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Sample records for small group medical

  1. 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.

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

    Science.gov (United States)

    Meo, Sultan Ayoub

    2013-01-01

    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. PMID:24353692

  3. PBL curriculum improves medical students' participation in small-group tutorials.

    Science.gov (United States)

    Wun, Y T; Tse, Eileen Y Y; Lam, T P; Lam, Cindy L K

    2007-09-01

    Group learning is the core of problem-based learning (PBL) but has not been extensively studied, especially in Asian students. This study compared students of PBL and non-PBL curricula in students' talking time and participation in small-group tutorials in a medical school in Asia. The proportions of student talking of 46 tutorials in three teaching rotations of the PBL curriculum and those of 43 corresponding tutorials in the non-PBL curriculum were counted. Twelve videotapes of tutorials (six from each curriculum), stratified for tutor, case scenario and students' learning stage, were randomly selected and transcribed. They were rated with the group-interaction (5 items) and active-participation (four items) tutorial assessment scales developed by Valle et al. These outcomes were compared between the students of PBL and non-PBL curricula. Students from the PBL curriculum talked significantly more. In only two (4.7%) of 43 tutorials in the non-PBL curriculum did the students talk more than the tutors; but students talked more than the tutors in 17 (37.0%) of 46 tutorials in the PBL curriculum. PBL students scored significantly higher than non-PBL students in all items except one item (respect to peers) of the tutorial assessment scales, and in the mean scores of both the group interaction scale (items 1-5) and the active participation scale (items 6-9). The results suggested that PBL starting from the early years of a medical curriculum was associated with more active student participation, interaction and collaboration in small-group tutorials.

  4. 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.

  5. Problem-based, small-group tutorial learning in clinical neurology for second-year medical students.

    Science.gov (United States)

    Yu, H Y; Wu, Z A; Su, M S; Yen, D J; Luk, H R; Chao, Y C; Liao, K K; Lin, K P; Yu, S M; Liu, H C

    2000-08-01

    Problem-based learning (PBL) in small-group tutorials has been a trend in medical education. Chinese students are known to be reserved and passive; thus, they may not be adaptable to PBL. Neuroanatomy, important to clinical neurology, is difficult to learn. We incorporated clinical neurology with PBL, complementary to the traditional neuroanatomy curriculum, to evaluate the feasibility of PBL for Chinese students in Taiwan. Forty-two second-year medical students and seven tutors participated in the clinical neurology PBL small-group tutorials. Twelve case reports were discussed weekly beginning in February, 1999. Each case was designed to meet the progressive curriculum of the neuroanatomy course. The tutors evaluated the students by the degree of their preparation, participation, key-point comprehension and interaction. All tutors and students filled out questionnaires at the end of each session. The majority of the students and tutors agreed that the case materials were clearly written. Ninety percent of the students agreed that the case materials matched the traditional content of neuroanatomy. Eighty-five percent of students and 71% of tutors were satisfied and found the class rewarding. Ninety-one percent of students and 74% of tutors were in favor of PBL being continued. This preliminary PBL, small-group tutorial learning in clinical neurology showed satisfactory results and was, indeed, complementary to a traditional neuroanatomy course. The students, as early as during the second year of their medical school education, were able to learn through the PBL. More integration of basic and clinical sciences by PBL may be considered in future curricula designs.

  6. Small Group Learning in Medical Education: A Second Look at the Springer, Stanne, and Donovan Meta-Analysis.

    Science.gov (United States)

    Colliver, Jerry A.; Feltovich, Paul J.; Verhulst, Steven J.

    2003-01-01

    Reviews the studies on which a meta-analysis by Springer, Stanne, and Donovan (1999) were based; the meta-analysis had concluded that small group learning in science, mathematics, engineering, and technology education is effective. Concludes that the meta-analysis' call for more widespread implementation of small group learning is not supported.…

  7. [Acquisition of skills in medical ethics in learning-teaching small groups. Comparing problem-based learning with the traditional model].

    Science.gov (United States)

    Figueira, Eliandro José Gutierres; Cazzo, Everton; Tuma, Paula; Silva Filho, Carlos Rodrigues da; Conterno, Lucieni de Oliveira

    2004-01-01

    Aiming to evaluate the acquisition of skills on Medical Ethics among medical students from Marilia Medical School, some of them from the small group learning-teaching method, others from traditional teaching method. A prospective analytical study was done based on the application of questionnaires about general themes on Ethics, at two different times. There weren't significant differences on the skills' acquisition between the two methods. Students from late graduation years showed a significantly better performance than those from early years. The themes that presented worse results were medical secret, legal responsible consent, patient autonomy, medical prescription, medical handbook and corporative feeling in the presence of medical mistake. The most important difference between the groups was not the pedagogical pattern but the exposition time to the theme. PBL gives the chance to distribute the theme in different situations accelerating the acquisition of knowledge in Medical Ethics. It was realized that a revitalization on Medical Ethics teaching is necessary at our institution, aiming a better integration with the socio-economical situation in our country.

  8. 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.

  9. Contextualizing the relevance of basic sciences: small-group simulation with debrief for first- and second-year medical students in an integrated curriculum

    Directory of Open Access Journals (Sweden)

    Ginzburg SB

    2017-01-01

    Full Text Available Samara B Ginzburg,1 Judith Brenner,1 Michael Cassara,2 Thomas Kwiatkowski,1 Joanne M Willey,1 1Department of Science Education, Hofstra Northwell School of Medicine, Hempstead, 2Department of Emergency Medicine, Northwell Health, Great Neck, NY, USA Aim: There has been a call for increased integration of basic and clinical sciences during ­preclinical years of undergraduate medical education. Despite the recognition that clinical simulation is an effective pedagogical tool, little has been reported on its use to demonstrate the relevance of basic science principles to the practice of clinical medicine. We hypothesized that simulation with an integrated science and clinical debrief used with early learners would illustrate the importance of basic science principles in clinical diagnosis and management of patients.  Methods: Small groups of first -and second-year medical students were engaged in a high-fidelity simulation followed by a comprehensive debrief facilitated by a basic scientist and clinician. Surveys including anchored and open-ended questions were distributed at the conclusion of each experience.  Results: The majority of the students agreed that simulation followed by an integrated debrief illustrated the clinical relevance of basic sciences (mean ± standard deviation: 93.8% ± 2.9% of first-year medical students; 96.7% ± 3.5% of second-year medical students and its importance in patient care (92.8% of first-year medical students; 90.4% of second-year medical students. In a thematic analysis of open-ended responses, students felt that these experiences provided opportunities for direct application of scientific knowledge to diagnosis and treatment, improving student knowledge, simulating real-world experience, and developing clinical reasoning, all of which specifically helped them understand the clinical relevance of basic sciences.  Conclusion: Small-group simulation followed by a debrief that integrates basic and clinical

  10. 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.

  11. 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

  12. Small Group Multitasking in Literature Classes

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    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…

  13. Affect and Engagement during Small Group Instruction

    Science.gov (United States)

    Linnenbrink-Garcia, Lisa; Rogat, Toni Kempler; Koskey, Kristin L. K.

    2011-01-01

    Two studies (Study 1: n = 137; Study 2: n = 192) were conducted to investigate how upper-elementary students' affect during small group instruction related to their social-behavioral engagement during group work. A circumplex model of affect consisting of valence (positive, negative) and activation (high, low) was used to examine the relation of…

  14. 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 ...

  15. Measuring the culture of medical group practices.

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    Kralewski, John; Dowd, Bryan E; Kaissi, Amer; Curoe, Ann; Rockwood, Todd

    2005-01-01

    To develop an instrument that can be used to assess the organizational culture of medical group practices. Study participants were primary care physicians in 267 medical group practices. The iterative process began in Minnesota and then expanded to practices in 21 other states. Practice culture statements were collected using questionnaires distributed at a national medical group practice meeting and mailed questionnaires sent to a broader set of participants identified by the Medical Group Management Association. Using a framework developed earlier, physicians in medical groups were asked to react to statements that described the basic assumptions and patterns of behavior characteristic of their practices. An iterative process involving over 500 physicians in 267 practices was used to identify and refine statements. Factor analysis was used to group the statements into cohesive cultural dimensions. Thirty-nine statements correlated with nine cultural dimensions were identified and a test of this instrument found that it successfully identified differences in the cultures of medical groups. Although there is increasing agreement that the culture of medical group practices is one of the most important factors influencing the cost and quality of care, efforts to understand and manage these cultures have been hampered by the lack of a measurement instrument. This article presents an instrument that has broad face validity in the group practice field and successfully differentiates the cultures of different types of practices.

  16. 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...

  17. 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.

  18. Volunteer patients and small groups contribute to abdominal examination's success

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    Shields HM

    2017-11-01

    Full Text Available Helen M Shields,1 Nielsen Q Fernandez-Becker,2 Sarah N Flier,2 Byron P Vaughn,2 Melissa H Tukey,2 Stephen R Pelletier,3 Douglas A Horst2 1Department of Medicine, Brigham and Women’s Hospital and Harvard Medical School, Boston, MA, 2Department of Medicine, Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, MA, 3Center for Evaluation, Harvard Medical School, Boston, MA, USA Background: Prior to 2007, we taught the abdominal examination in a hospital based group to 40 students, at one hospital. We used volunteer patients, small groups, repetition, and required faculty development sessions. In 2007, our medical school changed its “Introduction to Physical Examination” session so that the entire class was to be taught in a geographically central session. Our hospital was selected to lead the abdominal examination portion of the session. Aim: Our aim was to answer three questions. First, could we quadruple the recruitment of volunteer patients, and faculty? Second, was it volunteer patients, small groups, repetition, or faculty training that was most valued by the students? Third, would volunteer patients and/or faculty agree to participate a second time? Methods: A total of 43-46 patients and 43-46 faculty were recruited and 43-46 examining rooms were obtained for each of the 5 years of this study. Teachers were required to attend a 1-hour faculty development session. The class of about 170 students was divided into 43–46 groups each year. The teacher demonstrated the abdominal examination and each student practiced the examination on another student. Each student then repeated the full abdominal examination on a volunteer patient. Results: Over the 5-year time period (2008–2012, the abdominal examination ranked first among all organ systems’ “Introductory Sessions”. The abdominal examination ratings had the best mean score (1.35 on a Likert scale where 1 is excellent and 5 is poor. The students gave the most

  19. Medical group management: a marketing orientation.

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    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.

  20. 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.

  1. Using social media to support small group learning

    Directory of Open Access Journals (Sweden)

    Duncan Cole

    2017-11-01

    Full Text Available Abstract Background 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. Methods 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. Results 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. Conclusions 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.

  2. A small-group approach to teaching family medicine.

    Science.gov (United States)

    Lennox, L; Devieux, J; Huff, F; Barker, P; Arradondo, J E; Devieux, R

    1985-01-01

    The authors describe a method for teaching preclinical medical students some important family medicine concepts utilizing a seminar format which allows for improved student-teacher interaction and individualization of material. These seminars, on family health behavior, compliance, behavioral interventions for life-style change, and managing stress, were designed to encourage freshman medical students to understand and apply concepts concerning health behavior and attitudes, both personally and professionally. The format of these sessions included the use of self-assessment instruments, discussion, role play, and case studies. Results of student evaluations indicate they perceived the seminars positively. Specific areas of positive value included the content and small-group related processes. The seminars also provided data useful for developing programs for students.

  3. 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.

  4. The Role of Small Groups in Christian Adult Education.

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    Peters, Russel Marion

    Centering on a historical review and analysis of adult Christian education in small groups, this study was designed to identify certain conditions surrounding the formation and operation of selected small groups, to discover their distinctive educational features, and to suggest guidelines for effective use of the small group approach. The role of…

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

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    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

  6. Assessment Intelligence in Small Group Learning

    Science.gov (United States)

    Xing, Wanli; Wu, Yonghe

    2014-01-01

    Assessment of groups in CSCL context is a challenging task fraught with many confounding factors collected and measured. Previous documented studies are by and large summative in nature and some process-oriented methods require time-intensive coding of qualitative data. This study attempts to resolve these problems for teachers to assess groups…

  7. Orientation and Mobility Training Using Small Groups

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    Higgerty, Moira Jane; Williams, Allison Catherine

    2005-01-01

    This article describes a group training program for sighted trainee orientation and mobility (O&M) instructors in South Africa, where the need for O&M instructors is great and the availability of services is limited. The outcome was positive and encouraging and provides the initiative for the findings to be more broadly applied and for…

  8. 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?

  9. Small-Group Instruction. Theory and Practice

    Science.gov (United States)

    1974-01-01

    Resources Research Organization, Alexandria, Virginia, June 1963. Lange, Carl J., Rittenhouse, Carl H., Atkinson, Richard C. Films and Group Discussions as a...sentation or class discussion. 13. References Beckhard , R. How to Plan and Conduct Workshops and Conferences, Associated Press, New York, 1956, pp. 35-37...Harper and Bibliographic Review, Industrial Brothers, New York, 1954. Relations Center, University of Chicago, Beckhard , R. How to Plan and Conduct

  10. Increasing Social Presence in Online Learning through Small Group Discussions

    Science.gov (United States)

    Akcaoglu, Mete; Lee, Eunbae

    2016-01-01

    Social presence is difficult to achieve, but an imperative component of online learning. In this study, we investigated the effect of group size on students' perceptions of social presence in two graduate-level online courses, comparing small group versus whole class discussions. Our results indicated that when in small group discussions, students…

  11. Effectiveness of Small Group Social Skills Lessons with Elementary Students

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    Chupp, Amy I.; Boes, Susan R.

    2012-01-01

    This action research study (ARS) describes the effectiveness of small group social skills lessons with elementary students, using "Too Good for Violence: A Curriculum for Non-violent Living" by the Mendez Foundation. The school counselor and school social worker taught the curriculum in a structured small group of 4th grade students in 8…

  12. 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…

  13. Emergent Leaders and Small Groups in the EFL Classroom

    Science.gov (United States)

    Leeming, Ian Paul

    2014-01-01

    Small groups are integral for many activities in the foreign language classroom and their pedagogical importance is well established. Despite the widespread use of groups in foreign language education, there is a dearth of research investigating group processes and the impact of emergent leaders within these groups. This mixed-methods,…

  14. Hospital Contracts: Important Issues for Medical Groups.

    Science.gov (United States)

    Rosolio, Charles E

    2016-01-01

    Relationships with hospitals and outpatient medical facilities have always been an important part of the business model for private medical practices. As healthcare delivery to patients has evolved in the United States (much of it driven by the new government mandates, regulations, and the Affordable Care Act), the delivery of such services is becoming more and more centered on the hospital or institutional setting, thus making contractual relationships with hospitals even more important for medical practices. As a natural outgrowth of this relationship, attention to hospital contracts is becoming more important.

  15. Students' attitudes to small-group work in community health.

    Science.gov (United States)

    Whittaker, D E; Hoffman, M

    1987-07-01

    To encourage fourth-year medical students to review their ethnocentric attitudes to the politicized issues of population and undernutrition in South Africa, small-group work (SGW) was introduced during a month's teaching in community health at the University of Cape Town. We tested several formats for these sessions and chose one which seemed effective. This study examined the remaining students' attitudes to SGW as a means of briefly examining complex emotive topics. Sixty-nine students of a class of 168 were asked to complete a Likert questionnaire on their attitudes to SGW. Fifty-five students (79.7%) agreed that group work had allowed them to engage the topics briefly but usefully and 62 (90%) thought that the topics lent themselves to SGW. While 52 (75.3%) were not confused, 5 (7.2%) were confused by SGW. Thirty-nine students (56.5%) preferred lectures, tutorials or seminars to SGW. Thirty-seven students (53.6%) needed more fact to benefit fully from the SGW. Students found SGW appropriate for briefly examining these topics but wanted more fact to benefit fully from the sessions. The survey yielded valuable feedback from students on SGW as a means of addressing controversial and attitude-laden issues of central importance to the delivery of effective health care in Southern Africa.

  16. 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.

  17. 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.

  18. Implicit Contracts Regulating Small Group Leadership: The Influence of Culture.

    Science.gov (United States)

    Zamarripa, Perrin Orr; Krueger, Dorothy Lenk

    1983-01-01

    Examined culture variables in the negotiation of implicit rules which govern leadership behavior in small groups. American, French, and Arab students (N=42) were assigned identical decision-making tasks. Results showed monocultural groups presented homogeneous rules governing leadership prior to interaction, while intercultural groups presented…

  19. A Cooperative Small-Group Methodology in the Language Classroom.

    Science.gov (United States)

    Bejarano, Yael

    1987-01-01

    Assessment of the effects of two small-group cooperative techniques and the whole-class method on academic achievement in English as a foreign language for seventh-graders (N=665) revealed that the group methods (Discussion Group and Student Teams and Achievement Divisions) registered significantly greater improvement than the whole-class method.…

  20. Enhancing Leadership Abilities through Small-Group Activities.

    Science.gov (United States)

    Parise, James; Culp, William

    1988-01-01

    The article describes a 14-week program (one hour per week) of the Punxsutawney (Pennsylvania) schools in which 29 gifted high school students learned and practiced fundamentals of small group dynamics to enhance their leadership abilities. (DB)

  1. 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…

  2. 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.

  3. 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…

  4. Group purchasing of workplace health promotion services for small employers.

    Science.gov (United States)

    Harris, Jeffrey R; Hammerback, Kristen R; Hannon, Peggy A; McDowell, Julie; Katzman, Avi; Clegg-Thorp, Catherine; Gallagher, John

    2014-07-01

    Small employers are underserved with workplace health promotion services, so we explored the potential for group purchasing of these services. We conducted semistructured telephone interviews of member organizations serving small employers, as well as workplace health promotion vendors, in Washington State. We interviewed 22 employer organizations (chambers of commerce, trade associations, and an insurance trust) and vendors (of fitness facilities, healthy vending machines, fresh produce delivery, weight management services, and tobacco cessation quitlines). Both cautiously supported the idea of group purchasing but felt that small employers' workplace health promotion demand must increase first. Vendors providing off-site services, for example, quitline, found group purchasing more feasible than vendors providing on-site services, for example, produce delivery. Employer member organizations are well-positioned to group purchase workplace health promotion services; vendors are receptive if there is potential profit.

  5. Net Based Examination: Small Group Tutoring, Home Assignments, and Large Group Automatic and Peer Assessment

    Directory of Open Access Journals (Sweden)

    G. Karlsson

    2007-09-01

    Full Text Available This paper deals with net based examination,tutoring and scaffolding of groups of different sizes: Firstfor very small groups, then for normal sized groups around100 students and finally for very large groups. The threedifferent methods can be applied to internationally basedcourses. Methods which support deep learning throughtutoring, scaffolding, project work and peer learning arealso mentioned.

  6. Meta-analysis of targeted small-group reading interventions.

    Science.gov (United States)

    Hall, Matthew S; Burns, Matthew K

    2018-02-01

    Small-group reading interventions are commonly used in schools but the components that make them effective are still debated or unknown. The current study meta-analyzed 26 small-group reading intervention studies that resulted in 27 effect sizes. Findings suggested a moderate overall effect for small-group reading interventions (weighted g=0.54). Interventions were more effective if they were targeted to a specific skill (g=0.65), then as part of a comprehensive intervention program that addressed multiple skills (g=0.35). There was a small correlation between intervention effects and group size (r=0.21) and duration (r=0.11). Small-group interventions led to a larger median effect size (g=0.64) for elementary-aged students than for those in middle or high school (g=0.20), but the two confidence intervals overlapped. Implications for research and practice are discussed. Copyright © 2017 Society for the Study of School Psychology. Published by Elsevier Ltd. All rights reserved.

  7. Solar small-scale dynamo and polarity of sunspot groups

    Science.gov (United States)

    Sokoloff, D.; Khlystova, A.; Abramenko, V.

    2015-08-01

    In order to clarify a possible role of small-scale dynamo in formation of solar magnetic field, we suggest an observational test for small-scale dynamo action based on statistics of anti-Hale sunspot groups. As we have shown, according to theoretical expectations the small-scale dynamo action has to provide a population of sunspot groups which do not follow the Hale polarity law, and the density of such groups on the time-latitude diagram is expected to be independent on the phase of the solar cycle. Correspondingly, a percentage of the anti-Hale groups is expected to reach its maximum values during solar minima. For several solar cycles, we considered statistics of anti-Hale groups obtained by several scientific teams, including ours, to find that the percentage of anti-Hale groups becomes indeed maximal during a solar minimum. Our interpretation is that this fact may be explained by the small-scale dynamo action inside the solar convective zone.

  8. 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.

  9. 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

  10. 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.

  11. The Importance of Forming a Work Group in Small Group Teaching.

    Science.gov (United States)

    Ojanen, Sinikka; Keski-Luopa, Leila

    This article discusses the themes of individual and group processes, on the conscious level, as well as the main purpose of a work group, and asserts that psychoanalytical theory and knowledge are a tool for educators. The two problems studied are motivating student teachers to creative action within the small group structure and dealing with…

  12. 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.

  13. Commons Dilemma Choices in Small vs. Large Groups.

    Science.gov (United States)

    Powers, Richard B.; Boyle, William

    The purpose of the Commons Game is to teach students how social traps work; that is, that short-term individual gain tends to dominate long-term collective gain. Simulations of Commons Dilemma have grown considerably in the last decade; however, the research has used small face-to-face groups to study behavior in the Commons. To compare the…

  14. 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.

  15. 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

  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. 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

  18. 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...

  19. 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

  20. Improving learning and confidence through small group, structured otoscopy teaching: a prospective interventional study.

    Science.gov (United States)

    You, Peng; Chahine, Saad; Husein, Murad

    2017-12-28

    Otologic diseases are common and associated with significant health care costs. While accurate diagnosis relies on physical exam, existing studies have highlighted a lack of comfort among trainees with regards to otoscopy. As such, dedicated otoscopy teaching time was incorporated into the undergraduate medical curriculum in the form of a small group teaching session. In this study, we aimed to examine the effect of a small-group, structured teaching session on medical students' confidence with and learning of otoscopic examination. Using a prospective study design, an otolaryngologist delivered an one-hour, small group workshop to medical learners. The workshop included introduction and demonstration of otoscopy and pneumatic otoscopy followed by practice with peer feedback. A survey exploring students' confidence with otoscopy and recall of anatomical landmarks was distributed before(T1), immediately after(T2), and 1 month following the session(T3). One hundred and twenty five learners participated from February 2016 to February 2017. Forty nine participants with complete data over T1-T3 demonstrated significant improvement over time in confidence (Wilk's lambda = .09, F(2,48) = 253.31 p learning (Wilk's lambda = 0.34, F(2,47) = 24.87 p confidence with otoscopy and identification of otologic landmarks. Dedicated otoscopy teaching sessions may be a beneficial addition to the undergraduate medical curriculum.

  1. Psychosocial issues discovered through reflective group dialogue between medical students.

    Science.gov (United States)

    Chu, Shao-Yin; Lin, Chi-Wei; Lin, Meei-Ju; Wen, Chin-Chen

    2018-01-10

    The biopsychosocial model is a comprehensive approach emphasizing holistic medical care. However, medical curricula that incorporate narrative reflective writing and group dynamic discussion of psychosocial issues among patients and their family members in reflective dialogue groups are currently underutilized. The aim of this study was to determine psychosocial issues among patients and their family members through medical students' reflective dialogue groups. This study was completed as part of a pediatric clerkship. Fifty medical students were rotated to the department of Pediatrics. They completed a narrative writing assignment concerning patients' psychosocial issues and participated in a reflective group discussion during the rotation. The recordings of the six reflective group sessions were transcribed for thematic analysis. A six-step theme generation process was conducted in the first reading stage of all transcripts by four researchers. Subsequently, initial codes were generated and potential themes sought before possible themes were reviewed and thematic maps generated. Names for each theme were defined and a scholarly report of the analysis was presented through a consensus-based approach. A total of 108 psychosocial issues were coded and categorized as the following six main themes: medical communication, the intricate medical ecological system, role and function of a family, development of medical professionalism, ethical dilemmas, and various patient perspectives from diverse cultural backgrounds. All these themes underlie the complexity of clinical encounters. Clinical care is an extremely complex interactive ecological network involving human behavior, family, and public health care systems. The discovery of psychosocial problems by medical students as narrators in this study illustrates that medical care should focus not only on illnesses but also patients' psychosocial narratives.

  2. 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.

  3. 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.

  4. 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

  5. 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.

  6. Pharmacist elicited medication histories in the Emergency Department: Identifying patient groups at risk of medication misadventure

    OpenAIRE

    Ajdukovic, Maja; Crook, Meredith; Angley, Christopher; Stupans, Ieva; Soulsby, Natalie; Doecke, Christopher; Anderson, Barbara; Angley, Manya

    2007-01-01

    The Australian Pharmaceutical Advisory Committee guidelines call for a detailed medication history to be taken at the first point of admission to an Emergency Department (ED). The elderly, in particular those residing in Residential Aged Care Facilities and those with a non-English speaking background, have been identified as patient groups vulnerable to medication misadventure. Objective: to analyse the incidence of discrepancies in medication histories in these demographic groups when pharm...

  7. Small group activities within academic communities improve the connectedness of students and faculty.

    Science.gov (United States)

    Brandl, Katharina; Schneid, Stephen D; Smith, Sunny; Winegarden, Babbi; Mandel, Jess; Kelly, Carolyn J

    2017-08-01

    The University of California, San Diego, School of Medicine implemented a curriculum change that included reduction of lectures, incorporation of problem-based learning and other small group activities. Six academic communities were introduced for teaching longitudinal curricular content and organizing extracurricular activities. Surveys were collected from 904 first- and second-year medical students over 6 years. Student satisfaction data with their sense of connectedness and community support were collected before and after the implementation of the new curriculum. In a follow-up survey, medical students rated factors that contributed to their sense of connectedness with faculty and students (n = 134). Students' perception of connectedness to faculty significantly increased following implementation of a curriculum change that included academic communities. Students ranked small group clinical skills activities within academic communities significantly higher than other activities concerning their sense of connectedness with faculty. Students' perception of connectedness among each other was high at baseline and did not significantly change. Small group activities scored higher than extracurricular activities regarding students' connectedness among themselves. The implementation of a new curriculum with more small group educational activities including academic communities enhanced connectedness between students and faculty and resulted in an increased sense of community.

  8. Practice-based small group learning in GP specialty training.

    Science.gov (United States)

    Hesselgreaves, Hannah; MacVicar, Ronald

    2012-01-01

    Practice-based small group learning (PBSGL) is an approach to continuing professional development (CPD) for general practitioners (GPs) that originated in Canada. It involves small groups of GPs who work through clinical modules. PBSGL is now an established method of learning in Scotland, found to be effective in GP, practice nurse and multi-professional cohorts. However, the effectiveness of PBSGL has not been examined in GP specialty training, where it is becoming widely employed. This research aimed to explore GP Specialty Trainees' (GPSTs') perspectives of the impact of PBSGL on curriculum needs, preparation for independent practice, and facilitator learning. To avoid the risk of extrapolating assumptions from others who have used PBSGL as a learning strategy, this study adopted a qualitative approach, and conducted one-to-one interviews with 16 GPSTs from a range of Scottish deaneries and stages in training. Data took the form of verbatim transcripts, and the constant comparative technique from grounded theory was used to analyse the data, through the establishment of codes and categories. Findings were arranged in four main areas: • learning as a group was appreciated at this career stage, and group membership should consist of trainees at a similar career stage, as this supports psychological safety • PBSGL helped in locating a 'one best way' for future care planning, but was also used to find alternatives to trainees' current approaches • discussion during PBSGL helped GPSTs devise plans for how they would handle patients in the future • some facilitators moderated their involvement for the perceived benefit of the group. Learning is experienced in a very unique way for GPSTs, and the views of the cohort are formed on the basis of the delicate stage in their career. Aiding the transition from structured education into independent practice is a more immediate need for GPSTs than curriculum needs.

  9. The cyclopentyl group, as a small but bulky terminal group, allows rapid and efficient active transport.

    Science.gov (United States)

    Nishiyama, Junya; Makita, Yoshimasa; Kihara, Nobuhiro

    2015-01-02

    Secondary ammonium salts bearing a cyclopentyl terminal group rapidly formed pseudorotaxane with 1.5 equiv of DB24C8. Acylation of the pseudorotaxane with 50 equiv of benzoyl chloride in the presence of 50 equiv of triethylamine in toluene afforded rotaxane, the product of active transport, in 95% yield. The cyclopentyl group is small enough to allow rapid formation of pseudorotaxane, and bulky enough to facilitate the quantitative active transport by steric repulsion.

  10. 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…

  11. 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

  12. 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.

  13. 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.

