja; Beyeler, Christine

    2016-01-28

    The discrepancy between the extensive impact of musculoskeletal complaints and the common deficiencies in musculoskeletal examination skills lead to increased emphasis on structured teaching and assessment. However, studies of single interventions are scarce and little is known about the time-dependent effect of assisted learning in addition to a standard curriculum. We therefore evaluated the immediate and long-term impact of a small group course on musculoskeletal examination skills. All 48 Year 4 medical students of a 6 year curriculum, attending their 8 week clerkship of internal medicine at one University department in Berne, participated in this controlled study. Twenty-seven students were assigned to the intervention of a 6×1 h practical course (4-7 students, interactive hands-on examination of real patients; systematic, detailed feedback to each student by teacher, peers and patients). Twenty-one students took part in the regular clerkship activities only and served as controls. In all students clinical skills (CS, 9 items) were assessed in an Objective Structured Clinical Examination (OSCE) station, including specific musculoskeletal examination skills (MSES, 7 items) and interpersonal skills (IPS, 2 items). Two raters assessed the skills on a 4-point Likert scale at the beginning (T0), the end (T1) and 4-12 months after (T2) the clerkship. Statistical analyses included Friedman test, Wilcoxon rank sum test and Mann-Whitney U test. At T0 there were no significant differences between the intervention and control group. At T1 and T2 the control group showed no significant changes of CS, MSES and IPS compared to T0. In contrast, the intervention group significantly improved CS, MSES and IPS at T1 (p skills during regular clinical clerkship activities. However, an additional small group, interactive clinical skills course with feedback from various sources, improved these essential examination skills immediately after the teaching and several months later

  20. Data processing system for small and medium sized clinical chemistry and nuclear medical units

    Energy Technology Data Exchange (ETDEWEB)

    Mariss, P; Haubold, E; Porth, A J

    1987-06-01

    A computer system, in clinical use for over 5 years, with a group practice specializing in laboratory-nuclear medicine is described for its hardware and software configuration. In addition to the conventional tasks of a computer system (patient data acquisition, issuance of worklists, result input, plausibility control, quality assurance, findings documentation), an integrated word processing system was developed for nuclear medicine in-vitro and in-vivo diagnosis. In addition, the computer system masters major administrative tasks, such as private and panel accounts, account reminders payments to suppliers, etc. the hardware and data bank are designed in a manner which permits direct data access over a period of 18 to 21 months.

  1. Factors influencing the development of end-of-life communication skills: A focus group study of nursing and medical students.

    Science.gov (United States)

    Gillett, Karen; O'Neill, Bernadette; Bloomfield, Jacqueline G

    2016-01-01

    Poor communication between health care professionals and dying patients and their families results in complaints about end-of-life care. End-of-life communication skills should be a core part of nursing and medical education but research suggests that qualified doctors and nurses find this a challenging area of practice. The aim of this study was to explore factors influencing the development of end-of-life communication skills by nursing and medical students. A qualitative study comprising five focus groups. Second year undergraduate nursing (n=9 across 2 focus groups) and fourth year undergraduate medical students (n=10 across 3 focus groups) from a London University. Barriers and facilitators influenced nursing and medical students' experience of communication with dying patients and their families in clinical practice. Extrinsic barriers included gatekeeping by qualified staff and lack of opportunity to make sense of experiences through discussion. Intrinsic barriers included not knowing what to say, dealing with emotional responses, wasting patients' time, and concerns about their own ability to cope with distressing experiences. Facilitating factors included good role models, previous experience, and classroom input. In addition to clinical placements, formal opportunities for reflective discussion are necessary to facilitate the development of students' confidence and skills in end-of-life communication. For students and mentors to view end-of-life communication as a legitimate part of their learning it needs to be specified written practice-learning outcome. Mentors and supervisors may require training to enable them to facilitate students to develop end-of-life communication skills. Copyright © 2015 Elsevier Ltd. All rights reserved.

  2. 2001 report on Medical Physics in France. Radiotherapy-Chemotherapy Group, Cancer Plan 2000-2005

    International Nuclear Information System (INIS)

    Aubert, Bernard; Delpech, Jean-Paul; Estivallet, Andre; Estrade, Georges; Francois, Pascal; Gardin, Isabelle; Giraud, Jean-Yves; Lisbonna, Andre; Naudy, Suzanne; Noel, Alain; Sarrazin, Thierry

    2001-01-01

    This report first presents the medical physics sector by indicating physicist responsibilities, by describing the situation in France, in Europe and in the World, and by analysing the French situation. In the next part, the authors presents and comments the various fields of intervention: radiotherapy, nuclear medicine (dosimetry and patient radiation protection, optimisation and quality assurance, development and use of complex equipment and techniques, recommendations at the national and international level), radiology (image quality, reduction of doses received by patients), and radiation protection. They briefly describe physicist basic and continue training, the status of physicists in public hospitals, and technical means (present status, proposals for radiotherapy equipment, for simulation and control equipment, and for dosimetry equipment)

  3. Identifying Risk of Future Asthma Attacks Using UK Medical Record Data: A Respiratory Effectiveness Group Initiative.

    Science.gov (United States)

    Blakey, John D; Price, David B; Pizzichini, Emilio; Popov, Todor A; Dimitrov, Borislav D; Postma, Dirkje S; Josephs, Lynn K; Kaplan, Alan; Papi, Alberto; Kerkhof, Marjan; Hillyer, Elizabeth V; Chisholm, Alison; Thomas, Mike

    Asthma attacks are common, serious, and costly. Individual factors associated with attacks, such as poor symptom control, are not robust predictors. We investigated whether the rich data available in UK electronic medical records could identify patients at risk of recurrent attacks. We analyzed anonymized, longitudinal medical records of 118,981 patients with actively treated asthma (ages 12-80 years) and 3 or more years of data. Potential risk factors during 1 baseline year were evaluated using univariable (simple) logistic regression for outcomes of 2 or more and 4 or more attacks during the following 2-year period. Predictors with significant univariable association (P attacks included baseline-year markers of attacks (acute oral corticosteroid courses, emergency visits), more frequent reliever use and health care utilization, worse lung function, current smoking, blood eosinophilia, rhinitis, nasal polyps, eczema, gastroesophageal reflux disease, obesity, older age, and being female. The number of oral corticosteroid courses had the strongest association. The final cross-validated models incorporated 19 and 16 risk factors for 2 or more and 4 or more attacks over 2 years, respectively, with areas under the curve of 0.785 (95% CI, 0.780-0.789) and 0.867 (95% CI, 0.860-0.873), respectively. Routinely collected data could be used proactively via automated searches to identify individuals at risk of recurrent asthma attacks. Further research is needed to assess the impact of such knowledge on clinical prognosis. Copyright © 2016 American Academy of Allergy, Asthma & Immunology. Published by Elsevier Inc. All rights reserved.

  4. Traffic represents the main source of pollution in small Mediterranean urban areas as seen by lichen functional groups.

    Science.gov (United States)

    Llop, Esteve; Pinho, Pedro; Ribeiro, Manuel C; Pereira, Maria João; Branquinho, Cristina

    2017-05-01

    The land-use type (residential, green areas, and traffic) within relatively small Mediterranean urban areas determines significant changes on lichen diversity, considering species richness and functional groups related to different ecological factors. Those areas with larger volume of traffic hold lower species diversity, in terms of species richness and lichen diversity value (LDV). Traffic areas also affect the composition of the lichen community, which is evidenced by sensitive species. The abundance of species of lichens tolerant to low levels of eutrophication diminishes in traffic areas; oppositely, those areas show a higher abundance of species of lichens tolerating high levels of eutrophication. On the other hand, residential and green areas have an opposite pattern, mainly with species highly tolerant to eutrophication being less abundant than low or moderate ones. The characteristics of tree bark do not seem to affect excessively on lichen composition; however, tree species shows some effect that should be considered in further studies.

  5. Single case design studies in music therapy: resurrecting experimental evidence in small group and individual music therapy clinical settings.

    Science.gov (United States)

    Geist, Kamile; Hitchcock, John H

    2014-01-01

    The profession would benefit from greater and routine generation of causal evidence pertaining to the impact of music therapy interventions on client outcomes. One way to meet this goal is to revisit the use of Single Case Designs (SCDs) in clinical practice and research endeavors in music therapy. Given the appropriate setting and goals, this design can be accomplished with small sample sizes and it is often appropriate for studying music therapy interventions. In this article, we promote and discuss implementation of SCD studies in music therapy settings, review the meaning of internal study validity and by extension the notion of causality, and describe two of the most commonly used SCDs to demonstrate how they can help generate causal evidence to inform the field. In closing, we describe the need for replication and future meta-analysis of SCD studies completed in music therapy settings. SCD studies are both feasible and appropriate for use in music therapy clinical practice settings, particularly for testing effectiveness of interventions for individuals or small groups. © the American Music Therapy Association 2014. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

  6. INFRARED AND RADIO OBSERVATIONS OF A SMALL GROUP OF PROTOSTELLAR OBJECTS IN THE MOLECULAR CORE, L1251-C

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Jungha; Lee, Jeong-Eun [School of Space Research, Kyung Hee University, Yongin-Si, Gyeonggi-Do 446-701 (Korea, Republic of); Choi, Minho; Kang, Miju [Korea Astronomy and Space Science Institute, 776 Daedeokdaero, Yuseong, Daejeon 305-348 (Korea, Republic of); Bourke, Tyler L. [Square Kilometre Array Organisation, Jodrell Bank Observatory, Lower Withington, Cheshire SK11 9DL (United Kingdom); II, Neal J. Evans [Department of Astronomy, University of Texas at Austin, 2515 Speedway, Stop C1400, Austin, TX 78712-1205 (United States); Francesco, James Di [National Research Council Canada, Herzberg Institute of Astrophysics, Victoria, BC (Canada); Cieza, Lucas A. [Universidad Diego Portales, Facultad de Ingeniera, Av. Ejército 441, Santiago (Chile); Dunham, Michael M. [Harvard-Smithsonian Center for Astrophysics, 60 Garden Street, Cambridge, MA 02138 (United States)

    2015-05-15

    We present a multi-wavelength observational study of a low-mass star-forming region, L1251-C, with observational results at wavelengths from the near-infrared to the millimeter. Spitzer Space Telescope observations confirmed that IRAS 22343+7501 is a small group of protostellar objects. The extended emission in the east–west direction with its intensity peak at the center of L1251A has been detected at 350 and 850 μm with the Caltech Submillimeter Observatory and James Clerk Maxwell telescopes, tracing dense envelope material around L1251A. The single-dish data from the Korean VLBI Network and TRAO telescopes show inconsistencies between the intensity peaks of several molecular emission lines and that of the continuum emission, suggesting complex distributions of molecular abundances around L1251A. The Submillimeter Array interferometer data, however, show intensity peaks of CO 2–1 and {sup 13}CO 2–1 located at the position of IRS 1, which is both the brightest source in the Infrared Array Camera image and the weakest source in the 1.3 mm dust-continuum map. IRS 1 is the strongest candidate for the driving source of the newly detected compact CO 2–1 outflow. Over the entire region (14′ × 14′) of L125l-C, 3 Class I and 16 Class II sources have been detected, including three young stellar objects (YSOs) in L1251A. A comparison between the average projected distance among the 19 YSOs in L1251-C and that among the 3 YSOs in L1251A suggests that L1251-C is an example of low-mass cluster formation where protostellar objects form in a small group.

  7. Wireless Sensors Grouping Proofs for Medical Care and Ambient Assisted-Living Deployment.

    Science.gov (United States)

    Trček, Denis

    2016-01-02

    Internet of Things (IoT) devices are rapidly penetrating e-health and assisted living domains, and an increasing proportion among them goes on the account of computationally-weak devices, where security and privacy provisioning alone are demanding tasks, not to mention grouping proofs. This paper, therefore, gives an extensive analysis of such proofs and states lessons learnt to avoid possible pitfalls in future designs. It sticks with prudent engineering techniques in this field and deploys in a novel way the so called non-deterministic principle to provide not only grouping proofs, but (among other) also privacy. The developed solution is analyzed by means of a tangible metric and it is shown to be lightweight, and formally for security.

  8. Wireless Sensors Grouping Proofs for Medical Care and Ambient Assisted-Living Deployment

    Directory of Open Access Journals (Sweden)

    Denis Trček

    2016-01-01

    Full Text Available Internet of Things (IoT devices are rapidly penetrating e-health and assisted living domains, and an increasing proportion among them goes on the account of computationally-weak devices, where security and privacy provisioning alone are demanding tasks, not to mention grouping proofs. This paper, therefore, gives an extensive analysis of such proofs and states lessons learnt to avoid possible pitfalls in future designs. It sticks with prudent engineering techniques in this field and deploys in a novel way the so called non-deterministic principle to provide not only grouping proofs, but (among other also privacy. The developed solution is analyzed by means of a tangible metric and it is shown to be lightweight, and formally for security.

  9. Delivery of core medical training: the role of a local faculty group.

    Science.gov (United States)

    Black, David; Dewhurst, Graeme

    2011-10-01

    All physicians who are training young doctors of the future recognise the current challenge of doing this in the NHS. The recently published Temple Report documents the challenge and some of the solutions. For Kent, Surrey and Sussex (KSS) Deanery, one of the responses was to implement a new structure and process at local level--the local faculty groups (LFGs)--to ensure appropriate curriculum delivery. This paper sets out the history, structure and purpose of LFGs, describes what happens during a LFG meeting in both open and closed sessions and presents feedback of learning from two years in action across 11 acute trusts in the South East Coast (SEC) strategic health authority area. The experience of trainers in SEC is that the local faculty group structure and associated processes is one strand in the more effective delivery of education in the current NHS environment.

  10. Formation of potential radiation risk groups to render timely targeted medical care: Lessons of Chernobyl

    International Nuclear Information System (INIS)

    Ivanov, V. K.; Kashcheev, V. V.; Zamulaeva, I. A.; Saenko, A. S.; Orlova, N. V.; Smirnova, S. G.; Korelo, A. M.; Gorsky, A. I.; Maksioutov, M. A.

    2012-01-01

    The paper discusses technology for establishing potential cancer risk groups, based on methods of molecular and radiation epidemiology. Assay of gene mutations at the T-cell receptor (TCR) locus as the method of molecular epidemiology was used for measuring the frequency of TCR-mutations in 320 nuclear workers of the Inst. of Physics and Power Engineering (IPPE). The method of radiation epidemiology was applied to the estimation of attributable risk fraction (ARF) for solid cancers in these groups. The main estimates of radiation risk after the Chernobyl accident are in close agreement with the International Commission on Radiological Protection (ICRP) Publication, 103 models published in 2007. In nuclear workers of the IPPE with ARF ≥ 10%, the increased level of TCR-mutations occurs more often (risk ratio=9.7; 95% CI: 2.9; 32.1). (authors)

  11. Medical Management of the Acute Radiation Syndrome: Recommendations of the Strategic National Stockpile Radiation Working Group

    Science.gov (United States)

    2004-06-15

    STATEMENT Approved for public release; distribution unlimited 13. SUPPLEMENTARY NOTES 14. ABSTRACT 15. SUBJECT TERMS 16. SECURITY ...Assistance Medicine http://usuhs.mil U.S. Army www.nbc-med.org U.S. Department of Homeland Security Working Group on Radiological Dispersal Device...22. 97. Abbott B, Ippoliti C, Bruton J, Neumann J, Whaley R, Champlin R. Antiemetic efficacy of granisetron plus dexamethasone in bone marrow

  12. Medical Managment of the Acute Radiation Syndrome: Recommendations of the Strategic National Stockpile Radiation Working Group

    Science.gov (United States)

    2004-06-15

    AVAILABILITY STATEMENT Approved for public release; distribution unlimited 13. SUPPLEMENTARY NOTES 14. ABSTRACT 15. SUBJECT TERMS 16. SECURITY ...Humanitarian Assistance Medicine http://usuhs.mil U.S. Army www.nbc-med.org U.S. Department of Homeland Security Working Group on Radiological Dispersal...2002:11-22. 97. Abbott B, Ippoliti C, Bruton J, Neumann J, Whaley R, Champlin R. Antiemetic efficacy of granisetron plus dexamethasone in bone marrow

  13. Decision based on big data research for non-small cell lung cancer in medical artificial system in developing country.

