Science.gov

Sample records for including individual residences

  1. General design, construction, and operation guidelines: Constructed wetlands wastewater treatment systems for small users including individual residences

    SciTech Connect

    Steiner, G.R.; Watson, J.T.; Choate, K.D.

    1991-03-01

    A constructed wetlands system (CW) treats wastewater through natural water quality improvement processes (physical, chemical and biological) that occur in natural wetlands. Proper design, construction and operation of a CW optimize the processes. Treatment by CW can be effective, reliable, simple and relatively inexpensive as compared to conventional systems. CW systems can be built for wide flow ranges, including sources having relatively small flows (e.g., individual homes, small businesses and schools). A CW is an alternative for a small system where conventional on-site methods are ineffective due to poor site conditions (e.g., low soil percolation, shallow soils, high groundwater table, Karst topography). 4 figs.

  2. General design, construction, and operation guidelines: Constructed wetlands wastewater treatment systems for small users including individual residences. Second edition

    SciTech Connect

    Steiner, G.R.; Watson, J.T.

    1993-05-01

    One of the Tennessee Valley Authority`s (TVA`s) major goals is cleanup and protection of the waters of the Tennessee River system. Although great strides have been made, point source and nonpoint source pollution still affect the surface water and groundwater quality in the Tennessee Valley and nationally. Causes of this pollution are poorly operating wastewater treatment systems or the lack of them. Practical solutions are needed, and there is great interest and desire to abate water pollution with effective, simple, reliable and affordable wastewater treatment processes. In recognition of this need, TVA began demonstration of the constructed wetlands technology in 1986 as an alternative to conventional, mechanical processes, especially for small communities. Constructed wetlands can be downsized from municipal systems to small systems, such as for schools, camps and even individual homes.

  3. Short residence time coal liquefaction process including catalytic hydrogenation

    DOEpatents

    Anderson, Raymond P.; Schmalzer, David K.; Wright, Charles H.

    1982-05-18

    Normally solid dissolved coal product and a distillate liquid product are produced by continuously passing a feed slurry comprising raw feed coal and a recycle solvent oil and/or slurry together with hydrogen to a preheating-reaction zone (26, alone, or 26 together with 42), the hydrogen pressure in the preheating-reaction zone being at least 1500 psig (105 kg/cm.sup.2), reacting the slurry in the preheating-reaction zone (26, or 26 with 42) at a temperature in the range of between about 455.degree. and about 500.degree. C. to dissolve the coal to form normally liquid coal and normally solid dissolved coal. A total slurry residence time is maintained in the reaction zone ranging from a finite value from about 0 to about 0.2 hour, and reaction effluent is continuously and directly contacted with a quenching fluid (40, 68) to substantially immediately reduce the temperature of the reaction effluent to below 425.degree. C. to substantially inhibit polymerization so that the yield of insoluble organic matter comprises less than 9 weight percent of said feed coal on a moisture-free basis. The reaction is performed under conditions of temperature, hydrogen pressure and residence time such that the quantity of distillate liquid boiling within the range C.sub.5 -454.degree. C. is an amount at least equal to that obtainable by performing the process under the same condition except for a longer total slurry residence time, e.g., 0.3 hour. Solvent boiling range liquid is separated from the reaction effluent (83) and recycled as process solvent (16). The amount of solvent boiling range liquid is sufficient to provide at least 80 weight percent of that required to maintain the process in overall solvent balance.

  4. Short residence time coal liquefaction process including catalytic hydrogenation

    DOEpatents

    Anderson, R.P.; Schmalzer, D.K.; Wright, C.H.

    1982-05-18

    Normally solid dissolved coal product and a distillate liquid product are produced by continuously passing a feed slurry comprising raw feed coal and a recycle solvent oil and/or slurry together with hydrogen to a preheating-reaction zone, the hydrogen pressure in the preheating-reaction zone being at least 1,500 psig (105 kg/cm[sup 2]), reacting the slurry in the preheating-reaction zone at a temperature in the range of between about 455 and about 500 C to dissolve the coal to form normally liquid coal and normally solid dissolved coal. A total slurry residence time is maintained in the reaction zone ranging from a finite value from about 0 to about 0.2 hour, and reaction effluent is continuously and directly contacted with a quenching fluid to substantially immediately reduce the temperature of the reaction effluent to below 425 C to substantially inhibit polymerization so that the yield of insoluble organic matter comprises less than 9 weight percent of said feed coal on a moisture-free basis. The reaction is performed under conditions of temperature, hydrogen pressure and residence time such that the quantity of distillate liquid boiling within the range C[sub 5]-454 C is an amount at least equal to that obtainable by performing the process under the same condition except for a longer total slurry residence time, e.g., 0.3 hour. Solvent boiling range liquid is separated from the reaction effluent and recycled as process solvent. The amount of solvent boiling range liquid is sufficient to provide at least 80 weight percent of that required to maintain the process in overall solvent balance. 6 figs.

  5. Improving Psychiatry Residents' Attitudes Toward Individuals Diagnosed with Substance Use Disorders.

    PubMed

    Avery, Jonathan; Zerbo, Erin

    2015-01-01

    Special attention needs to be paid to the attitudes of psychiatry residents toward individuals diagnosed with substance use disorders. The attitudes of trainees may be worse toward these individuals than toward individuals with other diagnoses, and these attitudes may worsen over time. While psychiatry residencies are increasingly teaching residents about how to diagnosis and treat individuals diagnosed with substance use disorders, more attention needs to be paid to educating residents about common attitudes toward these individuals. We recommend that psychiatry residency programs start with basic educational didactics and reflection exercises on attitudes toward individuals diagnosed with substance use disorders and that programs try to form a positive "hidden curriculum" in their institutions.

  6. A laboratory medicine residency training program that includes clinical consultation and research.

    PubMed

    Spitzer, E D; Pierce, G F; McDonald, J M

    1990-04-01

    We describe a laboratory medicine residency training program that includes ongoing interaction with both clinical laboratories and clinical services as well as significant research experience. Laboratory medicine residents serve as on-call consultants in the interpretation of test results, design of testing strategies, and assurance of test quality. The consultative on-call beeper system was evaluated and is presented as an effective method of clinical pathology training that is well accepted by the clinical staff. The research component of the residency program is also described. Together, these components provide training in real-time clinical problem solving and prepare residents for the changing technological environment of the clinical laboratory. At the completion of the residency, the majority of the residents are qualified laboratory subspecialists and are also capable of running an independent research program.

  7. 26 CFR 1.871-2 - Determining residence of alien individuals.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 26 Internal Revenue 9 2010-04-01 2010-04-01 false Determining residence of alien individuals. 1...) INCOME TAX (CONTINUED) INCOME TAXES Nonresident Aliens and Foreign Corporations § 1.871-2 Determining residence of alien individuals. (a) General. The term nonresident alien individual means an individual...

  8. 26 CFR 1.871-2 - Determining residence of alien individuals.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... 26 Internal Revenue 9 2014-04-01 2014-04-01 false Determining residence of alien individuals. 1...) INCOME TAX (CONTINUED) INCOME TAXES (CONTINUED) Nonresident Aliens and Foreign Corporations § 1.871-2 Determining residence of alien individuals. (a) General. The term nonresident alien individual means...

  9. 26 CFR 1.871-2 - Determining residence of alien individuals.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... 26 Internal Revenue 9 2012-04-01 2012-04-01 false Determining residence of alien individuals. 1...) INCOME TAX (CONTINUED) INCOME TAXES (CONTINUED) Nonresident Aliens and Foreign Corporations § 1.871-2 Determining residence of alien individuals. (a) General. The term nonresident alien individual means...

  10. 26 CFR 1.871-2 - Determining residence of alien individuals.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... 26 Internal Revenue 9 2013-04-01 2013-04-01 false Determining residence of alien individuals. 1...) INCOME TAX (CONTINUED) INCOME TAXES (CONTINUED) Nonresident Aliens and Foreign Corporations § 1.871-2 Determining residence of alien individuals. (a) General. The term nonresident alien individual means...

  11. 26 CFR 1.871-2 - Determining residence of alien individuals.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 26 Internal Revenue 9 2011-04-01 2011-04-01 false Determining residence of alien individuals. 1...) INCOME TAX (CONTINUED) INCOME TAXES (CONTINUED) Nonresident Aliens and Foreign Corporations § 1.871-2 Determining residence of alien individuals. (a) General. The term nonresident alien individual means...

  12. Improving Psychiatry Residents' Attitudes Toward Individuals Diagnosed with Substance Use Disorders.

    PubMed

    Avery, Jonathan; Zerbo, Erin

    2015-01-01

    Special attention needs to be paid to the attitudes of psychiatry residents toward individuals diagnosed with substance use disorders. The attitudes of trainees may be worse toward these individuals than toward individuals with other diagnoses, and these attitudes may worsen over time. While psychiatry residencies are increasingly teaching residents about how to diagnosis and treat individuals diagnosed with substance use disorders, more attention needs to be paid to educating residents about common attitudes toward these individuals. We recommend that psychiatry residency programs start with basic educational didactics and reflection exercises on attitudes toward individuals diagnosed with substance use disorders and that programs try to form a positive "hidden curriculum" in their institutions. PMID:26146757

  13. Out of sight, out of mind: including group quarters residents with household residents can change what we know about working-age people with disabilities.

    PubMed

    Stapleton, David; Honeycutt, Todd; Schechter, Bruce

    2012-02-01

    Information about residents of institutional and noninstitutional group quarters (GQ), particularly those with disabilities, has been limited by gaps in survey data, and statistics based on data that exclude some or all GQ residents are biased as estimates of total population statistics. We used the 2006 and 2007 American Community Survey (ACS) to identify the distribution of working-age populations with and without disabilities by major residence type and to assess the sensitivity of disability statistics to GQ residence. Our findings show that (1) of those with disabilities, about 1 in 13 males and 1 in 33 females live in GQ; (2) GQ rates are higher for individuals reporting mental, self-care, or go-outside-the-home disabilities than for those reporting sensory, physical, or employment disabilities; (3) younger males with disabilities are more likely to reside there, particularly at institutional GQ, reflecting their relatively high incarceration rate; (4) individuals with and without disabilities who are black, American Indian, were never married, or have less than a high school education have higher GQ residence rates; (5) 40% of male and 62% of female GQ residents have a disability; (6) adding GQ residents to household residents increases estimated disability prevalence for males by 6%, and the estimated difference between disability prevalence rates by gender nearly disappears; and (7) inclusion of the GQ population substantially lowers employment rate estimates for young males, blacks, and American Indians. PMID:22109082

  14. The Quantitative Analysis on the Individual Characteristics of Urban Residents and Their Sport Consumption Motivation

    NASA Astrophysics Data System (ADS)

    Xianliang, Lei; Hongying, Yu

    Using the questionnaire, mathematical statistics and entropy measurement methods, the quantitative relationship between the individual characteristics urban residents and their sports consumption motivation are studied. The results show that the most main sports consumption motivation of urban residents is fitness motivation and social motivation. Urban residents of different gender, age, education and income levels are different in regulating psychological motivation, rational consumption motivation and seeking common motivation.

  15. 42 CFR 435.201 - Individuals included in optional groups.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ...) Aged individuals (65 years of age of older); (2) Blind individuals (as defined in § 435.530); (3) Disabled individuals (as defined in § 435.541); (4) Individuals under age 21 (or, at State option, under age 20, 19, or 18) or reasonable classifications of these individuals; (5) Specified relatives...

  16. 42 CFR 436.201 - Individuals included in optional groups.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... specified in the separate sections of this subpart: (1) Aged individuals (65 years of age or older); (2...) Individuals under age 21 (or, at State option), under age 20, 19, or 18) or reasonable classifications of these individuals; (5) Specified relatives under section 406(b)(1) of the Act who have in their care...

  17. IGSA: Individual Gene Sets Analysis, including Enrichment and Clustering

    PubMed Central

    Liu, Lei; Ma, Hongzhe; Yang, Jingbo; Xie, Hongbo; Liu, Bo; Jin, Qing

    2016-01-01

    Analysis of gene sets has been widely applied in various high-throughput biological studies. One weakness in the traditional methods is that they neglect the heterogeneity of genes expressions in samples which may lead to the omission of some specific and important gene sets. It is also difficult for them to reflect the severities of disease and provide expression profiles of gene sets for individuals. We developed an application software called IGSA that leverages a powerful analytical capacity in gene sets enrichment and samples clustering. IGSA calculates gene sets expression scores for each sample and takes an accumulating clustering strategy to let the samples gather into the set according to the progress of disease from mild to severe. We focus on gastric, pancreatic and ovarian cancer data sets for the performance of IGSA. We also compared the results of IGSA in KEGG pathways enrichment with David, GSEA, SPIA, ssGSEA and analyzed the results of IGSA clustering and different similarity measurement methods. Notably, IGSA is proved to be more sensitive and specific in finding significant pathways, and can indicate related changes in pathways with the severity of disease. In addition, IGSA provides with significant gene sets profile for each sample. PMID:27764138

  18. Measurements of individual radiation doses in residents living around the Fukushima Nuclear Power Plant.

    PubMed

    Nagataki, Shigenobu; Takamura, Noboru; Kamiya, Kenji; Akashi, Makoto

    2013-11-01

    At the outset of the accident at Fukushima Daiichi Nuclear Power Plant in March 2011, the radiation doses experienced by residents were calculated from the readings at monitoring posts, with several assumptions being made from the point of view of protection and safety. However, health effects should also be estimated by obtaining measurements of the individual radiation doses. The individual external radiation doses, determined by a behavior survey in the "evacuation and deliberate evacuation area" in the first 4 months, were <5 mSv in 97.4% of residents (maximum: 15 mSv). Doses in Fukushima Prefecture were <3 mSv in 99.3% of 386,572 residents analyzed. External doses in Fukushima City determined by personal dosimeters were <1 mSv/3 months (September-November, 2011) in 99.7% of residents (maximum: 2.7 mSv). Thyroid radiation doses, determined in March using a NaI (TI) scintillation survey meter in children in the evacuation and deliberate evacuation area, were <10 mSv in 95.7% of children (maximum: 35 mSv). Therefore, all doses were less than the intervention level of 50 mSv proposed by international organizations. Internal radiation doses determined by cesium-134 ((134)C) and cesium-137 ((137)C) whole-body counters (WBCs) were <1 mSv in 99% of the residents, and the maximum thyroid equivalent dose by iodine-131 WBCs was 20 mSv. The exploratory committee of the Fukushima Health Management Survey mentions on its website that radiation from the accident is unlikely to be a cause of adverse health effects in the future. In any event, sincere scientific efforts must continue to obtain individual radiation doses that are as accurate as possible. However, observation of the health effects of the radiation doses described above will require reevaluation of the protocol used for determining adverse health effects. The dose-response relationship is crucial, and the aim of the survey should be to collect sufficient data to confirm the presence or absence of radiation health

  19. Measurements of individual radiation doses in residents living around the Fukushima Nuclear Power Plant.

    PubMed

    Nagataki, Shigenobu; Takamura, Noboru; Kamiya, Kenji; Akashi, Makoto

    2013-11-01

    At the outset of the accident at Fukushima Daiichi Nuclear Power Plant in March 2011, the radiation doses experienced by residents were calculated from the readings at monitoring posts, with several assumptions being made from the point of view of protection and safety. However, health effects should also be estimated by obtaining measurements of the individual radiation doses. The individual external radiation doses, determined by a behavior survey in the "evacuation and deliberate evacuation area" in the first 4 months, were <5 mSv in 97.4% of residents (maximum: 15 mSv). Doses in Fukushima Prefecture were <3 mSv in 99.3% of 386,572 residents analyzed. External doses in Fukushima City determined by personal dosimeters were <1 mSv/3 months (September-November, 2011) in 99.7% of residents (maximum: 2.7 mSv). Thyroid radiation doses, determined in March using a NaI (TI) scintillation survey meter in children in the evacuation and deliberate evacuation area, were <10 mSv in 95.7% of children (maximum: 35 mSv). Therefore, all doses were less than the intervention level of 50 mSv proposed by international organizations. Internal radiation doses determined by cesium-134 ((134)C) and cesium-137 ((137)C) whole-body counters (WBCs) were <1 mSv in 99% of the residents, and the maximum thyroid equivalent dose by iodine-131 WBCs was 20 mSv. The exploratory committee of the Fukushima Health Management Survey mentions on its website that radiation from the accident is unlikely to be a cause of adverse health effects in the future. In any event, sincere scientific efforts must continue to obtain individual radiation doses that are as accurate as possible. However, observation of the health effects of the radiation doses described above will require reevaluation of the protocol used for determining adverse health effects. The dose-response relationship is crucial, and the aim of the survey should be to collect sufficient data to confirm the presence or absence of radiation health

  20. Age and individual sleep characteristics affect cognitive performance in anesthesiology residents after a 24-hour shift.

    PubMed

    Tadinac, Meri; Sekulić, Ante; Hromatko, Ivana; Mazul-Sunko, Branka; Ivancić, Romina

    2014-03-01

    Previous research has shown that both shift work and sleep deprivation have an adverse influence on various aspects of human cognitive performance. The aim of this study was to explore changes in cognitive functioning and subjective sleepiness of anesthesiology residents after a 24-hour shift. Twenty-six anesthesiology residents completed a set of psychological instruments at the beginning and at the end of the shift, as well as a questionnaire regarding information about the shift, Stanford Sleepiness Scale, and Circadian Type Questionnaire. There was a significant decline in cognitive performance measured by the Auditory Verbal Learning Test after the shift. The effect was stronger in older participants and in those with high scores on rigidity of sleep scale and low scores on the ability to overcome sleepiness scale. There were no differences in the digits forward test (a measure of concentration), while digits backward test (a measure of working memory) even showed an improved performance after the shift. Although participants reported being significantly sleepier after the shift, the subjective sleepiness did not correlate with any of the objective measures of cognitive performance. In conclusion, the performance in short tasks involving concentration and working memory was not impaired, while performance in long-term and monotone tasks declined after sleep deprivation, and the magnitude of this decline depended on the specific individual characteristics of sleep and on age Surprisingly, age seemed to have an important impact on cognitive functions after shift work even in the relatively age-homogeneous population of young anesthesiology residents.

  1. Homing behaviour and individual identification of the pipefish Nerophis lumbriciformis (Pisces; Syngnathidae): a true intertidal resident?

    NASA Astrophysics Data System (ADS)

    Monteiro, Nuno Miguel; Vieira, Maria da Natividade; Almada, Vitor

    2005-04-01

    Syngnathids have been the focus of growing interest due to their peculiar reproductive biology and vulnerability to environmental degradation and overcollecting. In this study, near the south limit of the species' geographic distribution, a description of the homing behaviour of the worm pipefish, Nerophis lumbriciformis, based on the unique facial pigmentation patterns, is presented. Even though the amount of facial pigmentation was substantially higher in larger adult females, suggesting that it can be part of the secondary sexual repertoire of this sex role reversed species, this technique allowed for the positive identification of adult individuals (males and females) during at least 19 months. Recaptures showed that this pipefish shows a strong homing behaviour, with individuals being regularly captured within less than 2 m of the original identification event. The absence of horizontal migrations to adjacent areas and the observation of adults in the subtidal, together with the overall low number of recaptures (even though some individuals were cyclically resighted) highlighted the fact that the intertidal is not N. lumbriciformis' permanent residence. This observation also demonstrates that the estimation of the population size, important for conservation purposes, based solely on intertidal data can be misleading because captured individuals are only a fraction of a larger, mainly subtidal, population.

  2. 26 CFR 1.6013-6 - Election to treat nonresident alien individual as resident of the United States.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... reason of the individual's domicile, residence, or citizenship. Under article 4 (1) of the treaty, W is a... both the United States and country X by reason of article 4 (1), the individual shall be deemed to be a... spouses legally separate under a degree of divorce or of separate maintenance. An election that...

  3. 26 CFR 1.6013-6 - Election to treat nonresident alien individual as resident of the United States.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... 26 Internal Revenue 13 2013-04-01 2013-04-01 false Election to treat nonresident alien individual... Statements § 1.6013-6 Election to treat nonresident alien individual as resident of the United States. (a... the other spouse is a nonresident alien. The effect of the election is that each spouse is treated...

  4. 26 CFR 1.6013-6 - Election to treat nonresident alien individual as resident of the United States.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... 26 Internal Revenue 13 2012-04-01 2012-04-01 false Election to treat nonresident alien individual... Statements § 1.6013-6 Election to treat nonresident alien individual as resident of the United States. (a... the other spouse is a nonresident alien. The effect of the election is that each spouse is treated...

  5. 26 CFR 1.6013-6 - Election to treat nonresident alien individual as resident of the United States.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 26 Internal Revenue 13 2011-04-01 2011-04-01 false Election to treat nonresident alien individual... Statements § 1.6013-6 Election to treat nonresident alien individual as resident of the United States. (a... the other spouse is a nonresident alien. The effect of the election is that each spouse is treated...

  6. 26 CFR 1.6013-6 - Election to treat nonresident alien individual as resident of the United States.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... 26 Internal Revenue 13 2014-04-01 2014-04-01 false Election to treat nonresident alien individual... Statements § 1.6013-6 Election to treat nonresident alien individual as resident of the United States. (a... the other spouse is a nonresident alien. The effect of the election is that each spouse is treated...

  7. 26 CFR 1.871-13 - Taxation of individuals for taxable year of change of U.S. citizenship or residence.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... change of U.S. citizenship or residence. 1.871-13 Section 1.871-13 Internal Revenue INTERNAL REVENUE....S. citizenship or residence. (a) In general. (1) An individual who is a citizen or resident of the... the period of U.S. citizenship or residence must be aggregated with the income for the period...

  8. 26 CFR 1.871-13 - Taxation of individuals for taxable year of change of U.S. citizenship or residence.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... change of U.S. citizenship or residence. 1.871-13 Section 1.871-13 Internal Revenue INTERNAL REVENUE....S. citizenship or residence. (a) In general. (1) An individual who is a citizen or resident of the... the period of U.S. citizenship or residence must be aggregated with the income for the period...

  9. 26 CFR 1.871-13 - Taxation of individuals for taxable year of change of U.S. citizenship or residence.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... change of U.S. citizenship or residence. 1.871-13 Section 1.871-13 Internal Revenue INTERNAL REVENUE....S. citizenship or residence. (a) In general. (1) An individual who is a citizen or resident of the... the period of U.S. citizenship or residence must be aggregated with the income for the period...

  10. 26 CFR 1.871-13 - Taxation of individuals for taxable year of change of U.S. citizenship or residence.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... change of U.S. citizenship or residence. 1.871-13 Section 1.871-13 Internal Revenue INTERNAL REVENUE....S. citizenship or residence. (a) In general. (1) An individual who is a citizen or resident of the... the period of U.S. citizenship or residence must be aggregated with the income for the period...

  11. Interannual variation and long-term trends in proportions of resident individuals in partially migratory birds.

    PubMed

    Meller, Kalle; Vähätalo, Anssi V; Hokkanen, Tatu; Rintala, Jukka; Piha, Markus; Lehikoinen, Aleksi

    2016-03-01

    Partial migration - a part of a population migrates and another part stays resident year-round on the breeding site - is probably the most common type of migration in the animal kingdom, yet it has only lately garnered more attention. Theoretical studies indicate that in partially migratory populations, the proportion of resident individuals (PoR) should increase in high latitudes in response to the warming climate, but empirical evidence exists for few species. We provide the first comprehensive overview of the environmental factors affecting PoR and the long-term trends in PoR by studying 27 common partially migratory bird species in Finland. The annual PoR values were calculated by dividing the winter bird abundance by the preceding breeding abundance. First, we analysed whether early-winter temperature, winter temperature year before or the abundance of tree seeds just before overwintering explains the interannual variation in PoR. Secondly, we analysed the trends in PoR between 1987 and 2011. Early-winter temperature explained the interannual variation in PoR in the waterbirds (waterfowl and gulls), most likely because the temperature affects the ice conditions and thereby the feeding opportunities for the waterbirds. In terrestrial species, the abundance of seeds was the best explanatory variable. Previous winter's temperature did not explain PoR in any species, and thus, we conclude that the variation in food availability caused the interannual variation in PoR. During the study period, PoR increased in waterbirds, but did not change in terrestrial birds. Partially migratory species living in physically contrasting habitats can differ in their annual and long-term population-level behavioural responses to warming climate, possibly because warm winter temperatures reduce ice cover and improve the feeding possibilities of waterbirds but do not directly regulate the food availability for terrestrial birds.

  12. Interannual variation and long-term trends in proportions of resident individuals in partially migratory birds.

    PubMed

    Meller, Kalle; Vähätalo, Anssi V; Hokkanen, Tatu; Rintala, Jukka; Piha, Markus; Lehikoinen, Aleksi

    2016-03-01

    Partial migration - a part of a population migrates and another part stays resident year-round on the breeding site - is probably the most common type of migration in the animal kingdom, yet it has only lately garnered more attention. Theoretical studies indicate that in partially migratory populations, the proportion of resident individuals (PoR) should increase in high latitudes in response to the warming climate, but empirical evidence exists for few species. We provide the first comprehensive overview of the environmental factors affecting PoR and the long-term trends in PoR by studying 27 common partially migratory bird species in Finland. The annual PoR values were calculated by dividing the winter bird abundance by the preceding breeding abundance. First, we analysed whether early-winter temperature, winter temperature year before or the abundance of tree seeds just before overwintering explains the interannual variation in PoR. Secondly, we analysed the trends in PoR between 1987 and 2011. Early-winter temperature explained the interannual variation in PoR in the waterbirds (waterfowl and gulls), most likely because the temperature affects the ice conditions and thereby the feeding opportunities for the waterbirds. In terrestrial species, the abundance of seeds was the best explanatory variable. Previous winter's temperature did not explain PoR in any species, and thus, we conclude that the variation in food availability caused the interannual variation in PoR. During the study period, PoR increased in waterbirds, but did not change in terrestrial birds. Partially migratory species living in physically contrasting habitats can differ in their annual and long-term population-level behavioural responses to warming climate, possibly because warm winter temperatures reduce ice cover and improve the feeding possibilities of waterbirds but do not directly regulate the food availability for terrestrial birds. PMID:26718017

  13. 21 CFR 312.310 - Individual patients, including for emergency use.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 21 Food and Drugs 5 2010-04-01 2010-04-01 false Individual patients, including for emergency use... Investigational Drugs for Treatment Use § 312.310 Individual patients, including for emergency use. Under this... determine that the patient cannot obtain the drug under another IND or protocol. (b) Submission....

  14. 34 CFR 607.11 - What must be included in individual development grant applications?

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... Does an Institution Apply for a Grant? § 607.11 What must be included in individual development grant... development grant must include— (a) The institution's comprehensive development plan; (b) A description of the... 34 Education 3 2010-07-01 2010-07-01 false What must be included in individual development...

  15. Organizational and Individual Conditions Associated with Depressive Symptoms among Nursing Home Residents over Time

    ERIC Educational Resources Information Center

    Cassie, Kimberly M.; Cassie, William E.

    2012-01-01

    Purpose: To examine the effect of organizational culture and climate on depressive symptoms among nursing home residents. Design and Methods: Using a pooled cross-sectional design, this study examines a sample of 23 nursing homes, 1,114 employees, and 5,497 residents. Depressive symptoms were measured using the Minimum Data Set, Depression Rating…

  16. 20 CFR 408.212 - What happens if you are a qualified individual already residing outside the United States?

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 20 Employees' Benefits 2 2010-04-01 2010-04-01 false What happens if you are a qualified individual already residing outside the United States? 408.212 Section 408.212 Employees' Benefits SOCIAL SECURITY ADMINISTRATION SPECIAL BENEFITS FOR CERTAIN WORLD WAR II VETERANS SVB Qualification...

  17. 20 CFR 408.212 - What happens if you are a qualified individual already residing outside the United States?

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... 20 Employees' Benefits 2 2012-04-01 2012-04-01 false What happens if you are a qualified individual already residing outside the United States? 408.212 Section 408.212 Employees' Benefits SOCIAL SECURITY ADMINISTRATION SPECIAL BENEFITS FOR CERTAIN WORLD WAR II VETERANS SVB Qualification...

  18. 20 CFR 408.212 - What happens if you are a qualified individual already residing outside the United States?

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... 20 Employees' Benefits 2 2013-04-01 2013-04-01 false What happens if you are a qualified individual already residing outside the United States? 408.212 Section 408.212 Employees' Benefits SOCIAL SECURITY ADMINISTRATION SPECIAL BENEFITS FOR CERTAIN WORLD WAR II VETERANS SVB Qualification...

  19. 20 CFR 408.212 - What happens if you are a qualified individual already residing outside the United States?

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... 20 Employees' Benefits 2 2014-04-01 2014-04-01 false What happens if you are a qualified individual already residing outside the United States? 408.212 Section 408.212 Employees' Benefits SOCIAL SECURITY ADMINISTRATION SPECIAL BENEFITS FOR CERTAIN WORLD WAR II VETERANS SVB Qualification...

  20. 20 CFR 408.212 - What happens if you are a qualified individual already residing outside the United States?

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 20 Employees' Benefits 2 2011-04-01 2011-04-01 false What happens if you are a qualified individual already residing outside the United States? 408.212 Section 408.212 Employees' Benefits SOCIAL SECURITY ADMINISTRATION SPECIAL BENEFITS FOR CERTAIN WORLD WAR II VETERANS SVB Qualification...

  1. Size of spawning population, residence time, and territory shifts of individuals in the spawning aggregation of a riverine catostomid

    USGS Publications Warehouse

    Grabowski, T.B.; Isely, J.J.

    2008-01-01

    Little is known about the behavior of individual fish in a spawning aggregation, specifically how long an individual remains in an aggregation. We monitored Moxostoma robustum (Cope) (Robust Redhorse) in a Savannah River spawning aggregation during spring 2004 and 2005 to provide an estimate of the total number of adults and the number of males comprising the aggregation and to determine male residence time and movements within a spawning aggregation. Robust Redhorse were captured using prepostioned grid electrofishers, identified to sex, weighed, measured, and implanted with a passive integrated transponder. Spawning aggregation size was estimated using a multiple census mark-and-recapture procedure. The spawning aggregation seemed to consist of approximately the same number of individuals (82-85) and males (50-56) during both years of this study. Individual males were present for a mean of 3.6 ?? 0.24 days (?? SE) during the 12-day spawning period. The mean distance between successive recaptures of individual males was 15.9 ?? 1.29 m (?? SE). We conclude that males establish spawning territories on a daily basis and are present within the spawning aggregation for at least 3-4 days. The relatively short duration of the aggregation may be the result of an extremely small population of adults. However, the behavior of individuals has the potential to influence population estimates made while fish are aggregated for spawning.

  2. NORs inheritance analysis in crossings including individuals from two stocks of rainbow trout (Oncorhynchus mykiss).

    PubMed

    Porto-Foresti, Fábio; Oliveira, Claudio; Tabata, Yara Aiko; Rigolino, Marcos Guilherme; Foresti, Fausto

    2002-01-01

    Silver nitrate staining of rainbow trouts (Oncorhynchus mykiss) chromosomes, for the identification of the nucleolar organizing regions (NORs), revealed that in individuals from Núcleo Experimental de Salmonicultura de Campos do Jordão (Brazil) NORs were located in the long arms of submetacentric pair while in specimens from Mount Shasta (USA) NORs were located in the short arms of a submetacentric pair. Cytogenetic analysis of the offspring, obtained through artificial crosses including individuals from both stocks, allowed the identification of NORs in two submetacentric chromosomes, one in the short arms and the other in the long arms, confirming the effectiveness of the hybridization process. Complementary results obtained using the FISH technique with 18S and 5S rDNA probes showed that NOR-bearing chromosomes exhibited a cluster of 5S genes located in tandem with the 18S gene cluster in both stocks. The results allow us to suggest that the difference in NOR-bearing chromosomes found between the two stocks is likely to be due to pericentric inversion involving the chromosome segment where 18S and 5S rDNA genes are located. The presence of ribosomal genes in the long arms of a submetacentric chromosome is apparently a particular characteristic of the rainbow trout stock of Campos do Jordão and might be used as a chromosome marker in studies of controlled crosses in this species.

  3. Overweight in men and women among urban area residents: individual factors and socioeconomic context.

    PubMed

    Andrade, Roseli Gomes de; Chaves, Otaviana Cardoso; Costa, Dário Alves da Silva; Andrade, Amanda Cristina de Souza; Bispo, Stephanie; Felicissimo, Monica Faria; Friche, Amélia Augusta de Lima; Proietti, Fernando Augusto; Xavier, César Coelho; Caiaffa, Waleska Teixeira

    2015-11-01

    The present study aimed to evaluate factors associated with overweight among adults living in urban areas, with the income of the census tract as a context variable. The survey assessed individuals from two health districts of Belo Horizonte, Minas Gerais State, Brazil. Excess weight was determined by body mass index > 25kg/m2. Multilevel logistic regression was used. The sample comprised 2,935 individuals aged 20 to 60 years. The prevalence of overweight was 52.3% (95%CI: 49.9-54.8), similar between men and women. Higher schooling proved to be protective against overweight in women and a risk for men. Living in census tracts with higher income was associated with excess weight only in males. Report of the consumption of diet soft drinks was positively associated with overweight in both sexes. The occurrence of this event seems to be influenced by different factors or to interrelate differently in men and women. PMID:26648370

  4. A Factual Look at Higher Education in Nebraska, Including Fall Headcount Enrollment, Freshman Residence, Degrees Awarded, Institutional Finance, Faculty Salaries. Fall 1996 IPEDS Surveys.

    ERIC Educational Resources Information Center

    Nebraska Coordinating Commission for Postsecondary Education, Lincoln.

    This report presents comparative data on postsecondary education in Nebraska in 1996. Data tables, analyses, and charts are grouped as follows: fall headcount enrollment, including freshmen residence; degrees awarded; institutional finance; faculty salaries; and private career schools. Headcount data cover full- and part-time students, race and…

  5. SEVESO WOMEN'S HEALTH STUDY: DOES ZONE OF RESIDENCE PREDICT INDIVIDUAL TCDD EXPOSURE? (R824761)

    EPA Science Inventory

    The compound, 2,3,7,8-tetrachlorodibenzo-p-dioxin (TCDD), is produced as an unwanted by-product of various chemical reactions and combustion processes, including the manufacture of chlorinated phenols and derivatives. In animals, TCDD exposure is associated with toxic, car...

  6. Individual welfare maximization in electricity markets including consumer and full transmission system modeling

    NASA Astrophysics Data System (ADS)

    Weber, James Daniel

    1999-11-01

    This dissertation presents a new algorithm that allows a market participant to maximize its individual welfare in the electricity spot market. The use of such an algorithm in determining market equilibrium points, called Nash equilibria, is also demonstrated. The start of the algorithm is a spot market model that uses the optimal power flow (OPF), with a full representation of the transmission system. The OPF is also extended to model consumer behavior, and a thorough mathematical justification for the inclusion of the consumer model in the OPF is presented. The algorithm utilizes price and dispatch sensitivities, available from the Hessian matrix of the OPF, to help determine an optimal change in an individual's bid. The algorithm is shown to be successful in determining local welfare maxima, and the prospects for scaling the algorithm up to realistically sized systems are very good. Assuming a market in which all participants maximize their individual welfare, economic equilibrium points, called Nash equilibria, are investigated. This is done by iteratively solving the individual welfare maximization algorithm for each participant until a point is reached where all individuals stop modifying their bids. It is shown that these Nash equilibria can be located in this manner. However, it is also demonstrated that equilibria do not always exist, and are not always unique when they do exist. It is also shown that individual welfare is a highly nonconcave function resulting in many local maxima. As a result, a more global optimization technique, using a genetic algorithm (GA), is investigated. The genetic algorithm is successfully demonstrated on several systems. It is also shown that a GA can be developed using special niche methods, which allow a GA to converge to several local optima at once. Finally, the last chapter of this dissertation covers the development of a new computer visualization routine for power system analysis: contouring. The contouring algorithm is

  7. Cerebrospinal fluid markers including trefoil factor 3 are associated with neurodegeneration in amyloid-positive individuals.

    PubMed

    Paterson, R W; Bartlett, J W; Blennow, K; Fox, N C; Shaw, L M; Trojanowski, J Q; Zetterberg, H; Schott, J M

    2014-07-29

    We aimed to identify cerebrospinal fluid (CSF) biomarkers associated with neurodegeneration in individuals with and without CSF evidence of Alzheimer pathology. We investigated 287 Alzheimer's Disease Neuroimaging Initiative (ADNI) subjects (age=74.9±6.9; 22/48/30% with Alzheimer's disease/mild cognitive impairment/controls) with CSF multiplex analyte data and serial volumetric MRI. We calculated brain and hippocampal atrophy rates, ventricular expansion and Mini Mental State Examination decline. We used false discovery rate corrected regression analyses to assess associations between CSF variables and atrophy rates in individuals with and without amyloid pathology, adjusting in stages for tau, baseline volume, p-tau, age, sex, ApoE4 status and diagnosis. Analytes showing statistically significant independent relationships were entered into reverse stepwise analyses. Adjusting for tau, baseline volume, p-tau, age, sex and ApoE4, 4/83 analytes were significantly independently associated with brain atrophy rate, 1/83 with ventricular expansion and 2/83 with hippocampal atrophy. The strongest CSF predictor for the three atrophy measures was low trefoil factor 3 (TFF3). High cystatin C (CysC) was associated with higher whole brain atrophy and hippocampal atrophy rates. Lower levels of vascular endothelial growth factor and chromogranin A (CrA) were associated with higher whole brain atrophy. In exploratory reverse stepwise analyses, lower TFF3 was associated with higher rates of whole brain, hippocampal atrophy and ventricular expansion. Lower levels of CrA were associated with higher whole brain atrophy rate. The relationship between low TFF3 and increased hippocampal atrophy rate remained after adjustment for diagnosis. We identified a series of CSF markers that are independently associated with rate of neurodegeneration in amyloid-positive individuals. TFF3, a substrate for NOTCH processing may be an important biomarker of neurodegeneration across the Alzheimer

  8. An in situ, individual-based approach to quantify connectivity of marine fish: ontogenetic movements and residency of lingcod.

    PubMed

    Bishop, Mary Anne; Reynolds, Brad F; Powers, Sean P

    2010-01-01

    As modern fishery assessments change in an effort to be more accurate and encompass the range of potential ecosystem interactions, critical information on the ecology of species including life history, intra and inter-specific competitive interactions and habitat requirements must be added to the standard fishery-dependent and independent data sets. One species whose movements and habitat associations greatly affects exploitation patterns is lingcod, Ophiodon elongatus, which support an economically important fishery along the coastal waters of the Pacific Coast of North America. High site fidelity and limited movements within nearshore areas are hypothesized to have resulted in high catchability, a major factor that has contributed to overfished stocks. Thus, assessing the level of movement and connectivity among lingcod subpopulations inhabiting nearshore habitats is a prerequisite to determining the condition of lingcod stocks. We used the Pacific Ocean Shelf Tracking (POST) Project acoustic receiver array in Alaska's Prince William Sound to monitor movements and residency of 21 acoustic-tagged lingcod for up to 16 months. Eight of sixteen lingcod (50%) initially aged at 2.5- to 3.5- years-old dispersed from their tag site. Dispersal was highly seasonal, occurring in two, five-week periods from mid-December through January and from mid-April through May. Dispersal in winter may be related to sexually immature lingcod or newly-mature male lingcod being displaced by territorial males. Spring dispersal may be indicative of the onset of migratory behavior where lingcod move out into Prince William Sound and possibly the offshore waters of the Gulf of Alaska. Our results reveal a pattern of ontogenetic dispersal as lingcod approach 4-years-old and exceed 50 cm total length. The large proportion of tagged fish migrating out of Port Gravina, their tagging site, reflects a high level of connectivity among Prince William Sound subpopulations. Our results also support the

  9. Including Social Factors in the Analysis of Reminiscence in Elderly Individuals.

    ERIC Educational Resources Information Center

    Lamme, Simone; Baars, Jan

    1993-01-01

    Contends that developmental, determinist, and contextualist psychologists, although all studying reminiscence in older adults, have not fully acknowledged the role the environment plays in establishing reminiscent behavior in elderly people. Suggests including sociological life course theory in the analyses and interpretation of this behavior.…

  10. 26 CFR 1.871-13 - Taxation of individuals for taxable year of change of U.S. citizenship or residence.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... change of U.S. citizenship or residence. 1.871-13 Section 1.871-13 Internal Revenue INTERNAL REVENUE... Foreign Corporations § 1.871-13 Taxation of individuals for taxable year of change of U.S. citizenship or... of tax imposed by section 1 or 1201 of the Code, all income for the period of U.S. citizenship...

  11. Text messaging interventions for individuals with mental health disorders including substance use: A systematic review.

    PubMed

    Watson, Tyler; Simpson, Scot; Hughes, Christine

    2016-09-30

    We completed a systematic review of the literature to characterize the impact of text messaging interventions on medication adherence or mental health related outcomes in people with mental health disorders including substance use. Four electronic databases were searched from January 1999 to October 2015. Seven studies met our inclusion criteria: three studies evaluated text messaging in patients with schizophrenia or schizoaffective disorder diagnosis, two studies evaluated text messaging in patients with chronic alcohol dependence, and two studies reviewed text messaging in patients with mood disorders. Six studies were randomized controlled trials and one was a prospective pilot study with pre-post intervention design. Text messaging frequency ranged from once weekly to twelve per day. The effect of text messaging on medication adherence was measured in five studies; one study reporting significant improvements in the text messaging intervention group. The effect of text messaging on mental health related outcomes was measured in all seven studies, with five studies showing significant improvements in a variety of psychiatric and social functioning assessments. Collectively, these studies suggest text messaging is a promising tool to support management of patients with mental illness. Further research examining theory-based text messaging interventions in larger samples of patients is required.

  12. Text messaging interventions for individuals with mental health disorders including substance use: A systematic review.

    PubMed

    Watson, Tyler; Simpson, Scot; Hughes, Christine

    2016-09-30

    We completed a systematic review of the literature to characterize the impact of text messaging interventions on medication adherence or mental health related outcomes in people with mental health disorders including substance use. Four electronic databases were searched from January 1999 to October 2015. Seven studies met our inclusion criteria: three studies evaluated text messaging in patients with schizophrenia or schizoaffective disorder diagnosis, two studies evaluated text messaging in patients with chronic alcohol dependence, and two studies reviewed text messaging in patients with mood disorders. Six studies were randomized controlled trials and one was a prospective pilot study with pre-post intervention design. Text messaging frequency ranged from once weekly to twelve per day. The effect of text messaging on medication adherence was measured in five studies; one study reporting significant improvements in the text messaging intervention group. The effect of text messaging on mental health related outcomes was measured in all seven studies, with five studies showing significant improvements in a variety of psychiatric and social functioning assessments. Collectively, these studies suggest text messaging is a promising tool to support management of patients with mental illness. Further research examining theory-based text messaging interventions in larger samples of patients is required. PMID:27423123

  13. Educational Rights of Parents under Provisions of the Individuals with Disabilities Education Act Including the Amendments of 1997 (Special Education).

    ERIC Educational Resources Information Center

    Bureau of Indian Affairs (Dept. of Interior), Washington, DC. Office of Indian Education Programs.

    This pamphlet describes the educational rights of parents provided under provisions of the Individuals with Disabilities Education Act, including the amendments of 1997. It discusses rights in the following areas: (1) free appropriate public education; (2) prior notice to parents, including a list of the information required to be in a notice that…

  14. Education: Guide to European Organizations and Programmes. A Guide to European Organizations Involved in Education, including Individual Programmes and Projects.