  14. 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

  15. Assessment of medical management outcomes in small populations.

    Science.gov (United States)

    Fetterolf, Donald; Tucker, Travis L

    2008-10-01

    Small sample size represents a vexing problem in evaluating medical management programs. Physician practices may have panel sizes of only 1000 total patients, disease management programs may enroll only several hundred patients, and hospitals may see only several dozen of a particular type of case per year. Given the high variation that occurs in the presentation, severity, and cost of medical conditions, estimation of either quality impact or economic return on investment can be difficult or impossible. This paper seeks to describe common approaches to this issue that are in practice within the industry today and to discuss limitations, alternative strategies, and consequences of method choices. A number of strategies exist to deal with this situation, but ongoing recognition of this issue in the planning phases of initiatives remains problematic. Significant linkage of financial rewards or penalties to poorly evaluated programs carries significant liabilities for the unsophisticated developers of such systems.

  16. 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.

  17. Risk Factor-tailored Small Group Education for Patients with First-time Acute Coronary Syndrome.

    Science.gov (United States)

    Hwang, Seon Young; Kim, Jin Shil

    2015-12-01

    The purpose of this study was to evaluate the effects of a risk factor-tailored small group education on anxiety and depressive symptoms, self-efficacy and self-care compliance in patients with first-time acute coronary syndrome (ACS) for 12-month follow-up. A quasi-experimental pretest and post-test design was used. Patients were recruited from a national university hospital from 2010 to 2011 in Korea. The group education consisted of a 60-minute long video developed using multimedia contents including voice-recorded texts, flash animation, and video clips, with nurses' dialogue. The intervention group (n = 34) participated in group education using the multimedia video in a small group of patients with similar risk factors, and received periodic telephone counseling and text messages. The control group (n = 40) received usual care and counseling upon request. Depressive symptoms decreased, and self-efficacy and self-care compliance in the areas of medication, exercise, and healthy diet practice significantly increased in patients in the intervention group, compared with those in the control group. Risk factor-tailored small group education and periodic text message were an effective strategy for decreasing depression, and increasing self-efficacy and long-term compliance with lifestyle changes in patients with first-time ACS. We suggested that risk factor-tailored small group education need to be given for first-time ACS patients for psychological support and behavioral change in clinical practice. It is also comparable to individual approach to encourage psychological and behavioral change. Copyright © 2015. Published by Elsevier B.V.

  18. 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.

  19. Pharmacist elicited medication histories in the Emergency Department: Identifying patient groups at risk of medication misadventure.

    Science.gov (United States)

    Ajdukovic, Maja; Crook, Meredith; Angley, Christopher; Stupans, Ieva; Soulsby, Natalie; Doecke, Christopher; Anderson, Barbara; Angley, Manya

    2007-10-01

    The Australian Pharmaceutical Advisory Committee guidelines call for a detailed medication history to be taken at the first point of admission to an Emergency Department (ED). The elderly, in particular those residing in Residential Aged Care Facilities and those with a non-English speaking background, have been identified as patient groups vulnerable to medication misadventure. to analyse the incidence of discrepancies in medication histories in these demographic groups when pharmacist elicited medication histories were compared with those taken by ED physicians. It also aimed to investigate the incidence of medication related ED presentations. The study was conducted over a six week period and included 100 patients over the age of 70, who take five or more regular medications, have three or more clinical co-morbidities and/or have been discharged from hospital in three months prior to the study. Twenty four participants were classified as 'language barrier'; 12 participants were from residential aged care facilities, and 64 participants were classified as 'general'. The number of correctly recorded medications was lowest in the 'language barrier' group (13.8%) compared with 18% and 19.6% of medications for 'general' patients and patients from residential aged care facilities respectively. Seven of the patients (29.2%) with 'language barrier'; 1 from a residential aged care facility (8.3%) and 13 of the (20.3%) patients from the 'general' category were suspected as having a medication related ED presentation. This study further highlights the positive contribution an ED pharmacist can make to enhancing medication management along the continuum of care. This study also confirms the vulnerability of patients with language barrier to medication misadventure and their need for interpreter services at all stages of their hospitalisation, in particular at the point of ED presentation.

  20. Pharmacist elicited medication histories in the Emergency Department: Identifying patient groups at risk of medication misadventure

    Directory of Open Access Journals (Sweden)

    Ajdukovic M

    2007-12-01

    Full Text Available The Australian Pharmaceutical Advisory Committee guidelines call for a detailed medication history to be taken at the first point of admission to an Emergency Department (ED. The elderly, in particular those residing in Residential Aged Care Facilities and those with a non-English speaking background, have been identified as patient groups vulnerable to medication misadventure. Objective: to analyse the incidence of discrepancies in medication histories in these demographic groups when pharmacist elicited medication histories were compared with those taken by ED physicians. It also aimed to investigate the incidence of medication related ED presentations. Methods: The study was conducted over a six week period and included 100 patients over the age of 70, who take five or more regular medications, have three or more clinical co-morbidities and/or have been discharged from hospital in three months prior to the study. Results: Twenty four participants were classified as ‘language barrier’; 12 participants were from residential aged care facilities, and 64 participants were classified as ‘general’. The number of correctly recorded medications was lowest in the ‘language barrier’ group (13.8% compared with 18% and 19.6% of medications for ‘general’ patients and patients from residential aged care facilities respectively. Seven of the patients (29.2% with ‘language barrier’; 1 from a residential aged care facility (8.3% and 13 of the (20.3% patients from the ‘general’ category were suspected as having a medication related ED presentation. Conclusion: This study further highlights the positive contribution an ED pharmacist can make to enhancing medication management along the continuum of care. This study also confirms the vulnerability of patients with language barrier to medication misadventure and their need for interpreter services at all stages of their hospitalisation, in particular at the point of ED presentation.

  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. Group O low titre only emergency donor panels for small combat teams.

    Science.gov (United States)

    Doughty, Heidi; Maguire, A; Fitchett, G; Parker, P

    2017-12-01

    Military elements increasingly operate in small teams in remote areas with no immediate blood product support. Planners and operators may endorse collection of fresh whole blood from pretested donors in emergency situations. The biggest risk of transfusion is the accidental use of ABO incompatible blood which can be fatal. The risk may be mitigated by using only group O LOw (OLO) titre donors with plasma containing low levels of the naturally occurring antibody to group A and B red cells. This paper reviews the ABO blood group distribution in potential blood donors from a high readiness UK medical regiment and explores the feasibility of using only group OLO donors in small teams. A retrospective review of routine volunteer blood donor samples was undertaken at 6 monthly intervals during a 2-year period. Personnel were tested in groups when available during training to create multiple donor panels to simulate small teams. 206 donation samples were collected from 157 potential donors. All donors were acceptable based on the lifestyle questionnaire, serology and microbiology screen. Of the 206 samples reviewed, 85 (41%) were group O (D pos and D neg). 14 group O (16.5%) were shown to have high titre of anti-A or B. Therefore, 71, that is, 34% overall were suitable as OLO donors. The donor panel size varied from 15 to 44. The absolute number of OLO donors in each panel ranged from 4 to 17 and the number of O neg donors was 0-3. A third of samples were suitable as OLO donors; however, there were insufficient 'universal' donors within smaller subgroups (group O and group A donors or the use of a buddy-buddy blood group matrix. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

  5. 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

  6. 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

  7. Technique forces for students of special medical group

    Directory of Open Access Journals (Sweden)

    Voronov N.P.

    2010-05-01

    Full Text Available The method of drafting complexes physical exercises is considered for students with the diseases of spine. In an experiment participated 21 student with violations of spine (mainly osteochondrosis and moderate scoliosis. Distinction is rotined in physical development and physical preparedness of students of task medical force and basic group. The orientation of complex of exercises is certain on forming of muscular corset of students by exercises of power character. Efficiency of the use is tested stretchings and weakening the skeletal muscles of exercises in alternation with power exercises.

  8. Collective Motivation Beliefs of Early Adolescents Working in Small Groups

    Science.gov (United States)

    Klassen, Robert M.; Krawchuk, Lindsey L.

    2009-01-01

    This study examined collective efficacy, group cohesion, and group performance in 125 randomly assigned groups of older (mean age 13.45 years) and younger (mean age 11.41 years) early adolescents working on three cooperative tasks. Collective motivation significantly predicted performance, even after controlling for past performance and…

  9. 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.

  10. 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…

  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. Leader Communication Style: Effects on Members of Small Groups.

    Science.gov (United States)

    Barlow, Sally; And Others

    1982-01-01

    Determined effects of different leader verbal styles on group members. Results indicated leader verbal style is a factor influencing communication style of members and that it affects members' perceptions of leader orientation; however, it does not affect members' satisfaction with leaders, nor the self-concept of group members. (Author/RC)

  13. 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

  14. Clients' Preferences for Small Groups vs. Individual Testing.

    Science.gov (United States)

    Backman, Margaret E.; And Others

    Test takers' preferences for group versus individual administration of the Micro-TOWER System of Vocational Evaluation are reported. The system was administered to 211 clients at a vocational rehabilitation center, and consisted of work samples measuring the following job skills: record checking, filing, lamp assembly, message-taking, zip coding,…

  15. 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…

  16. 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.

  17. Connecting, interacting and supporting : Social capital, peer network and cognitive perspectives on small group teaching

    NARCIS (Netherlands)

    Brouwer, Jasperina

    2017-01-01

    No mass lectures anymore but small-group teaching; this is the current trend in higher education and the way universities hope to attract future students. Students get to know each other easily when they collaborate in small groups. The question arises whether dividing a cohort of students in small

  18. 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…

  19. Found in translation: exporting patient-centered communication and small group teaching skills to China.

    Science.gov (United States)

    Blatt, Benjamin; Kallenberg, Gene; Lang, Forrest; Mahoney, Patrick; Patterson, JoEllen; Dugan, Beverly; Sun, Shaobang

    2009-06-26

    The Chinese Medical Doctor's Association asked us to develop a train-the-trainers program in doctor-patient communication and in teaching skills for a select group of Chinese health care professionals, who would then serve as trainers for practicing physicians throughout China. The request came in the context of increasing doctor-patient friction related, in part, to the dissolution of the socialist health care safety net in China. In this article we recount the implementation of our 5-day training program in Beijing. We explore cross-cultural issues that arose in presenting the program's two principal training domains: small group teaching and patient-centered doctor-patient communication. We also explore the linguistic challenges we encountered as non-Chinese speaking teachers. Finally, we reflect on the lessons learned from this project that may be of value to others called upon to export Western doctor-patient communications training to other cultures. In this age of increasing globalization, cross-cultural sharing of medical education represents a growing trend.

  20. Thoughts on Cataloging and Classification in a Small Medical Library

    Science.gov (United States)

    Waller, Salvador B.

    1970-01-01

    This article is based on experience with small library collections. It is an effort to point out some of the problems in cataloging and classification, to arouse an interest in self-analysis on the part of the small library, and to offer some suggestions as to how the small institution can streamline techniques and economize on meager resources with no loss of value to the card catalog. It is recognized that the catalogs in many small libraries are unsuited for their tasks as a result of adhering to philosophies of larger institutions. The small institution has neither the need nor resources for such completeness in cataloging and classification. Deviation from standard rules is not advocated. However, consistency in treatment is advised and adherence in depth to standard rules is questioned. PMID:5411704

  1. 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…

  2. Support groups for women in medical school: a first-year program.

    Science.gov (United States)

    Hilberman, E; Konanc, J; Perez-Reyes, M; Hunter, R; Scagnelli, J; Sanders, S

    1975-09-01

    This report presents a workable model for a support system for first-year women medical students at the University of North Carolina School of Medicine. The students met in small groups at weekly intervals with women faculty members from the Department of Psychiatry throughout the academic year. Role conflicts which confront these young women professionals entering a "masculine" field as a minority group are described. There is an elaboration of those factors, both personal and institutional, which serve either to promote or deter conflict resolution and the acquisition of a satisfactory professional and female identity. A discussion of group formation and processes and a year-end evaluation are included. Both students and faculty assessed the program as having provided a needed and constructive setting in which to explore the problems and identities of women professionals and to develop close supportive relationships with women colleagues.

  3. 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.

  4. 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.)

  5. [Medical rehabilitation group-programmes concerning health promotion, patient education and psychoeducation - a 2010 national survey].

    Science.gov (United States)

    Reusch, A; Schug, M; Küffner, R; Vogel, H; Faller, H

    2013-08-01

    High quality demands are being placed on concepts of educational group programmes in medical rehabilitation as well as the related trainer qualifications. A nationwide survey of German medical rehabilitation clinics in 2005 had revealed a need for improving educational practice according to these quality criteria. An updated investigation was performed in 2010 aiming at describing group programmes used in medical rehabilitation. 1 473 inpatient and outpatient medical rehabilitation clinics were invited to participate. 908 clinics reported on their training programmes. Data from clinics caring for patients with somatic disorders could be compared to the 2005 survey. Data from clinics for both psychosomatic and substance abuse disorders was collected for the first time in 2010. Overall, psychologists and physicians were reported to be the most frequent conductors of educative programmes. In somatic clinics, psychologists, dieticians and occupational therapists or physiotherapists were the most common conductors. Two-thirds of the institutions reported no training prerequisites for staff members to perform patient education. 80% of the education programmes were categorized post hoc into 3 classes: "generic health education", "disorder-specific patient education", and "psychoeducational group programmes". Almost two-thirds of all programmes were carried out with 8-15 participants, and many used several interactive didactic methods. Programmes conducted in small groups (15 participants). Only half of the programmes were manualized. Significantly more interactive methods were used in completely manualized programmes. Only about half of the programmes were evaluated, and only very few evaluation studies were published. The institutions wished additional support by workshops especially concerning qualification of their staff and concerning educational concepts. A need for further improvement and support exists relative to the training of educators and the development of

  6. 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

  7. An investigation into the factors that encourage learner participation in a large group medical classroom.

    Science.gov (United States)

    Moffett, Jennifer; Berezowski, John; Spencer, Dustine; Lanning, Shari

    2014-01-01

    Effective lectures often incorporate activities that encourage learner participation. A challenge for educators is how to facilitate this in the large group lecture setting. This study investigates the individual student characteristics involved in encouraging (or dissuading) learners to interact, ask questions, and make comments in class. Students enrolled in a Doctor of Veterinary Medicine program at Ross University School of Veterinary Medicine, St Kitts, were invited to complete a questionnaire canvassing their participation in the large group classroom. Data from the questionnaire were analyzed using Excel (Microsoft, Redmond, WA, USA) and the R software environment (http://www.r-project.org/). One hundred and ninety-two students completed the questionnaire (response rate, 85.7%). The results showed statistically significant differences between male and female students when asked to self-report their level of participation (P=0.011) and their confidence to participate (Pclassroom. Male students were more likely to participate in class and reported feeling more confident to participate than female students. Female students in this study commonly identified aversion to public speaking as a factor which held them back from participating in the large group lecture setting. These are important findings for veterinary and medical educators aiming to improve learner participation in the classroom. Potential ways of addressing this challenge include addition of small group activities and audience response systems during lectures, and inclusion of training interventions in public speaking at an early stage of veterinary and medical curricula.

  8. 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.

  9. 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…

  10. 45 CFR 159.120 - Data submission for the individual and small group markets.

    Science.gov (United States)

    2010-10-01

    ... 45 Public Welfare 1 2010-10-01 2010-10-01 false Data submission for the individual and small group... RELATING TO HEALTH CARE ACCESS HEALTH CARE REFORM INSURANCE WEB PORTAL § 159.120 Data submission for the individual and small group markets. (a) Health insurance issuers (hereinafter referred to as issuers) must...

  11. Effects of Small-Group Learning on Transfer: A Meta-Analysis

    Science.gov (United States)

    Pai, Hui-Hua; Sears, David A.; Maeda, Yukiko

    2015-01-01

    This study investigated the potential benefit of small-group learning on transfer performance using the method of meta-analysis. Results showed positive support for the hypothesis that small-group learning can increase students' transfer performance (average effect size of 0.30). Unlike reviews of effects of cooperation on learning, this…

  12. Relevant Prior Knowledge Moderates the Effect of Elaboration during Small Group Discussion on Academic Achievement

    Science.gov (United States)

    Van Blankenstein, Floris M.; Dolmans, Diana H. J. M.; Van der Vleuten, Cees P. M.; Schmidt, Henk G.

    2013-01-01

    This study set out to test whether relevant prior knowledge would moderate a positive effect on academic achievement of elaboration during small-group discussion. In a 2 × 2 experimental design, 66 undergraduate students observed a video showing a small-group problem-based discussion about thunder and lightning. In the video, a teacher asked…

  13. Relevant prior knowledge moderates the effect of elaboration during small group discussion on academic achievement

    NARCIS (Netherlands)

    F.M. van Blankenstein (Floris); D.H.J.M. Dolmans (Diana); C.P.M. van der Vleuten (Cees); H.G. Schmidt (Henk)

    2013-01-01

    textabstractThis study set out to test whether relevant prior knowledge would moderate a positive effect on academic achievement of elaboration during small-group discussion. In a 2 × 2 experimental design, 66 undergraduate students observed a video showing a small-group problem-based discussion

  14. 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…

  15. The Mentoring Lab: A Small Group Approach for Managing Emotions from Multicultural Counselor Training

    Science.gov (United States)

    Parker, Woodrow M.; Freytes, Magaly; Kaufman, Cindy J.; Woodruff, Rew; Hord, Rachel

    2004-01-01

    In an attempt to enable counselors-in-training to work through the strong emotional reactions experienced during the multicultural counseling course, a small group approach called the Multicultural Mentoring Lab has been developed. The purpose of the Multicultural Mentoring Lab is to provide a supportive, nonjudgmental, small group environment for…

  16. Learning and teaching in small groups: characteristics, benefits, problems and approaches.

    Science.gov (United States)

    Jones, R W

    2007-08-01

    Small group learning may be defined as a group of learners demonstrating three common characteristics; active participation, a specific task and reflection. This article provides an overview of small group learning and teaching, describes the characteristics of this form of small group work, benefits, problems, potential causes of less than optimal sessions, and summarises specific approaches. These include tutorials, free-discussion groups, brainstorming, snowballing, buzz groups, paired (or one-to-one) discussion, clinical teaching, simulations, seminars, plenary sessions, problem-based learning, team-based learning, role plays, games and IT approaches. The article concludes with an emphasis on the importance of the teacher and a check list for use when planning, teaching and evaluating a small group session.

  17. "I Hate Group Work!": Addressing Students' Concerns about Small-Group Learning

    Science.gov (United States)

    Allan, Elizabeth G.

    2016-01-01

    This article identifies the strategies used by architecture professors and their undergraduate students to mitigate common issues that students raise about group work. Based on participant-observation, interviews with students and faculty, and analysis of instructional materials and student work, this IRB-approved ethnographic case study…

  18. A small-group functional balance intervention for individuals with Alzheimer disease: a pilot study.

    Science.gov (United States)

    Ries, Julie D; Drake, Jamie Michelle; Marino, Christopher

    2010-03-01

    Individuals with Alzheimer disease (AD) have a higher risk of falls than their cognitively intact peers. This pilot study was designed to assess the feasibility and effectiveness of a small-group balance exercise program for individuals with AD in a day center environment. Seven participants met the inclusion criteria: diagnosis of AD or probable AD, medical stability, and ability to walk (with or without assistive device). We used an exploratory pre- and post-test study design. Participants engaged in a functional balance exercise program in two 45-minute sessions each week for eight weeks. Balance activities were functional and concrete, and the intervention was organized into constant, blocked, massed practice. Outcome measures included Berg Balance Scale (BBS), Timed Up and Go (TUG), and gait speed (GS; self-selected and fast assessed by an instrumented walkway). Data were analyzed by comparing individual change scores with previously identified minimal detectable change scores at the 90% confidence level (MDC90). Pre- and post-test data were acquired for five participants (two participants withdrew). The BBS improved in all five participants, and improved > or = 6.4 points (the MDC90 for the BBS in three participants. Four participants improved their performance on the TUG, and three participants improved > or = 4.09 seconds (the MDC90 for the TUG). Self-selected GS increased > or = 9.44 cm/sec (the MDC90 for gait speed) in three participants. Two participants demonstrated post-test self-selected GS comparable with their pretest fast GS. This pilot study suggests that a small-group functional balance intervention for individuals with AD is feasible and effective. Although participants had no explicit memory of the program, four of five improved in at least two outcome measures. Larger scale functional balance intervention studies with individuals with AD are warranted.

  19. 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 ...

  20. 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 ...

  1. 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…

  2. The Effects of Small Group Vocabulary Instruction on Second Grade Students' Expressive Vocabularies

    Science.gov (United States)

    Fariss, Laura Lester

    2013-01-01

    The purpose of this study was to investigate the effectiveness of small group vocabulary instruction above and beyond whole group, read aloud vocabulary instruction, on second grade students' expressive vocabularies. This experimental study reflected a between-subjects design as three treatment groups were compared using a pretest, posttest within…

  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. 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

  5. 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

  6. An investigation into the factors that encourage learner participation in a large group medical classroom

    Directory of Open Access Journals (Sweden)

    Moffett J

    2014-03-01

    participate than female students. Female students in this study commonly identified aversion to public speaking as a factor which held them back from participating in the large group lecture setting. These are important findings for veterinary and medical educators aiming to improve learner participation in the classroom. Potential ways of addressing this challenge include addition of small group activities and audience response systems during lectures, and inclusion of training interventions in public speaking at an early stage of veterinary and medical curricula. Keywords: age, class size, interaction, lecture, public speaking, sex, veterinary

  7. 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...

  8. Group concept mapping: An approach to explore group knowledge organization and collaborative learning in senior medical students.

    Science.gov (United States)

    Torre, Dario; Daley, Barbara J; Picho, Katherine; Durning, Steven J

    2017-10-01

    Group concept mapping may be used as a learning strategy that can potentially foster collaborative learning and assist instructors to assess the development of knowledge organization in medical students. Group concept maps were created by 39 medical students rotating through a fourth year medicine rotation. The group maps were developed based on a clinical vignette. Descriptive statistics and thematic analysis of students' evaluations were performed. Evaluations indicated that students enjoyed the collaborative nature of the exercise and the knowledge sharing activities associated with it. Group maps can demonstrate different knowledge organization Discussion: Group concept mapping can be used to explore students' organization and integration of knowledge structures in a collaborative setting. Additional research should focus on how group mapping and learning progresses over time and, whether group mapping can help identify curricular strengths and needs.

  9. Application of a Motor Learning Treatment for Speech Sound Disorders in Small Groups.

    Science.gov (United States)

    Skelton, Steven L; Richard, Jennifer T

    2016-06-01

    Speech sound treatment in the public schools is often conducted in small groups, but there are minimal data on the efficacy of group treatment. This study evaluated the efficacy of a motor learning-based treatment (Concurrent Treatment) provided to elementary-school students in small groups. Concurrent Treatment incorporates the randomized sequencing of various practice tasks (e.g., words, sentences, or storytelling) and can result in rapid speech sound acquisition during individual treatment settings. Twenty-eight 6- to 9-year-old children participated in a randomized pretest-posttest control group design. The experimental group received Concurrent Treatment, while the control group received treatment (if needed) after the study. Participants in the experimental group acquired their target speech sounds within 40 30-minute sessions in groups of up to four participants (effect size, d = 1.31). © The Author(s) 2016.

  10. 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...

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

    DEFF Research Database (Denmark)

    Andersen, Jacob

    2009-01-01

    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......, 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...... 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...

  12. Efficacy of a lay health worker led group antiretroviral medication ...

    African Journals Online (AJOL)

    There is a lack of theory-based randomized controlled trials to examine the effect of antiretroviral adherence in sub-Saharan Africa. We assessed the effectiveness of a lay health worker lead structured group intervention to improve adherence to antiretroviral therapy (ART) in a cohort of HIV-infected adults. This two-arm ...

  13. Efficacy of a lay health worker led group antiretroviral medication ...

    African Journals Online (AJOL)

    Karl Peltzer, Shandir Ramlagan, Deborah Jones, Stephen M. Weiss, Henry Fomundam, and Lucia Chanetsa

    We assessed the effectiveness of a lay health worker lead structured group intervention to improve adherence to antiretroviral therapy (ART) in a cohort of ... Deborah Jones is a Research Professor at the University of Miami Miller School of Medicine in the Department of Psychiatry & Behavioral Sciences in. Maimi, FL, USA.

  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. Learning to Love Reading: A Self-Study on Fostering Students' Reading Motivation in Small Groups

    Science.gov (United States)

    Miller, Rosa

    2015-01-01

    This study explores the relationship between small, differentiated reading groups and fourth-grade students' reading motivation. Using self-study methodology, the author examined her own process of implementing these reading groups through two cycles of action research. Data were analyzed from two different administrations of the Motivations for…

  16. Observational Learning of Academic and Social Behaviors during Small-Group Direct Instruction

    Science.gov (United States)

    Ledford, Jennifer R.; Wolery, Mark

    2015-01-01

    Many studies have shown that small-group direct instruction is effective and efficient for teaching students with and without disabilities, although relatively few studies have been conducted with heterogeneous groups of preschool participants. In addition, previous studies have primarily assessed whether observational learning occurred for…

  17. 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…

  18. Lexical Language-Related Episodes in Pair and Small Group Work

    Science.gov (United States)

    Mayo, Maria Del Pilar Garcia; Zeitler, Nora

    2017-01-01

    The present study investigates whether learner set up in interaction, namely in pairs or small groups, influences the frequency and outcome of lexical language-related episodes (LREs) and L2 vocabulary learning. Thirty Spanish English as a foreign language (EFL) university learners took part in the study. They worked in four groups and seven pairs…

  19. 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…

  20. 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.

  1. ECC-based grouping-proof RFID for inpatient medication safety.

    Science.gov (United States)

    Lin, Qiping; Zhang, Fangguo

    2012-12-01

    Several papers were proposed in which symmetric cryptography was used to design RFID grouping-proof for medication safety in the Journal of Medical Systems. However, if we want to ensure privacy, authentication and protection against the tracking of RFID-tags without losing system scalability, we must design an asymmetric cryptography-based RFID. This paper will propose a new ECC-based grouping-proof for RFID. Our ECC-based grouping-proof reduces the computation of tags and prevents timeout problems from occurring in n-party grouping-proof protocol. Based on asymmetric cryptography, the proposed scheme is practical, secure and efficient for medication applications.

  2. Use of psychotropic medication groups in people with severe mental illness and stressful childhood experiences.

    Science.gov (United States)

    Schneeberger, Andres R; Muenzenmaier, Kristina; Castille, Dorothy; Battaglia, Joseph; Link, Bruce

    2014-01-01

    Stressful childhood experiences (SCE) are associated with a variety of health and social problems. In people with severe mental illness (SMI) traumatic childhood experiences have been linked to more severe and treatment refractory forms of psychiatric symptoms, including psychotic symptoms. This study evaluates the use of psychotropic medication groups in a population of people with SMI and SCE, testing the association between SCE and prescription medication in an SMI population. A sample of 183 participants with SMI was divided into 2 exposure groups: high SCE (4 to 7 categories of SCE) and low SCE (0 to 3 categories of SCE). Both groups were compared in regard to prescribed dosing of psychotropic medications (antipsychotics, mood stabilizers, antidepressants, and anxiolytics/hypnotics). Participants who endorsed high SCE received higher doses of antipsychotic medications and mood stabilizers than those with low exposure. The results demonstrate that people with higher SCE categories received a higher dosing of psychotropic medication, specifically antipsychotic medication and mood stabilizers.

  3. Rate increase disclosure and review: definitions of "individual market" and "small group market." Final rule.

    Science.gov (United States)

    2011-09-06

    This final rule amends a May 23, 2011, final rule entitled "Rate Increase Disclosure and Review". The final rule provided that, for purposes of rate review only, definitions of "individual market" and "small group market" under State rate filing laws would govern even if those definitions departed from the definitions that otherwise apply under title XXVII of the Public Health Service Act (PHS Act). The preamble to the final rule requested comments on whether this policy should apply in cases in which State rate filing law definitions of "individual market" and "small group market" exclude association insurance policies that would be included in these definitions for other purposes under the PHS Act. In response to comments, this final rule amends the definitions of "individual market" and "small group market" that apply for rate review purposes to include coverage sold to individuals and small groups through associations even if the State does not include such coverage in its definitions of individual and small group market. This final rule also updates standards for health insurance issuers regarding disclosure and review of unreasonable premium increases under section 2794 of the Public Health Service Act.

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

    Science.gov (United States)

    Keifenheim, Katharina Eva; Petzold, Ernst Richard; Junne, Florian; Erschens, Rebecca Sarah; Speiser, Natalie; Herrmann-Werner, Anne; Zipfel, Stephan; Teufel, Martin

    2017-01-01

    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.

  5. 'Reactive' nano-complex coated medical cotton: a facile avenue for tailored release of small molecules.