    Science.gov (United States)

    Wu, Jia; Tan, Yanlin; Chen, Zhigang; Zhao, Ming

    2018-06-01

    Non-small cell lung cancer (NSCLC) is a high risk cancer and is usually scanned by PET-CT for testing, predicting and then give the treatment methods. However, in the actual hospital system, at least 640 images must be generated for each patient through PET-CT scanning. Especially in developing countries, a huge number of patients in NSCLC are attended by doctors. Artificial system can predict and make decision rapidly. According to explore and research artificial medical system, the selection of artificial observations also can result in low work efficiency for doctors. In this study, data information of 2,789,675 patients in three hospitals in China are collected, compiled, and used as the research basis; these data are obtained through image acquisition and diagnostic parameter machine decision-making method on the basis of the machine diagnosis and medical system design model of adjuvant therapy. By combining image and diagnostic parameters, the machine decision diagnosis auxiliary algorithm is established. Experimental result shows that the accuracy has reached 77% in NSCLC. Copyright © 2018 Elsevier B.V. All rights reserved.

  14. An online app platform enhances collaborative medical student group learning and classroom management.

    Science.gov (United States)

    Peacock, Justin G; Grande, Joseph P

    2016-01-01

    The authors presented their results in effectively using a free and widely-accessible online app platform to manage and teach a first-year pathology course at Mayo Medical School. The authors utilized the Google "Blogger", "Forms", "Flubaroo", "Sheets", "Docs", and "Slides" apps to effectively build a collaborative classroom teaching and management system. Students were surveyed on the use of the app platform in the classroom, and 44 (94%) students responded. Thirty-two (73%) of the students reported that "Blogger" was an effective place for online discussion of pathology topics and questions. 43 (98%) of the students reported that the "Forms/Flubaroo" grade-reporting system was helpful. 40 (91%) of the students used the remote, collaborative features of "Slides" to create team-based learning presentations, and 39 (89%) of the students found those collaborative features helpful. "Docs" helped teaching assistants to collaboratively create study guides or grading rubrics. Overall, 41 (93%) of the students found that the app platform was helpful in establishing a collaborative, online classroom environment. The online app platform allowed faculty to build an efficient and effective classroom teaching and management system. The ease of accessibility and opportunity for collaboration allowed for collaborative learning, grading, and teaching.

  15. DFT Study of Electronic and Optical Properties of Small Oligothiophenes Based on Terthiophene End-capped by Several Donor Groups

    Directory of Open Access Journals (Sweden)

    El Alamy Aziz

    2017-07-01

    Full Text Available Eight small molecules based on terthiophene end-capped by several donor groups have been carried out using density functional theory (DFT and time-dependent (TDDFT methods in neutral and doped states. The theoretical ground-state geometry, electronic structure and optical properties of the studied molecules were obtained by the DFT and TD-DFT methods at the B3LYP level with 6-31G(d basis set. Theoretical knowledge of the highest occupied molecular orbital (HOMO, the lowest unoccupied molecular orbital (LUMO energy levels the gap energy (Eg and the open-circuit voltage (Voc of the studied compounds are calculated and discussed. The effects of the donor group substituents on the geometries and optoelectronic properties of these materials are discussed to investigate the relationship between molecular structure and optoelectronic properties. The results of this work suggest some of these materials as a good candidate for organic solar cells. DOI: http://dx.doi.org/10.17807/orbital.v9i3.995

  16. Identification of risk groups in patients with completely resected N1 non-small cell lung carcinoma

    International Nuclear Information System (INIS)

    Sawyer, T.E.; Bonner, J.A.; Gould, P.J.; Foote, R.L.; Deschamps, C.; Trastek, V.F.; Pairolero, P.C.; Allen, M.S.; Lange, C. M.; Li, H.

    1997-01-01

    Purpose: Although the potential benefits of radiation therapy and chemotherapy in the management of completely resected AJCC N1 non-small cell lung cancer are unknown, the majority of studies have failed to demonstrate a survival benefit with any neoadjuvant or adjuvant therapy. While it is possible that radiation therapy and chemotherapy are ineffective adjunctive therapies in this disease, it is also possible that previous studies have been diluted by the inclusion of patients at low risk for local recurrence and/or distant metastasis and therefore, this study was undertaken to assess these risks. Methods: From 1987 through 1990, 107 patients underwent complete resection of AJCC N1 non-small cell lung carcinoma and received no other treatment. These patients were the subject of a retrospective review to separate patients into high-, medium-, and low-risk groups with respect to freedom from local recurrence (FFLR), freedom from distant metastasis (FFDM), and overall survival (OS) utilizing a regression analysis of Cox and a regression tree analysis (Breiman LI et al, Wadsworth International Group, Belmont, CA 1984). Results: The 5-year rates of FFLR, FFDM, and OS were 62%, 53%, and 32% respectively. The following factors were assessed for potential relationships with FFLR, FFDM, and OS: status of the pre-operative bronchoscopy, type of surgery performed (segmentectomy/wedge resection vs. lobectomy vs. bilobectomy/pneumonectomy), number of involved N1 nodes, number of involved N1 stations, number of N1 nodes removed, number of N2 nodes removed, number of lung lobes involved, tumor grade, tumor histology (squamous vs non-squamous), AJCC T-stage, pathologic tumor size, and pathologic margin status. Regression analyses revealed that the factors independently associated with an improved outcome included a positive bronchoscopy (FFLR, p=.005), a greater number of N1 nodes dissected (FFDM, p=.02), and a lesser T-stage (OS, p=.01). Regression tree analyses were then

  17. Measurement invariance of the strength of motivation for medical school: a multi-group confirmatory factor analysis.

    Science.gov (United States)

    An, M; Kusurkar, R A; Li, L; Xiao, Y; Zheng, C; Hu, J; Chen, M

    2017-07-11

    The Strength of Motivation for Medical School-Revised (SMMS-R) questionnaire measures students' motivation for studying medicine. It includes three subscales: 'willingness to sacrifice', 'readiness to start', and 'persistence'. Measurement invariance is a prerequisite for group comparisons. The objectives of this study were to verify the factorial structure of the SMMS-R questionnaire and to investigate it's measurement invariance. A total of 989 medical students were approached, 930 cases were kept for data analysis. Factorial structure of and measurement invariance of the SMMS-R were tested using single and multiple group confirmatory factor analyses with Mplus. Trational Cronbach's α along with McDonald's ω and glb were used to measure internal consistency for each subscale. Internal consistency for subscales and the full instrument were within the acceptable range. A 3-factor structure of the Chinese version of the SMMS-R was supported. Full configural, metric and partial scalar invariance were obtained. The SMMS-R showed measurement invariance across gender and two independent samples. So it can be used for group and cross-cultural comparisons.

  18. Specific collaborative group intervention for patients with medically unexplained symptoms in general practice: a cluster randomized controlled trial.

    Science.gov (United States)

    Schaefert, R; Kaufmann, C; Wild, B; Schellberg, D; Boelter, R; Faber, R; Szecsenyi, J; Sauer, N; Guthrie, E; Herzog, W

    2013-01-01

    Patients with medically unexplained symptoms (MUS) are frequent in primary care and substantially impaired in their quality of life (QoL). Specific training of general practitioners (GPs) alone did not demonstrate sustained improvement at later follow-up in current reviews. We evaluated a collaborative group intervention. We conducted a cluster randomized controlled trial. Thirty-five GPs recruited 304 MUS patients (intervention group: 170; control group: 134). All GPs were trained in diagnosis and management of MUS (control condition). Eighteen randomly selected intervention GPs participated in training for a specific collaborative group intervention. They conducted 10 weekly group sessions and 2 booster meetings in their practices, together with a psychosomatic specialist. Six and 12 months after baseline, QoL was assessed with the Short-Form 36. The primary outcome was the physical composite score (PCS), and the secondary outcome was the mental composite score (MCS). At 12 months, intention-to-treat analyses showed a significant between-group effect for the MCS (p = 0.023) but not for the PCS (p = 0.674). This effect was preceded by a significant reduction of somatic symptom severity (15-item somatic symptom severity scale of the Patient Health Questionnaire, PHQ-15) at 6 months (p = 0.008) that lacked significance at 12 months (p = 0.078). As additional between-group effects at 12 months, per-protocol analyses showed less health anxiety (Whiteley-7; p = 0.038) and less psychosocial distress (PHQ; p = 0.024); GP visits were significantly (p = 0.042) reduced in the intervention group. Compared to pure GP training, collaborative group intervention achieved a progressive, clinically meaningful improvement in mental but not physical QoL. It could bridge gaps between general practice and mental health care. Copyright © 2012 S. Karger AG, Basel.

  19. Benefits of adding small financial incentives or optional group meetings to a web-based statewide obesity initiative.

    Science.gov (United States)

    Leahey, Tricia M; Subak, Leslee L; Fava, Joseph; Schembri, Michael; Thomas, Graham; Xu, Xiaomeng; Krupel, Katie; Kent, Kimberly; Boguszewski, Katherine; Kumar, Rajiv; Weinberg, Brad; Wing, Rena

    2015-01-01

    To examine whether adding either small, variable financial incentives or optional group sessions improves weight losses in a community-based, Internet behavioral program. Participants (N = 268) from Shape Up Rhode Island 2012, a 3-month Web-based community wellness initiative, were randomized to: Shape Up+Internet behavioral program (SI), Shape Up+Internet program+incentives (SII), or Shape Up+Internet program+group sessions (SIG). At the end of the 3-month program, SII achieved significantly greater weight losses than SI (SII: 6.4% [5.1-7.7]; SI: 4.2% [3.0-5.6]; P = 0.03); weight losses in SIG were not significantly different from the other two conditions (SIG: 5.8% [4.5-7.1], P's ≥ 0.10). However, at the 12-month no-treatment follow-up visit, both SII and SIG had greater weight losses than SI (SII: 3.1% [1.8-4.4]; SIG: 4.5% [3.2-5.8]; SI: 1.2% [-0.1-2.6]; P's ≤ 0.05). SII was the most cost-effective approach at both 3 (SII: $34/kg; SI: $34/kg; SIG: $87/kg) and 12 months (SII: $64/kg; SI: $140/kg; SIG: $113/kg). Modest financial incentives enhance weight losses during a community campaign, and both incentives and optional group meetings improved overall weight loss outcomes during the follow-up period. However, the use of the financial incentives is the most cost-effective approach. © 2014 The Obesity Society.

  20. A path less traveled: A self-guided action science inquiry among a small group of adult learners

    Science.gov (United States)

    Folkman, Daniel Vance

    This dissertation provides an analysis of the dialogue that occurred among a small group of adult learners who engaged in a self-guided action science inquiry into their own practice. The following pages describe how this group of five practitioners ventured into a critical, self-reflective inquiry into their own values, feelings, and intentions in search of personal and professional growth. It is a deeply revealing story that shows how, through group dialogue, the members gradually unravel the interconnections between their values, feelings, and intention. They uncover surprising and unanticipated patterns in their reasoning-in-action that reflect lessons from present day experiences as well as childhood axioms about what constitutes appropriate behavior. They push their learning further to recognize emotional triggers that are useful in confronting old habits of mind that must be overcome if new Model II strategies are to be learned and internalized. They conclude that becoming Model II requires a centering on basic values, a personal commitment to change, a willingness to persist in the face of resistance, and the wisdom to act with deliberate caution. The transformative power of this insight lies in the realization of what it takes personally and collectively to make the world a truly respectful, productive, democratic, and socially just place in which to live and work. The action science literature holds the assumption that a trained facilitator is needed to guide such an inquiry and the learning of Model II skills. Unfortunately, there are few educator-trainers available to facilitate the learning of Model II proficiencies over the months and years that may be required. The data presented here show that it is possible for a group of highly motivated individuals to initiate and sustain their own action science inquiry without the aid of a highly skilled facilitator. A model of the group dialogue is presented that highlights the salient characteristics of an

  1. 50th Anniversary International Medical Informatics Association (IMIA) History Working Group and Its Projects.

    Science.gov (United States)

    Kulikowski, Casimir A; Mihalas, George; Greenes, Robert; Yacubsohn, Valerio; Park, Hyeoun-Ae

    2017-01-01

    The IMIA History Working Group has as its first goal the editing of a volume of contributions from pioneers and leaders in the field of biomedical and health informatics (BMHI) to commemorate the 50th anniversary of IMIA's predecessor IFIP-TC4. This paper describes how the IMIA History WG evolved from an earlier Taskforce, and has focused on producing the edited book of original contributions. We describe its proposed outline of objectives for the personal stories, and national and regional society narratives, together with some comments on the evolution of Medinfo meeting contributions over the years, to provide a reference source for the early motivations of the scientific, clinical, educational, and professional changes that have influenced the historical course of our field.

  2. Nutritional care of Danish medical inpatients: Effect on dietary intake and the occupational groups' perspectives of intervention

    Directory of Open Access Journals (Sweden)

    Jensen Lillian

    2004-09-01

    Full Text Available Abstract Background Many patients do not eat and drink sufficiently during hospitalisation. The clinical consequences of this under nutrition include lassitude, an increased risk of complications and prolonged convalescence. The aim of the study was 1 to introduce intervention targeting nutritional care for medical inpatients, 2 to investigate the effect of this intervention, and 3 to investigate the occupational groups' attitudes towards nutritional intervention and nutritional care in general. Methods The design was to determinate the extent to which the protein and energy requirements of medical inpatients were met before and after intervention. Dietary protein and energy intakes were assessed by 72-hour weighed food records. A total number of 108 medical patients at four bed sections and occupational groups in the two intervention bed sections, Aarhus University Hospital, Denmark participated. The intervention included introduction and implementation of nursing procedures targeting nutritional care during a five-month investigation period using standard food produced at the hospital. The effect of intervention for independent groups of patients were tested by one-way analysis of variance. After the intervention occupational groups were interviewed in focus groups. Results Before the intervention hospital food on average met 72% of the patients' protein requirement and 85% of their energy requirement. After intervention hospital food satisfied 85% of the protein and 103% of the energy requirements of 14 patients in one intervention section and 56% of the protein and 76% of the energy requirement of 17 patients in the other intervention section. Hospital food satisfied 61% of the protein and 75% of the energy requirement in a total of 29 controls. From the occupational groups' point of view lack of time, lack of access to food, and lack of knowledge of nutritional care for patients were identified as barriers to better integration of

  3. Patient-perceived value of Medication Therapy Management (MTM services: a series of focus groups

    Directory of Open Access Journals (Sweden)

    Heidi Schultz

    2012-01-01

    Full Text Available Objective: To determine the patient-perceived value of MTM services and non-financial barriers preventing patients with insurance coverage from receiving MTM services. Design: Focus groups. Setting: Fairview Pharmacy Services, Minneapolis, MN. Participants: Three focus groups, each with five to nine participants, consisting of different participant populations: (i patients who paid out-of-pocket to receive MTM services; (ii insurance beneficiaries, under which MTM is a covered benefit and participants may have received incentives for receiving MTM services; (iii patients with an insurance plan which covers MTM services who were recruited to receive MTM services but declined. Intervention: MTM services. Main Outcome Measure: Patient-perceived value of MTM services and non-financial barriers. Results: Seven themes were identified relating to the patient-perceived value of MTM services: collaboration of the health care team, MTM pharmacist as a supporter/advocate/confidant, MTM pharmacist as a resource for questions and education, accessibility to the MTM pharmacist, financial incentives for participation in MTM services, MTM pharmacy as a specialty field, and the MTM pharmacist as a coordinator. Three themes were identified regarding patient-perceived non-financial barriers to receiving MTM services, including: availability of the MTM pharmacist, patient/physician lack of knowledge of MTM services, patient's belief that MTM services are not needed. Conclusion: MTM is a service which patients identify as valuable. Patients are able to identify non-financial barriers that may prevent some patients from receiving MTM services. This study provides preliminary evidence of both the value and barriers perceived by patients.   Type: Original Research

  4. Patient-perceived value of Medication Therapy Management (MTM services: a series of focus groups

    Directory of Open Access Journals (Sweden)

    Amanda Brummel, PharmD

    2012-01-01

    Full Text Available Objective: To determine the patient-perceived value of MTM services and non-financial barriers preventing patients with insurance coverage from receiving MTM services. Design: Focus groups. Setting: Fairview Pharmacy Services, Minneapolis, MN.Participants: Three focus groups, each with five to nine participants, consisting of different participant populations: (i patients who paid out-of-pocket to receive MTM services; (ii insurance beneficiaries, under which MTM is a covered benefit and participants may have received incentives for receiving MTM services; (iii patients with an insurance plan which covers MTM services who were recruited to receive MTM services but declined. Intervention: MTM services. Main Outcome Measure: Patient-perceived value of MTM services and non-financial barriers. Results: Seven themes were identified relating to the patient-perceived value of MTM services: collaboration of the health care team, MTM pharmacist as a supporter/advocate/confidant, MTM pharmacist as a resource for questions and education, accessibility to the MTM pharmacist, financial incentives for participation in MTM services, MTM pharmacy as a specialty field, and the MTM pharmacist as a coordinator. Three themes were identified regarding patient-perceived non-financial barriers to receiving MTM services, including: availability of the MTM pharmacist, patient/physician lack of knowledge of MTM services, patient’s belief that MTM services are not needed. Conclusion: MTM is a service which patients identify as valuable. Patients are able to identify non-financial barriers that may prevent some patients from receiving MTM services. This study provides preliminary evidence of both the value and barriers perceived by patients.