    ERIC Educational Resources Information Center

    Hayes, Heledd

    This report presents a guide to European organizations involved in education, including individual programs and projects. Entries are brief as they are intended as simple outlines of the organizations or programs, but full addresses and telephone numbers are provided. Divided into four categories, the organizations listed are as follows: (1)…

  15. 20 CFR 666.140 - Which individuals receiving services are included in the core indicators of performance?

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... the core indicators of performance? (a)(1) The core indicators of performance apply to all individuals who are registered under 20 CFR 663.105 and 664.215 for the adult, dislocated worker and youth... included in the core indicators of performance? 666.140 Section 666.140 Employees' Benefits EMPLOYMENT...

  16. 45 CFR 286.135 - What information on penalties against individuals must be included in a Tribal Family Assistance...

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 45 Public Welfare 2 2012-10-01 2012-10-01 false What information on penalties against individuals must be included in a Tribal Family Assistance Plan? 286.135 Section 286.135 Public Welfare Regulations Relating to Public Welfare OFFICE OF FAMILY ASSISTANCE (ASSISTANCE PROGRAMS), ADMINISTRATION FOR CHILDREN AND FAMILIES, DEPARTMENT OF HEALTH...

  17. 20 CFR 666.140 - Which individuals receiving services are included in the core indicators of performance?

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... 20 Employees' Benefits 4 2012-04-01 2012-04-01 false Which individuals receiving services are included in the core indicators of performance? 666.140 Section 666.140 Employees' Benefits EMPLOYMENT AND TRAINING ADMINISTRATION, DEPARTMENT OF LABOR (CONTINUED) PERFORMANCE ACCOUNTABILITY UNDER TITLE I OF THE WORKFORCE INVESTMENT ACT State Measures...

  18. A cross-sectional case control study on genetic damage in individuals residing in the vicinity of a mobile phone base station.

    PubMed

    Gandhi, Gursatej; Kaur, Gurpreet; Nisar, Uzma

    2015-01-01

    Mobile phone base stations facilitate good communication, but the continuously emitting radiations from these stations have raised health concerns. Hence in this study, genetic damage using the single cell gel electrophoresis (comet) assay was assessed in peripheral blood leukocytes of individuals residing in the vicinity of a mobile phone base station and comparing it to that in healthy controls. The power density in the area within 300 m from the base station exceeded the permissive limits and was significantly (p = 0.000) higher compared to the area from where control samples were collected. The study participants comprised 63 persons with residences near a mobile phone tower, and 28 healthy controls matched for gender, age, alcohol drinking and occupational sub-groups. Genetic damage parameters of DNA migration length, damage frequency (DF) and damage index were significantly (p = 0.000) elevated in the sample group compared to respective values in healthy controls. The female residents (n = 25) of the sample group had significantly (p = 0.004) elevated DF than the male residents (n = 38). The linear regression analysis further revealed daily mobile phone usage, location of residence and power density as significant predictors of genetic damage. The genetic damage evident in the participants of this study needs to be addressed against future disease-risk, which in addition to neurodegenerative disorders, may lead to cancer. PMID:25006864

  19. A cross-sectional case control study on genetic damage in individuals residing in the vicinity of a mobile phone base station.

    PubMed

    Gandhi, Gursatej; Kaur, Gurpreet; Nisar, Uzma

    2015-01-01

    Mobile phone base stations facilitate good communication, but the continuously emitting radiations from these stations have raised health concerns. Hence in this study, genetic damage using the single cell gel electrophoresis (comet) assay was assessed in peripheral blood leukocytes of individuals residing in the vicinity of a mobile phone base station and comparing it to that in healthy controls. The power density in the area within 300 m from the base station exceeded the permissive limits and was significantly (p = 0.000) higher compared to the area from where control samples were collected. The study participants comprised 63 persons with residences near a mobile phone tower, and 28 healthy controls matched for gender, age, alcohol drinking and occupational sub-groups. Genetic damage parameters of DNA migration length, damage frequency (DF) and damage index were significantly (p = 0.000) elevated in the sample group compared to respective values in healthy controls. The female residents (n = 25) of the sample group had significantly (p = 0.004) elevated DF than the male residents (n = 38). The linear regression analysis further revealed daily mobile phone usage, location of residence and power density as significant predictors of genetic damage. The genetic damage evident in the participants of this study needs to be addressed against future disease-risk, which in addition to neurodegenerative disorders, may lead to cancer.

  20. Insomnia and urban neighbourhood contexts – are associations modified by individual social characteristics and change of residence? Results from a population-based study using residential histories

    PubMed Central

    2012-01-01

    Background Until now, insomnia has not been much of interest in epidemiological neighbourhood studies, although literature provides evidence enough for insomnia-related mechanisms being potentially dependent on neighbourhood contexts. Besides, studies have shown differences in sleep along individual social characteristics that might render residents more vulnerable to neighbourhood contextual exposures. Given the role of exposure duration and changes in the relationship between neighbourhoods and health, we studied associations of neighbourhood unemployment and months under residential turnover with insomnia by covering ten years of residential history of nearly 3,000 urban residents in the Ruhr Area, Germany. Methods Individual data were retrieved from the Heinz Nixdorf Recall Study, a population-based study of randomly chosen participants from adjacent cities, which contains self-rated insomnia symptoms and individual social characteristics. Participants’ residential addresses were retrospectively assessed using public registries. We built individually derived exposure measures informing about mean neighbourhood unemployment rates and months under high residential turnover. These measures were major predictors in multivariate logistic regressions modelling the association between social neighbourhood characteristics and insomnia in the whole sample and subgroups defined by low income, low education, social isolation, and change of residence. Traffic-related noise, age, gender, economic activity, and education were considered as covariates. Results Nearly 12 per cent of the participants complained about insomnia. Associations of neighbourhood unemployment with insomnia were more consistent than those of residential turnover in the whole sample (adjusted OR 1.42, 95% CI 1.00-2.03 for neighbourhood unemployment and OR 1.33, 95% CI 0.78-2.25 for residential turnover in the highest exposure categories). In low-income and socially isolated participants, neighbourhood

  1. The agreement between proxy and self-completed EQ-5D for care home residents was better for index scores than individual domains☆

    PubMed Central

    Devine, Angela; Taylor, Stephanie J.C.; Spencer, Anne; Diaz-Ordaz, Karla; Eldridge, Sandra; Underwood, Martin

    2014-01-01

    Objective Proxy measures are an alternative source of data for care home residents who are unable to complete the health utility measure, but the agreement levels between residents and care home staff for the EQ-5D have not been investigated previously. The objective of the present study was to examine the inter-rater agreement levels for the reporting of EQ-5D by care home residents and staff, adjusting for the impact of clustering. Study Design and Setting The data consist of EQ-5D scores for 565 pairs of care home residents and proxies and quality-adjusted life-years (QALYs) for 248 pairs. Cluster-adjusted agreement was compared for the domains, index scores, and QALYs from the EQ-5D. Factors influencing index score agreement are also described. Results The results show poor to fair agreement at the domain level (cluster-adjusted Kappa −0.03 to 0.26) and moderate agreement at the score level (cluster-adjusted intra-class correlation coefficient [ICC] 0.44–0.50) and for QALYs (cluster-adjusted ICC 0.59). A higher likelihood of depression and lower cognitive impairment were both associated with smaller discrepancy between proxy and self-completed scores. Conclusion Proxies appear to be an acceptable source of data for index scores and QALYs but may be less reliable if individual domains are considered. PMID:24837298

  2. Measurement of individual doses of radiation by personal dosimeter is important for the return of residents from evacuation order areas after nuclear disaster.

    PubMed

    Orita, Makiko; Hayashida, Naomi; Taira, Yasuyuki; Fukushima, Yoshiko; Ide, Juichi; Endo, Yuuko; Kudo, Takashi; Yamashita, Shunichi; Takamura, Noboru

    2015-01-01

    To confirm the availability of individual dose evaluation for the return of residents after the accident at the Fukushima Dai-ichi Nuclear Power Plant (FNPP), we evaluated individual doses of radiation as measured by personal dosimeters in residents who temporarily stayed in Evacuation Order Areas in Kawauchi village, which is partially located within a 20 km radius of the FNPP. We also compared individual doses with the external radiation doses estimated from the ambient dose rates and with doses estimated from the concentrations of radionuclides in the soil around each individual's house. Individual doses were significantly correlated with the ambient doses in front of the entrances to the houses (r = 0.90, p<0.01), in the backyards (r = 0.41, p<0.01) and in the nearby fields (r = 0.80, p<0.01). The maximum cumulative ambient doses in the backyards and fields around the houses were 6.38 and 9.27 mSv/y, respectively. The maximum cumulative individual dose was 3.28 mSv/y, and the median and minimum doses were 1.35 and 0.71 mSv/y. The estimated external effective doses from concentrations of artificial radionuclides in soil samples ranged from 0.03 to 23.42 mSv/y. The individual doses were moderately correlated with external effective doses in the backyards (r = 0.38, p<0.01) and in the fields (r = 0.36, p<0.01); however, the individual doses were not significantly correlated with the external effective doses in front of the entrances (r = 0.01, p = 0.92). Our study confirmed that individual doses are low levels even in the evacuation order area in Kawauchi village, and external effective dose levels are certainly decreasing due to the decay of artificial radionuclides and the decontamination of contaminated soil. Long-term follow-up of individual doses as well as internal-exposure doses, environmental monitoring and reconstruction of infrastructure are needed so that residents may return to their hometowns after a nuclear disaster.

  3. Measurement of individual doses of radiation by personal dosimeter is important for the return of residents from evacuation order areas after nuclear disaster.

    PubMed

    Orita, Makiko; Hayashida, Naomi; Taira, Yasuyuki; Fukushima, Yoshiko; Ide, Juichi; Endo, Yuuko; Kudo, Takashi; Yamashita, Shunichi; Takamura, Noboru

    2015-01-01

    To confirm the availability of individual dose evaluation for the return of residents after the accident at the Fukushima Dai-ichi Nuclear Power Plant (FNPP), we evaluated individual doses of radiation as measured by personal dosimeters in residents who temporarily stayed in Evacuation Order Areas in Kawauchi village, which is partially located within a 20 km radius of the FNPP. We also compared individual doses with the external radiation doses estimated from the ambient dose rates and with doses estimated from the concentrations of radionuclides in the soil around each individual's house. Individual doses were significantly correlated with the ambient doses in front of the entrances to the houses (r = 0.90, p<0.01), in the backyards (r = 0.41, p<0.01) and in the nearby fields (r = 0.80, p<0.01). The maximum cumulative ambient doses in the backyards and fields around the houses were 6.38 and 9.27 mSv/y, respectively. The maximum cumulative individual dose was 3.28 mSv/y, and the median and minimum doses were 1.35 and 0.71 mSv/y. The estimated external effective doses from concentrations of artificial radionuclides in soil samples ranged from 0.03 to 23.42 mSv/y. The individual doses were moderately correlated with external effective doses in the backyards (r = 0.38, p<0.01) and in the fields (r = 0.36, p<0.01); however, the individual doses were not significantly correlated with the external effective doses in front of the entrances (r = 0.01, p = 0.92). Our study confirmed that individual doses are low levels even in the evacuation order area in Kawauchi village, and external effective dose levels are certainly decreasing due to the decay of artificial radionuclides and the decontamination of contaminated soil. Long-term follow-up of individual doses as well as internal-exposure doses, environmental monitoring and reconstruction of infrastructure are needed so that residents may return to their hometowns after a nuclear disaster. PMID:25806523

  4. Measurement of Individual Doses of Radiation by Personal Dosimeter Is Important for the Return of Residents from Evacuation Order Areas after Nuclear Disaster

    PubMed Central

    Orita, Makiko; Hayashida, Naomi; Taira, Yasuyuki; Fukushima, Yoshiko; Ide, Juichi; Endo, Yuuko; Kudo, Takashi; Yamashita, Shunichi; Takamura, Noboru

    2015-01-01

    To confirm the availability of individual dose evaluation for the return of residents after the accident at the Fukushima Dai-ichi Nuclear Power Plant (FNPP), we evaluated individual doses of radiation as measured by personal dosimeters in residents who temporarily stayed in Evacuation Order Areas in Kawauchi village, which is partially located within a 20 km radius of the FNPP. We also compared individual doses with the external radiation doses estimated from the ambient dose rates and with doses estimated from the concentrations of radionuclides in the soil around each individual’s house. Individual doses were significantly correlated with the ambient doses in front of the entrances to the houses (r = 0.90, p<0.01), in the backyards (r = 0.41, p<0.01) and in the nearby fields (r = 0.80, p<0.01). The maximum cumulative ambient doses in the backyards and fields around the houses were 6.38 and 9.27 mSv/y, respectively. The maximum cumulative individual dose was 3.28 mSv/y, and the median and minimum doses were 1.35 and 0.71 mSv/y. The estimated external effective doses from concentrations of artificial radionuclides in soil samples ranged from 0.03 to 23.42 mSv/y. The individual doses were moderately correlated with external effective doses in the backyards (r = 0.38, p<0.01) and in the fields (r = 0.36, p<0.01); however, the individual doses were not significantly correlated with the external effective doses in front of the entrances (r = 0.01, p = 0.92). Our study confirmed that individual doses are low levels even in the evacuation order area in Kawauchi village, and external effective dose levels are certainly decreasing due to the decay of artificial radionuclides and the decontamination of contaminated soil. Long-term follow-up of individual doses as well as internal-exposure doses, environmental monitoring and reconstruction of infrastructure are needed so that residents may return to their hometowns after a nuclear disaster. PMID:25806523

  5. 42 CFR 435.403 - State residence.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... State placement, the term also includes foster care homes, licensed as set forth in 45 CFR 1355.20, and... Act, the State of residence is the State where the child lives. (h) Individuals under Age 21. (1) For... accordance with 45 CFR 233.40, the rules governing residence under the AFDC program. (4) For...

  6. 42 CFR 435.403 - State residence.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... State placement, the term also includes foster care homes, licensed as set forth in 45 CFR 1355.20, and... Act, the State of residence is the State where the child lives. (h) Individuals under Age 21. (1) For... accordance with 45 CFR 233.40, the rules governing residence under the AFDC program. (4) For...

  7. 42 CFR 435.403 - State residence.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... State placement, the term also includes foster care homes, licensed as set forth in 45 CFR 1355.20, and... Act, the State of residence is the State where the child lives. (h) Individuals under Age 21. (1) For... accordance with 45 CFR 233.40, the rules governing residence under the AFDC program. (4) For...

  8. US dermatology residency program rankings.

    PubMed

    Aquino, Lisa L; Wen, Ge; Wu, Jashin J

    2014-10-01

    Unlike many other adult specialties, US News & World Report does not rank dermatology residency programs annually. We conducted a study to rank individual US dermatology residency programs based on set criteria. For each residency program, data from 2008 related to a number of factors were collected, including annual amount of National Institutes of Health (NIH) and Dermatology Foundation (DF) funding received; number of publications from full-time faculty members; number of faculty lectures given at 5 annual society meetings; and number of full-time faculty members who were on the editorial boards of 6 dermatology journals with the highest impact factors. Most of the data were obtained through extensive Internet searches, and missing data were obtained by contacting individual residency programs. The programs were ranked based on the prior factors according to a weighted ranking algorithm. A list of overall rankings also was created.

  9. Federal Government Health, Education, and Welfare Programs of Assistance to American Indians Residing on Federal Reservations (Including Table of Contents and Index).

    ERIC Educational Resources Information Center

    Langone, Stephen A.

    Federal health, education, and welfare programs for 1970 benefiting American Indians residing on Federal reservations are listed. The report is divided into 3 sections: (1) Federal Indian programs aimed at improving or providing Indian health services, tribal management services, housing, higher education, and conservation; (2) Federal programs…

  10. Risk Factors for Low Bone Mineral Density in Individuals Residing in a Facility for the People with Intellectual Disability

    ERIC Educational Resources Information Center

    Jaffe, J. S.; Timell, A. M.; Elolia, R.; Thatcher, S. S.

    2005-01-01

    Background: Individuals with intellectual disability (ID) are known to have a high prevalence of both low bone mineral density (BMD) and fractures with significant attendant morbidity. Effective strategies aimed at reducing fractures will be facilitated by the identification of predisposing risk factors. Methods: Bone mineral density was measured…

  11. The Association of Age With Rate of Cognitive Decline in Elderly Individuals Residing in Supporting Care Facilities

    PubMed Central

    Ravona-Springer, Ramit; Luo, Xiaodong; Schmeidler, James; Wysocki, Michael; Lesser, Gerson T.; Rapp, Michael A.; Dahlman, Karen; Grossman, Hillel T.; Haroutunian, Vahram; Beeri, Michal Schnaider

    2012-01-01

    Objectives This study examines the effect of age on rate of cognitive decline in different stages of dementia, of nursing home and assisted-living residents. Methods In this longitudinal study, the Mini Mental State Examination (MMSE) was used to measure rate of cognitive decline in subjects who were nondemented [Clinical Dementia Rating (CDR)=0; n=353], questionably demented (CDR=0.5; n=121), or frankly demented (CDR≥1; n=213) at baseline. Results A generalized estimating equation was used to model the MMSE scores over time (mean follow-up 2.9±2.0 y). The generalized estimating equation model had the MMSE scores at successive follow-up time points as dependent variables and had linear and quadratic age, follow-up time from baseline, CDR at baseline, and all the interactions among them as independent variables, controlling for MMSE at baseline, sex, race, and education. The mean age of the entire sample was 85.2±7.4 years at baseline. There were no significant interactions of linear age effects with rate of cognitive decline. The analysis of interaction of quadratic age with rate of cognitive decline showed complex relationships: in the nondemented group, there was no substantial quadratic association of age with the rate of cognitive decline (P=0.13); in the questionable demented group, the oldest subjects declined relatively faster (P=0.02); and in the demented group, the youngest and oldest subjects tended to decline relatively less than subjects in the intermediate ages (P=0.07). Conclusions This study adds an additional aspect to the complexity of the association between age and rate of cognitive decline, showing that the direction and amplitude of this effect differs according to the stage along the course of cognitive decline. PMID:21572311

  12. Facility Focus: Residence Halls.

    ERIC Educational Resources Information Center

    College Planning & Management, 1999

    1999-01-01

    Describes four college residence halls that have successfully combined a comfortable, aesthetically pleasing, and socially stimulating atmosphere for its residents. Photographs and interior-design line drawings are included. (GR)

  13. 20 CFR 666.140 - Which individuals receiving services are included in the core indicators of performance?

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... educate individuals about the labor market and their employment strengths, weaknesses, and the range of... TRAINING ADMINISTRATION, DEPARTMENT OF LABOR PERFORMANCE ACCOUNTABILITY UNDER TITLE I OF THE WORKFORCE... who are registered under 20 CFR 663.105 and 664.215 for the adult, dislocated worker and...

  14. The Role of Economic Factors, Including the Level of Tuition, in Individual University Participation Decisions in Canada

    ERIC Educational Resources Information Center

    Johnson, David R.; Rahman, Fiona T.

    2005-01-01

    The study uses individual data from the Canadian Labour Force Survey to consider economic factors in university participation decisions by persons aged 17-24 from 1976 to 2003. The level of real tuition is one economic factor that may affect the university participation decision. There is also regional variation in the opportunity cost of…

  15. 42 CFR 435.403 - State residence.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... State placement, the term also includes foster care homes, licensed as set forth in 45 CFR 1355.20, and... Act, the State of residence is the State where the child lives. (h) Individuals age 21 and over... is used if the individual has been abandoned by his or her parent(s), does not have a legal...

  16. 42 CFR 435.403 - State residence.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... State placement, the term also includes foster care homes, licensed as set forth in 45 CFR 1355.20, and... Act, the State of residence is the State where the child lives. (h) Individuals age 21 and over... is used if the individual has been abandoned by his or her parent(s), does not have a legal...

  17. Summary of Changes Related to the Individualized Education Program (IEP): Current Law and 1997 IDEA Amendments, Including Congressional Committee Comments. Final Report.

    ERIC Educational Resources Information Center

    Schrag, Judy; Ahearn, Eileen M.

    This report summarizes provisions and highlights changes for the Individualized Education Program (IEP) within the Individuals with Disabilities Education Act (IDEA) Amendments of 1997. Also included are references from the two Congressional Committee Reports--those of the Senate Labor and Human Resources Committee and the House Committee on…

  18. Rewarding the Resident Teacher

    ERIC Educational Resources Information Center

    McBride, Jennifer M.; Drake, Richard L.

    2011-01-01

    Residents routinely make significant contributions to the education of medical students. However, little attention has been paid to rewarding these individuals for their involvement in these academic activities. This report describes a program that rewards resident teachers with an academic appointment as a Clinical Instructor. The residents…

  19. Individual Radiological Protection Monitoring of Utrok Atoll Residents Based on Whole Body Counting of Cesium-137 (137Cs) and Plutonium Bioassay

    SciTech Connect

    Hamilton, T; Kehl, S; Brown, T; Martinelli, R; Hickman, D; Jue, T; Tumey, S; Langston, R

    2007-06-08

    This report contains individual radiological protection surveillance data developed during 2006 for adult members of a select group of families living on Utrok Atoll. These Group I volunteers all underwent a whole-body count to determine levels of internally deposited cesium-137 ({sup 137}Cs) and supplied a bioassay sample for analysis of plutonium isotopes. Measurement data were obtained and the results compared with an equivalent set of measurement data for {sup 137}Cs and plutonium isotopes from a second group of adult volunteers (Group II) who were long-term residents of Utrok Atoll. For the purposes of this comparison, Group II volunteers were considered representative of the general population on Utrok Atoll. The general aim of the study was to determine residual systemic burdens of fallout radionuclides in each volunteer group, develop data in response to addressing some specific concerns about the preferential uptake and potential health consequences of residual fallout radionuclides in Group I volunteers, and generally provide some perspective on the significance of radiation doses delivered to volunteers (and the general Utrok Atoll resident population) in terms of radiological protection standards and health risks. Based on dose estimates from measurements of internally deposited {sup 137}Cs and plutonium isotopes, the data and information developed in this report clearly show that neither volunteer group has acquired levels of internally deposited fallout radionuclides specific to nuclear weapons testing in the Marshall Islands that are likely to have any consequence on human health. Moreover, the dose estimates are well below radiological protection standards as prescribed by U.S. regulators and international agencies, and are very small when compared to doses from natural sources of radiation in the Marshall Islands and the threshold where radiation health effects could be either medically diagnosed in an individual or epidemiologically discerned in a

  20. Predictors, Including Blood, Urine, Anthropometry, and Nutritional Indices, of All-Cause Mortality among Institutionalized Individuals with Intellectual Disability

    ERIC Educational Resources Information Center

    Ohwada, Hiroko; Nakayama, Takeo; Tomono, Yuji; Yamanaka, Keiko

    2013-01-01

    As the life expectancy of people with intellectual disability (ID) increases, it is becoming necessary to understand factors affecting survival. However, predictors that are typically assessed among healthy people have not been examined. Predictors of all-cause mortality, including blood, urine, anthropometry, and nutritional indices, were…

  1. Short-term effects of a snack including dried prunes on energy intake and satiety in normal-weight individuals.

    PubMed

    Farajian, Paul; Katsagani, Maria; Zampelas, Antonis

    2010-08-01

    The purpose of this study was to test the hypothesis that a preload including dried prunes consumed as a snack before a meal, compared to an isoenergetic and equal weighed bread product preload would: (a) have greater short-term effect on satiety measured by subsequent ad libitum meal intake, (b) induce greater satiety as assessed by visual analogue scales (VAS), and (c) reduce appetite for dessert offered shortly after lunch. Forty-five healthy, normal-weight subjects participated in this randomised within-subject crossover study. Statistical analysis of the results showed that when subjects consumed the preload that included dried prunes, also consumed less amount of dessert and had lower total energy intake at meal. Additionally, subjects' feeling of hunger, desire and motivation to eat, as assessed with the use of VAS, were lower at all time points between snack and meal. Since macronutrients content of both preloads were similar, the satiating power of prunes could be due to their relatively high fiber content. Identifying meal patterns and foods that promote satiety without increasing considerably the overall energy intake is very important. The addition of dried prunes to a snack seems to promote satiety besides providing valuable nutrients.

  2. Training Personnel for the Education of Individuals with Disabilities Program. Component 2: Preparation of Related Services Personnel (Pediatric Residents). Final Report.

    ERIC Educational Resources Information Center

    Bruder, Mary Beth

    This final report describes the activities and outcomes of a project designed to develop, implement, and evaluate a new three-year longitudinal competency based curriculum for pediatric residents on their role in early intervention and special education. The curriculum consisted of four half-days per month for every resident in an ambulatory…

  3. General surgery residency training issues.

    PubMed

    Klingensmith, Mary E; Lewis, Frank R

    2013-01-01

    The practice of general surgery has undergone a marked evolution in the past 20 years, which has been inadequately recognized and minimally addressed. The changes that have occurred have been disruptive to residency training, and to date there has been inadequate compensation for these. Evidence is now emerging of significant issues in the overall performance of recent graduates from at least 3 sources: the evaluation of external agents who incorporate these graduates into their practice or group, the opinions of the residents themselves, and the performance of graduates on the oral examination of the American Board of Surgery during the past 8 years. The environmental and technological causes of the present situation represent improvements in care for patients, and are clearly irreversible. Hence, solutions to the problems must be sought in other areas. To address the issues effectively, greater recognition and engagement are needed by the surgical community so that effective solutions can be crafted. These will need to include improvements in the efficiency of teaching, with the assumption of greater individual resident responsibility for their knowledge, the establishment of more defined standards for knowledge and skills acquisition by level of residency training, with flexible self-assessment available online, greater focus of the curriculum on current rather than historical practice, increased use of structured assessments (including those in a simulated environment), and modifications to the overall structure of the traditional 5-year residency.

  4. Resident recruitment.

    PubMed

    Longmaid, H Esterbrook

    2003-02-01

    This article has introduced the reader to the critical components of successful recruitment of radiology residents. With particular attention to the ACGME institutional and program requirements regarding resident recruitment, and an explanation of the support systems (ERAS and NRMP) currently available to those involved in applicant review and selection, the article has sought to delineate a sensible approach to recruitment. Successful recruiters have mastered the essentials of these programs and have learned to adapt the programs to their needs. As new program directors work with their departments' resident selection committees, they will identify the factors that faculty and current residents cite as most important in the successful selection of new residents. By structuring the application review process, exploiting the power of the ERAS, and crafting a purposeful and friendly interview process, radiology residency directors can find and recruit the residents who best match their programs. PMID:12585436

  5. Resident and graduate training in veterinary nutrition.

    PubMed

    Fascetti, Andrea J

    2008-01-01

    Training programs for veterinarians seeking board certification by the American College of Veterinary Nutrition (ACVN) are structured in one of two ways: (1) as programs similar to specialty training in other clinical disciplines or (2) as graduate programs leading to advanced degrees combined with clinical training. Residency training occurs through a variety of approaches, including didactic coursework, case-based and applied learning, clinical training, teaching, research, and self-study. Challenges to successful residency and graduate training include low numbers of diplomates, particularly at veterinary schools; low numbers of applicants; small numbers of funded programs; and faculty promotion systems that do not reward residency or graduate training and program development. The mentoring of individuals seeking both board certification and a graduate degree presents additional considerations, including recruitment of individuals motivated in research and structuring a combined program that facilitates completion of both tasks in a timely fashion. PMID:18723818

  6. Delinking resident duty hours from patient safety.

    PubMed

    Osborne, Roisin; Parshuram, Christopher S

    2014-01-01

    Patient safety is a powerful motivating force for change in modern medicine, and is often cited as a rationale for reducing resident duty hours. However, current data suggest that resident duty hours are not significantly linked to important patient outcomes. We performed a narrative review and identified four potential explanations for these findings. First, we question the relevance of resident fatigue in the creation of harmful errors. Second, we discuss factors, including workload, experience, and individual characteristics, that may be more important determinants of resident fatigue than are duty hours. Third, we describe potential adverse effects that may arise from--and, therefore, counterbalance any potential benefits of--duty hour reductions. Fourth, we explore factors that may mitigate any risks to patient safety associated with using the services of resident trainees. In summary, it may be inappropriate to justify a reduction in working hours on the grounds of a presumed linkage between patient safety and resident duty hours. Better understanding of resident-related factors associated with patient safety will be essential if improvements in important patient safety outcomes are to be realized through resident-focused strategies. PMID:25561349

  7. 26 CFR 1.962-1 - Limitation of tax for individuals on amounts included in gross income under section 951(a).

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... United States shareholder may elect to be subject to tax at corporate rates on amounts included in his gross income under section 951(a) and to have the benefit of a credit for certain foreign taxes paid... 26 Internal Revenue 10 2010-04-01 2010-04-01 false Limitation of tax for individuals on...

  8. Accidental blood exposures among medical residents in Paris, France.

    PubMed

    Mir, O; Adam, J; Veyrie, N; Chousterman, B; Gaillard, R; Gregory, T; Yordanov, Y; Berveiller, P; Loulergue, P

    2011-03-01

    Accidental blood exposure (ABE) exposes healthcare workers, including medical residents, to the risk of occupational infection. We aimed to determine the characteristics of ABEs in residents with an anonymous self-reporting electronic questionnaire. A total of 350 residents (33% from surgical disciplines) entered this survey. One hundred and eighty-five residents (52%) reported at least one ABE during their residency (median, 2; range, 1-25), 53% of which occurred in operating theatres. Sixty-nine per cent of residents followed the current procedures for local disinfection. ABEs were notified to the hospital administration by 62% of residents, but only 51% of residents were referred to the occupational medicine department. The most frequently reported concerns following ABEs were human immunodeficiency virus (52%) and hepatitis C virus infection (39%). In 74% of cases, the serological status of the index patient was investigated. Only 54% of residents were aware of their hepatitis B surface antibody titres. Medical residents behaved inappropriately in 33% of cases in this survey. Further educational programmes should include residents, and not only senior healthcare workers, in order to improve individual behaviours.

  9. Implementation of an Integrative Medicine Curriculum for Preventive Medicine Residents.

    PubMed

    Chiaramonte, Delia R; D'Adamo, Christopher; Amr, Sania

    2015-11-01

    The University of Maryland Department of Epidemiology and Public Health collaborated with the Center for Integrative Medicine at the same institution to develop and implement a unique integrative medicine curriculum within a preventive medicine residency program. Between October 2012 and July 2014, Center for Integrative Medicine faculty provided preventive medicine residents and faculty, and occasionally other Department of Epidemiology and Public Health faculty, with comprehensive exposure to the field of integrative medicine, including topics such as mind-body medicine, nutrition and nutritional supplements, Traditional Chinese Medicine, massage, biofield therapies, manual medicine, stress management, creative arts, and the use of integrative medicine in the inpatient setting. Preventive medicine residents, under the supervision of Department of Epidemiology and Public Health faculty, led integrative medicine-themed journal clubs. Resident assessments included a case-based knowledge evaluation, the Integrative Medicine Attitudes Questionnaire, and a qualitative evaluation of the program. Residents received more than 60 hours of integrative medicine instruction, including didactic sessions, experiential workshops, and wellness retreats in addition to clinical experiences and individual wellness mentoring. Residents rated the program positively and recommended that integrative medicine be included in preventive medicine residency curricula. The inclusion of a wellness-focused didactic, experiential, and skill-based integrative medicine program within a preventive medicine residency was feasible and well received by all six preventive medicine residents.

  10. Effects of Green House nursing homes on residents' families.

    PubMed

    Lum, Terry Y; Kane, Rosalie A; Cutler, Lois J; Yu, Tzy-Chyi

    2008-01-01

    A longitudinal quasi-experimental study with two comparison groups was conducted to test the effects of a Green House (GH) nursing home program on residents' family members. The GHs are individual residences, each serving 10 elders, where certified nursing assistant (CNA)-level resident assistants form primary relationships with residents and family, family is encouraged to visits, and professionals adapted their roles to support the model. GH family were somewhat less involved in providing assistance to their residents although family contact did not differ among the settings at any time period. GH family were more satisfied with their resident's care and with their own experience as family members, and had no greater family burden. Issues in studying family outcomes are discussed as well as implications for roles of various personnel, including social service and activities staff in a GH model.

  11. Resident-to-resident violence triggers in nursing homes.

    PubMed

    Snellgrove, Susan; Beck, Cornelia; Green, Angela; McSweeney, Jean C

    2013-11-01

    Certified nurses' assistants (CNAs) employed by a rural nursing home in Northeast Arkansas described their perceptions of resident-to-resident violence in order to provide insight on factors, including unmet needs, that may trigger the phenomenon. Semistructured interviews were conducted with 11 CNAs. Data were analyzed using content analysis and constant comparison. Two categories of triggers emerged from the data-active and passive. Active triggers involved the actions of other residents that were intrusive in nature, such as wandering into a residents' personal space, taking a resident's belongings, and so forth. Passive triggers did not involve the actions of residents but related to the internal and external environment of the residents. Examples were factors such as boredom, competition for attention and communication difficulties. Results indicate that there are factors, including unmet needs within the nursing home environment that may be identified and altered to prevent violence between residents.

  12. Promoting residencies to pharmacy students.

    PubMed

    Knapp, K K

    1991-08-01

    A program for promoting pharmacy residency training to pharmacy students at the University of the Pacific (UOP) is described. A residency club was started in 1982 to increase UOP students' interest in residency training and to provide them with relevant information. Some students needed to be convinced that residencies were primarily educational rather than staffing experiences. Students were made aware of pharmacists' practice in specialty areas, for which residency training is needed, and were taught how to prepare themselves for selection for residencies. The club was formed to encourage mutual support among the students, which would be less likely to occur if residencies were promoted only through work with individual students. Club meetings provide information about available residencies, the application process, and the value of residency training to a career in pharmacy. Students are taught how to prepare curricula vitae, how to interview, and how to select programs to which to apply. Applications for residencies increased. Although the rate of acceptance was low at first, it was expected to increase as more UOP students demonstrated their interest in and qualification for residency training. The promotion of residencies as part of a balanced career planning and placement program for pharmacy students is encouraged.

  13. Permanent resident

    PubMed Central

    Fisher, John F.

    2016-01-01

    The training of physicians in the past century was based primarily on responsibility and the chain-of-command. Those with the bulk of that responsibility in the fields of pediatrics and internal medicine were residents. Residents trained the medical students and supervised them carefully in caring for patients. Most attending physicians supervised their teams at arm's length, primarily serving as teachers of the finer points of diagnosis and treatment during set periods of the day or week with a perfunctory signature on write-ups or progress notes. Residents endeavored to protect the attending physician from being heavily involved unless they were unsure about a clinical problem. Before contacting the attending physician, a more senior resident would be called. Responsibility was the ultimate teacher. The introduction of diagnosis-related groups by the federal government dramatically changed the health care delivery system, placing greater emphasis on attending physician visibility in the medical record, ultimately resulting in more attending physician involvement in day-to-day care of patients in academic institutions. Without specified content in attending notes, hospital revenues would decline. Although always in charge technically, attending physicians increasingly have assumed the role once dominated by the resident. Using biographical experiences of more than 40 years, the author acknowledges and praises the educational role of responsibility in his own training and laments its declining role in today's students and house staff. PMID:27193992

  14. Permanent resident.

    PubMed

    Fisher, John F

    2016-01-01

    The training of physicians in the past century was based primarily on responsibility and the chain-of-command. Those with the bulk of that responsibility in the fields of pediatrics and internal medicine were residents. Residents trained the medical students and supervised them carefully in caring for patients. Most attending physicians supervised their teams at arm's length, primarily serving as teachers of the finer points of diagnosis and treatment during set periods of the day or week with a perfunctory signature on write-ups or progress notes. Residents endeavored to protect the attending physician from being heavily involved unless they were unsure about a clinical problem. Before contacting the attending physician, a more senior resident would be called. Responsibility was the ultimate teacher. The introduction of diagnosis-related groups by the federal government dramatically changed the health care delivery system, placing greater emphasis on attending physician visibility in the medical record, ultimately resulting in more attending physician involvement in day-to-day care of patients in academic institutions. Without specified content in attending notes, hospital revenues would decline. Although always in charge technically, attending physicians increasingly have assumed the role once dominated by the resident. Using biographical experiences of more than 40 years, the author acknowledges and praises the educational role of responsibility in his own training and laments its declining role in today's students and house staff.

  15. Sex-stratified Genome-wide Association Studies Including 270,000 Individuals Show Sexual Dimorphism in Genetic Loci for Anthropometric Traits

    PubMed Central

    Jackson, Anne U.; Monda, Keri L.; Kilpeläinen, Tuomas O.; Esko, Tõnu; Mägi, Reedik; Li, Shengxu; Workalemahu, Tsegaselassie; Feitosa, Mary F.; Croteau-Chonka, Damien C.; Day, Felix R.; Fall, Tove; Ferreira, Teresa; Gustafsson, Stefan; Locke, Adam E.; Mathieson, Iain; Scherag, Andre; Vedantam, Sailaja; Wood, Andrew R.; Liang, Liming; Steinthorsdottir, Valgerdur; Thorleifsson, Gudmar; Dermitzakis, Emmanouil T.; Dimas, Antigone S.; Karpe, Fredrik; Min, Josine L.; Nicholson, George; Clegg, Deborah J.; Person, Thomas; Krohn, Jon P.; Bauer, Sabrina; Buechler, Christa; Eisinger, Kristina; Bonnefond, Amélie; Froguel, Philippe; Hottenga, Jouke-Jan; Prokopenko, Inga; Waite, Lindsay L.; Harris, Tamara B.; Smith, Albert Vernon; Shuldiner, Alan R.; McArdle, Wendy L.; Caulfield, Mark J.; Munroe, Patricia B.; Grönberg, Henrik; Chen, Yii-Der Ida; Li, Guo; Beckmann, Jacques S.; Johnson, Toby; Thorsteinsdottir, Unnur; Teder-Laving, Maris; Khaw, Kay-Tee; Wareham, Nicholas J.; Zhao, Jing Hua; Amin, Najaf; Oostra, Ben A.; Kraja, Aldi T.; Province, Michael A.; Cupples, L. Adrienne; Heard-Costa, Nancy L.; Kaprio, Jaakko; Ripatti, Samuli; Surakka, Ida; Collins, Francis S.; Saramies, Jouko; Tuomilehto, Jaakko; Jula, Antti; Salomaa, Veikko; Erdmann, Jeanette; Hengstenberg, Christian; Loley, Christina; Schunkert, Heribert; Lamina, Claudia; Wichmann, H. Erich; Albrecht, Eva; Gieger, Christian; Hicks, Andrew A.; Johansson, Åsa; Pramstaller, Peter P.; Kathiresan, Sekar; Speliotes, Elizabeth K.; Penninx, Brenda; Hartikainen, Anna-Liisa; Jarvelin, Marjo-Riitta; Gyllensten, Ulf; Boomsma, Dorret I.; Campbell, Harry; Wilson, James F.; Chanock, Stephen J.; Farrall, Martin; Goel, Anuj; Medina-Gomez, Carolina; Rivadeneira, Fernando; Estrada, Karol; Uitterlinden, André G.; Hofman, Albert; Zillikens, M. Carola; den Heijer, Martin; Kiemeney, Lambertus A.; Maschio, Andrea; Hall, Per; Tyrer, Jonathan; Teumer, Alexander; Völzke, Henry; Kovacs, Peter; Tönjes, Anke; Mangino, Massimo; Spector, Tim D.; Hayward, Caroline; Rudan, Igor; Hall, Alistair S.; Samani, Nilesh J.; Attwood, Antony Paul; Sambrook, Jennifer G.; Hung, Joseph; Palmer, Lyle J.; Lokki, Marja-Liisa; Sinisalo, Juha; Boucher, Gabrielle; Huikuri, Heikki; Lorentzon, Mattias; Ohlsson, Claes; Eklund, Niina; Eriksson, Johan G.; Barlassina, Cristina; Rivolta, Carlo; Nolte, Ilja M.; Snieder, Harold; Van der Klauw, Melanie M.; Van Vliet-Ostaptchouk, Jana V.; Gejman, Pablo V.; Shi, Jianxin; Jacobs, Kevin B.; Wang, Zhaoming; Bakker, Stephan J. L.; Mateo Leach, Irene; Navis, Gerjan; van der Harst, Pim; Martin, Nicholas G.; Medland, Sarah E.; Montgomery, Grant W.; Yang, Jian; Chasman, Daniel I.; Ridker, Paul M.; Rose, Lynda M.; Lehtimäki, Terho; Raitakari, Olli; Absher, Devin; Iribarren, Carlos; Basart, Hanneke; Hovingh, Kees G.; Hyppönen, Elina; Power, Chris; Anderson, Denise; Beilby, John P.; Hui, Jennie; Jolley, Jennifer; Sager, Hendrik; Bornstein, Stefan R.; Schwarz, Peter E. H.; Kristiansson, Kati; Perola, Markus; Lindström, Jaana; Swift, Amy J.; Uusitupa, Matti; Atalay, Mustafa; Lakka, Timo A.; Rauramaa, Rainer; Bolton, Jennifer L.; Fowkes, Gerry; Fraser, Ross M.; Price, Jackie F.; Fischer, Krista; KrjutÅ¡kov, Kaarel; Metspalu, Andres; Mihailov, Evelin; Langenberg, Claudia; Luan, Jian'an; Ong, Ken K.; Chines, Peter S.; Keinanen-Kiukaanniemi, Sirkka M.; Saaristo, Timo E.; Edkins, Sarah; Franks, Paul W.; Hallmans, Göran; Shungin, Dmitry; Morris, Andrew David; Palmer, Colin N. A.; Erbel, Raimund; Moebus, Susanne; Nöthen, Markus M.; Pechlivanis, Sonali; Hveem, Kristian; Narisu, Narisu; Hamsten, Anders; Humphries, Steve E.; Strawbridge, Rona J.; Tremoli, Elena; Grallert, Harald; Thorand, Barbara; Illig, Thomas; Koenig, Wolfgang; Müller-Nurasyid, Martina; Peters, Annette; Boehm, Bernhard O.; Kleber, Marcus E.; März, Winfried; Winkelmann, Bernhard R.; Kuusisto, Johanna; Laakso, Markku; Arveiler, Dominique; Cesana, Giancarlo; Kuulasmaa, Kari; Virtamo, Jarmo; Yarnell, John W. G.; Kuh, Diana; Wong, Andrew; Lind, Lars; de Faire, Ulf; Gigante, Bruna; Magnusson, Patrik K. E.; Pedersen, Nancy L.; Dedoussis, George; Dimitriou, Maria; Kolovou, Genovefa; Kanoni, Stavroula; Stirrups, Kathleen; Bonnycastle, Lori L.; Njølstad, Inger; Wilsgaard, Tom; Ganna, Andrea; Rehnberg, Emil; Hingorani, Aroon; Kivimaki, Mika; Kumari, Meena; Assimes, Themistocles L.; Barroso, Inês; Boehnke, Michael; Borecki, Ingrid B.; Deloukas, Panos; Fox, Caroline S.; Frayling, Timothy; Groop, Leif C.; Haritunians, Talin; Hunter, David; Ingelsson, Erik; Kaplan, Robert; Mohlke, Karen L.; O'Connell, Jeffrey R.; Schlessinger, David; Strachan, David P.; Stefansson, Kari; van Duijn, Cornelia M.; Abecasis, Gonçalo R.; McCarthy, Mark I.; Hirschhorn, Joel N.; Qi, Lu; Loos, Ruth J. F.; Lindgren, Cecilia M.; North, Kari E.; Heid, Iris M.