    Science.gov (United States)

    Rather, Adil Majeed; Mahato, Sulendar; Maji, Kousik; Gogoi, Neeha; Manna, Uttam

    2017-11-02

    Controlled and sustained release of drug-like small molecules in an aqueous medium still remains a challenging problem due to rapid infiltration of liquid water in most reported drug release systems. However, internal-superhydrophobicity with an antifouling property extending beyond the surface of a material recently has been recognized as a potential avenue for sustained and extended release of drug-like small molecules. Sluggish removal of metastable trapped air in a superhyrophobic material provides a basis to achieve extended release of encapsulated small molecules. In this article, naturally abundant medical-cotton-extensively used in wound management including control of bleeding, absorbance of secretions and protecting wounds from contamination-is strategically exploited in tailoring (from rapid to extended) the release of small molecules by appropriate modulation of liquid water wettability. Modulation included bio-mimicked adhesive and non-adhesive superhydrophobicity of the medical cotton without erosion of any polymeric material. In this process, amine 'reactive' nano-complexes (RNC) were prepared by just mixing branched poly(ethylenimine) (BPEI) with dipentaerythritol pentaacrylate (5Acl) in ethanol with appropriate compositions. Then they were covalently immobilized on fibrous medical-cotton through a facile and robust 1,4-conjugated addition reaction. Residual acrylate moieties in the immobilized RNC provide an opportunity to tailor water wettability through strategic and appropriate post-chemical modification of RNC-coated medical cotton with a primary amine containing various small molecules. This medical-cotton with tunable wettability was exploited further to control the release rate of small molecules from rapid (100 days) times. A volatile solvent induced transient and reversible switching of anti-fouling properties which allowed further varying the amount of post-loading small molecules into the medical cotton up to 2.36 wt% without

  6. 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.

  7. Comparing medication attitudes and reasons for medication nonadherence among three disparate groups of individuals with serious mental illness.

    Science.gov (United States)

    Levin, Jennifer B; Seifi, Nasim; Cassidy, Kristin A; Tatsuoka, Curtis; Sams, Johnny; Akagi, Kouri K; Sajatovic, Martha

    2014-11-01

    This analysis compared medication attitudes and reasons for nonadherence in three distinct groups of patients with serious mental illness (SMI). Cohort 1 had 43 patients with bipolar disorder (BD) treated in a community mental health setting, cohort 2 had 43 patients with BD taking an atypical antipsychotic and treated in an academic medical center, and cohort 3 had 30 patients with schizophrenia or schizoaffective disorder who had been homeless in the last year. Standardized attitudinal scales found generally negative attitudes toward medication and limited illness insight. Although the three cohorts differed with regard to severity of symptoms, age of onset, education, baseline adherence, and race, the groups had similar medication attitudes before and after treatment. Despite group differences in demographic and clinical variables, our analyses found more similarities than differences in medication attitudes among these three discrete groups of poorly adherent, symptomatic patients with SMI. The common attitudinal characteristics have implications for delivery of health care services that can enhance treatment adherence in high-risk SMI patients.

  8. 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

  9. 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.

  10. 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.

  11. Defining smallness for gestational age in the early years of the Danish Medical Birth Registry

    DEFF Research Database (Denmark)

    á Rogvi, Rasmus; Mathiasen, Rene; Greisen, Gorm

    2011-01-01

    Being born small for gestational age (SGA) is associated with decreased insulin sensitivity and increased blood pressure in childhood, but the association with clinical disease in early adulthood is less certain. The Danish Medical Birth Registry has registered all births in Denmark since 1973, b...

  12. International medical students' expectations and worries at the beginning of their medical education: a qualitative focus group study.

    Science.gov (United States)

    Huhn, Daniel; Huber, Julia; Ippen, Franziska M; Eckart, Wolfgang; Junne, Florian; Zipfel, Stephan; Herzog, Wolfgang; Nikendei, Christoph

    2016-01-28

    The number of international students has increased substantially within the last decade. Due to cultural barriers, this specific group faces diverse challenges. In comparison to German colleagues, international medical students perform significantly lower in clinical examinations and exceed the average duration of study; they suffer from personal distress as well as insufficient support. Within the present study, their individual perspectives, expectations, hopes and fears were examined. Four focus groups with first-year international medical students (N = 16) were conducted in October 2013. Each 60- to 90-min discussion was audiotaped, transcribed and analysed using qualitative methods. International medical students go abroad in search of good study-conditions. For the choice of place of study, affordability, social ties as well as an educational system following the achievement principle are decisive factors. While contact with German-students and other international students is seen as beneficial, international medical students are most concerned to encounter problems and social exclusion due to language deficits and intercultural differences. Facilitating the access to university places, the provision of financial aid and, moreover, social support, nurturing cultural integration, would greatly benefit international medical students. Hereby, the establishment of specific medical language courses as well as programs fostering intercultural-relations could prove to be valuable.

  13. 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 ...

  14. Second teaching: An exploration of cognitive factors in small group physics learning

    Science.gov (United States)

    Novemsky, Lisa Forman

    This inquiry was focused on an exploration of introductory physics teaching. Alan Van Heuvelen's Overview Case Study (OCS) physics was the pedagogical approach involving guided small group problem solving and stressing concepts first, before mathematics. Second teaching is a new pedagogical construct based on Vygotsky's ideas. Structured small group activity follows traditional instruction facilitating learning for non-traditional students. It is a model of structured small group activity designed to follow traditional instruction to facilitate the learning process for students who find a physics optic (way of seeing) and physics language foreign. In informal small group settins students describe, explain, elaborate, test, and defend ideas in their own familiar vernacular as they collaborate in solving problems. Collective wisdom of a collaborative group, somewhat beyond the level for each individual member, is created then recreated through self-correction. Students improved significantly in physics knowledge. In a classroom setting, small groups of non-traditional physics students engaged in second teaching were observed. Written explanations to conceptual physics questions were analyzed. Development of language usage in relationship to introductory physics concept learning was studied. Overall physics learning correlated positively with gains in language clarity thus confirming the hypothesis that language development can be linked with gains in physics knowledge. Males and females were found to be significantly different in this respect. Male gains in language clarity were closely coupled with physics learning whereas female gains in the two measures were not coupled. Physics discourse, particularly in relationship to force and motion, seems to resonate with natural developmentally acquired sex-typical male but not female discourse. Thus, for males but not for females, physics learning proceeds in a seamless fashion wherein knowledge gains are coupled with

  15. 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

  16. 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)

  17. 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.…

  18. Small-Group Standardized Patient Encounter Improves Athletic Training Students' Psychosocial Intervention and Referral Skills

    Science.gov (United States)

    Walker, Stacy E.; Weidner, Thomas G.; Thrasher, Ashley B.

    2016-01-01

    Context: Athletic trainers provide psychological support, counseling, intervention, and referral to patients during clinical practice. However, students are rarely exposed to real-life opportunities to develop these skills. Objective: To determine if a small-group standardized patient (SP) encounter improved athletic training students'…

  19. 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…

  20. 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…

  1. 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…

  2. 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…

  3. The Study of Small Groups and Microevolution: A Project for Physical Anthropology.

    Science.gov (United States)

    Rice, Patricia C.

    1985-01-01

    Describes a hands-on project in which anthropology students play the role of professional physical anthropologist in collecting and analyzing data on a small group of contemporary humans. Use of simulated data to represent ancestral populations results in an analysis of microevolution. (KH)

  4. 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…

  5. 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…

  6. Teaching Macroeconomics to the Visually Impaired: New Tactile Methods, Verbal Precision, and Small Groups

    Science.gov (United States)

    Naples, Michele I.

    2017-01-01

    Visually-impaired students require tailored pedagogies to ensure their instruction is as high quality as for sighted students. They follow board work during class by referring to typed class notes provided ahead of time via a Braille reader, and in-class small groups solving problems create an inclusive "esprit de corps" and promote…

  7. 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…

  8. Learning through Discussions: Comparing the Benefits of Small-Group and Large-Class Settings

    Science.gov (United States)

    Pollock, Philip H.; Hamann, Kerstin; Wilson, Bruce M.

    2011-01-01

    The literature on teaching and learning heralds the benefits of discussion for student learner outcomes, especially its ability to improve students' critical thinking skills. Yet, few studies compare the effects of different types of face-to-face discussions on learners. Using student surveys, we analyze the benefits of small-group and large-class…

  9. Small-Group Cooperative Learning. The Best of ERIC on Educational Management Number 76.

    Science.gov (United States)

    ERIC Clearinghouse on Educational Management, Eugene, OR.

    Annotations from 12 entries in the ERIC database were selected as significant and useful sources of information about small-group cooperative learning. Five of the citations are literature reviews. Among these is a meta-analysis, drawn from 217 studies, about the effects of cooperative learning on student achievement and interpersonal attraction;…

  10. Enactment of Teacher Identity in Resolving Student Disagreements in Small Group Peer Interactions

    Science.gov (United States)

    Sharma, Bal Krishna

    2013-01-01

    This study presents a sequential analysis of the enactment of teacher identity in closing disagreements among students in small group peer interactions in an advanced academic writing class. In doing so, it discusses: (a) the micro-details of how oppositional stances and opinions are constructed, challenged and/or defended; (b) the sequential…

  11. Exploring Small Group Analysis of Instructional Design Cases in Online Learning Environments

    Science.gov (United States)

    Trespalacios, Jesus

    2017-01-01

    The case-based approach is a constructivist instructional strategy that helps students apply their emerging knowledge by studying design problems in authentic real-world situations. One important instructional strategy in case-based instruction is to analyze cases in small groups before discussing them with the whole class. This study investigates…

  12. 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.

  13. Online Self-Tracking Groups to Increase Fruit and Vegetable Intake: A Small-Scale Study on Mechanisms of Group Effect on Behavior Change.

    Science.gov (United States)

    Meng, Jingbo; Peng, Wei; Shin, Soo Yun; Chung, Minwoong

    2017-03-06

    between a focal participant and his/her group members during the experiment), such that participants who had a low performance discrepancy from other group members had greater fruit and vegetable consumption than participants who had a high performance discrepancy from other group members (P=.002). A mediation test showed that low performance discrepancy led to greater downward contrast (b=-0.78, 95% CI -2.44 to -0.15), which in turn led to greater fruit and vegetable consumption. Online self-tracking groups were more effective than self-tracking alone in promoting fruit and vegetable consumption for early young adults. Low performance discrepancy from other group members lead to downward contrast, which in turn increased participants' fruit and vegetable consumption over time. The study highlighted social comparison processes in online groups that allow for sharing personal health information. Lastly, given the small scale of this study, nonsignificant results with small effect sizes might be subject to bias. ©Jingbo Meng, Wei Peng, Soo Yun Shin, Minwoong Chung. Originally published in the Journal of Medical Internet Research (http://www.jmir.org), 06.03.2017.

  14. 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.

  15. 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.

  16. 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

  17. 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.

  18. Identifying, understanding and overcoming barriers to medication error reporting in hospitals: a focus group study.

    Science.gov (United States)

    Hartnell, Nicole; MacKinnon, Neil; Sketris, Ingrid; Fleming, Mark

    2012-05-01

    The under-reporting of medication errors can compromise patient safety. A qualitative study was conducted to enhance the understanding of barriers to medication error reporting in healthcare organisations. Focus groups (with physicians, pharmacists and nurses) and in-depth interviews (with risk managers) were used to identify medication error reporting beliefs and practices at four community hospitals in Nova Scotia, Canada. Audio tapes were transcribed verbatim and analysed for thematic content using the template style of analysis. The development and analysis of this study were guided by Safety Culture Theory. Incentives for medication error reporting were thematised into three categories: patient protection, provider protection and professional compliance. Barriers to medication error reporting were thematised into five categories: reporter burden, professional identity, information gap, organisational factors and fear. Facilitators to encourage medication error reporting were classified into three categories: reducing reporter burden, closing the communication gap and educating for success. Participants indicated they would report medication errors more frequently if reporting were made easier, if they were adequately educated about reporting, and if they received timely feedback. Study results may lead to a better understanding of the barriers to medication error reporting, why these barriers exist and what can be done to successfully overcome them. These results could be used by hospitals to encourage reporting of medication errors and ultimately make organisational changes leading to a reduction in the incidence of medication errors and an improvement in patient safety.

  19. 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.

  20. 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

  1. Benefits and Challenges of Focus Groups in the Evaluation of a New Graduate Entry Medical Programme

    Science.gov (United States)

    Nestel, Debra; Ivkovic, Amelie; Hill, Robyn A.; Warrens, Anthony N.; Paraskevas, Paraskeva A.; McDonnell, Jacqueline A.; Mudarikwa, Ruvimbo S.; Browne, Chris

    2012-01-01

    Programme evaluation is essential for quality assurance in education. In this paper, we describe our evaluation strategy for the first year of a new medical programme. Although we used multiple methods in the evaluation, the use of the focus group method was core. This paper reports our experiences of focus groups for this purpose. We describe the…

  2. Interaktiver Kleingruppenunterricht für Medizinstudenten der Klinischen Semester in einer onkologischen Gemeinschaftspraxis [Interactive medical education for medical students in an oncology group practice

    OpenAIRE

    Weide, Rudolf; Heymanns, Jochen; Thomalla, Jörg; Köppler, Hubert

    2007-01-01

    [english] Background: The education of medical students to become qualified medical doctors should be improved in Germany. Reasons for this are medical teachers not properly trained in education, a lack of quality control and low esteem of medical education, too large groups, no intensive relationship between students and academic teachers and the triad for medical teachers at university hospitals to qualify in their discipline, to perform science and lecture medical students. At the same tim...

  3. [Health-care research from the German Medical Association's perspective on small-area analysis].

    Science.gov (United States)

    Zorn, U

    2014-02-01

    As early as 2003, the German medical profession realized the necessity of not only forwarding medical research, but also analyzing the process of health care itself. Approved by a decision of the 108th German Medical Assembly in 2005, an initiative on health-care research paid by contributions of the medical profession was launched. Since then several projects have been supported with the results being published continuously. From the perspective of the German Medical Association, the success of the initiative also proves the effective approach of the scientific and medical communities' self-administration. Although the current results from health-care research can be used to support health-care politics and decision making at a macro level, a focus on small-area analysis tends to be an intrinsic attribute of health-care research, keeping a local approach toward changes so as to obtain real effects. Without local settings and without data reflecting the local situation, the"last mile" of a health-care system, which is the core subject of health-care research, will not be comprehensible.

  4. 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

  5. Student satisfaction and perceptions of small group process in case-based interprofessional learning.

    Science.gov (United States)

    Curran, Vernon R; Sharpe, Dennis; Forristall, Jennifer; Flynn, Kate

    2008-01-01

    The small group, case-based learning approach is believed to be a useful strategy for facilitating interprofessional learning and interaction factors are said to have a significant effect on student interest, learning and satisfaction with such approaches. The purpose of our study was twofold: assess students' satisfaction with a blended approach to interprofessional learning which combined computer-mediated and face-to-face, case-based learning; and examine the relationship between student satisfaction and perceptions of the collaborative learning process. We introduced six interprofessional learning modules to approximately 520 undergraduate health professional students from medicine (61), nursing (351), pharmacy (20), and social work (89). All students were invited to complete an evaluation survey which assessed student satisfaction with the interprofessional learning experience and students' perceptions of the small group learning process. Students' satisfaction with interprofessional education was related to professional background. Students from across professions reported greater satisfaction with face-to-face, case-based learning when compared with other learning methods. A more positive perception of face-to-face, case-based learning was related to greater satisfaction with interprofessional learning. The findings support the case-based method in facilitating interprofessional learning and highlight the importance of effective facilitation of small-group collaborative learning to enhance student satisfaction with interprofessional learning experiences.

  6. International medical students’ expectations and worries at the beginning of their medical education: a qualitative focus group study

    OpenAIRE

    Huhn, Daniel; Huber, Julia; Ippen, Franziska M.; Eckart, Wolfgang; Junne, Florian; Zipfel, Stephan; Herzog, Wolfgang; Nikendei, Christoph

    2016-01-01

    Background: The number of international students has increased substantially within the last decade. Due to cultural barriers, this specific group faces diverse challenges. In comparison to German colleagues, international medical students perform significantly lower in clinical examinations and exceed the average duration of study; they suffer from personal distress as well as insufficient support. Within the present study, their individual perspectives, expectations, hopes and fears were ex...

  7. 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.

  8. 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.

  9. Experiences of the gender climate in clinical training ? a focus group study among Swedish medical students

    OpenAIRE

    Kristoffersson, Emelie; Andersson, Jenny; Bengs, Carita; Hamberg, Katarina

    2016-01-01

    Background Research shows that medical education is characterized by unequal conditions for women and men, but there is a lack of qualitative studies investigating the social processes that enable and maintain gender inequalities that include both male and female students. In this focus group study, we therefore explored male as well as female medical students? experiences of the gender climate ? i.e., how beliefs, values, and norms about gender were communicated ? during clinical training an...

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

    Science.gov (United States)

    2010-07-26

    ... Employment and Training Administration TA-W-73,682, Hartford Financial Services Group, Incorporated, Medical...; TA-W-73,682A, Hartford Financial Services Group, Incorporated Medical Bill Processing and Production... Financial Services Group, Incorporated, Medical Bill Processing and Production Center Support, Aurora...

  11. Factors affecting electronic medical record system adoption in small korean hospitals.

    Science.gov (United States)

    Park, Young-Taek; Lee, Jinhyung

    2014-07-01

    The objective of this paper is to investigate the factors affecting adoption of an Electronic Medical Record (EMR) system in small Korean hospitals. This study used survey data on adoption of EMR systems; data included that from various hospital organizational structures. The survey was conducted from April 10 to August 3, 2009. The response rate was 33.5% and the total number of small general hospitals was 144. Data were analyzed using the generalized estimating equation method to adjust for environmental clustering effects. The adoption rate of EMR systems was 40.2% for all responding small hospitals. The study results indicate that IT infrastructure (OR, 1.48; 95% CI, 1.23 to 1.80) and organic hospital structure (OR, 1.86; 95% CI, 1.07 to 3.23) rather than mechanistic hospital structure or the number of hospitals within a county (OR, 1.08; 95% CI, 1.01 to 1.17) were critical factors for EMR adoption after controlling for various hospital covariates. This study found that several managerial features of hospitals and one environmental factor were related to the adoption of EMR systems in small Korean hospitals. Considering that health information technology produces many positive health outcomes and that an 'adoption gap' regarding information technology exists in small clinical settings, healthcare policy makers should understand which organizational and environmental factors affect adoption of EMR systems and take action to financially support small hospitals during this transition.

  12. 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.

  13. Medication safety: using incident data analysis and clinical focus groups to inform educational needs.

    Science.gov (United States)

    Hesselgreaves, Hannah; Watson, Anne; Crawford, Andy; Lough, Murray; Bowie, Paul

    2013-02-01

    Medication-related safety incidents are a source of concern to patients, policy makers and clinicians. The role of education in improving safety-critical practices in health care is poorly appreciated. This pilot study aimed to initiate collective discussion among professional groups of clinical staff about a range of medicine-related patient safety issues which were identified from a local incident reporting system. In engaging staff to collectively reflect on reported medication incidents we attempted to uncover a deeper understanding of local contextual issues and potential educational needs. A mixed method study was conducted involving categorical analysis of 1058 medication incident reports (Phase 1) and the use of three mixed focus groups of clinical staff (Phase 2) in three acute hospitals in one locality in NHS Scotland. Focus group transcript analysis produced four main themes (e.g. the medical role) and 12 related sub-themes (e.g. pharmacological education and skill mix for administration of medicines) concerning medication-related practices and possible educational interventions. While it is necessary to review reported incident data and disseminate the educational messages for the improvement of quality, this traditional risk management process is inadequate on its own. Reporting systems can be enhanced by collective examination of reported information about medicines by local clinical teams. We identified a strong message from the focus groups for learning about each other and from each other, and that the method piloted may be an important inter-professional mechanism for improvement. © 2011 Blackwell Publishing Ltd.

  14. Effects of Group Fitness Classes on Stress and Quality of Life of Medical Students.

    Science.gov (United States)

    Yorks, Dayna M; Frothingham, Christopher A; Schuenke, Mark D

    2017-11-01

    Medical school can produce intense psychological distress in its students; however, there is a paucity of research exploring potential means of improving medical students' well-being. To investigate the relationship between physical exercise and stress and quality of life (QOL) in a medical student population. This nonrandomized, controlled, 12-week study used a survey research design. First- and second-year osteopathic medical students at the University of New England College of Osteopathic Medicine were recruited to participate in 1 of 3 groups: (1) students participating in 30-minute CXWORX (Les Mills International LTD) group fitness classes; (2) students exercising alone or with up to 2 additional partners regularly (eg, running, weight lifting), henceforth called the health-enhancement group; and (3) students in a control group who did not engage in regular exercise. Participants completed the Perceived Stress Scale survey once every 4 weeks, as well as visual analog scale surveys to assess physical, mental, and emotional QOL weekly during the course of the study. Statistical significance was defined as Psolution to improving the emotional well-being and stress level of medical students.

  15. 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.

  16. Performance anxiety at English PBL groups among Taiwanese medical students: a preliminary study.

    Science.gov (United States)

    Chen, Cheng-Sheng; Lai, Chung-Sheng; Lu, Peih-Ying; Tsai, Jer-Chia; Chiang, Hung-Che; Huang, In-Ting; Yu, Hsin-Su

    2008-03-01

    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.

  17. 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.

  18. 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

  19. Discovery of group I introns in the nuclear small subunit ribosomal RNA genes of Acanthamoeba.

    Science.gov (United States)

    Gast, R J; Fuerst, P A; Byers, T J

    1994-01-01

    The discovery of group I introns in small subunit nuclear rDNA (nsrDNA) is becoming more common as the effort to generate phylogenies based upon nsrDNA sequences grows. In this paper we describe the discovery of the first two group I introns in the nsrDNA from the genus Acanthamoeba. The introns are in different locations in the genes, and have no significant primary sequence similarity to each other. They are identified as group I introns by the conserved P, Q, R and S sequences (1), and the ability to fit the sequences to a consensus secondary structure model for the group I introns (1, 2). Both introns are absent from the mature srRNA. A BLAST search (3) of nucleic acid sequences present in GenBank and EMBL revealed that the A. griffini intron was most similar to the nsrDNA group I intron of the green alga Dunaliella parva. A similar search found that the A. lenticulata intron was not similar to any of the other reported group I introns. Images PMID:8127708

  20. 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)

  1. 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.

  2. 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.

  3. [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.

  4. 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.

  5. An RFID solution for enhancing inpatient medication safety with real-time verifiable grouping-proof.

    Science.gov (United States)

    Chen, Yu-Yi; Tsai, Meng-Lin

    2014-01-01

    The occurrence of a medication error can threaten patient safety. The medication administration process is complex and cumbersome, and nursing staffs are prone to error when they are tired. Proper Information Technology (IT) can assist the nurse in correct medication administration. We review a recent proposal regarding a leading-edge solution to enhance inpatient medication safety by using RFID technology. The proof mechanism is the kernel concept in their design and worth studying to develop a well-designed grouping-proof scheme. Other RFID grouping-proof protocols could be similarly applied in administering physician orders. We improve on the weaknesses of previous works and develop a reading-order independent RFID grouping-proof scheme in this paper. In our scheme, tags are queried and verified under the direct control of the authorized reader without connecting to the back-end database server. Immediate verification in our design makes this application more portable and efficient and critical security issues have been analyzed by the threat model. Our scheme is suitable for the safe drug administration scenario and the drug package scenario in a hospital environment to enhance inpatient medication safety. It automatically checks for correct drug unit-dose and appropriate inpatient treatments. Copyright © 2013. Published by Elsevier Ireland Ltd.

  6. 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.

  7. Teachers' and students' verbal behaviours during cooperative and small-group learning.

    Science.gov (United States)

    Gillies, Robyn M

    2006-06-01

    Teachers play a critical role in promoting interactions between students and engaging them in the learning process. This study builds on a study by Hertz-Lazarowitz and Shachar (1990) who found that during cooperative learning teachers' verbal behaviours were more helpful to and encouraging of their students' efforts while during whole-class instruction, their verbal behaviours tended to be more authoritarian, rigid, and impersonal. This study seeks to determine if teachers who implement cooperative learning engage in more facilitative learning interactions with their students than teachers who implement group work only. The study also seeks to determine if students in the cooperative groups model their teachers' behaviours and engage in more positive helping interactions with each other than their peers in the group work groups. The study involved 26 teachers and 303 students in Grades 8 to 10 from 4 large high schools in Brisbane, Australia. All teachers agreed to establish cooperative, small-group activities in their classrooms for a unit of work (4 to 6 weeks) once a term for 3 school terms. The teachers were audiotaped twice during these lessons and samples of the students' language, as they worked in their groups, were also collected at the same time. The results show that teachers who implement cooperative learning in their classrooms engage in more mediated-learning interactions and make fewer disciplinary comments than teachers who implement group work only. Furthermore, the students model many of these interactions in their groups. The study shows that when teachers implement cooperative learning, their verbal behaviour is affected by the organizational structure of the classroom.

  8. Experimental Exposure to Gamma Radiation of Small Medical Articles and Pharmaceutical Protein Solutions

    International Nuclear Information System (INIS)

    Saint-Aubert, G. de; Valette, L. R.; Plan, R.; Cherby, D.

    1967-01-01

    The behaviour under exposure to gamma rays of small medical articles (multipuncture rings and self-injecting plastic ampoule-syringes) and protein solutions (purified anti-tetanus serum and polyvalent gamma globulins in glass phials) has been studied with a view to considering the applicability of radiosterilization techniques to such articles and solutions. The radiation source used was an assembly of 60 Co rods of the C. E. A. T. 16 type, with a total activity of 41 600 Ci (1. 65 Mrad/h). The articles were exposed to a fixed dose of 3.3 Mrad. Various batches of solutions were exposed to doses ranging from 0. 5 to 3.3 Mrad. The irradiated articles were physically checked for sterility in culture media and also for harmful effects on small animals. Physical checks were carried out on the protein solutions for sterility in culture media, activity in small animals and by serum neutralization, and physico-chemical checks were also performed by immuno-electrophoresis and electrophoresis. The results of these different checks, which showed that the protein solutions were extremely unstable, were studied with a view to assessing the possibility of exposing these medical articles and pharmaceutical solutions to sterilizing doses of gamma radiation. (author) [fr

  9. 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

  10. 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.

  11. 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.

  12. 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.; Robbe, P.F.

    2008-01-01

    OBJECTIVES: In this study, we evaluated the internal validity of EPICON, an application for grouping ICPC-coded 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

  13. 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.

  14. 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.

  15. The Medicaid medically improved group: losing disability status and growing earnings.

    Science.gov (United States)

    Thomas, Kathleen C; Hall, Jean P

    2014-01-01

    Under the Ticket to Work and Work Incentives Improvement Act (PL 106-170), states may extend Medicaid Buy-In coverage to a medically improved group. Improved group coverage allows adults with disabilities to retain Medicaid coverage even once they lose disability status due to medical improvement, as long as they retain the original medical impairment. The goal of this paper is to describe who participated, the patterns of their participation, and employment outcomes. The study population consists of all individuals (n = 315) who participated in medically improved group coverage 2002-2009 in the seven states with coverage by 2009 (Arizona, Connecticut, Kansas, New York, North Carolina, Pennsylvania, and West Virginia). Linked data from state Medicaid Buy-In finder files and Social Security Administration Ticket Research and Master Earnings Files were used to describe improved group participants and their patterns of enrollment. Although enrollment has been limited, with 255 participants in 2009, it has doubled annually on average with little churning and drop-out. Participants' earnings grew nearly 200 dollars per month after two years, likely reflecting increased work hours and/or higher pay rates. Improved group participants represent an unusually successful group of individuals with disabilities, many of whom have recently moved off Social Security cash benefit rolls or who were diverted from them. Specifics of insurance eligibility and coverage for improved group participants are uncertain under the Affordable Care Act. The challenge remains to provide a pathway for adults with disabilities to increase work and assets without loss of adequate health insurance.

  16. 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.

  17. Technical note: Harmonising metocean model data via standard web services within small research groups

    Science.gov (United States)

    Signell, Richard P.; Camossi, Elena

    2016-05-01

    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.

  18. 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.

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

    Science.gov (United States)

    Bonaldo, Roberta M; 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 (reef organisms is largely decoupled from local adult reproduction. We examined the structure of 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.

  20. 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 (reef organisms is largely decoupled from local adult reproduction. We examined the structure of 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

  1. Small-Scale Systems of Galaxies. II. Properties of the NGC 4756 Group of Galaxies

    Science.gov (United States)

    Grützbauch, R.; Kelm, B.; Focardi, P.; Trinchieri, G.; Rampazzo, R.; Zeilinger, W. W.