  5. FREQUENCY AND DISTRIBUTION OF ABO & RH BLOOD GROUP IN BILASPUR DISTRICT OF CHHATTISGARH STATE : A STUDY FROM MEDICAL COLLEGE HOSPITAL

    Directory of Open Access Journals (Sweden)

    Bhanu Pratap

    2015-07-01

    Full Text Available BACKGROUND : Approximate 30 blood group systems have discovered and more than 400 erythrocytes antigens are identified. Blood group ABO and Rh are most important among all other blood group systems in transfusion service practices. The frequency of four major blood gr oup s namely A, B, O, AB with Rh Positive and Negative varies in different population of the world and differ also in region and race wise. MATERIAL AND METHOD : This 5 years retrospective study was conducted at Blood Bank of a Medical college Hospital of Bi laspur in Northern Chhattisgarh, catering the 1/3 population of state. Data were collected from the Blood Bank Grouping record from the period of January 2010 to December 2014. Blood group of blood donors and patients were determined by Monoclonal Anti Ser a by slide agglutinations tests. Rare case and difficult case were examined by test tube agglutination method and Matrix Gel System of Tulip. RESULT AND CONCLUSIO N: 31973 subjects were examined for blood group during observation period, Out of these 31092( 97.25% were male and 881 (2.75% were female. The frequency of blood group B in these populations was 11007 (34.42% (33.36% Rh Positive and 1.06% Rh Negative Followed by O were 10864 (33.97% (33.33% Rh Positive and 0.64% Rh Negative, A was 9113 (28.50 % (27.99 % Rh Positive and 0.51% Rh Negative and AB was 989 (3.11% (3.01% Rh Positive and 0.1% Rh Negative. Rhesus group Rh Positive were 31242 (97.7 % and Rh Negative were 731 (2.3 %.

  6. The Abundances of the Fe Group Elements in AV 304, an Abundance Standard in the Small Magellanic Cloud

    Science.gov (United States)

    Peters, Geraldine J.; Lanz, Thierry; Bouret, Jean-Claude; Proffitt, Charles R.; Adelman, Saul J.; Hubeny, Ivan

    2018-06-01

    AV 304 is a B0.5 IV field star in the Small Magellanic Cloud with ultra-sharp spectral lines that has emerged as an abundance standard. We have combined recent spectroscopic observations from the Cosmic Origins Spectrograph (COS) on the Hubble Space Telescope with archival data from the Far Ultraviolet Spectroscopic Explorer (FUSE) and ESO’s VLT/UVES to determine the abundances of the Fe group elements (Ti, V, Cr, Mn, Fe, Co, & Ni). The analysis was carried through using the Hubeny/Lanz NLTE programs TLUSTY/SYNSPEC. The COS observations were secured with the G130M, G160M, G185M, and G225M gratings. Combined with the FUSE data, we have achieved spectral coverage in the UV from 950 to 2400 A. Measurable lines from the Fe group, except for a very few multiplets of Fe II, III are not observed in optical spectra. The following stellar parameters were found: Teff = 27500±500 K, log g = 3.7±0.1 cm/s2, Vturb= 1±1 km/s, and v sin i = 8 ±2 km/s. The Fe abundance appears to be only slightly lower than the mean depletion in the SMC, but the other Fe group elements are underabundant by 0.3 dex or more. This study confirmed the low abundance of nitrogen (-1.25 dex relative to the solar value) that was reported by Peters & Adelman (ASP Conf. Series, 348, p. 136, 2006). Whereas the light elements are delivered to the ISM by core-collapse supernovae (CCSNe), the Fe group elements are believed to come mostly from low/intermediate mass binaries containing white dwarfs that undergo SNe Ia explosions. A single SNe Ia can deliver 0.5 solar masses of pure Fe (and maybe Mn) to the ISM compared with about 0.07 solar masses from a CCSNe. It appears that there is very little processed material from its interior in the atmosphere of AV 304 and that the star did not form from an interstellar cloud that was enriched by material from earlier supernova activity. Support from STScI grants HST-GO-14081.002 and HST-GO-13346.022, and USC’s Women in Science and Engineering (WiSE) program is

  7. Case Finding and Medical Treatment of Type 2 Diabetes among Different Ethnic Minority Groups: The HELIUS Study

    Directory of Open Access Journals (Sweden)

    Marieke B. Snijder

    2017-01-01

    Full Text Available Aims. Prevention of diabetes complications depends on the level of case finding and successful treatment of diabetes, which may differ between ethnicities. Therefore, we studied the prevalence by age, awareness, treatment, and control of type 2 diabetes, among a multiethnic population. Methods. We included 4,541 Dutch, 3,032 South-Asian Surinamese, 4,109 African Surinamese, 2,323 Ghanaian, 3,591 Turkish, and 3,887 Moroccan participants (aged 18–70 y from the HELIUS study. The prevalence of diabetes was analysed by sex, ethnicity, and 10-year age groups. Ethnic differences in the prevalence, awareness, treatment, and control of diabetes were studied by logistic regression. Results. From the age of 31–40 years and older, the prevalence of diabetes was 3 to 12 times higher among ethnic minority groups than that among the Dutch host population. Awareness and medical treatment of diabetes were 2 to 5 times higher among ethnic minorities than that among Dutch. Among those medically treated, only 37–53% had HbA1c levels on target (≤7.0%; only Dutch men had HbA1c levels on target more often (67%. Conclusions. Our results suggest that the age limit for case finding among ethnic minority groups should be lower than that for the general population. Importantly, despite higher awareness and treatment among ethnic minorities, glycemic control was low, suggesting a need for increased efforts to improve the effectiveness of treatment in these groups.

  8. Preliminary investigation of stereotactic body radiation therapy for medically inoperable stage I/II non-small cell lung cancer

    International Nuclear Information System (INIS)

    Guo Jindong; Lu Changxing; Wang Jiaming; Liu Jun; Li Hongxuan; Wang Changlu; Gao Lanting; Zhao Lei

    2011-01-01

    Objective: To evaluate the therapeutic efficacy and treatment-related toxicity of stereotactic body radiation therapy (SBRT) in patients with medically inoperable stage I/II non-small cell lung cancer (NSCLC). Methods: SBRT was applied to 30 patients, including clinically staged T 1 , T 2 (≤5 cm) or T 3 (chest wall primary tumors only), N 0 , M 0 ,biopsy-confirmed NSCLC. All patients were precluded from lobotomy because of physical condition or comorbidity. No patients developed tumors of any T-stage in the proximal zone. SBRT was performed with the total dose of 50 Gy to 70 Gy in 10 - 11 fractions during 12 - 15 days. prescription line was set onthe edge of the PTV. Results: The follow-up rate was 100%. The number of patients who completed the 1-, and 2-year follow-up were 15, and 10, respectively. All 30 patients completed therapy as planned. The complete response (CR), partial response (PR) and stable disease (SD) rates were 37%, 53% and 3%, respectively. With a median follow-up of 16 months (range, 4-36 months), Kaplan-Meier local control at 2 years was 94%. The 2-year overall survival was 84% and the 2-year cancer specific survival was 90%. Seven patients(23%) developed Grade 2 pneumonitis, no grade > 2 acute or late lung toxicity was observed. No one developed chest wall pain. Conclusions: It is feasible to deliver 50 Gy to 70 Gy of SBRT in 10 - 11 fractions for medically inoperable patients with stage I / II NSCLC. It was associated with low incidence of toxicities and provided sustained local tumor control.The preliminary investigation indicated the cancer specific survival probability of SBRT was high. It is necessary to perform similar investigation in a larger number of patients with long-term follow-up. (authors)

  9. [Development of clinical trial education program for pharmaceutical science students through small group discussion and role-playing using protocol].

    Science.gov (United States)

    Imakyure, Osamu; Shuto, Hideki; Nishikawa, Fumi; Hagiwara, Yoshifuka; Inoue, Sachiko; Koyanagi, Taeko; Hirakawa, Masaaki; Kataoka, Yasufumi

    2010-08-01

    The acquirement of basic knowledge of clinical trials and professional attitude in their practices is a general instructional objective in the Model Core Curriculum for Pharmaceutical Education. Unfortunately, the previous program of clinical trial education was not effective in the acquirement of a professional attitude in their practices. Then, we developed the new clinical trial education program using protocol through small group discussion (SGD) and roll-playing. Our program consists of 7 steps of practical training. In step 1, the students find some problems after presentation of the protocol including case and prescription. In step 2, they analyse the extracted problems and share the information obtained in SGD. In steps 3 and 5, five clinical case scenarios are presented to the students and they discuss which case is suitable for entry to the clinical trial or which case corresponds to the discontinuance criteria in the present designed protocol. In steps 4 and 6, the roll-playing is performed by teachers and students as doctors and clinical research coordinators (CRC) respectively. Further, we conducted a trial practice based on this program for the students. In the student's self-evaluation into five grades, the average score of the skill acquisition level in each step was 3.8-4.7 grade. Our clinical trial education program could be effective in educating the candidates for CRC or clinical pharmacists.

  10. Small ubiquitin-like modifier (SUMO) conjugation impedes transcriptional silencing by the polycomb group repressor Sex Comb on Midleg.

    Science.gov (United States)

    Smith, Matthew; Mallin, Daniel R; Simon, Jeffrey A; Courey, Albert J

    2011-04-01

    The Drosophila protein Sex Comb on Midleg (Scm) is a member of the Polycomb group (PcG), a set of transcriptional repressors that maintain silencing of homeotic genes during development. Recent findings have identified PcG proteins both as targets for modification by the small ubiquitin-like modifier (SUMO) protein and as catalytic components of the SUMO conjugation pathway. We have found that the SUMO-conjugating enzyme Ubc9 binds to Scm and that this interaction, which requires the Scm C-terminal sterile α motif (SAM) domain, is crucial for the efficient sumoylation of Scm. Scm is associated with the major Polycomb response element (PRE) of the homeotic gene Ultrabithorax (Ubx), and efficient PRE recruitment requires an intact Scm SAM domain. Global reduction of sumoylation augments binding of Scm to the PRE. This is likely to be a direct effect of Scm sumoylation because mutations in the SUMO acceptor sites in Scm enhance its recruitment to the PRE, whereas translational fusion of SUMO to the Scm N terminus interferes with this recruitment. In the metathorax, Ubx expression promotes haltere formation and suppresses wing development. When SUMO levels are reduced, we observe decreased expression of Ubx and partial haltere-to-wing transformation phenotypes. These observations suggest that SUMO negatively regulates Scm function by impeding its recruitment to the Ubx major PRE.

  11. Small Ubiquitin-like Modifier (SUMO) Conjugation Impedes Transcriptional Silencing by the Polycomb Group Repressor Sex Comb on Midleg*

    Science.gov (United States)

    Smith, Matthew; Mallin, Daniel R.; Simon, Jeffrey A.; Courey, Albert J.

    2011-01-01

    The Drosophila protein Sex Comb on Midleg (Scm) is a member of the Polycomb group (PcG), a set of transcriptional repressors that maintain silencing of homeotic genes during development. Recent findings have identified PcG proteins both as targets for modification by the small ubiquitin-like modifier (SUMO) protein and as catalytic components of the SUMO conjugation pathway. We have found that the SUMO-conjugating enzyme Ubc9 binds to Scm and that this interaction, which requires the Scm C-terminal sterile α motif (SAM) domain, is crucial for the efficient sumoylation of Scm. Scm is associated with the major Polycomb response element (PRE) of the homeotic gene Ultrabithorax (Ubx), and efficient PRE recruitment requires an intact Scm SAM domain. Global reduction of sumoylation augments binding of Scm to the PRE. This is likely to be a direct effect of Scm sumoylation because mutations in the SUMO acceptor sites in Scm enhance its recruitment to the PRE, whereas translational fusion of SUMO to the Scm N terminus interferes with this recruitment. In the metathorax, Ubx expression promotes haltere formation and suppresses wing development. When SUMO levels are reduced, we observe decreased expression of Ubx and partial haltere-to-wing transformation phenotypes. These observations suggest that SUMO negatively regulates Scm function by impeding its recruitment to the Ubx major PRE. PMID:21278366

  12. Aortic valve replacement with 17-mm St. Jude Medical prostheses for a small aortic root in elderly patients.

    Science.gov (United States)

    Takaseya, Tohru; Kawara, Takemi; Tokunaga, Shigehiko; Kohno, Michitaka; Oishi, Yasuhisa; Morita, Shigeki

    2007-06-01

    There are few reports about the optimal prosthesis for elderly patients who have small aortic roots with an aortic annular size of less than 19 mm. From October 2004 to October 2006, 11 women aged 70 years or older (mean age, 74.9 +/- 3.5 years) underwent aortic valve replacement with a 17-mm Regent prosthesis (St. Jude Medical, St. Paul, MN), with the size determined using the manufacturer's sizer. Clinical status and the results of preoperative and postoperative echocardiography were evaluated. The patients had a mean body surface area of 1.33 +/- 0.13 m2. Preoperative average New York Heart Association (NYHA) functional class was 2.5 +/- 0.7. Preoperative echocardiography showed a mean indexed effective orifice area of 0.33 +/- 0.14 cm2/m2 and a left ventricular mass index of 175 +/- 63 g/m2. Seven patients underwent associated procedures. Postoperative ventilation time was 14 +/- 5.6 hours, and the intensive care unit stay was 1.0 +/- 0.4 days. No patients died perioperatively. The NYHA functional class improved to class I in 9 patients. No obstruction of valve opening was observed. A significant increase in the mean indexed effective orifice area (0.87 +/- 0.10 cm2/m2) and regression of left ventricular mass index were found (114 +/- 46 cm2/m2) on postoperative echocardiography. Aortic valve replacement in elderly patients with small aortic roots (less than 19 mm) using a 17-mm Regent prosthesis showed satisfactory clinical and hemodynamic results.