    2013-01-01

    Given the anthropometric differences between men and women and previous evidence of sex-difference in genetic effects, we conducted a genome-wide search for sexually dimorphic associations with height, weight, body mass index, waist circumference, hip circumference, and waist-to-hip-ratio (133,723 individuals) and took forward 348 SNPs into follow-up (additional 137,052 individuals) in a total of 94 studies. Seven loci displayed significant sex-difference (FDR<5%), including four previously established (near GRB14/COBLL1, LYPLAL1/SLC30A10, VEGFA, ADAMTS9) and three novel anthropometric trait loci (near MAP3K1, HSD17B4, PPARG), all of which were genome-wide significant in women (P<5×10−8), but not in men. Sex-differences were apparent only for waist phenotypes, not for height, weight, BMI, or hip circumference. Moreover, we found no evidence for genetic effects with opposite directions in men versus women. The PPARG locus is of specific interest due to its role in diabetes genetics and therapy. Our results demonstrate the value of sex-specific GWAS to unravel the sexually dimorphic genetic underpinning of complex traits. PMID:23754948

  16. Effects of Lifestyle Interventions That Include a Physical Activity Component in Class II and III Obese Individuals: A Systematic Review and Meta-Analysis

    PubMed Central

    Baillot, Aurélie; Romain, Ahmed J.; Boisvert-Vigneault, Katherine; Audet, Mélisa; Baillargeon, Jean Patrice; Dionne, Isabelle J.; Valiquette, Louis; Chakra, Claire Nour Abou; Avignon, Antoine; Langlois, Marie-France

    2015-01-01

    Background In class II and III obese individuals, lifestyle intervention is the first step to achieve weight loss and treat obesity-related comorbidities before considering bariatric surgery. A systematic review, meta-analysis, and meta-regression were performed to assess the impact of lifestyle interventions incorporating a physical activity (PA) component on health outcomes of class II and III obese individuals. Methods An electronic search was conducted in 4 databases (Medline, Scopus, CINAHL and Sportdiscus). Two independent investigators selected original studies assessing the impact of lifestyle interventions with PA components on anthropometric parameters, cardiometabolic risk factors (fat mass, blood pressure, lipid and glucose metabolism), behaviour modification (PA and nutritional changes), and quality of life in adults with body mass index (BMI) ≥ 35 kg/m2. Estimates were pooled using a random-effect model (DerSimonian and Laird method). Heterogeneity between studies was assessed by the Cochran’s chi-square test and quantified through an estimation of the I². Results Of the 3,170 identified articles, 56 met our eligibility criteria, with a large majority of uncontrolled studies (80%). The meta-analysis based on uncontrolled studies showed significant heterogeneity among all included studies. The pooled mean difference in weight loss was 8.9 kg (95% CI, 10.2–7.7; p < 0.01) and 2.8 kg/m² in BMI loss (95% CI, 3.4–2.2; p < 0.01). Long-term interventions produced superior weight loss (11.3 kg) compared to short-term (7.2 kg) and intermediate-term (8.0 kg) interventions. A significant global effect of lifestyle intervention on fat mass, waist circumference, blood pressure, total cholesterol, LDL-C, triglycerides and fasting insulin was found (p<0.01), without significant effect on HDL-C and fasting blood glucose. Conclusions Lifestyle interventions incorporating a PA component can improve weight and various cardiometabolic risk factors in class II

  17. Resident-to-Resident Violence Triggers in Nursing Homes

    PubMed Central

    Snellgrove, Susan; Beck, Cornelia; Green, Angela; McSweeney, Jean C.

    2014-01-01

    Certified nurses’ assistants (CNAs) employed by a rural nursing home in Northeast Arkansas described their perceptions of resident-to-resident violence in order to provide insight on factors, including unmet needs, that may trigger the phenomenon. Semistructured interviews were conducted with 11 CNAs. Data were analyzed using content analysis and constant comparison. Two categories of triggers emerged from the data—active and passive. Active triggers involved the actions of other residents that were intrusive in nature, such as wandering into a residents’ personal space, taking a resident’s belongings, and so forth. Passive triggers did not involve the actions of residents but related to the internal and external environment of the residents. Examples were factors such as boredom, competition for attention and communication difficulties. Results indicate that there are factors, including unmet needs within the nursing home environment that may be identified and altered to prevent violence between residents. PMID:23447361

  18. Burnout During Residency Training: A Literature Review

    PubMed Central

    IsHak, Waguih William; Lederer, Sara; Mandili, Carla; Nikravesh, Rose; Seligman, Laurie; Vasa, Monisha; Ogunyemi, Dotun; Bernstein, Carol A.

    2009-01-01

    Objective Burnout is a state of mental and physical exhaustion related to work or care giving activities. Burnout during residency training has gained significant attention secondary to concerns regarding job performance and patient care. This article reviews the relevant literature on burnout in order to provide information to educators about its prevalence, features, impact, and potential interventions. Methods Studies were identified through a Medline and PsychInfo search from 1974 to 2009. Fifty-one studies were identified. Definition and description of burnout and measurement methods are presented followed by a thorough review of the studies. Results An examination of the burnout literature reveals that it is prevalent in medical students (28%–45%), residents (27%–75%, depending on specialty), as well as practicing physicians. Psychological distress and physical symptoms can impact work performance and patient safety. Distress during medical school can lead to burnout, which in turn can result in negative consequences as a working physician. Burnout also poses significant challenges during early training years in residency. Time demands, lack of control, work planning, work organization, inherently difficult job situations, and interpersonal relationships, are considered factors contributing to residents' burnout. Potential interventions include workplace-driven and individual-driven measures. Workplace interventions include education about burnout, workload modifications, increasing the diversity of work duties, stress management training, mentoring, emotional intelligence training, and wellness workshops. Individual-driven behavioral, social, and physical activities include promoting interpersonal professional relations, meditation, counseling, and exercise. Conclusions Educators need to develop an active awareness of burnout and ought to consider incorporating relevant instruction and interventions during the process of training resident physicians

  19. Conversations with Holocaust survivor residents.

    PubMed

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

    2011-03-01

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

  20. A phenomenologic investigation of pediatric residents' experiences being parented and giving parenting advice.

    PubMed

    Bax, A C; Shawler, P M; Blackmon, D L; DeGrace, E W; Wolraich, M L

    2016-09-01

    Factors surrounding pediatricians' parenting advice and training on parenting during residency have not been well studied. The primary purpose of this study was to examine pediatric residents' self-reported experiences giving parenting advice and explore the relationship between parenting advice given and types of parenting residents received as children. Thirteen OUHSC pediatric residents were individually interviewed to examine experiences being parented and giving parenting advice. Phenomenological methods were used to explicate themes and secondary analyses explored relationships of findings based upon Baumrind's parenting styles (authoritative, authoritarian, permissive). While childhood experiences were not specifically correlated to the parenting advice style of pediatric residents interviewed, virtually all reported relying upon childhood experiences to generate their advice. Those describing authoritative parents reported giving more authoritative advice while others reported more variable advice. Core interview themes related to residents' parenting advice included anxiety about not being a parent, varying advice based on families' needs, and emphasis of positive interactions and consistency. Themes related to how residents were parented included discipline being a learning process for their parents and recalling that their parents always had expectations, yet always loved them. Pediatric residents interviewed reported giving family centered parenting advice with elements of positive interactions and consistency, but interviews highlighted many areas of apprehension residents have around giving parenting advice. Our study suggests that pediatric residents may benefit from more general educational opportunities to develop the content of their parenting advice, including reflecting on any impact from their own upbringing. PMID:27367930

  1. A phenomenologic investigation of pediatric residents' experiences being parented and giving parenting advice.

    PubMed

    Bax, A C; Shawler, P M; Blackmon, D L; DeGrace, E W; Wolraich, M L

    2016-09-01

    Factors surrounding pediatricians' parenting advice and training on parenting during residency have not been well studied. The primary purpose of this study was to examine pediatric residents' self-reported experiences giving parenting advice and explore the relationship between parenting advice given and types of parenting residents received as children. Thirteen OUHSC pediatric residents were individually interviewed to examine experiences being parented and giving parenting advice. Phenomenological methods were used to explicate themes and secondary analyses explored relationships of findings based upon Baumrind's parenting styles (authoritative, authoritarian, permissive). While childhood experiences were not specifically correlated to the parenting advice style of pediatric residents interviewed, virtually all reported relying upon childhood experiences to generate their advice. Those describing authoritative parents reported giving more authoritative advice while others reported more variable advice. Core interview themes related to residents' parenting advice included anxiety about not being a parent, varying advice based on families' needs, and emphasis of positive interactions and consistency. Themes related to how residents were parented included discipline being a learning process for their parents and recalling that their parents always had expectations, yet always loved them. Pediatric residents interviewed reported giving family centered parenting advice with elements of positive interactions and consistency, but interviews highlighted many areas of apprehension residents have around giving parenting advice. Our study suggests that pediatric residents may benefit from more general educational opportunities to develop the content of their parenting advice, including reflecting on any impact from their own upbringing.

  2. Meeting Resident Scholarly Activity Requirements Through a Longitudinal Quality Improvement Curriculum

    PubMed Central

    Simasek, Madeline; Ballard, Stephanie L.; Phelps, Phillip; Pingul-Ravano, Rowena; Kolb, N. Randall; Finkelstein, Alan; Weaver-Agostoni, Jacqueline; Takedai, Teiichi

    2015-01-01

    Abstract Background Quality improvement (QI) skills are learned during residency, yet there are few reports of the scholarly activity outcomes of a QI curriculum in a primary care program. Intervention We examined whether scholarly activity can result from a longitudinal, experiential QI curriculum that involves residents, clinic staff, and faculty. Methods The University of Pittsburgh Medical Center Shadyside Family Medicine Residency implemented a required longitudinal outpatient practice improvement rotation (LOPIR) curriculum in 2005. The rotation format includes weekly multidisciplinary work group meetings alternating with resident presentations delivered to the entire program. Residents present the results of a literature review and provide 2 interim project updates to the residency. A completed individual project is required for residency graduation, with project results presented at Residency Research Day. Scholarly activity outcomes of the curriculum were analyzed using descriptive statistics. Results As of 2014, 60 residents completed 3 years of the LOPIR curriculum. All residents satisfied the 2014 Accreditation Council for Graduate Medical Education (ACGME) scholarly activity and QI requirements with a literature review presentation in postgraduate year 2, and the presentation of a completed QI project at Residency Research Day. Residents have delivered 83 local presentations, 13 state/regional presentations, and 2 national presentations. Residents received 7 awards for QI posters, as well as 3 grants totaling $21,639. The educational program required no additional curriculum time, few resources, and was acceptable to residents, faculty, and staff. Conclusions LOPIR is an effective way to meet and exceed the 2014 ACGME scholarly activity requirements for family medicine residents. PMID:26217429

  3. Factors associated with burnout among residents in a developing country

    PubMed Central

    Zubairi, Akbar Jaleel; Noordin, Shahryar

    2016-01-01

    Introduction Recent literature has focused on burnout as a specific job related distress syndrome among physicians and residents having adverse effects on patient care. Local data on burnout is lacking. Materials & methods An online self-administered questionnaire was sent via email to all residents (325) at our institute with and a response rate of 110 (34%) was achieved. Out of these 82 residents consented and completely filled the questionnaires and were included in the analysis. The questionnaire comprised of demographic variables, the Maslach burnout inventory and occupational risk factors. Results High levels of burnout on at least one subscale were reported by 61(74.4%) residents, in 2 components by 34(41.5%) whereas an alarming 10(12.2%) residents scored high on all three subscales. Among the individual subscales emotional exhaustion was most frequent in 49(59.8%). Among the departments Radiology reported the highest levels (100%) of burnout and low levels were reported by Pediatrics (45%). There was no difference between burnout levels among junior and senior residents. Dissatisfaction with workload, length of work hours, relationship with co-workers and lack of autonomy were significantly associated with high level of burnout. Conclusion High levels of burnout are prevalent among trainee doctors in our part of the world which are comparable with international literature. Efforts to improve the work environment of residents may significantly reduce levels of burnout. PMID:26955475

  4. From individuals to populations to communities: a dynamic energy budget model of marine ecosystem size-spectrum including life history diversity.

    PubMed

    Maury, Olivier; Poggiale, Jean-Christophe

    2013-05-01

    Individual metabolism, predator-prey relationships, and the role of biodiversity are major factors underlying the dynamics of food webs and their response to environmental variability. Despite their crucial, complementary and interacting influences, they are usually not considered simultaneously in current marine ecosystem models. In an attempt to fill this gap and determine if these factors and their interaction are sufficient to allow realistic community structure and dynamics to emerge, we formulate a mathematical model of the size-structured dynamics of marine communities which integrates mechanistically individual, population and community levels. The model represents the transfer of energy generated in both time and size by an infinite number of interacting fish species spanning from very small to very large species. It is based on standard individual level assumptions of the Dynamic Energy Budget theory (DEB) as well as important ecological processes such as opportunistic size-based predation and competition for food. Resting on the inter-specific body-size scaling relationships of the DEB theory, the diversity of life-history traits (i.e. biodiversity) is explicitly integrated. The stationary solutions of the model as well as the transient solutions arising when environmental signals (e.g. variability of primary production and temperature) propagate through the ecosystem are studied using numerical simulations. It is shown that in the absence of density-dependent feedback processes, the model exhibits unstable oscillations. Density-dependent schooling probability and schooling-dependent predatory and disease mortalities are proposed to be important stabilizing factors allowing stationary solutions to be reached. At the community level, the shape and slope of the obtained quasi-linear stationary spectrum matches well with empirical studies. When oscillations of primary production are simulated, the model predicts that the variability propagates along the

  5. 2009 Canadian Radiation Oncology Resident Survey

    SciTech Connect

    Debenham, Brock; Banerjee, Robyn; Fairchild, Alysa; Dundas, George; Trotter, Theresa; Yee, Don

    2012-03-15

    Purpose: Statistics from the Canadian post-MD education registry show that numbers of Canadian radiation oncology (RO) trainees have risen from 62 in 1999 to approximately 150 per year between 2003 and 2009, contributing to the current perceived downturn in employment opportunities for radiation oncologists in Canada. When last surveyed in 2003, Canadian RO residents identified job availability as their main concern. Our objective was to survey current Canadian RO residents on their training and career plans. Methods and Materials: Trainees from the 13 Canadian residency programs using the national matching service were sought. Potential respondents were identified through individual program directors or chief resident and were e-mailed a secure link to an online survey. Descriptive statistics were used to report responses. Results: The eligible response rate was 53% (83/156). Similar to the 2003 survey, respondents generally expressed high satisfaction with their programs and specialty. The most frequently expressed perceived weakness in their training differed from 2003, with 46.5% of current respondents feeling unprepared to enter the job market. 72% plan on pursuing a postresidency fellowship. Most respondents intend to practice in Canada. Fewer than 20% of respondents believe that there is a strong demand for radiation oncologists in Canada. Conclusions: Respondents to the current survey expressed significant satisfaction with their career choice and training program. However, differences exist compared with the 2003 survey, including the current perceived lack of demand for radiation oncologists in Canada.

  6. Day-to-day care: the interplay of CNAs' views of residents & nursing home environments.

    PubMed

    Fisher, Lucy Takesue; Wallhagen, Margaret I

    2008-11-01

    This qualitative study identified certified nursing assistants' (CNAs') perspectives of nursing home residents and how these perspectives translate into care practices. Data included observations of and interviews with 27 CNAs in three dissimilar nursing homes. All participants were people of color, and all but 3 were immigrants. CNAs constructed three views of residents: as fictive kin, as a commodity, and as an autonomous person. Although individual CNAs held one primary view of residents in general, select residents were viewed from an alternative perspective, resulting in variations in care practices. These findings suggest that such distinctions, in tandem with structural, organizational, and cultural differences in nursing homes, present opportunities for nursing leadership to affect the visible, everyday practice of nursing CNAs. To target interventions, further research is needed on how CNAs come to differentially view residents and how these differences influence CNAs' care relationships with residents. PMID:19024427

  7. The Effects of Intravenous Immunoglobulins in Women with Recurrent Miscarriages: A Systematic Review of Randomised Trials with Meta-Analyses and Trial Sequential Analyses Including Individual Patient Data

    PubMed Central

    Egerup, Pia; Lindschou, Jane; Gluud, Christian; Christiansen, Ole Bjarne

    2015-01-01

    Background Immunological disturbances are hypothesised to play a role in recurrent miscarriage (RM) and therefore intravenous immunoglubulins (IVIg) have been tested in RM patients. Objectives The objectives were to investigate the benefits and harms of IVIg versus placebo, no intervention, or treatment as usual in women with RM. Search Strategy We searched the published literature in all relevant databases. Selection Criteria Randomised trials investigating IVIg versus placebo, no intervention, or treatment as usual in women with RM. Data Collection and Analysis We undertook meta-analyses of aggregated data and individual patient data using a two-step approach, and we conducted bias domain assessments and trial sequential analyses to assess the risks of systematic and random errors. Main Results We identified 11 randomised clinical trials. No significant difference in the frequency of no live birth was found when IVIg was compared with placebo or treatment as usual (RR 0.92, 95% CI 0.75–1.12, p = 0.42). Trial sequential analysis showed that the required information size of 1,008 participants was not obtained. IVIg compared with placebo seems to increase the risk of adverse events. Subgroup analysis suggests that women with RM after a birth (secondary RM) seemed most likely to obtain a potential beneficial effect of IVIg (RR for no live birth 0.77, 95%CI 0.58–1.02, p = 0.06), however, trial sequential analysis showed that insufficient information is presently accrued. Conclusion We cannot recommend or refute IVIg in women with RM. IVIg should therefore be assessed in further randomised clinical trials with positive outcomes before any clinical use is considered. PMID:26517123

  8. Toolbox for Evaluating Residents as Teachers

    ERIC Educational Resources Information Center

    Coverdale, John H.; Ismail, Nadia; Mian, Ayesha; Dewey, Charlene

    2010-01-01

    Objective: The authors review existing assessment tools related to evaluating residents' teaching skills and teaching effectiveness. Methods: PubMed and PsycInfo databases were searched using combinations of keywords including "residents," "residents as teachers," "teaching skills," and "assessments" or "rating scales." Results: Eleven evaluation…

  9. Prediction of individual milk proteins including free amino acids in bovine milk using mid-infrared spectroscopy and their correlations with milk processing characteristics.

    PubMed

    McDermott, A; Visentin, G; De Marchi, M; Berry, D P; Fenelon, M A; O'Connor, P M; Kenny, O A; McParland, S

    2016-04-01

    The aim of this study was to evaluate the effectiveness of mid-infrared spectroscopy in predicting milk protein and free amino acid (FAA) composition in bovine milk. Milk samples were collected from 7 Irish research herds and represented cows from a range of breeds, parities, and stages of lactation. Mid-infrared spectral data in the range of 900 to 5,000 cm(-1) were available for 730 milk samples; gold standard methods were used to quantify individual protein fractions and FAA of these samples with a view to predicting these gold standard protein fractions and FAA levels with available mid-infrared spectroscopy data. Separate prediction equations were developed for each trait using partial least squares regression; accuracy of prediction was assessed using both cross validation on a calibration data set (n=400 to 591 samples) and external validation on an independent data set (n=143 to 294 samples). The accuracy of prediction in external validation was the same irrespective of whether undertaken on the entire external validation data set or just within the Holstein-Friesian breed. The strongest coefficient of correlation obtained for protein fractions in external validation was 0.74, 0.69, and 0.67 for total casein, total β-lactoglobulin, and β-casein, respectively. Total proteins (i.e., total casein, total whey, and total lactoglobulin) were predicted with greater accuracy then their respective component traits; prediction accuracy using the infrared spectrum was superior to prediction using just milk protein concentration. Weak to moderate prediction accuracies were observed for FAA. The greatest coefficient of correlation in both cross validation and external validation was for Gly (0.75), indicating a moderate accuracy of prediction. Overall, the FAA prediction models overpredicted the gold standard values. Near-unity correlations existed between total casein and β-casein irrespective of whether the traits were based on the gold standard (0.92) or mid

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

    NASA Astrophysics Data System (ADS)

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

    2010-03-01

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

  11. Perspectives on Healthy Eating Among Appalachian Residents

    PubMed Central

    Schoenberg, Nancy E.; Howell, Britteny M.; Swanson, Mark; Grosh, Christopher; Bardach, Shoshana

    2013-01-01

    Purpose Extensive attention has been focused on improving the dietary intake of Americans. Such focus is warranted due to increasing rates of overweight, obesity, and other dietary-related disease. To address suboptimal dietary intake requires an improved, contextualized understanding of the multiple and intersecting influences on healthy eating, particularly among those populations at greatest risk of and from poor diet, including rural residents. Methods During 8 focus groups (N=99) and 6 group key informant interviews (N=20), diverse Appalachian rural residents were queried about their perceptions of healthy eating, determinants of healthy food intake, and recommendations for improving the dietary intake of people in their communities. Participants included church members and other laypeople, public health officials, social service providers, health care professionals, and others. Findings Participants offered insights on healthy eating consistent with the categories of individual, interpersonal, community, physical, environmental and society-level influences described in the socioecological model. Although many participants identified gaps in dietary knowledge as a persistent problem, informants also identified extra-individual factors, including the influence of family, fellow church members, and schools, policy, advertising and media, and general societal trends, as challenges to healthy dietary intake. We highlight Appalachian residents’ recommendations for promoting healthier diets, including support groups, educational workshops, cooking classes, and community gardening. Conclusions We discuss the implications of these findings for programmatic development in the Appalachian context. PMID:23944277

  12. Internal Medicine Residents' Perceptions of Cross-Cultural Training

    PubMed Central

    Park, Elyse R; Betancourt, Joseph R; Miller, Elizabeth; Nathan, Michael; MacDonald, Ellie; Ananeh-Firempong, Owusu; Stone, Valerie E

    2006-01-01

    BACKGROUND Physicians increasingly face the challenge of managing clinical encounters with patients from a range of cultural backgrounds. Despite widespread interest in cross-cultural care, little is known about resident physicians' perceptions of what will best enable them to provide quality care to diverse patient populations. OBJECTIVES To assess medicine residents' (1) perceptions of cross-cultural care, (2) barriers to care, and (3) training experiences and recommendations. DESIGN, SETTING, AND PATIENTS Qualitative individual interviews were conducted with 26 third-year medicine residents at Massachusetts General Hospital in Boston (response rate = 87%). Interviews were recorded, transcribed, and analyzed. RESULTS Despite significant interest in cross-cultural care, almost all of the residents reported very little training during residency. Most had gained cross-cultural skills through informal learning. A few were skeptical about formal training, and some expressed concern that it is impossible to understand every culture. Challenges to the delivery of cross-cultural care included managing patients with limited English proficiency, who involve family in critical decision making, and who have beliefs about disease that vary from the biomedical model. Residents cited many implications to these barriers, ranging from negatively impacting the patient-physician relationship to compromised care. Training recommendations included making changes to the educational climate and informal and formal training mechanisms. CONCLUSIONS If cross-cultural education is to be successful, it must take into account residents' perspectives and be focused on overcoming residents' cited barriers. It is important to convey that cross-cultural education is a set of skills that can be taught and applied, in a time-efficient manner, rather than requiring an insurmountable knowledge base. PMID:16704391

  13. Educational interventions to empower nursing home residents: a systematic literature review

    PubMed Central

    Schoberer, Daniela; Leino-Kilpi, Helena; Breimaier, Helga E; Halfens, Ruud JG; Lohrmann, Christa

    2016-01-01

    Purpose of the study Health education is essential to improve health care behavior and self-management. However, educating frail, older nursing home residents about their health is challenging. Focusing on empowerment may be the key to educating nursing home residents effectively. This paper examines educational interventions that can be used to empower nursing home residents. Methods A systematic literature search was performed of the databases PubMed, CINAHL, CENTRAL, PsycINFO, and Embase, screening for clinical trials that dealt with resident education and outcomes in terms of their ability to empower residents. An additional, manual search of the reference lists and searches with SIGLE and Google Scholar were conducted to identify gray literature. Two authors independently appraised the quality of the studies found and assigned levels to the evidence reported. The results of the studies were grouped according to their main empowering outcomes and described narratively. Results Out of 427 identified articles, ten intervention studies that addressed the research question were identified. The main educational interventions used were group education sessions, motivational and encouragement strategies, goal setting with residents, and the development of plans to meet defined goals. Significant effects on self-efficacy and self-care behavior were reported as a result of the interventions, which included group education and individual counseling based on resident needs and preferences. In addition, self-care behavior was observed to significantly increase in response to function-focused care and reasoning exercises. Perceptions and expectations were not improved by using educational interventions with older nursing home residents. Conclusion Individually tailored, interactive, continuously applied, and structured educational strategies, including motivational and encouraging techniques, are promising interventions that can help nursing home residents become more

  14. The Individual Pupil Profile (Including Manual).

    ERIC Educational Resources Information Center

    Potter, Anne; Berman, Steven

    Because of the diversity, range, and combination of disabilities at the Center for Multiple-Handicapped Children, operated under the auspices of the New York City Board of Education, a unique instrument was needed for assessing functional levels, setting goals, and charting progress of handicapped children in special education facilities, regular…

  15. Residents as teachers

    PubMed Central

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

    2013-01-01

    Abstract Objective To examine Canadian family medicine residents’ perspectives surrounding teaching opportunities and mentorship in teaching. Design A 16-question online survey. Setting Canadian family medicine residency programs. Participants Between May and June 2011, all first- and second-year family medicine residents registered in 1 of the 17 Canadian residency programs as of September 2010 were invited to participate. A total of 568 of 2266 residents responded. Main outcome measures Demographic characteristics, teaching opportunities during residency, and resident perceptions about teaching. Results A total of 77.7% of family medicine residents indicated that they were either interested or highly interested in teaching as part of their future careers, and 78.9% of family medicine residents had had opportunities to teach in various settings. However, only 60.1% of respondents were aware of programs within residency intended to support residents as teachers, and 33.0% of residents had been observed during teaching encounters. Conclusion It appears that most Canadian family medicine residents have the opportunity to teach during their residency training. Many are interested in integrating teaching as part of their future career goals. Family medicine residencies should strongly consider programs to support and further develop resident teaching skills. PMID:24029529

  16. Psychiatry Residency Training around the World

    ERIC Educational Resources Information Center

    Zisook, Sidney; Balon, Richard; Bjorksten, Karin S.; Everall, Ian; Dunn, Laura; Ganadjian, Krauz; Jin, Hua; Parikh, Sagar; Sciolla, Andres; Sidhartha, Tanuj; Yoo, Tai

    2007-01-01

    Objective: The authors compare and contrast psychiatry residency training in the United States to that in Canada and selected countries in South America, Europe, and Asia. Method: Nine individuals who are intimately familiar with psychiatry residency training in the United States (primarily chairs, training directors, associate training directors,…

  17. 42 CFR 436.403 - State residence.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... “foster care homes”, licensed as set forth in 45 CFR 1355.20, and providing food, shelter and supportive... Social Security Act, the State of residence is the State where the child lives. (g) Individuals under age... determined in accordance with 45 CFR 233.40, the rules governing residence under the AFDC program. (4)...

  18. 42 CFR 436.403 - State residence.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... “foster care homes”, licensed as set forth in 45 CFR 1355.20, and providing food, shelter and supportive... Social Security Act, the State of residence is the State where the child lives. (g) Individuals under age... determined in accordance with 45 CFR 233.40, the rules governing residence under the AFDC program. (4)...

  19. 42 CFR 436.403 - State residence.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... “foster care homes”, licensed as set forth in 45 CFR 1355.20, and providing food, shelter and supportive... Social Security Act, the State of residence is the State where the child lives. (g) Individuals under age... determined in accordance with 45 CFR 233.40, the rules governing residence under the AFDC program. (4)...

  20. 42 CFR 436.403 - State residence.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... “foster care homes”, licensed as set forth in 45 CFR 1355.20, and providing food, shelter and supportive... Social Security Act, the State of residence is the State where the child lives. (g) Individuals under age... determined in accordance with 45 CFR 233.40, the rules governing residence under the AFDC program. (4)...

  1. 42 CFR 436.403 - State residence.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... “foster care homes”, licensed as set forth in 45 CFR 1355.20, and providing food, shelter and supportive... Social Security Act, the State of residence is the State where the child lives. (g) Individuals under age... determined in accordance with 45 CFR 233.40, the rules governing residence under the AFDC program. (4)...

  2. Residency research requirements and the CanMEDS-FM scholar role

    PubMed Central

    Koo, Jonathan; Bains, Jason; Collins, Marisa B.; Dharamsi, Shafik

    2012-01-01

    Abstract Objective To explore the perspectives of family medicine residents and recent family medicine graduates on the research requirements and other CanMEDS scholar competencies in family practice residency training. Design Semistructured focus groups and individual interviews. Setting Family practice residency program at the University of British Columbia in Vancouver. Participants Convenience sample of 6 second-year family medicine residents and 6 family physicians who had graduated from the University of British Columbia family practice residency program within the previous 5 years. Methods Two focus groups with residents and individual interviews with each of the 6 recently graduated physicians. All interviews were audiotaped, transcribed, and analyzed for thematic content. Main findings Three themes emerged that captured key issues around research requirements in family practice training: 1) relating the scholar role to family practice, 2) realizing that scholarship is more than simply the creation or discovery of new knowledge, and 3) addressing barriers to integrating research into a clinical career. Conclusion Creation of new medical knowledge is just one aspect of the CanMEDS scholar role, and more attention should be paid to the other competencies, including teaching, enhancing professional activities through ongoing learning, critical appraisal of information, and learning how to better contribute to the dissemination, application, and translation of knowledge. Research is valued as important, but opinions still vary as to whether a formal research study should be required in residency. Completion of residency research projects is viewed as somewhat rewarding, but with an equivocal effect on future research intentions. PMID:22859631

  3. Pharmacists teaching in family medicine residency programs

    PubMed Central

    Jorgenson, Derek; Muller, Andries; Whelan, Anne Marie; Buxton, Kelly

    2011-01-01

    Abstract Objective To determine the percentage of family medicine residency programs that have pharmacists directly involved in teaching residents, the types and extent of teaching provided by pharmacists in family medicine residency programs, and the primary source of funding for the pharmacists. Design Web-based survey. Setting One hundred fifty-eight resident training sites within the 17 family medicine residency programs in Canada. Participants One hundred residency program directors who were responsible for overseeing the training sites within the residency programs were contacted to determine the percentage of training sites in which pharmacists were directly involved in teaching. Pharmacists who were identified by the residency directors were invited to participate in the Web-based survey. Main outcome measures The percentage of training sites for family medicine residency that have pharmacists directly involved in teaching residents. The types and the extent of teaching performed by the pharmacists who teach in the residency programs. The primary source of funding that supports the pharmacists’ salaries. Results More than a quarter (25.3%) of family medicine residency training sites include direct involvement of pharmacist teachers. Pharmacist teachers reported that they spend a substantial amount of their time teaching residents using a range of teaching modalities and topics, but have no formal pharmacotherapy curriculums. Nearly a quarter (22.6%) of the pharmacists reported that their salaries were primarily funded by the residency programs. Conclusion Pharmacists have a role in training family medicine residents. This is a good opportunity for family medicine residents to learn about issues related to pharmacotherapy; however, the role of pharmacists as educators might be optimized if standardized teaching methods, curriculums, and evaluation plans were in place. PMID:21918131

  4. Eleven-year outcomes from an integrated residency program to train research psychiatrists.

    PubMed

    Tsai, Alexander C; Ordóñez, Anna E; Reus, Victor I; Mathews, Carol A

    2013-07-01

    In 2000, to address the critical shortage of research psychiatrists, faculty in the Residency Training Program in General Adult Psychiatry at the University of California, San Francisco, School of Medicine developed and implemented a research resident training program (RRTP). In this article, the authors describe the program's development process, including its organizational structure, eligibility criteria for residents, and core program elements, and they report 11 years of outcomes data. Notable RRTP components include research and career mentorship, individualized training plans, the integration of clinical and research experiences, protected research time, and research funding. From 2000 to 2011, the RRTP enrolled 48 residents. The authors' primary outcome of interest in determining the success of the program was whether or not each RRTP resident entered a postdoctoral research fellowship after graduation. The authors found that more than 80% of graduates had matriculated to postdoctoral research fellowships, irrespective of their previous doctoral-level training in the basic or social sciences. The authors conclude that this flexible, individualized, and innovative training program for psychiatry residents was successful in facilitating the entry of participants into primary research careers, reasoning that it may serve as a model for other residency programs with similar goals. More widespread adoption of similar educational models may help to address the critical shortage of research psychiatrists. PMID:23702520

  5. Life After Residency.

    PubMed

    Sorrel, Amy Lynn

    2016-04-01

    Many residents don't receive any formal business training. The University of Texas at Austin Dell Medical School created a crash course to teach residents some of the business and job-hunting basics they'll need.

  6. Intertwining Psychiatry Residency Training and Ethics in the College Setting.

    PubMed

    Sondheimer, Adrian

    2015-10-01

    An ethical responsibility exists, currently unaddressed, for mandated psychiatry residency training with college student populations. Such training brings numerous potential benefits, including exposure to specific disorders and administrative structures. As well, individual cases pose ethical dilemmas unique to this developmental stage, which segues seamlessly from that of adolescence. Relevant case illustrations are employed. Likewise, psychiatric education oversight bodies are urged to fulfill their ethical obligations to provide pertinent training.

  7. Characteristics of Optometric Residencies in the Veterans Administration.

    ERIC Educational Resources Information Center

    Koch, Daniel J.; Newcomb, Robert D.

    1986-01-01

    Results of a study of the characteristics of 10 Veterans Administration optometric residency programs are presented and compared with results of an earlier survey. Factors analyzed include resident characteristics, specializations, program design, residents' salaries and health insurance, and post-residency employment options. (MSE)

  8. Radiation oncology residents' computer workstation.

    PubMed

    Zusag, T W; McDonald, S; Miller, A; Purdy, J A; Rubin, P

    1992-01-01

    We are investigating the feasibility of using the Macintosh computer as a workstation platform for radiation oncology residents because of its ease of use, graphics capability, and low cost. Hypercard was chosen as the programming environment because it easily mixes graphics, text, and control functions in an integrated screen display. Furthermore, it results in a system that can be relatively easily extended and customized by individual users with varying degrees of computer skills. We have developed several software modules in order to test the ability of this environment to support the demands of such a workstation. Modules created thus far include various clinical physics aids and tutorials, treatment planning guides, oncology databases, and others. The software runs on all Macintosh configurations, but calculation speeds are improved when a 68020 or greater processor is used. In general, we have been pleased with the implementation thus far. Graphics display capability is good, but design and entry of graphics have proved labor-intensive. Searching is fast and text is easily entered and manipulated. Finished modules can be customized with minimal computer training, but implementing complex new functions requires familiarity with Hypercard's programming language. New modules, once developed, are easily integrated into the workstation universe, suggesting that cooperative development of the workstation by multiple contributors is realistically achievable. PMID:1727112

  9. Radiation oncology residents' computer workstation.

    PubMed

    Zusag, T W; McDonald, S; Miller, A; Purdy, J A; Rubin, P

    1992-01-01

    We are investigating the feasibility of using the Macintosh computer as a workstation platform for radiation oncology residents because of its ease of use, graphics capability, and low cost. Hypercard was chosen as the programming environment because it easily mixes graphics, text, and control functions in an integrated screen display. Furthermore, it results in a system that can be relatively easily extended and customized by individual users with varying degrees of computer skills. We have developed several software modules in order to test the ability of this environment to support the demands of such a workstation. Modules created thus far include various clinical physics aids and tutorials, treatment planning guides, oncology databases, and others. The software runs on all Macintosh configurations, but calculation speeds are improved when a 68020 or greater processor is used. In general, we have been pleased with the implementation thus far. Graphics display capability is good, but design and entry of graphics have proved labor-intensive. Searching is fast and text is easily entered and manipulated. Finished modules can be customized with minimal computer training, but implementing complex new functions requires familiarity with Hypercard's programming language. New modules, once developed, are easily integrated into the workstation universe, suggesting that cooperative development of the workstation by multiple contributors is realistically achievable.

  10. Depression in nursing home residents.

    PubMed

    Abrams, R C; Teresi, J A; Butin, D N

    1992-05-01

    Although their extent remains unclear, major and minor depressions are widespread in the nursing home population. This statement appears intuitively to be correct when consideration is given to the inactivity, decline in functional competence, loss of personal autonomy, and unavoidable confrontation with the process of death and dying that are associated with nursing home placement. In addition, some nursing home residents have had previous episodes of depression or are admitted to the facility already dysthymic or with other chronic forms of the illness. Such circumstances provide a favorable culture for the development and persistence of depressive illness. When the high frequency of other psychiatric disorders among nursing home residents is factored in, it is not surprising that long-term health care facilities have come to be regarded as de facto psychiatric hospitals. Nursing homes largely lack the treatment resources of psychiatric hospitals, however. Nursing home physicians are often unprepared to make psychiatric diagnoses, and a perfunctory annual psychiatric evaluation is insufficient to manage the complex depression syndromes of nursing home residents. Because nursing home psychiatrists typically work on a consultation basis, recommendations are not necessarily acted upon by the primary physicians. The consequences of undiagnosed and untreated depression are substantial. From the psychiatric perspective, the possibility that depression increases the risk for eventual development of permanent dementia highlights the importance of early identification for cases of reversible dementia. From the rehabilitation point of view, persistent depression among individuals with physical dependency following a catastrophic illness is associated with failure to improve in physical functioning. Depression can probably be linked to increased medical morbidity in nursing home residents, a relationship that also has been suggested for elderly medical inpatients. If so

  11. Overwork Among Residents in India: A Medical Resident's Perspective

    PubMed Central

    Azhar, Gulrez S.; Azhar, Abdullah Z.; Azhar, Ahmad S.

    2012-01-01

    This paper argues that medical residents who do most of the hard work in big hospitals and medical colleges are overworked. A hierarchical organizational structure, staffing patterns, and fear of failure in examinations leads to overwork among residents going unreported. This can lead to poor academic performance and research work. Gaps in communication have serious implications on patient health. Undesirable practices like LAMA (leave against medical advice) also result from overwork. Issues of pay and contracts including mandatory service need to be looked into carefully. National and international recommendations on work hours have consistently been ignored. The solutions suggested are simple and easy to implement. PMID:24479024

  12. 42 CFR 483.114 - Annual review of NF residents.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... residents. (a) Individuals with mental illness. For each resident of a NF who has mental illness, the State mental health authority must determine in accordance with § 483.130 whether, because of the resident's... 65 or older; and (2) Specialized services for mental illness, as defined in § 483.120....

  13. 42 CFR 483.114 - Annual review of NF residents.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... residents. (a) Individuals with mental illness. For each resident of a NF who has mental illness, the State mental health authority must determine in accordance with § 483.130 whether, because of the resident's... 65 or older; and (2) Specialized services for mental illness, as defined in § 483.120....

  14. 42 CFR 483.114 - Annual review of NF residents.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... residents. (a) Individuals with mental illness. For each resident of a NF who has mental illness, the State... 65 or older; and (2) Specialized services for mental illness, as defined in § 483.120. (b... be conducted for each resident of a Medicaid NF who has mental illness or mental retardation not...

  15. 42 CFR 483.114 - Annual review of NF residents.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... residents. (a) Individuals with mental illness. For each resident of a NF who has mental illness, the State... 65 or older; and (2) Specialized services for mental illness, as defined in § 483.120. (b... be conducted for each resident of a Medicaid NF who has mental illness or mental retardation not...

  16. 42 CFR 483.114 - Annual review of NF residents.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... residents. (a) Individuals with mental illness. For each resident of a NF who has mental illness, the State mental health authority must determine in accordance with § 483.130 whether, because of the resident's... 65 or older; and (2) Specialized services for mental illness, as defined in § 483.120....

  17. Perceptions of pediatric chief residents on minority house staff recruitment and retention in large pediatric residency programs.

    PubMed

    Giardino, A P; Cooper, M C

    1999-08-01

    This study examined methods of recruiting and retaining minority house staff at US residency training programs. A 28-item questionnaire was mailed to pediatric chief residents at 78 US training programs with more than 35 residents. The response rate was 74%. Programs were characterized by patient populations served, number of ethnic/racial minority house staff and faculty, and the presence of minority house staff support systems within the institution. In this largely urban sample, minority recruitment and retention was reported as an explicit priority by 40% of pediatric chief residents. The majority (71%) reported that their house staff recruitment committees had no explicitly defined recruitment goals regarding minority house staff. Seventy-seven percent reported that within their departments, recruitment efforts toward minorities were no different than for nonminorities. Overall, few minority house staff and minority faculty were identified in the responding institutions. The most frequently reported intra-institutional support systems for minority house staff included individual pairing with faculty advisors from the same minority group (29%), an affirmative-action office located at the institution (8%), and the existence of a minority faculty support group (4%). These results indicate that pediatric chief residents may not be fully aware of the specific challenges related to the recruitment and retention of minority physicians, and most house staff recruitment committees do not have explicit goals in this regard. PMID:12656435

  18. Receptivity of Community Residents to Tenants of Community Mental Health Residences as Neighbours.

    ERIC Educational Resources Information Center

    Aubry, Tim; And Others

    Using a theoretical model developed from Ajzen's and Fishbein's (1980) theory of reasoned action, researchers investigated the neighboring intentions of community residents toward mentally disabled individuals. A random sample of 345 residents in Winnipeg, Canada, responded to a survey by mail. Questionnaires were randomly assigned one of eight…

  19. Space use and habitat selection of migrant and resident American Avocets in San Francisco Bay

    USGS Publications Warehouse

    Demers, Scott A.; Takekawa, J.Y.; Ackerman, J.T.; Warnock, N.; Athearn, N.D.

    2010-01-01

    San Francisco Bay is a wintering area for shorebirds, including American Avocets (Recurvirostra americana). Recently, a new resident population of avocets has emerged, presumably because of the development of tidal marshes into salt-evaporation ponds. In habitat restoration now underway, as many as 90% of salt ponds will be restored to tidal marsh. However, it is unknown if wintering and resident avocets coexist and if their requirements for space and habitat differ, necessitating different management for their populations to be maintained during restoration. We captured and radio-marked wintering avocets at a salt pond and a tidal flat to determine their population status (migrant or resident) and examine their space use and habitat selection. Of the radio-marked avocets, 79% were migrants and 21% were residents. At the salt pond, residents' fidelity to their location of capture was higher, and residents moved less than did migrants from the same site. Conversely, on the tidal flat, fidelity of residents to their site of capture was lower, and residents' home ranges were larger than those of migrants from the same site. Habitat selection of migrants and residents differed little; however, capture site influenced habitat selection far more than the birds' status as migrants or residents. Our study suggests that individual avocets have high site fidelity while wintering in San Francisco Bay, although the avocet as a species is plastic in its space use and habitat selection. This plasticity may allow wintering migrant and resident avocets to adapt to habitat change in San Francisco Bay. ?? The Cooper Ornithological Society 2010.