    2005-04-01

    This paper is part of a series that focuses on investigating galaxy formation and evolution in small-scale systems of galaxies in low-density environments. We present results from a study of the NGC 4756 group, which is dominated by the elliptical galaxy NGC 4756. The characteristics of the group are investigated through (1) the detailed investigation of the morphological, photometric, and spectroscopic properties of nine galaxies among the dominant members of the group; (2) the determination of the photometric parameters of the faint galaxy population in an area of 34'×34' centered on NGC 4756 and (3) an analysis of the X-ray emission in the area based on archival data. The nine member galaxies are located in the core part of the NGC 4756 group (a strip ~300 kpc in diameter, H0=70 km s-1 Mpc-1), which has a very loose configuration. The central part of the NGC 4756 group contains a significant fraction of early-type galaxies. Three new group members with previously unknown systemic velocities are identified, one of which is type dE. At about 7.5 arcmin southwest of NGC 4756 a substructure of the group is detected, including IC 829, MCG -2-33-35, MCG -2-33-36, and MCG -2-33-38, that meets the Hickson criteria for being a compact group. Most of the galaxies in this substructure show interaction signatures. We do not detect apparent fine structure and signatures of recent interaction events in the early-type galaxy population, with the exception of a strong dust lane in the elliptical galaxy MCG -2-33-38. However, this galaxy displays signatures of nuclear activity. Strong [O III], [N II], and [S II] line emission, combined with comparatively weak but broad Hα emission, suggests an intermediate Seyfert type classification. Although the area is heavily contaminated by the background cluster A1631, X-ray data suggest the presence of a hot intergalactic medium related to the detected X-ray emission of the group. The present results are discussed in the context of

  2. 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.

  3. 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

  4. 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.

  5. 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...... 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...

  6. 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

  7. Reflecting on our practice: an evaluation of Balint groups for medical students in psychiatry.

    Science.gov (United States)

    Parker, Stephen D; Leggett, Andrew

    2014-04-01

    This paper qualitatively evaluates a one-year trial of Balint clinical reflection groups for medical students in psychiatry at a large Australian tertiary referral hospital. The trial considered whether clinical reflection groups following the Balint process would be perceived as useful and relevant to the learning needs of the student participants. A grounded theory approach was undertaken. This included survey data, thematic analysis of written feedback, and facilitator reflection on the process. Facilitators adapted the group process in response to participants' needs. These modifications included: increased education regarding the Balint process; the introduction of co-presenters; and the inclusion of a didactic summary following each session. The evaluation suggested that fidelity of the Balint group experience was achieved and that student attitudes were neutral to mildly positive regarding the educational experience. Balint groups are potentially useful to medical students in the Australian context. We suggest that Balint groups may be more useful when applied in less alienating learning environments, such as during general practice rotations. Emphasis is placed on the need to maintain a dynamic approach by adapting the group and the educational processes as the work unfolds.

  8. Franchising as a Strategy for Combining Small and Large Group Advantages (Logics) in Social Entrepreneurship: A Hayekian Perspective

    OpenAIRE

    Beckmann, Markus; Zeyen, Anica

    2014-01-01

    This article develops a Hayekian perspective on social franchising that distinguishes between the end-connected logic of the small group and the rule-connected logic of the big group. Our key claim is that mission-driven social entrepreneurs often draw on the small-group logic when starting their social ventures and then face difficulties when the process of scaling shifts their operations toward a big-group logic. In this situation, social franchising offers a strategy to replicate the small...

  9. Design and development of low-loss transformer for powering small implantable medical devices.

    Science.gov (United States)

    Shiba, K; Morimasa, A; Hirano, H

    2010-04-01

    Small implantable medical devices, such as wireless capsule endoscopes, that can be swallowed have previously been developed. However, these devices cannot continuously operate for more than 8 h because of battery limitations; moreover, additional functionalities cannot be introduced. This paper proposes a design method for a high-efficiency energy transmission transformer (ETT) that can transmit energy transcutaneously to small implantable medical devices using electromagnetic induction. First, the authors propose an unconventional design method to develop such a high-efficiency ETT. This method can be readily used to calculate the exact transmission efficiency for changes in the material and design parameters (i.e., the magnetic material, transmission frequency, load resistance, etc.). Next, the ac-to-ac energy transmission efficiency is calculated and compared with experimental measurements. Then, suitable conditions for practical transmission are identified. A maximum efficiency of 33.1% can be obtained at a transmission frequency of 500 kHz and a receiving power of 100 mW for a receiving coil size of ¿5 mm × 20 mm. Future design optimization is possible by using this method.

  10. Problem-based learning: facilitating multiple small teams in a large group setting.

    Science.gov (United States)

    Hyams, Jennifer H; Raidal, Sharanne L

    2013-01-01

    Problem-based learning (PBL) is often described as resource demanding due to the high staff-to-student ratio required in a traditional PBL tutorial class where there is commonly one facilitator to every 5-16 students. The veterinary science program at Charles Sturt University, Australia, has developed a method of group facilitation which readily allows one or two staff members to facilitate up to 30 students at any one time while maintaining the benefits of a small PBL team of six students. Multi-team facilitation affords obvious financial and logistic advantages, but there are also important pedagogical benefits derived from uniform facilitation across multiple groups, enhanced discussion and debate between groups, and the development of self-facilitation skills in students. There are few disadvantages to the roaming facilitator model, provided that several requirements are addressed. These requirements include a suitable venue, large whiteboards, a structured approach to support student engagement with each disclosure, a detailed facilitator guide, and an open, collaborative, and communicative environment.

  11. An interactive online approach to small-group student presentations and discussions.

    Science.gov (United States)

    Thor, Der; Xiao, Nan; Zheng, Meixun; Ma, Ruidan; Yu, Xiao Xi

    2017-12-01

    Student presentations had been widely implemented across content areas, including health sciences education. However, due to various limitations, small-group student presentations in the classroom may not reach their full potential for student learning. To address challenges with presentations in the classroom, we redesigned the assignment by having students present and discuss online using VoiceThread, a cloud-based presentation and discussion tool. First-year students pursuing a Doctor of Dental Surgery degree were assigned into small groups to present physiology content and to discuss that content online. This assignment was similar to traditional student classroom presentations, with the exception that the entire assignment was conducted online. The primary purpose of this exploratory study was to investigate the impact of the online format on the discussion quality. Another purpose of the study was to examine students' perceptions of using VoiceThread for presenting and learning, as well as the online interactions between the presenter and audience. Students posted a higher number of questions and comments than required by the assignment. The questions from students were also higher level questions, and the answers to these questions were more thorough compared with what we had previously observed in classroom presentations. The survey results showed that students preferred using VoiceThread for presenting, learning from other presentations, and discussing presentation content over performing this process in the classroom. Preliminary findings suggested that having dental students make presentations and hold discussions online might help address the challenges of student presentations in the classroom. Copyright © 2017 the American Physiological Society.

  12. 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

    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. We conducted an ethnographic study of 5 small family medicine offices (having relationships. MA career motivations comprised interest in health care, easy training/workload, and customer service orientation. Clinician-MA relationships were influenced by how MAs and clinicians respond to their perceptions of MA clinical competence (illustrated predominantly by comparing MAs with nurses) and organizational structure. We propose a model, trust and verify, to describe the structure of the clinician-MA relationship. This model is 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. 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.

  13. Continuing Veterinary Medical Education Needs Assessment of Small Animal Practitioners in South Korea.

    Science.gov (United States)

    Chun, Myung-Sun; Hwang, Cheol-Yong

    2015-01-01

    This first survey of small animal veterinarians in Korea explores demographic patterns, previous learning experiences, and program preferences for continuing veterinary medical education (CVME). Data were analyzed to identify and describe learning needs and preferences. Respondents' average CVME hours (38.4 hours/year) exceeded the mandatory 10 hours per year. Almost all respondents recognized the importance of CVME. Lack of time and travel distance were identified as significant barriers to CVME participation. CVME courses scheduled after 9 p.m. on weekdays with a registration fee of up to $50 US per hour were preferred. Respondents clearly defined the educational quality criteria of preferred CVME programs: delivery in a series of interventions in a small seminar format, with lectures on theory combined with practical skill-building wet labs taught by experienced veterinarians and board-certified specialists. Small animal veterinarians in Korea are enthusiastic life-long learners who are strongly motivated to select CVME learning activities based on self-identified needs. The changing environment of veterinary medicine in Korea demands an evolution of CVME quality criteria, such as clear program goals reflecting veterinarians' educational needs and desirable competencies, and specific measurable learning objectives. Moreover, the current accreditation system, which does not encourage hands-on skill development formats, needs urgent improvement.

  14. 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.

  15. Initiatives by the government and physician groups to improve awareness of medical ethics: Challenges in Japan.

    Science.gov (United States)

    Morioka, Yasuhiko

    2012-01-01

    Physicians have been required to possess high ethical standards, as medical practice is directly involved with patients' lives. Although ethics arise out of an individual's consciousness, ethical regulations imposed by the nation/government together with self-regulation by physician groups are important in the practice of ethics, for which reason countries around the world undertake various initiatives. This paper investigates physician licensure, organizations governing physician status, the role of physician groups, and the actual conditions of lifelong learning and ethics education in developed countries worldwide, in contrast with which it throws problems in the situation in Japan into relief. Organizations governing physician status, the form of medical associations, and the improvement of lifelong learning are pointed out as critical issues especially in Japan.

  16. 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.

  17. 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

  18. 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.

  19. 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.

  20. Educational network comparative analysis of small groups: Short- and long-term communications

    Science.gov (United States)

    Berg, D. B.; Zvereva, O. M.; Nazarova, Yu. Yu.; Chepurov, E. G.; Kokovin, A. V.; Ranyuk, S. V.

    2017-11-01

    The present study is devoted to the discussion of small group communication network structures. These communications were observed in student groups, where actors were united with a regular educational activity. The comparative analysis was carried out for networks of short-term (1 hour) and long-term (4 weeks) communications, it was based on seven structural parameters, and consisted of two stages. At the first stage, differences between the network graphs were examined, and the random corresponding Bernoulli graphs were built. At the second stage, revealed differences were compared. Calculations were performed using UCINET software framework. It was found out that networks of long-term and short-term communications are quite different: the structure of a short-term communication network is close to a random one, whereas the most of long-term communication network parameters differ from the corresponding random ones by more than 30%. This difference can be explained by strong "noisiness" of a short-term communication network, and the lack of social in it.

  1. Group Medical Visits to Provide Gynecologic Care for Women Affected by Breast Cancer

    Directory of Open Access Journals (Sweden)

    Sally R. Greenwald

    2017-01-01

    Full Text Available Purpose: Women with breast cancer have complex and unique gynecologic needs that are challenging to effectively and comprehensively meet in a traditional gynecology visit format. Group medical visits are an effective and well-received model of care in other disease settings and can provide comprehensive health education as an adjunct to one-on-one evaluation and treatment. There are limited data regarding the use of this type of health care delivery in providing gynecology-focused care to women affected by breast cancer. Methods: A group medical visit model was created for gynecology providers to see new breast cancer patient consults. From May 2012 to February 2014, 148 patients (3–6 per group participated in a 1-hour informational session followed by a 15- to 30-minute individual visit with a physician that included history, physical examination and evaluation. We surveyed 101 women who attended these visits to evaluate a group model for providing gynecologic care and educational support to women with breast cancer. Results: Of those who responded to the survey question, 100% agreed or somewhat agreed that their expectations for an initial intake visit were met during the group visit; 81% agreed or somewhat agreed that they felt a group visit was preferable to an individual introductory visit. More than 95% agreed or somewhat agreed that the information was understandable and their questions were answered during the visit. Only 5 respondents expressed dissatisfaction with the additional time commitment for this type of visit. Conclusions: The majority of women surveyed expressed satisfaction with their experience with a group visit format. The women who participated preferred this format compared to an individual intake appointment when establishing gynecology care after breast cancer diagnosis/treatment, regardless of age, menopausal status, cancer stage or hormone receptor status. While further studies are warranted to directly compare and

  2. Inviting Argument by Analogy: Analogical-Mapping-Based Comparison Activities as a Scaffold for Small-Group Argumentation

    Science.gov (United States)

    Emig, Brandon R.; McDonald, Scott; Zembal-Saul, Carla; Strauss, Susan G.

    2014-01-01

    This study invited small groups to make several arguments by analogy about simple machines. Groups were first provided training on analogical (structure) mapping and were then invited to use analogical mapping as a scaffold to make arguments. In making these arguments, groups were asked to consider three simple machines: two machines that they had…

  3. 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

  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. Mapping the Balint groups to the Accreditation Council for Graduate Medical Education family medicine competencies.

    Science.gov (United States)

    Lichtenstein, Albert; Antoun, Jumana; Rule, Chris; Knowlton, Katherine; Sternlieb, Jeffrey

    2018-01-01

    Introduction Balint group discussions provide learning opportunities for many of the competencies and milestones put forward by the Accreditation Council for Graduate Medical Education. The current literature is mixed concerning the effect of Balint groups on communication skills and professionalism. Aim To map the content of the Balint discussion to the competencies and milestones put forward by the Accreditation Council for Graduate Medical Education. A group who were both experts in Balint and members of the clinical competency committee of residency programs rated narratives that summarized Balint group discussions. Credentialed Leaders of the American Balint Society were invited via email to submit narratives (250 words) about Balint groups that they have led, or were leading, with residents. Results Only four narratives were submitted. Additional cases were recruited through literature review of published Balint discussion cases. A total of 25 cases were rated by the committee. There was agreement between three out of four raters on at least one core milestone in every case. The most frequent milestones were C1 (develops meaningful therapeutic relationships with patients and families), C2 (communicated effectively with patients, families, and public), Prof1 (completes a process of professionalization), and Prof3 (demonstrates humanism and cultural proficiency). Balint groups provided a learning opportunity for a subset of milestones in at least 36% of the cases. Conclusion This pilot research suggests that Balint groups and the discussions of complex and challenging cases provide learning opportunities for multiple family medicine milestones, mainly communication skills and professionalism. Further research is needed to refine the methodology and the rating system.

  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. 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-...

  8. Commercial Laboratory Testing of Excision Repair Cross-Complementation Group 1 Expression in Non-Small Cell Lung Cancer

    Science.gov (United States)

    Farhadfar, Nosha; Sivapiragasam, Abirami; Geller, Matthew; Islam, Shahidul; Selbs, Elena

    2014-01-01

    Introduction. Excision repair cross-complementation group 1 (ERCC1) expression by non-small cell lung cancer (NSCLC) has been reported to predict resistance to platinum-based therapies. On this basis, several commercial laboratories have offered ERCC1 testing to facilitate clinical decision making, but the reliability of such assays has recently been called into question. Methods. First, three large commercial laboratories were queried for their cumulative ERCC1 test results in NSCLC patients to compare their independent rates of ERCC1 expression. Second, identical tumor blocks from individual NSCLC patients underwent round-robin analysis to evaluate interlaboratory concordance for ERCC1 expression. Third, a retrospective review of medical records from NSCLC patients identified those who were both highly responsive and resistant to platinum-based chemotherapies. Tumor blocks from these patients were then used in a gold standard analysis to determine individual laboratory sensitivity and specificity for ERCC1 results. Results. Significant differences were observed in independent laboratory ERRC1 expression rates (Clarient 70% vs. Genzyme 60% vs. Third Laboratory 44%, p marketed laboratory assays achieved a specificity of greater than 50%. Conclusion. The results of commercial laboratory testing for ERCC1 are inconsistent and unreliable. Better validation and postmarketing surveillance should be mandated before tumor biomarker assays are allowed to enter the clinical arena. PMID:24705979

  9. 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.

  10. 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...

  11. Percutaneous cryoablation for the treatment of medically inoperable stage I non-small cell lung cancer.

    Directory of Open Access Journals (Sweden)

    Yoshikane Yamauchi

    Full Text Available BACKGROUND: To evaluate the midterm results of percutaneous cryoablation for medically inoperable stage I non-small cell lung cancer. METHODOLOGY/PRINCIPAL FINDINGS: Between January 2004 and June 2010, 160 patients underwent computer tomography guided percutaneous cryoablation for lung tumors at our institution. Of these patients, histologically proven stage I lung cancer patients with more than one year of follow-up, were retrospectively reviewed. All of these patients were considered to be medically inoperable with Charlson comorbidity index of 3 or greater. Follow-up was based primarily on computed tomography. There were 22 patients with 34 tumors who underwent 25 sessions of cryoablation treatment. Complications were pneumothoraces in 7 treatments (28%, chest tube required in one treatment, and pleural effusions in 8 treatments (31%. The observation period ranged from 12-68 months, average 29±19 months, median 23 months. Local tumor progression was observed in one tumor (3%. Mean local tumor progression-free interval was 69±2 months. One patient died of lung cancer progression at 68 months. Two patients died of acute exacerbations of idiopathic pulmonary fibrosis which were not considered to be directly associated with cryoablation, at 12 and 18 months, respectively. The overall 2- and 3-year survivals were 88% and 88%, respectively. Mean overall survival was 62±4 months. Median overall survival was 68 months. The disease-free 2- and 3-year survivals were 78% and 67%, respectively. Mean disease-free survival was 46±6 months. Pulmonary function tests were done in 16 patients (18 treatments before and after cryoablation. Percentage of predicted vital capacity, and percentage of predicted forced expiratory volume in 1 second, did not differ significantly before and after cryoablation (93±23 versus 90±21, and 70±11 versus 70±12, respectively. CONCLUSIONS/SIGNIFICANCE: Although further accumulation of data is necessary regarding efficacy

  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. 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.

  14. 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

  15. 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

  16. 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

  17. 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.

  18. Assessment of impact of small group teaching among students in community medicine

    Directory of Open Access Journals (Sweden)

    Ranabir Pal

    2012-01-01

    Full Text Available Background: We conducted a study to assess the impact of small group teaching (SGT among students by feedback analysis to identify intricacy so that learning can be facilitated. Materials and Methods: This cross-sectional study was undertaken among 182 MBBS students studying at a teaching hospital at Gangtok. Students were provided with a questionnaire following an assignment on a scheduled topic. Students were asked to provide feedback on the modes of teaching-learning practiced in community medicine with the parameters of evaluation including assessment of presentation by faculty member in reference to relevance, sequencing, depth, interaction, etc., to the overall rating of presentations in different teaching-learning methods. Results: The faculty members were on the positive evaluation by the students in the SGT, which was preferred over "lectures" as the teaching-learning methods. Among SGTs "tutorials" were graded better than "practical," "seminar" and "field posting" on the basis of longer duration at a stretch. Among the parameters for evaluation, relevance, depth, and interaction in regard to scheduled topic of presentations, the rating was significantly higher in SGT than different other teaching-learning methods. Largely the students noted that the time devoted and number of hours/sessions allotted for each topic was adequate. Conclusion: All forms of SGT were on the positive appraisal by the students on their learning experience and were considered as a comprehensive tool for in-depth teacher-student interaction.

  19. Whistles of small groups of Sotalia fluviatilis during foraging behavior in southeastern Brazil

    Science.gov (United States)

    Pivari, Daniela; Rosso, Sergio

    2005-10-01

    Whistle emissions were recorded from small groups of marine tucuxi dolphins (Sotalia fluviatilis) in two beaches located in an important biological reserve in the Cananéia estuary (25°03'S, 47°58'W), southeastern Brazil. A total of 17 h of acoustic data was collected when dolphins were engaged in a specific feeding foraging activity. The amount of 3235 whistles was recorded and 40% (n=1294) were analyzed. Seven acoustic whistle parameters were determined: duration (ms), number of inflection points, start and end frequency (kHz), minimum and maximum frequency (kHz), and frequency range (kHz). Whistles with up to four inflection points were found. Whistles with no inflection points and rising frequency corresponded to 85% (n=1104) of all analyzed whistles. Whistle duration varied from 38 to 627 ms (mean=229.6+/-109.9 ms), with the start frequency varying between 1 and 16 kHz (mean=8.16+/-3.0 kHz) and the end frequency between 2 and 18 kHz (mean=14.35+/-3.0 kHz). The importance of this study requires an accurate measurement of the whistles' emissions in an unusual foraging feeding behavior situation on two beaches where several tucuxis, mostly mother-calf pairs, are frequently present. These two beaches are located in a federal and state environment Environmental Protected Area threatened by the progressive increase of tourism.

  20. 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.

  1. 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.

  2. 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.

  3. 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.

  4. Evolution of small putative group I introns in the SSU rRNA gene locus of Phialophora species

    Directory of Open Access Journals (Sweden)

    Harris Lorena B

    2011-07-01

    Full Text Available Abstract Background Group I introns (specifically subgroup IC1 are common in the nuclear ribosomal RNA genes of fungi. While most range in length from more than 200 to nearly 1800 nucleotides (nt in length, several small putative (or degenerate group I introns have been described that are between 56 and 81 nt. Although small, previously we demonstrated that the PaSSU intron in the rRNA small subunit gene of Phialophora americana isolate Wang 1046 is capable of in vitro splicing using a standard group I intron pathway, thus qualifying it as a functional ribozyme. Findings Here, we describe eight short putative group I introns, ranging in length from 63 to 75 nt, in the rRNA small subunit genes of Phialophora isolates, a fungal genus that ranges from saprobic to pathogenic on plants and animals. All contain putative pairing regions P1, P7, and P10, as well as a pairing region formed between the middle of the intron and part of the 3' exon. The other pairing regions common in the core of standard group I introns are absent. However, parts of the 3' exon may aid in the stabilization of these small introns. Although the eight putative group I introns were from at least three species of Phialophora, phylogenetic analysis indicated that the eight are monophyletic. They are also monophyletic with the small introns of two lichen-forming fungi, Porpidia crustulata and Arthonia lapidicola. Conclusions The small putative group I introns in Phialophora have common features that may represent group I introns at their minima. They appear to have a single origin as indicated by their monophyly in phylogenetic analyses.

  5. Activities of working group on atomic, molecular and nuclear data for medical science

    International Nuclear Information System (INIS)

    1985-03-01

    This is a report on the activities of the Working Group on Atomic, Molecular and Nuclear Data for Medical Science, Japanese Nuclear Data Committee in the fisical years of 1982 and 1983. This report consists of (1) brief reviews on stopping powers of charged particles and electrons and related topics, and on problems to use these data for practical radiotheraphy, (2) reports on the investigation of the present status of data activities in other countries, (3) references, and (4) future plans after 1984. (author)

  6. 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:…

  7. Clinical experience and minority group students. A perspective from Harvard Medical School.

    Science.gov (United States)

    Poussaint, A F

    1999-05-01

    Medical educators realize that there are no simple predictors for student performance in the clinical training years. College grades and Medical College Admission Test scores may suggest the strength of a student's achievement in the basic sciences but cannot be relied on to predict efficacy in patient care. There is no fool proof way of assessing noncognitive abilities critical to clinical competence. However, in admissions, extracurricular activities, community service, leadership abilities, recommendations, and interviews are examined to assess personal strengths. The author's observations suggest that noncognitive attributes are important in the success of disadvantaged students. Although some, but not all, with low Medical College Admission Test scores may not excel in the basic sciences, once they reach the clinical years, a leveling of the playing field gives them an opportunity to show their special competence with patients. Minority students, perhaps because of their own life experiences, often are alert to the needs and sensitivities of patients. As a group, they are respectful of the dignity of patients. Many embrace the dictum: treat every patient as you would want a family member to be treated. Most minority students, despite pressures of being a minority in predominantly white environments, perform at a very high level in the clinical years and thereafter.

  8. The effect of small peer group continuous quality improvement on the clinical practice of midwives in The Netherlands.

    NARCIS (Netherlands)

    Engels, Y.; Verheijen, Nicole; Fleuren, M; Mokkink, Henk; Grol, R.

    2003-01-01

    OBJECTIVE: To study the effects of small group continuous quality improvement (CQI) on the clinical practice of midwives in the Netherlands. DESIGN: Randomised pre-/post-test (balanced block). INTERVENTION: The CQI groups were assigned to either the set of peer review topics including 'perineal

  9. The effect of small peer group continuous quality improvement on the clinical practice of midwives in The Netherlands

    NARCIS (Netherlands)

    Engels, Y.; Verheijen, N.; Fleuren, M.; Mokkink, H.; Grol, R.

    2003-01-01

    Objective: To study the effects of small group continuous quality improvement (CQI) on the clinical practice of midwives in the Netherlands. Design: Randomised pre-/post-test (balanced block). Intervention: The CQI groups were assigned to either the set of peer review topics including 'perineal

  10. 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...

  11. 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.

  12. 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.

  13. [The medical management of the allergic worker in small industries and for craftsmen].

    Science.gov (United States)

    Cirla, A M

    2009-01-01

    This report is aimed to suggest how allergic subjects can be admitted to activities at risk and how workers affected by occupational allergy can be relocated. Allergy is a mechanism strictly joined with the individuality trough the immunologic system of protection of the organism Works are the background of a possible exposure to agents able to rouse a specific hypersensitivity, but also the purposes of everyone for having a normal way of life. Population studies demonstrated that 70% of adults that present themselves for working as craftsmen or in small industries are normally reactive, but about 30% have a condition of a diagnosed allergy or are hyperreactive to the environment. Therefore it is unfeasible to exclude the allergic ones from work even for preventive aims. The true prevention is linked to manage a methodology of assessing and grading the allergologic risk at the workplaces (four levels are proposed) and of classifying the subjects by medical parameters (five class are proposed). The individual job fitness may be so defined, either at the first examination or periodically during working activity, monitoring self-reported symptoms and changement of used materials or of specific tasks. Informal guidelines are proposed to manage three possible situations of occupational allergic diseases and the engagement of the occupational physician also to be connected with allergy specialists and family doctors is recommended.

  14. 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

    2016-08-01

    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 differently. We use data from 5367 university students nested within 1141 science, engineering, and mathematics learning groups and use a regression analysis to estimate the effect of group diversity, measured in two ways, on course performance. Our results indicate that academic-preparedness diversity is generally associated with positive learning outcomes, that academically less-prepared students derive greater benefit, and that less-prepared students fare best when they are not alone in a group of highly prepared students. Implications for teaching and small-group facilitation are addressed.

  15. Kaiser Permanente Georgia's Experience with Operation Zero: A Group Medical Appointment to Address Pediatric Overweight.

    Science.gov (United States)

    Hinchman, Josephine; Beno, Luke; Mims, Adrienne

    2006-01-01

    The rate of overweight (OW) in children in the United States has more than tripled since 1980. The health consequences of pediatric OW include type 2 diabetes and significant illness later in life. Treating pediatric OW is a necessity; however, health care clinicians have minimal access to successful and comprehensive treatment modalities for addressing it. Kaiser Permanente of Georgia (KPGA) offers a group medical appointment clinic, Operation Zero (O.Z.), as a referral program for preadolescent and adolescent patients who are in the 85th or higher percentile for body mass index (BMI) for their age. The eight-session clinic uses a family-oriented approach and provides a supportive group environment with interactive learning, games, physical activity, and creative problem solving. The goal of the program is to improve lifestyle behaviors for nutrition and physical activity. Clinically, meeting these goals can manifest as reductions in body fat (BF), waist size, and BMI-for-age percentile. Two implementation models help improve dissemination of the program within KPGA. Baseline and eight-week postclinical outcomes for O.Z. participants were analyzed to determine program effectiveness. A retrospective analysis with a control group looked at long-term clinical outcomes to determine weight maintenance. Main outcome measures were weight, BMI-for-age percentile, waist size, and percentage of body fat (%BF). At eight weeks after program completion compared with baseline, there were significant reductions in %BF and waist size for the total sample and specifically for adolescents, preteens, and participants who attended six or more sessions. Among O.Z. participants, there were insignificant increases in weight at six months after program participation and BMI-for-age percentile at one year after participation. At six months, the mean change in weight and BMI in the O.Z. group was statistically less than the mean change in the control group. A structured, family

  16. Radiotherapy in medically inoperable early stage non-small cell lung cancer

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Bo Kyoung; Park, Charn II [College of Medicine, Seoul National Univ., Seoul (Korea, Republic of)

    2000-12-01

    For early stage non-small-cell lung cancer, surgical resection is the treatment of choice. But when the patients are not able to tolerate it because of medical problem and when refuse surgery, radiation therapy is considered an acceptable alternative. We report on the treatment results and the effect of achieving local control of primary tumors on survival end points and analyze factors that may influence survival and local control. We reviewed the medical records of 32 patients with medically inoperable non--small cell lung cancer treated at our institution from June, 1987 through June, 1997. All patients had a pathologic diagnosis of non-small cell lung cancer and were not. candidate for surgical resection because of either patients refusal (4), old age (2), lung problem (21), chest wall invasion (3) and heart problems (3). In 8 patients, there were more than 2 problems. The median age of the patients was 68 years (ranging from 60 to 86 years). Histologic cell type included squamous (24), adenocarcinoma (6) and unclassified squamous cell (2). The clinical stages of the patients were T1 in 5. T2 in 25, T3 in 2 patients. Initial tumor size was {<=}3.0 cm in 11, between 3.0 cm and 5.0 cm in 13 and more than 5.0 em in 8 patients. All patients had taken chest x-rays, chest CT, abdomen USG and bone scan. Radiotherapy was delivered using 6 MV or 10 MV linear accelerators. The doses of primary tumor were the ranging from 54.0 Gy to 68.8 Gy (median; 61.2 Gy). The duration of treatment was from 37 days through 64 days (median; 48.5 days) and there was no treatment interruption except 1 patient due to poor general status. In 12 patients, concomitant boost technique was used. There were no neoadjuvant or adjuvant treatments such as surgery or chemotherapy. The period of follow-up was ranging from 2 months through 93 months (median; 23 months). Survival was measured from the date radiation therapy was initiated. The overall survival rate was 44.6% at 2 years and 24.5% at 5

  17. Model for Developing Educational Research Productivity: The Medical Education Research Group.

    Science.gov (United States)

    Perry, Marcia; Hopson, Laura; House, Joseph B; Fischer, Jonathan P; Dooley-Hash, Suzanne; Hauff, Samantha; Wolff, Margaret S; Sozener, Cemal; Nypaver, Michele; Moll, Joel; Losman, Eve D; Carney, Michele; Santen, Sally A

    2015-11-01

    Education research and scholarship are essential for promotion of faculty as well as dissemination of new educational practices. Educational faculty frequently spend the majority of their time on administrative and educational commitments and as a result educators often fall behind on scholarship and research. The objective of this educational advance is to promote scholarly productivity as a template for others to follow. We formed the Medical Education Research Group (MERG) of education leaders from our emergency medicine residency, fellowship, and clerkship programs, as well as residents with a focus on education. First, we incorporated scholarship into the required activities of our education missions by evaluating the impact of programmatic changes and then submitting the curricula or process as peer-reviewed work. Second, we worked as a team, sharing projects that led to improved motivation, accountability, and work completion. Third, our monthly meetings served as brainstorming sessions for new projects, research skill building, and tracking work completion. Lastly, we incorporated a work-study graduate student to assist with basic but time-consuming tasks of completing manuscripts. The MERG group has been highly productive, achieving the following scholarship over a three-year period: 102 abstract presentations, 46 journal article publications, 13 MedEd Portal publications, 35 national didactic presentations and five faculty promotions to the next academic level. An intentional focus on scholarship has led to a collaborative group of educators successfully improving their scholarship through team productivity, which ultimately leads to faculty promotions and dissemination of innovations in education.