  13. [Factors forming opnion on marijuana legalization in Poland among group of students from medical and technical college faculty].

    Science.gov (United States)

    Suwała, Małgorzata; Gerstenkorn, Andrzej; Szewczyk, Anna

    2015-01-01

    Marijuana is the most popular illegal drug in the world. In 2010 17.6% of polish adult population (age 15-64) and 37.3% of youth (age 17-18) declared use of marijuana at least once in their lifetime. Recent years in Poland brought back public discussion regarding decriminalization and legalization of marijuana. The main goal of the study was to reveal the opinion about legalization of marijuana in Poland among students of medical and technical faculty in correlation with chosen socio-demographic factors, college major, attitude to tobacco smoking, use of drugs and religious practice. Study included 230 students (110 from Medical University of Lodz and 120 from Technical University of Lodz). Women consisted on 56.1% of surveyed and men on 43.9%. Study used audit survey as a research method. Results. 40.4% of students considered marijuana as "soft" drug and in majority (65.7%) are convinced that it is not addictive. The main part of studied group (83%) claimed that marijuana is easily accessible in Poland. The majority of the group (38.75%) was against marijuana legalization, a little bit less (35.2%) approved its legalization in Poland and 26.1% had no opinion. Type of college faculty had not been detected as a factor influencing support for legalization. Important factors influencing positive opinion on legalization was: living in the city, tobacco smoking, socializing with legalization supporters, lack of regular religious practice, drug use. CONCLUSION. Young people's diversified opinion regarding legalization of marijuana in Poland should encourage further discussion. Educational and preventive activities within different social groups are necessary to form a conscious opinion on legalization of marijuana in Poland based on the knowledge of actual scientific facts.

  14. Proposed full automatic control system for the Medical Small Cyclotron C-30 at the Institute of Nuclear Studies, Poland

    International Nuclear Information System (INIS)

    Jankowski, A.

    1987-01-01

    The computer control system for the C-30 Medical Small Cyclotron, which is currently under construction at the Institute of Nuclear Studies will be presented. The features of this simple and secure system are briefly discussed. Some efforts have been done to make a conversational system easily understandable for operators. The keystone of the control system is an fibre optical link (wireless) between the cyclotron and the computer. The control system is based on the use of an extended configuration of the IBM PC/AT computer. A new system software is used to execute multitask hierarchical programs to control the cyclotron. The comercial adapters for control and data aquisition, connected with the fibre optic communication channels are used to transmit data and control codes. Two colour graphic CRT displays the ongoing status and function of each controlled units so that the operator can monitor the whole system conditions at a glance. The paper gives a general description of the programs which are executed on the computer. It also shows how the cyclotron is controlled by dedicated computer practically without special electronic equipment except of the hardware safety cutout switch. The cyclotron is protected against operating incidents and mistakes by a complex system of interlocks. (author)

  15. Who Is the Competent Physics Student? A Study of Students' Positions and Social Interaction in Small-Group Discussions

    Science.gov (United States)

    Due, Karin

    2014-01-01

    This article describes a study which explored the social interaction and the reproduction and challenge of gendered discourses in small group discussions in physics. Data for the study consisted of video recordings of eight upper secondary school groups solving physics problems and 15 audiotaped individual interviews with participating students.…

  16. Temozolomide in patients with advanced non-small cell lung cancer with and without brain metastases. a phase II study of the EORTC Lung Cancer Group (08965).

    NARCIS (Netherlands)

    Dziadziuszko, R; Ardizzoni, A.; Postmus, P.E.; Smit, E.F.; Price, A; Debruyne, C.; Legrand, C; Giaccone, G.

    2003-01-01

    This study was performed to evaluate the activity of single-agent temozolomide in two groups of chemotherapy-naive non-small cell lung cancer (NSCLC) patients, with (12 patients) and without (13 patients) brain metastases (BM). Patients in both groups were treated with temozolomide 200 mg/m(2)/day,

  17. A Band of Sisters: The Impact of Long-Term Small Group Participation--Forty Years in a Women's Prayer and Bible Study Group

    Science.gov (United States)

    Lawson, Kevin E.

    2006-01-01

    This article reports on a case study of a women's prayer and Bible study group that has met for over forty years. The report focuses on factors contributing to the group's longevity and vitality over time, how it changed over the years, and its impact on the lives of the women who participated in it. It also addresses how this long-term group…

  18. Revealing the Value of “Green” and the Small Group with a Big Heart in Transportation Mode Choice

    Directory of Open Access Journals (Sweden)

    David Gaker

    2013-07-01

    Full Text Available To address issues of climate change, people are more and more being presented with the greenhouse gas emissions associated with their alternatives. Statements of pounds or kilograms of CO2 are showing up in trip planners, car advertisements, and even restaurant menus under the assumption that this information influences behavior. This research contributes to the literature that investigates how travelers respond to such information. Our objective is to better understand the “value of green” or how much travelers are willing to pay in money in order to reduce the CO2 associated with their travel. As with previous work, we designed and conducted a mode choice experiment using methods that have long been used to study value of time. The contributions of this paper are twofold. First, we employ revealed preference data, whereas previous studies have been based on stated preferences. Second, we provide new insight on how the value of green is distributed in the population. Whereas previous work has specified heterogeneity either systematically or with a continuous distribution, we find that a latent class choice model specification better fits the data and also is attractive behaviorally. The best fitting latent class model has two classes: one large class (76% of the sample who are not willing to spend any time or money to reduce their CO2 and a second class (24% of the sample who value reducing their CO2 at a very high rate of $2.68 per pound of reduction—our so-called small group with a big heart. We reanalyzed three datasets that we had previously collected and found considerable robustness of this two class result.

  19. The challenge of NSCLC diagnosis and predictive analysis on small samples. Practical approach of a working group

    DEFF Research Database (Denmark)

    Thunnissen, Erik; Kerr, Keith M; Herth, Felix J F

    2012-01-01

    Until recently, the division of pulmonary carcinomas into small cell lung cancer (SCLC) and non-small cell lung cancer (NSCLC) was adequate for therapy selection. Due to the emergence of new treatment options subtyping of NSCLC and predictive testing have become mandatory. A practical approach to...

  20. Effects of kinship or familiarity? Small thrips larvae experience lower predation risk only in groups of mixed-size siblings

    NARCIS (Netherlands)

    de Bruijn, P.J.A.; Sabelis, M.W.; Egas, M.

    2014-01-01

    In many species of insects, larvae are distributed in an aggregated fashion. As they may differ in size and size matters to predation risk, small larvae may be less likely to fall prey to predators when near large and therefore better-defended larvae. We hypothesize that the small larvae may profit

  1. Factorial Invariance and Convergent Validity of the Group-Based Medical Mistrust Scale across Gender and Ethnoracial Identity.

    Science.gov (United States)

    Wheldon, Christopher W; Kolar, Stephanie K; Hernandez, Natalie D; Daley, Ellen M

    2017-01-01

    The objective of this study was to assess the factorial invariance and convergent validity of the Group-Based Medical Mistrust Scale (GBMMS) across gender (male and female) and ethnoracial identity (Latino and Black). Minority students (N = 686) attending a southeastern university were surveyed in the fall of 2011. Psychometric analysis of the GBMMS was performed. A three-factor solution fit the data after the omission of two problematic items. This revised version of the GBMMS exhibited sufficient configural, metric, and scalar invariance. Convergence of the GBMMS with conceptually related measures provided further evidence of validity; however, there was variation across ethnoracial identity. The GBMMS has viable psychometric properties across gender and ethnoracial identity in Black and Latino populations.

  2. Zygomycosis in Europe: analysis of 230 cases accrued by the registry of the European Confederation of Medical Mycology (ECMM) Working Group on Zygomycosis between 2005 and 2007.

    NARCIS (Netherlands)

    Skiada, A.; Pagano, L.; Groll, A.; Zimmerli, S.; Dupont, B.; Lagrou, K.; Lass-Florl, C.; Bouza, E.; Klimko, N.; Gaustad, P.; Richardson, M.; Hamal, P.; Akova, M.; Meis, J.F.G.M.; Rodriguez-Tudela, J.L.; Roilides, E.; Mitrousia-Ziouva, A.; Petrikkos, G.

    2011-01-01

    Zygomycosis is an important emerging fungal infection, associated with high morbidity and mortality. The Working Group on Zygomycosis of the European Confederation of Medical Mycology (ECMM) prospectively collected cases of proven and probable zygomycosis in 13 European countries occurring between

  3. Principles of developing a well-rounded program of physical rehabilitation for female students in the special medical group with consideration of physical activity impairment

    Directory of Open Access Journals (Sweden)

    N. R. Golod

    2015-05-01

    Full Text Available Purpose : to highlight the main provisions of a comprehensive physical rehabilitation program for students of special medical group based on violations of the motor capacity. Material : testing 24 students of special medical group and the same number of their healthy peers on standardized tests of physical qualities. To reflect the movement disorders applied functional movement screen. Results : a program of rehabilitation of the students included: lifestyle modification; morning hygienic gymnastics; kinesitherapy (using yoga fitness, functional training; aerobic exercise (swimming, Nordic Walking, jogging, aerobics wellness; massage. First presented a unified approach to working with students of special medical groups - selection based on load capacity motor disorders according to the results of tests of functional movement screen. The complexity of the impact of the program involves the impact on the physical, social and mental health components. Conclusions : the author's program of physical rehabilitation of students of special medical group is complex.

  4. Engaging with economic evaluation methods: insights from small and medium enterprises in the UK medical devices industry after training workshops

    Directory of Open Access Journals (Sweden)

    Craven Michael P

    2012-09-01

    Full Text Available Abstract Background With increased governmental interest in value assessment of technologies and where medical device manufacturers are finding it increasingly necessary to become more familiar with economic evaluation methods, the study sought to explore the levels of health economics knowledge within small and medium-sized enterprises (SMEs and to scope strategies they employ to demonstrate the value of their products to purchasers. Methods A short questionnaire was completed by participants attending one of five workshops on product development in the medical device sector that took place in England between 2007 and 2011. From all responses obtained, a large proportion of participants were based in SMEs (N = 43, and these responses were used for the analysis. Statistical analysis using non-parametric tests was performed on questions with approximately interval scales. Qualitative data from participant responses were analysed to reveal emerging themes. Results The questionnaire results revealed that 60% of SME participants (mostly company directors or managers, including product or project managers rated themselves as having low or no knowledge of health economics prior to the workshops but the rest professed at least medium knowledge. Clinical trials and cost analyses or cost-effectiveness studies were the most highly cited means by which SMEs aim to demonstrate value of products to purchasers. Purchasers were perceived to place most importance on factors of safety, expert opinion, cost-effectiveness and price. However many companies did not utilise formal decision-making tools to prioritise these factors. There was no significant dependence of the use of decision-making tools in general with respect to professed knowledge of health economics methods. SMEs did not state a preference for any particular aspect of potential value when deciding whether to develop a product. A majority of SMEs stated they would use a health economics tool

  5. Engaging with economic evaluation methods: insights from small and medium enterprises in the UK medical devices industry after training workshops.

    Science.gov (United States)

    Craven, Michael P; Allsop, Matthew J; Morgan, Stephen P; Martin, Jennifer L

    2012-09-03

    With increased governmental interest in value assessment of technologies and where medical device manufacturers are finding it increasingly necessary to become more familiar with economic evaluation methods, the study sought to explore the levels of health economics knowledge within small and medium-sized enterprises (SMEs) and to scope strategies they employ to demonstrate the value of their products to purchasers. A short questionnaire was completed by participants attending one of five workshops on product development in the medical device sector that took place in England between 2007 and 2011. From all responses obtained, a large proportion of participants were based in SMEs (N = 43), and these responses were used for the analysis. Statistical analysis using non-parametric tests was performed on questions with approximately interval scales. Qualitative data from participant responses were analysed to reveal emerging themes. The questionnaire results revealed that 60% of SME participants (mostly company directors or managers, including product or project managers) rated themselves as having low or no knowledge of health economics prior to the workshops but the rest professed at least medium knowledge. Clinical trials and cost analyses or cost-effectiveness studies were the most highly cited means by which SMEs aim to demonstrate value of products to purchasers. Purchasers were perceived to place most importance on factors of safety, expert opinion, cost-effectiveness and price. However many companies did not utilise formal decision-making tools to prioritise these factors. There was no significant dependence of the use of decision-making tools in general with respect to professed knowledge of health economics methods. SMEs did not state a preference for any particular aspect of potential value when deciding whether to develop a product. A majority of SMEs stated they would use a health economics tool. Research and development teams or marketing and sales

  6. Benefit-risk of Patients' Online Access to their Medical Records: Consensus Exercise of an International Expert Group.

    Science.gov (United States)

    Liyanage, Harshana; Liaw, Siaw-Teng; Konstantara, Emmanouela; Mold, Freda; Schreiber, Richard; Kuziemsky, Craig; Terry, Amanda L; de Lusignan, Simon

    2018-04-22

     Patients' access to their computerised medical records (CMRs) is a legal right in many countries. However, little is reported about the benefit-risk associated with patients' online access to their CMRs.  To conduct a consensus exercise to assess the impact of patients' online access to their CMRs on the quality of care as defined in six domains by the Institute of Medicine (IoM), now the National Academy of Medicine (NAM).  A five-round Delphi study was conducted. Round One explored experts' (n = 37) viewpoints on providing patients with access to their CMRs. Round Two rated the appropriateness of statements arising from Round One (n = 16). The third round was an online panel discussion of findings (n = 13) with the members of both the International Medical Informatics Association and the European Federation of Medical Informatics Primary Health Care Informatics Working Groups. Two additional rounds, a survey of the revised consensus statements and an online workshop, were carried out to further refine consensus statements.  Thirty-seven responses from Round One were used as a basis to initially develop 15 statements which were categorised using IoM's domains of care quality. The experts agreed that providing patients online access to their CMRs for bookings, results, and prescriptions increased efficiency and improved the quality of medical records. Experts also anticipated that patients would proactively use their online access to share data with different health care providers, including emergencies. However, experts differed on whether access to limited or summary data was more useful to patients than accessing their complete records. They thought online access would change recording practice, but they were unclear about the benefit-risk of high and onerous levels of security. The 5-round process, finally, produced 16 consensus statements.  Patients' online access to their CMRs should be part of all CMR systems. It improves the process

  7. Macro and Micro-Nutrients Intake, Food Groups Consumption and Dietary Habits among Female Students in Isfahan University of Medical Sciences

    OpenAIRE

    Azadbakht, L; Esmaillzadeh, A

    2012-01-01

    Background Improving the dietary intake among different groups and population is important for improving the health status. This study determines the nutrients and food group intake as well as dietary habits among female students in Isfahan University of Medical Sciences. Methods Two hundreds and eighty nine healthy female youths who were randomly selected among students of Isfahan University of Medical Sciences in Isfahan, Iran were enrolled. A validated semi quantitative food frequency ques...

  8. Nordic working group for medical x-ray diagnostics: Diagnostic reference levels within xray diagnostics - experiences in the Nordic countries

    International Nuclear Information System (INIS)

    Leitz, W.; Groen, P.; Servomaa, A.; Einarsson, G.; Olerud, H.