  20. Ethics education for dermatology residents.

    PubMed

    Bercovitch, Lionel; Long, Thomas P

    2009-01-01

    The Accreditation Council for Graduate Medical Education and the Royal College of Physicians and Surgeons of Canada both require the teaching and demonstration of general competencies, which include professionalism and ethics as a condition of training program accreditation and specialty certification, respectively. Residents in dermatology and other specialties perceive their training in ethics is inadequate in numerous areas. Residents and specialists in dermatology encounter numerous ethical and professional issues throughout their workday. A dermatoethics curriculum was developed at The Warren Alpert Medical School of Brown University in 2001 to address the need for training in bioethics and professionalism. The subject matter of the curriculum and didactic methods are reviewed. Guidelines for effective teaching of ethics and professionalism to dermatology residents are presented. It is important to make the teaching sessions relevant to the residents' day-to-day work experiences and personal needs. Honesty and openness on the part of faculty and trainees is important. Although informality fosters such exchanges, the sessions should be a learning experience. Resources outside the residency program should be used as necessary. Evaluation of ethics and professionalism in trainees is addressed. PMID:19539170

  1. Encouraging energy conservation in multifamily housing: RUBS and other methods of allocating energy costs to residents

    SciTech Connect

    McClelland, L

    1980-10-01

    Methods of encouraging energy conservation in multifamily housing by allocating energy costs to residents are discussed; specifically, methods appropriate for use in master metered buildings without equipment to monitor energy consumption in individual apartments are examined. Several devices available for monitoring individual energy consumption are also discussed plus methods of comparing the energy savings and cost effectiveness of monitoring devices with those of other means of promoting conservation. Specific information in Volume I includes a comparison study on energy use in master and individually metered buildings; types of appropriate conservation programs for master metered buildings; a description of the Resident Utility Billing System (RUBS); energy savings associated with RUBS; Resident reactions to RUBS; cost effectiveness of RUBS for property owners; potential abuses, factors limiting widespread use, and legal status of RUBS. Part I of Volume II contains a cost allocation decision guide and Part II in Volume II presents the RUBS Operations Manual. Pertinent appendices to some chapters are attached. (MCW)

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

    PubMed

    Serrano, Karen

    2007-08-01

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

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

    PubMed

    Serrano, Karen

    2007-08-01

    The number of women in medicine has increased dramatically in the last few decades, and women now represent half of all incoming medical students. Yet residency training still resembles the historical model when there were few women in medicine. This article reviews the issues facing women in residency today. Data suggest that the experience of female residents is more negative than that of males. Unique challenges facing female residents include the existence of gender bias and sexual harassment, a scarcity of female mentors in leadership positions, and work/family conflicts. Further research is needed to understand the experience of female residents and to identify barriers that hinder their optimal professional and personal development. Structural and cultural changes to residency programs are needed to better accommodate the needs of female trainees. PMID:17874672

  4. PBL in Undergraduate Medical Education: A Qualitative Study of the Views of Canadian Residents

    ERIC Educational Resources Information Center

    Lohfeld, Lynne; Neville, Alan; Norman, Geoffrey

    2005-01-01

    Background and Objectives: At McMaster University, the birthplace of problem-based learning (PBL), administrators and curriculum planners have begun the process of renewing the undergraduate MD curriculum. One step has been to conduct an environmental scan that includes input from medical residents. Methods: Individual interviews with 17 medical…

  5. Residence Hall Furnishings Top 20 List.

    ERIC Educational Resources Information Center

    Tampke, Dale

    1999-01-01

    Provides advice on how to best meet the furniture needs of student residents now and in the future to ensure their privacy and value from the residence hall experience. Twenty tips are highlighted that include considering fire safety, upholstering, lifecycle costs, input from stakeholders, the Americans with Disabilities Act, comfort, lighting,…

  6. Tuition fees for residents: one physician's perspective.

    PubMed

    Cummings, B

    1999-10-01

    Although the education, expertise and guidance of Canada's academic physicians cannot be overlooked, individual universities appear to see tuition fees for residents as an easy source of much needed revenue. If tuition should "rise to market levels," perhaps residents' wages should similarly rise to reflect the amount of training received, skills required, responsibilities discharged and time expended. Unfortunately, tuition fees will be an area of contention for some time. Support of provincial resident associations and medical societies may lend both moral and, possibly, financial support to future members of the profession.

  7. Life After Residency.

    PubMed

    Sorrel, Amy Lynn

    2016-04-01

    Many residents don't receive any formal business training. The University of Texas at Austin Dell Medical School created a crash course to teach residents some of the business and job-hunting basics they'll need. PMID:27049910

  8. Knowledge, attitudes, and practices related to Leptospirosis among urban slum residents in Brazil.

    PubMed

    Navegantes de Araújo, Wildo; Finkmoore, Brooke; Ribeiro, Guilherme S; Reis, Renato B; Felzemburgh, Ridalva D M; Hagan, José E; Reis, Mitermayer G; Ko, Albert I; Costa, Federico

    2013-02-01

    Leptospirosis disproportionately affects residents of urban slums. To understand the knowledge, attitudes, and practices regarding leptospirosis, we conducted a cross-sectional study among residents of an urban slum community in Salvador, Brazil. Of the 257 residents who were interviewed, 225 (90%) were aware of leptospirosis and more than two-thirds of respondents correctly identified the modes of disease transmission and ways to reduce exposure. However, study participants who performed risk activities such as cleaning open sewers had limited access to protective clothing such as boots (33%) or gloves (35%). Almost all respondents performed at least one activity to prevent household rat infestation, which often included use of an illegal poison. Our findings support the need for interventions targeted at the individual and household levels to reduce risk of leptospirosis until large-scale structural interventions are available to residents of urban slum communities.

  9. Knowledge, Attitudes, and Practices Related to Leptospirosis among Urban Slum Residents in Brazil

    PubMed Central

    Navegantes de Araújo, Wildo; Finkmoore, Brooke; Ribeiro, Guilherme S.; Reis, Renato B.; Felzemburgh, Ridalva D. M.; Hagan, José E.; Reis, Mitermayer G.; Ko, Albert I.; Costa, Federico

    2013-01-01

    Leptospirosis disproportionately affects residents of urban slums. To understand the knowledge, attitudes, and practices regarding leptospirosis, we conducted a cross-sectional study among residents of an urban slum community in Salvador, Brazil. Of the 257 residents who were interviewed, 225 (90%) were aware of leptospirosis and more than two-thirds of respondents correctly identified the modes of disease transmission and ways to reduce exposure. However, study participants who performed risk activities such as cleaning open sewers had limited access to protective clothing such as boots (33%) or gloves (35%). Almost all respondents performed at least one activity to prevent household rat infestation, which often included use of an illegal poison. Our findings support the need for interventions targeted at the individual and household levels to reduce risk of leptospirosis until large-scale structural interventions are available to residents of urban slum communities. PMID:23269657

  10. Drug information residency rotation with pharmaceutical industry.

    PubMed

    Cramer, R L

    1986-01-01

    A drug information rotation in pharmaceutical industry may be elected as a component of a hospital pharmacy residency program. Program objectives include improving communication between the pharmaceutical industry and hospital pharmacy/academia, exposing the resident to the challenges the pharmaceutical industry encounters, improving proficiency in drug information practice, and providing insight into the working relationships of various departments within the company. During the rotation, the resident serves as a member of the Drug Information Service. Resident activities include participating in interviews with corporate professionals, updating pharmacokinetic profiles, responding to drug information requests and participating in other information projects. This rotation enables the resident to better understand pharmaceutical industry's concerns and relate these concerns to clinical pharmacy practice. PMID:10277398

  11. The Residency Training Experience in Podiatric Medicine and Surgery.

    PubMed

    Shofler, David; Chuang, Taijung; Argade, Nina

    2015-01-01

    The podiatric medicine and surgery residency is currently characterized by 3 years of comprehensive training. Contemporary issues have recently influenced the direction of training in the profession of podiatric medicine. Formal investigation into the residency training experience has, nonetheless, been limited. The purpose of the present study was to conduct a learning needs assessment of podiatric residency training. An electronic survey was developed, with comparable versions for program directors and residents. The specific topics investigated included the use of minimum activity volume numbers, learning resources, duty hours, strengths and weaknesses of residents, motivation of hosting student externship positions, noncognitive residency traits, meetings between residents and directors, resident satisfaction, and director satisfaction. A total of 197 program directors nationwide were sent the survey electronically, and 109 (53%) responded. Of 230 residents receiving the survey, 159 (78%) responded. Several statistically significant differences, and notable similarities, were observed between the 2 groups encompassing many aspects of the survey. A majority opinion, among both directors and residents, was found that the use of procedural assessment tools might improve resident evaluation. The responding directors and residents agreed that the following 3 topics were weaknesses in podiatric training: practice management, biomechanics, and performing podiatric research. Direct feedback immediately after surgery was the most valuable learning resource reported by the residents. The results of our study reflect the current status of the podiatric medicine and surgery residency and could facilitate improvement in the residency training experience.

  12. Documentation of quality improvement exposure by internal medicine residency applicants

    PubMed Central

    Kolade, Victor O.; Sethi, Anuradha

    2016-01-01

    Background Quality improvement (QI) has become an essential component of medical care in the United States. In residency programs, QI is a focus area of the Clinical Learning Environment Review visits conducted by the Accreditation Council for Graduate Medical Education. The readiness of applicants to internal medicine residency to engage in QI on day one is unknown. Purpose To document the reporting of QI training or experience in residency applications. Methods Electronic Residency Application Service applications to a single internal medicine program were reviewed individually looking for reported QI involvement or actual projects in the curriculum vitae (CVs), personal statements (PSs), and letters of recommendation (LORs). CVs were also reviewed for evidence of education in QI such as completion of Institute for Healthcare Improvement (IHI) modules. Results Of 204 candidates shortlisted for interview, seven had QI items on their CVs, including one basic IHI certificate. Three discussed their QI work in their PSs, and four had recommendation letters describing their involvement in QI. One applicant had both CV and LOR evidence, so that 13 (6%) documented QI engagement. Conclusion Practice of or instruction in QI is rarely mentioned in application documents of prospective internal medicine interns. PMID:26908376

  13. Technology in Residence.

    ERIC Educational Resources Information Center

    Fox, Jordan

    1999-01-01

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

  14. Conducting a successful residency research project.

    PubMed

    Barletta, Jeffrey F

    2008-08-15

    The residency research project can be a challenging endeavor for pharmacy residents since they typically have limited experience in this area. Furthermore, as the number of accredited residency programs has increased, so has the demand for preceptors with research experience. This review is intended to assist the resident and preceptor by providing steps and guidance with conducting a successful residency research project. Items such as idea generation, proposing the right type of project, departmental review, and project management skills are discussed and guidance with writing the research protocol is provided. Items that must be addressed in every research protocol are described and a generalized protocol template is presented. In addition, the institutional review board review process is described and tips and pointers for obtaining approval are included. Finally, useful tools and resources are provided that can be used up front or throughout each phase of the research project.

  15. Surgical residency training and international volunteerism: a national survey of residents from 2 surgical specialties

    PubMed Central

    Matar, Wadih Y.; Trottier, Daniel C.; Balaa, Fady; Fairful-Smith, Robin; Moroz, Paul

    2012-01-01

    Background Many low- and middle-income countries (LMICs) lack basic surgical resources, resulting in avoidable disability and mortality. Recently, residents in surgical training programs have shown increasing interest in overseas elective experiences to assist surgical programs in LMICs. The purpose of this study was to survey Canadian surgical residents about their interest in international volunteerism. Methods We sent a web-based survey to all general and orthopedic surgery residents enrolled in surgical training programs in Canada. The survey assessed residents’ interests, attitudes and motivations, and perceived barriers and aids with respect to international volunteerism. Results In all, 361 residents completed the survey for a response rate of 38.0%. Half of the respondents indicated that the availability of an international surgery elective would have positively influenced their selection of a residency program. Excluding the 18 residents who had volunteered during residency, 63.8% of the remaining residents confirmed an interest in international volunteering with “contributing to an important cause,” “teaching” and “tourism/cultural enhancement” as the leading reasons for their interest. Perceived barriers included “lack of financial support” and “lack of available organized opportunities.” All (100%) respondents who had done an international elective during residency confirmed that they would pursue such work in the future. Conclusion Administrators of Canadian surgical programs should be aware of strong resident interest in global health care and accordingly develop opportunities by encouraging faculty mentorships and resources for global health teaching. PMID:22854155

  16. Residents as Educators: A Modern Model.

    PubMed

    Kensinger, Clark D; McMaster, William G; Vella, Michael A; Sexton, Kevin W; Snyder, Rebecca A; Terhune, Kyla P

    2015-01-01

    Education during surgical residency has changed significantly. As part of the shifting landscape, the importance of an organized and structured curriculum has increased. However, establishing this is often difficult secondary to clinical demands and pressure both on faculty and residents. We present a peer-assisted learning model for academic institutions without professional non-clinical educations. The "resident as educator" (RAE) model empowers residents to be the organizers of the education curriculum. RAE is built on a culture of commitment to education, skill development and team building, allowing the upper level residents to develop and execute the curriculum. Several modules designed to address junior level residents and medical students' educational needs have been implemented, including (1) intern boot camp, (2) summer school, (3) technical skill sessions, (4) trauma orientation, (5) weekly teaching conferences, and (4) a fourth year medical student surgical preparation course. Promoting residents as educators leads to an overall benefit for the program by being cost-effective and time-efficient, while simultaneously promoting professional development of residents and a culture of education. PMID:26143515

  17. Army orthopaedic surgery residency program directors' selection criteria.

    PubMed

    Orr, Justin D; Hoffmann, Jeffrey D; Arrington, Edward D; Gerlinger, Tad L; Devine, John G; Belmont, Philip J

    2015-01-01

    Factors associated with successful selection in U.S. Army orthopaedic surgical programs are unreported. The current analysis includes survey data from all Army orthopaedic surgery residency program directors (PDs) to determine these factors. PDs at all Army orthopaedic surgery residency programs were provided 17 factors historically considered critical to successful selection and asked to rank order the factors as well as assign a level of importance to each. Results were collated and overall mean rankings are provided. PDs unanimously expressed that performance during the on-site orthopaedic surgery rotation at the individual program director's institution was most important. Respondents overwhelmingly reported that Steps 1 and 2 licensing exam scores were next most important, respectively. Survey data demonstrated that little importance was placed on letters of recommendation and personal statements. PDs made no discriminations based on allopathic or osteopathic degrees. The most important factors for Army orthopaedic surgery residency selection were clerkship performance at the individual PD's institution and licensing examination score performance. Army PDs consider both USMLE and COMLEX results, because Army programs have a higher percentage of successful osteopathic applicants.

  18. Army orthopaedic surgery residency program directors' selection criteria.

    PubMed

    Orr, Justin D; Hoffmann, Jeffrey D; Arrington, Edward D; Gerlinger, Tad L; Devine, John G; Belmont, Philip J

    2015-01-01

    Factors associated with successful selection in U.S. Army orthopaedic surgical programs are unreported. The current analysis includes survey data from all Army orthopaedic surgery residency program directors (PDs) to determine these factors. PDs at all Army orthopaedic surgery residency programs were provided 17 factors historically considered critical to successful selection and asked to rank order the factors as well as assign a level of importance to each. Results were collated and overall mean rankings are provided. PDs unanimously expressed that performance during the on-site orthopaedic surgery rotation at the individual program director's institution was most important. Respondents overwhelmingly reported that Steps 1 and 2 licensing exam scores were next most important, respectively. Survey data demonstrated that little importance was placed on letters of recommendation and personal statements. PDs made no discriminations based on allopathic or osteopathic degrees. The most important factors for Army orthopaedic surgery residency selection were clerkship performance at the individual PD's institution and licensing examination score performance. Army PDs consider both USMLE and COMLEX results, because Army programs have a higher percentage of successful osteopathic applicants. PMID:25988694

  19. Assimilating Traditional Healing Into Preventive Medicine Residency Curriculum.

    PubMed

    Kesler, Denece O; Hopkins, L Olivia; Torres, Eliseo; Prasad, Arti

    2015-11-01

    Comprehensive cultural competency includes knowledge and awareness of culturally based healing and wellness practices. Healthcare providers should be aware of the individual patient's beliefs, culture, and use of culturally based health practices because patients may adopt such practices for general wellness or as adjunct therapies without the benefit of discussion with their healthcare provider. This article describes the culturally based traditional healing curriculum that has been implemented in the University of New Mexico Public Health and General Preventive Medicine Residency Program in order to fulfill this knowledge necessity. Curricular elements were added in a stepwise manner starting in 2011, with the full content as described implemented starting in 2013. Data were collected annually with evaluation of the full curriculum occurring in 2015. New Mexico has a diverse population base that includes predominantly Hispanic and Native American cultures, making the inclusion of curriculum regarding traditional healing practices very pertinent. Residents at the University of New Mexico were educated through several curricular components about topics such as Curanderismo, the art of Mexican Folk Healing. An innovative approach was used, with a compendium of training methods that included learning directly from traditional healers and participation in healing practices. The incorporation of this residency curriculum resulted in a means to produce physicians well trained in approaching patient care and population health with knowledge of culturally based health practices in order to facilitate healthy patients and communities. PMID:26477902

  20. Assimilating Traditional Healing Into Preventive Medicine Residency Curriculum.

    PubMed

    Kesler, Denece O; Hopkins, L Olivia; Torres, Eliseo; Prasad, Arti

    2015-11-01

    Comprehensive cultural competency includes knowledge and awareness of culturally based healing and wellness practices. Healthcare providers should be aware of the individual patient's beliefs, culture, and use of culturally based health practices because patients may adopt such practices for general wellness or as adjunct therapies without the benefit of discussion with their healthcare provider. This article describes the culturally based traditional healing curriculum that has been implemented in the University of New Mexico Public Health and General Preventive Medicine Residency Program in order to fulfill this knowledge necessity. Curricular elements were added in a stepwise manner starting in 2011, with the full content as described implemented starting in 2013. Data were collected annually with evaluation of the full curriculum occurring in 2015. New Mexico has a diverse population base that includes predominantly Hispanic and Native American cultures, making the inclusion of curriculum regarding traditional healing practices very pertinent. Residents at the University of New Mexico were educated through several curricular components about topics such as Curanderismo, the art of Mexican Folk Healing. An innovative approach was used, with a compendium of training methods that included learning directly from traditional healers and participation in healing practices. The incorporation of this residency curriculum resulted in a means to produce physicians well trained in approaching patient care and population health with knowledge of culturally based health practices in order to facilitate healthy patients and communities.

  1. Value Dimensions Versus Social Indicators as Predictors of Individual Modernity.

    ERIC Educational Resources Information Center

    Korsching, Peter F.; Burdge, Rabel J.

    This investigation is an empirical attempt to locate variables which best predict individual modernity and to explicate causal relationships. The dimensions chosen for analysis are defined by several relevant models in past research. The independent variables include two personal characteristics (age and sex); five structural variables (residence,…

  2. Resident Transitions to Assisted Living: A Role for Social Workers

    ERIC Educational Resources Information Center

    Fields, Noelle LeCrone; Koenig, Terry; Dabelko-Schoeny, Holly

    2012-01-01

    This study explored key aspects of resident transitions to assisted living (AL), including the frequency and importance of preadmission resident education and the potential role of social workers in this setting. To examine the factors that may help or hinder resident transitions to AL, a written survey was administered to a statewide,…

  3. The Reference Function in a Residence Hall Library.

    ERIC Educational Resources Information Center

    Krupp, Robert Allen

    This two-part paper based on experience at the University of Michigan includes a discussion of the potential reference function of a residence hall library in a university setting and a bibliography of over 100 suggested reference tools for residence hall libraries. The residence hall library is presented as a place where students should be able…

  4. Factors Influencing Residents' Satisfaction in Residential Aged Care

    ERIC Educational Resources Information Center

    Chou, Shu-Chiung; Boldy, Duncan P.; Lee, Andy H.

    2003-01-01

    Purpose: The aim of this study was to identify the important factors influencing residents' satisfaction in residential aged care and to provide a better understanding of their interrelationships. Design and Methods: A cross-sectional survey design was used to collect the required information, including resident satisfaction, resident dependency…

  5. Redesigning journal club in residency.

    PubMed

    Al Achkar, Morhaf

    2016-01-01

    The gap between production and implementation of knowledge is the main reason for the suboptimal quality of health care. To eliminate this gap and improve the quality of patient care, journal club (JC) in graduate medical education provides an opportunity for learning the skills of evidence-based medicine. JC, however, continues to face many challenges mainly due to poorly defined goals, inadequate preparation, and lack of interest. This article presents an innovative model to prepare and present JC based on three pillars: dialogical learning through group discussion, mentored residents as peer teachers, and including JC as part of a structured curriculum to learn evidence-based medicine. This engaging model has the potential to transform JC from a moribund session that is daunting for residents into a lively discussion to redefine clinical practice using the most current evidence. PMID:27313486

  6. Resident Wellness Matters: Optimizing Resident Education and Wellness Through the Learning Environment.

    PubMed

    Jennings, M L; Slavin, Stuart J

    2015-09-01

    The problem of poor mental health in residency is well established. Burnout, depression, and suicidal ideation are prevalent among resident physicians, and these problems appear to persist into practice. Leaders in graduate medical education such as policy makers at the Accreditation Council for Graduate Medical Education (ACGME) and directors of individual programs and institutions should acknowledge these important issues and take steps to address them. The ACGME's Clinical Learning Environment Review (CLER) Program currently outlines an expectation that institutions both educate residents about burnout and measure burnout annually. The CLER Program could go further by expecting institutions to create quality initiatives to enhance resident wellness and increase resident engagement. The ACGME should also call for and support research in this area. Leaders or directors of individual programs and institutions should consider wellness initiatives that both (1) identify and address suboptimal aspects of the learning environment and (2) train residents in resilience skills. Efforts to improve the residency learning environment could be guided by the work of Maslach and Leiter, who describe six categories of work stress that can contribute to burnout: (1) workload, (2) control, (3) balance between effort and reward, (4) community, (5) fairness, and (6) values.

  7. Resident mesenchymal progenitors of articular cartilage

    PubMed Central

    Candela, Maria Elena; Yasuhara, Rika; Iwamoto, Masahiro; Enomoto-Iwamoto, Motomi

    2015-01-01

    Articular cartilage has poor capacity of self-renewal and repair. Insufficient number and activity of resident mesenchymal (connective tissue) progenitors is likely one of the underlying reasons. Chondroprogenitors reside not only in the superficial zone of articular cartilage but also in other zones of articular cartilage and in the neighboring tissues, including perichondrium (groove of Ranvier), synovium and fat pad. These cells may respond to injury and contribute to articular cartilage healing. In addition, marrow stromal cells can migrate through subchondral bone when articular cartilage is damaged. We should develop drugs and methods that correctly stimulate resident progenitors for improvement of repair and inhibition of degenerative changes in articular cartilage. PMID:25179676

  8. Resident mesenchymal progenitors of articular cartilage.

    PubMed

    Candela, Maria Elena; Yasuhara, Rika; Iwamoto, Masahiro; Enomoto-Iwamoto, Motomi

    2014-10-01

    Articular cartilage has poor capacity of self-renewal and repair. Insufficient number and activity of resident mesenchymal (connective tissue) progenitors is likely one of the underlying reasons. Chondroprogenitors reside not only in the superficial zone of articular cartilage but also in other zones of articular cartilage and in the neighboring tissues, including perichondrium (groove of Ranvier), synovium and fat pad. These cells may respond to injury and contribute to articular cartilage healing. In addition, marrow stromal cells can migrate through subchondral bone when articular cartilage is damaged. We should develop drugs and methods that correctly stimulate resident progenitors for improvement of repair and inhibition of degenerative changes in articular cartilage. PMID:25179676

  9. Assessment of Competence: The Accreditation Council for Graduate Medical Education/Residency Review Committee Perspective.

    PubMed

    Potts, John R

    2016-02-01

    Competency is an individual trait. As an agency that accredits programs and institutions, the Accreditation Council for Graduate Medical Education (ACGME) does not define or access competency. However, in the past 15 years the ACGME has promulgated several initiatives to aid programs in the assessment of the competence of their residents and fellows. Those initiatives include the Outcomes Project (which codified the competencies), the Milestones, and the Clinical Learning Environment Review Program. In the near future, the ACGME will implement an initiative by which programs can develop and study the results of competency-based residency curricula.

  10. Emergency medicine residents and statistics: what is the confidence?

    PubMed

    Hack, Jason B; Bakhtiari, Poopak; O'Brien, Kevin

    2009-10-01

    The objective of this study was to assess whether residents have the essential tools and a sense of competency when evaluating published studies, especially the statistics. Questionnaires were mailed to emergency medicine (EM) residency programs in the United States querying residents' demographics and training in statistics as well as their impressions and use of statistics in the current literature; a five-question statistical quiz was also included. Possible responses of-almost always, more than (1/2) time, (1/2) time, less than (1/2) time, almost never-were tallied individually as well as compared in groups of polarized answers: over 1/2 time (almost always + more than (1/2) time) vs. under (1/2) time (less than (1/2) time + almost never). There were 495 questionnaires returned from 42 centers. No significant difference was found when comparing quiz performance with participants' self-reported statistical knowledge. There were considerable differences in the polarized answers (Over vs. Under), whether statistics: were used appropriately (40% vs. 15%, respectively); were used to enhance weak data (54% vs. 13%, respectively); enhanced their understanding of information (38% vs. 24%, respectively); simplified complex data (26% vs. 41%, respectively); were understood by them (23% vs. 38%, respectively); confused them (37% vs. 24%, respectively); were skipped (52% vs. 23%, respectively). Participants felt there should be more statistical training (49% vs. 22%, Over vs. Under, respectively). There was no difference in respondents who did or did not read the statistics (39% vs. 34%, Over vs. Under, respectively). Many EM residents surveyed do not trust, read, or understand statistics presented in current journal articles. Residency programs may want to consider enhanced training in statistics.

  11. Teaching professionalism to residents.

    PubMed

    Klein, Eileen J; Jackson, J Craig; Kratz, Lyn; Marcuse, Edgar K; McPhillips, Heather A; Shugerman, Richard P; Watkins, Sandra; Stapleton, F Bruder

    2003-01-01

    The need to teach professionalism during residency has been affirmed by the Accreditation Council for Graduate Medical Education, which will require documentation of education and evaluation of professionalism by 2007. Recently the American Academy of Pediatrics has proposed the following components of professionalism be taught and measured: honesty/integrity, reliability/responsibility, respect for others, compassion/empathy, self-improvement, self-awareness/knowledge of limits, communication/collaboration, and altruism/advocacy. The authors describe a curriculum for introducing the above principles of professionalism into a pediatrics residency that could serve as a model for other programs. The curriculum is taught at an annual five-day retreat for interns, with 11 mandatory sessions devoted to addressing key professionalism issues. The authors also explain how the retreat is evaluated and how the retreat's topics are revisited during the residency, and discuss general issues of teaching and evaluating professionalism.

  12. Residence Conditions on Community Treatment Orders

    PubMed Central

    Dawson, John; O’Reilly, Richard

    2015-01-01

    Objective: To identify the clinical reasons and legal authority for including a residential placement condition in a community treatment order (CTO). Method: We describe the clinical reasons for imposing a residence condition and discuss how this is authorized by the laws of the Canadian provinces (using Ontario as the main example). Results: A residence condition can facilitate numerous benefits, including: regular access to a person by a clinical team; continuing therapeutic relations; supervision of medication; provision of general medical care; and reduction in substance use, risks of victimization, and other unintended harm. A resident condition can be lawfully imposed when it clearly fits the purposes of the CTO legislation and stops short of authorizing detention in a community facility. Conclusions: In certain circumstances, a residence condition is clinically justified and a lawful aspect of a CTO. PMID:26720510

  13. An Assigned Teaching Resident Rotation

    ERIC Educational Resources Information Center

    Daniels-Brady, Catherine; Rieder, Ronald

    2010-01-01

    Objective: The authors' adult psychiatry residency training program identified several educational needs for residents at their institution. Junior residents needed enhanced learning of clinical interviewing skills and learning connected to the inpatient psychiatry ward rotations, and senior residents needed opportunities to prepare for the…

  14. Intellectuality and emotionality in psychiatric residents.

    PubMed

    Paris, J

    1981-04-01

    The fully trained psychiatrist must be able to integrate vast amounts of phenomenological data as well as to empathically share feeling states in patients. Beginning psychiatric residents often lean either towards intellectuality or towards emotionality, tendencies which potentially reinforce splitting within the profession. Cognitive styles may correlate with neurophysiological indicators, such as hemispheric dominance and the augmenting-reducing dimension. There may also be sex differences in cognition; if so, they would have to be taken into account as more women enter psychiatric training. A theoretical understanding of individual differences in students provides a basis for the pedagogical correction of biases. Overly intellectual residents may be organically or psychodynamically oriented. In either case they favour theory over concrete experience, and there are difficulties in mobilizing their empathic capacities. Identification with empathic teachers and a focus in supervision on the perception and integration of more stimuli, especially nonverbal cues, are important correctives. Overly emotional residents identify excessively with their patients and tend to have problems with boundaries. An augmenting tendency, leading to stimulus overload, can be controlled by teaching residents how to structure and set limits. Identification with the supervisor is sided by clear boundaries in the supervisory relationship. In both cases the resident's strengths must not be denigrated while correcting his weaknesses. Examples of learning problems in both kinds of residents are given, with discussion of supervisory pitfalls.

  15. Induction process of trainees in pathology residency

    PubMed Central

    Siddiqui, Imran; Ali, Natasha

    2016-01-01

    This article describes the evolution of the induction process of pathology residency at The Aga Khan University hospital. The Department of Postgraduate Medical Education was established in 1985. The induction process is an exhaustive exercise that includes an admission test held simultaneously in Karachi, Hyderabad, Lahore, and Rawalpindi, followed by an interview of the shortlisted candidates. The pathology residency program was started 25 years ago and since then the induction process has undergone major changes with the course of time. PMID:27313487

  16. Listening to Include

    ERIC Educational Resources Information Center

    Veck, Wayne

    2009-01-01

    This paper attempts to make important connections between listening and inclusive education and the refusal to listen and exclusion. Two lines of argument are advanced. First, if educators and learners are to include each other within their educational institutions as unique individuals, then they will need to listen attentively to each other.…

  17. Mind the Gap: Promoting Careers in Academic Research to Psychiatry Residents

    PubMed Central

    Posporelis, Sotirios; Sawa, Akira; Smith, Gwenn S.; Stitzer, Maxine L.; Lyketsos, Constantine G.; Chisolm, Margaret S.

    2014-01-01

    Objective With the shift of interest in psychiatry towards patient-oriented research with clinically relevant outcomes, there is a critical need for well-trained psychiatrist-scientists. The authors report on two developmentally-tailored, longitudinal research training curricula designed to use peer mentoring to bridge the gap between physicians and scientists, and to promote careers in academic research. Methods The authors instituted two independent research training curricula, one for first-year and one for second-to-fourth year psychiatry residents, spanning two campuses of one institutional residency training program. Each curriculum’s participants included psychiatry residents and peer scientific investigators, and both were attended by senior scientists and departmental leaders. The authors developed and administered an anonymous survey at the end of the first cycle of the first-year resident curriculum to assess participant attitudes. Results The first-year and second-to-fourth-year resident curricula have been implemented for 3and 2 years respectively. The authors observed overall participant satisfaction with the first-year curricula, independent of trainee status. Furthermore, first-year psychiatry residents reported increased interest in academic research careers after exposure to the curricula. Conclusions Results suggest it is possible to encourage academic research careers using peer mentoring, an innovative approach that requires minimal funding, little disruption to the residents’ schedule, and engages the gamut of individuals involved in psychiatry care and research: psychiatrists-in-training and young non-clinician scientists-in-training. PMID:24497181

  18. Vitamin D insufficiency in internal medicine residents.

    PubMed

    Haney, E M; Stadler, D; Bliziotes, M M

    2005-01-01

    Medical residents may be vulnerable to low vitamin D status because of long work hours and lack of sun exposure. We conducted a prospective cohort study to measure serum 25-hydroxyvitamin D concentrations among internal medicine residents, document seasonal variation in vitamin D status, and assess risk factors for inadequate vitamin D stores. Dietary intake of calcium and vitamin D, lifestyle characteristics, and serum concentrations of 25(OH)-vitamin D and intact parathyroid hormone (iPTH) were measured in 35 resident volunteers before and after the winter season. A total of 63-69% of medical residents consumed <400 IU/day of vitamin D; 61-67% consumed <1000 mg/day of calcium. Twenty-five (74%) had lower serum 25(OH)-vitamin D concentrations and 23 (68%) had higher serum iPTH in the spring than in the fall. Nine (26%) residents had serum concentrations of 25(OH)-vitamin D of <20 ng/mL in the fall; and sixteen (47%) in the spring. Seven residents (20%) had serum concentrations of 25(OH)-vitamin D of <20 ng/mL at both time-periods; Eighteen residents (51.4%) had 25(OH)-vitamin D levels of <20 ng/mL for at least one of the time-periods. Medical residents are at risk for hypovitaminosis D, particularly during the winter months and should be aware of the need to supplement their vitamin D stores. Insufficient vitamin D status and inadequate vitamin D intake may have long-term implications for bone health in these individuals. Increased educational efforts to promote healthy dietary and lifestyle choices that allow attainment and maintenance of skeletal health are appropriate in this population. PMID:15478001

  19. The Fukushima Health Management Survey: estimation of external doses to residents in Fukushima Prefecture.

    PubMed

    Ishikawa, Tetsuo; Yasumura, Seiji; Ozasa, Kotaro; Kobashi, Gen; Yasuda, Hiroshi; Miyazaki, Makoto; Akahane, Keiichi; Yonai, Shunsuke; Ohtsuru, Akira; Sakai, Akira; Sakata, Ritsu; Kamiya, Kenji; Abe, Masafumi

    2015-08-04

    The Fukushima Health Management Survey (including the Basic Survey for external dose estimation and four detailed surveys) was launched after the Fukushima Dai-ichi Nuclear Power Plant accident. The Basic Survey consists of a questionnaire that asks Fukushima Prefecture residents about their behavior in the first four months after the accident; and responses to the questionnaire have been returned from many residents. The individual external doses are estimated by using digitized behavior data and a computer program that included daily gamma ray dose rate maps drawn after the accident. The individual external doses of 421,394 residents for the first four months (excluding radiation workers) had a distribution as follows: 62.0%, <1 mSv; 94.0%, <2 mSv; 99.4%, <3 mSv. The arithmetic mean and maximum for the individual external doses were 0.8 and 25 mSv, respectively. While most dose estimation studies were based on typical scenarios of evacuation and time spent inside/outside, the Basic Survey estimated doses considering individually different personal behaviors. Thus, doses for some individuals who did not follow typical scenarios could be revealed. Even considering such extreme cases, the estimated external doses were generally low and no discernible increased incidence of radiation-related health effects is expected.

  20. The Fukushima Health Management Survey: estimation of external doses to residents in Fukushima Prefecture

    NASA Astrophysics Data System (ADS)

    Ishikawa, Tetsuo; Yasumura, Seiji; Ozasa, Kotaro; Kobashi, Gen; Yasuda, Hiroshi; Miyazaki, Makoto; Akahane, Keiichi; Yonai, Shunsuke; Ohtsuru, Akira; Sakai, Akira; Sakata, Ritsu; Kamiya, Kenji; Abe, Masafumi

    2015-08-01

    The Fukushima Health Management Survey (including the Basic Survey for external dose estimation and four detailed surveys) was launched after the Fukushima Dai-ichi Nuclear Power Plant accident. The Basic Survey consists of a questionnaire that asks Fukushima Prefecture residents about their behavior in the first four months after the accident; and responses to the questionnaire have been returned from many residents. The individual external doses are estimated by using digitized behavior data and a computer program that included daily gamma ray dose rate maps drawn after the accident. The individual external doses of 421,394 residents for the first four months (excluding radiation workers) had a distribution as follows: 62.0%, <1 mSv 94.0%, <2 mSv 99.4%, <3 mSv. The arithmetic mean and maximum for the individual external doses were 0.8 and 25 mSv, respectively. While most dose estimation studies were based on typical scenarios of evacuation and time spent inside/outside, the Basic Survey estimated doses considering individually different personal behaviors. Thus, doses for some individuals who did not follow typical scenarios could be revealed. Even considering such extreme cases, the estimated external doses were generally low and no discernible increased incidence of radiation-related health effects is expected.

  1. The Fukushima Health Management Survey: estimation of external doses to residents in Fukushima Prefecture.

    PubMed

    Ishikawa, Tetsuo; Yasumura, Seiji; Ozasa, Kotaro; Kobashi, Gen; Yasuda, Hiroshi; Miyazaki, Makoto; Akahane, Keiichi; Yonai, Shunsuke; Ohtsuru, Akira; Sakai, Akira; Sakata, Ritsu; Kamiya, Kenji; Abe, Masafumi

    2015-01-01

    The Fukushima Health Management Survey (including the Basic Survey for external dose estimation and four detailed surveys) was launched after the Fukushima Dai-ichi Nuclear Power Plant accident. The Basic Survey consists of a questionnaire that asks Fukushima Prefecture residents about their behavior in the first four months after the accident; and responses to the questionnaire have been returned from many residents. The individual external doses are estimated by using digitized behavior data and a computer program that included daily gamma ray dose rate maps drawn after the accident. The individual external doses of 421,394 residents for the first four months (excluding radiation workers) had a distribution as follows: 62.0%, <1 mSv; 94.0%, <2 mSv; 99.4%, <3 mSv. The arithmetic mean and maximum for the individual external doses were 0.8 and 25 mSv, respectively. While most dose estimation studies were based on typical scenarios of evacuation and time spent inside/outside, the Basic Survey estimated doses considering individually different personal behaviors. Thus, doses for some individuals who did not follow typical scenarios could be revealed. Even considering such extreme cases, the estimated external doses were generally low and no discernible increased incidence of radiation-related health effects is expected. PMID:26239643

  2. An Evidence-Based Medicine Curriculum Improves General Surgery Residents' Standardized Test Scores in Research and Statistics

    PubMed Central

    Trickey, Amber W.; Crosby, Moira E.; Singh, Monika; Dort, Jonathan M.

    2014-01-01

    Background The application of evidence-based medicine to patient care requires unique skills of the physician. Advancing residents' abilities to accurately evaluate the quality of evidence is built on understanding of fundamental research concepts. The American Board of Surgery In-Training Examination (ABSITE) provides a relevant measure of surgical residents' knowledge of research design and statistics. Objective We implemented a research education curriculum in an independent academic medical center general residency program, and assessed the effect on ABSITE scores. Methods The curriculum consisted of five 1-hour monthly research and statistics lectures. The lectures were presented before the 2012 and 2013 examinations. Forty residents completing ABSITE examinations from 2007 to 2013 were included in the study. Two investigators independently identified research-related item topics from examination summary reports. Correct and incorrect responses were compared precurriculum and postcurriculum. Regression models were calculated to estimate improvement in postcurriculum scores, adjusted for individuals' scores over time and postgraduate year level. Results Residents demonstrated significant improvement in postcurriculum examination scores for research and statistics items. Correct responses increased 27% (P < .001). Residents were 5 times more likely to achieve a perfect score on research and statistics items postcurriculum (P < .001). Conclusions Residents at all levels demonstrated improved research and statistics scores after receiving the curriculum. Because the ABSITE includes a wide spectrum of research topics, sustained improvements suggest a genuine level of understanding that will promote lifelong evaluation and clinical application of the surgical literature. PMID:26140115

  3. The Residence Life Cinema.

    ERIC Educational Resources Information Center

    Dungan, Jane Fidler; Elion, Audrey; Gusmano, Phil

    1997-01-01

    Explores the implementation, results, and the limitations of the Residence Life Cinema program at the University of Memphis. Claims that such programs offer an innovative method for fostering student development by utilizing movies to stimulate affective and cognitive processes in students--processes that may not occur without a catalyst. (RJM)

  4. Selection of Anesthesiology Residents.

    ERIC Educational Resources Information Center

    Baker, J. David, III; And Others

    1993-01-01

    Selection data for all Medical University of South Carolina anesthesiology residency applicants (about 200 per year) and the 8 selected per year were compared for 4 years. Results showed standardized test scores, grades, and class ranks of those selected were not higher than of others, but interview and recommendation scores were higher.…

  5. Financial debt of orthopedic residents.

    PubMed

    Hwang, John S; Beebe, Kathleen S; Benevenia, Joseph; Karanfilian, Briette; Berberian, Wayne S

    2012-04-01

    Many orthopedic residents accrue considerable debt by residency graduation. These debts for graduating medical students continue to increase due to the yearly increase of medical school tuition. The purpose of this study was to examine the causes of financial debt, as well the effects of debt on orthopedic residents.Orthopedic residents from postgraduate years 1 to 5 (N=27) completed an anonymous, optional financial survey. The survey asked questions regarding the characteristics of the residents' debt and their concern caused by their debt. All residents from our institute (N=27) voluntarily participated in the survey. The residents consisted of 4 (15%) women and 23 (85%) men, with 14 (56%) single residents and 12 (44%) married residents. No statistically significant difference existed in total debt >$100,000 between single and married residents or men and women. Forty-eight percent (n=13) of the residents had medical educational debt >$100,000, whereas 45% (n=12) had total debt >$200,000. Residents with total debt >$100,000 were concerned about their debt, whereas 1 of 4 residents with <$100,000 of total debt reported concern (P<.001).Debts affect orthopedic residents financially and may cause stress and hinder their medical training. Appropriate measures should be taken to help residents properly manage their debt and to provide supplemental assistance with their financial struggles. PMID:22495858

  6. Financial debt of orthopedic residents.

    PubMed

    Hwang, John S; Beebe, Kathleen S; Benevenia, Joseph; Karanfilian, Briette; Berberian, Wayne S

    2012-04-01

    Many orthopedic residents accrue considerable debt by residency graduation. These debts for graduating medical students continue to increase due to the yearly increase of medical school tuition. The purpose of this study was to examine the causes of financial debt, as well the effects of debt on orthopedic residents.Orthopedic residents from postgraduate years 1 to 5 (N=27) completed an anonymous, optional financial survey. The survey asked questions regarding the characteristics of the residents' debt and their concern caused by their debt. All residents from our institute (N=27) voluntarily participated in the survey. The residents consisted of 4 (15%) women and 23 (85%) men, with 14 (56%) single residents and 12 (44%) married residents. No statistically significant difference existed in total debt >$100,000 between single and married residents or men and women. Forty-eight percent (n=13) of the residents had medical educational debt >$100,000, whereas 45% (n=12) had total debt >$200,000. Residents with total debt >$100,000 were concerned about their debt, whereas 1 of 4 residents with <$100,000 of total debt reported concern (P<.001).Debts affect orthopedic residents financially and may cause stress and hinder their medical training. Appropriate measures should be taken to help residents properly manage their debt and to provide supplemental assistance with their financial struggles.

  7. Perceived resident-facility fit and sense of control in assisted living.

    PubMed

    Pirhonen, Jari; Pietilä, Ilkka

    2016-08-01

    The concept of resident-facility fit has largely been used to illustrate whether a residential care facility and a resident are together able to meet requirements set by only the hampering functional abilities of the latter. The purpose of this paper is to study how assisted living residents perceive resident-facility fit. The data were gathered ethnographically from both observations and resident interviews in a sheltered home in Finland during 2013-2014. Perceived resident-facility fit is based on several relational factors that connect to both the residents as individuals and their surroundings. This fit seems also to be partly conditional and indeed depends on residents' trust in having their own potential to act. Good resident-facility fit results in feeling at home in a facility, whereas poor fit can even result in residents' feeling imprisoned. Care providers can thus utilize our results to affirm residents' quality of life in residential facilities. PMID:27531452

  8. Internet Training to Respond to Aggressive Resident Behaviors

    ERIC Educational Resources Information Center

    Irvine, A. Blair; Billow, Molly B.; Gates, Donna M.; Fitzwater, Evelyn L.; Seeley, John R.; Bourgeois, Michelle

    2012-01-01

    Purpose: This research evaluated an individualized Internet training designed to teach nurse aides (NAs) strategies to prevent or, if necessary, react to resident aggression in ways that are safe for the resident as well as the caregiver. Design and Methods: A randomized treatment and control design was implemented, with baseline, 1-, and 2-month…

  9. 42 CFR 483.356 - Protection of residents.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... (CONTINUED) STANDARDS AND CERTIFICATION REQUIREMENTS FOR STATES AND LONG TERM CARE FACILITIES Condition of... Inpatient Psychiatric Services for Individuals Under Age 21 § 483.356 Protection of residents. (a) Restraint... behavior, and the resident's chronological and developmental age; size; gender; physical, medical,...