  18. 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

  19. 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…

  20. 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.

  1. 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

  2. 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

  3. Subjective risk factors of unhealthy behaviors in a group of medical doctors

    Directory of Open Access Journals (Sweden)

    Monika Bąk-Sosnowska

    2015-09-01

    Full Text Available Introduction. Unhealthy behaviors displayed by doctors impact negatively on the attitude of patients towards illness prevention and treatment. The aim of the study was to identify risk factors of unhealthy behaviors among physicians. Material and methods. 523 active medical doctors were examined. The mean age was 49.16±13.56 yrs., average professional experience was 23.68±13.77 yrs. We used the method of diagnostic survey and following research tools: Health Behavior Inventory (IZZ, List of Health Criteria (LKZ, Coping with Stress questionnaire (Mini-COPE, Sense of Coherence questionnaire (SOC-29. Results. The dominance of unhealthy behaviors was observed in 27.34% of the studied group. On the basis of logistic regression analysis it was revealed that the risk of unhealthy behaviors in a group of doctors is increasing: about 3.2% of any prior year after the completion of specialization (p<0.01, by 2.6% with lowering by every point of a general result in the sense of coherence scale SOC-29 (p<0.001, 14.4% with lowering by each point of the result in the scale of active coping Mini-COPE (p<0.01. Conclusions. 1. The risk of unhealthy behaviors among physicians is increased by the following factors: reduced ability to cope actively with stress, shorter time after obtaining the specialization, lower sense of coherence. 2. During medical studies it is necessary to create the conditions conducive to a sense of coherence of students as well as enhance their activity and health perception in terms of the process.

  4. Factors Affecting the Management of Women Groups' Micro and Small Enterprises in Kakamega District, Kenya

    Science.gov (United States)

    Wawire, Nelson H. W.; Nafukho, Fredrick M.

    2010-01-01

    Purpose: The purpose of this study is to highlight the main factors that affect the management of the WGs' Micro and Small Enterprises (MSEs) in Kakamega District and Africa in general. Design/methodology/approach: The study adopted a descriptive research design. This is because the study was concerned about a univariate question in which the…

  5. Active games in physical education students of special medical group with limited capacity of cardiovascular system

    Directory of Open Access Journals (Sweden)

    M.V. Kovaleva

    2013-08-01

    Full Text Available It is considered the directions of the development an effective methods of usage moving elements of sports and games in exercises. The experiment involved students of special medical groups that have various abnormalities of the cardiovascular system. The study was conducted in four stages: a search, the first experimental, the second experimental, final. We used questioning and education registry books of academic work. Found that the use of sports and outdoor games is students' interest, and increasing motivation for physical activity. Justified by the possibility of using games and exercises performed their adaptation by changing the pulse value. The resulting modification of gaming exercises are divided into three groups: the game in the area of heart rate to 110, 110-130 and 130-150 beats per minute. The first version of the experimental procedure at a heart rate of 110 and 110-130 beats per minute was ineffective for the emergence of significant positive changes in the functional state of the cardiovascular system students. Recommended experimental procedure based on the alternation and equivalence ratio of mobile elements and sports games and increases the heart rate to 130-150 beats per minute. Application of the method increases the overall level of physical health, improves the functional state of the cardiovascular system, health, activity and mood of the students.

  6. Features of effective medical knowledge resources to support point of care learning: a focus group study.

    Directory of Open Access Journals (Sweden)

    David A Cook

    Full Text Available OBJECTIVE: Health care professionals access various information sources to quickly answer questions that arise in clinical practice. The features that favorably influence the selection and use of knowledge resources remain unclear. We sought to better understand how clinicians select among the various knowledge resources available to them, and from this to derive a model for an effective knowledge resource. METHODS: We conducted 11 focus groups at an academic medical center and outlying community sites. We included a purposive sample of 50 primary care and subspecialist internal medicine and family medicine physicians. We transcribed focus group discussions and analyzed these using a constant comparative approach to inductively identify features that influence the selection of knowledge resources. RESULTS: We identified nine features that influence users' selection of knowledge resources, namely efficiency (with sub-features of comprehensiveness, searchability, and brevity, integration with clinical workflow, credibility, user familiarity, capacity to identify a human expert, reflection of local care processes, optimization for the clinical question (e.g., diagnosis, treatment options, drug side effect, currency, and ability to support patient education. No single existing resource exemplifies all of these features. CONCLUSION: The influential features identified in this study will inform the development of knowledge resources, and could serve as a framework for future research in this field.

  7. Perspective: a business school view of medical interprofessional rounds: transforming rounding groups into rounding teams.

    Science.gov (United States)

    Bharwani, Aleem M; Harris, G Chad; Southwick, Frederick S

    2012-12-01

    An effective interprofessional medical team can efficiently coordinate health care providers to achieve the collective outcome of improving each patient's health. To determine how current teams function, four groups of business students independently observed interprofessional work rounds on four different internal medicine services in a typical academic hospital and also interviewed the participants. In all instances, caregivers had formed working groups rather than working teams. Participants consistently exhibited parallel interdependence (individuals working alone and assuming their work would be coordinated with other caregivers) rather than reciprocal interdependence (individuals working together to actively coordinate patient care), the hallmark of effective teams. With one exception, the organization was hierarchical, with the senior attending physician possessing the authority. The interns exclusively communicated with the attending physician in one-on-one conversations that excluded all other members of the team. Although nurses and pharmacists were often present, they never contributed their ideas and rarely spoke.The authors draw on these observations to form recommendations for enhancing interprofessional rounding teams. These are to include the bedside nurse, pharmacist, and case manager as team members, begin with a formal team launch that encourages active participation by all team members, use succinct communication protocols, conduct work rounds in a quiet, distraction-free environment, have teams remain together for longer durations, and receive teamwork training and periodic coaching. High-performing businesses have effectively used teams for decades to achieve their goals, and health care professionals should follow this example.

  8. Investigating the Distribution of Medical Services among Socioeconomic Groups in Texas

    Science.gov (United States)

    Daniel, A.; Zhao, Ph D., S.; O'Keefe, Ph D., CRNP, RN, L.

    2016-12-01

    The Environmental Justice (EJ) literature generally focuses on negative environmental externalities and disamenities found around certain types of demographic conditions such as poor and ethnic groups. This study aims to identify any relationships among environmental risks, communities, and access to hospital services. Community demographic variables will be defined by census tracts and units based on a geographic information system, such as buffer tools. Empirical analyses of the relationships between demographics and environmental burdens take a prominent position in the large EJ literature. However, there is a dearth of research regarding exposed communities and access to hospitals for medical services. Leveraging a dataset that combines hospital locations, pollution sources, and demographic information, the authors will analyze whether different social groups (defined by gender, age, income, and education level) have equal access to hospitals. The research team consists of researchers from Earth system science, public policy, and nursing, and adopts an interdisciplinary approach including ArcGIS analysis and statistical modeling. This project also bridges the literature of health, air pollution, and environmental policy.

  9. 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…

  10. 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…

  11. The Application of Video Clips with Small Group and Individual Activities to Improve Young Learners' Speaking Performance

    Science.gov (United States)

    Muslem, Asnawi; Mustafa, Faisal; Usman, Bustami; Rahman, Aulia

    2017-01-01

    This study investigated whether the application of video clips with small groups or with individual teaching-learning activities improved the speaking skills of young EFL learners the most; accordingly a quasi-experimental study with a pre-test, post-test design was done. The instrument used in this study was a test in the form of an oral test or…

  12. Enhancing Teacher Read Alouds with Small-Group Vocabulary Instruction for Students with Low Vocabulary in First-Grade Classrooms

    Science.gov (United States)

    Fien, Hank; Santoro, Lana; Baker, Scott K.; Park, Yonghan; Chard, David J.; Williams, Susanna; Haria, Priti

    2011-01-01

    The purpose of the current study was to evaluate the effect of small-group instruction on the vocabulary and comprehension of first-grade students identified with low language and low vocabulary skills. Overall, 102 first-grade students scoring below the 50th percentile on relational vocabulary were blocked by classroom, matched according to…

  13. A Different Approach to Answering a Good Question: A Response to Hewes's Models of Communication Effects on Small Group Outcomes

    Science.gov (United States)

    Bonito, Joseph A.; Sanders, Robert E.

    2009-01-01

    This article presents the authors' response to Hewes's (1986, 1996, 2009) models of communication effects on small group outcomes. As sophisticated and thoughtful as Hewes's new model is, however, the authors take issue with it. For one, there is reason to question whether his approach is feasible. For another, his models are not founded on solid…

  14. 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…

  15. Intercultural Interactions of Mono-Cultural, Mono-Lingual Local Students in Small Group Learning Activities: A Bourdieusian Analysis

    Science.gov (United States)

    Colvin, Cassandra; Fozdar, Farida; Volet, Simone

    2015-01-01

    This research examines the understandings and experiences of mono-cultural, mono-lingual local students in relation to intercultural interactions within small group learning activities at university. Bourdieu's concepts of field, habitus and capital are employed to illuminate a number of barriers to intercultural interaction. Using qualitative…

  16. 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…

  17. Supporting Small-Group Learning Using Multiple Web 2.0 Tools: A Case Study in the Higher Education Context

    Science.gov (United States)

    Laru, Jari; Naykki, Piia; Jarvela, Sanna

    2012-01-01

    In this single-case study, small groups of learners were supported by use of multiple social software tools and face-to-face activities in the context of higher education. The aim of the study was to explore how designed learning activities contribute to students' learning outcomes by studying probabilistic dependencies between the variables.…

  18. Assessing the Role of Peer Relationships in the Small Group Communication Course

    Science.gov (United States)

    Myers, Scott A.; Shimotsu, Stephanie; Byrnes, Kerry; Frisby, Brandi N.; Durbin, James; Loy, Brianna N.

    2010-01-01

    Based on the typology posited by Kram and Isabella (1985) that identifies three peer relationships present in organizations (i.e., information, collegial, and special), this assessment examined the association between students' perceptions of their in-class group members and six group outcomes (i.e., grouphate, cohesion, relational satisfaction,…

  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. 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...

  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. 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

  4. 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

  5. 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

  6. 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

  7. Dental Students' Perceptions of Learning Value in PBL Groups with Medical and Dental Students Together versus Dental Students Alone.

    Science.gov (United States)

    Amin, Maryam; Zulla, Rosslynn; Gaudet-Amigo, Gisele; Patterson, Steven; Murphy, Natalie; Ross, Shelley

    2017-01-01

    At a dental school in Canada, problem-based learning (PBL) sessions were restructured from an integrated dental-medical model to a separate dental model, resulting in three groups of students available for study: those who had participated in the two-year dental and medical combined, the one-year dental and medical combined, the one-year dental alone, and the two-year dental alone. The aim of this qualitative study was to examine the extent to which the PBL structure affected the dental students' perceptions of the learning value of PBL in the different models. A total of 34 first-, second-, and third-year dental students participated in six focus groups in May and June 2011 (34% of students in those total classes). Semistructured questions explored their experiences in the different PBL structures. The interviews were recorded and transcribed verbatim, and thematic analysis was employed. The results showed positive and negative perceptions for both the combined dental and medical settings and the settings with dental students alone. For students in the combined PBL groups, positive perceptions included gaining information from medical peers, motivation to learn, and interdisciplinary collaborations. The negative perceptions mainly related to irrelevant content, dominating medical students, and ineffective preceptors. Members of the separate dental groups were more positive about the content and felt a sense of belonging. They appreciated the dental preceptors but were concerned about the inadequacy of their medical knowledge. Overall, the dental students valued the combined PBL experience and appreciated the opportunity to learn with their medical colleagues. Close attention, however, must be paid to PBL content and the preceptor's role to optimize dental students' experience in combined medical and dental groups.

  8. Expeditionary Strike Group: New Label, or New Concept - for Future Naval Warriors of America's Small Wars?

    National Research Council Canada - National Science Library

    Hancock, Daryl

    2003-01-01

    ... as, emergent contingency operations, and major theater wars. In the near future they will accomplish this mission while deployed around the globe under the new concept of Expeditionary Strike Groups (ESG...

  9. 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.

  10. 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.

  11. Virtual Environments and Interactive Tools to communicate Medical Culture in small museums

    Directory of Open Access Journals (Sweden)

    Alessandra Scucces

    2012-12-01

    Full Text Available EnVirtual Environment technologies are becoming increasingly important, carving out place in several sectors like training, learning, entertainment or industry, thanks to their adaptability for different contexts.In the Cultural Heritage field, they have been mostly used to reconstruct and represent lost archaeological patrimony, or to create virtual tours of ancient cities and sites. However, these technologies have now also entered museums and cultural institutions, contributing in changing the concept itself of Museum as institution and its relation with the public, supporting an approach more centered on engagement and participatory experiences.This is particularly true in the case of topics commonly intended as “specialistic”, difficult to approach and understand for general public, such as those related to scientific, anatomical and medical collections. The use of VEs and, in general, also of simpler but carefully designed ICT tools (such as institutional websites can become an important tool to raise awareness and knowledge about these matters.In the present work we describe our experience, focused on a small Anatomy Museum of the University of Pisa, in which we have conducted a study on visitors, and consequently developed asset of interactive tools, aiming at increasing engagement and improving the educational experience, attempting at reducing the gap between the general public and the communication of scientific and medical topics.ItLe nuove tecnologie di Ambienti Virtuali stanno acquisendo una importanza sempre crescente, conquistandosi un posto in ambiti quali training, istruzione, eduntainment e settori industriali, grazie alla loro adattabilità ai vari contesti. Nel campo dei Beni Culturali sono state spesso impiegate nella ricostruzione e rappresentazione del patrimonio archeologico perduto o nella creazione di tour virtuali di antichi siti e città. Attualmente, queste tecnologie hanno fatto il loro ingresso nei musei e

  12. 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.

  13. Scottish pharmacists' perceptions and experiences of a practice-based small group learning pilot: a qualitative study.

    Science.gov (United States)

    Cunningham, David E; Zlotos, Leon; Power, Ailsa

    2014-05-01

    CPD is an important feature of healthcare professions and regulatory bodies consider it mandatory. Studies of CPD activity of pharmacists showed that 10% were undertaking no CPD. Practice-based small group learning (PBSGL) is a well-received and popular learning resource for GPs in Scotland. From 2011, a pharmacy pilot was undertaken: pharmacists were trained as peer-facilitators and existing PBSGL modules were adapted. Four NHS boards took part and this study aimed to explore the perceptions and experiences of pharmacists. A qualitative research approach was adopted using focus groups and in-depth interviews. Interviews were audio-recorded and transcriptions made. Transcripts were coded and themes developed using grounded theory methods. Participants welcomed PBSGL: it was a feasible learning method, acceptable and had educational impact. They appreciated its interactive nature and discussions founded on their experiences in practice. Participants liked the self-reliance of PBSGL in that they were not dependent on specialist practitioners. There were logistical challenges that impacted on the success of group discussion; some pharmacists were less familiar with small group work. Pharmacists felt isolated during work and appreciated peer discussion. There was a tentative welcome to inter-professional learning but group composition and module topics might impact on the success of this. Pharmacists were able to change their learning practice in uni-professional PBSGL groups and were able to learn from each other. There may be further learning opportunities if pharmacists participate in inter-professional groups.

  14. Student recognition of visual affordances: Supporting use of physics simulations in whole class and small group settings

    Science.gov (United States)

    Stephens, A. Lynn

    The purpose of this study is to investigate student interactions with simulations, and teacher support of those interactions, within naturalistic high school physics classroom settings. This study focuses on data from two lesson sequences that were conducted in several physics classrooms. The lesson sequences were conducted in a whole class discussion format in approximately half of the class sections and in a hands-on-computer small group format in matched class sections. Analysis used a mixed methods approach where: (1) quantitative methods were used to evaluate pre-post data; (2) open coding and selective coding were used for transcript analysis; and (3) comparative case studies were used to consider the quantitative and qualitative data in light of each other and to suggested possible explanations. Although teachers expressed the expectation that the small group students would learn more, no evidence was found in pre-post analysis for an advantage for the small group sections. Instead, a slight trend was observed in favor of the whole class discussion sections, especially for students in the less advanced sections. In seeking to explain these results, qualitative analyses of transcript and videotape data were conducted, revealing that many more episodes of support for interpreting visual elements of the simulations occurred in the whole class setting than in the matched small group discussions; not only teachers, but, at times, students used more visual support moves in the whole class discussion setting. In addition, concepts that had been identified as key were discussed for longer periods of time in the whole class setting than in the matched small group discussions in six of nine matched sets. For one of the lesson sequences, analysis of student work on in-class activity sheets identified no evidence that any of the Honors or College Preparatory students in the small groups had made use in their thinking of the key features of the sophisticated and popular

  15. Group Medical Visits (GMVs) in primary care: an RCT of group-based versus individual appointments to reduce HbA1c in older people.

    Science.gov (United States)

    Khan, Karim M; Windt, Adriaan; Davis, Jennifer C; Dawes, Martin; Liu-Ambrose, Teresa; Madden, Ken; Marra, Carlo A; Housden, Laura; Hoppmann, Christiane; Adams, David J

    2015-07-13

    Type 2 diabetes mellitus (T2DM) affects more than 1.1 million Canadians aged ≥65 years. Group Medical Visits are an emerging health service delivery method. Recent systematic reviews show that they can significantly reduce glycated haemoglobin (HbA1c) levels, but Group Visits have not been evaluated within primary care. We intend to determine the clinical effectiveness, quality of life and economic implications of Group Medical Visits within a primary care setting for older people with T2DM. A 2-year proof-of-concept, single-blinded (measurement team) randomised control trial to test the efficacy of Group Medical Visits in an urban Canadian primary care setting. Participants ≥65 years old with T2DM (N=128) will be equally randomised to either eight groups of eight patients each (Group Medical Visits; Intervention) or to Individual visits (Standard Care; Controls). Those administering cointerventions are not blinded to group assignment. Our sample size is based on estimates of variance (±1.4% for HbA1c) and effect size (0.9/1.4=0.6) from the literature and from our own preliminary data. Forty participants per group will provide a β likelihood of 0.80, assuming an α of 0.05. A conservative estimation of an effect size of 0.7/1.4 changes the N in the power calculation to 59 per group. Hence, we aim to enrol 64 participants in each study arm. We will use intention-to-treat analysis and compare mean HbA1c (% glycosylated HbA1c) (primary outcome) of Intervention/Control participants at 12 months, 24 months and 1 year postintervention on selected clinical, patient-rated and economic measures. NCT02002143. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

  16. 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.

  17. 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.

  18. 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

  19. [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.

  20. A Rapid Review of the Factors Affecting Healthcare Students' Satisfaction with Small-Group, Active Learning Methods.

    Science.gov (United States)

    Kilgour, James M; Grundy, Lisa; Monrouxe, Lynn V

    2016-01-01

    PHENOMENON: Problem-based learning (PBL) and other small-group, active learning methodologies have been widely adopted into undergraduate and postgraduate healthcare curricula across the world. Although much research has examined student perceptions of these innovative teaching pedagogies, there are still questions over which factors influence these views. This article aims to identify these key elements that affect healthcare student satisfaction with PBL and other small-group learning methods, including case-based and team-based learning. A systematic rapid review method was used to identify high-quality original research papers from the healthcare education literature from between 2009 and 2014. All papers were critically appraised before inclusion in line with published guidelines. Narrative synthesis was achieved using an inductively developed, thematic framework approach. Fifty-four papers were included in the narrative synthesis. The evidence suggests that, despite an initial period of negative emotion and anxiety, the perspectives of healthcare students toward small-group, active learning methods are generally positive. The key factors influencing this satisfaction level include (a) the facilitator role, (b) tutorial structure, (c) individual student factors, (d) case authenticity, (e) increased feedback, (f) group harmony, and (g) resource availability. Insights: Student satisfaction is an important determinant of healthcare education quality, and the findings of this review may be of value in future curriculum design. The evidence described here suggests that an ideal curriculum may be based on an expert-led, hybrid PBL model.

  1. Small Group Dynamics and the Watergate Coverup: A Case Study of Groupthink.

    Science.gov (United States)

    Cline, Rebecca J.

    The decisions President Richard Nixon and his closest advisors made in the Watergate coverup were products of what Irving Janis calls "groupthink." Groupthink, a type of decision-making emphasizing unanimity over objective evaluation, develops when the decision makers (1) form a group of marked cohesiveness, (2) insulate themselves from…

  2. 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…

  3. On the suitability of group lending model in South Sudan's small and ...

    African Journals Online (AJOL)

    The success of this mode of SME funding in selected jurisdictions, namely Angola, Bangladesh, Bolivia, Burundi, and Colombia underscores such a position. The socio-economic, legal and political environment of the three jurisdictions studied in this paper where group lending has been successful closely mirror that of ...

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

    DEFF Research Database (Denmark)

    Rasmussen, Ole Dahl

    2012-01-01

    , 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...

  5. The Multiple Family Group as a Small Society: Fitting Theory and Method.

    Science.gov (United States)

    Reiss, David; And Others

    This is a comprehensive report of a study of the mechanisms by which the family regulates its interaction with the immediate social environment. Subjects were four multiple family groups, each composed of six or more families, meeting in both hospital and home settings. In each family, at least one member was either an alcoholic or an adolescent…

  6. 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…

  7. 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…

  8. Awareness about antibiotic resistance in a self-medication user group from Eastern Romania: a pilot study.

    Science.gov (United States)

    Topor, Gabi; Grosu, Ionela-Alina; Ghiciuc, Cristina Mihaela; Strat, Aurel Lulu; Lupuşoru, Cătălina Elena

    2017-01-01

    Awareness about antibiotic resistance depends on the attitudes and information about antibiotic resistance of both patients and physicians. Persons who practice self-medication are at high risk of also self-medicating with antibiotics. The purpose of the present study was to evaluate the awareness about antibiotic resistance by investigating the practice in a group of self-medication users in a sample of adults in Romania and the variables associated with such practice. A cross-sectional self-filled questionnaire based study was conducted from December 2016 through January 2017 amongst 218 self-medication users (SMUG). The attitudes, the level of knowledge, the perceptions, about antibiotic use (ABU) and about antibiotic resistance (ABR) were compared to a reference group represented by medical residents group in their specialty training (MRG) considered to have a higher level of knowledge and awareness about ABU and ABR. The response rate was 87.2% in the SMUG group and 100% in the MRG group. The SMUG group reported self-medication practices for antibiotics with a high frequency at any time in life (72%), but with a very low frequency from the month previous to the date of the study (12%), comparative with the MRG group (75% and 7%, respectively). The multivariate logistic regression analysis showed that self-medication with antibiotics at any time in life in the SMUG group could be predicted by the answers to two questions regarding the practices and knowledge about ABU (Q13 and Q20). On the other hand, in the MRG group, a question about ABR perception (Q23), could be predictor for self-medication with antibiotics. Self-medication with antibiotics in the month previous to the date of the study in the SMUG group could be predicted with three questions: one about ABU practice (Q14), one about ABR perception (Q26) and one referring to ABR knowledge (Q28). On the other hand, in the MRG group, a question about ABR knowledge (Q32) could be predictor for self-medication

  9. 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.

  10. 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.

  11. A collaborative working environment for small group meetings in Second Life.

    Science.gov (United States)

    da Silva, Cintia Rc; Garcia, Ana Cristina B

    2013-01-01

    This paper presents the SLMeetingRoom, a virtual reality online environment to support group meetings of geographically dispersed participants. A prototype was developed to demonstrate the feasibility of the approach using the Second Life platform. Ten additional components had to be added to Second Life environment to support group work essential activities such as participants' communication, tasks' and participants' coordination, participants' collaboration and work evolution's perception. Empirical studies, both pilot and experiment, were developed comparing four different meeting settings: face-to-face, videoconference, stand Second Life and SLMeetingRoom. The study involved graduate students enrolled in the Interface and Multimedia discipline at the Fluminense Federal University (UFF) in Brazil. Results indicated that groups working within SLMeetingRoom environment presented similar results as face-to-face meeting as far as sense of presence is concerned and with low cognitive effort. Task completion and degree of participation were not affected by the meeting set up. It was concluded that Second Life, in conjunction with the SLMeetingRoom components, is a good tool for holding synchronous remote meetings and coexists with other electronic meeting technologies.

  12. 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.

  13. A qualitative analysis of student Balint groups in medical education: contexts and triggers of case presentations and discussion themes.

    Science.gov (United States)

    Torppa, Martina A; Makkonen, Eeva; Mårtenson, Camilla; Pitkälä, Kaisu H

    2008-07-01

    No previous rigorous qualitative studies exist on student Balint groups. The aim of this study was to explore the contexts and triggers of cases presented in student Balint groups and to clarify the themes in the group discussions. Fifteen student Balint sessions in two groups were organised. Nine female students participated. A grounded theory-based approach with thematic content analysis of the field notes was used. We identified five triggers for case narrations (witnessing injustice, value conflict, difficult human relationships, incurable patient, role confusion) that originated from three distinct contexts (patient encounters, confusing experiences in medical education, tension between privacy and profession). Four main discussion themes could be identified (feelings related to patients, building professional identity, negative role models, cooperation with other medical professionals). The concept of case in student Balint groups was wider than in traditional Balint groups. Feelings related to patients and to one's own role as a doctor were openly discussed in groups. The discussions often touched on professional growth and future professional identity as doctors. The Balint groups may support medical students' professional growth process. This topic warrants further study in more heterogeneous student groups.

  14. 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

  15. Categorising Patients Mental Illness by Medical Surgical Nurses in the General Hospital Ward: A Focus Group Study.

    Science.gov (United States)

    Brunero, Scott; Buus, Niels; West, Sandra

    2017-12-01

    To gain insight into medical surgical nurses' process(es) of categorising mental illness in general hospitals. Categorising patients is a daily social practice that helps medical surgical nurses understand their work and actions. Medical surgical nurses' categorising of mentally ill patients in general hospitals is a means in which they articulate their understanding of mental illness and perform their clinical practice. How medical surgical nurses categorise, and the impact that categorising can have on their work practices is poorly understood. A focus group study. Focus group discussions (n=2) of medical surgical nurses' understanding and experience of delivering care to patients with mental illness in a general tertiary referral hospital were conducted in November 2014. Discourse analysis was used to analyse the transcribed data to uncover how participants made discursive evaluations and how this related to their daily clinical practice. The analysis uncovered participant's use of four categories of mentally ill patients: the managed, the unpredictable, the emotional and the dangerous. For participants these categories explained and justified their clinical practice as linked to the challenges and barriers they experienced in providing effective care within the larger healthcare organisation. The language used by medical/surgical reflects the wider discourse of managerialism in healthcare organisations. The recognition of these categories can be used by educators, liaison mental health services and policy makers to reconsider service design and learning opportunities for medical surgical nurses to reduce stigmatisation of patients with mental illness. Copyright © 2017 Elsevier Inc. All rights reserved.