    2003-01-01

    Medical x-ray diagnostics is one of the few applications of ionising radiation where people are irradiated on purpose. The strategy for radiation protection is also different compared to that in other areas that have the zero-alternative as its ultimate goal, meaning that no human beings at all are exposed in these practices. The focus in x-ray diagnostics concerning radiation protection is justification and optimisation. Optimisation implies that the examination is performed in such a way that the radiation dose is as small as possible without jeopardising the diagnostic security. X- ray diagnostics is a complex method where many technical parameters and methodology factors together are interacting in the determination of radiation dose and image quality. The optimisation process is not a simple and uncomplicated procedure, this difficulty is reflected in many international and national surveys showing a large spread of patient doses for one and the same type of examination. The concept diagnostic reference levels (DRL) has been introduced as a tool for reducing this wide distribution that is obviously indicating a lack of optimisation, and for cutting the highest radiation doses. In this presentation the concept for DRL and the experience gained in the Nordic countries with DRL are described. (orig.)

  9. Lack of independent effect of type 2 diabetes beyond characteristic comorbidities and medications on small muscle mass exercising muscle blood flow and exercise tolerance.

    Science.gov (United States)

    Poitras, Veronica J; Bentley, Robert F; Hopkins-Rosseel, Diana H; LaHaye, Stephen A; Tschakovsky, Michael E

    2015-08-01

    Persons with type 2 diabetes (T2D) are believed to have reduced exercise tolerance; this may be partly due to impaired exercising muscle blood flow (MBF). Whether there is an impact of T2D on exercising MBF within the typical constellation of comorbidities (hypertension, dyslipidemia, obesity) and their associated medications has not been investigated. We tested the hypothesis that small muscle mass exercise tolerance is reduced in persons with T2D versus Controls (matched for age, body mass index, fitness, comorbidities, non-T2D medications) and that this is related to blunted MBF. Eight persons with T2D and eight controls completed a forearm critical force (fCFimpulse) test as a measure of exercise tolerance (10-min intermittent maximal effort forearm contractions; the average contraction impulse in the last 30 sec quantified fCFimpulse). Forearm blood flow (FBF; ultrasound) and mean arterial pressure (MAP; finger photoplethysmography) were measured; forearm vascular conductance (FVK) was calculated. Data are means ± SD, T2D versus Control. fCFimpulse was not different between groups (136.9 ± 47.3  N·sec vs. 163.1 ± 49.7 N·sec, P = 0.371) nor was the ∆FBF from rest to during exercise at fCFimpulse (502.9 ± 144.6 vs. 709.1 ± 289.2 mL/min, P = 0.092), or its determinants ∆FVK and ∆MAP (both P > 0.05), although there was considerable interindividual variability. ∆FBF was strongly related to fCFimpulse (r = 0.727, P = 0.002), providing support for the relationship between oxygen delivery and exercise tolerance. We conclude that small muscle mass exercising MBF and exercise tolerance are not impaired in representative persons with T2D versus appropriately matched controls. This suggests that peripheral vascular control impairment does not contribute to reduced exercise tolerance in this population. © 2015 The Authors. Physiological Reports published by Wiley Periodicals, Inc. on behalf of the American Physiological Society and

  10. Evaluation of Small Student-Led Discussion Groups as an Adjunct to a Course in Abnormal Psychology

    Science.gov (United States)

    White, Geoffry D.

    1978-01-01

    Presents data related to student involvement in biweekly student-led discussion groups in an undergraduate abnormal psychology course. Evaluates the degree to which students felt they benefited from discussion groups composed of similar and dissimilar students. (Author/AV)

  11. What do people appreciate in physicians' communication? An international study with focus groups using videotaped medical consultations.

    Science.gov (United States)

    Mazzi, Maria A; Rimondini, Michela; Deveugele, Myriam; Zimmermann, Christa; Moretti, Francesca; van Vliet, Liesbeth; Deledda, Giuseppe; Fletcher, Ian; Bensing, Jozien

    2015-10-01

    The literature shows that the quality of communication is usually determined from a professional perspective. Patients or lay people are seldom involved in the development of quality indicators or communication. To give voice to the lay people perspective on what constitutes 'good communication' by evoking their reactions to variations in physician communication. Lay people from four different countries watched the same videotaped standardized medical encounters and discussed their preferences in gender-specific focus groups who were balanced in age groups. Two hundred and fifty-nine lay people (64 NL, 72 IT, 75 UK and 48 BE) distributed over 35 focus groups of 6-8 persons each. Comments on doctors' behaviours were classified by the GULiVer framework in terms of contents and preferences. Participants prevalently discussed 'task-oriented expressions' (39%: competency, self-confident, providing solutions), 'affective oriented/emotional expressions' (25%: empathy, listening, reassuring) and 'process-oriented expressions' (23%: flexibility, summarizing, verifying). 'Showing an affective attitude' was most appreciated (positive percentage within category: 93%, particularly facilitations and inviting attitude), followed by 'providing solution' (85%). Among disfavoured behaviour, repetitions (88%), 'writing and reading' (54%) and asking permission (42%) were found. Although an affective attitude is appreciated by nearly everybody, people may vary widely in their communication needs and preferences: what is 'good communication' for one person may be disliked or even a source of irritation for another. A physician should be flexible and capable of adapting the consultation to the different needs of different patients. This challenges the idea of general communication guidelines. © 2013 John Wiley & Sons Ltd.

  12. The efficacy of psycho-educational group program on medication adherence and global functioning of patients with bipolar disorder type I.

    Science.gov (United States)

    Bahredar, Mohammad Jafar; Asgharnejad Farid, Ali Asghar; Ghanizadeh, Ahmad; Birashk, Behrooz

    2014-01-01

    Psycho-education is now considered as part of the integrated treatment for bipolar disorder. This study aimed to determine the efficacy of group psycho-education on medication adherence and global functioning of patients with bipolar disorder type I. 45 patients with bipolar disorder type I were allocated one of the three groups of psycho-education plus pharmacotherapy, pharmacotherapy and placebo plus pharmacotherapy. A psycho-educational program was conducted for the psycho-educational group during 9 weekly sessions. Medication adherence and global functioning of all the three groups were evaluated before the intervention, three months and six months after the intervention using Medication Adherence Rating Scale (MARS) and Global Assessment of Functioning (GAF). ANOVA was performed to examine the data. In the first and second assessments, the mean score of medication adherence and gobal functioning for patients in the psycho-educational group was significantly higher than that in the control and placebo groups (P=0.001). Medication adherence score of the psycho-educational group was increased from 6.27(0.88) to 7.92(1.38). while the mean score of the psycho-educational group increased from 56.6 (3.58) to 64.17 (2.12):, the global functioning reduced from 56.27(3.17) to 54.17(5.08) in the control group and from 56.67 (3.58) to 56 (4.36) in the placebo group. Psycho-educational program plus pharmacotherapy was effective in improvement medication adherence and global functioning of bipolar patients.

  13. Motivated strategies for learning and their association with academic performance of a diverse group of 1styear medical students

    Directory of Open Access Journals (Sweden)

    Shaista Hamid

    2016-05-01

    Full Text Available Background. Most instruments, including the well-known Motivated Strategies for Learning Questionnaire (MSLQ, have been designed in western homogeneous settings. Use of the MSLQ in health professions education is limited. Objective. To assess the MSLQ and its association with the academic performance of a heterogeneous group of 1st-year medical students. Methods. Eighty-three percent of 1st-year medical students consented to participate in this quantitative study. The MSLQ consisted of a motivation strategies component with six subscales, while the learning strategies component had nine subscales. Demographic and academic achievement information of the students was also collected. Stata version 13 (StataCorp LP, USA was used for the statistical analyses of all data. Results. Female students displayed significantly higher motivational scores. Students with prior educational experience and those who attended peer mentoring sessions had significantly higher learning strategy scores. Significant but moderate relationships were found between academic performance and the motivation strategies subsumed within the categories ‘task value’ and ‘self-efficacy for learning performance’. In terms of the ‘learning strategy component’, ‘critical thinking’, and ‘time and study environment’, the composite score was significantly but poorly correlated to academic performance. Conclusion. Overall, limited correlations were found between the MSLQ scores and academic performance. Further investigation of the use of the MSLQ and its association with academic achievement is recommended, with greater focus on specific learning events than on course outcomes. This study highlights the importance of evaluating an instrument in a specific context before accepting the findings of others with regard to the use of the instrument and its correlation with academic performance.

  14. The well-being and personal wellness promotion strategies of medical oncologists in the North Central Cancer Treatment Group.

    Science.gov (United States)

    Shanafelt, Tait D; Novotny, Paul; Johnson, Mary E; Zhao, Xinghua; Steensma, David P; Lacy, Martha Q; Rubin, Joseph; Sloan, Jeff

    2005-01-01

    The well-being of oncologists is important to the well-being of their patients. While much is known about oncologist distress, little is known about oncologist well-being. We set out to evaluate oncologist well-being and the personal wellness promotion strategies used by oncologists. We performed a cross-sectional survey of medical oncologists in the North Central Cancer Treatment Group using a validated instrument to measure quality of life. Study-specific questions explored stressors, wellness promotion strategies and career satisfaction. Of 241 responding oncologists (response rate 61%), 121 (50%) reported high overall well-being. Being age 50 or younger (57 vs. 41%; p = 0.01), male (53 vs. 31%; p = 0.01) and working 60 h or less per week (50 vs. 33%; p = 0.005) were associated with increased overall well-being on bivariate analysis. Ratings of the importance of a number of personal wellness promotion strategies differed for oncologists with high well-being compared with those without high well-being. Developing an approach/philosophy to dealing with death and end-of-life care, using recreation/hobbies/exercise, taking a positive outlook and incorporating a philosophy of balance between personal and professional life were all rated as substantially more important wellness strategies by oncologists with high well-being (p values career satisfaction. Half of medical oncologists experience high overall well-being. Use of specific personal wellness promotion strategies appears to be associated with oncologist well-being. Further investigations of the prevalence, promotion, causes, inequities and clinical impact of physician well-being are needed. .

  15. Active Learning: A Small Group Histology Laboratory Exercise in a Whole Class Setting Utilizing Virtual Slides and Peer Education

    Science.gov (United States)

    Bloodgood, Robert A.

    2012-01-01

    Histology laboratory instruction is moving away from the sole use of the traditional combination of light microscopes and glass slides in favor of virtual microscopy and virtual slides. At the same time, medical curricula are changing so as to reduce scheduled time for basic science instruction as well as focusing on student-centered learning…

  16. Perceived effectiveness of environmental decision support systems in participatory planning: Evidence from small groups of end-users

    NARCIS (Netherlands)

    Inman, D.; Blind, M.; Ribarova, I.; Krause, A.; Roosenschoon, O.R.; Kassahun, A.; Scholten, H.; Arampatzis, G.; Abrami, G.; McIntosh, B.S.; Jeffrey, P.

    2011-01-01

    The challenges associated with evaluating the effectiveness of environmental decision support systems (EDSS) based on the perceptions of only a small sample of end-users are well understood. Although methods adopted from Management Information Systems (MISs) evaluation research have benefited from

  17. Qualitative Assessment of Learning Strategies among Medical Students Using Focus Group Discussions and In-depth Interviews.

    Science.gov (United States)

    Joshi, Anuradha Sujai; Ganjiwale, Jaishree Deepak; Varma, Jagdish; Singh, Praveen; Modi, Jyoti Nath; Singh, Tejinder

    2017-12-01

    Globally, students with top academic performance and high intellectual capacity usually opt to study medicine. However, once students get enrolled, their academic performance varies widely. Such variations appear to be determined by various factors, one of them being types of learning strategies adopted by students. The learning strategies utilized by the students with better academic performance are likely to be more effective learning strategies. The objective is to identify effective learning strategies used by medical students. This study was carried out among the MBBS students of Final Professional Part I. Students were categorized into three groups namely: high, average, and low rankers based on overall academic performance in second Professional University examination. First, a questionnaire consisting of closed- and open-ended questions was administered to students, to find their learning strategies. Subsequently, focus group discussion and in-depth interviews were conducted for high- and low-rankers. Discussions were audio-recorded, transcribed, and analyzed. Key statements were highlighted, collated, and categorized into general themes and sub-themes. Evident themes which emerged as effective strategies were hard work in the form of regularity of studies, meticulous preparation of notes, constructive use of time, utilization of e-learning, learning styles and deep learning approach and regular ward visits. Intrinsic motivation, family support, balancing physical activities and studies, guidance by seniors, teachers, dealing with nonacademic issues such as language barriers and stress were also identified as important strategies. Disseminating effective learning strategies in a systematic manner may be helpful to students in achieving better academic outcomes. Furthermore, educationists need to modulate their teaching strategies based on students' feedback.

  18. The "Project": Putting Student Controlled, Small Group Work and Transferable Skills at the Core of a Geography Course.

    Science.gov (United States)

    Hindle, Brian Paul

    1993-01-01

    Describes how a cooperative group project has become a foundation of the first two years of a three-year program in college-level geography. Discusses the origin, development, and topic selection for each of the cohort groups working in the program. Asserts that the program has been favorably received by both students and faculty members. (CFR)

  19. Pediatric Obesity Empowerment Model Group Medical Visits (POEM-GMV) as Treatment for Pediatric Obesity in an Underserved Community.

    Science.gov (United States)

    Geller, Jeffrey S; Dube, Eileen T; Cruz, Glavielinys A; Stevens, Jason; Keating Bench, Kara

    2015-10-01

    This is a retrospective cohort study to evaluate a novel group medical visit (GMV) program using an empowerment curriculum as treatment for pediatric obesity in a federally qualified community health center. Biometric and self-reported data were reviewed from 417 overweight or obese children ages 5-18 attending the pediatric obesity empowerment model GMV program (POEM-GMV) at least twice during a 3-year period. Variables were evaluated using paired means t-test. Pearson's correlation test was used to evaluate variables and the BMI z-score. Subanalysis by gender was performed. The average participant was 10.48 ± 2.53 years old and participated for 301 ± 287 days. BMI z-score reduced from 2.99 ± 0.96 to 2.88 ± 0.88 (p pediatric obesity in an underserved community. There were statistically significantly improved outcomes in obesity, especially for boys. Significant improvement was observed in many lifestyle factors associated with obesity. Weight loss most closely correlated with reduced stress levels and sugary beverage consumption. Additional studies are needed to further evaluate the efficacy of POEM-GMV.

  20. The Supply of Medical Radioisotopes. Final Report of the Third Mandate of the High-level Group on the Security of Supply of Medical Radioisotopes (2013-2015)

    International Nuclear Information System (INIS)

    Charlton, Kevin; )

    2016-07-01

    At the request of its member countries, the Organisation for Economic Co-operation and Development (OECD) Nuclear Energy Agency (NEA) became involved in global efforts to ensure a secure supply of molybdenum-99 ( 99 Mo)/technetium-99m ( 99m Tc). In April 2009, the High-level Group on the Security of Supply of Medical Radioisotopes (HLG-MR) was created and received an initial, two-year mandate from the NEA Steering Committee for Nuclear Energy to examine the causes of supply shortages of 99 Mo/ 99m Tc and develop a policy approach to address them. In its first mandate, the HLG-MR conducted a comprehensive economic study of the 99 Mo/ 99m Tc supply chain, which identified the key areas of vulnerability and major issues to be addressed. The HLG-MR released a policy approach, including six principles (Appendix 1) and supporting recommendations to help resolve the issues in the 99 Mo/ 99m Tc market. In the second mandate (2011-2013), the HLG-MR worked to encourage the implementation of the six policy principles and promoted an industry transition away from the use of highly enriched uranium (HEU) targets for 99 Mo production. Projects were undertaken by the NEA that resulted in the publication of documents and reports to assist in implementing the HLG-MR policy approach. The second mandate showed that, while commendable progress had occurred in many areas, there were still major issues in the 99 Mo/ 99m Tc market, with some continued government subsidisation, insufficient ORC and inadequate reimbursement for 99 mTc. Potential future periods of supply shortage were identified, particularly concerning the likely loss of significant capacity around 2016. In the third mandate, the HLG-MR continued its efforts to help ensure the global security of supply of 99 Mo/ 99m Tc through implementation of the six policy principles. The NEA undertook a further self-assessment review of the 99 Mo/ 99m Tc supply chain, focusing again on progress with implementing FCR and paid ORC and

  1. Novel polyfucosylated N-linked glycopeptides with blood group A, H, X and Y determinants from human small intestinal epithelial cells

    NARCIS (Netherlands)

    Vliegenthart, J.F.G.; Finne, J.; Breimer, M.E.; Hansson, G.C.; Karlsson, K.-A.; Leffler, H.; Halbeek, H. van

    1989-01-01

    A novel type of N-linked glycopeptides representing a major part of the glycans in human small intestinal epithelial cells from blood group A and O individuals were isolated by gel filtrations and affinity chromatography on concanavalin A-Sepharose and Bandeiraea simplicifolia lectin I-Sepharose.