  10. 26 CFR 301.7701(b)-1 - Resident alien.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... 26 Internal Revenue 18 2013-04-01 2013-04-01 false Resident alien. 301.7701(b)-1 Section 301.7701... ADMINISTRATION PROCEDURE AND ADMINISTRATION Definitions § 301.7701(b)-1 Resident alien. (a) Scope. Section 301.7701(b)-1(b) provides rules for determining whether an alien individual is a lawful permanent...

  11. 26 CFR 301.7701(b)-1 - Resident alien.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 26 Internal Revenue 18 2011-04-01 2011-04-01 false Resident alien. 301.7701(b)-1 Section 301.7701... ADMINISTRATION PROCEDURE AND ADMINISTRATION Definitions § 301.7701(b)-1 Resident alien. (a) Scope. Section 301.7701(b)-1(b) provides rules for determining whether an alien individual is a lawful permanent...

  12. 26 CFR 301.7701(b)-1 - Resident alien.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... 26 Internal Revenue 18 2012-04-01 2012-04-01 false Resident alien. 301.7701(b)-1 Section 301.7701... ADMINISTRATION PROCEDURE AND ADMINISTRATION Definitions § 301.7701(b)-1 Resident alien. (a) Scope. Section 301.7701(b)-1(b) provides rules for determining whether an alien individual is a lawful permanent...

  13. 26 CFR 301.7701(b)-1 - Resident alien.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... 26 Internal Revenue 18 2014-04-01 2014-04-01 false Resident alien. 301.7701(b)-1 Section 301.7701... ADMINISTRATION PROCEDURE AND ADMINISTRATION Definitions § 301.7701(b)-1 Resident alien. (a) Scope. Section 301.7701(b)-1(b) provides rules for determining whether an alien individual is a lawful permanent...

  14. The influence of aquariums on weight in individuals with dementia.

    PubMed

    Edwards, Nancy E; Beck, Alan M

    2013-01-01

    This study assessed whether individuals with dementia who observe aquariums increase the amount of food they consume and maintain body weight. The sample included 70 residents in dementia units within 3 extended care facilities in 2 states. The intervention included the introduction of an aquarium into each common dining area. A total increase of 196.9 g of daily food intake (25.0%) was noted from baseline to the end of the 10-week study. Resident body weight increased an average of 2.2 pounds during the study. Eight of 70 residents experienced a weight loss ((Equation is included in full-text article.)=1.89 lbs). People with advanced dementia responded to aquariums in their environment documenting that attraction to the natural environment is so innate that it survives dementia. PMID:23138175

  15. Global Health Simulation During Residency

    PubMed Central

    Rosenman, Jane R.; Fischer, Philip R.; Arteaga, Grace M.; Hulyalkar, Manasi; Butteris, Sabrina M.; Pitt, Michael B.

    2016-01-01

    Resident participation in international health electives (IHEs) has been shown to be beneficial, yet not all residents have the opportunity to participate. We sought to determine whether participating in simulated global health cases, via the standardized Simulation Use for Global Away Rotations (SUGAR) curriculum, was useful for all pediatric residents, not merely those planning to go on an IHE. Pediatric residents in our program took part in 2 SUGAR cases and provided feedback via an online survey. Thirty-six of 40 residents participated (90%); 72% responded to the survey. Three of 10 residents not previously planning to work in resource-limited settings indicated participation in SUGAR made them more likely to do so. Nearly all residents (88%) felt SUGAR should be part of the residency curriculum. All felt better prepared for working cross-culturally. While designed to prepare trainees for work in resource-limited settings, SUGAR may be beneficial for all residents. PMID:27583300

  16. Global Health Simulation During Residency.

    PubMed

    Rosenman, Jane R; Fischer, Philip R; Arteaga, Grace M; Hulyalkar, Manasi; Butteris, Sabrina M; Pitt, Michael B

    2016-01-01

    Resident participation in international health electives (IHEs) has been shown to be beneficial, yet not all residents have the opportunity to participate. We sought to determine whether participating in simulated global health cases, via the standardized Simulation Use for Global Away Rotations (SUGAR) curriculum, was useful for all pediatric residents, not merely those planning to go on an IHE. Pediatric residents in our program took part in 2 SUGAR cases and provided feedback via an online survey. Thirty-six of 40 residents participated (90%); 72% responded to the survey. Three of 10 residents not previously planning to work in resource-limited settings indicated participation in SUGAR made them more likely to do so. Nearly all residents (88%) felt SUGAR should be part of the residency curriculum. All felt better prepared for working cross-culturally. While designed to prepare trainees for work in resource-limited settings, SUGAR may be beneficial for all residents. PMID:27583300

  17. Quality of Life of Nursing Home Residents with Dementia: A Comparison of Perspectives of Residents, Family, and Staff

    ERIC Educational Resources Information Center

    Crespo, Maria; Bernaldo de Quiros, Monica; Gomez, M. Mar; Hornillos, Carlos

    2012-01-01

    Purpose: Quality of Life (QoL) has become increasingly valued as a key outcome in dementia both in clinical practice and in research. This study compares the QoL of long-term residents with dementia as assessed by the individuals, their relatives, and their care staff. Design and Methods: Data on residents with dementia were collected in 11…

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

    PubMed

    Smalley, Hannah K; Keskinocak, Pinar

    2016-03-01

    At academic teaching hospitals around the country, the majority of clinical care is provided by resident physicians. During their training, medical residents often rotate through various hospitals and/or medical services to maximize their education. Depending on the size of the training program, manually constructing such a rotation schedule can be cumbersome and time consuming. Further, rules governing allowable duty hours for residents have grown more restrictive in recent years (ACGME 2011), making day-to-day shift scheduling of residents more difficult (Connors et al., J Thorac Cardiovasc Surg 137:710-713, 2009; McCoy et al., May Clin Proc 86(3):192, 2011; Willis et al., J Surg Edu 66(4):216-221, 2009). These rules limit lengths of duty periods, allowable duty hours in a week, and rest periods, to name a few. In this paper, we present two integer programming models (IPs) with the goals of (1) creating feasible assignments of residents to rotations over a one-year period, and (2) constructing night and weekend call-shift schedules for the individual rotations. These models capture various duty-hour rules and constraints, provide the ability to test multiple what-if scenarios, and largely automate the process of schedule generation, solving these scheduling problems more effectively and efficiently compared to manual methods. Applying our models on data from a surgical residency program, we highlight the infeasibilities created by increased duty-hour restrictions placed on residents in conjunction with current scheduling paradigms. PMID:25171938

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

    PubMed

    Smalley, Hannah K; Keskinocak, Pinar

    2016-03-01

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

  20. Residents values in a rational decision-making model: an interest in academics in emergency medicine.

    PubMed

    Burkhardt, John Christian; Smith-Coggins, Rebecca; Santen, Sally

    2016-10-01

    Academic physicians train the next generation of doctors. It is important to understand the factors that lead residents to choose an academic career to continue to effectively recruit residents who will join the national medical faculty. A decision-making theory-driven, large scale assessment of this process has not been previously undertaken. To examine the factors that predict an Emergency resident's interest in pursuing an academic career at the conclusion of training. This study employs the ABEM Longitudinal Survey (n = 365). A logistic regression model was estimated using an interest in an academic career in residency as the dependent variable. Independent variables include gender, under-represented minority status, survey cohort, number of dependent children, possession of an advanced degree, ongoing research, publications, and the appeal of science, independence, and clinical work in choosing EM. Logistic regression resulted in a statistically significant model (p < 0.001). Residents who chose EM due to the appeal of science, had peer-reviewed publications and ongoing research were more likely to be interested in an academic career at the end of residency (p < 0.05). An increased number of children (p < 0.05) was negatively associated with an interest in academics. Individual resident career interests, research productivity, and lifestyle can help predict an interest in pursuing an academic career. Recruitment and enrichment of residents who have similar values and behaviors should be considered in programs interested in generating more graduates who enter an academic career.

  1. Residents values in a rational decision-making model: an interest in academics in emergency medicine.

    PubMed

    Burkhardt, John Christian; Smith-Coggins, Rebecca; Santen, Sally

    2016-10-01

    Academic physicians train the next generation of doctors. It is important to understand the factors that lead residents to choose an academic career to continue to effectively recruit residents who will join the national medical faculty. A decision-making theory-driven, large scale assessment of this process has not been previously undertaken. To examine the factors that predict an Emergency resident's interest in pursuing an academic career at the conclusion of training. This study employs the ABEM Longitudinal Survey (n = 365). A logistic regression model was estimated using an interest in an academic career in residency as the dependent variable. Independent variables include gender, under-represented minority status, survey cohort, number of dependent children, possession of an advanced degree, ongoing research, publications, and the appeal of science, independence, and clinical work in choosing EM. Logistic regression resulted in a statistically significant model (p < 0.001). Residents who chose EM due to the appeal of science, had peer-reviewed publications and ongoing research were more likely to be interested in an academic career at the end of residency (p < 0.05). An increased number of children (p < 0.05) was negatively associated with an interest in academics. Individual resident career interests, research productivity, and lifestyle can help predict an interest in pursuing an academic career. Recruitment and enrichment of residents who have similar values and behaviors should be considered in programs interested in generating more graduates who enter an academic career. PMID:26885848

  2. Individualizing Medicare.

    PubMed

    Chollet, D J

    1999-05-01

    Despite the enactment of significant changes to the Medicare program in 1997, Medicare's Hospital Insurance trust fund is projected to be exhausted just as the baby boom enters retirement. To address Medicare's financial difficulties, a number of reform proposals have been offered, including several to individualize Medicare financing and benefits. These proposals would attempt to increase Medicare revenues and reduce Medicare expenditures by having individuals bear risk--investment market risk before retirement and insurance market risk after retirement. Many fundamental aspects of these proposals have yet to be worked out, including how to guarantee a baseline level of saving for health insurance after retirement, how retirees might finance unanticipated health insurance price increases after retirement, the potential implications for Medicaid of inadequate individual saving, and whether the administrative cost of making the system fair and adequate ultimately would eliminate any rate-of-return advantages from allowing workers to invest their Medicare contributions in corporate stocks and bonds.

  3. Individualizing Medicare.

    PubMed

    Chollet, D J

    1999-05-01

    Despite the enactment of significant changes to the Medicare program in 1997, Medicare's Hospital Insurance trust fund is projected to be exhausted just as the baby boom enters retirement. To address Medicare's financial difficulties, a number of reform proposals have been offered, including several to individualize Medicare financing and benefits. These proposals would attempt to increase Medicare revenues and reduce Medicare expenditures by having individuals bear risk--investment market risk before retirement and insurance market risk after retirement. Many fundamental aspects of these proposals have yet to be worked out, including how to guarantee a baseline level of saving for health insurance after retirement, how retirees might finance unanticipated health insurance price increases after retirement, the potential implications for Medicaid of inadequate individual saving, and whether the administrative cost of making the system fair and adequate ultimately would eliminate any rate-of-return advantages from allowing workers to invest their Medicare contributions in corporate stocks and bonds. PMID:10915458

  4. A survey of resident perspectives on surgical case minimums and the impact on milestones, graduation, credentialing, and preparation for practice: AOA critical issues.

    PubMed

    Jeray, Kyle J; Frick, Steven L

    2014-12-01

    Residency education continues to evolve. Several major changes have occurred in the past several years, including emphasis on core competencies, duty-hour restrictions, and call. The Accreditation Council for Graduate Medical Education (ACGME) Next Accreditation System (NAS) implemented educational milestones in orthopaedic surgery in July 2013. Additionally, the Residency Review Committee for orthopaedic surgery published suggested surgical case minimums in 2012, which overlap with several of the milestones.We conducted a survey to assess the opinions of orthopaedic residents regarding the ACGME-suggested surgical case minimums and the effects that these may have on resident education and potential future privileges in hospitals. The survey was sent via e-mail to all of the residents participating in the American Orthopaedic Association (AOA) Resident Leadership Forum for both 2011 and 2012. Participants in the Resident Leadership Forum are in either postgraduate year 4 or postgraduate year 5, are selected by the program directors as resident leaders, and represent 80% of the orthopaedic residency programs in the United States. The survey was completed by 157 of the 314 participants. Sixty-nine percent of the participants believed that case logs with minimum numbers of surgical procedures were an effective way to monitor the work but were not necessarily the only way to monitor the educational progress of the residents. Thirty-two percent believed that the minimums should not be required. Overwhelmingly, there was agreement that important cases were missing from the currently proposed sixteen core surgical minimums. Specifically, the residents believed that a minimum number of cases are necessary for distal radial fracture fixation and proximal humeral fracture fixation and possibly have a milestone to reflect the progress of the residents for each fixation.Most residents thought that surgical case minimums are an effective tool in monitoring the progress of

  5. [Individualizing Education.

    ERIC Educational Resources Information Center

    Horrigan, William J.

    The individually guided education (IGE) program developed by the Kettering Foundation was implemented in September of 1973 at the John F. Kennedy Memorial Junior High School in Woburn, Massachusetts. The components of the program described in this speech include pupil and teacher scheduling, physical layout, pupil selection and adjustment,…

  6. 38 CFR 51.90 - Resident behavior and facility practices.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... AFFAIRS (CONTINUED) PER DIEM FOR NURSING HOME CARE OF VETERANS IN STATE HOMES Standards § 51.90 Resident..., and sexual assault. (4) Neglect is any impaired quality of life for an individual because of...

  7. 38 CFR 51.90 - Resident behavior and facility practices.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... AFFAIRS (CONTINUED) PER DIEM FOR NURSING HOME CARE OF VETERANS IN STATE HOMES Standards § 51.90 Resident..., and sexual assault. (4) Neglect is any impaired quality of life for an individual because of...

  8. 38 CFR 51.90 - Resident behavior and facility practices.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... AFFAIRS (CONTINUED) PER DIEM FOR NURSING HOME CARE OF VETERANS IN STATE HOMES Standards § 51.90 Resident..., and sexual assault. (4) Neglect is any impaired quality of life for an individual because of...

  9. 38 CFR 51.90 - Resident behavior and facility practices.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... AFFAIRS (CONTINUED) PER DIEM FOR NURSING HOME CARE OF VETERANS IN STATE HOMES Standards § 51.90 Resident..., and sexual assault. (4) Neglect is any impaired quality of life for an individual because of...

  10. Scientist in residence

    NASA Astrophysics Data System (ADS)

    Thiel, David

    1990-03-01

    In order to enthuse secondary school students about science, and physics in particular, the author spent two one-week periods taking classes in local secondary schools as a `scientist in residence'. Two different private schools were involved and classes were given to students in the last four years preceding tertiary entrance. This article relates some of the motivation, method and implementation of this novel idea and some tentative conclusions are presented.

  11. Emergency preparedness: addressing a residency training gap.

    PubMed

    Uddin, Sayeedha Ghori; Barnett, Daniel J; Parker, Cindy L; Links, Jonathan M; Alexander, Miriam

    2008-03-01

    As the importance of physician involvement and leadership in crisis preparedness is recognized, the literature suggests that few physicians are adequately trained to practice effectively in a large-scale crisis situation. A logical method for addressing the emergency preparedness training deficiency identified across several medical specialties is to include disaster and emergency preparedness training in residency curricula. In this article, the authors outline the development and implementation of an emergency preparedness curriculum for the Johns Hopkins General Preventive Medicine Residency (JHGPMR) from 2004 to 2006. The curriculum consists of two components. The first was developed for the academic year in the JHGPMR and includes didactic lectures, practical exercises to apply new knowledge, and an opportunity to integrate the knowledge and skills in a real-world exercise. The second, developed for the practicum year of the residency, includes Web-based lectures and online content and culminates in a tabletop preparedness exercise. Topics for both components include weapons of mass destruction, risk communication and personal preparedness, aspects of local emergency response planning, and mental health and psychological aspects of terrorism. On the basis of the emergency preparedness training gap that has been identified in the literature, and the success of the three-year experience in implementing a preparedness training curriculum in the JHGPMR, the authors recommend incorporation of competency-based emergency preparedness training for residencies of all specialties, and offer insights into how the described curriculum could be adapted for use in other residency settings.

  12. Individuals with Disabilities Education Amendments of 1991. Report To Accompany H.R. 3053; Including Cost Estimate of the Congressional Budget Office. Committee on Education and Labor, House of Representatives, 102d Congress, 1st Session.

    ERIC Educational Resources Information Center

    Congress of the U.S., Washington, DC. House Committee on Education and Labor.

    This report by the House of Representatives Committee on Education and Labor presents recommended 1991 amendments to the Individuals with Disabilities Education Act. Reauthorization of Part H (the Infants and Toddlers with Disabilities Program) is recommended, with several amendments relating to: (1) transition from early intervention programs to…

  13. Program Strengths and Opportunities for Improvement Identified by Residents During ACGME Site Visits in 5 Surgical Specialties.

    PubMed

    Caniano, Donna A; Hamstra, Stanley J

    2016-05-01

    Background There is limited information about how residents in surgical specialties view program strengths and opportunities for improvement (OFIs). Objective This study aggregated surgical residents' perspectives on program strengths and OFIs to determine whether there was agreement in perspectives among residents in 5 surgical specialties. Methods Resident consensus lists of program strengths and areas for improvement were aggregated from site visits reports during 2012 and 2013 for obstetrics and gynecology, orthopaedic surgery, otolaryngology, plastic surgery, and surgery programs. Four trained individuals coded each strength or OFI in 1 of 3 categories: (1) factors common to all specialties; (2) program or institutional resources; and (3) factors unique to surgical specialties. Themes were classified as most frequent when listed by residents in more than 20% of the programs and less frequent when listed by residents in less than 20% of the programs. Results This study included a total of 359 programs, representing 27% to 49% of the Accreditation Council for Graduate Medical Education accredited programs in the 5 specialties. The most frequent strengths were progressive autonomy, collegiality, program leadership, and operative volume. Improving research and didactics, increasing faculty teaching and attendance at educational sessions, and increasing the number of nurse practitioners and physician assistants were common OFIs. Conclusions Factors identified as important by surgical residents related to their learning environment, their educational program, and program and institutional support. Across programs in the study, similar attributes were listed as both program strengths and OFIs. PMID:27168889

  14. The impact of a sleep hygiene intervention on residents of a private residential facility for individuals with co-occurring mental health and substance use disorders: results of a pilot study.

    PubMed

    Morse, Siobhan A; MacMaster, Samuel A; Kodad, Vicki; Robledo, Kathy

    2014-01-01

    An increasing number of Americans are experiencing sleep problems. There is evidence of a complex, bidirectional relationship between sleep disorders, substance abuse, and mental health symptoms. Institutional settings have been shown to elicit sleep problems as well. This pilot study was conducted with 28 patients in private, residential, dual-diagnosis treatment for addiction and mental health disorders. Upon admission, consenting patients were administered the Addiction Severity Index to assess pretreatment substance use and mental health symptoms. Patients followed a normal course of treatment as well as participated in a nightly sleep hygiene group that included relaxation suggestions. Evaluations with the Addiction Severity Index were completed again 30 days after discharge from treatment. Significant improvements in some substance use patterns as well as mental health symptoms were noted. Although results cannot be directly attributed to the use of a sleep hygiene group, this pilot study lays the foundation for future investigations of interventions supporting sleep in the dual-diagnosis population.

  15. Electrodiagnostic medicine skills competency in physical medicine and rehabilitation residents: a method for development and assessment.

    PubMed

    Brown, David; Cuccurullo, Sara; Lee, Joseph; Petagna, Ann; Strax, Thomas

    2008-08-01

    This project sought to create an educational module including evaluation methodology to instruct physical medicine and rehabilitation (PM&R) residents in electrodiagnostic evaluation of patients with neuromuscular problems, and to verify acquired competencies in those electrodiagnostic skills through objective evaluation methodology. Sixteen residents were trained by board-certified neuromuscular and electrodiagnostic medicine physicians through technical training, lectures, and review of self-assessment examination (SAE) concepts from the American Academy of Physical Medicine & Rehabilitation syllabus provided in the Archives of Physical Medicine and Rehabilitation. After delivery of the educational module, knowledge acquisition and skill attainment were measured in (1) clinical skill in diagnostic procedures via a procedure checklist, (2) diagnosis and ability to design a patient-care management plan via chart simulated recall (CSR) exams, (3) physician/patient interaction via patient surveys, (4) physician/staff interaction via 360-degree global ratings, and (5) ability to write a comprehensive patient-care report and to document a patient-care management plan in accordance with Medicare guidelines via written patient reports. Assessment tools developed for this program address the basic competencies outlined by the Accreditation Council for Graduate Medical Education (ACGME). To test the success of the standardized educational module, data were collected on an ongoing basis. Objective measures compared resident SAE scores in electrodiagnostics (EDX) before and after institution of the comprehensive EDX competency module in a PM&R residency program. Fifteen of 16 residents (94%) successfully demonstrated proficiency in every segment of the evaluation element of the educational module by the end of their PGY-4 electrodiagnostic rotation. The resident who did not initially pass underwent remedial coursework and passed on the second attempt. Furthermore, the

  16. Neuromuscular medicine competency in physical medicine and rehabilitation residents: a method of development and assessment.

    PubMed

    Lin, Lei; Cuccurullo, Sara J; Innerfield, Caitlin E; Strax, Thomas E; Petagna, Anne

    2013-03-01

    This project endeavored to create an educational module including methodology to instruct physical medicine and rehabilitation residents in the evaluation and appropriate treatment of patients with neuromuscular disorders. It further sought to verify acquired competencies in neuromuscular rehabilitation through objective evaluation methodology. An American Association of Neuromuscular and Electrodiagnostic Medicine board-certified physician with 10 yrs of clinical experience in neuromuscular and general rehabilitation trained 19 residents using a standardized competency-based module. The residents were trained through clinical training, lectures, and review of self-assessment examination concepts from the American Academy of Physical Medicine & Rehabilitation syllabus provided in the Archives of Physical Medicine and Rehabilitation. After delivery of the educational module, knowledge acquisition and skill proficiency were measured in (1) completion of neuromuscular history and physical examination satisfactorily, (2) diagnosis and ability to design a patient care management plan via chart stimulated recall examinations, (3) physician-patient interaction via patient surveys, (4) physician-staff interaction via 360-degree global ratings, and (5) ability to write a comprehensive patient care report and to document a patient care management plan in accordance with Medicare guidelines via written patient reports. Assessment tools developed for this program address the basic competencies outlined by the Accreditation Council for Graduate Medical Education. To test the success of the standardized educational module, data were collected on an ongoing basis. The objective measures compared resident self-assessment examination scores in neuromuscular rehabilitation before and after the institution of the comprehensive neuromuscular competency module in the residency program. Nineteen (100%) of 19 residents successfully demonstrated proficiency in every segment of the

  17. Electrodiagnostic medicine skills competency in physical medicine and rehabilitation residents: a method for development and assessment.

    PubMed

    Brown, David; Cuccurullo, Sara; Lee, Joseph; Petagna, Ann; Strax, Thomas

    2008-08-01

    This project sought to create an educational module including evaluation methodology to instruct physical medicine and rehabilitation (PM&R) residents in electrodiagnostic evaluation of patients with neuromuscular problems, and to verify acquired competencies in those electrodiagnostic skills through objective evaluation methodology. Sixteen residents were trained by board-certified neuromuscular and electrodiagnostic medicine physicians through technical training, lectures, and review of self-assessment examination (SAE) concepts from the American Academy of Physical Medicine & Rehabilitation syllabus provided in the Archives of Physical Medicine and Rehabilitation. After delivery of the educational module, knowledge acquisition and skill attainment were measured in (1) clinical skill in diagnostic procedures via a procedure checklist, (2) diagnosis and ability to design a patient-care management plan via chart simulated recall (CSR) exams, (3) physician/patient interaction via patient surveys, (4) physician/staff interaction via 360-degree global ratings, and (5) ability to write a comprehensive patient-care report and to document a patient-care management plan in accordance with Medicare guidelines via written patient reports. Assessment tools developed for this program address the basic competencies outlined by the Accreditation Council for Graduate Medical Education (ACGME). To test the success of the standardized educational module, data were collected on an ongoing basis. Objective measures compared resident SAE scores in electrodiagnostics (EDX) before and after institution of the comprehensive EDX competency module in a PM&R residency program. Fifteen of 16 residents (94%) successfully demonstrated proficiency in every segment of the evaluation element of the educational module by the end of their PGY-4 electrodiagnostic rotation. The resident who did not initially pass underwent remedial coursework and passed on the second attempt. Furthermore, the

  18. Neuromuscular medicine competency in physical medicine and rehabilitation residents: a method of development and assessment.

    PubMed

    Lin, Lei; Cuccurullo, Sara J; Innerfield, Caitlin E; Strax, Thomas E; Petagna, Anne

    2013-03-01

    This project endeavored to create an educational module including methodology to instruct physical medicine and rehabilitation residents in the evaluation and appropriate treatment of patients with neuromuscular disorders. It further sought to verify acquired competencies in neuromuscular rehabilitation through objective evaluation methodology. An American Association of Neuromuscular and Electrodiagnostic Medicine board-certified physician with 10 yrs of clinical experience in neuromuscular and general rehabilitation trained 19 residents using a standardized competency-based module. The residents were trained through clinical training, lectures, and review of self-assessment examination concepts from the American Academy of Physical Medicine & Rehabilitation syllabus provided in the Archives of Physical Medicine and Rehabilitation. After delivery of the educational module, knowledge acquisition and skill proficiency were measured in (1) completion of neuromuscular history and physical examination satisfactorily, (2) diagnosis and ability to design a patient care management plan via chart stimulated recall examinations, (3) physician-patient interaction via patient surveys, (4) physician-staff interaction via 360-degree global ratings, and (5) ability to write a comprehensive patient care report and to document a patient care management plan in accordance with Medicare guidelines via written patient reports. Assessment tools developed for this program address the basic competencies outlined by the Accreditation Council for Graduate Medical Education. To test the success of the standardized educational module, data were collected on an ongoing basis. The objective measures compared resident self-assessment examination scores in neuromuscular rehabilitation before and after the institution of the comprehensive neuromuscular competency module in the residency program. Nineteen (100%) of 19 residents successfully demonstrated proficiency in every segment of the

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

    PubMed

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

    2016-04-15

    Our goal in this study was to examine Accreditation Council for Graduate Medical Education case logs for Stanford anesthesia residents graduating in 2013 (25 residents) and 2014 (26 residents). The resident with the fewest recorded patients in 2013 had 43% the number of patients compared with the resident with the most patients, and in 2014, this equaled 48%. There were residents who had 75% more than the class average number of cases for several of the 12 case types and 3 procedure types required by the Accreditation Council for Graduate Medical Education. Also, there were residents with fewer than half as many for some of the required cases or procedure types. Some of the variability may have been because of the hazards of self-reporting.

  20. The residence time of carbon in Amazonian primary forests

    NASA Astrophysics Data System (ADS)

    Trumbore, S.; Vieira, S. A.; Camargo, P.; Chambers, J. Q.; Higuchi, N.; Selhorst, D.; Martinelli, L. A.

    2004-12-01

    The residence time of carbon is a major determiner of the capacity of an ecosystem to function as a source or sink of carbon. The overall residence time of carbon in primary forests is determined by (1) what fraction of photosynthetic products get respired quickly and (2) the residence time of C allocated to living plant tissues, and (3) the time each of these components takes to decay, including what fraction is oxidized to CO2 versus what becomes stabilized in soil organic matter. Using radiocarbon to determine the age of carbon in various pools in forests, we conclude that: (1) carbon use efficiency of these forests is low, with ~70% of photosynthetic products respired within a year, and only 30% allocated to growth of wood, root and leaf tissues; (2) carbon resides on average for 2-3 years in leaves and 3-10 years in fine roots; very rapid or ephemeral root turnover is assigned in our budgets to AƒAøAøâ_sA¬A<Å"autotrophicAƒAøAøâ_sA¬Aøâ_zAø respiration (3) the mean age of carbon in living trees is longer (200-260 years) than the mean residence time of carbon derived from the biomass stock divided by annual wood growth increment (40-100 years) because most of the biomass is in the largest, fastest growing, trees, while most of the individuals are smaller, slower growing, shaded trees; (4) decomposition rates are rapid, but potentially recycling of carbon in the microbial community leads to a significant decadally cycling pool in near-surface organic matter. We will summarize these findings and use them with models of carbon dynamics to estimate carbon storage and loss potential on interannual to decadal timescales. The overall age of heterotrophically respired carbon (carbon derived from microbial decomposition) is 6-10 years, with much of the time lag due to the time spent by C in living leaf and root tissues. Even when combined with 70% autotrophically respired C with residence times of <1 year, this significant time lag can lead to large

  1. Variable residence time vortex combustor

    DOEpatents

    Melconian, Jerry O.

    1987-01-01

    A variable residence time vortex combustor including a primary combustion chamber for containing a combustion vortex, and a plurality of louvres peripherally disposed about the primary combustion chamber and longitudinally distributed along its primary axis. The louvres are inclined to impel air about the primary combustion chamber to cool its interior surfaces and to impel air inwardly to assist in driving the combustion vortex in a first rotational direction and to feed combustion in the primary combustion chamber. The vortex combustor also includes a second combustion chamber having a secondary zone and a narrowed waist region in the primary combustion chamber interconnecting the output of the primary combustion chamber with the secondary zone for passing only lower density particles and trapping higher density particles in the combustion vortex in the primary combustion chamber for substantial combustion.

  2. Attitudes and Perceptions of Pediatric Residents on Transitioning to CPOE

    PubMed Central

    Webber, E.C.

    2014-01-01

    Summary Background Many resident physicians have experienced transitioning from traditional paper documentation and ordering to an electronic process during their training. Objective We sought to investigate the attitudes and perceptions of residents related to implementation of computer provider order entry (CPOE) and clinical decision support (CDS). Methods Pediatric residents completed web-based surveys prior to CPOE implementation and at 6 months and 12 months after implementation. The survey assessed resident attitudes and perceptions related to CPOE and the use of CDS tools. Additionally, at 6 and 12 months, residents were asked how electronic medical record (EMR) resources might impact future career decisions. Results Prior to CPOE implementation, 70% of residents were looking forward to CPOE, but 28% did not want to transition from paper ordering. At 12 months post-implementation, 80% of residents favored CPOE over paper ordering and only 3.33% wished to revert to paper ordering. Residents reported an increase in time needed to enter admission orders 6-months after CPOE implementation. By 12 months post-implementation, there was no significant difference in perceived time to complete admission orders when compared to pre-CPOE responses. Most residents (91.67%) identified that overall EMR resources were an important factor when considering future employment opportunities. The most important factors included the degree of EMR implementation, technology resources and the amount of support staff. The least important factors included patient portal access and which EMR product is used. Conclusions Overall, residents demonstrated a preference for CPOE compared to traditional paper order entry. Many residents remained unaware of CDS tools embedded within CPOE at the 12 month follow-up, but a majority of residents did find them helpful and felt more knowledgeable about current guidelines. EMR resources, including degree of EMR implementation, technology resources

  3. Taste detection ability of elderly nursing home residents.

    PubMed

    Ogawa, T; Uota, M; Ikebe, K; Notomi, Y; Iwamoto, Y; Shirobayashi, I; Kibi, M; Masayasu, S; Sasaki, S; Maeda, Y

    2016-07-01

    Due to the rapid rise of aged populations throughout the world, it is essential to elucidate the cause of taste dysfunction, because it may reduce appetite, leading to inadequate dietary intake. We aimed to compare taste detection ability between dependently and independently living geriatric individuals of nearly the same age with oral status. Forty-three elderly individuals considered to be cognitively eligible and residing in nursing homes in Japan were enrolled (n = 43, 82·3 ± 8·5 years) and were compared with an independently living elderly group (n = 949, 79·9 ± 0·8 years), aiming to compare taste detection ability between dependently and independently living elders of nearly the same age. Information regarding comorbidity and medication was obtained as general health status, and oral status including number of present teeth, denture usage and maximal occlusal force was also noted. In the dependently living group, 69·4%, 14·3%, 16·3% and 8·2% of participants could detect sweet, sour, salty and bitter tastes, respectively, which was significantly lower than the independently living group for each taste (97·9%, 70·8%, 89·6% and 43·8% for sweet, sour, salty and bitter tastes, respectively). The multivariate logistic regression analysis revealed that residing in nursing homes was associated with reduced sensitivity for four different tastes. The diseases and the situation of dependent elders were more likely the cause of the decreased taste sensitivity. PMID:27027615

  4. Educational outcomes from a novel house call curriculum for internal medicine residents: report of a 3-year experience.

    PubMed

    Hayashi, Jennifer; Christmas, Colleen; Durso, Samuel C

    2011-07-01

    Physician house calls are an important mode of healthcare delivery to frail homebound older adults and positively affect patient outcomes and learner education, but most physicians receive scant training in home care medicine. A novel longitudinal curriculum in house call medicine for internal medicine residents was implemented in July 2006, and educational outcomes were evaluated over the following 3 years. The 2-year curriculum included didactic and experiential components. Residents made house calls with preceptors and alone and completed a series of computer modules outlining knowledge essential to providing home-based care. They discussed the important features of the modules in regularly scheduled small groups throughout the 2-year experience, and each taught a "house call morning report" in their senior resident year. Evaluation methods included surveys before, during, and at the end of the 2-year curriculum (knowledge and attitudes); direct observation by preceptors during house calls (skills); and an online, anonymous survey at the end of each year (attitudes). Results show statistically significant increases in residents' knowledge, skills, and attitudes relevant to home care medicine. Residents describe educationally significant and positive effects from their house call experiences. This novel curriculum improved medical residents' knowledge, attitudes, and skills in performing house calls for frail elderly individuals. The longer-term outcomes of this intervention will continue to be studied, with the hope that it may be used to help provide educational opportunities to prepare the physician workforce to meet the service needs of a growing segment of the population.

  5. Seasonal movement, residency, and migratory patterns of Wilson's Snipe (Gallinago delicata)

    USGS Publications Warehouse

    Cline, Brittany B.; Haig, Susan M.

    2011-01-01

    Cross-seasonal studies of avian movement establish links between geographically distinct wintering, breeding, and migratory stopover locations, or assess site fidelity and movement between distinct phases of the annual cycle. Far fewer studies have investigated individual movement patterns within and among seasons over an annual cycle. Within western Oregon's Willamette Valley throughout 2007, we quantified intra- and interseasonal movement patterns, fidelity (regional and local), and migratory patterns of 37 radiomarked Wilson's Snipe (Gallinago delicata) to elucidate residency in a region of breeding- and wintering-range overlap. Telemetry revealed complex regional population structure, including winter residents (74%), winter transients (14%), summer residents (9%), and one year-round resident breeder (3%). Results indicated a lack of connectivity between winter and summer capture populations, some evidence of partial migration, and between-season fidelity to the region (winter-resident return; subsequent fall). Across seasons, the extent of movements and use of multiple wetland sites suggested that Wilson's Snipe were capable of exploratory movements but more regularly perceived local and fine-scale segments of the landscape as connected. Movements differed significantly by season and residency; individuals exhibited contracted movements during late winter and more expansive movements during precipitation-limited periods (late spring, summer, fall). Mean home-range size was 3.5& plusmn; 0.93 km2 (100% minimum convex polygon [MCP]) and 1.6 ± 0.42 km2 (95% fixed kernel) and did not vary by sex; however, home range varied markedly by season (range of 100% MCPs: 1.04-7.56 km2). The results highlight the need to consider seasonal and interspecific differences in shorebird life histories and space-use requirements when developing regional wetland conservation plans.

  6. 31 CFR 542.514 - Transactions related to U.S. persons residing in Syria authorized.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... residing in Syria authorized. 542.514 Section 542.514 Money and Finance: Treasury Regulations Relating to... related to U.S. persons residing in Syria authorized. (a) Except as provided in paragraph (b) of this section, individuals who are U.S. persons residing in Syria are authorized to pay their personal...

  7. Including the Group Quarters Population in the US Synthesized Population Database

    PubMed Central

    Chasteen, Bernadette M.; Wheaton, William D.; Cooley, Philip C.; Ganapathi, Laxminarayana; Wagener, Diane K.

    2011-01-01

    In 2005, RTI International researchers developed methods to generate synthesized population data on US households for the US Synthesized Population Database. These data are used in agent-based modeling, which simulates large-scale social networks to test how changes in the behaviors of individuals affect the overall network. Group quarters are residences where individuals live in close proximity and interact frequently. Although the Synthesized Population Database represents the population living in households, data for the nation’s group quarters residents are not easily quantified because of US Census Bureau reporting methods designed to protect individuals’ privacy. Including group quarters population data can be an important factor in agent-based modeling because the number of residents and the frequency of their interactions are variables that directly affect modeling results. Particularly with infectious disease modeling, the increased frequency of agent interaction may increase the probability of infectious disease transmission between individuals and the probability of disease outbreaks. This report reviews our methods to synthesize data on group quarters residents to match US Census Bureau data. Our goal in developing the Group Quarters Population Database was to enable its use with RTI’s US Synthesized Population Database in the Modeling of Infectious Diseases Agent Study. PMID:21841972

  8. Movement of resident rainbow trout transplanted below a barrier to anadromy

    USGS Publications Warehouse

    Wilzbach, Margaret A.; Ashenfelter, Mark J.; Ricker, Seth J.

    2012-01-01

    We tracked the movement of resident coastal rainbow trout Oncorhynchus mykiss irideus that were experimentally transplanted below a migration barrier in a northern California stream. In 2005 and 2006, age-1 and older rainbow trout were captured above a 5-m-high waterfall in Freshwater Creek and individually marked with passive integrated transponder tags. Otolith microchemistry confirmed that the above-barrier trout were the progeny of resident rather than anadromous parents, and genetic analysis indicated that the rainbow trout were introgressed with cutthroat trout O. clarkii. At each of three sampling events, half of the tagged individuals (n = 22 and 43 trout in 2005 and 2006, respectively) were released 5 km downstream from the waterfall (approximately 10 km upstream from tidewater), and an equal number of tagged individuals were released above the barrier. Tagged individuals were subsequently relocated with stationary and mobile antennae or recaptured in downstream migrant traps, or both, until tracking ceased in October 2007. Most transplanted individuals remained within a few hundred meters of their release location. Three individuals, including one rainbow trout released above the waterfall, were last detected in the tidally influenced lower creek. Two additional tagged individuals released above the barrier were found alive in below-barrier reaches and had presumably washed over the falls. Two of seven tagged rainbow trout captured in downstream migrant traps had smolted and one was a presmolt. The smoltification of at least some individuals, coupled with above-barrier "leakage" of fish downstream, suggests that above-barrier resident trout have the potential to exhibit migratory behavior and to enter breeding populations of steelhead (anadromous rainbow trout) within the basin.

  9. Evidence of empowerment in resident council groups: an examination of two leadership models in assisted living.

    PubMed

    Bonifas, Robin P; Hedgpeth, Jay; Kramer, Christie

    2013-01-01

    Individuals living in long-term care facilities and the professionals working with them are seeking methods to enhance resident choice and self-direction in personal care and internal community planning. This article presents findings from a study examining the incidence of empowerment opportunities in two resident council groups in assisted living facilities; one group used a resident leadership model and the other used an administrative leadership model by residents' choice. Results indicate that even with health and mental health challenges, residents were able to exercise choice in complicated situations under both leadership models, suggesting that resident council groups are a beneficial empowerment strategy.

  10. Drug Information Residency Rotation with Pharmaceutical Industry.

    ERIC Educational Resources Information Center

    Cramer, Richard L.

    1986-01-01

    Program objectives of a drug information rotation at the Upjohn Company include improving communication between the pharmaceutical industry and hospital pharmacy/academia, exposing the resident to the challenges the industry encounters, improving proficiency in drug information practice, and providing insight into the working relationships of…

  11. Experiencing Architecture: Teacher Residency at Fallingwater.

    ERIC Educational Resources Information Center

    Mims, Sandra K.

    1993-01-01

    Describes a one-week residency program for art educators at Fallingwater, a Frank Lloyd Wright-designed retreat in western Pennsylvania. Discusses the significance of the architecture on the goals and outcomes of the program. Asserts that the experience encouraged the participants to include architecture education in their art education programs.…

  12. Tissue-resident macrophages

    PubMed Central

    Davies, Luke C.; Jenkins, Stephen J.; Allen, Judith E.; Taylor, Philip R.

    2014-01-01

    Tissue-resident macrophages are a heterogeneous population of immune cells that fulfill tissue-specific and niche-specific functions. These range from dedicated homeostatic functions, such as clearance of cellular debris and iron processing, to central roles in tissue immune-surveillance, response to infection and the resolution of inflammation. Recent studies highlight marked heterogeneity in the origins of tissue macrophages that arise from hematopoietic versus self-renewing embryo-derived populations. We discuss the tissue–niche-specific factors that dictate cell phenotype, the definition of which will allow novel strategies to promote the restoration of tissue homeostasis. Understanding the mechanisms that dictate tissue macrophage heterogeneity should explain why simplified paradigms of macrophage activation do not explain the extent of heterogeneity seen in vivo. PMID:24048120

  13. Differences in the Nature of Body Image Disturbances between Female Obese Individuals with versus without a Comorbid Binge Eating Disorder: An Exploratory Study Including Static and Dynamic Aspects of Body Image

    ERIC Educational Resources Information Center

    Legenbauer, Tanja; Vocks, Silja; Betz, Sabrina; Puigcerver, Maria Jose Baguena; Benecke, Andrea; Troje, Nikolaus F.; Ruddel, Heinz

    2011-01-01

    Various components of body image were measured to assess body image disturbances in patients with obesity. To overcome limitations of previous studies, a photo distortion technique and a biological motion distortion device were included to assess static and dynamic aspects of body image. Questionnaires assessed cognitive-affective aspects, bodily…

  14. Differences in the Nature of Body Image Disturbances between Female Obese Individuals with versus without a Comorbid Binge Eating Disorder: An Exploratory Study Including Static and Dynamic Aspects of Body Image

    ERIC Educational Resources Information Center

    Legenbauer, Tanja; Vocks, Silja; Betz, Sabrina; Puigcerver, Maria Jose Baguena; Benecke, Andrea; Troje, Nikolaus F.; Ruddel, Heinz

    2011-01-01

    Various components of body image were measured to assess body image disturbances in patients with obesity. To overcome limitations of previous studies, a photo distortion technique and a biological motion distortion device were included to assess static and dynamic aspects of body image. Questionnaires assessed cognitive-affective aspects, bodily…

  15. Characteristics of anesthesiology residency program directors.

    PubMed

    Long, Timothy R; Brown, Michael J; Elliott, Beth A; Rose, Steven H

    2010-12-01

    The roles and responsibilities of anesthesiology core program directors have evolved, in part because the Anesthesiology Residency Review Committee of the Accreditation Council for Graduate Medical Education no longer requires that the department chair also serve in this role. We reviewed several core anesthesiology program director academic and demographic characteristics including age, academic rank, gender, duration of service, board certification and re-certification status, and whether the program director also serves as department chair. Anesthesiology core residency program directors range in age from 33 to 74 years, with a median of 52 years. Thirty-seven (28%) program directors are women. The majority (67%) have senior academic rank (professor or associate professor). The median appointment duration is 3.7 years. The core residency program director currently also serves as department chair in 24 of the 131 (18.3%) programs.