  16. Long-term evolution of the S788 fungal nuclear small subunit rRNA group I introns

    OpenAIRE

    HAUGEN, PEIK; RUNGE, HENRY JOSEPH; BHATTACHARYA, DEBASHISH

    2004-01-01

    More than 1000 group I introns have been identified in fungal rDNA. Little is known, however, of the splicing and secondary structure evolution of these ribozymes. Here, we use a combination of comparative and biochemical methods to address the evolution and splicing of a vertically inherited group I intron found at position 788 in the fungal small subunit (S) rRNA. The ancestral state of the S788 intron contains a highly conserved core and an extended P5 domain typical of IC1 introns. In con...

  17. 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.

  18. Level one algebraic cusp forms of classical groups of small rank

    CERN Document Server

    Chenevier, Gaëtan

    2015-01-01

    The authors determine the number of level 1, polarized, algebraic regular, cuspidal automorphic representations of \\mathrm{GL}_n over \\mathbb Q of any given infinitesimal character, for essentially all n \\leq 8. For this, they compute the dimensions of spaces of level 1 automorphic forms for certain semisimple \\mathbb Z-forms of the compact groups \\mathrm{SO}_7, \\mathrm{SO}_8, \\mathrm{SO}_9 (and {\\mathrm G}_2) and determine Arthur's endoscopic partition of these spaces in all cases. They also give applications to the 121 even lattices of rank 25 and determinant 2 found by Borcherds, to level o

  19. 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.

  20. Challenges and solutions in medically managed ACS in the Asia-Pacific region: expert recommendations from the Asia-Pacific ACS Medical Management Working Group.

    Science.gov (United States)

    Huo, Yong; Thompson, Peter; Buddhari, Wacin; Ge, Junbo; Harding, Scott; Ramanathan, Letchuman; Reyes, Eugenio; Santoso, Anwar; Tam, Li-Wah; Vijayaraghavan, Govindan; Yeh, Hung-I

    2015-03-15

    Acute coronary syndromes (ACS) remain a leading cause of mortality and morbidity in the Asia-Pacific (APAC) region. International guidelines advocate invasive procedures in all but low-risk ACS patients; however, a high proportion of ACS patients in the APAC region receive solely medical management due to a combination of unique geographical, socioeconomic, and population-specific barriers. The APAC ACS Medical Management Working Group recently convened to discuss the ACS medical management landscape in the APAC region. Local and international ACS guidelines and the global and APAC clinical evidence-base for medical management of ACS were reviewed. Challenges in the provision of optimal care for these patients were identified and broadly categorized into issues related to (1) accessibility/systems of care, (2) risk stratification, (3) education, (4) optimization of pharmacotherapy, and (5) cost/affordability. While ACS guidelines clearly represent a valuable standard of care, the group concluded that these challenges can be best met by establishing cardiac networks and individual hospital models/clinical pathways taking into account local risk factors (including socioeconomic status), affordability and availability of pharmacotherapies/invasive facilities, and the nature of local healthcare systems. Potential solutions central to the optimization of ACS medical management in the APAC region are outlined with specific recommendations. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

  1. 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.

  2. Effect of recreational activities on the physical development of girls 11–12 years of the preparatory medical group

    Directory of Open Access Journals (Sweden)

    Maryna Prudnikova

    2017-12-01

    Full Text Available Purpose: conduct research on the impact of recreational activities on changes in the body's systems of girls 11 and 12 years of preparatory medical group. Material & Methods: 20 girls aged 11 and 12 who participated in the program developed by us during the year participated in the experiment. Assessment of the physical state of the body was carried out with the help of pedagogical and medico-biological methods. Results: based on the results of the study, the dynamics of morphological and functional indices and the level of physical qualities of girls 11 and 12 years of the preparatory medical group. Conclusion: results of the conducted study confirm the effectiveness of using recreational exercises with the help of various means that positively influenced the state of the systems of the organism of the girls of the preparatory medical group.

  3. Beyond the focus group: understanding physicians' barriers to electronic medical records.

    Science.gov (United States)

    Yan, Helen; Gardner, Rebekah; Baier, Rosa

    2012-04-01

    Although electronic medical records (EMRs) have potential to improve quality of care, physician adoption remains low. Rhode Island physicians' perceptions of barriers to EMRs and the association between these barriers and physician characteristics were examined. It was hypothesized that physicians with and without EMRs would differ in the types and magnitude of barriers identified. Data were drawn from the Rhode Island Department of Health's mandatory 2009 Physician Health Information Technology (HIT) survey of physicians licensed and in active practice in Rhode Island or an adjacent state. Some 1,888 (58.1% of the target population of 3,248 physicians) responded. Respondents, who were invited to provide open-ended comments, were asked to consider 11 issues as barriers to EMR use: Access to technical support, lack of computer skills, availability of a computer in the appropriate location, impact of a computer on doctor-patient interaction, lack of interoperability, privacy or security concerns, start-up financial costs, ongoing financial costs, technic limitations of systems, training and productivity impact, and lack of uniform industry standards. Respondents with EMRs consistently perceived significantly fewer barriers than those without them (p < .0001). For example, 78.9% of physicians without EMRs viewed start-up financial costs as a major barrier versus only 45.8% of physicians with EMRs. An understanding of physicians' reluctance to use EMRs is critical for developing adoption strategies. Policies to increase EMR adoption should be tailored to different physician groups to achieve maximum effectiveness. Further research into the differences between current EMR users' and nonusers' perceptions of barriers may help elucidate how to facilitate subsequent adoption.

  4. 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.

  5. 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.

  6. A focus group based study of the perspectives of the Maltese population and healthcare professionals on medication wastage.

    Science.gov (United States)

    West, Lorna Marie; Diack, Lesley; Cordina, Maria; Stewart, Derek

    2016-10-01

    Background The World Health Organization states that globally more than half of all medication is inappropriately prescribed, dispensed or sold with a need to implement wastage reduction strategies. Developing processes which include behaviour change theories, such as the Theoretical Domains Framework (TDF), significantly impacts the positive implementation of evidence into healthcare practice. Objective To describe and understand the beliefs and behaviours regarding medication wastage of the Maltese public and healthcare professionals (HCPs) and to explore potential solutions. Malta. Method Five 90 min audio recorded focus groups (2 public and 3 HCPs) were conducted with a purposive sample who responded to a previous survey study and were willing to participate in focus groups in Malta. The guide was based upon the TDF with interview questions derived from findings of the questionnaire phase. Focus groups were audio recorded and transcribed verbatim. Analysis was carried using the framework approach. Main outcome measure Beliefs and behaviours regarding medication wastage and potential solutions to reduce medication wastage. Results A total of eleven pharmacists, six doctors and six members of the public consented to participate. Focus groups conducted with HCPs and the general public identified the following four key themes aligned with the TDF domains to address proposed solutions to minimise medication wastage: (1) practitioner effects; (2) patients effects; (3) political effects; (4) societal effects. Conclusion This study has employed a theoretical framework to obtain a better understanding of facilitators which require attention as part of strategic development.

  7. 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

  8. History of the evaluation and exploitation of a group of small uranium mines in Portugal

    International Nuclear Information System (INIS)

    Cameron, J.

    1980-01-01

    In the period 1945-1962 a multiple small-scale uranium mining project was successfully operated in Portugal by the Companhia Portuguesa de Radium Lda, the Urgeirica Mine and some 28 smaller mines produced ore between 1951 and 1962 and provided uranium concentrates for export under an agreement between the Portugal, the United Kingdom and the United States Governments. The uranium deposits occur in near-vertical fractures in the granites of the Beiras mostly having a NE-SW strike trend. The veins are the siliceous-pyrite-galena type with red jasper and black and white quartz gangue and much wall rock alternation and shearing. The primary uranium mineral is pitchblende and the secondary minerals tobernite and autunite occur in the near-surface zones. Of the 63 concessions controlled in 1945, the Urgeirica Mine, dating from the radium period, was by far the biggest, but by mid-1946, after a very rapid preliminary evaluation, it was concluded that a total ''possible'' ore reserve of 1080 tons U 3 O 8 might exist in the concessions. On this basis an agreement was reached with the Portuguese Government for the production and export of between 120 and 150 t U 3 O 8 per year for a twelve-year period up to the end of 1962, and for a maximum of 1325 t U 3 O 8 . Production commenced on a regular basis at the beginning of 1952 and the total production quota of 1325 t U 3 O 8 was produced by 31 March 1962

  9. 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

  10. Teaching tobacco dependence treatment and counseling skills during medical school: rationale and design of the Medical Students helping patients Quit tobacco (MSQuit) group randomized controlled trial.

    Science.gov (United States)

    Hayes, Rashelle B; Geller, Alan; Churchill, Linda; Jolicoeur, Denise; Murray, David M; Shoben, Abigail; David, Sean P; Adams, Michael; Okuyemi, Kola; Fauver, Randy; Gross, Robin; Leone, Frank; Xiao, Rui; Waugh, Jonathan; Crawford, Sybil; Ockene, Judith K

    2014-03-01

    Physician-delivered tobacco treatment using the 5As is clinically recommended, yet its use has been limited. Lack of adequate training and confidence to provide tobacco treatment is cited as leading reasons for limited 5A use. Tobacco dependence treatment training while in medical school is recommended, but is minimally provided. The MSQuit trial (Medical Students helping patients Quit tobacco) aims to determine if a multi-modal and theoretically-guided tobacco educational intervention will improve tobacco dependence treatment skills (i.e. 5As) among medical students. 10 U.S. medical schools were pair-matched and randomized in a group-randomized controlled trial to evaluate whether a multi-modal educational (MME) intervention compared to traditional education (TE) will improve observed tobacco treatment skills. MME is primarily composed of TE approaches (i.e. didactics) plus a 1st year web-based course and preceptor-facilitated training during a 3rd year clerkship rotation. The primary outcome measure is an objective score on an Objective Structured Clinical Examination (OSCE) tobacco-counseling smoking case among 3rd year medical students from schools who implemented the MME or TE. MSQuit is the first randomized to evaluate whether a tobacco treatment educational intervention implemented during medical school will improve medical students' tobacco treatment skills. We hypothesize that the MME intervention will better prepare students in tobacco dependence treatment as measured by the OSCE. If a comprehensive tobacco treatment educational learning approach is effective, while also feasible and acceptable to implement, then medical schools may substantially influence skill development and use of the 5As among future physicians. Copyright © 2014 The Authors. Published by Elsevier Inc. All rights reserved.

  11. 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.

  12. [Qualification concept for delegation of medical tasks to nonmedical professional groups. The "Greifswalder 3-level model"].

    Science.gov (United States)

    Hoffmann, W; van den Berg, N; Dreier, A

    2013-04-01

    To manage the current demographics and the expected medical, nursing, and social care needs of the population, structural changes are needed in the German health care system. On the regional level, there is a shortage of general practitioners in Germany. In the future, the number of affected regions will likely increase. These trends require new support strategies, which include the delegation of medical tasks to nonphysician professionals of which nurses and medical assistants are the primary profession. Thus, they will expand their traditional scope of work. However, their traditional training does not qualify them to perform medical tasks responsibly and with high quality. Hence, there is a need for further development of advanced training programs. The goal is to tailor modular advanced training to the specific support needs of the patients. A recent law (GKV-Versorgungsstrukturgesetz, GKV-VStG, 1 January 2012) was passed that specifies and extends the delegation options of medical tasks beyond the restrictions defined in previous German legislation (§ 63, SGB V in 2008). In this article, we present a three-stage model for qualifying nonphysician medical professionals for defined ranges of medical tasks.

  13. Do recreational cannabis users, unlicensed and licensed medical cannabis users form distinct groups?

    Science.gov (United States)

    Sznitman, Sharon R

    2017-04-01

    This study aims to gain a more nuanced perspective on the differences between recreationally and medically motivated cannabis use by distinguishing between people who use cannabis for recreational purposes, unlicensed and licensed medical users. Data collection was conducted online from a convenience sample of 1479 Israeli cannabis users. Multinomial regression analysis compared unlicensed medical users (38%) with recreational (42%) and licensed medical (5.6%) users in terms of sociodemographics, mode, frequency and problematic cannabis use. There were more variables distinguishing unlicensed from licensed users than there were distinguishing features between unlicensed and recreational users. Recreational users were more likely to be male, less likely to eat cannabis, to use cannabis frequently and to use alone and before midday than unlicensed users. Licensed users were older than unlicensed users, they reported less hours feeling stoned, less cannabis use problems and they were more likely to report cannabis use patterns analogous of medication administration for chronic problems (frequent use, vaping, use alone and use before midday). This study suggests that a sizable proportion of cannabis users in Israel self-prescribe cannabis and that licensed medical cannabis users differ from unlicensed users. This is, in turn, suggestive of a rigorous medicalized cannabis program that does not function as a backdoor for legal access to recreational use. However, due to methodological limitations this conclusion is only suggestive. The most meaningful differences across recreational, unlicensed and licensed users were mode and patterns of use rather than cannabis use problems. Current screening tools for cannabis use problems may, however, not be well suited to assess such problems in medically motivated users. Indeed, when screening for problematic cannabis use there is a need for a more careful consideration of whether or not cannabis use is medically motivated

  14. 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

  15. Genomic selection accuracies within and between environments and small breeding groups in white spruce.

    Science.gov (United States)

    Beaulieu, Jean; Doerksen, Trevor K; MacKay, John; Rainville, André; Bousquet, Jean

    2014-12-02

    Genomic selection (GS) may improve selection response over conventional pedigree-based selection if markers capture more detailed information than pedigrees in recently domesticated tree species and/or make it more cost effective. Genomic prediction accuracies using 1748 trees and 6932 SNPs representative of as many distinct gene loci were determined for growth and wood traits in white spruce, within and between environments and breeding groups (BG), each with an effective size of Ne ≈ 20. Marker subsets were also tested. Model fits and/or cross-validation (CV) prediction accuracies for ridge regression (RR) and the least absolute shrinkage and selection operator models approached those of pedigree-based models. With strong relatedness between CV sets, prediction accuracies for RR within environment and BG were high for wood (r = 0.71-0.79) and moderately high for growth (r = 0.52-0.69) traits, in line with trends in heritabilities. For both classes of traits, these accuracies achieved between 83% and 92% of those obtained with phenotypes and pedigree information. Prediction into untested environments remained moderately high for wood (r ≥ 0.61) but dropped significantly for growth (r ≥ 0.24) traits, emphasizing the need to phenotype in all test environments and model genotype-by-environment interactions for growth traits. Removing relatedness between CV sets sharply decreased prediction accuracies for all traits and subpopulations, falling near zero between BGs with no known shared ancestry. For marker subsets, similar patterns were observed but with lower prediction accuracies. Given the need for high relatedness between CV sets to obtain good prediction accuracies, we recommend to build GS models for prediction within the same breeding population only. Breeding groups could be merged to build genomic prediction models as long as the total effective population size does not exceed 50 individuals in order to obtain high prediction accuracy such as that

  16. Building life-long learning capacity in undergraduate nursing freshmen within an integrative and small group learning context.

    Science.gov (United States)

    Chiang, Vico C L; Leung, Sharron S K; Chui, Caroline Y Y; Leung, Angela Y M; Mak, Y W

    2013-10-01

    Life-long learning involves the development of skills in critical thinking (CT), effective group process (GP), and self-directedness (SDL). Recent studies have shown that small group learning with active interactions is effective in enabling students to develop themselves as independent learners beyond graduation. With a view to integrative learning, the purpose of this study was to evaluate life-long learning outcomes through the work of small group teaching and learning for a class of undergraduate nursing freshmen during one academic year. A mixed-methods approach was used to evaluate the CT, GP and SDL of 99 freshmen with a self-assessment questionnaire before and after their learning activities in three nursing courses, and to identify themes from a total of six focus group interviews with the students and teachers. The CT, GP and SDL results obtained from self-assessment did not indicate significant differences. Four themes emerged from the qualitative analysis. Many factors contributed to the results on life-long learning skill development of students in this study. The qualitative analysis provided good insights for future teaching and learning development. With a developmental perspective, life-long learning may be better developed and evaluated over a longer period of time in the nursing program. Copyright © 2012 Elsevier Ltd. All rights reserved.

  17. 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.

  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. Small-Group Learning in an Upper-Level University Biology Class Enhances Academic Performance and Student Attitudes Toward Group Work

    Science.gov (United States)

    Nakonechny, Joanne; Cragg, Jacquelyn J.; Ramer, Matt S.

    2010-01-01

    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. PMID:21209910

  20. 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......, and detection bias may account for the findings in earlier studies....

  1. 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 self-medication was 79% in the Suburban pharmacy and 77% in City Center pharmacy. In both settings, amoxicillin was reported as the antibiotic most commonly used. High proportions of self-medication with antibiotics were reported in two pharmacies serving disparate socio-economic groups in 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.

  2. xGASS: gas-rich central galaxies in small groups and their connections to cosmic web gas feeding

    Science.gov (United States)

    Janowiecki, Steven; Catinella, Barbara; Cortese, Luca; Saintonge, Amélie; Brown, Toby; Wang, Jing

    2017-04-01

    We use deep H I observations obtained as part of the extended GALEX Arecibo SDSS survey (xGASS) to study the cold gas properties of central galaxies across environments. We find that below stellar masses of 1010.2 M⊙, central galaxies in groups have an average atomic hydrogen gas fraction ˜0.3 dex higher than those in isolation at the same stellar mass. At these stellar masses, group central galaxies are usually found in small groups of N = 2 members. The higher H I content in these low-mass group central galaxies is mirrored by their higher average star formation activity and molecular hydrogen content. At larger stellar masses, this difference disappears and central galaxies in groups have similar (or even smaller) gas reservoirs and star formation activity compared to those in isolation. We discuss possible scenarios able to explain our findings and suggest that the higher gas content in low-mass group central galaxies is likely due to the contributions from the cosmic web or H I-rich minor mergers, which also fuel their enhanced star formation activity.

  3. 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

  4. 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…

  5. 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...... diabetes, chronic obstructive pulmonary disease, or chronic heart failure and a likelihood of hospitalization in the upper quartile of the population, as predicted by insurance data analysis. Intervention: We compared protocol-based care management including structured assessment, action planning...

  6. 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.

  7. Appropriate training based on Balint groups can improve the empathic abilities of medical students: a preliminary study.

    Science.gov (United States)

    Airagnes, Guillaume; Consoli, Silla M; De Morlhon, Olivier; Galliot, Anne-Marie; Lemogne, Cédric; Jaury, Philippe

    2014-05-01

    Although empathy is critical in a doctor-patient relationship, empathic abilities seem to decline throughout medical school. This study aimed at examining changes in empathic abilities of fourth-year medical students who participated in an optional certificate based on Balint groups. Thirty-four students were included in the "Balint group" certificate and compared with 129 participating in other certificates. Before the training sessions and 4 months later, they filled up the interpersonal reactivity index (IRI) and were asked to rate their emotional reactions in response to two case-reports: the first described a woman with diabetes, borderline- personality traits and a history of childhood trauma; the second, a woman with histrionic traits suffering from multiple sclerosis and hospitalized for functional symptoms. A principal component analysis extracted four factors from the 8 questions asked: empathic-approach (e.g. finding the patient touching), rejecting-attitude, intellectual-interest and fear of emotion contagion. At baseline, there were no socio-demographic or psychological differences between groups. At follow-up, an increase of IRI fantasy-scale (p=0.02) and a decrease of IRI empathic-concern (p=0.006) were observed, regardless of the group. Empathic-approach only increased in the "Balint group" and for the first case-report (p=0.023), with a difference between the groups at follow-up (p=0.003). Results suggest that Balint groups may enable medical students to better handle difficult clinical situations such as those presented by borderline personalities. Our findings encourage assessing training initiatives designed at helping young medical students to take into account the emotional component of a doctor-patient relationship. Copyright © 2014 Elsevier Inc. All rights reserved.

  8. 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

  9. Small Groups: Student Productive Interactions in Learning Cooperative (Case Study of Mathematics Learning at Junior High School in Pakis, Malang

    Directory of Open Access Journals (Sweden)

    Katarina Tri Utaminingtyas

    2017-06-01

    Full Text Available The purpose of this study is to describe the process of student interaction in solving problems through cooperative learning. The subject of this research are 7th grade students of a junior high school in Malang, Indonesia. Data were collected by recording directly when learning takes place especially when pairing or forming small groups. This interaction is built with heterogeneous student skills. The results showed that the interaction that occurs in students provides an understanding of the concept of opportunity. Consequently, the students solved the problem correctly. This interaction is known as productive interaction.

  10. 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...

  11. 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

  12. 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

  13. Affective Balance, Team Prosocial Efficacy and Team Trust: A Multilevel Analysis of Prosocial Behavior in Small Groups

    Science.gov (United States)

    Cuadrado, Esther; Tabernero, Carmen

    2015-01-01

    Little research has focused on how individual- and team-level characteristics jointly influence, via interaction, how prosocially individuals behave in teams and few studies have considered the potential influence of team context on prosocial behavior. Using a multilevel perspective, we examined the relationships between individual (affective balance) and group (team prosocial efficacy and team trust) level variables and prosocial behavior towards team members. The participants were 123 students nested in 45 small teams. A series of multilevel random models was estimated using hierarchical linear and nonlinear modeling. Individuals were more likely to behave prosocially towards in-group members when they were feeling good. Furthermore, the relationship between positive affective balance and prosocial behavior was stronger in teams with higher team prosocial efficacy levels as well as in teams with higher team trust levels. Finally, the relevance of team trust had a stronger influence on behavior than team prosocial efficacy. PMID:26317608

  14. 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.

  15. 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.

  16. Hospital physicians' work stressors in different medical specialities: a statistical group comparison.

    Science.gov (United States)

    Tanner, Grit; Bamberg, Eva; Kozak, Agnessa; Kersten, Maren; Nienhaus, Albert

    2015-01-01

    Some studies on the occupational health of hospital physicians have found that working conditions have different effects on physician's well-being and health in different medical specialities. There has been no comparative study of the effects of various work stressors in different specialities. This study aims to close this gap. German hospital physicians were asked about their working conditions and aspects of health. The short version of the Instrument for Stress-Related Job Analysis for Hospital Physicians was used to measure working conditions. Irritation and emotional exhaustion were used to assess health. Physicians were also asked for socio-demographic aspects, including their medical speciality. Data from 763 hospital physicians were included in the analyses. Significant differences between medical specialities were demonstrated for time pressure, uncertainty, frustration about how work needs to be done and social stressors with patients. Physicians in internal medicine showed consistently high levels of stressors. Time pressure, frustration about how work needs to be done, and emotional dissonance were found to be significantly related to both aspects of health. The results showed that some medical specialities are more affected by specific stressors. It is therefore discussed how improvements can be implemented. Furthermore, it is illustrated which stressors are especially relevant for health. These relationships to health should be investigated in further research and in longitudinal designs to allow hints of causal relationships.

  17. Psychotropic medication in a randomly selected group of citizens receiving residential or home care

    DEFF Research Database (Denmark)

    Futtrup, Tina Bergmann; Helnæs, Ann Kathrine; Schultz, Hanne

    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...

  18. 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

  19. NATO CBRN Medical Working Group Table Top Exercise on International Health Regulations: Documentation and Output

    Science.gov (United States)

    2014-05-01

    poliomyelitis due to wild-type poliovirus , human influenza caused by a new subtype, severe acute respiratory syndrome, cholera, pneumonic plague, yellow fever...Figure 5 and Figure 6, with this assumption in place, there was again a growing consensus around a single response—report to the JFC Medical Advisor

  20. 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 ho...

  1. 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

  2. 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)

  3. 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

  4. Medical image of the week: extensive small cell lung cancer with cardiac invasion

    Directory of Open Access Journals (Sweden)

    Nahapetian R

    2013-03-01

    Full Text Available A 73 year old woman was seen with a lung mass and acute onset of ataxia. MRI of the brain was notable for multifocal infarcts (Figure 1. Echocardiography (ECHO was obtained to identify cardiac source of emboli and was notable for freely mobile mass tethered to the lateral left atrial wall, crossing the mitral valve into the left atrium (Figure 2. A contrast enhanced CT scan of the chest was obtained which confirmed the presence of a large right upper lobe mass with extension to the right pulmonary vein, left atrium and into the left ventricle (Figures 3 and 4. The biopsy confirmed small cell lung cancer.

  5. The role of prophylactic cranial irradiation in regionally advanced non-small cell lung cancer. A Southwest Oncology Group Study

    International Nuclear Information System (INIS)

    Rusch, V.W.; Griffin, B.R.; Livingston, R.B.

    1989-01-01

    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

  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. 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

  8. Designing Learning Outcomes for Handoff Teaching of Medical Students Using Group Concept Mapping: Findings From a Multicountry European Study.

    Science.gov (United States)

    Hynes, Helen; Stoyanov, Slavi; Drachsler, Hendrik; Maher, Bridget; Orrego, Carola; Stieger, Lina; Druener, Susanne; Sopka, Sasa; Schröder, Hanna; Henn, Patrick

    2015-07-01

    To develop, by consultation with an expert group, agreed learning outcomes for the teaching of handoff to medical students using group concept mapping. In 2013, the authors used group concept mapping, a structured mixed-methods approach, applying both quantitative and qualitative measures to identify an expert group's common understanding about the learning outcomes for training medical students in handoff. Participants from four European countries generated and sorted ideas, then rated generated themes by importance and difficulty to achieve. The research team applied multidimensional scaling and hierarchical cluster analysis to analyze the themes. Of 127 experts invited, 45 contributed to the brainstorming session. Twenty-two of the 45 (48%) completed pruning, sorting, and rating phases. They identified 10 themes with which to select learning outcomes and operationally define them to form a basis for a curriculum on handoff training. The themes "Being able to perform handoff accurately" and "Demonstrate proficiency in handoff in workplace" were rated as most important. "Demonstrate proficiency in handoff in simulation" and "Engage with colleagues, patients, and carers" were rated most difficult to achieve. The study identified expert consensus for designing learning outcomes for handoff training for medical students. Those outcomes considered most important were among those considered most difficult to achieve. There is an urgent need to address the preparation of newly qualified doctors to be proficient in handoff at the point of graduation; otherwise, this is a latent error within health care systems. This is a first step in this process.

  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...... status. RESULTS: Two thirds of the citizens (64.5%) used one or more PMs (antipsychotics 15.9%, antidepressants 43.5%, anxiolytics/hypnotics 27.1% and anti-dementia drugs 16.4%). Citizens treated with antipsychotics were also prescribed antidepressants (52.9%), anxiolytics/hypnotics (35.3%) and anti...