  2. The Effectiveness of the Smart Board-Based Small-Group Graduated Guidance Instruction on Digital Gaming and Observational Learning Skills of Children with Autism Spectrum Disorder

    Science.gov (United States)

    Cattik, Melih; Odluyurt, Serhat

    2017-01-01

    The objective of this study was to teach digital gaming skills to children with autism spectrum disorder (ASD) using a SMART board with a graduated guidance teaching method in a small-group instructional format, to determine the participants' levels of learning by observation, and to determine the views of their families on the conducted…

  3. Teaching Children with Autism in Small Groups with Students Who Are At-Risk for Academic Problems: Effects on Academic and Social Behaviors

    Science.gov (United States)

    Ledford, Jennifer R.; Wehby, Joseph H.

    2015-01-01

    Students with ASD are often taught in individual instructional arrangements, even when they receive educational services in inclusive settings. Providing intervention in small group arrangements may increase opportunities for social interactions, particularly when these opportunities are systematically planned. In this study, academic instruction…

  4. Improving Executive Functions in 5- and 6-year-olds: Evaluation of a Small Group Intervention in Prekindergarten and Kindergarten Children

    Science.gov (United States)

    Röthlisberger, Marianne; Neuenschwander, Regula; Cimeli, Patriza; Michel, Eva; Roebers, Claudia M.

    2012-01-01

    Research suggests a central role of executive functions for children's cognitive and social development during preschool years, especially in promoting school readiness. Interventions aiming to improve executive functions are therefore being called for. The present study examined the effect of a small group intervention implemented in kindergarten…

  5. Reducing the Grade Disparities between American Indians and Euro-American Students in Introduction to Psychology through Small-Group, Peer-Mentored, Supplemental Instruction

    Science.gov (United States)

    Okun, Morris Alan; Berlin, Anna; Hanrahan, Jeanne; Lewis, James; Johnson, Kathryn

    2015-01-01

    Supplemental instruction (SI) is a small-group, peer-mentored programme which is compatible with the learning preferences of American Indian students. We tested the hypothesis that SI is a compensatory strategy that reduces the differences in the grades earned in introduction to psychology by Euro-American and American Indian students. The sample…

  6. Inference With Difference-in-Differences With a Small Number of Groups: A Review, Simulation Study, and Empirical Application Using SHARE Data.

    Science.gov (United States)

    Rokicki, Slawa; Cohen, Jessica; Fink, Günther; Salomon, Joshua A; Landrum, Mary Beth

    2018-01-01

    Difference-in-differences (DID) estimation has become increasingly popular as an approach to evaluate the effect of a group-level policy on individual-level outcomes. Several statistical methodologies have been proposed to correct for the within-group correlation of model errors resulting from the clustering of data. Little is known about how well these corrections perform with the often small number of groups observed in health research using longitudinal data. First, we review the most commonly used modeling solutions in DID estimation for panel data, including generalized estimating equations (GEE), permutation tests, clustered standard errors (CSE), wild cluster bootstrapping, and aggregation. Second, we compare the empirical coverage rates and power of these methods using a Monte Carlo simulation study in scenarios in which we vary the degree of error correlation, the group size balance, and the proportion of treated groups. Third, we provide an empirical example using the Survey of Health, Ageing, and Retirement in Europe. When the number of groups is small, CSE are systematically biased downwards in scenarios when data are unbalanced or when there is a low proportion of treated groups. This can result in over-rejection of the null even when data are composed of up to 50 groups. Aggregation, permutation tests, bias-adjusted GEE, and wild cluster bootstrap produce coverage rates close to the nominal rate for almost all scenarios, though GEE may suffer from low power. In DID estimation with a small number of groups, analysis using aggregation, permutation tests, wild cluster bootstrap, or bias-adjusted GEE is recommended.

  7. Perspectives on Positioning, Interaction, and Learning in Small-Group Discussion: Possibilities for Extending the Analytic Lens

    Science.gov (United States)

    Kittleson, Julie M.; Wilson, Rachel E.

    2014-01-01

    In this forum piece, we respond to Karin Due's study of social dynamics in groups of students in physics class and gender issues that play out in this context. We discuss two threads that appear in Due's paper: one pertains to patterns of talk within groups and how these patterns open up possibilities for learning, the other pertains to…

  8. "Medical students" burn out – need of student mentor and support groups and emotional resilience skills training to be a part of medical school curriculum

    Directory of Open Access Journals (Sweden)

    Shoaib M

    2017-02-01

    Full Text Available Maria Shoaib,1 Anoshia Afzal,1 Muhammad Aadil,2 1Department of Medicine, Dow Medical College, Dow University of Health Sciences, Karachi, Pakistan; 2Department of Psychiatry, Rush University Medical Center, Chicago, IL, USA We would like to applaud the authors of the article “Potential predictors of psychological distress and well-being in medical students: a cross-sectional pilot study” for conducting a cross-sectional pilot study to understand the predictors of psychological distress and well-being and for assessing their extent using latest scales that have not been extensively used for this purpose before.1 We would like to add some views in its support. View the original paper by Bore and colleagues. 

  9. The quality of life of medical students studying in New Zealand: a comparison with nonmedical students and a general population reference group.

    Science.gov (United States)

    Henning, Marcus A; Krägeloh, Christian U; Hawken, Susan J; Zhao, Yipin; Doherty, Iain

    2012-01-01

    Quality of life is an essential component of learning and has strong links with the practice and study of medicine. There is burgeoning evidence in the research literature to suggest that medical students are experiencing health-related problems such as anxiety, depression, and burnout. The aim of the study was to investigate medical students' perceptions concerning their quality of life. Two hundred seventy-four medical students studying in their early clinical years (response rate = 80%) participated in the present study. Medical students were asked to fill in the abbreviated version of the World Health Organization Quality of Life questionnaire to elicit information about their quality of life perceptions in relation to their physical health, psychological health, social relationships, and environment. Subsequently, their responses were compared with two nonmedical students groups studying at a different university in the same city and an Australian general population norm. The findings were compared using independent group's t tests, confidence intervals, and Cohen's d. The main finding of the study indicated that medical students had similar quality of life perceptions to nonmedical students except in relation to the environment domain. Furthermore, the medical student group scored lower than the general population reference group on the physical health, psychological health, and environment quality of life domains. The results suggest that all university students are expressing concerns related to quality of life, and thus their health might be at risk. The findings in this study provided no evidence to support the notion that medical students experience lower levels of quality of life compared to other university students. When compared to the general population, all student groups examined in this study appeared to be experiencing lower levels of quality of life. This has implications for pastoral support, educationalists, student support personnel, and the

  10. Study of the Knowledge, Attitude and Experience of Medical Tourism Among Target Groups with Special Emphasis on South India

    Directory of Open Access Journals (Sweden)

    Rajeev A

    2009-09-01

    Full Text Available Medical tourism aims at providing cost-effective customized health care in collaboration with the tourism industry in distant locations wherein the hospitality component is handled efficiently so that fixing appointments, making arrangements for accommodation and other logistics become hassle-free for the patient. This allows more concentration on the procedure at hand and the interaction between the medical fraternity and the patient becomes smoother. More and more hospitals in India are gearing up to provide such services to neighbouring countries and even to the developed nations across the world. The purpose of this study was to study the knowledge, attitude and experiences of the population of a suitable cross-section regarding the emerging scenario of medical tourism with special interest vis-à-vis Non Resident Indians (NRIs specifically to the state of Karnataka and Mangalore in particular. It was found that compared to the locals (kannadigas or non-kannadigas, the Non-resident Indians were more dissatisfied with the health care facilities available in their proximity. Though a majority of them do have medical insurance, it still looks as if the care is more cost-effective when sourced to India. NRIs are more aware of the potential of medical tourism through their communication with the medical fraternity as well as the general public and 11.1% of NRIs have really utilized the services of medical tourism. An e-mail survey which was also conducted among a number of foreigners yielded the interesting fact that they indeed had a greater awareness regarding medical tourism with an emphasis on health tourism. The reason why these foreigners opted for medical tourism was due to the substandard medical care available in their locality, rather than due to the cost of medical care as such.

  11. Middle-school students of United Arab Emirates: effects of heterogeneous small group work on attitudes toward mathematics.

    Science.gov (United States)

    Alkhateeb, H M; Jumaa, M

    2000-10-01

    This study compared the effects of two instructional strategies, small heterogeneous cooperative learning experience versus lecture and discussion, on students' attitudes toward mathematics. 54 boys and 57 girls in Grade 8 of four middle-school mathematics classes participated. Two classes (57 students) were taught using a cooperative learning method and the other two classes (54 students) were taught using traditional lecture and discussion. Differences between attitudes of boys and girls were also investigated and discussed in the light of Arabic culture. The results suggested that cooperative learning might be a valuable method with which to teach mathematics concepts to boys.

  12. Comparing antibiotic self-medication in two socio-economic groups in Guatemala City: a descriptive cross-sectional study.

    Science.gov (United States)

    Ramay, Brooke M; Lambour, Paola; Cerón, Alejandro

    2015-04-27

    Self-medication with antibiotics may result in antimicrobial resistance and its high prevalence is of particular concern in Low to Middle Income Countries (LMIC) like Guatemala. A better understanding of self-medication with antibiotics may represent an opportunity to develop interventions guiding the rational use of antibiotics. We aimed to compare the magnitude of antibiotic self-medication and the characteristics of those who self-medicate in two pharmacies serving disparate socio-economic communities in Guatemala City. We conducted a descriptive, cross-sectional study in one Suburban pharmacy and one City Center pharmacy in Guatemala City. We used a questionnaire to gather information about frequency of self-medication, income and education of those who self-medicate. We compared proportions between the two pharmacies, using two-sample z-test as appropriate. Four hundred and eighteen respondents completed the survey (221 in the Suburban pharmacy and 197 in the City Center pharmacy). Most respondents in both pharmacies were female (70%). The reported monthly income in the suburban pharmacy was between $1,250.00-$2,500.00, the city-center pharmacy reported a monthly income between $125.00- $625.00 (p Guatemala City. Additionally, self-medicating respondents were most often women and most commonly self-medicated with amoxicillin. Our findings support future public health interventions centered on the regulation of antibiotic sales and on the potential role of the pharmacist in guiding prescription with antibiotics in Guatemala.

  13. Factors associated with self-medication in Spain: a cross-sectional study in different age groups.

    Science.gov (United States)

    Niclós, Gracia; Olivar, Teresa; Rodilla, Vicent

    2018-06-01

    The identification of factors which may influence a patient's decision to self-medicate. Descriptive, cross-sectional study of the adult population (at least 16 years old), using data from the 2009 European Health Interview Survey in Spain, which included 22 188 subjects. Logistic regression models enabled us to estimate the effect of each analysed variable on self-medication. In total, 14 863 (67%) individuals reported using medication (prescribed and non-prescribed) and 3274 (22.0%) of them self-medicated. Using logistic regression and stratifying by age, four different models have been constructed. Our results include different variables in each of the models to explain self-medication, but the one that appears on all four models is education level. Age is the other important factor which influences self-medication. Self-medication is strongly associated with factors related to socio-demographic, such as sex, educational level or age, as well as several health factors such as long-standing illness or physical activity. When our data are compared to those from previous Spanish surveys carried out in 2003 and 2006, we can conclude that self-medication is increasing in Spain. © 2017 Royal Pharmaceutical Society.

  14. Controlling the Morphology of BDTT-DPP-Based Small Molecules via End-Group Functionalization for Highly Efficient Single and Tandem Organic Photovoltaic Cells.

    Science.gov (United States)

    Kim, Ji-Hoon; Park, Jong Baek; Yang, Hoichang; Jung, In Hwan; Yoon, Sung Cheol; Kim, Dongwook; Hwang, Do-Hoon

    2015-11-04

    A series of narrow-band gap, π-conjugated small molecules based on diketopyrrolopyrrole (DPP) electron acceptor units coupled with alkylthienyl-substituted-benzodithiophene (BDTT) electron donors were designed and synthesized for use as donor materials in solution-processed organic photovoltaic cells. In particular, by end-group functionalization of the small molecules with fluorine derivatives, the nanoscale morphologies of the photoactive layers of the photovoltaic cells were successfully controlled. The influences of different fluorine-based end-groups on the optoelectronic and morphological properties, carrier mobilities, and the photovoltaic performances of these materials were investigated. A high power conversion efficiency (PCE) of 6.00% under simulated solar light (AM 1.5G) illumination has been achieved for organic photovoltaic cells based on a small-molecule bulk heterojunction system consisting of a trifluoromethylbenzene (CF3) end-group-containing oligomer (BDTT-(DPP)2-CF3) as the donor and [6,6]-phenyl-C71-butyric acid methyl ester (PC71BM) as the acceptor. As a result, the introduction of CF3 end-groups has been found to enhance both the short circuit current density (JSC) and fill factor (FF). A tandem photovoltaic device comprising an inverted BDTT-(DPP)2-CF3:PC71BM cell and a poly(3-hexylthiophene) (P3HT):indene-C60-bisadduct (IC60BA)-based cell as the top and bottom cell components, respectively, showed a maximum PCE of 8.30%. These results provide valuable guidelines for the rational design of conjugated small molecules for applications in high-performance organic photovoltaic cells. Furthermore, to the best of our knowledge, this is the first report on the design of fluorine-functionalized BDTT-DPP-based small molecules, which have been shown to be a viable candidate for use in inverted tandem cells.

  15. Effects of racial and ethnic group and health literacy on responses to genomic risk information in a medically underserved population.

    Science.gov (United States)

    Kaphingst, Kimberly A; Stafford, Jewel D; McGowan, Lucy D'Agostino; Seo, Joann; Lachance, Christina R; Goodman, Melody S

    2015-02-01

    Few studies have examined how individuals respond to genomic risk information for common, chronic diseases. This randomized study examined differences in responses by type of genomic information (genetic test/family history) and disease condition (diabetes/heart disease), and by race/ethnicity in a medically underserved population. 1,057 English-speaking adults completed a survey containing 1 of 4 vignettes (2-by-2 randomized design). Differences in dependent variables (i.e., interest in receiving genomic assessment, discussing with doctor or family, changing health habits) by experimental condition and race/ethnicity were examined using chi-squared tests and multivariable regression analysis. No significant differences were found in dependent variables by type of genomic information or disease condition. In multivariable models, Hispanics were more interested in receiving a genomic assessment than Whites (OR = 1.93; p literacy had greater interest than those with adequate health literacy. Blacks (OR = 1.78; p = .001) and Hispanics (OR = 1.85; p = .001) had greater interest in discussing information with family than Whites. Non-Hispanic Blacks (OR = 1.45; p = .04) had greater interest in discussing genomic information with a doctor than Whites. Blacks (β = -0.41; p literacy was negatively associated with number of health habits participants intended to change. Findings suggest that race/ethnicity may affect responses to genomic risk information. Additional research could examine how cognitive representations of this information differ across racial/ethnic groups. Health literacy is also critical to consider in developing approaches to communicating genomic information.