  16. Networks, space, and residents' perception of cohesion.

    PubMed

    Boessen, Adam; Hipp, John R; Smith, Emily J; Butts, Carter T; Nagle, Nicholas N; Almquist, Zack

    2014-06-01

    Community scholars increasingly focus on the linkage between residents' sense of cohesion with the neighborhood and their own social networks in the neighborhood. A challenge is that whereas some research only focuses on residents' social ties with fellow neighbors, such an approach misses out on the larger constellation of individuals' relationships and the spatial distribution of those relationships. Using data from the Twin Communities Network Study, the current project is one of the first studies to examine the actual spatial distribution of respondents' networks for a variety of relationships and the consequences of these for neighborhood and city cohesion. We also examine how a perceived structural measure of cohesion-triangle degree-impacts their perceptions of neighborhood and city cohesion. Our findings suggest that perceptions of cohesion within the neighborhood and the city depend on the number of neighborhood safety contacts as well as on the types of people with which they discuss important matters. On the other hand, kin and social friendship ties do not impact cohesion. A key finding is that residents who report more spatially dispersed networks for certain types of ties report lower levels of neighborhood and city cohesion. Residents with higher triangle degree within their neighborhood safety networks perceived more neighborhood cohesion.

  17. Combating the stress of residency: one school's approach.

    PubMed

    Dabrow, Sharon; Russell, Stephen; Ackley, Karen; Anderson, Eric; Fabri, Peter Jeff

    2006-05-01

    Residency is a time of stress and turmoil for many residents. The stresses are varied and great, often involving both personal and professional issues. One institutional mechanism that has been shown to help residents cope with stress is the use of residents' wellness, or assistance, programs. The University of South Florida (USF) College of Medicine developed the USF Residency Assistance Program (RAP) in 1997, modeled after business employee assistance programs but tailored to enhance the well-being of residents. The program was developed in an organized, thoughtful manner starting with a Request for Proposals to all local employee assistance programs and the selection of one of these to run the program. The RAP is broad-based, readily available, easily accessible, totally voluntary and confidential, and not reportable to the state board of medicine. It is well integrated into all residency programs and has had excellent acceptance from the administration; information about access to the RAP is available to all residents through multiple venues. The cost is minimal, at only seven cents a day per resident. The authors present data from the eight years the RAP has been operating, including information on program use, referral rates, acceptance, and types of problems encountered. One suicide occurred during this time period, and the RAP provided a significant role in grief counseling. Assistance programs are critical to the well-being of residents. The USF program presents a model that can be used by other programs around the country. PMID:16639197

  18. Global health education in general preventive medicine residencies.

    PubMed

    Bussell, Scottie A; Kihlberg, Courtney J; Foderingham, Nia M; Dunlap, Julie A; Aliyu, Muktar H

    2015-05-01

    Opportunities for global health training during residency are steadily increasing. For example, surveys show that more than half of residency programs now offer international electives. Residency programs are increasingly recognizing that global health training improves communication skills, fosters awareness of health disparities, and inspires careers in primary care and public health. Although research has focused on global health education in other specialties, there is a paucity of research on global health training in public health and general preventive medicine (GPM). We sought to describe the extent of global health training across GPM residencies, capture the perspectives of program directors regarding competencies residents need for careers in global health, and identify program directors' perceived barriers to providing global health training. The survey was sent electronically to 42 U.S. GPM residency program directors from September to October 2013. Twenty-three completed surveys were returned. Information from residencies that did not complete the study survey was collected through a predefined search protocol. Data analysis was performed from February through July 2014. Among program directors completing the survey, the most common types of reported global health education were courses (n=17), followed by international rotations (n=10). Ten program directors indicated that resident(s) were involved in global health training, research, or service initiatives. Commonly perceived barriers included funding (87%), scheduling (56.5%), and partnership and sustainability (34.8%). Through global health coursework, research, and practicum rotations, GPM residents could acquire skills, knowledge, and attitudes contributing to careers in global health. PMID:25891059

  19. Global health education in general preventive medicine residencies.

    PubMed

    Bussell, Scottie A; Kihlberg, Courtney J; Foderingham, Nia M; Dunlap, Julie A; Aliyu, Muktar H

    2015-05-01

    Opportunities for global health training during residency are steadily increasing. For example, surveys show that more than half of residency programs now offer international electives. Residency programs are increasingly recognizing that global health training improves communication skills, fosters awareness of health disparities, and inspires careers in primary care and public health. Although research has focused on global health education in other specialties, there is a paucity of research on global health training in public health and general preventive medicine (GPM). We sought to describe the extent of global health training across GPM residencies, capture the perspectives of program directors regarding competencies residents need for careers in global health, and identify program directors' perceived barriers to providing global health training. The survey was sent electronically to 42 U.S. GPM residency program directors from September to October 2013. Twenty-three completed surveys were returned. Information from residencies that did not complete the study survey was collected through a predefined search protocol. Data analysis was performed from February through July 2014. Among program directors completing the survey, the most common types of reported global health education were courses (n=17), followed by international rotations (n=10). Ten program directors indicated that resident(s) were involved in global health training, research, or service initiatives. Commonly perceived barriers included funding (87%), scheduling (56.5%), and partnership and sustainability (34.8%). Through global health coursework, research, and practicum rotations, GPM residents could acquire skills, knowledge, and attitudes contributing to careers in global health.

  20. Individualized Communications

    NASA Technical Reports Server (NTRS)

    1997-01-01

    IntelliWeb and IntelliPrint, products from MicroMass Communications, utilize C Language Integrated Production System (CLIPS), a development and delivery expert systems tool developed at Johnson Space Center. IntelliWeb delivers personalized messages by dynamically creating single web pages or entire web sites based on information provided by each website visitor. IntelliPrint is a product designed to create tailored, individualized messages via printed media. The software uses proprietary technology to generate printed messages that are personally relevant and tailored to meet each individual's needs. Intelliprint is in use in many operations including Brystol-Myers Squibb's personalized newsletter, "Living at Your Best," geared to each recipient based on a health and lifestyle survey taken earlier; and SmithKline Beecham's "Nicorette Committed Quitters Program," in which customized motivational materials support participants in their attempt to quit smoking.

  1. Resident Exposure to Peripheral Nerve Surgical Procedures During Residency Training.

    PubMed

    Gil, Joseph A; Daniels, Alan H; Akelman, Edward

    2016-05-01

    Background Variability in case exposures has been identified for orthopaedic surgery residents. It is not known if this variability exists for peripheral nerve procedures. Objective The objective of this study was to assess ACGME case log data for graduating orthopaedic surgery, plastic surgery, general surgery, and neurological surgery residents for peripheral nerve surgical procedures and to evaluate intraspecialty and interspecialty variability in case volume. Methods Surgical case logs from 2009 to 2014 for the 4 specialties were compared for peripheral nerve surgery experience. Peripheral nerve case volume between specialties was performed utilizing a paired t test, 95% confidence intervals were calculated, and linear regression was calculated to assess the trends. Results The average number of peripheral nerve procedures performed per graduating resident was 54.2 for orthopaedic surgery residents, 62.8 for independent plastic surgery residents, 84.6 for integrated plastic surgery residents, 22.4 for neurological surgery residents, and 0.4 for surgery residents. Intraspecialty comparison of the 10th and 90th percentile peripheral nerve case volume in 2012 revealed remarkable variability in training. There was a 3.9-fold difference within orthopaedic surgery, a 5.0-fold difference within independent plastic surgery residents, an 8.8-fold difference for residents from integrated plastic surgery programs, and a 7.0-fold difference within the neurological surgery group. Conclusions There is interspecialty and intraspecialty variability in peripheral nerve surgery volume for orthopaedic, plastic, neurological, and general surgery residents. Caseload is not the sole determinant of training quality as mentorship, didactics, case breadth, and complexity play an important role in training. PMID:27168883

  2. 19 CFR 113.35 - Individual sureties.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 19 Customs Duties 1 2010-04-01 2010-04-01 false Individual sureties. 113.35 Section 113.35 Customs... CUSTOMS BONDS Principals and Sureties § 113.35 Individual sureties. (a) Number required. If individuals...) Qualifications to act as surety—(1) Residency and citizenship. Each individual surety on a Customs bond must...

  3. Implementing the 2009 Institute of Medicine recommendations on resident physician work hours, supervision, and safety

    PubMed Central

    Blum, Alexander B; Shea, Sandra; Czeisler, Charles A; Landrigan, Christopher P; Leape, Lucian

    2011-01-01

    , discussion of the Institute of Medicine report has been largely confined to the medical education community, led by the Accreditation Council for Graduate Medical Education (ACGME). To begin gathering these perspectives and developing a plan to implement safer work hours for resident physicians, a conference entitled “Enhancing sleep, supervision and safety: What will it take to implement the Institute of Medicine recommendations?” was held at Harvard Medical School on June 17–18, 2010. This White Paper is a product of a diverse group of 26 representative stakeholders bringing relevant new information and innovative practices to bear on a critical patient safety problem. Given that our conference included experts from across disciplines with diverse perspectives and interests, not every recommendation was endorsed by each invited conference participant. However, every recommendation made here was endorsed by the majority of the group, and many were endorsed unanimously. Conference members participated in the process, reviewed the final product, and provided input before publication. Participants provided their individual perspectives, which do not necessarily represent the formal views of any organization. In September 2010 the ACGME issued new rules to go into effect on July 1, 2011. Unfortunately, they stop considerably short of the Institute of Medicine’s recommendations and those endorsed by this conference. In particular, the ACGME only applied the limitation of 16 hours to first-year resident physicans. Thus, it is clear that policymakers, hospital administrators, and residency program directors who wish to implement safer health care systems must go far beyond what the ACGME will require. We hope this White Paper will serve as a guide and provide encouragement for that effort. Resident physician workload and supervision By the end of training, a resident physician should be able to practice independently. Yet much of resident physicians’ time is dominated by

  4. BBA impacts on hospital residents, finances, and Medicare subsidies.

    PubMed

    Cromwell, Jerry; Adamache, Walter; Drozd, Edward M

    2006-01-01

    Concern over rapidly rising Medicare expenditures prompted Congress to pass the 1997 Balanced Budget Act (BBA) that included provisions reducing graduate medical education (GME) payments and capped the growth in residents for payment purposes. Using Medicare cost reports through 2001, we find that both actual and capped residents continued to grow post-BBA. While teaching hospital total margins declined, GME payment reductions of approximately 17 percent had minimal impact on revenue growth (-0.5 percent annually). Four years after BBA, residents remained a substantial line of business for nearly one-half of teaching hospitals with Medicare effective marginal subsidies exceeding resident stipends by nearly $50,000 on average. Coupled with an estimated replacement cost of over $100,000 per resident, it is not surprising that hospitals accepted nearly 4,000 residents beyond their allowable payment caps in just 4 years post-BBA.

  5. 26 CFR 301.6362-6 - Requirements relating to residence.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... determination under State law as to which State is treated as the residence or domicile of the decedent for purposes other than its individual income tax (such as liability for State inheritance tax or jurisdiction... laws shall contain provisions for methods of current collection with respect to individuals...

  6. Development of residency program guidelines for interaction with the pharmaceutical industry. Education Council, Residency Training Programme in Internal Medicine, Department of Medicine, McMaster University, Hamilton, Ont.

    PubMed Central

    1993-01-01

    Medical residency programs are likely to face increasing pressure to address their relations with the pharmaceutical industry. Our internal medicine residency program has developed guidelines that were adopted after extensive debate by residents and faculty members. The guidelines are based on the principles that residents and faculty should set the educational agenda and that the residency program should not allow gifts of any sort from industry to residents. Specific policies include obtaining and screening educational materials from the industry before residents are exposed to them, proscribing "drug lunches" and accepting industry sponsorship only when the residency program maintains complete control of the educational event being sponsored. The industry response to the guidelines was split; about half reacted negatively, and half found the guidelines acceptable. Our experience suggests that productive debate about guidelines for the interaction of residency programs with the pharmaceutical industry is possible and desirable and that explicit policies can clarify areas of ambiguity. PMID:8348422

  7. Redesigning residency training in internal medicine: the consensus report of the Alliance for Academic Internal Medicine Education Redesign Task Force.

    PubMed

    Meyers, Frederick J; Weinberger, Steven E; Fitzgibbons, John P; Glassroth, Jeffrey; Duffy, F Daniel; Clayton, Charles P

    2007-12-01

    Because of numerous criticisms of the content and structure of residency training, redesigning graduate medical education (GME) has become a high priority for the internal medicine community. From 2005 to 2007, the leadership of the internal medicine community, working under the auspices of the Alliance for Academic Internal Medicine Education Redesign Task Force, developed six recommendations it will pursue to improve residency education: (1) focus education around a "core" of internal medicine, which provides the framework for both the structure and content of residents' educational experiences, (2) fully adopt competency-based evaluation and advancement, which will enhance training by focusing on individual learners' needs, (3) allow for increased, resident-centered education beyond the internal medicine core, because different types of practice require customized knowledge and skills, (4) improve ambulatory training by providing patient-centered longitudinal care that addresses the conflict between inpatient and outpatient responsibilities, (5) use new faculty models that emphasize the creation of a core faculty, and (6) align institutional and programmatic resources with the goals of redesign, balancing the clinical mission of the institution with the educational goals of residency training. Adoption of these recommendations will require significant efforts, including pilot projects, faculty development, changes in accreditation requirements, and modifications of GME funding systems. Opportunities are ample for individual programs to develop creative approaches based on the framework for educational redesign outlined in this article, and for these educational and clinical redesign initiatives to work hand-in-hand for the benefit of patients, faculty, trainees, and institutions.

  8. Implementing Proactive Network Management Solutions in the Residence Halls

    ERIC Educational Resources Information Center

    Bedi, Param

    2005-01-01

    This paper discusses how to implement networking solutions in residence halls at Arcadia University in Philadelphia. Sections of the paper include: (1) About Arcadia University; (2) Residence Halls Network; (3) How Campus Manager Helped Arcadia University; (4) What Is Campus Manager; (5) How Campus Manager Works; (6) Campus Manager Remediation…

  9. A Pilot Study To Define Quality in Residency Education.

    ERIC Educational Resources Information Center

    Klessig, Jill M.; Wolfsthal, Susan D.; Levine, Mark A.; Stickley, William; Bing-You, Robert G.; Lansdale, Thomas F.; Battinelli, David L.

    2000-01-01

    A modified Delphi process was used to survey program directors and medical residents to identify indicators of quality in internal medicine residency training. Items rated important by both groups included faculty characteristics such as stability, supervision, clinical skills, and teaching commitment; institutional support; and amount of resident…

  10. 8 CFR 1216.1 - Definition of conditional permanent resident.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... specified, the rights, privileges, responsibilities and duties which apply to all other lawful permanent residents apply equally to conditional permanent residents, including but not limited to the right to apply for naturalization (if otherwise eligible), the right to file petitions on behalf of...

  11. 8 CFR 1216.1 - Definition of conditional permanent resident.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... specified, the rights, privileges, responsibilities and duties which apply to all other lawful permanent residents apply equally to conditional permanent residents, including but not limited to the right to apply for naturalization (if otherwise eligible), the right to file petitions on behalf of...

  12. 8 CFR 1216.1 - Definition of conditional permanent resident.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... specified, the rights, privileges, responsibilities and duties which apply to all other lawful permanent residents apply equally to conditional permanent residents, including but not limited to the right to apply for naturalization (if otherwise eligible), the right to file petitions on behalf of...

  13. 8 CFR 1216.1 - Definition of conditional permanent resident.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... specified, the rights, privileges, responsibilities and duties which apply to all other lawful permanent residents apply equally to conditional permanent residents, including but not limited to the right to apply for naturalization (if otherwise eligible), the right to file petitions on behalf of...

  14. 8 CFR 1216.1 - Definition of conditional permanent resident.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... specified, the rights, privileges, responsibilities and duties which apply to all other lawful permanent residents apply equally to conditional permanent residents, including but not limited to the right to apply for naturalization (if otherwise eligible), the right to file petitions on behalf of...

  15. Resident Duty Hours: Enhancing Sleep, Supervision, and Safety

    ERIC Educational Resources Information Center

    Ulmer, Cheryl, Ed.; Wolman, Dianne Miller, Ed.; Johns, Michael M. E., Ed.

    2009-01-01

    Medical residents in hospitals are often required to be on duty for long hours. In 2003 the organization overseeing graduate medical education adopted common program requirements to restrict resident workweeks, including limits to an average of 80 hours over 4 weeks and the longest consecutive period of work to 30 hours in order to protect…

  16. A Larger Scale. Tenth Annual Residence Hall Construction Report.

    ERIC Educational Resources Information Center

    Argon, Joe

    1999-01-01

    Presents data from the American School & University's 10th Annual Residence Hall Construction Report that show dormitories are costing more per square foot to build while also becoming larger accommodations. Data tables are provided as are highlighted discussions that include residence hall design flexibility, environmental concerns and building…

  17. 24 CFR 964.15 - HUD policy on resident management.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... corporation. Potential benefits of resident-managed entities include improved quality of life, experiencing the dignity of meaningful work, enabling residents to choose where they want to live, and meaningful... DEVELOPMENT (CONTINUED) OFFICE OF ASSISTANT SECRETARY FOR PUBLIC AND INDIAN HOUSING, DEPARTMENT OF HOUSING...

  18. 24 CFR 964.15 - HUD policy on resident management.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... corporation. Potential benefits of resident-managed entities include improved quality of life, experiencing the dignity of meaningful work, enabling residents to choose where they want to live, and meaningful... Development (Continued) OFFICE OF ASSISTANT SECRETARY FOR PUBLIC AND INDIAN HOUSING, DEPARTMENT OF HOUSING...

  19. 24 CFR 964.15 - HUD policy on resident management.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... corporation. Potential benefits of resident-managed entities include improved quality of life, experiencing the dignity of meaningful work, enabling residents to choose where they want to live, and meaningful... DEVELOPMENT (CONTINUED) OFFICE OF ASSISTANT SECRETARY FOR PUBLIC AND INDIAN HOUSING, DEPARTMENT OF HOUSING...

  20. 24 CFR 964.15 - HUD policy on resident management.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... corporation. Potential benefits of resident-managed entities include improved quality of life, experiencing the dignity of meaningful work, enabling residents to choose where they want to live, and meaningful... DEVELOPMENT (CONTINUED) OFFICE OF ASSISTANT SECRETARY FOR PUBLIC AND INDIAN HOUSING, DEPARTMENT OF HOUSING...

  1. 24 CFR 964.15 - HUD policy on resident management.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... corporation. Potential benefits of resident-managed entities include improved quality of life, experiencing the dignity of meaningful work, enabling residents to choose where they want to live, and meaningful... DEVELOPMENT (CONTINUED) OFFICE OF ASSISTANT SECRETARY FOR PUBLIC AND INDIAN HOUSING, DEPARTMENT OF HOUSING...

  2. A Longitudinal "Teaching-to-Teach" Curriculum for Psychiatric Residents

    ERIC Educational Resources Information Center

    Lehmann, Susan W.

    2010-01-01

    Objective: Psychiatric residents' self-reported confidence levels related to teaching medical students were assessed before and after a five-part teaching seminar series. Methods: Five 1-hour seminars on teaching medical students in the psychiatry clerkship were presented to second postgraduate year (PGY-2) residents. Topics included how to teach…

  3. Immunotoxicology: environmental contamination by polybrominated biphenyls and immune dysfunction among residents of the State of Michigan

    SciTech Connect

    Bekesi, J.G.; Roboz, J.P.; Fischbein, A.; Mason, P.

    1987-01-01

    In 1973, inadvertent contamination occurred in a special farm feed supplement for lactating cows. Polybrominated biphenyls (PBBs) were used in place of magnesium oxide resulting in serious harm to farm animals, including cattle, chickens, geese, ducks. Farm families, accustomed to eating their own products, were most heavily exposed. To study the impact of PBBs, 336 adult Michigan farm residents, 117 general consumers for comparison, 75 dairy farm residents in Wisconsin, who had not eaten PBB-contaminated food, were examined, as were 79 healthy subjects in New York City. Abnormalities in the Michigan groups included hypergammaglobulinemia, exaggerated hypersensitive response to streptococci, significant decrease in absolute numbers and percentage of T and B-lymphocytes, and increased number of lymphocytes with no detectable surface markers (''null cells''). Significant reduction of in vitro immune function was noted in 20-25% of the Michigan farm residents who had eaten food containing PBB. The decreased immune function detected among the PBB-exposed farm residents tended to affect families as a unit and was independent of exposed individuals' age or sex, pointing against the possibility of genetic predisposition.

  4. Teaching Residents Genomic Pathology: A Novel Approach for New Technology

    PubMed Central

    Haspel, Richard L.

    2013-01-01

    Genomics-based diagnostics have become part of patient care. As pathologists have the expertise in clinical laboratory testing as well as access to patient samples, all genomic medicine is genomic pathology. This article will review the evidence that there is a critical need for pathology resident training in genomics. Several individual program curricula are described as well as the progress of the Training Residents in Genomic (TRIG) Working Group. This group has made significant advances towards developing, implementing and evaluating a national curriculum in genomics for pathology residents. The novel approach of the TRIG Working Group can be used as a model for training pathology professionals in any new technology. PMID:23399798

  5. Preparedness of Entering Pediatric Dentistry Residents: Advanced Pediatric Program Directors' and First-Year Residents' Perspectives.

    PubMed

    Rutkauskas, John; Seale, N Sue; Casamassimo, Paul; Rutkauskas, John S

    2015-11-01

    For children to receive needed oral health care, adequate training at both the predoctoral and postdoctoral levels of dental education is required, but previous studies have found inadequacies in predoctoral education that lead to general dentists' unwillingness to treat certain young populations. As another way of assessing predoctoral preparation, the aim of this study was to determine the perspectives of first-year residents and pediatric program directors about residents' preparedness to enter advanced education programs in pediatric dentistry. Surveys were sent to all 74 U.S. program directors and 360 first-year residents. The survey focused on procedures related to prevention, behavior management, restorative procedures, pulp therapy, sedation, and surgery, as well as treating patients funded by Medicaid and with special health care needs. Among the first-year residents, 173 surveys were returned for a 48% response rate; 61 directors returned surveys for an 82% response rate. Only half of the residents (55%) reported feeling adequately prepared for their first year in residency; less than half cited adequate preparation to place stainless steel crowns (SSCs) (42%) and perform pulpotomies (45%). Far fewer felt adequately prepared to provide treatment for children six months to three years of age, including examinations (29%), infant oral exams (27%), and children with severe caries (37%). The program directors were even less positive about the adequacy of residents' preparation. Only 17% deemed them adequately prepared to place SSCs and 13% to perform pulpotomies. Approximately half reported their first-year residents were inadequately prepared to treat very young children and children with severe caries (55% each). This study found that the perceived inadequacy of predoctoral education in pediatric dentistry was consistent at both the learner and educator levels, supporting previous studies identifying inadequacies in this area. PMID:26522630

  6. Residence Hall Seating That Works.

    ERIC Educational Resources Information Center

    Wiens, Janet

    2003-01-01

    Describes the seating chosen for residence halls at the Massachusetts Institute of Technology and the University of New England. The seating required depends on ergonomics, aesthetics, durability, cost, and code requirements. In addition, residence halls must have a range of seating types to accommodate various uses. (SLD)

  7. Substance Abuse by Anesthesiology Residents.

    ERIC Educational Resources Information Center

    Lutsky, Irving; And Others

    1991-01-01

    The analysis of 183 responses to a survey of former anesthesiology residents of the Medical College of Wisconsin found that 29 had been self-administered problematic substance abusers during their residencies, 23 had been alcohol dependent, and 6 had been drug dependent. More than 85 percent of respondents considered the drug policy information…

  8. Sexual Education for Psychiatric Residents

    ERIC Educational Resources Information Center

    Levine, Stephen B.; Scott, David L.

    2010-01-01

    Objective: The authors seek to promote sexuality curriculum development in departments of psychiatry. Methods: The authors first focus on educational philosophy about what residents can be taught about sexual topics and then provide numerical and narrative resident evaluation data following a 6-month, half day per week rotation in a sexuality…

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

    PubMed

    Kansagra, Akash P

    2014-01-01

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

  10. Electrocardiographic interpretation skills of cardiology residents: are they competent?

    PubMed

    Sibbald, Matthew; Davies, Edward G; Dorian, Paul; Yu, Eric H C

    2014-12-01

    Achieving competency at electrocardiogram (ECG) interpretation among cardiology subspecialty residents has traditionally focused on interpreting a target number of ECGs during training. However, there is little evidence to support this approach. Further, there are no data documenting the competency of ECG interpretation skills among cardiology residents, who become de facto the gold standard in their practice communities. We tested 29 Cardiology residents from all 3 years in a large training program using a set of 20 ECGs collected from a community cardiology practice over a 1-month period. Residents interpreted half of the ECGs using a standard analytic framework, and half using their own approach. Residents were scored on the number of correct and incorrect diagnoses listed. Overall diagnostic accuracy was 58%. Of 6 potentially life-threatening diagnoses, residents missed 36% (123 of 348) including hyperkalemia (81%), long QT (52%), complete heart block (35%), and ventricular tachycardia (19%). Residents provided additional inappropriate diagnoses on 238 ECGs (41%). Diagnostic accuracy was similar between ECGs interpreted using an analytic framework vs ECGs interpreted without an analytic framework (59% vs 58%; F(1,1333) = 0.26; P = 0.61). Cardiology resident proficiency at ECG interpretation is suboptimal. Despite the use of an analytic framework, there remain significant deficiencies in ECG interpretation among Cardiology residents. A more systematic method of addressing these important learning gaps is urgently needed.

  11. An Academic Multihealth System PGY2 Pediatric Pharmacy Residency Program.

    PubMed

    Klosterman, Theresa; Meyers, Rachel; Siu, Anita; Shah, Pooja; Kimler, Katelin; Sturgill, Marc; Robinson, Christine

    2015-01-01

    We describe a novel multihealth system pediatric pharmacy residency program through the Ernest Mario School of Pharmacy at Rutgers University. Pediatric clinical pharmacy is a growing field that has seen an increase in demand for practitioners. Practice sites include freestanding children's hospitals, children's hospitals within adult hospitals, and pediatric units within adult hospitals. To accommodate a residency program in a region with no freestanding children's hospital, the pediatric faculty members at the Ernest Mario School of Pharmacy at Rutgers University developed a multihealth system postgraduate year 2 (PGY2) pediatric pharmacy residency program with 6 pediatric faculty members functioning as preceptors at their 5 respective practice sites. The multihealth system setup of the program provides the resident exposure to a multitude of patient populations, pediatric specialties, and pediatric pharmacy practices. In addition, the affiliation with Rutgers University allows an emphasis on academia with opportunities for the resident to lecture in small and large classrooms, facilitate discussion periods, assist with clinical laboratory classes, and precept pharmacy students. The resident has the unique opportunity to develop a research project with a large and diverse patient population owing to the multihealth system rotation sites. A multihealth system PGY2 residency in pediatric pharmacy provides the resident a well-rounded experience in pediatric clinical practice, research, and academia that will enhance the resident's ability to build his or her own pediatric pharmacy practice. PMID:26766936

  12. Building a resident research program in emergency medicine.

    PubMed

    Nocera, Romy; Ramoska, Edward Anthony; Hamilton, Richard Joseph

    2016-03-01

    Residency training programs requirements state, "Residents should participate in scholarly activity." However, there is little consensus regarding how best to achieve these requirements. The objective of this study is to implement a resident research program that emphasizes resident participation in quantitative or qualitative empirical work. A three-step program "Think, Do, Write" roughly follows the 3 years of the residency. During the first phase, the resident chooses a topic, formulates a hypothesis, and completes standard research certifications. Phase 2 involves obtaining Institutional Review Board approval, and conducting the study. The final phase entails analyzing and interpreting the data, and writing an abstract to present during an annual research day. Residents are encouraged to submit their projects for presentation at scientific conferences and for publication. Multiple departmental resources are available, including a Resident Research Fund, and full support of the faculty. Prior to the new program, most scholarly activity consisted of case reports, book chapters, review articles, or other miscellaneous projects; only 27 % represented empirical studies. Starting in 2012, the new program was fully implemented, resulting in notable growth in original empirical works among residents. Currently there is almost 100 % participation in studies, and numerous residents have presented at national conferences, and have peer-reviewed publications. With a comprehensive and supported program in place, emergency medicine residents proved capable of conducting high-quality empirical research within their relatively limited time. Overall, residents developed valuable skills in research design and statistical analysis, and greatly increased their productivity as academic and clinical researchers. PMID:26597875

  13. Resident memory T cells in human health and disease

    PubMed Central

    Clark, Rachael A.

    2015-01-01

    Resident memory T cells are non-recirculating memory T cells that persist long term in epithelial barrier tissues, including the gastrointestinal tract, lung, skin and reproductive tract. Resident memory T cells persist in the absence of antigens, have impressive effector functions and provide rapid on-site immune protection against known pathogens in peripheral tissues. A fundamentally distinct gene expression program differentiates resident memory T cells from circulating T cells. Although these cells likely evolved to provide rapid immune protection against pathogens, autoreactive, aberrantly activated and malignant resident memory cells contribute to numerous human inflammatory diseases including mycosis fungoides and psoriasis. This review will discuss both the science and medicine of resident memory T cells, exploring how these cells contribute to healthy immune function and discussing what is known about how these cells contribute to human inflammatory and autoimmune diseases. PMID:25568072

  14. Migratory New World blackbirds (icterids) are more neophobic than closely related resident icterids.

    PubMed

    Mettke-Hofmann, Claudia; Winkler, Hans; Hamel, Paul B; Greenberg, Russell

    2013-01-01

    Environments undergo short-term and long-term changes due to natural or human-induced events. Animals differ in their ability to cope with such changes which can be related to their ecology. Changes in the environment often elicit avoidance reactions (neophobia) which protect animals from dangerous situations but can also inhibit exploration and familiarization with novel situations and thus, learning about new resources. Studies investigating the relationship between a species' ecology and its neophobia have so far been restricted to comparing only a few species and mainly in captivity. The current study investigated neophobia reactions to experimentally-induced changes in the natural environment of six closely-related blackbird species (Icteridae), including two species represented by two distinct populations. For analyses, neophobic reactions (difference in number of birds feeding and time spent feeding with and without novel objects) were related to several measures of ecological plasticity and the migratory strategy (resident or migratory) of the population. Phylogenetic relationships were incorporated into the analysis. The degree of neophobia was related to migratory strategy with migrants expressing much higher neophobia (fewer birds feeding and for a shorter time with objects present) than residents. Furthermore, neophobia showed a relationship to diet breadth with fewer individuals of diet generalists than specialists returning when objects were present supporting the dangerous niche hypothesis. Residents may have evolved lower neophobia as costs of missing out on opportunities may be higher for residents than migrants as the former are restricted to a smaller area. Lower neophobia allows them approaching changes in the environment (e.g. novel objects) quickly, thereby securing access to resources. Additionally, residents have a greater familiarity with similar situations in the area than migrants and the latter may, therefore, initially stay behind

  15. Migratory New World blackbirds (icterids) are more neophobic than closely related resident icterids.

    PubMed

    Mettke-Hofmann, Claudia; Winkler, Hans; Hamel, Paul B; Greenberg, Russell

    2013-01-01

    Environments undergo short-term and long-term changes due to natural or human-induced events. Animals differ in their ability to cope with such changes which can be related to their ecology. Changes in the environment often elicit avoidance reactions (neophobia) which protect animals from dangerous situations but can also inhibit exploration and familiarization with novel situations and thus, learning about new resources. Studies investigating the relationship between a species' ecology and its neophobia have so far been restricted to comparing only a few species and mainly in captivity. The current study investigated neophobia reactions to experimentally-induced changes in the natural environment of six closely-related blackbird species (Icteridae), including two species represented by two distinct populations. For analyses, neophobic reactions (difference in number of birds feeding and time spent feeding with and without novel objects) were related to several measures of ecological plasticity and the migratory strategy (resident or migratory) of the population. Phylogenetic relationships were incorporated into the analysis. The degree of neophobia was related to migratory strategy with migrants expressing much higher neophobia (fewer birds feeding and for a shorter time with objects present) than residents. Furthermore, neophobia showed a relationship to diet breadth with fewer individuals of diet generalists than specialists returning when objects were present supporting the dangerous niche hypothesis. Residents may have evolved lower neophobia as costs of missing out on opportunities may be higher for residents than migrants as the former are restricted to a smaller area. Lower neophobia allows them approaching changes in the environment (e.g. novel objects) quickly, thereby securing access to resources. Additionally, residents have a greater familiarity with similar situations in the area than migrants and the latter may, therefore, initially stay behind

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

    PubMed

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

    2015-01-01

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

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

    PubMed Central

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

    2015-01-01

    Medical resident education in the United States has been a matter of national priority for decades, exemplified initially through the Liaison Committee for Graduate Medical Education and then superseded by the Accreditation Council for Graduate Medical Education. A recent Special Report in the New England Journal of Medicine, however, has described resident educational programs to date as prescriptive, noting an absence of innovation in education. Current aims of contemporary medical resident education are thus being directed at ensuring quality in learning as well as in patient care. Achievement and work-motivation theories attempt to explain people’s choice, performance, and persistence in tasks. Expectancy Theory as one such theory was reviewed in detail, appearing particularly applicable to surgical residency training. Correlations between Expectancy Theory as a work-motivation theory and residency education were explored. Understanding achievement and work-motivation theories affords an opportunity to gain insight into resident motivation in training. The application of Expectancy Theory in particular provides an innovative perspective into residency education. Afforded are opportunities to promote the development of programmatic methods facilitating surgical resident motivation in education. PMID:25995656

  18. Dietary patterns, metabolic markers and subjective sleep measures in resident physicians.

    PubMed

    Mota, Maria Carliana; De-Souza, Daurea Abadia; Rossato, Luana Thomazetto; Silva, Catarina Mendes; Araújo, Maria Bernadete Jeha; Tufik, Sérgio; de Mello, Marco Túlio; Crispim, Cibele Aparecida

    2013-10-01

    Shiftwork is common in medical training and is necessary for 24-h hospital coverage. Shiftwork poses difficulties not only because of the loss of actual sleep hours but also because it can affect other factors related to lifestyle, such as food intake, physical activity level, and, therefore, metabolic patterns. However, few studies have investigated the nutritional and metabolic profiles of medical personnel receiving training who are participating in shiftwork. The aim of the present study was to identify the possible negative effects of food intake, anthropometric variables, and metabolic and sleep patterns of resident physicians and establish the differences between genders. The study included 72 resident physicians (52 women and 20 men) who underwent the following assessments: nutritional assessment (3-day dietary recall evaluated by the Adapted Healthy Eating Index), anthropometric variables (height, weight, body mass index, and waist circumference), fasting metabolism (lipids, cortisol, high-sensitivity C-reactive protein [hs-CRP], glucose, and insulin), physical activity level (Baecke questionnaire), sleep quality (Pittsburgh Sleep Quality Index; PSQI), and sleepiness (Epworth Sleepiness Scale; ESS). We observed a high frequency of residents who were overweight or obese (65% for men and 21% for women; p = 0.004). Men displayed significantly greater body mass index (BMI) values (p = 0.002) and self-reported weight gain after the beginning of residency (p = 0.008) than women. Poor diet was observed for both genders, including the low intake of vegetables and fruits and the high intake of sweets, saturated fat, cholesterol, and caffeine. The PSQI global scores indicated significant differences between genders (5.9 vs. 7.5 for women and men, respectively; p = 0.01). Women had significantly higher mean high-density lipoprotein cholesterol (HDL-C; p < 0.005), hs-CRP (p = 0.04), and cortisol (p = 0.009) values than men. The elevated prevalence of

  19. Learning styles of orthodontic residents.

    PubMed

    Hughes, Janeen M; Fallis, Drew W; Peel, Jennifer L; Murchison, David F

    2009-03-01

    Significant challenges face many orthodontic residency programs, particularly a shortage of full-time experienced faculty members. Due to this shortage, it is critical that program directors design comprehensive curricula that incorporate the most effective and efficient teaching methods. It is theorized that teaching effectiveness and efficiency are optimized when the course design and content closely match students' learning preferences. This survey study was designed to distinguish the learning preferences of orthodontic residents utilizing Felder and Soloman's Index of Learning Styles, which assesses student learning preferences in four dimensions using dichotomous scales, thereby providing insight into how teaching strategies can best be structured. As a secondary focus, additional questions on the survey were asked to gain information about residents' access to the Internet and comfort level with online learning so as to address acceptance of web-based courses in response to the shortage of full-time faculty members. Orthodontic residents, contacted via email, were requested to complete an online survey; 261 responses were collected. The results indicate that orthodontic residents are highly visual learners and show a preference for sensing and sequential learning strategies. In terms of information technology, the residents are comfortable with and have adequate access to current technological assets; therefore, they may be well suited for inclusion of computer-based teaching modules and other multimedia devices in their residency curriculum.

  20. Social Individualism.

    ERIC Educational Resources Information Center

    Cornille, Thomas A.; Harrigan, John

    Relationships between individuals and society have often been presented from the perspective of the social institution. Social psychology has addressed the variables that affect the individual in relationships with larger groups. Social individualism is a conceptual framework that explores the relationship of the individual and society from the…

  1. [Motivation and satisfaction of residents in urology].

    PubMed

    Enzmann, T; Buxel, H; Benzing, F

    2010-08-01

    To address the increasing shortage of qualified residents, which leads to further discontent and additional on-call rotations for the remaining physicians, an analysis of the current situation was performed. Stress in the daily working routine, not enough free time, too little pay, or too little compensatory time off for overtime as well as inadequate options for continuing education were reported to be the main elements of dissatisfaction. The economic pressure of day-to-day work continues to define the physician's role and places demands on the medical staff by burdening them with nonmedical and administrative tasks.The major causes mentioned were staff shortage and lack of support provided by supervisors and the administration. For this reason, human resource development should be considered a strategic and central goal. This requires a normative, cross-functional approach at all levels of management and inclusion of personnel departments in the strategic processes of the hospital. The most important aspects for resident satisfaction were the work environment, acceptable work-life balance and remuneration, compensation for overtime, and quality of available continuing education, which is often rated as being insufficient.Effective strategies to improve the motivation of residents comprise offering opportunities for structured continuing education, optimizing the everyday work processes, and involving employees in social networks. The establishment of feedback strategies, including recognition of residents' achievements, will help to ensure their loyalty and identification with their clinic. This can serve as a preventive measure to offset any potential willingness to change jobs. PMID:20640397

  2. Leadership and business education in orthopaedic residency training programs.

    PubMed

    Kiesau, Carter D; Heim, Kathryn A; Parekh, Selene G

    2011-01-01

    Leadership and business challenges have become increasingly present in the practice of medicine. Orthopaedic residency programs are at the forefront of educating and preparing orthopaedic surgeons. This study attempts to quantify the number of orthopaedic residency programs in the United States that include leadership or business topics in resident education program and to determine which topics are being taught and rate the importance of various leadership characteristics and business topics. A survey was sent to all orthopaedic department chairpersons and residency program directors in the United States via e-mail. The survey responses were collected using a survey collection website. The respondents rated the importance of leadership training for residents as somewhat important. The quality of character, integrity, and honesty received the highest average rating among 19 different qualities of good leaders in orthopaedics. The inclusion of business training in resident education was also rated as somewhat important. The topic of billing and coding received the highest average rating among 14 different orthopaedically relevant business topics. A variety of topics beyond the scope of clinical practice must be included in orthopaedic residency educational curricula. The decreased participation of newly trained orthopaedic surgeons in leadership positions and national and state orthopaedic organizations is concerning for the future of orthopaedic surgery. Increased inclusion of leadership and business training in resident education is important to better prepare trainees for the future. PMID:21838073

  3. Leadership and business education in orthopaedic residency training programs.

    PubMed

    Kiesau, Carter D; Heim, Kathryn A; Parekh, Selene G

    2011-01-01

    Leadership and business challenges have become increasingly present in the practice of medicine. Orthopaedic residency programs are at the forefront of educating and preparing orthopaedic surgeons. This study attempts to quantify the number of orthopaedic residency programs in the United States that include leadership or business topics in resident education program and to determine which topics are being taught and rate the importance of various leadership characteristics and business topics. A survey was sent to all orthopaedic department chairpersons and residency program directors in the United States via e-mail. The survey responses were collected using a survey collection website. The respondents rated the importance of leadership training for residents as somewhat important. The quality of character, integrity, and honesty received the highest average rating among 19 different qualities of good leaders in orthopaedics. The inclusion of business training in resident education was also rated as somewhat important. The topic of billing and coding received the highest average rating among 14 different orthopaedically relevant business topics. A variety of topics beyond the scope of clinical practice must be included in orthopaedic residency educational curricula. The decreased participation of newly trained orthopaedic surgeons in leadership positions and national and state orthopaedic organizations is concerning for the future of orthopaedic surgery. Increased inclusion of leadership and business training in resident education is important to better prepare trainees for the future.

  4. Learning preference and personality type: their association in paediatric residents.

    PubMed

    Greenberg, L W; Goldberg, R M; Foley, R P

    1996-07-01

    The objective of this study was to determine if there is a relationship between the learning preferences and personality types of residents in paediatrics. As part of a study to teach residents in paediatrics how to teach, the authors administered the Learning Preference Inventory (LPI) and Fundamental Interpersonal Relationship Orientation (FIRO-B) instruments to 55 residents in paediatrics at all three levels of training. The instruments provided data that were used to provide feedback to residents on their learning preferences and interaction styles, as well as how these factors might affect teaching and learning in the clinical setting. The Pearson correlation coefficient was used to determine relationships between the LPI and the FIRO-B. Fifty-two of the 55 residents (95%) completed the instruments. The results revealed that residents' learning preferences were significantly related to their personality types. For example, residents with high inclusion and affection scores on the FIRO-B preferred learning with others, which was significantly related to their high interpersonal scores on the LPI. Residents with low inclusion and affection scores were more likely to prefer independent learning (high individual and student-structured scores on the LPI) and abstract learning at statistically significant levels. The scores obtained by residents in paediatrics on the LPI were strongly correlated with those obtained on the FIRO-B. These data may have important implications for the way in which staff recruit, counsel and teach residents. The fact that the LPI is easy to administer and does not purport to measure personality styles makes it an acceptable educational tool that can be used in many areas of training.

  5. Peace psychology should include the study of peaceful individuals.

    PubMed

    Nelson, Linden L

    2014-09-01

    The selection of topics for the special issue on peace psychology (October 2013) probably gave readers the impression that peace psychology should be defined as the study of conflict and peace at intergroup, societal, and global levels.

  6. Resident work hour restrictions impact chief resident operative experience.

    PubMed

    Christmas, A Britton; Brintzenhoff, Rita A; Sing, Ronald F; Schmelzer, Thomas M; Bolton, Sandra D; Miles, William S; Thomason, Michael H

    2009-11-01

    Since the institution of the Accreditation Council for Graduate Medical Education resident work restrictions, much discussion has arisen regarding the potential effect on surgical resident training. We undertook this study to examine the effects on resident operative experience. We retrospectively analyzed chief residents' Accreditation Council for Graduate Medical Education case logs before (PRE) and after (POST) the 80-hour work restriction. Overall, 22 resident logs were evaluated, six PRE and 16 POST. Four case categories were examined: total major cases, total trauma operative cases, total chief cases, and total teaching assistant cases. Significance was defined as P < 0.05. Comparing the PRE and POST groups demonstrated a trend toward fewer total major cases (1061 vs 964, P = 0.38) and fewer total trauma operative cases (55 vs 47, P = 0.37). Teaching assistant cases increased from 67 to 91 but also failed to reach significance (P = 0.37). However, further comparison between the PRE and POST groups yielded a statistically significant decrease in the number of total chief cases (494 vs 333, P = 0.0092). The significant decrease in the number of total chief cases demonstrates that the work hour restriction most affected the chief year operative experience. Further evaluation of resident participation in nonoperative facets may reveal additional deficiencies of surgical training under work hour restrictions.