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

    Science.gov (United States)

    2004-06-15

    The Clinical Care of Victim. New York: Parthenon ; 2002. 8. Fliedner TM, Meineke V, Dainiak N, Gourmelon P, Akashi M, eds. Radi- ation-Induced Multi...Clinical Care of Victims. New York: Parthenon ; 2002: 217-24. 38. Peter RU. Management of skin injuries in radiation accidents: the cutaneous radiation... Parthenon ; 2002: 225-9. 39. Fliedner, TM, Friesecke, I, Beyrer K. Medical Management of Radiation Accidents: Manual on the Acute Radiation Syndrome

  11. Interaktiver Kleingruppenunterricht für Medizinstudenten der Klinischen Semester in einer onkologischen Gemeinschaftspraxis [Interactive medical education for medical students in an oncology group practice

    Directory of Open Access Journals (Sweden)

    Weide, Rudolf

    2007-02-01

    Full Text Available [english] Background: The education of medical students to become qualified medical doctors should be improved in Germany. Reasons for this are medical teachers not properly trained in education, a lack of quality control and low esteem of medical education, too large groups, no intensive relationship between students and academic teachers and the triad for medical teachers at university hospitals to qualify in their discipline, to perform science and lecture medical students. At the same time experienced associate professors who left university are not integrated optimally in medical education programs. Pilotproject: Since 1998 we are performing weekend seminars for advanced medical students. 3 students are educated by 1 teacher. The topics of the training are differential diagnosis of anaemia, polyglobulinaemia, leukocytopenia, leukocytosis, thrombocytopenia, thrombocytosis, training in morphology, diagnosis and treatment of leukaemia and lymphoma and principles of communication skills. Patient cases are presented in a problem oriented learning manner using patient files, a video microscope and a computer based learning programme for interactive purposes.Results: So far 320 students have participated in our seminars. Systematic quality evaluation of the teaching reveals excellent marks for practical relevance, learning atmosphere, didactics and effectiveness. Impressions of the routine work in an oncology group practice widens the experience of the students.Conclusion: Academical training for medical students is feasable and successful in an oncology group practice. This teaching model enables external associate professors to give their education in the environment where they are working and may relieve the University personally and financially.[german] Hintergrund: Die Ausbildung von Medizinstudenten zu guten Ärzten ist in Deutschland verbesserungsbedürftig. Die Gründe für ein suboptimales Studium sind die häufig fehlende Vernetzung von

  12. Knowledge and attitude towards patient safety among a group of undergraduate medical students in saudi arabia.

    Science.gov (United States)

    Almaramhy, Hamdi; Al-Shobaili, Hani; El-Hadary, Kamal; Dandash, Khadiga

    2011-01-01

    This study aimed to measure knowledge and attitude of undergraduate medical students towards patient safety concepts, and to detect variation by the mode of learning. A cross sectional study administrated an anonymous questionnaire to a random sample of 150 medical students graduated from two national medical schools, one follow the traditional lecture based learning (LBL) and the other applies innovative learning strategy (ILS). Students' self-ratings of knowledge level and attitude towards patient safety in relation to the mode of learning were measured. The study was conducted in April 2010. More than half of the participants (52.7%) self-rated their general knowledge on patient safety on good level compared to 27.3% for the specific knowledge issues score. Most participants (60.7%) agreed the importance of patient safety. The majority agreed to support peers who make unintentional errors and not to blame them for their own mistake (76.0 and 80.7% respectively). Less than half (44.7%) of the participants agreed the patients' role in error prevention and 47.3% agreed error disclosure to the patient. ILS participants were significantly more recognizable of the patient safety issues: problem solving (Ptowards patient safety issues. Basic relevant educational interventions with focus on deficient issues are recommended.

  13. 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.

  14. Clinical observation on the small incision non phacoemusification cataract surgery performed by China medical team in Africa

    Directory of Open Access Journals (Sweden)

    En-Hui Yi

    2017-02-01

    Full Text Available AIM:To observe the clinical effects of the small incision non phacoemusification cataract surgery in 462 Sudanese cataract cases(536 eyes. METHODS:From September 2013 to August 2015, we analyzed the 462 Sudanese cataract cases(536 eyesperformed cataract surgery by the way of the small incision non phacoemusification with intraocular lens(IOLimplantation and summarized the intraoperative and postoperative complications, the eyesight and intraocular pressure(IOPof the eyes in 1d, 1wk and 1mo after operation. RESULTS: Intraoperative complications: posterior capsular ruptured and vitreous prolapsed in 18 eyes(3.4%, iris prolapsed in 10 eyes(1.9%, suspensory ligament of the lens ruptured in 7 eyes(1.3%, not implanted IOL in 5 eyes(0.9%, descent's membrane detachment in 3 eyes(0.6%, iridodialysis in 1 eye(0.2%. Postoperative complications: corneal edema in 47 eyes(8.8%, anterior chamber inflammatory reaction in 32 eyes(6.0%, pupil oval or slightly upward in 12 eyes(2.2%, the upper iris incarcerated in the tunnel incision in 3 eyes(0.6%,hyphema in 2 eyes(0.4%, infective endophthalmitis in 1 eye(0.2%. Visual acuity: uncorrected visual acuity were ≤0.1 in 52 eyes(9.7%, >0.1-0.1-CONCLUSION:The small incision non phacoemusification cataract surgery with IOL implantation has the advantages of small incision, short operation time, relatively safe, easy to mastered, no-suture, quick visual function recovery and low cost. And, the operation equipments are simple and do not need many expensive medical equipments, supplies and professional staffs. So, the small incision non phacoemusification cataract surgery with IOL implantation is suitable for the anti-blind work of cataract in the foreign aid and remote areas.

  15. 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 (preferences and thus, the body of evidence. One way to tackle this important obstacle is to archive URLs permanently.

  16. Deep learning in the small sample size setting: cascaded feed forward neural networks for medical image segmentation

    Science.gov (United States)

    Gaonkar, Bilwaj; Hovda, David; Martin, Neil; Macyszyn, Luke

    2016-03-01

    Deep Learning, refers to large set of neural network based algorithms, have emerged as promising machine- learning tools in the general imaging and computer vision domains. Convolutional neural networks (CNNs), a specific class of deep learning algorithms, have been extremely effective in object recognition and localization in natural images. A characteristic feature of CNNs, is the use of a locally connected multi layer topology that is inspired by the animal visual cortex (the most powerful vision system in existence). While CNNs, perform admirably in object identification and localization tasks, typically require training on extremely large datasets. Unfortunately, in medical image analysis, large datasets are either unavailable or are extremely expensive to obtain. Further, the primary tasks in medical imaging are organ identification and segmentation from 3D scans, which are different from the standard computer vision tasks of object recognition. Thus, in order to translate the advantages of deep learning to medical image analysis, there is a need to develop deep network topologies and training methodologies, that are geared towards medical imaging related tasks and can work in a setting where dataset sizes are relatively small. In this paper, we present a technique for stacked supervised training of deep feed forward neural networks for segmenting organs from medical scans. Each `neural network layer' in the stack is trained to identify a sub region of the original image, that contains the organ of interest. By layering several such stacks together a very deep neural network is constructed. Such a network can be used to identify extremely small regions of interest in extremely large images, inspite of a lack of clear contrast in the signal or easily identifiable shape characteristics. What is even more intriguing is that the network stack achieves accurate segmentation even when it is trained on a single image with manually labelled ground truth. We validate

  17. Risk contracting and operational capabilities in large medical groups during national healthcare reform.

    Science.gov (United States)

    Mechanic, Robert E; Zinner, Darren

    2016-06-01

    Little is known about the scope of alternative payment models outside of Medicare. This study measures the full complement of public and private payment arrangements in large, multi-specialty group practices as a barometer of payment reform among advanced organizations. We collected information from 33 large, multi-specialty group practices about the proportion of their total revenue in 7 payment models, physician compensation strategies, and the implementation of selected performance management initiatives. We grouped respondents into 3 categories based on the proportion of their revenue in risk arrangements: risk-based (45%-100%), mixed (10%-35%), and fee-for-service (FFS) (0%-10%). We analyzed changes in contracting and operating characteristics between 2011 and 2013. In 2013, 68% of groups' total patient revenue was from FFS payments and 32% was from risk arrangements (unweighted average). Risk-based groups had 26% FFS revenue, whereas mixed-payment and FFS groups had 75% and 98%, respectively. Between 2011 and 2013, 9 groups increased risk contract revenue by about 15 percentage points and 22 reported few changes. Risk-based groups reported more advanced implementation of performance management strategies and were more likely to have physician financial incentives for quality and patient experience. The groups in this study are well positioned to manage risk-based contracts successfully, but less than one-third receive a majority of their revenue from risk arrangements. The experience of these relatively advanced groups suggests that expanding risk-based arrangements across the US health system will likely be slower and more challenging than many people assume.

  18. 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.

  19. Acceptability of offering financial incentives to achieve medication adherence in patients with severe mental illness: a focus group study.

    Science.gov (United States)

    Priebe, Stefan; Sinclair, Julia; Burton, Alexandra; Marougka, Stamatina; Larsen, John; Firn, Mike; Ashcroft, Richard

    2010-08-01

    Offering financial incentives to achieve medication adherence in patients with severe mental illness is controversial. To explore the views of different stakeholders on the ethical acceptability of the practice. Focus group study consisting of 25 groups with different stakeholders. Eleven themes dominated the discussions and fell into four categories: (1) 'wider concerns', including the value of medication, source of funding, how patients would use the money, and a presumed government agenda behind the idea; (2) 'problems requiring clear policies', comprising of practicalities and assurance that incentives are only one part of a tool kit; (3) 'challenges for research and experience', including effectiveness, the possibility of perverse incentives, and impact on the therapeutic relationship; (4) 'inherent dilemmas' around fairness and potential coercion. The use of financial incentives is likely to raise similar concerns in most stakeholders, only some of which can be addressed by empirical research and clear policies.

  20. An Internal Evaluation of Educational Groups in Dentistry Faculty of Tabriz Medical University Using CIPP model in 2015

    Directory of Open Access Journals (Sweden)

    Farnaz Limouei

    2016-11-01

    Full Text Available The present study was carried out with the purpose of internal evaluation of educational groups in dentistry faculty of Tabriz Medical University using CIPP model. Statistical population of this descriptive- cross sectional study consists of faculty members (n=106 and specialized assistants (n=108, conducted as whole counting. Questionnaires in four aspects of context, input, process and product were used to collect data. Reliability coefficient was obtained by Cronbach’s Alpha method. It was 0.886 for faculty members and 0.916 for assistants. Descriptive statistical methods were used for data analysis. In the context aspect, it was assessed fairly favorable and favorable by professors and assistants, respectively, for Endodontics, dental Prosthodontics, Pathology and Pediatric dentistry groups; it was evaluated fairly favorable for the other groups according to both perspectives. Professors of Periodontics group evaluated the input aspect fairly favorable and the assistants evaluated it favorable; Radiology professors assessed the input favorable and assistants recognized it fairly favorable and in other groups, professors and assistants assessed the input aspect fairly favorable. The process aspect was evaluated fairly favorable in Orthodontics, Pediatric and Radiology groups, favorable in Pathology group, and fairly favorable according to the professors and favorable according to the assistants in other groups. The product aspect was favorable in operative and Pathology groups from professors' viewpoints and fairly favorable according to the assistants' opinions.

  1. Shaping beside student of the special medical group of the culture sound lifestyle by means of computer technology

    Directory of Open Access Journals (Sweden)

    Vovk L.V.

    2010-07-01

    Full Text Available Considered results of the pedagogical experiment with use computer information-diagnostic system "Passport of health" on shaping the culture sound lifestyle beside student of the special medical group. Two groups student have took part in experiment in amount 151 persons. It is proved that pedagogical experiment has positively influenced upon fortification of health, life activity, high level of the knowledges and practical skills during education in high school. It is installed that one of the main of the conditions to efficiency of the physical education, are a knowledges, which allow effective to solve the delivered problems of the physical education to personalities.

  2. 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.

  3. Monte-Carlo simulations on the radiological characteristics of a small medical cyclotron

    International Nuclear Information System (INIS)

    Asova, Galina; Artinyan, Ari; Goutev, Nikolay; Mineva, Milena N.; Tonev, Dimitar; Ivanova, Severina; Zheleva, Nonka

    2018-01-01

    The Department of Nuclear Medicine, St. Marina University Hospital in Varna, is equipped with a self-shielded BG-75 cyclotron and synthesis unit for production of single doses of 18F-FDG. The cyclotron is capable to deliver 7.5 MeV proton beam with maximal current of 5 μA. During irradiation, a small target volume of 18 O-enriched water is bombarded with protons and the resulting neutron and gamma fields induce nuclear reactions within the target bulk, machine components and shielding, the walls of the cyclotron vault. The aim of the present work is to define the radiological characteristics of the activation products generated during the operation of the cyclotron that need to be considered for daily maintenance and for decommissioning of the facility in future. For that purpose Monte-Carlo calculations with detailed models of the vault and the machinery are used. Key words: cyclotron, target, vault, activation, radioactive waste, Monte-Carlo simulations

  4. 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.

  5. 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.

  6. 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.

  7. 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.

  8. 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...... status. RESULTS: Two thirds of the citizens (64.5%) used one or more PMs (antipsychotics 15.9%, antidepressants 43.5%, anxiolytics/hypnotics 27.1% and anti-dementia drugs 16.4%). Citizens treated with antipsychotics were also prescribed antidepressants (52.9%), anxiolytics/hypnotics (35.3%) and anti-dementia...... drugs (20.9%). Citizens treated with anti-dementia drugs were also prescribed antipsychotics (20.0%) and antidepressants (54.3%). Doses over 20 mg and 10 mg of citalopram and escitalopram, respectively, were given to 28.0% of the citizens treated with these antidepressants. CONCLUSION: Compared...

  9. 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)

  10. Experiences of the gender climate in clinical training – a focus group study among Swedish medical students

    Directory of Open Access Journals (Sweden)

    Emelie Kristoffersson

    2016-10-01

    Full Text Available Abstract Background Research shows that medical education is characterized by unequal conditions for women and men, but there is a lack of qualitative studies investigating the social processes that enable and maintain gender inequalities that include both male and female students. In this focus group study, we therefore explored male as well as female medical students’ experiences of the gender climate – i.e., how beliefs, values, and norms about gender were communicated – during clinical training and how the students dealt with these experiences. Methods Focus group interviews were conducted with 24 medical students (nine men at Umeå University, Sweden. The interviews were structured around personal experiences in clinical training where the participants perceived that gender had mattered. Data were analysed using qualitative content analysis. Results The students described gender-stereotyped expectations, discriminatory treatment, compliments, comments, and demeaning jargon. Female students gave more personal and varied examples than the men. The students’ ways of handling their experiences were marked by efforts to fit in, for example, by adapting their appearance and partaking in the prevailing jargon. They felt dependent on supervisors and staff, and due to fear of repercussions they kept silent and avoided unpleasant situations and people rather than challenging humiliating jargon or supervisors who were behaving badly. Conclusions Everyday communication of gender beliefs combined with students’ adaptation to stereotyped expectations and discrimination came across as fundamental features through which unequal conditions for male and female students are reproduced and maintained in the clinic. Because they are in a dependent position, it is often difficult for students to challenge problematic gender attitudes. The main responsibility for improvements, therefore, lies with medical school leadership who need to provide students

  11. 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.

  12. 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

  13. DISCHARGE AGAINST MEDICAL ADVICE (DAMA AMONG THE PAEDIATRIC AGE GROUP IN ENUGU STATE UNIVERSITY TEACHING HOSPITAL PARKLANE, ENUGU.

    Directory of Open Access Journals (Sweden)

    2016-11-01

    Full Text Available Discharge against medical advice (DAMA can be defined as a situation in which a patient chooses to leave the hospital before the managing physician recommends discharge. It presents a peculiar challenge amongst the pediatric population because children are dependent on their parents or care givers for decisions regarding healthcare. Understanding the risks and reasons for DAMA is important for health system policy and the proactive management of those at risk of DAMA. This was a retrospective study that reviewed the medical records of children aged one day to 17 years discharged against medical advice in the Paediatrics Department of ESUTH, over a three-year period from 1st January, 2013 to 31st December, 2015.A total of 5464 patients were admitted into CHER, Newborn and the Children\\'s wards during the study period. Out of these, 170 patients, representing 3.1%, were DAMA. Among the age groups, DAMA was more common amongst infants (45.6%. Malaria was the most common condition on discharge against medical advice (20.1% followed by pneumonia (15.7% and sepsis (12.3%.All the patients had evidence of signed documentation in the form of a signed entry in the case files. There was no alternative treatment plan offered to 111 (97.4% cases and no option for follow up in 109 (95.6%. We recommend that the current documentation for DAMA as a signed entry in the case notes should be reviewed.

  14. Group medical visits in the follow-up of women with a BRCA mutation: design of a randomized controlled trial

    Directory of Open Access Journals (Sweden)

    Hoogerbrugge Nicoline

    2011-08-01

    Full Text Available Abstract Background BRCA mutation carriers have a 40-80% life-time risk of developing breast cancer. They may opt for yearly breast cancer surveillance or for prophylactic mastectomy. Both options show increased survival rates. It is a complex choice to be made between these two options. As a result most women experience high levels of distress and high needs for information. To fulfill the needs for psychosocial support and information we have introduced group medical consultations (GMCs. A GMC provides individual medical visits conducted within a group. This 90 minute group-visit with 8-12 patients gives patients the opportunity to spend more time with their clinician and a behavioral health professional and learn from other patients experiencing similar topics. However, it should be noted that group sessions may increase fear in some patients or influence their decision making. Methods/design In this randomized controlled trial, 160 BRCA mutation carriers diagnosed maximally 2 years ago are recruited from the Radboud University Nijmegen Medical Centre. Participants are randomized in a 1:1 ratio to either the GMC intervention group (onetime participation in a GMC instead of a standard individual visit or to a usual care control group. Primary outcome measures are empowerment and psychological distress (SCL 90. Secondary outcome measures are fear of cancer, information needs before the consultation and the received information, self-examination of the breasts, patient satisfaction, quality of life and cost-effectiveness. Data are collected via self-reported questionnaires 1 week before the visit, and at 1 week and at 3 months follow-up. A pilot study was conducted to test all procedures and questionnaires. Discussion The possibility for interaction with other BRCA mutation carriers within a medical visit is unique. This study will assess the effectiveness of GMCs for BRCA mutation carriers to improve empowerment and decrease distress compared

  15. Population health management in a small health system: Impact of controlled substance stewardship in a patient-centered medical home.

    Science.gov (United States)

    Homsted, Felicity A E; Magee, Chelsea E; Nesin, Noah

    2017-09-15

    The success of a patient-centered medical home in providing population health management (PHM) services through controlled substance stewardship is described. In 2013, Penobscot Community Health Care (PCHC), in Bangor, Maine, was fully engulfed in the prescription opioid crisis. At PCHC, patients' opioid doses were startlingly high. Within the organization, measures to ensure that prescriptions were being used as prescribed, and not diverted, were underutilized. PCHC responded to these challenges by developing a comprehensive approach to controlled substance stewardship, defined as a coordinated effort to promote the appropriate use of controlled substances, improve patient outcomes, reduce misuse and abuse, and decrease patient morbidity and mortality attributed to these high-risk medications. Since the establishment of the program, over 1,300 patient reviews have been conducted. During this time, the number of PCHC patients receiving chronic opioids has decreased by 67.2% and continues to drop, with a corresponding 65.6% decrease in the number of patients receiving benzodiazepines. Premature deaths were reviewed to identify associations with opioids prescribed at the time of death, which revealed a decline of 50% between 2013 and 2015. Since program inception, the reviews conducted based on internal quality-improvement reports have been expanded to include patients on combinations of opioids and benzodiazepines, high-dose opioids, and carisoprodol. Systematic approaches addressing areas of critical need in high-risk populations are integral to PHM efforts in small health systems. The pharmacy team can serve a unique role in identifying, developing, and implementing key PHM services. Coupled with strategic community partnerships, successful PHM integration can assist in the financial survival of small health systems. Copyright © 2017 by the American Society of Health-System Pharmacists, Inc. All rights reserved.

  16. 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.

  17. 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.

  18. 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.

  19. 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.

  20. Group therapy for patients with tinnitus at the University of Brasilia Medical School.

    Science.gov (United States)

    Holdefer, Lisiane; Oliveira, Carlos Augusto C P de; Venosa, Alessandra Ramos

    2010-01-01

    Although group therapy for tinnitus is a well documented field in the international literature, as far as we know it has never been held in Brazil. This study represents a successful experience of a group therapy for tinnitus based on the tinnitus retraining therapy associated with behavioral cognitive techniques. The goal of the present study is to assess patients with tinnitus before and after the group therapy based on the tinnitus retraining therapy and the behavioral cognitive therapy. Prospective cohort study: 27 subjects signed in for the study, and answered the Tinnitus Handicap Inventory (THI) and the Hospital Depression and Anxiety Scale (HAD), before and after the treatment. We held six structured sessions according to the principles of tinnitus retraining therapy associated with behavioral cognitive techniques. 27 patients started and 19 finished the treatment (8 were taken off). 47.4% men, mean age of 47.6. THI results before and after treatment were respectively: functional: 29 and 14, emotional 24 and 10 and catastrophic 12 and 5 and the HAD scale: anxiety 2 and 9 and depression 10 and 6. The treatment described is effective in improving tinnitus symptoms.

  1. 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

  2. Medical research: civil liability and compensation for personal injury--a discussion paper. Ciba Foundation Study Group.

    Science.gov (United States)

    1980-01-01

    The Ciba Foundation Study Group has considered the most appropriate means of compensating participants (or their relatives) for injuries received as a consequence of medical research. The group recognises that injury may occur despite the exercise of the highest degree of skill and care by the investigator and that compensation through an action for negligence is therefore not available. At present injured participants have to rely on ex gratia payments. The group considers this unsatisfactory and recommends the establishment of a centrally operated fund with authority to provide compensation on a no-fault basis. These recommendations do not diminish the rights of the participant to bring an action in the event of negligence on the part of the investigator or an action under the law relating to product liability against the manufacturers of defective equipment or drugs. PMID:7388452

  3. Genetic background of lead and mercury metabolism in a group of medical students in Austria.

    Science.gov (United States)

    Gundacker, Claudia; Wittmann, Karl J; Kukuckova, Martina; Komarnicki, Günter; Hikkel, Imrich; Gencik, Martin

    2009-08-01

    Information on the impact of genetic predisposition on metal toxicokinetics in the human body is limited. There is increasing evidence that certain genetic polymorphisms modify lead and mercury toxicokinetics. This called for analysis of further candidate genes. Medical students (N=324) were examined in order to detect potential associations between lead exposure and polymorphisms in HFE, VDR, ALAD, and MT genes, as well as between mercury exposure and GSTT1, GSTM1, GSTA1, GSTP1, GCLC, and MT polymorphisms. The levels of lead and mercury exposure of students were determined by blood, urine, and hair analyses (ICP-MS, CV-AAS). Genotyping of common polymorphisms was examined by MALDI-TOF MS and the TaqMan methodology. Associations between lead and mercury exposures and genetic background were examined by bivariate analysis, and by categorical regression analysis (CATREG) controlled by metal- and matrix-specific variables. Lead and mercury levels in urine, blood, and hair indicated low exposures. VDR polymorphism and joint presence of VDR/ALAD polymorphisms were significantly and independently associated with urine lead concentrations (CATREG Plead and mercury metabolism, suggesting gene-environment and gene-gene-environment interactions. The modes of interaction remain to be evaluated.

  4. 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.

  5. General guidelines for medically screening mixed population groups potentially exposed to nerve or vesicant agents

    Energy Technology Data Exchange (ETDEWEB)

    Watson, A.P.; Munro, N.B. (Oak Ridge National Lab., TN (United States)); Sidell, F.R. (Army Medical Research Inst. of Chemical Defense, Aberdeen Proving Ground, MD (United States)); Leffingwell, S.S. (Centers for Disease Control, Atlanta, GA (United States). Center for Environmental Health and Injury Control)

    1992-01-01

    A number of state and local planners have requested guidance on screening protocols and have expressed interest in sampling body fluids from exposed or potentially exposed individuals as a means of estimating agent dose. These guidelines have been developed to provide a clear statement that could be used by state and local emergency response personnel in the event of a nerve or vesicant agent incident resulting in off-post contamination; maximum protection from harm is the goal. The assumption is that any population group so exposed would be heterogeneous for age, gender, reproductive status, and state of health.

  6. 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.

  7. 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.

  8. 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.

  9. Consensus Statement on medication use in multiple sclerosis by the Spanish Society of Neurology's study group for demyelinating diseases.

    Science.gov (United States)

    García-Merino, A; Fernández, O; Montalbán, X; de Andrés, C; Oreja-Guevara, C; Rodríguez-Antigüedad, A; Arbizu, T

    2013-01-01

    Treatments for multiple sclerosis therapy are rapidly evolving. It is believed that new drugs will be approved in the near future, thereby changing current indications for treatment. In this context, the Spanish Society of Neurology's study group on demyelinating diseases, which evaluates medication use in MS, has decided to draw up a consensus statement on the current indications and guidelines for multiple sclerosis treatment. Copyright © 2013 Sociedad Española de Neurología. Published by Elsevier Espana. All rights reserved.

  10. Quality assurance in radiotherapy: the importance of medical physics staffing levels. Recommendations from an ESTRO/EFOMP joint task group.

    Science.gov (United States)

    Belletti, S; Dutreix, A; Garavaglia, G; Gfirtner, H; Haywood, J; Jessen, K A; Lamm, I L; Mijnheer, B; Noël, A; Nüsslin, F; Rosenow, U; Schneider, P; Seelentag, W; Sheriff, S; Svensson, H; Thwaites, D

    1996-10-01

    The safe application of ionising radiation for diagnosis and therapy requires a high level of knowledge of the underlying processes and of quality assurance. Sophisticated modern equipment can be used effectively for complicated diagnostic and therapeutic techniques only with adequate physics support. In the light of recent analyses and recommendations by national and international societies a joint working group of representatives from ESTRO (European Society for Therapeutic Radiology and Oncology) and from EFOMP (European Federation of Organisations for Medical Physics) was set up to assess the necessary staffing levels for physics support to radiotherapy. The method used to assess the staffing levels, the resulting recommendations and examples of their practical application are described.

  11. 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

  12. Individual and small-group market health insurance rate review and disclosure: state and federal roles after PPACA.

    Science.gov (United States)

    Linehan, Kathryn

    2011-09-28

    Oversight of private insurance, including health insurance, is primarily a state responsibility. Each state establishes its own laws and regulations regarding insurer activities, including premium increases for the insurance products within its purview. The authority that state regulators have to review and deny requests for premium changes varies from state to state, as do the amount of resources available to state insurance departments for reviewing premium changes. In some markets where insurers have proposed or implemented steep increases, such changes have received considerable attention from the press, state regulators, and policymakers. The Patient Protection and Affordable Care Act (PPACA) requires annual review of premium increases and disclosure of those increases determined unreasonable beginning in September 2011. Under PPACA, each state will conduct these reviews for individual and small-group health insurance unless the federal government concludes they do not have an effective review program and assumes review responsibility. As they did prior to PPACA, state laws govern whether rates go into effect and establish the parameters of regulators' authority. This issue brief outlines specific state and federal roles in the rate review process and changes to rate review processes since PPACA was enacted.

  13. 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.

  14. 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

  15. 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 %.

  16. Group Motivational Interviewing to Promote Adherence to Antiretroviral Medications and Risk Reduction Behaviors in HIV Infected Women

    Science.gov (United States)

    Holstad, Marcia McDonnell; DiIorio, Colleen; Kelley, Mary E.; Resnicow, Kenneth; Sharma, Sanjay

    2011-01-01

    We present the results of a clinical trial that tested the efficacy of using motivational interviewing (MI) in a group format to promote adherence to antiretroviral medications and risk reduction behaviors (RRB) in 203 predominately African American HIV infected women. It was compared to a group health promotion program. Participants were followed for 9 months. Adherence was measured by MEMS®; and RRB by self-report. Controlling for recruitment site and years on ART, no significant group by time effects were observed. Attendance (≥7/8 sessions) modified the effects. Higher MI attendees had better adherence at all follow-ups, a borderline significant group by time effect (p = 0.1) for % Doses Taken on Schedule, a significantly larger proportion who reported abstinence at 2 weeks, 6, and 9 months, and always used protection during sex at 6 and 9 months. Though not conclusive, the findings offer some support for using MI in a group format to promote adherence and some risk reduction behaviors when adequate attendance is maintained. PMID:21165692

  17. 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.

  18. 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.

  19. 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…

  20. Markedly Increased High-Mobility Group Box 1 Protein in a Patient with Small-for-Size Syndrome

    Directory of Open Access Journals (Sweden)

    Darren G. Craig

    2014-01-01

    Full Text Available Background. Small-for-size syndrome (SFSS occurs in the presence of insufficient liver mass to maintain normal function after liver transplantation. Murine mortality following 85% hepatectomy can be reduced by the use of soluble receptor for advanced glycation end products (sRAGE to scavenge damage-associated molecular patterns and prevent their engagement with membrane-bound RAGE. Aims. To explore serum levels of sRAGE, high-mobility group box-1 (HMGB1 protein, and other soluble inflammatory mediators in a fatal case of SFSS. Methods. Serum levels of HMGB1, sRAGE, IL-18, and other inflammatory mediators were measured by ELISA in a case of SFSS, and the results were compared with 8 patients with paracetamol-induced acute liver failure (ALF and 6 healthy controls (HC. Results. HMGB1 levels were markedly higher in the SFSS patient (92.1 ng/mL compared with the ALF patients (median (IQR 11.4 (3.7–14.8 ng/mL and HC (1.42 (1.38–1.56 ng/mL. In contrast, sRAGE levels were lower in the SFSS patient (1.88 ng/mL compared with the ALF patients (3.53 (2.66–12.37 ng/mL and were similar to HC levels (1.40 (1.23–1.89 ng/mL. Conclusion. These results suggest an imbalance between pro- and anti-inflammatory innate immune pathways in SFSS. Modulation of the HMGB1-RAGE axis may represent a future therapeutic avenue in this condition.