  16. Explanation and relations. How do general practitioners deal with patients with persistent medically unexplained symptoms: a focus group study

    Directory of Open Access Journals (Sweden)

    van Spaendonck Karel P

    2009-09-01

    Full Text Available Abstract Background Persistent presentation of medically unexplained symptoms (MUS is troublesome for general practitioners (GPs and causes pressure on the doctor-patient relationship. As a consequence, GPs face the problem of establishing an ongoing, preferably effective relationship with these patients. This study aims at exploring GPs' perceptions about explaining MUS to patients and about how relationships with these patients evolve over time in daily practice. Methods A qualitative approach, interviewing a purposive sample of twenty-two Dutch GPs within five focus groups. Data were analyzed according to the principles of constant comparative analysis. Results GPs recognise the importance of an adequate explanation of the diagnosis of MUS but often feel incapable of being able to explain it clearly to their patients. GPs therefore indicate that they try to reassure patients in non-specific ways, for example by telling patients that there is no disease, by using metaphors and by normalizing the symptoms. When patients keep returning with MUS, GPs report the importance of maintaining the doctor-patient relationship. GPs describe three different models to do this; mutual alliance characterized by ritual care (e.g. regular physical examination, regular doctor visits with approval of the patient and the doctor, ambivalent alliance characterized by ritual care without approval of the doctor and non-alliance characterized by cutting off all reasons for encounter in which symptoms are not of somatic origin. Conclusion GPs feel difficulties in explaining the symptoms. GPs report that, when patients keep presenting with MUS, they focus on maintaining the doctor-patient relationship by using ritual care. In this care they meticulously balance between maintaining a good doctor-patient relationship and the prevention of unintended consequences of unnecessary interventions.

  17. [Unravelling medical leadership].

    Science.gov (United States)

    Voogt, Judith J; van Rensen, Elizabeth L J; Noordegraaf, Mirko; Schneider, Margriet M E

    2015-01-01

    Medical leadership is a popular topic in the Netherlands, and several interest groups now incorporate medical leadership into postgraduate medical education. However, there is no consensus on what this concept entails. By conducting a discourse analysis, a qualitative method which uses language and text to reveal existing viewpoints, this article reveals three perspectives on medical leadership: administrative leadership, leadership within organisations and leadership within each doctor's daily practice. Text analysis shows that the first two perspectives refer to medical leadership mainly in a defensive manner: by demonstrating medical leadership doctors could 'take the lead' once again; patient care only seems to play a small part in the process. These perspectives are not free of consequences, they will determine how the medical profession is constructed. For this reason, it is argued that there should be more emphasis on the third perspective, in which the quality of care for patients is of primary importance.

  18. Central model predictive control of a group of domestic heat pumps, case study for a small district

    NARCIS (Netherlands)

    van Leeuwen, Richard Pieter; Fink, J.; Smit, Gerardus Johannes Maria; Helfert, Markus; Krempels, Karl-Heinz; Donnellan, Brian; Klein, Cornel

    2015-01-01

    In this paper we investigate optimal control of a group of heat pumps. Each heat pump provides space heating and domestic hot water to a single household. Besides a heat pump, each house has a buffer for domestic hot water and a floor heating system for space heating. The paper describes models and

  19. Ethnocultural Groups--The Making of Canada: Economic Contributions to Canadian Life. Report 2: Seven Successful Small Business Entrepreneurs.

    Science.gov (United States)

    Dutt, S.; And Others

    Immigrants and refugees come to Canada for many reasons and are often risk-takers. Some ethnic groups follow identifiable patterns of distinctive economic development, while others meld and blend into Canadian society so that no discernible pattern can be identified. This publication provides an overview of the contributions made by seven…

  20. [Benefits of cisplatin-based polychemotherapy in non-small cell bronchogenic carcinoma. Kyushu Lung Cancer Chemotherapy Study Group].

    Science.gov (United States)

    Ohta, M; Hara, N; Ichikawa, Y; Kanda, T; Shima, K; Tamura, K; Hokama, M

    1988-06-01

    We studied the efficacy of cisplatin-based polychemotherapy for non-small-cell lung cancer. One hundred nineteen patients with adenocarcinoma or large cell carcinoma were randomized to receive cyclophosphamide, adriamycin, cisplatin and mitomycin C (CAPM) or mitomycin C, cytosine arabinoside and tegafur (MCT), and 48 patients with squamous cell carcinoma were randomized to receive cisplatin, adriamycin and peplomycin (PAP) or mitomycin C, cyclophosphamide, tespamine, toyomycin and tegafur (MCTTT). Radiation was given to the chest in patients with stage I-III disease. The response rates were CAPM, 34.5%; MCT, 13.1% (p less than 0.01) and PAP, 63.3%; MCTTT, 42.3%. A significant difference in response rate between the CAPM and MCT regimens was observed only in stage IV patients and not in stage I-III patients. The median survival was 9.5 months in the CAPM arm vs. 6.5 months in the MCT arm (p less than 0.007), and 8.5 months in the PAP arm vs. 6.5 months in the MCTTT arm. Improved median survival for the CAPM regimen was noted only in stage IV patients and not in stage I-III patients when compared to patients given the MCT regimen, respectively. Nausea and vomiting were significantly increased in patients with cisplatin-based polychemotherapy. Myelosuppression was more severe with the CAPM regimen than with the other chemotherapy regimens. We concluded that cisplatin-based polychemotherapy, CAPM and PAP therapy were of more benefit to patients with disseminated non-small-cell lung cancer than MCT and MCTTT therapy.

  1. Off-label use of medical products in radiation therapy: Summary of the Report of AAPM Task Group No. 121

    International Nuclear Information System (INIS)

    Thomadsen, Bruce R.; Thompson, Heaton H. II; Jani, Shirish K.

    2010-01-01

    Medical products (devices, drugs, or biologics) contain information in their labeling regarding the manner in which the manufacturer has determined that the products can be used in a safe and effective manner. The Food and Drug Administration (FDA) approves medical products for use for these specific indications which are part of the medical product's labeling. When medical products are used in a manner not specified in the labeling, it is commonly referred to as off-label use. The practice of medicine allows for this off-label use to treat individual patients, but the ethical and legal implications for such unapproved use can be confusing. Although the responsibility and, ultimately, the liability for off-label use often rests with the prescribing physician, medical physicists and others are also responsible for the safe and proper use of the medical products. When these products are used for purposes other than which they were approved, it is important for medical physicists to understand their responsibilities. In the United States, medical products can only be marketed if officially cleared, approved, or licensed by the FDA; they can be used if they are not subject to or specifically exempt from FDA regulations, or if they are being used in research with the appropriate regulatory safeguards. Medical devices are either cleared or approved by FDA's Center for Devices and Radiological Health. Drugs are approved by FDA's Center for Drug Evaluation and Research, and biological products such as vaccines or blood are licensed under a biologics license agreement by FDA's Center for Biologics Evaluation and Research. For the purpose of this report, the process by which the FDA eventually clears, approves, or licenses such products for marketing in the United States will be referred to as approval. This report summarizes the various ways medical products, primarily medical devices, can legally be brought to market in the United States, and includes a discussion of the

  2. Off-label use of medical products in radiation therapy: Summary of the Report of AAPM Task Group No. 121

    Energy Technology Data Exchange (ETDEWEB)

    Thomadsen, Bruce R.; Thompson, Heaton H. II; Jani, Shirish K. [Department of Medical Physics, University of Wisconsin, Madison, Wisconsin 53705 (United States); Hagerstown, Maryland 21740 (United States); and others

    2010-05-15

    Medical products (devices, drugs, or biologics) contain information in their labeling regarding the manner in which the manufacturer has determined that the products can be used in a safe and effective manner. The Food and Drug Administration (FDA) approves medical products for use for these specific indications which are part of the medical product's labeling. When medical products are used in a manner not specified in the labeling, it is commonly referred to as off-label use. The practice of medicine allows for this off-label use to treat individual patients, but the ethical and legal implications for such unapproved use can be confusing. Although the responsibility and, ultimately, the liability for off-label use often rests with the prescribing physician, medical physicists and others are also responsible for the safe and proper use of the medical products. When these products are used for purposes other than which they were approved, it is important for medical physicists to understand their responsibilities. In the United States, medical products can only be marketed if officially cleared, approved, or licensed by the FDA; they can be used if they are not subject to or specifically exempt from FDA regulations, or if they are being used in research with the appropriate regulatory safeguards. Medical devices are either cleared or approved by FDA's Center for Devices and Radiological Health. Drugs are approved by FDA's Center for Drug Evaluation and Research, and biological products such as vaccines or blood are licensed under a biologics license agreement by FDA's Center for Biologics Evaluation and Research. For the purpose of this report, the process by which the FDA eventually clears, approves, or licenses such products for marketing in the United States will be referred to as approval. This report summarizes the various ways medical products, primarily medical devices, can legally be brought to market in the United States, and includes a

  3. COMPARISON OF MEDICAL COSTS AND CARE OF APPENDECTOMY PATIENTS BETWEEN FEE-FOR-SERVICE AND SET FEE FOR DIAGNOSIS-RELATED GROUP SYSTEMS IN 20 CHINESE HOSPITALS.

    Science.gov (United States)

    Zhang, Yin-hua; He, Guo-ping; Liu, Jing-wei

    2016-09-01

    The objective of this study was to compare the fee-for-service and set fee for diagnosis-related group systems with regard to quality of medical care and cost to appendectomy patients. We conducted a retrospective study of 208 inpatients (from 20 hospitals) who undergone appendectomy in Changsha, China during 2013. Data were obtained from databases of medical insurance information systems directly connected to the hospital information systems. We collected and compared patient ages, length of study, and total medical costs for impatient appendectomies between patients using fee-for-service and set fee for diagnosisrelated group systems. One hundred thirty-three patients used the fee for service system and 75 used the set fee diagnosis related group system. For those using the diagnosis-related group system, the mean length of hospitalization (6.2 days) and mean number of prescribed antimicrobials (2.4) per patient were significantly lower than those of the patients who used the fee-for-service system (7.3 days and 3.0, respectively; p = 0.018; p < 0.05) and were accompanied by lower medical costs and cost of antimicrobials (RMB 2,518 versus RMB 4,484 and RMB476 versus RMB1,108, respectively; p = 0.000, p = 0.000). There were no significant differences in post-surgical complications between the two systems. The diagnosis-related group system had significantly medical costs for appendectomy compared to the fee-for-service system, without sacrificing quality of medical care.

  4. Primary social and emotional aspects of learning (SEAL small group interventions: a qualitative study of factors affecting implementation and the role of Local Authority support

    Directory of Open Access Journals (Sweden)

    Neil Humphrey

    2009-11-01

    Full Text Available The aims of the current study were to examine the factors affecting implementation of social and emotional aspects of learning (SEAL small group interventions in primary schools and to explore the role of support from Local Authorities (LAs in the implementation process. Telephone interviews were conducted with lead SEAL staff in 12 LAs across England as part of a larger national evaluation of this educational initiative. Data were transcribed and subjected to qualitative content analysis. Subsequently, a tentative model was developed to document the relationship between the nature of support provided by LAs (e.g. training events, developing/providing additional materials, factors affecting implementation at school level (e.g. school readiness, the profile of SEAL and perceived barriers to success (e.g. misconceptions about the purpose of small group interventions. These findings are discussed in relation to the existing literature on the implementation of social-emotional initiatives and interventions in education.

  5. Study of the Knowledge, Attitude and Experience of Medical Tourism Among Target Groups with Special Emphasis on South India

    OpenAIRE

    A, Rajeev; Latif, Sanam

    2009-01-01

    Medical tourism aims at providing cost-effective customized health care in collaboration with the tourism industry in distant locations wherein the hospitality component is handled efficiently so that fixing appointments, making arrangements for accommodation and other logistics become hassle-free for the patient. This allows more concentration on the procedure at hand and the interaction between the medical fraternity and the patient becomes smoother. More and more hospitals in India are gea...

  6. Development of partitioning method: confirmation of behavior of technetium in 4-Group Partitioning Process by a small scale experiment

    International Nuclear Information System (INIS)

    Morita, Yasuji; Yamaguchi, Isoo; Fujiwara, Takeshi; Kubota, Masumitsu; Mizoguchi, Kenichi

    1998-08-01

    The separation behavior of Tc in the whole of 4-Group Partitioning Process was examined by a flask-scale experiment using simulated high-level liquid waste containing a macro amount of Tc, in order to confirm the reproducibility of the results obtained in previous studies on the Tc behavior at each step of the process. The 4-Group Partitioning Process consists of pre-treatment step, extraction step with diisodecylphosphoric acid (DIDPA), adsorption step with active carbon or precipitation step by denitration for the separation of Tc and platinum group metals (PGM), and adsorption step with inorganic ion exchangers. The present study deals with the behavior of Tc and other elements at all the above steps and additional step for Tc dissolution from the precipitate formed by the denitration. At the pre-treatment step, the ratio of Tc precipitated was very low (about 0.2%) at both operations of heating-denitration and colloid removal. Tc was not extracted with DIDPA and was contained quantitatively in the raffinate from the extraction step. Batch adsorption with active carbon directly from the raffinate showed that distribution coefficient of Tc was more than 100ml/g, which is high enough for the separation. It also revealed much effect of coexisting Mo on the Tc adsorption. At the precipitation step by denitration, 98.2% of Tc were precipitated. At the Tc dissolution from the precipitate with H 2 O 2 , 84.2% of Tc were selectively dissolved in a single operation. Tc was not adsorbed with inorganic ion exchangers. From these results, composition of Tc product from the partitioning process was estimated. The weight ratio of Tc in the Tc product can be increased to about 50% at least. Main contaminating elements are Cr, Ni, Sr, Ba, Mo and Pd. Process optimization to decrease their contamination should be performed in a next study. (J.P.N.)

  7. The rate of spread of sheep scab within small groups of Merino and Dorper sheep : short communication

    Directory of Open Access Journals (Sweden)

    T. Meintjies

    2002-07-01

    Full Text Available A single Merino sheep, artificially infested with the sheep scab mite, Psoroptes ovis, and a similarly infested Dorper sheep were placed with 9 uninfested Merino or 9 uninfested Dorper sheep respectively during winter and the rate of spread of infestation on the uninfested sheep observed. The same procedure was repeated in summer. It took 14 and 8 weeks respectively in winter before all sheep in the 2 groups displayed lesions of sheep scab, whereas in summer it took 10 and 12 weeks before all sheep had lesions.