  7. 19 CFR 113.35 - Individual sureties.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... both a resident and citizen of the United States. (2) Married women. A married woman may be accepted as.... (3) Granting of power of attorney. Any individual other than a married woman in a state where she...

  8. 19 CFR 113.35 - Individual sureties.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... both a resident and citizen of the United States. (2) Married women. A married woman may be accepted as.... (3) Granting of power of attorney. Any individual other than a married woman in a state where she...

  9. 19 CFR 113.35 - Individual sureties.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... both a resident and citizen of the United States. (2) Married women. A married woman may be accepted as.... (3) Granting of power of attorney. Any individual other than a married woman in a state where she...

  10. 19 CFR 113.35 - Individual sureties.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... both a resident and citizen of the United States. (2) Married women. A married woman may be accepted as.... (3) Granting of power of attorney. Any individual other than a married woman in a state where she...

  11. 34 CFR 303.15 - Include; including.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 34 Education 2 2010-07-01 2010-07-01 false Include; including. 303.15 Section 303.15 Education Regulations of the Offices of the Department of Education (Continued) OFFICE OF SPECIAL EDUCATION AND REHABILITATIVE SERVICES, DEPARTMENT OF EDUCATION EARLY INTERVENTION PROGRAM FOR INFANTS AND TODDLERS...

  12. Connecting resident education to patient outcomes: the evolution of a quality improvement curriculum in an internal medicine residency.

    PubMed

    Zafar, Muhammad A; Diers, Tiffiny; Schauer, Daniel P; Warm, Eric J

    2014-10-01

    As part of the Accreditation Council for Graduate Medical Education's Next Accreditation System, residency programs must connect resident-physician education to improved patient care outcomes. Residency training programs, however, face multiple obstacles in doing so. Results from residency quality improvement (QI) curricula tend to show improvement in simple process-based measures but not in more complex outcomes of care such as diabetes or blood pressure control. In this article, the authors describe the evolution of their QI educational program for internal medicine residents at the University of Cincinnati Medical Center within the structure of a novel training model called the Ambulatory Long Block. They discuss a resident-run project that led to reduced rates of patients with uncontrolled diabetes as an example of improvement in outcome measures. Despite favorable results from that particular resident group, the successful intervention did not spread practice-wide. Using this example, they detail the phases of evolution and lessons learned from their curriculum from 2006 to 2014 within a framework of previously published general principles for successful QI education, including those of exemplary care and learning sites. Successful programs require leadership, faculty expertise and mentorship, data management, learner buy-in, and patient engagement. Their experience will hopefully be of help to others as they attempt to simultaneously improve care and education. Further research and innovation are needed in this area, including optimizing strategies for strengthening resident-driven projects through partnership with nursing, allied health, and longitudinally engaged faculty members.

  13. Position Paper: Dental General Practice Residency Programs: Financing and Operations.

    ERIC Educational Resources Information Center

    Hanson, Paul W.

    1983-01-01

    A discussion of changeable economic issues that can affect dental general practice residency program planning includes costs and resource allocation, maximizing efficiency and productivity, ambulatory and inpatient revenue sources, management functions, faculty as practitioners, faculty appointments, and marketing. (MSE)

  14. Community Needs Assessment with Hispanic, Spanish-monolingual Residents.

    ERIC Educational Resources Information Center

    Batsche, C.; Hernandez, M.; Montenegro, M. C.

    1999-01-01

    Describes methods to increase the participation of Hispanic residents in community-needs-assessment activities based on experiences in Tampa (Florida). Includes suggestions for defining the population, estimating population size, selecting the sample, translating instruments, and administering the survey. (SLD)

  15. Transition within a graduate nurse residency program.

    PubMed

    Varner, Kendra D; Leeds, Ruth A

    2012-11-01

    As evidence of the effectiveness of these programs grows, nurse leaders feel the pressure to establish high-quality, yet cost-effective graduate nurse transition programs. In 2009, the authors developed an innovative program by incorporating transition theory, research results, stakeholder involvement, and the recommendations of the National Council of State Boards of Nursing. The graduate nurse residency program yielded positive outcomes, including stakeholder satisfaction and high retention rates. PMID:23061408

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

    PubMed Central

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

    2006-01-01

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

  17. Bahamas connection: residence areas selected by breeding female loggerheads tagged in Dry Tortugas National Park, USA

    USGS Publications Warehouse

    Hart, Kristen M.; Sartain-Iverson, Autumn R.; Fujisaki, Ikuko

    2015-01-01

    We demonstrate a previously unknown link between Dry Tortugas nesting beaches and Bahamas residence areas; 17/39 (43.6%) of nesting loggerheads tagged in and tracked from the Dry Tortugas take up residence at sites in the Bahamas. Residence area estimates for these turtles were similar in size to previous foraging area estimates for two turtles tracked to the Bahamas in other studies. We show inter-annual residence area repeatability, and that residence areas of different individuals generally did not overlap. We suggest that these loggerheads possibly establish territories.

  18. The Optometric Residency: Its Bloom.

    ERIC Educational Resources Information Center

    Bleything, Willard B.

    1979-01-01

    Guidelines for proposed residencies in optometry are presented for pediatric, rehabilitative, and hospital optometry. Their significance in terms of costs, patient population, faculty expertise, and critical mass are discussed. (JMF)

  19. Residents' leadership styles and effectiveness as perceived by nurses.

    PubMed

    McCue, J D; Magrinat, G; Hansen, C J; Bailey, R S

    1986-01-01

    Although physicians are required to act as leaders in a variety of situations, leadership ability and leadership training have been largely ignored by medical educators. The leadership styles and leadership effectiveness of 17 residents in a community hospital were studied as part of a leadership training seminar. Self-ratings and ratings of the residents by nurses who had worked with them were used to assess the residents' leadership style and the nurses' perceptions of the effectiveness of those styles. Styles that emphasized relationships with co-workers (encouraging and coaching styles) predominated over low relationship-oriented styles (delegating and structuring). The nurses perceived individual residents who exhibited encouraging and coaching leadership styles as being distinctly more effective leaders than the residents who exhibited structuring and delegating styles. The residents, however, rated all four styles as similarly effective. Leadership training programs and studies of the type reported here may provide an opportunity for faculty members to help residents learn more appropriate and productive styles of leadership.

  20. Rapid hydropyrolysis of resid oil

    SciTech Connect

    Mathur, V.K.; Salahuddin, M.A.; Mohamed, A.R.

    1994-12-31

    The objective of this investigation was to study the rapid hydropyrolysis of Arabian Light atmospheric resid oil and vacuum resid oil for the production of light distillates. The results of this study have been divided into the effect of exposure time, temperature, and gaseous atmosphere. The heat flux used was in the range of 70 to about 97 watt/cm{sup 2}. The results from ASTM simulated distillation of the hydrogenated oil obtained at various experimental conditions are also presented.

  1. 38 CFR 51.70 - Resident rights.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... FOR NURSING HOME CARE OF VETERANS IN STATE HOMES Standards § 51.70 Resident rights. The resident has a...; (iii) Physicians of the resident's choice (to provide care in the nursing home, physicians must...

  2. 38 CFR 51.70 - Resident rights.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... FOR NURSING HOME CARE OF VETERANS IN STATE HOMES Standards § 51.70 Resident rights. The resident has a...; (iii) Physicians of the resident's choice (to provide care in the nursing home, physicians must...

  3. Towards the reliable calculation of residence time for off-lattice kinetic Monte Carlo simulations

    NASA Astrophysics Data System (ADS)

    Alexander, Kathleen C.; Schuh, Christopher A.

    2016-08-01

    Kinetic Monte Carlo (KMC) methods have the potential to extend the accessible timescales of off-lattice atomistic simulations beyond the limits of molecular dynamics by making use of transition state theory and parallelization. However, it is a challenge to identify a complete catalog of events accessible to an off-lattice system in order to accurately calculate the residence time for KMC. Here we describe possible approaches to some of the key steps needed to address this problem. These include methods to compare and distinguish individual kinetic events, to deterministically search an energy landscape, and to define local atomic environments. When applied to the ground state  ∑5(2 1 0) grain boundary in copper, these methods achieve a converged residence time, accounting for the full set of kinetically relevant events for this off-lattice system, with calculable uncertainty.

  4. Resident aggression toward staff at a center for the developmentally disabled.

    PubMed

    West, Christine A; Galloway, Ellen; Niemeier, Maureen T

    2014-01-01

    Few studies have examined factors contributing to nonfatal assaults to staff working in residential care facilities. The authors evaluated resident assaults toward direct care/nursing staff at an intermediate Care Facility for Individuals with Mental Retardation (ICF/MR), which included observations of work areas, employee interviews, calculation of injury and assault rates for 2004 to 2007 from Occupational Safety and Health Administration Logs, and review of state ICP/MR guidelines. Most staff interviewed reported having been injured during physical restraint of a resident and the average rate of injury from assault at the center evaluated was higher than the average national rates for the health care and social assistance sector for the same time period. The center lacked policies and developing a post-incident response and evaluation program to assist staff in coping with the consequences of assault and/or occupational injury. PMID:24571051

  5. The Effects of Evacuation on Nursing Home Residents With Dementia

    PubMed Central

    Brown, Lisa M.; Dosa, David M.; Thomas, Kali; Hyer, Kathryn; Feng, Zhanlian; Mor, Vincent

    2013-01-01

    Background In response to the hurricane-related deaths of nursing home residents, there has been a steady increase in the number of facilities that evacuate under storm threat. This study examined the effects of evacuation during Hurricane Gustav on residents who were cognitively impaired. Methods Nursing homes in counties located in the path of Hurricane Gustav were identified. The Minimum Data Set resident assessment files were merged with the Centers for Medicare enrollment file to determine date of death for residents in identified facilities. Difference-in-differences analyses were conducted adjusting for residents’ demographic characteristics and acuity. Results The dataset included 21,255 residents living in 119 at risk nursing homes over three years of observation. Relative to the two years before the storm, there was a 2.8 percent increase in death at 30 days and a 3.9 percent increase in death at 90 days for residents with severe dementia who evacuated for Hurricane Gustav, controlling for resident demographics and acuity. Conclusions The findings of this research reveal the deleterious effects of evacuation on residents with severe dementia. Interventions need to be developed and tested to determine the best methods for protecting this at risk population when there are no other options than to evacuate the facility. PMID:22930698

  6. Female residents experiencing medical errors in general internal medicine: a qualitative study

    PubMed Central

    2014-01-01

    Background Doctors, especially doctors-in-training such as residents, make errors. They have to face the consequences even though today’s approach to errors emphasizes systemic factors. Doctors’ individual characteristics play a role in how medical errors are experienced and dealt with. The role of gender has previously been examined in a few quantitative studies that have yielded conflicting results. In the present study, we sought to qualitatively explore the experience of female residents with respect to medical errors. In particular, we explored the coping mechanisms displayed after an error. This study took place in the internal medicine department of a Swiss university hospital. Methods Within a phenomenological framework, semi-structured interviews were conducted with eight female residents in general internal medicine. All interviews were audiotaped, fully transcribed, and thereafter analyzed. Results Seven main themes emerged from the interviews: (1) A perception that there is an insufficient culture of safety and error; (2) The perceived main causes of errors, which included fatigue, work overload, inadequate level of competences in relation to assigned tasks, and dysfunctional communication; (3) Negative feelings in response to errors, which included different forms of psychological distress; (4) Variable attitudes of the hierarchy toward residents involved in an error; (5) Talking about the error, as the core coping mechanism; (6) Defensive and constructive attitudes toward one’s own errors; and (7) Gender-specific experiences in relation to errors. Such experiences consisted in (a) perceptions that male residents were more confident and therefore less affected by errors than their female counterparts and (b) perceptions that sexist attitudes among male supervisors can occur and worsen an already painful experience. Conclusions This study offers an in-depth account of how female residents specifically experience and cope with medical errors. Our

  7. Prevalence of enteroparasites in a residence for children in the Córdoba Province, Argentina.

    PubMed

    Guignard, S; Arienti, H; Freyre, L; Lujan, H; Rubinstein, H

    2000-03-01

    A study of the prevalence of enteroparasites in a population belonging to a substitute home that gives shelter to orphaned and homeless children was done using conventional methods of analysis. This home is located in Córdoba Province, Argentina, and has the following characteristics: It has nine houses located inside the main plot of ground, that shelter 139 individuals, and 25 houses outside this plot distributed randomly in Unquillo city and that shelter 257 individuals. The overall parasitic infection, pathogen and commensal organisms included, yielded 84.8% and the prevalence of the most important parasites was: Enterobius vermicularis (43.4%), Giardia lamblia (23.0%), Ascaris lumbricoides (13.1%), Entamoeba coli (45.5%), Blastocystis hominis (44.4%) and Endolimax nana (34.6%). We also analyzed the population dividing it according to the residence place (inside or outside the plot), age and sex of the individuals. In reference to the location of the patients, A. lumbricoides and E. coli showed significant prevalence in the individuals living inside the plot (p < 0.001 and p < 0.005, respectively) and of B. hominis in those living outside the main plot (p < 0.005). Results indicated a greater parasitism level in the outside residents (61.5%, p < 0.001). When the individuals were studied according to sex, no significant difference was observed, except for E. vermicularis that showed greater prevalence in the male sex (p < 0.04). When the individuals were grouped according to age ranges, a greater prevalence in individuals from 5 to 14 years was noticed (p < 0.01). In this study is also included an analysis of the multiparasitism level that comprises the whole population. PMID:10870946

  8. Health effects of residence near hazardous waste landfill sites: a review of epidemiologic literature.

    PubMed Central

    Vrijheid, M

    2000-01-01

    This review evaluates current epidemiologic literature on health effects in relation to residence near landfill sites. Increases in risk of adverse health effects (low birth weight, birth defects, certain types of cancers) have been reported near individual landfill sites and in some multisite studies, and although biases and confounding factors cannot be excluded as explanations for these findings, they may indicate real risks associated with residence near certain landfill sites. A general weakness in the reviewed studies is the lack of direct exposure measurement. An increased prevalence of self-reported health symptoms such as fatigue, sleepiness, and headaches among residents near waste sites has consistently been reported in more than 10 of the reviewed papers. It is difficult to conclude whether these symptoms are an effect of direct toxicologic action of chemicals present in waste sites, an effect of stress and fears related to the waste site, or an effect of reporting bias. Although a substantial number of studies have been conducted, risks to health from landfill sites are hard to quantify. There is insufficient exposure information and effects of low-level environmental exposure in the general population are by their nature difficult to establish. More interdisciplinary research can improve levels of knowledge on risks to human health of waste disposal in landfill sites. Research needs include epidemiologic and toxicologic studies on individual chemicals and chemical mixtures, well-designed single- and multisite landfill studies, development of biomarkers, and research on risk perception and sociologic determinants of ill health. PMID:10698726

  9. 24 CFR 964.140 - Resident training.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ...: (1) Community organization and leadership training; (2) Organizational development training for Resident Management Corporations and duly elected Resident Councils; (3) Public housing policies,...

  10. 24 CFR 964.140 - Resident training.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ...: (1) Community organization and leadership training; (2) Organizational development training for Resident Management Corporations and duly elected Resident Councils; (3) Public housing policies,...

  11. Models for Individualized Instruction.

    ERIC Educational Resources Information Center

    Georgiades, William, Ed.; Clark, Donald C., Ed.

    This book, consisting of five parts, provides a collection of source materials that will assist in implementing individualized instruction; provides examples of interrelated systems for individualizing instruction; and describes the components of individualized instructional systems, including flexible use of time, differentiated staffing, new…

  12. Educating residents in behavioral health care and collaboration: integrated clinical training of pediatric residents and psychology fellows.

    PubMed

    Pisani, Anthony R; leRoux, Pieter; Siegel, David M

    2011-02-01

    Pediatric residency practices face the challenge of providing both behavioral health (BH) training for pediatricians and psychosocial care for children. The University of Rochester School of Medicine and Dentistry and Rochester General Hospital developed a joint training program and continuity clinic infrastructure in which pediatric residents and postdoctoral psychology fellows train and practice together. The integrated program provides children access to BH care in a primary care setting and gives trainees the opportunity to integrate collaborative BH care into their regular practice routines. During 1998-2008, 48 pediatric residents and 8 psychology fellows trained in this integrated clinical environment. The program's accomplishments include longevity, faculty and fiscal stability, sustained support from pediatric leadership and community payers, the development in residents and faculty of greater comfort in addressing BH problems and collaborating with BH specialists, and replication of the model in two other primary care settings. In addition to quantitative program outcomes data, the authors present a case example that illustrates how the integrated program works and achieves its goals. They propose that educating residents and psychology trainees side by side in collaborative BH care is clinically and educationally valuable and potentially applicable to other settings. A companion report published in this issue provides results from a study comparing the perceptions of pediatric residents whose primary care continuity clinic took place in this integrated setting with those of residents from the same pediatric residency who had their continuity clinic training in a nonintegrated setting.

  13. 42 CFR 413.79 - Direct GME payments: Determination of the weighted number of FTE residents.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... approved preventive medicine residency or fellowship program also may be counted as a full FTE resident for... in geriatric medicine, accredited by the appropriate approving body listed in § 415.152 of this... paragraph (c)(3)(ii)(A)(1) of this section, to include the number of FTE residents for which a new...

  14. 42 CFR 409.15 - Services furnished by an intern or a resident-in-training.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 42 Public Health 2 2012-10-01 2012-10-01 false Services furnished by an intern or a resident-in... Inpatient Critical Access Hospital Services § 409.15 Services furnished by an intern or a resident-in-training. Medical or surgical services provided by an intern or a resident-in-training are included...

  15. 42 CFR 409.15 - Services furnished by an intern or a resident-in-training.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 42 Public Health 2 2011-10-01 2011-10-01 false Services furnished by an intern or a resident-in... Inpatient Critical Access Hospital Services § 409.15 Services furnished by an intern or a resident-in-training. Medical or surgical services provided by an intern or a resident-in-training are included...

  16. 42 CFR 409.15 - Services furnished by an intern or a resident-in-training.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 42 Public Health 2 2014-10-01 2014-10-01 false Services furnished by an intern or a resident-in... Inpatient Critical Access Hospital Services § 409.15 Services furnished by an intern or a resident-in-training. Medical or surgical services provided by an intern or a resident-in-training are included...

  17. 42 CFR 409.15 - Services furnished by an intern or a resident-in-training.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 42 Public Health 2 2013-10-01 2013-10-01 false Services furnished by an intern or a resident-in... Inpatient Critical Access Hospital Services § 409.15 Services furnished by an intern or a resident-in-training. Medical or surgical services provided by an intern or a resident-in-training are included...

  18. 24 CFR 982.610 - Group home: Who may reside in a group home.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... disabilities in accordance with 24 CFR part 8. See § 982.316 concerning occupancy by a live-in aide. (c) Except for a live-in aide, all residents of a group home, whether assisted or unassisted, must be elderly... reside in the unit, including assisted and unassisted residents and any live-in aide....

  19. 24 CFR 982.610 - Group home: Who may reside in a group home.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... disabilities in accordance with 24 CFR part 8. See § 982.316 concerning occupancy by a live-in aide. (c) Except for a live-in aide, all residents of a group home, whether assisted or unassisted, must be elderly... reside in the unit, including assisted and unassisted residents and any live-in aide....

  20. 24 CFR 982.610 - Group home: Who may reside in a group home.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... disabilities in accordance with 24 CFR part 8. See § 982.316 concerning occupancy by a live-in aide. (c) Except for a live-in aide, all residents of a group home, whether assisted or unassisted, must be elderly... reside in the unit, including assisted and unassisted residents and any live-in aide....

  1. 24 CFR 982.610 - Group home: Who may reside in a group home.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... disabilities in accordance with 24 CFR part 8. See § 982.316 concerning occupancy by a live-in aide. (c) Except for a live-in aide, all residents of a group home, whether assisted or unassisted, must be elderly... reside in the unit, including assisted and unassisted residents and any live-in aide....

  2. 24 CFR 982.610 - Group home: Who may reside in a group home.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... disabilities in accordance with 24 CFR part 8. See § 982.316 concerning occupancy by a live-in aide. (c) Except for a live-in aide, all residents of a group home, whether assisted or unassisted, must be elderly... reside in the unit, including assisted and unassisted residents and any live-in aide....

  3. 42 CFR 415.204 - Services of residents in skilled nursing facilities and home health agencies.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 42 Public Health 3 2013-10-01 2013-10-01 false Services of residents in skilled nursing facilities... SETTINGS Services of Residents § 415.204 Services of residents in skilled nursing facilities and home... nursing facility. Payment to a participating skilled nursing facility may include the cost of services...

  4. 42 CFR 415.204 - Services of residents in skilled nursing facilities and home health agencies.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 42 Public Health 3 2014-10-01 2014-10-01 false Services of residents in skilled nursing facilities... SETTINGS Services of Residents § 415.204 Services of residents in skilled nursing facilities and home... nursing facility. Payment to a participating skilled nursing facility may include the cost of services...

  5. 42 CFR 415.204 - Services of residents in skilled nursing facilities and home health agencies.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 42 Public Health 3 2012-10-01 2012-10-01 false Services of residents in skilled nursing facilities... SETTINGS Services of Residents § 415.204 Services of residents in skilled nursing facilities and home... nursing facility. Payment to a participating skilled nursing facility may include the cost of services...

  6. An Examination of Mentoring Relationships and Leadership Capacity in Resident Assistants

    ERIC Educational Resources Information Center

    Early, Sherry L.

    2016-01-01

    The leadership capacity of resident assistants can be impacted by many experiences, including involvement in mentoring relationships. The purpose of this study was to examine if and how resident assistants' leadership capacities are influenced by participating in these relationships. A sample of 6,006 resident assistants was analyzed using data…

  7. Association of the duration of residence with obesity-related eating habits and dietary patterns among Latin-American immigrants in Spain.

    PubMed

    Marín-Guerrero, A C; Rodríguez-Artalejo, Fernando; Guallar-Castillón, P; López-García, Esther; Gutiérrez-Fisac, Juan L

    2015-01-28

    The dietary patterns of immigrants usually change with the duration of residence and progressively resemble those of the host country. However, very few studies have investigated individuals migrating to countries with a high-quality diet, such as the Mediterranean diet (MD), and none has yet focused on Latin-American immigrants. The present study examined the association of the duration of residence with obesity-related eating habits and dietary patterns among Latin-American immigrants residing in Spain. A cross-sectional study was conducted in 2008-10 in a representative sample of the adult population residing in Spain. Adherence to the MD was defined as a MD Adherence Screener score ≥ 9. Analyses were conducted by including 419 individuals aged 18-64 years born in Latin-American countries. Compared with immigrants residing in Spain for < 5 years, those residing for ≥ 10 years accounted for a lower percentage of individuals who habitually ate at fast-food restaurants and never trimmed visible fat from meat. Moreover, these immigrants were found to have a lower intake of sugary beverages and a higher intake of Na, saturated fat, fibre, olive oil, vegetables and fish and to more frequently strictly adhere to the MD. A longer duration of residence in Spain was found to be associated with both healthy and unhealthy changes in some eating habits and dietary patterns among Latin-American immigrants. Some of the healthy changes observed contrasted the 'Westernisation' of the diet reported in studies conducted in other Western countries. The results of the present study support the role of the food environment of the host country in the modification of the dietary patterns of immigrants.

  8. Association of the duration of residence with obesity-related eating habits and dietary patterns among Latin-American immigrants in Spain.

    PubMed

    Marín-Guerrero, A C; Rodríguez-Artalejo, Fernando; Guallar-Castillón, P; López-García, Esther; Gutiérrez-Fisac, Juan L

    2015-01-28

    The dietary patterns of immigrants usually change with the duration of residence and progressively resemble those of the host country. However, very few studies have investigated individuals migrating to countries with a high-quality diet, such as the Mediterranean diet (MD), and none has yet focused on Latin-American immigrants. The present study examined the association of the duration of residence with obesity-related eating habits and dietary patterns among Latin-American immigrants residing in Spain. A cross-sectional study was conducted in 2008-10 in a representative sample of the adult population residing in Spain. Adherence to the MD was defined as a MD Adherence Screener score ≥ 9. Analyses were conducted by including 419 individuals aged 18-64 years born in Latin-American countries. Compared with immigrants residing in Spain for < 5 years, those residing for ≥ 10 years accounted for a lower percentage of individuals who habitually ate at fast-food restaurants and never trimmed visible fat from meat. Moreover, these immigrants were found to have a lower intake of sugary beverages and a higher intake of Na, saturated fat, fibre, olive oil, vegetables and fish and to more frequently strictly adhere to the MD. A longer duration of residence in Spain was found to be associated with both healthy and unhealthy changes in some eating habits and dietary patterns among Latin-American immigrants. Some of the healthy changes observed contrasted the 'Westernisation' of the diet reported in studies conducted in other Western countries. The results of the present study support the role of the food environment of the host country in the modification of the dietary patterns of immigrants. PMID:25418887

  9. Implementing the 2009 Institute of Medicine recommendations on resident physician work hours, supervision, and safety

    PubMed Central

    Blum, Alexander B; Shea, Sandra; Czeisler, Charles A; Landrigan, Christopher P; Leape, Lucian

    2011-01-01

    , discussion of the Institute of Medicine report has been largely confined to the medical education community, led by the Accreditation Council for Graduate Medical Education (ACGME). To begin gathering these perspectives and developing a plan to implement safer work hours for resident physicians, a conference entitled “Enhancing sleep, supervision and safety: What will it take to implement the Institute of Medicine recommendations?” was held at Harvard Medical School on June 17–18, 2010. This White Paper is a product of a diverse group of 26 representative stakeholders bringing relevant new information and innovative practices to bear on a critical patient safety problem. Given that our conference included experts from across disciplines with diverse perspectives and interests, not every recommendation was endorsed by each invited conference participant. However, every recommendation made here was endorsed by the majority of the group, and many were endorsed unanimously. Conference members participated in the process, reviewed the final product, and provided input before publication. Participants provided their individual perspectives, which do not necessarily represent the formal views of any organization. In September 2010 the ACGME issued new rules to go into effect on July 1, 2011. Unfortunately, they stop considerably short of the Institute of Medicine’s recommendations and those endorsed by this conference. In particular, the ACGME only applied the limitation of 16 hours to first-year resident physicans. Thus, it is clear that policymakers, hospital administrators, and residency program directors who wish to implement safer health care systems must go far beyond what the ACGME will require. We hope this White Paper will serve as a guide and provide encouragement for that effort. Resident physician workload and supervision By the end of training, a resident physician should be able to practice independently. Yet much of resident physicians’ time is dominated by

  10. Resident Health Advocates in Public Housing Family Developments

    PubMed Central

    Bowen, Deborah J; Bhosrekar, Sarah Gees; Rorie, Jo-Anna; Goodman, Rachel; Thomas, Gerry; Maxwell, Nancy Irwin; Smith, Eugenia

    2015-01-01

    Translation of research to practice often needs intermediaries to help the process occur. Our Prevention Research Center has identified a total of 89 residents of public housing in the last 11 years who have been working in the Resident Health Advocate (RHA) program to engage residents in improving their own and other residents’ health status, by becoming trained in skills needed by Community Health Workers. Future directions include training for teens to become Teen RHAs and further integration of our RHA program with changes in the health care system and in the roles of community health workers in general. PMID:25739061

  11. 42 CFR 483.13 - Resident behavior and facility practices.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... has the right to be free from verbal, sexual, physical, and mental abuse, corporal punishment, and... resident property. (1) The facility must— (i) Not use verbal, mental, sexual, or physical abuse, corporal punishment, or involuntary seclusion; (ii) Not employ individuals who have been— (A) Found guilty of...

  12. 42 CFR 483.13 - Resident behavior and facility practices.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... has the right to be free from verbal, sexual, physical, and mental abuse, corporal punishment, and... resident property. (1) The facility must— (i) Not use verbal, mental, sexual, or physical abuse, corporal punishment, or involuntary seclusion; (ii) Not employ individuals who have been— (A) Found guilty of...

  13. 42 CFR 483.13 - Resident behavior and facility practices.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... has the right to be free from verbal, sexual, physical, and mental abuse, corporal punishment, and... resident property. (1) The facility must— (i) Not use verbal, mental, sexual, or physical abuse, corporal punishment, or involuntary seclusion; (ii) Not employ individuals who have been— (A) Found guilty of...

  14. 42 CFR 483.13 - Resident behavior and facility practices.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... has the right to be free from verbal, sexual, physical, and mental abuse, corporal punishment, and... resident property. (1) The facility must— (i) Not use verbal, mental, sexual, or physical abuse, corporal punishment, or involuntary seclusion; (ii) Not employ individuals who have been— (A) Found guilty of...

  15. 42 CFR 483.13 - Resident behavior and facility practices.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... has the right to be free from verbal, sexual, physical, and mental abuse, corporal punishment, and... resident property. (1) The facility must— (i) Not use verbal, mental, sexual, or physical abuse, corporal punishment, or involuntary seclusion; (ii) Not employ individuals who have been— (A) Found guilty of...

  16. Chiropractic Use by Urban and Rural Residents with Insurance Coverage

    ERIC Educational Resources Information Center

    Lind, Bonnie K.; Diehr, Paula K.; Grembowski, David E.; Lafferty, William E.

    2009-01-01

    Purpose: To describe the use of chiropractic care by urban and rural residents in Washington state with musculoskeletal diagnoses, all of whom have insurance coverage for this care. The analyses investigate whether restricting the analyses to insured individuals attenuates previously reported differences in the prevalence of chiropractic use…

  17. 26 CFR 301.6362-6 - Requirements relating to residence.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... determination under State law as to which State is treated as the residence or domicile of the decedent for purposes other than its individual income tax (such as liability for State inheritance tax or jurisdiction... Liability for State Y Tax=$400×292/365=$320. (f) Current collection of tax. The State tax laws shall...

  18. 26 CFR 301.6362-6 - Requirements relating to residence.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... determination under State law as to which State is treated as the residence or domicile of the decedent for purposes other than its individual income tax (such as liability for State inheritance tax or jurisdiction... Liability for State Y Tax=$400×292/365=$320. (f) Current collection of tax. The State tax laws shall...

  19. Sociocultural Integration of Older American Residents of Paris.

    ERIC Educational Resources Information Center

    Taietz, Philip

    1987-01-01

    Interviewed 104 older American residents of Paris, France. Found that 70 percent had medium to high levels of sociocultural integration and 92 percent had adequate proficiency in French language. Concluded that congruence of Paris environment and individual values had implications for sociocultural integration; declines in health, income, and loss…

  20. Firearm Anticipatory Guidance Training in Psychiatric Residency Programs

    ERIC Educational Resources Information Center

    Price, James H.; Thompson, Amy J.; Khubchandani, Jagdish; Mrdjenovich, Adam J.; Price, Joy A.

    2010-01-01

    Objective: Most suicides (60%) are committed with firearms, and most (80%) of individuals attempting suicide meet diagnostic criteria for mental illness. This study assessed the prevalence of firearm injury prevention training in psychiatric residency programs. Methods: A three-wave mail survey was sent to the directors of 179 psychiatric…

  1. Clinician-Educator Tracks for Residents: Three Pilot Programs

    ERIC Educational Resources Information Center

    Jibson, Michael D.; Hilty, Donald M.; Arlinghaus, Kimberly; Ball, Valdesha L.; McCarthy, Tracy; Seritan, Andreea L.; Servis, Mark E.

    2010-01-01

    Objective: Over the past 30 years, clinician-educators have become a prominent component of medical school faculties, yet few of these individuals received formal training for this role and their professional development lags behind other faculty. This article reviews three residency tracks designed to build skills in teaching, curriculum…

  2. Improving Resident Knowledge of Spacers.

    PubMed

    Kilgore, Brian; Al Katranji, Khalid; Woodall, Meredith; Shepherd, Meagan; Flesher, Susan L

    2016-10-01

    Studies show the delivery of inhaled medications is maximized when a metered-dose inhaler (MDI) with a spacer is utilized. Our residents expressed concern with their knowledge of MDIs and spacers. This study was designed to address those concerns. Residents were given a 12-question pre-intervention, self-assessment questionnaire that explored their overall knowledge and comfort in utilizing MDI with spacers. Participants then received educational intervention via multimedia videos and a demonstration of proper use of MDI with spacer. Participants were given the same questionnaire immediately following the education and again 3 months later. Improvement was significant (P < .05) for each element studied as derived from the 12 questions. Improvement remained significant when these variables were assessed in the 3-month follow-up. In this study, we successfully improved the ability of our residents to deliver quality care by improving their knowledge and confidence in utilizing MDIs with spacers. PMID:27630006

  3. 28 CFR 115.233 - Resident education.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 28 Judicial Administration 2 2013-07-01 2013-07-01 false Resident education. 115.233 Section 115... STANDARDS Standards for Community Confinement Facilities Training and Education § 115.233 Resident education... resident is transferred to a different facility. (c) The agency shall provide resident education in...

  4. 28 CFR 115.233 - Resident education.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 28 Judicial Administration 2 2014-07-01 2014-07-01 false Resident education. 115.233 Section 115... STANDARDS Standards for Community Confinement Facilities Training and Education § 115.233 Resident education... resident is transferred to a different facility. (c) The agency shall provide resident education in...

  5. 28 CFR 115.233 - Resident education.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 28 Judicial Administration 2 2012-07-01 2012-07-01 false Resident education. 115.233 Section 115... STANDARDS Standards for Community Confinement Facilities Training and Education § 115.233 Resident education... resident is transferred to a different facility. (c) The agency shall provide resident education in...

  6. Predictors of Success in an Anesthesiology Residency.

    ERIC Educational Resources Information Center

    Warrick, Shirley S.; Crumrine, Robert S.

    1986-01-01

    Factors that contributed to successful residency performance by anesthesiology residents were examined in order to assist the program's selection committee in developing selection criteria. The best predictor of a resident's academic average in the anethesiology program was the number of years the resident had spent in other specialities.…

  7. Investigating factors for disaster preparedness among residents of Kuala Lumpur

    NASA Astrophysics Data System (ADS)

    Mohammad-pajooh, E.; Aziz, K. Ab.

    2014-05-01

    The review of past researches discussed that factors such as climate change and movement toward urbanization will result in more frequent and severe disasters in the near future (Yasuhara et al., 2011). Flash flood is the most common type of disaster that residents of Kuala Lumpur (KL) come across, thus in this study, it was desired to discover the factors affecting preparedness among residents of KL as well as assessing the variation of individual preparedness among residents. With the aid of SPSS analysis, the reliability of data, correlation and regression analysis between the investigated factors and disaster preparedness were obtained. According to this research it was found that level of preparedness of residents of KL is still below average; majority of social demographic indicators such as income, education, age, and property ownership showed significant contribution to the variation of disaster preparedness among the residents. For instance men were much more prepared in comparison to women; residents with high level of income and education had also significantly higher preparedness compared to those with low level of income and education. Race was the only factor that differs from the findings of previous studies; since race does not affect the preparedness.

  8. Annual average radon concentrations in California residences.

    PubMed

    Liu, K S; Hayward, S B; Girman, J R; Moed, B A; Huang, F Y

    1991-09-01

    A study was conducted to determine the annual average radon concentrations in California residences, to determine the approximate fraction of the California population regularly exposed to radon concentrations of 4 pCi/l or greater, and to the extent possible, to identify regions of differing risk for high radon concentrations within the state. Annual average indoor radon concentrations were measured with passive (alpha track) samplers sent by mail and deployed by home occupants, who also completed questionnaires on building and occupant characteristics. For the 310 residences surveyed, concentrations ranged from 0.10 to 16 pCi/l, with a geometric mean of whole-house (bedroom and living room) average concentrations of 0.85 pCi/l and a geometric standard deviation of 1.91. A total of 88,000 California residences (0.8 percent) were estimated to have radon concentrations exceeding 4 pCi/l. When the state was divided into six zones based on geology, significant differences in geometric mean radon concentrations were found between several of the zones. Zones with high geometric means were the Sierra Nevada mountains, the valleys east of the Sierra Nevada, the central valley (especially the southern portion), and Ventura and Santa Barbara Counties. Zones with low geometric means included most coastal counties and the portion of the state from Los Angeles and San Bernardino Counties south.

  9. Pathology residency training: time for a new paradigm.

    PubMed

    Domen, Ronald E; Baccon, Jennifer

    2014-06-01

    The exponential growth of the field of pathology over the past several decades has created challenges for residency training programs. These challenges include the ability to train competent pathologists in 4 years, an increased demand for fellowship training, and the structuring and completion of maintenance of certification. The authors feel that pathology residency training has reached a critical point and that a new paradigm for training is required.

  10. Residency Surgical Training at an Independent Academic Medical Center.

    PubMed

    Jones, Jeremiah; Sidwell, Richard A

    2016-02-01

    Independent academic medical centers have been training surgeons for more than a century; this environment is distinct from university or military programs. There are several advantages to training at a community program, including a supportive learning environment with camaraderie between residents and faculty, early and broad operative experience, and improved graduate confidence. Community programs also face challenges, such as resident recruitment and faculty engagement. With the workforce needs for general surgeons, independent training programs will continue to play an integral role.

  11. Individual Education.

    ERIC Educational Resources Information Center

    Corsini, Raymond

    1981-01-01

    Paper presented at the 66th Convention of the International Association of Pupil Personnel Workers, October 20, 1980, Baltimore, Maryland, describes individual education based on the principles of Alfred Adler. Defines six advantages of individual education, emphasizing student responsibility, mutual respect, and allowing students to progress at…

  12. Designing and implementing a resiliency program for family medicine residents.

    PubMed

    Brennan, Julie; McGrady, Angele

    2015-01-01

    Family medicine residents are at risk for burnout due to extended work hours, lack of control over their work schedule, and challenging work situations and environments. Building resiliency can prevent burnout and may improve a resident's quality of life and health behavior. This report describes a program designed to build resiliency, the ability to bounce back from stress, in family medicine residents in a medium sized U.S. residency training program. Interactive sessions emphasized building self-awareness, coping skills, strengths and meaning in work, time management, self-care, and connections in and outside of medicine to support resident well-being. System changes which fostered wellness were also implemented. These changes included increasing the availability of fresh fruits in the conference and call room, purchasing an elliptical exercise machine for the on call room, and offering a few minutes of mindfulness meditation daily to the inpatient residents. Results to date show excellent acceptance of the program by trainees, increased consumption of nutritious foods, more personal exercise, and self-reported decreased overreactions to stress. Resiliency programs can effectively serve to meet accreditation requirements while fostering residents' abilities to balance personal and professional demands. PMID:26130769

  13. Burnout in medical residents: a questionnaire and interview study.

    PubMed

    Ringrose, Rik; Houterman, Saskia; Koops, Willem; Oei, Guid

    2009-08-01

    High burnout levels have been observed in medical residents. The purpose of this study is to assess the burnout rates and potential determinants of burnout in a sample of medical residents. In total, 58 medical residents working in a Dutch teaching hospital, received questionnaires at home, including the Maslach Burnout Inventory (MBI). In addition, they were asked for an in-depth interview to investigate the relevant indicators for developing burnout. In total, 47 residents responded (81%) from which 15 (31%) met the MBI criteria for burnout. Work-family conflict, work-related autonomy and level of work-engagement were significantly associated with burnout. Ten respondents were interviewed; none of those reported any serious burnout symptoms but two met the criteria for burnout. In this study, burnout rates from questionnaires and interviews in medical residents are not consistent. Regular burnout screenings and performing interviews are recommended in addition to burnout questionnaires, in order to efficiently identify residents at risk for burnout. This allows improved monitoring of a resident's mental state thus facilitating prevention of escalating burnout symptoms. Future research could focus on preventive factors for developing burnout.

  14. Emissions of VPOC from residences in the metropolitan Toronto area

    SciTech Connect

    Fellin, P.; Otson, R.

    1997-12-31

    Airborne vapor phase organic compound (VPOC) concentrations were determined indoors and outdoors concurrently over 24 h periods for 44 randomly selected residences in the Greater Toronto Area (GTA). Indoor to outdoor air exchange rates, measured by means of a perfluorocarbon tracer technique, averaged 0.45 and ranged from 0.04 to 2.2 air changes per hour (ach). For compounds occurring above the method detection limits (MDL), indoor sources contributed significantly to the occurrence of 7 of the 30 target VPOC since indoor to outdoor concentration ratios were greater than 1 for more than 50% of the homes for these compounds. Emissions from residences to the ambient air were calculated, and ranged up to 725 g/yr/residence for the sum of the target compounds for the residence with the largest emissions and averaged 96 g/yr/residence for all residences. The four compounds with the largest emissions averaged 53 (maximum, 500), 41 (maximum, 220), 22 (maximum, 110) and 20 (maximum, 240) g/yr/residence, respectively, for 1,4-dichlorobenzene, d-limonene, naphthalene and toluene. In a previous study, 1,4-dichlorobenzene and toluene were among the three VPOC with the greatest emissions from residences. However, the emissions were calculated from measured indoor concentrations, outdoor values were obtained at different times or by different methods, and average rather than individually measured air exchange rates were used. The emissions estimated in this study were compared to those from the previous study, and their impact on ambient air quality was estimated.

  15. 24 CFR 248.173 - Resident homeownership program.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... of the proceeds, if any, from the initial sale for costs of the homeownership program, including... to be received from HUD and of all other funds, including proceeds from the sale of units to initial..., including, but not limited to, the resident council's acquisition cost, estimated rehabilitation...

  16. Predictors of Residence Hall Involvement

    ERIC Educational Resources Information Center

    Arboleda, Ana; Wang, Yongyi; Shelley, Mack C., II; Whalen, Donald F.

    2003-01-01

    Residence hall students' (N = 1,186, 52% male, 90% White, 66% freshmen) involvement in their living community is influenced significantly by precollege student characteristics (gender, ethnicity), classification, attitudes (toward hall director, house cabinet, academic comfort, social environment, group study), and environmental variables (noise,…

  17. Confused Resident Care. Instructor Guide.

    ERIC Educational Resources Information Center

    Missouri Univ., Columbia. Instructional Materials Lab.