  1. Trimodality therapy for superior sulcus non-small cell lung cancer: Southwest Oncology Group-Intergroup Trial S0220.

    Science.gov (United States)

    Kernstine, Kemp H; Moon, James; Kraut, Michael J; Pisters, Katherine M W; Sonett, Joshua R; Rusch, Valerie W; Thomas, Charles R; Waddell, Thomas K; Jett, James R; Lyss, Alan P; Keller, Steven M; Gandara, David R

    2014-08-01

    Although preoperative chemotherapy (cisplatin-etoposide) and radiotherapy, followed by surgical resection, is considered a standard of care for superior sulcus cancers, treatment is rigorous and relapse limits long-term survival. The Southwest Oncology Group-Intergroup Trial S0220 was designed to incorporate an active systemic agent, docetaxel, as consolidation therapy. Patients with histologically proven and radiologically defined T3 to 4, N0 to 1, M0 superior sulcus non-small cell lung cancer underwent induction therapy with cisplatin-etoposide, concurrently with thoracic radiotherapy at 45 Gy. Nonprogressing patients underwent surgical resection within 7 weeks. Consolidation consisted of docetaxel every 3 weeks for 3 doses. The accrual goal was 45 eligible patients. The primary objective was feasibility. Of 46 patients registered, 44 were eligible and assessable; 38 (86%) completed induction, 29 (66%) underwent surgical resection, and 20 (45% of eligible, 69% surgical, and 91% of those initiating consolidation therapy) completed consolidation docetaxel; 28 of 29 (97%) underwent a complete (R0) resection; 2 (7%) died of adult respiratory distress syndrome. In resected patients, 21 of 29 (72%) had a pathologic complete or nearly complete response. The known site of first recurrence was local in 2, local-systemic in 1, and systemic in 10, with 7 in the brain only. The 3-year progression-free survival was 56%, and 3-year overall survival was 61%. Although trimodality therapy provides excellent R0 and local control, only 66% of patients underwent surgical resection and only 45% completed the treatment regimen. Even in this subset, distant recurrence continues to be a major problem, particularly brain-only relapse. Future strategies to improve treatment outcomes in this patient population must increase the effectiveness of systemic therapy and reduce the incidence of brain-only metastases. Copyright © 2014 The Society of Thoracic Surgeons. Published by Elsevier

  2. Evaluation of cardiac function in a group of small for gestational age school-age children treated with growth hormone.

    Science.gov (United States)

    Aurensanz Clemente, Esther; Ayerza Casas, Ariadna; Samper Villagrasa, Pilar; Ruiz Frontera, Pablo; Bueno Lozano, Gloria

    2017-02-09

    Small for gestational age (SGA) patients have an increased risk of developing a cardiovascular pathology, as well as a metabolic syndrome. Our objective is to evaluate the cardiac morphology and function of SGA children treated with growth hormone (GH), identifying changes that could potentially have long-term consequences. We selected 23 SGA school-age patients and 23 healthy children. We measured their weight, height, blood pressure and heart rate. Using transthoracic echocardiography, we evaluated cardiac chamber size, ascending and abdominal aortic diameter as well as the systolic and diastolic function of both ventricles. SGA children have a higher systolic and diastolic blood pressure (P<.05) without significant changes in their heart rate. They also have a thicker interventricular septum (SGA Z-score 1.57 vs. 0.89; P=.026) and a worse right ventricular systolic function, with a lower TAPSE (SGA Z-score -0.98 vs. 0.95; P=.000), as well as a lower blood flow rate in the pulmonary artery (SGA 0.85m/s vs. 0.97m/s; P=.045). No significant difference was observed in the patients' left ventricular function. SGA patients' ascending aortic diameter was greater (SGA Z-score -1.09 vs. -1.93; P=.026), whereas the systolic abdominal aortic diameter was smaller (SGA Z-score-0.89 vs. -0.19; P=.015). We found functional and morphological cardiac changes in SGA school-age patients treated with GH. It is important to follow-up this patient group in order to determine if these changes contribute to an increased cardiac morbidity in adulthood. Copyright © 2016 Elsevier España, S.L.U. All rights reserved.

  3. 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.

  4. Sequence type 1 group B Streptococcus, an emerging cause of invasive disease in adults, evolves by small genetic changes.

    Science.gov (United States)

    Flores, Anthony R; Galloway-Peña, Jessica; Sahasrabhojane, Pranoti; Saldaña, Miguel; Yao, Hui; Su, Xiaoping; Ajami, Nadim J; Holder, Michael E; Petrosino, Joseph F; Thompson, Erika; Margarit Y Ros, Immaculada; Rosini, Roberto; Grandi, Guido; Horstmann, Nicola; Teatero, Sarah; McGeer, Allison; Fittipaldi, Nahuel; Rappuoli, Rino; Baker, Carol J; Shelburne, Samuel A

    2015-05-19

    The molecular mechanisms underlying pathogen emergence in humans is a critical but poorly understood area of microbiologic investigation. Serotype V group B Streptococcus (GBS) was first isolated from humans in 1975, and rates of invasive serotype V GBS disease significantly increased starting in the early 1990s. We found that 210 of 229 serotype V GBS strains (92%) isolated from the bloodstream of nonpregnant adults in the United States and Canada between 1992 and 2013 were multilocus sequence type (ST) 1. Elucidation of the complete genome of a 1992 ST-1 strain revealed that this strain had the highest homology with a GBS strain causing cow mastitis and that the 1992 ST-1 strain differed from serotype V strains isolated in the late 1970s by acquisition of cell surface proteins and antimicrobial resistance determinants. Whole-genome comparison of 202 invasive ST-1 strains detected significant recombination in only eight strains. The remaining 194 strains differed by an average of 97 SNPs. Phylogenetic analysis revealed a temporally dependent mode of genetic diversification consistent with the emergence in the 1990s of ST-1 GBS as major agents of human disease. Thirty-one loci were identified as being under positive selective pressure, and mutations at loci encoding polysaccharide capsule production proteins, regulators of pilus expression, and two-component gene regulatory systems were shown to affect the bacterial phenotype. These data reveal that phenotypic diversity among ST-1 GBS is mainly driven by small genetic changes rather than extensive recombination, thereby extending knowledge into how pathogens adapt to humans.

  5. 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...

  6. [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.

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

    OpenAIRE

    Andrew King; Sarah Greenberger; Michael Prats; Creagh Boulger; Alyssa Tyransky; Laura Thompson; Nicholas Kman; Cynthia Leung; Jennifer Mitzman; Michael Barrie; Sorabh Khandelwal; Christopher San Miguel

    2017-01-01

    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 ...

  8. Exploring medical student learning in the large group teaching environment: examining current practice to inform curricular development.

    Science.gov (United States)

    Luscombe, Ciara; Montgomery, Julia

    2016-07-19

    Lectures continue to be an efficient and standardised way to deliver information to large groups of students. It has been well documented that students prefer interactive lectures, based on active learning principles, to didactic teaching in the large group setting. Despite this, it is often the case than many students do not engage with active learning tasks and attempts at interaction. By exploring student experiences, expectations and how they use lectures in their learning we will provide recommendations for faculty to support student learning both in the lecture theatre and during personal study time. This research employed a hermeneutic phenomenological approach. Three focus groups, consisting of 19 students in total, were used to explore the experiences of second year medical students in large group teaching sessions. Using generic thematic data analysis, these accounts have been developed into a meaningful account of experience. This study found there to be a well-established learning culture amongst students and with it, expectations as to the format of teaching sessions. Furthermore, there were set perceptions about the student role within the learning environment which had many implications, including the way that innovative teaching methods were received. Student learning was perceived to take place outside the lecture theatre, with a large emphasis placed on creating resources that can be taken away to use in personal study time. Presented here is a constructive review of reasons for student participation, interaction and engagement in large group teaching sessions. Based on this are recommendations constructed with the view to aid educators in engaging students within this setting. Short term, educators can implement strategies that monopolise on the established learning culture of students to encourage engagement with active learning strategies. Long term, it would be beneficial for educators to consider ways to shift the current student learning

  9. Working with patients who have big burns: exploring the perspectives of senior medical staff of different professional groups.

    Science.gov (United States)

    Camhi, Claudia; Cohn, Nancy

    2007-01-01

    This study aimed to explore the views of senior medical staff on the emotional impact and dilemmas of working with patients who have big burns. Six members of medical staff from different professional groups were interviewed: two consultant plastic and reconstructive surgeons, two consultant anesthetists, and two senior physiotherapists. Their interviews were analyzed using a qualitative methodology, namely interpretative phenomenological analysis. The emerging patterns were discussed in the light of systemic and social constructionist theory. The emerging themes revolved around three main areas. The participants shared their ideas on the tensions around decision-making and the different positions they take when they have to make life-or-death decisions or when they have to live with the consequences of these decisions taken by others. They brought to the discussion differing ideas about what they consider as the right emotional distance and emotional talk with patients. Finally, they reflected on intragroup ways of support generated by their burns team and they highlight the use of humor and the use informal networks as ways of support.

  10. 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

  11. 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

  12. 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)

    Golod N. R.

    2015-04-01

    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.

  13. 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.

  14. 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

  15. 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...

  16. 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)

  17. 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…

  18. Continuous quality improvement in small general medical practices: the attitudes of general practitioners and other practice staff.

    NARCIS (Netherlands)

    Geboers, H.J.A.M.; Mokkink, H.G.A.; Montfort, P.A.P. van; Hoogen, H.J.M. van den; Bosch, W.J.H.M. van den; Grol, R.P.T.M.

    2001-01-01

    OBJECTIVES: Continuous quality improvement (CQI) offers opportunities to improve care in small-scale office-based practice. Little is yet known about the implementation of CQI in small primary care practices. We studied the attitudes of physicians and staff in small family practices to a model of

  19. 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.

  20. 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. .

  1. Dental students\\' satisfaction of applying a combination of lecture and work in small groups compared to applying only lecture: a quasi-experimental study

    Directory of Open Access Journals (Sweden)

    Pouyan Amini Shakib

    2015-12-01

    Full Text Available Background and Aims: Choosing an appropriate style of teaching-learning by educators is a way to reach high quality education. The objective of this study conducted in Babol Dental School was to compare dental students, satisfaction of teaching theoretical general pathology course by means of a combination of lecture and work in small groups with their satisfaction of teaching the course by means of only lecture. Materials and Methods: This study was performed in the second semester of school year 2011-12 and 2012-13. In 2012 (intervention group, response rate=92%, the teaching of theoretical general pathology course was implemented by means of a combination of lecture and work in small groups, but in 2013 (control group, response rate=81% by means of only lecture. An anonymous self-administered questionnaire was used to assess students, satisfaction of the teaching methods. To compare the mean total score of satisfaction (ranging from 18 through 90 between the two groups, T-test was used. Results: Comparing the mean total scores between the two groups revealed that students, satisfaction of the combined teaching method was significantly higher (P<0.001. The difference of satisfaction between genders (separately for each group was not significant in combination group and lecture group (P=0.63 and P=0.87,   respectively. Conclusion: Regarding learning, combining lecture with other teaching methods such as work in small groups may increase health sciences students' satisfaction. In regard to teaching theoretical general pathology course, our findings could confirm this hypothesis.

  2. Standard Setting in a Small Scale OSCE: A Comparison of the Modified Borderline-Group Method and the Borderline Regression Method

    Science.gov (United States)

    Wood, Timothy J.; Humphrey-Murto, Susan M.; Norman, Geoffrey R.

    2006-01-01

    When setting standards, administrators of small-scale OSCEs often face several challenges, including a lack of resources, a lack of available expertise in statistics, and difficulty in recruiting judges. The Modified Borderline-Group Method is a standard setting procedure that compensates for these challenges by using physician examiners and is…

  3. 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.

  4. The Iterative Decision Method (IDM): Academy of Health Sciences Reports, Small Group Decision-Making and Problem-Solving Bibliography, and Statistical References.

    Science.gov (United States)

    1983-03-01

    475. IDM Bibliography 11 * 89. James , J. A preliminary study of the size determinant in small group . interaction. American Sociological Review, 1951...Social Psydology, 1969, 12, 144-150. 109. Laughlin, P. R., & Jaccard , J. J. Social facilitation and observational learning of individuals and

  5. Perceived occupational and environmental health hazards among workers in small scale industries in Dar es Salaam, Tanzania: a focus group discussion study.

    NARCIS (Netherlands)

    Rongo, L.M.B.; Haan, S. de; Barten, F.J.M.H.; Msamanga, G.I.; Dolmans, W.M.V.; Naerssen, A.L. van; Heerderik, D.; Rongo, L.M.B.

    2003-01-01

    While the informal sector is rapidly emerging as the major source of employment in poor countries, little is known to the health hazards encountered by the workers in small-scale industries (SSI). We conducted 11 focus group discussions (FGD) among the workers in SSI to assess felt occupational

  6. 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…

  7. Comparison of Two Small-Group Learning Methods in 12th-Grade Physics Classes Focusing on Intrinsic Motivation and Academic Performance

    Science.gov (United States)

    Berger, Roland; Hanze, Martin

    2009-01-01

    Twelfth-grade physics classes with 344 students participated in a quasi-experimental study comparing two small-group learning settings. In the jigsaw classroom, in contrast to the cyclical rotation method, teaching expectancy as well as resource interdependence is established. The study is based on the self-determination theory of motivation,…

  8. Effects of Small-Group Tutoring with and without Validated Classroom Instruction on At-Risk Students' Math Problem Solving: Are Two Tiers of Prevention Better than One?

    Science.gov (United States)

    Fuchs, Lynn S.; Fuchs, Douglas; Craddock, Caitlin; Hollenbeck, Kurstin N.; Hamlett, Carol L.; Schatschneider, Christopher

    2008-01-01

    This study assessed the effects of small-group tutoring with and without validated classroom instruction on at-risk students' math problem solving. Stratifying within schools, 119 3rd-grade classes were randomly assigned to conventional or validated problem-solving instruction (Hot Math, schema-broadening instruction). Students identified as at…

  9. 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…

  10. 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)

  11. More Perspectives, New Politics, New Life: How a Small Group UsedThe Integral Process For Working On Complex Issues

    OpenAIRE

    Sara Ross

    2006-01-01

    This article reports on a small research project with citizens who wanted to address their community’s chronically adversarial behaviors and atmosphere. It complements a longer research report on the same project, which is also published in this issue of Integral Review. The project used a structured public discourse process, The Integral Process For Working On Complex Issues (TIP). This article supplies background on TIP’s origins, then focuses on two areas. First, it explains the process st...

  12. Prognostic Factors in Non-Small Cell Lung Cancer Less Than 3 Centimeters: Actuarial Analysis, Accumulative Incidence and Risk Groups.

    Science.gov (United States)

    Peñalver Cuesta, Juan C; Jordá Aragón, Carlos; Mancheño Franch, Nuria; Cerón Navarro, José A; de Aguiar Quevedo, Karol; Arrarás Martínez, Miguel; Vera Sempere, Francisco J; Padilla Alarcón, Jose D

    2015-09-01

    In TNM classification, factors determining the tumor (T) component in non-small cell lung cancer have scarcely changed over time and are still based solely on anatomical features. Our objective was to study the influence of these and other morphopathological factors on survival. A total of 263 patients undergoing lung resection due to stage I non-small cell lung cancer ≤3cm in diameter were studied. A survival analysis and competing-risk estimate study was made on the basis of clinical, surgical and pathological variables using actuarial analysis and accumulative incidence methods, respectively. A risk model was then generated from the results. Survival at 5 and 10 years was 79.8 and 74.3%, respectively. The best prognostic factors were presence of symptoms, smoking habit and FEV1>60%, number of resected nodes>7, squamous histology, absence of vascular invasion, absence of visceral pleural invasion and presence of invasion more proximal than the lobar bronchus. All these were statistically significant according to the actuarial method. The factor "age60%. Pleural invasion and vascular invasion determine survival or risk of death due to non-small cell lung cancer ≤3cm and can be used for generating a predictive risk model. Copyright © 2014 SEPAR. Published by Elsevier Espana. All rights reserved.

  13. 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.

  14. 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.

  15. The Effect of Education-Based Intervention Using Small Group Discussion in Empowering Adolescent Girls to Prevent Iron Deficiency Anemia

    Directory of Open Access Journals (Sweden)

    Fatemehsadat Seyed Nematollah Roshan

    2014-10-01

    Results: At baseline, independent T-test showed no significant difference between the two groups in the perceived susceptibility, perceived severity, and self efficacy, all of which could be regarded as empowerment process components (P>0.05. However, significant differences were observed after intervention. Also, the paired T-test showed a significant difference before and after the intervention in the test group in means of the perceived susceptibility, perceived severity, self efficacy and, in the grand scheme, adolescent girls' empowerment (P

  16. 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.

  17. 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

  18. 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.

  19. Cost and Impact of Voluntary Medical Male Circumcision in South Africa: Focusing the Program on Specific Age Groups and Provinces.

    Directory of Open Access Journals (Sweden)

    Katharine Kripke

    Full Text Available In 2012, South Africa set a goal of circumcising 4.3 million men ages 15-49 by 2016. By the end of March 2014, 1.9 million men had received voluntary medical male circumcision (VMMC. In an effort to accelerate progress, South Africa undertook a modeling exercise to determine whether circumcising specific client age groups or geographic locations would be particularly impactful or cost-effective. Results will inform South Africa's efforts to develop a national strategy and operational plan for VMMC.The study team populated the Decision Makers' Program Planning Tool, Version 2.0 (DMPPT 2.0 with HIV incidence projections from the Spectrum/AIDS Impact Module (AIM, as well as national and provincial population and HIV prevalence estimates. We derived baseline circumcision rates from the 2012 South African National HIV Prevalence, Incidence and Behaviour Survey. The model showed that circumcising men ages 20-34 offers the most immediate impact on HIV incidence and requires the fewest circumcisions per HIV infection averted. The greatest impact over a 15-year period is achieved by circumcising men ages 15-24. When the model assumes a unit cost increase with client age, men ages 15-29 emerge as the most cost-effective group. When we assume a constant cost for all ages, the most cost-effective age range is 15-34 years. Geographically, the program is cost saving in all provinces; differences in the VMMC program's cost-effectiveness across provinces were obscured by uncertainty in HIV incidence projections.The VMMC program's impact and cost-effectiveness vary by age-targeting strategy. A strategy focusing on men ages 15-34 will maximize program benefits. However, because clients older than 25 access VMMC services at low rates, South Africa could consider promoting demand among men ages 25-34, without denying services to those in other age groups. Uncertainty in the provincial estimates makes them insufficient to support geographic targeting.

  20. The Skilled Use of Interaction Strategies: Creating a Framework for Improved Small-Group Communicative Interaction in the Language Classroom.

    Science.gov (United States)

    Bejarano, Yael; And Others

    1997-01-01

    Focuses on the need to provide English-as-a-Second-Language learners with preparatory training to ensure more effective communicative interaction during group work conducted in the classroom. Findings indicate that Israeli students exposed to training in the skilled use of interaction strategies used significantly more modified-interaction and…

  1. 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

  2. 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…

  3. Social Resources Generated by Group Support Networks May Not Be Beneficial to Asian Immigrant-Owned Small Businesses.

    Science.gov (United States)

    Bates, Timothy

    1994-01-01

    Data from the Census Bureau's Characteristics of Business Owners, 1979-87, suggest that the success and survival patterns of businesses owned by Asian immigrants derive from large investments of financial capital and the business owners' superior educational credentials. Questions the validity of attributing this group's self-employment success to…

  4. [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.

  5. 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

    2017-08-17

    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.

  6. 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.

  7. Risk of suicide in medical and related occupational groups: a national study based on Danish case population-based registers.

    Science.gov (United States)

    Hawton, Keith; Agerbo, Esben; Simkin, Sue; Platt, Belinda; Mellanby, Richard J

    2011-11-01

    Suicide risk may be elevated in 'medical' occupational groups, although results of studies are inconsistent. National data are required to examine this issue. It is also important to investigate the possible contribution of psychiatric disorder and access to specific suicide methods. In a nested case-control design we used data from Danish national registers for 1981-2006 to examine risk of suicide in nurses, physicians, dentists, pharmacists and veterinary surgeons compared to teachers and the general population, and associations with psychiatric service contact and suicide methods. Crude age- and gender-adjusted rate ratios for suicide compared to teachers were significantly elevated in nurses (RR 1.90, 95% CI 1.63-2.21), physicians (RR 1.87, 95% CI 1.55-2.26), dentists (RR 2.10, 95% CI 1.58-2.79) and pharmacists (RR 1.91, 95% CI 1.26-2.87), but not veterinary surgeons. Risk was also elevated in nurses, physicians and dentists compared with the rest of the general population, the relative risk increasing following adjustments for psychiatric service contact, marital status, gross income and labour market status. Results were similar in both genders. The elevated risk in nurses and dentists decreased during the study period. Elevated risks were not associated with greater psychiatric service contact. Medicinal drugs were commonly used for suicide by nurses, physicians and pharmacists. The study was based in one country. Risk of suicide is increased in nurses, physicians, dentists and pharmacists in Denmark. This is not reflected in excess psychiatric service contact. Ready access to medicinal drugs may influence risk in nurses, physicians and pharmacists. Copyright © 2011 Elsevier B.V. All rights reserved.

  8. 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.

  9. Benefits of foraging in small groups: An experimental study on public information use in red knots Calidris canutus.

    Science.gov (United States)

    Bijleveld, Allert I; van Gils, Jan A; Jouta, Jeltje; Piersma, Theunis

    2015-08-01

    Social foraging is common and may provide benefits of safety and public information. Public information permits faster and more accurate estimates of patch resource densities, thus allowing more effective foraging. In this paper we report on two experiments with red knots Calidris canutus, socially foraging shorebirds that eat bivalves on intertidal mudflats. The first experiment was designed to show that red knots are capable of using public information, and whether dominance status or sex affected its use. We showed that knots can detect the foraging success of conspecifics and choose a patch accordingly. Neither dominance status nor sex influenced public information use. In the second experiment, by manipulating group size, we investigated whether public information use affected food-patch discovery rates and patch residence times. We showed that the time needed before locating a food patch decreased in proportion to group size. Also, an individual's number of patch visits before locating the food declined with group size, and, to our surprise, their average patch residence time did as well. Moreover, knots differed in their search strategy in that some birds consistently exploited the searching efforts of others. We conclude that socially foraging knots have the potential to greatly increase their food-finding rate by using public information. This article is part of a Special Issue entitled: In Honor of Jerry Hogan. Copyright © 2014 Elsevier B.V. All rights reserved.

  10. Recurrent stroke after transient ischaemic attack or minor ischaemic stroke: does the distinction between small and large vessel disease remain true to type? Dutch TIA Trial Study Group.

    OpenAIRE

    Kappelle, L J; van Latum, J C; van Swieten, J C; Algra, A; Koudstaal, P J; van Gijn, J

    1995-01-01

    The incidence and vascular type of recurrent ischaemic stroke was studied in patients with supratentorial transient ischaemic attacks or non-disabling ischaemic strokes, who were treated with aspirin (30 or 283 mg). Patients were divided into groups with small vessel disease (SVD) (n = 1216) or large vessel disease (LVD) (n = 1221) on the grounds of their clinical features and CT at baseline. Patients with evidence of both SVD and LVD (n = 180) were excluded from further analyses. During foll...

  11. The application of heterogeneous cluster grouping to reflective writing for medical humanities literature study to enhance students' empathy, critical thinking, and reflective writing.

    Science.gov (United States)

    Liao, Hung-Chang; Wang, Ya-Huei

    2016-09-02

    To facilitate interdisciplinary collaboration and to make connections between patients' diseases and their social/cultural contexts, the study examined whether the use of heterogeneous cluster grouping in reflective writing for medical humanities literature acquisition could have positive effects on medical university students in terms of empathy, critical thinking, and reflective writing. A 15-week quasi-experimental design was conducted to investigate the learning outcomes. After conducting cluster algorithms, heterogeneous learning clusters (experimental group; n = 43) and non-heterogeneous learning clusters (control group; n = 43) were derived for a medical humanities literature study. Before and after the intervention, an Empathy Scale in Patient Care (ES-PC), a critical thinking disposition assessment (CTDA-R), and a reflective writing test were administered to both groups. The findings showed that on the empathy scale, significant differences in the "behavioral empathy," "affective empathy," and overall sections existed between the post-test mean scores of the experimental group and those of the control group, but such differences did not exist in "intelligent empathy." Regarding critical thinking, there were significant differences in "systematicity and analyticity," "skepticism and well-informed," "maturity and skepticism," and overall sections. As for reflective writing, significant differences existed in "ideas," "voice and point of view," "critical thinking and representation," "depth of reflection on personal growth," and overall sections, but not in "focus and context structure" and "language and conventions." This study outlined an alternative for using heterogeneous cluster grouping in reflective writing about medical humanities literature to facilitate interdisciplinary cooperation to provide more humanizing medical care.

  12. 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

  13. Transition to farming more likely for small, conservative groups with property rights, but increased productivity is not essential.

    Science.gov (United States)

    Gallagher, Elizabeth M; Shennan, Stephen J; Thomas, Mark G

    2015-11-17

    Theories for the origins of agriculture are still debated, with a range of different explanations offered. Computational models can be used to test these theories and explore new hypotheses; Bowles and Choi [Bowles S, Choi J-K (2013) Proc Natl Acad Sci USA 110(22):8830-8835] have developed one such model. Their model shows the coevolution of farming and farming-friendly property rights, and by including climate variability, replicates the timings for the emergence of these events seen in the archaeological record. Because the processes modeled occurred a long time ago, it can be difficult to justify exact parameter values; hence, we propose a fitting to idealized outcomes (FIO) method to explore the model's parameter space in more detail. We have replicated the model of Bowles and Choi, and used the FIO method to identify complexities and interactions of the model previously unidentified. Our results indicate that the key parameters for the emergence of farming are group structuring, group size, conservatism, and farming-friendly property rights (lending further support to Bowles and Choi's original proposal). We also find that although advantageous, it is not essential that farming productivity be greater than foraging productivity for farming to emerge. In addition, we highlight how model behaviors can be missed when gauging parameter sensitivity via a fix-all-but-one variation approach.

  14. Lifting the mask: identification of new small molecule inhibitors of uropathogenic Escherichia coli group 2 capsule biogenesis.

    Science.gov (United States)

    Goller, Carlos C; Arshad, Mehreen; Noah, James W; Ananthan, Subramaniam; Evans, Carrie W; Nebane, N Miranda; Rasmussen, Lynn; Sosa, Melinda; Tower, Nichole A; White, E Lucile; Neuenswander, Benjamin; Porubsky, Patrick; Maki, Brooks E; Rogers, Steven A; Schoenen, Frank; Seed, Patrick C

    2014-01-01

    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.

  15. 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

    service member been on the same medication and dosage regimen with good control. • Presence of end organ disease (i.e. Heart. Kidney, Retina ...glucose as measured by hemoglobin A1c. • Presence of end organ disease (i.e. heart. kidney, retina , vascular). • History of diabetes mellitus...Conspicuous emotional detachment , numbing of feeling, and avoidance of stimuli that might arouse recollection of the trauma are often present but are not

  16. Guidelines for education and training of medical physicists in radiotherapy. Recommendations from an ESTRO/EFOMP working group.

    NARCIS (Netherlands)

    Eudaldo, T.; Huizenga, H.; Lamm, I.L.; McKenzie, A.; Milano, F.; Schlegel, W.; Thwaites, D.; Heeren, G.

    2004-01-01

    PURPOSE: To provide a guideline curriculum covering theoretical and practical aspects of education and training for medical physicists in radiotherapy within Europe. MATERIAL AND METHODS: Guidelines have been developed for the specialist theoretical knowledge and practical experience required to

  17. Use of Alternative Medications for Menopause-Related Symptoms in Three Major Ethnic Groups of Ipoh, Perak, Malaysia.

    Science.gov (United States)

    Ohn Mar, Saw; Malhi, Fatehpal; Syed Rahim, Syed Hamid; Chua, Chin Tong; Sidhu, Sarjeet Singh; Sandheep, Sugathan

    2015-11-01

    This cross-sectional study investigated the use of alternative medications to alleviate menopause-related symptoms among Malay, Chinese, and Indian women of Ipoh city. The prevalence, types, effectiveness, and associated factors were determined. The prevalence of alternative medication use was 41.4%. Evening primrose oil (EPO) was the most popular medication used (18.1%), followed by soy-based products (12.3%), green tea (6.8%), and gingko (5.8%). The medication was reported to be highly effective by 58.3% of soya bean diet users and 41.1% of EPO users. Significant variables associated with the use were Chinese or Indian ethnicity (P Chinese and Indians had significantly higher odds for the use than Malays (Chinese: odds ratio [OR] = 4.33, 95% confidence interval [CI] = 2.392-7.837; Indians: OR = 3.248, 95% CI = 1.586-6.654). © 2015 APJPH.

  18. 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.

  19. 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.

  20. 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