  8. Medical Fitness for Expeditionary Missions: A NATO Guide for Assessing Deployability for Military Personnel with Medical Conditions. Task Group 174, Human Factors and Medicine Panel

    Science.gov (United States)

    2013-07-30

    personnel subjected to barometric pressure changes (i.e. pilots, divers, HALO jumpers) 3. No evidence of active periodontal disease that is beyond control...by self-care 4. No periodontally involved teeth with untreated associated apical involvement. When treated, teeth show both clinical and...tuberculoma). Latent Tuberculosis Has a Small Risk of Becoming Active Tuberculosis “Latent tuberculosis” refers to a person with live TB bacteria in

  9. Prevalence of somatoform disorders and medically unexplained symptoms in old age populations in comparison with younger age groups : A systematic review

    NARCIS (Netherlands)

    Hilderink, P. H.; Collard, R.; Rosmalen, J. G. M.; Voshaar, R. C. Oude

    Objective: To review current knowledge regarding the prevalence of somatization problems in later life by level of caseness (somatoform disorders and medically unexplained symptoms, MUS) and to compare these rates with those in middle-aged and younger age groups. Method: A systematic search of the

  10. The diagnostic suitability of a xerostomia questionnaire and the association between xerostomia, hyposalivation and medication use in a group of nursing home residents

    NARCIS (Netherlands)

    Putten, Gerard van der; Brand, H.S.; Schols, J.M.; Baat, C. de

    2011-01-01

    The study objective was to explore the diagnostic suitability of the Xerostomia Inventory and the association between xerostomia, hyposalivation and medication use in a group of nursing home residents. A cross-sectional study was carried out in 50 physically impaired nursing home residents (20 men)

  11. Eight years' experience with a Medical Education Journal Club in Mexico: a quasi-experimental one-group study.

    Science.gov (United States)

    Sánchez-Mendiola, Melchor; Morales-Castillo, Daniel; Torruco-García, Uri; Varela-Ruiz, Margarita

    2015-12-14

    A time-honored strategy for keeping up to date in medicine and improving critical appraisal skills is the Journal Club (JC). There are several reports of its use in medicine and allied health sciences but almost no reports of JC focused on medical education. The purpose of the study is to describe and evaluate an eight years' experience with a medical education Journal Club (MEJC). We started a monthly medical education JC in 2006 at UNAM Faculty of Medicine in Mexico City. Its goal is to provide faculty with continuing professional development in medical education. A discussion guide and a published paper were sent 2 weeks before sessions. We reviewed the themes and publication types of the papers used in the sessions, and in June-July 2014 administered a retrospective post-then-pre evaluation questionnaire to current participants that had been regular attendees to the JC for more than 2 years. The retrospective post-then-pre comparisons were analyzed with Wilcoxon signed-rank test. Effect sizes were calculated for the pre-post comparisons with Cohen's r. There have been 94 MEJC sessions until July 2014. Average attendance is 20 persons, a mix of clinicians, educators, psychologists and a sociologist. The articles were published in 32 different journals, and covered several medical education themes (curriculum, faculty development, educational research methodology, learning methods, assessment, residency education). 22 Attendees answered the evaluation instrument. The MEJC had a positive evaluation from good to excellent, and there was an improvement in self-reported competencies in medical education literature critical appraisal and behaviors related to the use of evidence in educational practice, with a median effect size higher than 0.5. The evaluation instrument had a Cronbach's alpha of 0.96. A periodic Medical Education Journal Club can improve critical appraisal of the literature, and be maintained long-term using evidence-based strategies. This activity

  12. Lifting the mask: identification of new small molecule inhibitors of uropathogenic Escherichia coli group 2 capsule biogenesis.

    Directory of Open Access Journals (Sweden)

    Carlos C Goller

    Full Text Available Uropathogenic Escherichia coli (UPEC is the leading cause of community-acquired urinary tract infections (UTIs, with over 100 million UTIs occurring annually throughout the world. Increasing antimicrobial resistance among UPEC limits ambulatory care options, delays effective treatment, and may increase overall morbidity and mortality from complications such as urosepsis. The polysaccharide capsules of UPEC are an attractive target a therapeutic, based on their importance in defense against the host immune responses; however, the large number of antigenic types has limited their incorporation into vaccine development. The objective of this study was to identify small-molecule inhibitors of UPEC capsule biogenesis. A large-scale screening effort entailing 338,740 compounds was conducted in a cell-based, phenotypic screen for inhibition of capsule biogenesis in UPEC. The primary and concentration-response assays yielded 29 putative inhibitors of capsule biogenesis, of which 6 were selected for further studies. Secondary confirmatory assays identified two highly active agents, named DU003 and DU011, with 50% inhibitory concentrations of 1.0 µM and 0.69 µM, respectively. Confirmatory assays for capsular antigen and biochemical measurement of capsular sugars verified the inhibitory action of both compounds and demonstrated minimal toxicity and off-target effects. Serum sensitivity assays demonstrated that both compounds produced significant bacterial death upon exposure to active human serum. DU011 administration in mice provided near complete protection against a lethal systemic infection with the prototypic UPEC K1 isolate UTI89. This work has provided a conceptually new class of molecules to combat UPEC infection, and future studies will establish the molecular basis for their action along with efficacy in UTI and other UPEC infections.

  13. Recovery or removal of uranium contained in small quantity in waste water by tannic-group adsorbent

    Energy Technology Data Exchange (ETDEWEB)

    Komoto, Shigetoshi [Power Reactor and Nuclear Fuel Development Corp., Kamisaibara, Okayama (Japan). Ningyo Toge Works

    1991-12-01

    It was found that tannic compounds have a very strong affinity for uranium and thorium which are nuclear fuel materials, and the new uranium adsorbents composed mainly by tannic-group compounds were made. The solid-state refractory persimmon tannins in those compounds has the most superior capacity for uranium as high as 1.7 g of uranium on 1 g of the adsorbent. The tests adsorbing uranium on the adsorbent are carried out practically by using dam water of Ningyo-toge Works, PNC. Adsorption tests changed the pH or temperature of dam water, elution test, and adsorption-elution repeating test were performed, and it was found that uranium in dam water contained from ppb-level to ppm-level was recovered or removed with very excellent efficiency. (author).

  14. Physical Function After Total Knee Replacement: An Observational Study Describing Outcomes in a Small Group of Women From China and the United States.

    Science.gov (United States)

    White, Daniel K; Li, Zhichang; Zhang, Yuqing; Marmon, Adam R; Master, Hiral; Zeni, Joseph; Niu, Jingbo; Jiang, Long; Zhang, Shu; Lin, Jianhao

    2018-01-01

    To describe physical function before and six months after Total Knee Replacement (TKR) in a small sample of women from China and the United States. Observational. Community environment. Both groups adhered to the Osteoarthritis Research Society International (OARSI) protocols for the 6-minute walk and 30-second chair stand. We compared physical function prior to TKR and 6 months after using linear regression adjusted for covariates. Women (N=60) after TKR. Not applicable. Age and body mass index in the China group (n=30; 66y and 27.0kg/m 2 ) were similar to those in the U.S. group (n=30; 65y and 29.6kg/m 2 ). Before surgery, the China group walked 263 (95% confidence interval [CI], -309 to -219) less meters and had 10.2 (95% CI, -11.8 to -8.5) fewer chair stands than the U.S. group. At 6 months when compared with the U.S. group, the China group walked 38 more meters, but this difference did not reach statistical significance (95% CI, -1.6 to 77.4), and had 3.1 (95% CI, -4.4 to -1.7) fewer chair stands. The China group had greater improvement in the 6-minute walk test than did the U.S. group (PChina group had greater gains in walking endurance and similar gains in repeated chair stands than did the U.S. group after surgery. Copyright © 2017 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

  15. Small-group, computer-mediated argumentation in middle-school classrooms: the effects of gender and different types of online teacher guidance.

    Science.gov (United States)

    Asterhan, Christa S C; Schwarz, Baruch B; Gil, Julia

    2012-09-01

    Research has shown the importance of careful teacher support during collaborative group work to promote productive discourse between students (Webb, 2009). However, this research has traditionally focused on face-to-face communication. The role of online teacher guidance of small-group computer-mediated discussions has received little attention, especially in secondary school classroom settings. Researchers of computer-supported collaborative learning (CSCL), on the other hand, have traditionally focused on software-embedded features, such as scripts, to support a-synchronous peer dialogue, and less so on human guidance of synchronous group discussions. The main aim of the present in vivo, experimental study is to examine whether online teacher guidance can improve the quality of small-group synchronous discussions, and whether different types of guidance (epistemic or interaction guidance) affect these discussions differently, when compared to an unguided condition. The second goal of this study is to explore potential differences between all-female and all-male discussion groups. Eighty-two 9th graders (three classrooms) and six teachers from a rural high school in Israel. Whereas epistemic guidance only improved aspects of the argumentative quality of the discussion, interaction guidance only improved aspects of collaboration. Discussions of all-girls groups scored higher on aspects of collaboration and argumentative quality, compared to all-boys groups. The findings show that teacher guidance of synchronous, online discussions in classrooms is realizable and reasonably reaches its intended goals. Training should be focused on acquiring various guidance strategies to augment their beneficial effects. Furthermore, future research should pay more attention to potential gender differences in peer-to-peer argumentation. ©2011 The British Psychological Society.

  16. Thermal properties of some small peptides (N-acetyl-amino acid-N′-methylamides) with non-polar side groups

    International Nuclear Information System (INIS)

    Badea, Elena; Della Gatta, Giuseppe; Pałecz, Bartłomiej

    2014-01-01

    Highlights: • T fus and Δ fus H m of methylamides of N-acetyl substituted non-polar amino acids were measured. • T fus and Δ fus H m increased as a function of the molar mass of the alkyl side chains. • DL racemates showed T fus of about 40 °C lower than those of the corresponding pure L enantiomers. • Ideal solubility of solids at T = 298.15 K was estimated based on their T fus and Δ fus S m . - Abstract: Temperatures and molar enthalpies of fusion of a series of uncharged small peptides, namely the methylamides of N-acetyl substituted glycine, α-amino-butyric acid, alanine, valine, norvaline, leucine, isoleucine, norleucine, and proline, were measured by differential scanning calorimetry (d.s.c.), and molar entropies of fusion were derived. Both L- and DL-compunds were taken into account for the chiral molecules. No solid-to-solid transitions were detected from room temperature to fusion except for N-acetyl-N′-methyl alaninamide. Comparisons were made with the values for the N-acetyl amides of the corresponding amino acids previously reported. Both L enantiomers and DL racemates of α-aminobutyric acid, alanine, valine and isoleucine methylamides displayed temperatures of fusion sharply increasing as a function of molar mass, whereas much lower values, in countertendency with their molar mass increase, were found for proline and leucine methylamides. The racemic DL crystals showed temperatures of fusion of about 40 °C lower than those of the corresponding pure L enantiomers, except for proline and leucine derivatives. The enthalpies and entropies of fusion also varied as a function of molar mass following a similar trend with that of temperatures of fusion, except for alanine derivatives which showed lower values than expected. The values of ideal solubility of solids at T = 298.15 K were estimated based on their temperatures and molar entropies of fusion. Results were discussed with reference to the packing patterns based on hydrogen bonding and

  17. Data Decision and Drug Therapy Based on Non-Small Cell Lung Cancer in a Big Data Medical System in Developing Countries

    Directory of Open Access Journals (Sweden)

    Jia Wu

    2018-05-01

    Full Text Available In many developing or underdeveloped countries, limited medical resources and large populations may affect the survival of mankind. The research for the medical information system and recommendation of effective treatment methods may improve diagnosis and drug therapy for patients in developing or underdeveloped countries. In this study, we built a system model for the drug therapy, relevance parameter analysis, and data decision making in non-small cell lung cancer. Based on the probability analysis and status decision, the optimized therapeutic schedule can be calculated and selected, and then effective drug therapy methods can be determined to improve relevance parameters. Statistical analysis of clinical data proves that the model of the probability analysis and decision making can provide fast and accurate clinical data.

  18. Macro and Micro-Nutrients Intake, Food Groups Consumption and Dietary Habits among Female Students in Isfahan University of Medical Sciences.

    Science.gov (United States)

    Azadbakht, L; Esmaillzadeh, A

    2012-04-01

    Improving the dietary intake among different groups and population is important for improving the health status. This study determines the nutrients and food group intake as well as dietary habits among female students in Isfahan University of Medical Sciences. Two hundreds and eighty nine healthy female youths who were randomly selected among students of Isfahan University of Medical Sciences in Isfahan, Iran were enrolled. A validated semi quantitative food frequency questionnaire was used. Folate, iron, calcium and fiber intake were lower than the recommended dietary allowances (RDA) amounts (70, 76, 90, 56% of RDA, respectively). Forty five percent of the population consumed fast foods 2 times a week and 35% used the frying oils for cooking most of the time. Female youths had lower amount of some micronutrients. Consuming frying oils, hydrogenated vegetable oils, and fast food intake should be limited among this group.

  19. Awareness of preventive medication among women at high risk for breast cancer and their willingness to consider transdermal or oral tamoxifen: a focus group study

    International Nuclear Information System (INIS)

    Karavites, Lindsey C.; Allu, Subhashini; Khan, Seema A.; Kaiser, Karen

    2015-01-01

    Despite demonstrated efficacy, acceptance of selective estrogen receptor modulators (SERMs), such as tamoxifen, for breast cancer risk reduction remains low. Delivering SERMs via local transdermal therapy (LTT) could significantly reduce systemic effects and therefore may increase acceptance. We aim to assess women’s knowledge of breast cancer prevention medications and views on LTT of SERMs. Focus groups were conducted with healthy women identified through the comprehensive breast center of a large urban cancer institution. Group discussions covered risk perceptions, knowledge of and concerns about risk reducing medications. Participants reported their perceived risk for breast cancer (average, below/above average), preference for SERMs in a pill or gel form, risk factors, and prior physician recommendations regarding risk-reducing medicines. Participants’ breast cancer risk was estimated using tools based on the Gail Model. Trained personnel examined all qualitative results systematically; risk perceptions and preferred method of medication delivery were tallied quantitatively. Four focus groups (N = 32) were conducted. Most participants had at least a college degree (78.2 %) and were of European (50 %) or African ancestry (31 %). The majority (72 %) were at elevated risk for breast cancer; approximately half of these women perceived themselves to be at elevated risk. Few participants had prior knowledge of preventive medications. The women noted a number of concerns about LTT, including dosage, impact on day-to-day life, and side effects; nonetheless, over 90 % of the women stated they would prefer LTT to a pill. Awareness of preventive medications was low even in a highly educated sample of high-risk women. If given a choice in the route of administration, most women preferred a gel to a pill, anticipating fewer side effects. Future work should focus on demonstrating equivalent efficacy and reduced toxicity of topical over oral medications and on raising

  20. Awareness of preventive medication among women at high risk for breast cancer and their willingness to consider transdermal or oral tamoxifen: a focus group study.

    Science.gov (United States)

    Karavites, Lindsey C; Allu, Subhashini; Khan, Seema A; Kaiser, Karen

    2015-11-09

    Despite demonstrated efficacy, acceptance of selective estrogen receptor modulators (SERMs), such as tamoxifen, for breast cancer risk reduction remains low. Delivering SERMs via local transdermal therapy (LTT) could significantly reduce systemic effects and therefore may increase acceptance. We aim to assess women's knowledge of breast cancer prevention medications and views on LTT of SERMs. Focus groups were conducted with healthy women identified through the comprehensive breast center of a large urban cancer institution. Group discussions covered risk perceptions, knowledge of and concerns about risk reducing medications. Participants reported their perceived risk for breast cancer (average, below/above average), preference for SERMs in a pill or gel form, risk factors, and prior physician recommendations regarding risk-reducing medicines. Participants' breast cancer risk was estimated using tools based on the Gail Model. Trained personnel examined all qualitative results systematically; risk perceptions and preferred method of medication delivery were tallied quantitatively. Four focus groups (N = 32) were conducted. Most participants had at least a college degree (78.2 %) and were of European (50 %) or African ancestry (31 %). The majority (72 %) were at elevated risk for breast cancer; approximately half of these women perceived themselves to be at elevated risk. Few participants had prior knowledge of preventive medications. The women noted a number of concerns about LTT, including dosage, impact on day-to-day life, and side effects; nonetheless, over 90 % of the women stated they would prefer LTT to a pill. Awareness of preventive medications was low even in a highly educated sample of high-risk women. If given a choice in the route of administration, most women preferred a gel to a pill, anticipating fewer side effects. Future work should focus on demonstrating equivalent efficacy and reduced toxicity of topical over oral medications and on raising