    This instructional module was designed for certified nurse assistants (CNA). This voluntary training program was developed as a "continuing education" option for the practicing graduate CNA with the intention of providing CNAs with the requisite knowledge and skills to provide care for the confused elderly resident in a long-term care facility.…

  18. Residents' strikes on policy issues.

    PubMed

    Sharma, Vishal; Aggarwal, Sourabh

    2009-01-01

    Strikes by residents or medical students have become fairly common and the new trend is to resort to strikes to protest matters concerning health policies. This article discusses the justification for and the ethical issues involved in these strike actions. Mechanisms to prevent such strikes are also discussed. PMID:19241959

  19. Residency effects in animal contests.

    PubMed Central

    Kemp, Darrell J.; Wiklund, Christer

    2004-01-01

    The question of why territorial residents usually win asymmetrical owner-intruder contests is critical to our understanding of animal contest evolution. Game theory suggests that, under certain conditions, residency could be used as an arbitrary means of contest settlement in a manner analogous to tossing a coin. Key empirical support for this idea is provided by a study on the speckled wood butterfly (Pararge aegeria); however, this result has proven controversial. We show conclusively that residency does not serve as an arbitrary cue for contest settlement in this species. By means of a series of manipulative experiments, conducted on two phenotypically divergent populations of P. aegeria, we also rule out the recently presented alternative that contests are settled due to resource-correlated asymmetries in thoracic temperature. Our results instead suggest that more intrinsically aggressive males accumulate as residents and continue to win due to the self-reinforcing effect of prior winning experience. Truly arbitrary contest settlement may be rare or non-existent in the wild. PMID:15306291

  20. From Residency to Lifelong Learning.

    PubMed

    Brandt, Keith

    2015-11-01

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

  1. From Residency to Lifelong Learning.

    PubMed

    Brandt, Keith

    2015-11-01

    The residency training experience is the perfect environment for learning. The university/institution patient population provides a never-ending supply of patients with unique management challenges. Resources abound that allow the discovery of knowledge about similar situations. Senior teachers provide counseling and help direct appropriate care. Periodic testing and evaluations identify deficiencies, which can be corrected with future study. What happens, however, when the resident graduates? Do they possess all the knowledge they'll need for the rest of their career? Will medical discovery stand still limiting the need for future study? If initial certification establishes that the physician has the skills and knowledge to function as an independent physician and surgeon, how do we assure the public that plastic surgeons will practice lifelong learning and remain safe throughout their career? Enter Maintenance of Certification (MOC). In an ideal world, MOC would provide many of the same tools as residency training: identification of gaps in knowledge, resources to correct those deficiencies, overall assessment of knowledge, feedback about communication skills and professionalism, and methods to evaluate and improve one's practice. This article discusses the need; for education and self-assessment that extends beyond residency training and a commitment to lifelong learning. The American Board of Plastic Surgery MOC program is described to demonstrate how it helps the diplomate reach the goal of continuous practice improvement. PMID:26517466

  2. Bioassay measurements of individuals living near the US Department of Energy's Hanford Site in Washington State, Fall 1985

    SciTech Connect

    Sula, M.J.; Bihl, D.E.

    1986-05-01

    The purpose of the bioassay measurements was to provide individuals, living within a specific area near the Hanford Site, information on the current levels of radionuclides in their bodies. The measurements included whole body counter (in vivo) examinations and urine sample analyses for detecting the presence of major radionuclides related to current and historical operations at Hanford. Notifications of the special measurements were sent by letter to 515 residences in north Franklin County. Eighty-nine individuals from 52 of the 515 residences requested and received whole body counts. Of these, 32 also provided urine samples. The measurements gave no evidence of unusual levels of radioactivity in any individual. The ability of bioassay measurements to detect the presence of radioactivity in an individual following an exposure is dependent on the quality of the measurement and the nature of the exposure. This report includes a discussion of the capability, under various circumstances, of the measurements that were provided.

  3. The Care of Non-English Speaking Background Residents in Mainstream Nursing Homes and Hostels.

    ERIC Educational Resources Information Center

    Perkons, Rita

    A survey of 104 individuals of non-English-speaking backgrounds (NESBs) living in South Australia nursing homes and personal care homes and staff of 75 institution housing NESB residents is reported. The study's objectives was to determine the culturally-based needs of the residents and the provision of culturally appropriate services to them. The…

  4. Directory of Resident Outdoor Education Sites in Northern Illinois and Southern Wisconsin.

    ERIC Educational Resources Information Center

    Curtis, Ramona E.

    Designed as a tool for school personnel seeking sites and facilities for resident outdoor education, this directory provides information on 45 resident outdoor education sites in Northern Illinois and Southern Wisconsin. The document is organized in a comprehensive table and in individual site descriptions. For each site, the table briefly…

  5. 26 CFR 1.163-10T - Qualified residence interest (temporary).

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 26 Internal Revenue 2 2011-04-01 2011-04-01 false Qualified residence interest (temporary). 1.163-10T Section 1.163-10T Internal Revenue INTERNAL REVENUE SERVICE, DEPARTMENT OF THE TREASURY (CONTINUED) INCOME TAX (CONTINUED) INCOME TAXES (CONTINUED) Itemized Deductions for Individuals and Corporations § 1.163-10T Qualified residence interest...

  6. 26 CFR 1.163-10T - Qualified residence interest (temporary).

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 26 Internal Revenue 2 2010-04-01 2010-04-01 false Qualified residence interest (temporary). 1.163-10T Section 1.163-10T Internal Revenue INTERNAL REVENUE SERVICE, DEPARTMENT OF THE TREASURY (CONTINUED) INCOME TAX (CONTINUED) INCOME TAXES (CONTINUED) Itemized Deductions for Individuals and Corporations § 1.163-10T Qualified residence interest...

  7. Workplace Violence and Harassment Against Emergency Medicine Residents

    PubMed Central

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

    2016-01-01

    Introduction Several studies have shown that workplace violence in the emergency department (ED) is common. Residents may be among the most vulnerable staff, as they have the least experience with these volatile encounters. The goal for this study was to quantify and describe acts of violence against emergency medicine (EM) residents by patients and visitors and to identify perceived barriers to safety. Methods This cross-sectional survey study queried EM residents at multiple New York City hospitals. The primary outcome was the incidence of violence experienced by residents while working in the ED. The secondary outcomes were the subtypes of violence experienced by residents, as well as the perceived barriers to safety while at work. Results A majority of residents (66%, 78/119) reported experiencing at least one act of physical violence during an ED shift. Nearly all residents (97%, 115/119) experienced verbal harassment, 78% (93/119) had experienced verbal threats, and 52% (62/119) reported sexual harassment. Almost a quarter of residents felt safe “Occasionally,” “Seldom” or “Never” while at work. Patient-based factors most commonly cited as contributory to violence included substance use and psychiatric disease. Conclusion Self-reported violence against EM residents appears to be a significant problem. Incidence of violence and patient risk factors are similar to what has been found previously for other ED staff. Understanding the prevalence of workplace violence as well as the related systems, environmental, and patient-based factors is essential for future prevention efforts. PMID:27625721

  8. [Specialized training in geriatric psychiatry during residency in France].

    PubMed

    Lepetit, Alexis; Lavigne, Benjamin; Legros, Emilie; Herrmann, Mathieu; Sebbane, Déborah

    2014-09-01

    Aging of the population is a growing concern in developed countries. Therefore, geriatric psychiatry has gradually emerged from general psychiatry. Many names have been proposed to term this sub-specialty: old age psychiatry (OAP), psychogeriatrics, geropsychiatry. A working group of the French federation of psychiatric trainees (AFFEP) set up an inventory of the theoretical instruction and clinical practice of OAP during the training of psychiatrists in France. Methods. A survey of both academic teaching and practical training for OAP was carried out in the 28 local AFFEP representatives of every French medical residency district, including overseas. We assessed the supply of general courses and seminars devoted to OAP during the training of French residents in psychiatry, and the offer of university or inter-university degrees as well as the possibility of specialized internship in every residency district. Results. 96% of French medical residency districts offered general courses of OAP with a mean volume of 11.5 hours along the four years of psychiatric training in France. Fifty percent of medical residency districts proposed at least one seminar devoted to OAP. Half of medical residency districts also offer a specialized university or inter-university degree. Concerning clinical practice, 86% of medical residency districts had one internship dedicated to OAP, in 39% of cases in teaching hospitals. Conclusion. Nationwide, there is an overall effort to make OAP available to French psychiatric residents by general courses and internship, but some disparity appeared in academic teaching (i.e. offering seminars and university/inter-university degrees) according to various residency districts.

  9. Workplace Violence and Harassment Against Emergency Medicine Residents

    PubMed Central

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

    2016-01-01

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

  10. A Balint seminar in the family practice residency setting.

    PubMed

    Scheingold, L

    1980-02-01

    British psychoanalyst Michael Balint made important theoretical and pragmatic contributions to family practice, through the seminars of general practitioners he led at the Tavistock Clinic. A weekly Balint seminar, modeled on the Tavistock groups, was held in a family practice residency. The group of second and third year residents, co-led by a behavioral scientist and a family practice faculty member, met for 12 weeks and then re-evaluated topics and discussion format. Issues covered included physician-patient relationships, ethical dilemmas, group therapy concerns, and coping with clinic pressures. Objective evaluation of these seminars, where the goal is attitudinal rather than behavioral change, presents some difficulty. The conclusion is that residents benefited from the seminar, and that some aspects of psychoanalytic theory and technique are applicable to the teaching of behavioral science in family practice residencies.

  11. A model for communication skills development for family practice residents.

    PubMed

    Hornsby, J L; Payne, F E

    1979-01-01

    The purpose of this paper is twofold: (1) to demonstrate the need for including interpersonal communication skills training in family practice residency programs, and (2) to present a communication model that can be used for such training. Interpersonal communication skills are important in almost all areas of contact with patients: history taking, physical examination, prescription writing and patient education, counseling, and psychotherapy. Presentation of the communication model includes definition of the interpersonal communication skills that would be stressed in family practice residency programs. These skills include empathy, respect, warmth, concreteness, genuineness, self-disclosure, confrontation, immediacy, and behavior modification. Examples of how a family physician may communicate each of these skills are also included. The implementation of the communication model in a department of family practice for training residents and faculty in the use of these communication skills is also described. PMID:759551

  12. A model for communication skills development for family practice residents.

    PubMed

    Hornsby, J L; Payne, F E

    1979-01-01

    The purpose of this paper is twofold: (1) to demonstrate the need for including interpersonal communication skills training in family practice residency programs, and (2) to present a communication model that can be used for such training. Interpersonal communication skills are important in almost all areas of contact with patients: history taking, physical examination, prescription writing and patient education, counseling, and psychotherapy. Presentation of the communication model includes definition of the interpersonal communication skills that would be stressed in family practice residency programs. These skills include empathy, respect, warmth, concreteness, genuineness, self-disclosure, confrontation, immediacy, and behavior modification. Examples of how a family physician may communicate each of these skills are also included. The implementation of the communication model in a department of family practice for training residents and faculty in the use of these communication skills is also described.

  13. Treatment of heart failure in nursing home residents

    PubMed Central

    Daamen, Mariëlle AMJ; Hamers, Jan PH; Gorgels, Anton PM; Tan, Frans ES; Schols, Jos MGA; Rocca, Hans-Peter Brunner-la

    2016-01-01

    Background For the treatment of chronic heart failure (HF), both pharmacological and non-pharmacological treatment should be employed in HF patients. Although HF is highly prevalent in nursing home residents, it is not clear whether the recommendations in the guidelines for pharmacological therapy also are followed in nursing home residents. The aim of this study is to investigate how HF is treated in nursing home residents and to determine to what extent the current treatment corresponds to the guidelines. Methods Nursing home residents of five large nursing home care organizations in the southern part of the Netherlands with a previous diagnosis of HF based on medical records irrespective of the left ventricle ejection fraction (LVEF) were included in this cross-sectional design study. Data were gathered on the (medical) records, which included clinical characteristics and pharmacological- and non-pharmacological treatment. Echocardiography was used as part of the study to determine the LVEF. Results Out of 501 residents, 112 had a diagnosis of HF at inclusion. One-third of them received an ACE-inhibitor and 40% used a β-blocker. In 66%, there was a prescription of diuretics with a preference of a loop diuretic. Focusing on the residents with a LVEF ≤ 40%, only 46% of the 22 residents used an ACE-inhibitor and 64% a β-blocker. The median daily doses of prescribed medication were lower than those that were recommended by the guidelines. Non-pharmacological interventions were recorded in almost none of the residents with HF. Conclusions The recommended medical therapy of HF was often not prescribed; if prescribed, the dosage was usually far below what was recommended. In addition, non-pharmacological interventions were mostly not used at all. PMID:26918012

  14. Determinants of the use of specialist mental health services by nursing home residents.

    PubMed Central

    Shea, D G; Streit, A; Smyer, M A

    1994-01-01

    OBJECTIVE. This study examines the effects of resident and facility characteristics on the probability of nursing home residents receiving treatment by mental health professionals. DATA SOURCES/STUDY SETTING. The study uses data from the Institutional Population Component of the 1987 National Medical Expenditure Survey, a secondary data source containing data on 3,350 nursing home residents living in 810 nursing homes as of January 1, 1987. STUDY DESIGN. Andersen's health services use model (1968) is used to estimate a multivariate logistic equation for the effects of independent variables on the probability that a resident has received services from mental health professionals. Important variables include resident race, sex, and age; presence of several behaviors and reported mental illnesses; and facility ownership, facility size, and facility certification. DATA COLLECTION/EXTRACTION METHODS. Data on 188 residents were excluded from the sample because information was missing on several important variables. For some additional variables residents who had missing information were coded as negative responses. This left 3,162 observations for analysis in the logistic regressions. PRINCIPAL FINDINGS. Older residents and residents with more ADL limitations are much less likely than other residents to have received treatment from a mental health professional. Residents with reported depression, schizophrenia, or psychoses, and residents who are agitated or hallucinating are more likely to have received treatment. Residents in government nursing homes, homes run by chains, and homes with low levels of certification are less likely to have received treatment. CONCLUSIONS. Few residents receive treatment from mental health professionals despite need. Older, physically disabled residents need special attention. Care in certain types of facilities requires further study. New regulations mandating treatment for mentally ill residents will demand increased attention from

  15. Coaching for Success: A Residency Search Primer and Update for Preceptors and Faculty

    PubMed Central

    Adams, Alex J.; Ulbrich, Timothy R.; Soric, Mate M.

    2015-01-01

    Pharmacy residency programs have become increasingly competitive in recent years, and changes to the residency search and application process have altered the process for matching with a residency. In this article, major residency topics, from the benefits of residency training to searching for and ranking programs, are summarized. A discussion of tips and tricks for applying for residencies and interviewing for positions is included along with specific suggestions developed with data following the implementation of the Pharmacy Online Residency Centralized Application Service (PhORCAS). The article is organized in a question and answer format to help facilitate understanding of key concepts and common questions that may arise from applicants. Many changes have taken place in the residency search and application process in recent years, and the process of obtaining a residency is complex. Residency applicants and those advising applicants may find value in the answers to commonly asked residency application questions to help ensure the greatest chance of a successful residency match. PMID:26405338

  16. Test of Integrated Professional Skills: Objective Structured Clinical Examination/Simulation Hybrid Assessment of Obstetrics-Gynecology Residents' Skill Integration

    PubMed Central

    Winkel, Abigail Ford; Gillespie, Colleen; Hiruma, Marissa T.; Goepfert, Alice R.; Zabar, Sondra; Szyld, Demian

    2014-01-01

    Background Assessment of obstetrics-gynecology residents' ability to integrate clinical judgment, interpersonal skills, and technical ability in a uniform fashion is required to document achievement of benchmarks of competency. An observed structured clinical examination that incorporates simulation and bench models uses direct observation of performance to generate formative feedback and standardized evaluation. Methods The Test of Integrated Professional Skills (TIPS) is a 5-station performance-based assessment that uses standardized patients and complex scenarios involving ultrasonography, procedural skills, and evidence-based medicine. Standardized patients and faculty rated residents by using behaviorally anchored checklists. Mean scores reflecting performance in TIPS were compared across competency domains and by developmental level (using analysis of variance) and then compared to standard faculty clinical evaluations (using Spearman ρ). Participating faculty and residents were also asked to evaluate the usefulness of the TIPS. Results Twenty-four residents participated in the TIPS. Checklist items used to assess competency were sufficiently reliable, with Cronbach α estimates from 0.69 to 0.82. Performance improved with level of training, with wide variation in performance. Standard faculty evaluations did not correlate with TIPS performance. Several residents who were rated as average or above average by faculty performed poorly on the TIPS (> 1 SD below the mean). Both faculty and residents found the TIPS format useful, providing meaningful evaluation and opportunity for feedback. Conclusions A simulation-based observed structured clinical examination facilitates observation of a range of skills, including competencies that are difficult to observe and measure in a standardized way. Debriefing with faculty provides an important interface for identification of performance gaps and individualization of learning plans. PMID:24701321

  17. A pilot structured resident orientation curriculum improves the confidence of incoming first-year obstetrics and gynecology residents.

    PubMed

    Hiraoka, Mark; Kamikawa, Ginny; McCartin, Richard; Kaneshiro, Bliss

    2013-11-01

    A prospective, observational study was performed to evaluate a pilot orientation curriculum which involved all 7 incoming obstetrics and gynecology residents in June 2012. The objective of this study was to assess how a structured orientation curriculum, which employs an evaluation of baseline competency, affects the confidence of incoming first-year obstetrics and gynecology residents. The curriculum included didactic lectures, online modules, simulation, and mock clinical scenarios. Pre- and post-course surveys were conducted online via SurveyMonkey™ and were sent to all incoming obstetrics and gynecology residents. All seven incoming obstetrics and gynecology residents completed the orientation curriculum which included evaluations at the end of the orientation to assess baseline competency prior to taking part in clinical care. Confidence levels improved in all 27 elements assessed. Statistically significant improvement in confidence levels occurred in cognitive skills such as obstetric emergency management (2.9 vs 3.9, P< .05) and technical skills such as knot tying (3.9 vs. 4.6, P< .05). Certain teaching skills also demonstrated statistically significant improvements. A structured orientation program which improves resident self-confidence levels and demonstrates baseline competencies in certain clinical areas can be valuable for many residency training programs.

  18. Co-residence between males and their mothers and grandmothers is more frequent in bonobos than chimpanzees.

    PubMed

    Schubert, Grit; Vigilant, Linda; Boesch, Christophe; Klenke, Reinhard; Langergraber, Kevin; Mundry, Roger; Surbeck, Martin; Hohmann, Gottfried

    2013-01-01

    In long-lived social mammals such as primates, individuals can benefit from social bonds with close kin, including their mothers. In the patrilocal chimpanzee (Pan troglodytes spp.) and bonobo (Pan paniscus), sexually mature males reside and reproduce in their natal groups and can retain post-dependency bonds with their mothers, while immatures of both sexes might also have their paternal grandmothers available. However, quantitative information on the proportion of males and immatures that co-reside with both types of these close female relatives is limited for both species. Combining genetic parentage determination and group composition data from five communities of wild chimpanzees and three communities of wild bonobos, we estimated the frequency of co-residence between (1) mature males and their mothers, and (2) immature males and females and their paternal grandmothers. We found that adult males resided twice as frequently with their mothers in bonobos than in chimpanzees, and that immature bonobos were three times more likely to possess a living paternal grandmother than were immature chimpanzees. Patterns of female and male survivorship from studbook records of captive individuals of both species suggest that mature bonobo females survive longer than their chimpanzee counterparts, possibly contributing to the differences observed in mother-son and grandmother-immature co-residency levels. Taking into account reports of bonobo mothers supporting their sons' mating efforts and females sharing food with immatures other than their own offspring, our findings suggest that life history traits may facilitate maternal and grandmaternal support more in bonobos than in chimpanzees.

  19. Co–Residence between Males and Their Mothers and Grandmothers Is More Frequent in Bonobos Than Chimpanzees

    PubMed Central

    Schubert, Grit; Vigilant, Linda; Boesch, Christophe; Klenke, Reinhard; Langergraber, Kevin; Mundry, Roger; Surbeck, Martin; Hohmann, Gottfried

    2013-01-01

    In long–lived social mammals such as primates, individuals can benefit from social bonds with close kin, including their mothers. In the patrilocal chimpanzee (Pan troglodytes spp.) and bonobo (Pan paniscus), sexually mature males reside and reproduce in their natal groups and can retain post-dependency bonds with their mothers, while immatures of both sexes might also have their paternal grandmothers available. However, quantitative information on the proportion of males and immatures that co-reside with both types of these close female relatives is limited for both species. Combining genetic parentage determination and group composition data from five communities of wild chimpanzees and three communities of wild bonobos, we estimated the frequency of co-residence between (1) mature males and their mothers, and (2) immature males and females and their paternal grandmothers. We found that adult males resided twice as frequently with their mothers in bonobos than in chimpanzees, and that immature bonobos were three times more likely to possess a living paternal grandmother than were immature chimpanzees. Patterns of female and male survivorship from studbook records of captive individuals of both species suggest that mature bonobo females survive longer than their chimpanzee counterparts, possibly contributing to the differences observed in mother–son and grandmother–immature co-residency levels. Taking into account reports of bonobo mothers supporting their sons' mating efforts and females sharing food with immatures other than their own offspring, our findings suggest that life history traits may facilitate maternal and grandmaternal support more in bonobos than in chimpanzees. PMID:24358316

  20. THE ETHICAL EDUCATION OF OPHTHALMOLOGY RESIDENTS: AN EXPERIMENT

    PubMed Central

    Packer, Samuel

    2005-01-01

    Purpose To demonstrate the effect of ethics education on a resident’s ability to answer questions that relate to moral dilemmas and on the clinical evaluations of residents by faculty. Methods The curriculum for the ethics education that was used for this study was designed by the author and consisted of 10 lectures of 1.5 hours each. Five residencies were included in the project. One residency received one lecture, two residencies received three lectures, and two residencies received 10 lectures. To evaluate the moral skills of the residents at the beginning of the course and at the end, the residents were given the Defining Issues Test (DIT-2) developed by James Rest, which involves answering standardized questions about four moral dilemmas. Faculty evaluations were completed before and after the ethics lectures were given. At the beginning of the ethics course, each resident was given a social survey that was designed to assess participation in community, religious, political, and societal activities as well as attitudes about these activities. All residents were also asked demographic information, including their age, gender, and year of residency. Results The results of the DIT-2 taken before and after the ethics lectures were compared. No correlations were found in faculty evaluations of clinical performance of the residents before and after the course (P = .052). Associations between DIT-2 scores and questions on community and religion in the social survey were noted. Conclusion The finding that the effect of an ethics course on residents’ ability to answer moral dilemmas did not achieve statistical significance should be accepted with the understanding that this was a first attempt at standardization of many variables, especially the format of the curriculum and materials used. The use of faculty evaluations to assess clinical performance needs to be standardized, and the faculty members need additional training to ensure validity of the results. The

  1. 42 CFR 440.315 - Exempt individuals.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ..., individuals with disabling mental disorders (including children with serious emotional disturbances and adults with serious mental illness), individuals with chronic substance use disorders, individuals...

  2. Pump apparatus including deconsolidator

    SciTech Connect

    Sonwane, Chandrashekhar; Saunders, Timothy; Fitzsimmons, Mark Andrew

    2014-10-07

    A pump apparatus includes a particulate pump that defines a passage that extends from an inlet to an outlet. A duct is in flow communication with the outlet. The duct includes a deconsolidator configured to fragment particle agglomerates received from the passage.

  3. Mentoring Emotionally Sensitive Individuals.

    ERIC Educational Resources Information Center

    Shaughnessy, Michael F.; Self, Elizabeth

    Mentoring individuals who are gifted, talented, and creative, but somewhat emotionally sensitive is a challenging and provocative arena. Several reasons individuals experience heightened sensitivity include: lack of nurturing, abuse, alcoholism in the family, low self-esteem, unrealistic parental expectations, and parental pressure to achieve.…

  4. Alternative families in recovery: fictive kin relationships among residents of sober living homes.

    PubMed

    Heslin, Kevin C; Hamilton, Alison B; Singzon, Trudy K; Smith, James L; Anderson, Nancy Lois Ruth

    2011-04-01

    Sober living homes are group residences for people attempting to maintain abstinence from alcohol and drugs in a mutually supportive setting. Residents typically develop strong psychological and economic ties and have been referred to as "alternative families," thus evoking the anthropological concept of fictive kinship. We analyzed data from seven focus groups with sober living home residents to assess the prevalence and functions of fictive kinship in these settings. Results suggest that residents created kinship by exchanging various types of support, and by incorporating other residents into existing family relationships, particularly in homes where there were children. Residents perceived fictive kin as more supportive than actual kin, encouraging them toward greater individuation, in contrast with family backgrounds that were sometimes described as stifling. These accounts of the therapeutic qualities of fictive kin in sober living homes could inform the work of fair housing advocates and other community stakeholders.

  5. Personality types of family practice residents in the 1980s.

    PubMed

    Taylor, A D; Clark, C; Sinclair, A E

    1990-03-01

    This study was based on a nationwide sample of 778 family practice residents in the mid-1980s and was conducted to determine the personality types that were most common among those residents. The results showed that the single most common personality type was that in which the individual prefers to see the world in terms of challenges and future possibilities and to make decisions based upon his or her subjective values. These results showed that the sample differed significantly in Myers-Briggs personality type from both the general practitioners of the 1950s and the early family practice residents of the 1970s, who preferred to see the world in terms of the immediate facts of experience and to make decisions objectively. There were also significant differences between the civilian and military family practice residents, but not between the community-based and university-based residents. Implications regarding future practice styles, physicians' personal values, and manpower needs are discussed. PMID:2306322

  6. Light, Including Ultraviolet

    PubMed Central

    Maverakis, Emanual; Miyamura, Yoshinori; Bowen, Michael P.; Correa, Genevieve; Ono, Yoko; Goodarzi, Heidi

    2009-01-01

    Ultraviolet (UV) light is intricately linked to the functional status of the cutaneous immune system. In susceptible individuals, UV radiation can ignite pathogenic inflammatory pathways leading to allergy or autoimmunity. In others, this same UV radiation can be used as a phototherapy to suppress pathogenic cutaneous immune responses. These vastly different properties are a direct result of UV light’s ability to ionize molecules in the skin and thereby chemically alter them. Sometimes these UV-induced chemical reactions are essential, the formation of pre-vitamin D3 from 7-dehydrocholesterol, for example. In other instances they can be potentially detrimental. UV radiation can ionize a cell’s DNA causing adjacent pyrimidine bases to chemically bond to each other. To prevent malignant transformation, a cell may respond to this UV-induced DNA damage by undergoing apoptosis. Although this pathway prevents skin cancer it also has the potential of inducing or exacerbating autoreactive immune responses by exposing the cell’s nuclear antigens. Ultaviolet-induced chemical reactions can activate the immune system by a variety of other mechanisms as well. In response to UV irradiation keratinocytes secrete cytokines and chemokines, which activate and recruit leukocytes to the skin. In some individuals UV-induced chemical reactions can synthesize novel antigens resulting in a photoallergy. Alternatively, photosensitizing molecules can damage cells by initiating sunburn-like phototoxic reactions. Herein we review all types of UV-induced skin reactions, especially those involving the immune system. PMID:20018479

  7. 7 CFR 273.3 - Residency.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... resident of a shelter for battered women and children as defined in § 271.2 and was a member of a household containing the person who had abused him or her. Residents of shelters for battered women and children...

  8. Optical modulator including grapene

    DOEpatents

    Liu, Ming; Yin, Xiaobo; Zhang, Xiang

    2016-06-07

    The present invention provides for a one or more layer graphene optical modulator. In a first exemplary embodiment the optical modulator includes an optical waveguide, a nanoscale oxide spacer adjacent to a working region of the waveguide, and a monolayer graphene sheet adjacent to the spacer. In a second exemplary embodiment, the optical modulator includes at least one pair of active media, where the pair includes an oxide spacer, a first monolayer graphene sheet adjacent to a first side of the spacer, and a second monolayer graphene sheet adjacent to a second side of the spacer, and at least one optical waveguide adjacent to the pair.

  9. Defining skilled nursing facility residents' dining style preferences.

    PubMed

    Adams, Katy; Anderson, Janet B; Archuleta, Martha; Smith Kudin, Janette

    2013-01-01

    The desire of skilled nursing facilities to increase quality of service to meet changes in residents' expectations, improve marketability, and adhere to regulations warrant a new look at culture change and homelike dining as defined by residents in skilled nursing facilities (SNF). The objectives of this study were to determine residents' home dining practices, to define residents' desired dining style practices in the SNF, and to determine the relationship between home dining practices and dining preferences in SNF. One hundred and four residents in three SNF in the central Texas area who met the cognition criteria and consumed facility-provided food were engaged in a standardized interview using the Resident Dining Style Preferences Survey. Data were analyzed to determine the degree to which home practices determine SNF dining preferences. Our findings showed that the majority of the participants want hot, home cooked meals served in the dining room. They want to be seated at the table with friends and neighbors and served on every day plates in a quiet atmosphere, with food served restaurant or table service style. Length of stay and generational group were not significant predictors of dining style preferences. Study limitations included small sample size and lack of ethnic diversity. Our study results show that removing dining time restrictions may be the most valuable adaptation for a SNF looking to initiate culture change. PMID:23924255

  10. Re-thinking clinical research training in residency

    PubMed Central

    O’Brien, Jennifer; D’Eon, Marcel

    2014-01-01

    Background There are good reasons to train clinician researchers, including a lack of translational and patient centered research, a decline in physicians choosing academic careers, the need for physicians who are able to critically appraise research, and accreditation requirements. However, why are we insisting that residents engage in original clinical research? Discussion This paper is structured around three questions: 1) Is mandating original research the answer? 2) What ought to be the central purpose of research training? And 3) What are the alternatives to original clinical research? The successful development of clinician-scientists involves many more factors than resident research training. While invoking social accountability and public welfare, we argue for considering the opportunity cost of resident research training. We question the focus on original resident research and challenge medical educators to encourage research training aimed steadfastly at public good in the local setting. Finally, we offer preliminary suggestions for how to move forward. Conclusions We conclude that medical educators should critically re-think our programs to develop resident researchers. If it is worthwhile to require original research projects during residency, then we must consider the priorities of local settings to best serve the public interest. PMID:26451223

  11. Principles of fatigue in residency education: a qualitative study

    PubMed Central

    Taylor, Taryn S.; Watling, Christopher J.; Teunissen, Pim W.; Dornan, Tim; Lingard, Lorelei

    2016-01-01

    Background: Proposals to implement fatigue-management strategies in residency education assume that medicine shares the view of other risk-adverse industries that fatigue is hazardous. This view is an essential underpinning of fatigue-management strategies that other industries have embedded as part of their workplace occupational health and safety programs. We sought to explore how residents understand fatigue in the context of their training environment. Methods: We interviewed 21 residents in 7 surgical and nonsurgical programs at Western University in 2014. All participants met the inclusion criteria of routinely working 24-hour call shifts while enrolled in their training program. Data collection and analysis occurred iteratively in keeping with constructivist grounded theory methodology and informed theoretical sampling to sufficiency. Results: Four predominant principles of fatigue captured how the social learning environment shaped residents' perceptions of fatigue. These included the conceptualization of fatigue as (a) inescapable and therefore accepted, (b) manageable through experience, (c) necessary for future practice and (d) surmountable when required. Interpretation: This study elaborates our understanding of how principles of fatigue are constructed and reinforced by the training environment. Whereas fatigue is seen as a collective hazard in other industries, our data showed that, in residency training, fatigue may be seen as a personal challenge. Consequently, fatigue-management strategies that conceptualize fatigue as an occupational threat may have a limited impact on resident behaviour and patient safety. PMID:27398364

  12. Trends in ophthalmology resident surgical experience from 2009 to 2015

    PubMed Central

    Chadha, Nisha; Liu, Ji; Maslin, Jessica S; Teng, Christopher C

    2016-01-01

    Background Resident procedure minimums have been established in surgical training programs to ensure adequate training experience. However, achievement of these minimums may fluctuate. Review of resident experience is essential for maintaining successful training curricula. Objective To evaluate trends in ophthalmology resident surgical experience from 2009 to 2015. Methods This was a database study reviewing Accreditation Council for Graduate Medical Education ophthalmology resident surgical case logs. Case logs from 2,797 US ophthalmology residents were reviewed for trends in average surgical cases performed by residents as primary surgeon in the area of cataract, cornea, retina, glaucoma, pediatrics, plastics, and trauma from 2009 to 2015. Results Significant trends in resident surgical experience were demonstrated in the areas of cataract, retina, and glaucoma, while experience in cornea, pediatrics, plastics, and trauma remained stable. These trends included an increase in average cases of phacoemulsification cataract surgery from 143.8 to 173.6, vitreous tap/inject procedures from 31.3 to 93.1, and glaucoma shunt surgery from 4.5 to 6.7, with a decline in average cases of nonphacoemulsification cataract surgery from 3.8 to 2.2, retinal photocoagulation from 59.6 to 45.5, and filtering surgery from 6 to 4.5. Conclusion Trends in ophthalmology surgical experience in cataract, retina, and glaucoma paralleled new surgical or therapeutic developments as well as practice pattern shifts in these fields. Educators should be cognizant of the impact of such trends on resident experience and determine if curricular adjustments should be made to maintain comprehensive education of physicians-in-training. PMID:27418803

  13. Effort-reward imbalance and depression in Japanese medical residents.

    PubMed

    Sakata, Yumi; Wada, Koji; Tsutsumi, Akizumi; Ishikawa, Hiroyasu; Aratake, Yutaka; Watanabe, Mayumi; Katoh, Noritada; Aizawa, Yoshiharu; Tanaka, Katsutoshi

    2008-01-01

    The effort-reward imbalance is an important psychosocial factor which is related to poor health among employees. However, there are few studies that have evaluated effort-reward imbalance among medical residents. The present study was done to determine the association between psychosocial factors at work as defined by the effort-reward imbalance model and depression among Japanese medical residents. We distributed a questionnaire to 227 medical residents at 16 teaching hospitals in Japan at the end of August 2005. We asked participants to answer questions which included demographic information, depressive symptoms, effort-reward imbalance, over-commitment and social support. Depression was evaluated using the Japanese version of the Center for Epidemiologic Studies-Depression (CES-D) scale. The effort-reward imbalance and over-commitment were assessed by the Effort-Reward Imbalance (ERI) questionnaire which Siegrist developed. Social support was determined on a visual analog scale. Logistic regression analysis was performed to determine the associations between effort-reward imbalance and depressive symptoms. Depressive symptoms were found in 35 (29.2%) 1st-year residents and 21 (27.6%) 2nd-year residents. The effort-reward ratio >1 (OR, 8.83; 95% CI, 2.87-27.12) and low social support score (OR, 2.77, 95% CI, 1.36-5.64) were associated with depressive symptoms among medical residents. Effort-reward imbalance was independently related to depression among Japanese medical residents. The present study suggests that balancing between effort and reward at work is important for medical residents' mental health.

  14. [Polymorphism of 11 non-CODIS STRs in a population sample of ethnic minority of Polish Tatars residing in northeastern Poland].

    PubMed

    Pepiński, Witold; Niemcunowicz-Janica, Anna; Skawrońska, Małgorzata; Aleksandrowicz-Bukin, Maria

    2009-01-01

    Population genetic data for 11 STRs included in the Humantype Chimera kit were obtained by multiplex PCR and subsequent automated fluorescent detection (ABI 310) from a sample of 125 unrelated individuals of ethnic minority of Polish Tatars residing in Podlasie Region (NE Poland). The genotype distributions conformed to HWE for all the analyzed loci except D2S1360 and D21S2055. The highly polymorphic systems exhibit high informativeness and are a potential extension to CODIS loci.

  15. First Author Research Productivity of United States Radiation Oncology Residents: 2002-2007

    SciTech Connect

    Morgan, Peter B. Sopka, Dennis M.; Kathpal, Madeera; Haynes, Jeffrey C.; Lally, Brian E.; Li, Linna

    2009-08-01

    Purpose: Participation in investigative research is a required element of radiation oncology residency in the United States. Our purpose was to quantify the first author research productivity of recent U.S. radiation oncology residents during their residency training. Methods and Materials: We performed a computer-based search of PubMed and a manual review of the proceedings of the annual meetings of the American Society for Therapeutic Radiology and Oncology to identify all publications and presented abstracts with a radiation oncology resident as the first author between 2002 and 2007. Results: Of 1,098 residents trained at 81 programs, 50% published {>=}1 article (range, 0-9), and 53% presented {>=}1 abstract (range, 0-3) at an American Society for Therapeutic Radiology and Oncology annual meeting. The national average was 1.01 articles published and 1.09 abstracts presented per resident during 4 years of training. Of 678 articles published, 82% represented original research and 18% were review articles. Residents contributed 15% of all abstracts at American Society for Therapeutic Radiology and Oncology annual meetings, and the resident contribution to orally presented abstracts increased from 12% to 21% during the study period. Individuals training at programs with >6 residents produced roughly twice as many articles and abstracts. Holman Research Pathway residents produced double the national average of articles and abstracts. Conclusion: Although variability exists among individuals and among training programs, U.S. radiation oncology residents routinely participate in investigative research suitable for publication or presentation at a scientific meeting. These data provide national research benchmarks that can assist current and future radiation oncology residents and training programs in their self-assessment and research planning.

  16. Health and Healthcare Perspectives of African American Residents of an Unincorporated Community: A Qualitative Assessment

    PubMed Central

    King, Denae W.; Snipes, S. Amy; Herrera, Angelica P.; Jones, Lovell A.

    2009-01-01

    Residential perspectives about health in unincorporated communities are virtually unexplored. In this study, we conducted focus groups to assess individual and community health status, environmental health mediators, and systematic barriers to healthcare among African American residents of the unincorporated town, Fresno, Texas. Residents described their individual health status as excellent, but depicted the community’s health status as fair. Unaffordable healthcare, limited access to healthcare, and environmental mediators were perceived to impact the Fresno community’s health status. Our findings suggest a need to begin to examine health outcomes for minority residents in other unincorporated communities. PMID:18835739

  17. Decision support using anesthesia information management system records and accreditation council for graduate medical education case logs for resident operating room assignments.

    PubMed

    Wanderer, Jonathan P; Charnin, Jonathan; Driscoll, William D; Bailin, Michael T; Baker, Keith

    2013-08-01

    Our goal in this study was to develop decision support systems for resident operating room (OR) assignments using anesthesia information management system (AIMS) records and Accreditation Council for Graduate Medical Education (ACGME) case logs and evaluate the implementations. We developed 2 Web-based systems: an ACGME case-log visualization tool, and Residents Helping in Navigating OR Scheduling (Rhinos), an interactive system that solicits OR assignment requests from residents and creates resident profiles. Resident profiles are snapshots of the cases and procedures each resident has done and were derived from AIMS records and ACGME case logs. A Rhinos pilot was performed for 6 weeks on 2 clinical services. One hundred sixty-five requests were entered and used in OR assignment decisions by a single attending anesthesiologist. Each request consisted of a rank ordered list of up to 3 ORs. Residents had access to detailed information about these cases including surgeon and patient name, age, procedure type, and admission status. Success rates at matching resident requests were determined by comparing requests with AIMS records. Of the 165 requests, 87 first-choice matches (52.7%), 27 second-choice matches (16.4%), and 8 third-choice matches (4.8%) were made. Forty-three requests were unmatched (26.1%). Thirty-nine first-choice requests overlapped (23.6%). Full implementation followed on 8 clinical services for 8 weeks. Seven hundred fifty-four requests were reviewed by 15 attending anesthesiologists, with 339 first-choice matches (45.0%), 122 second-choice matches (16.2%), 55 third-choice matches (7.3%), and 238 unmatched (31.5%). There were 279 overlapping first-choice requests (37.0%). The overall combined match success rate was 69.4%. Separately, we developed an ACGME case-log visualization tool that allows individual resident experiences to be compared against case minimums as well as resident peer groups. We conclude that it is feasible to use ACGME case

  18. Decision support using anesthesia information management system records and accreditation council for graduate medical education case logs for resident operating room assignments.

    PubMed

    Wanderer, Jonathan P; Charnin, Jonathan; Driscoll, William D; Bailin, Michael T; Baker, Keith

    2013-08-01

    Our goal in this study was to develop decision support systems for resident operating room (OR) assignments using anesthesia information management system (AIMS) records and Accreditation Council for Graduate Medical Education (ACGME) case logs and evaluate the implementations. We developed 2 Web-based systems: an ACGME case-log visualization tool, and Residents Helping in Navigating OR Scheduling (Rhinos), an interactive system that solicits OR assignment requests from residents and creates resident profiles. Resident profiles are snapshots of the cases and procedures each resident has done and were derived from AIMS records and ACGME case logs. A Rhinos pilot was performed for 6 weeks on 2 clinical services. One hundred sixty-five requests were entered and used in OR assignment decisions by a single attending anesthesiologist. Each request consisted of a rank ordered list of up to 3 ORs. Residents had access to detailed information about these cases including surgeon and patient name, age, procedure type, and admission status. Success rates at matching resident requests were determined by comparing requests with AIMS records. Of the 165 requests, 87 first-choice matches (52.7%), 27 second-choice matches (16.4%), and 8 third-choice matches (4.8%) were made. Forty-three requests were unmatched (26.1%). Thirty-nine first-choice requests overlapped (23.6%). Full implementation followed on 8 clinical services for 8 weeks. Seven hundred fifty-four requests were reviewed by 15 attending anesthesiologists, with 339 first-choice matches (45.0%), 122 second-choice matches (16.2%), 55 third-choice matches (7.3%), and 238 unmatched (31.5%). There were 279 overlapping first-choice requests (37.0%). The overall combined match success rate was 69.4%. Separately, we developed an ACGME case-log visualization tool that allows individual resident experiences to be compared against case minimums as well as resident peer groups. We conclude that it is feasible to use ACGME case

  19. Evaluating Medical Residents' Literature-Appraisal Skills.

    ERIC Educational Resources Information Center

    Stern, David T.; And Others

    1995-01-01

    A study of 28 medical residents' skills in evaluating research compared student evaluations of a journal article with 1 developed by means of a Delphi technique utilizing 5 experts. Residents' scores were not significantly associated with residency year or self-assessed critical appraisal skill. The method is proposed as an objective means of…

  20. 38 CFR 51.110 - Resident assessment.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ...) PER DIEM FOR NURSING HOME CARE OF VETERANS IN STATE HOMES Standards § 51.110 Resident assessment. The... standards of quality; and (ii) Be provided by qualified persons in accordance with each resident's written...) Review of assessments. The nursing facility management must examine each resident no less than once...

  1. 38 CFR 51.110 - Resident assessment.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ...) PER DIEM FOR NURSING HOME CARE OF VETERANS IN STATE HOMES Standards § 51.110 Resident assessment. The... standards of quality; and (ii) Be provided by qualified persons in accordance with each resident's written...) Review of assessments. The nursing facility management must examine each resident no less than once...

  2. 38 CFR 51.110 - Resident assessment.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ...) PER DIEM FOR NURSING HOME CARE OF VETERANS IN STATE HOMES Standards § 51.110 Resident assessment. The... standards of quality; and (ii) Be provided by qualified persons in accordance with each resident's written...) Review of assessments. The nursing facility management must examine each resident no less than once...

  3. 38 CFR 51.110 - Resident assessment.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ...) PER DIEM FOR NURSING HOME CARE OF VETERANS IN STATE HOMES Standards § 51.110 Resident assessment. The... standards of quality; and (ii) Be provided by qualified persons in accordance with each resident's written...) Review of assessments. The nursing facility management must examine each resident no less than once...

  4. 38 CFR 51.110 - Resident assessment.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ...) PER DIEM FOR NURSING HOME CARE OF VETERANS IN STATE HOMES Standards § 51.110 Resident assessment. The... standards of quality; and (ii) Be provided by qualified persons in accordance with each resident's written...) Review of assessments. The nursing facility management must examine each resident no less than once...

  5. Residency Training in Child Sexual Abuse Evaluation.

    ERIC Educational Resources Information Center

    Giardino, Angelo P.; Brayden, Robert M.; Sugarman, Jacqueline M.

    1998-01-01

    A survey of 147 pediatric faculty and 64 resident pediatricians examined the quantity and adequacy of training in child sexual abuse evaluation. Both faculty and residents believed that preparation in how to conduct a sexual abuse evaluation may be inadequate for residents during their three years of post-graduate training. (CR)

  6. 28 CFR 115.333 - Resident education.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 28 Judicial Administration 2 2012-07-01 2012-07-01 false Resident education. 115.333 Section 115... STANDARDS Standards for Juvenile Facilities Training and Education § 115.333 Resident education. (a) During... provide comprehensive age-appropriate education to residents either in person or through video...

  7. 28 CFR 115.333 - Resident education.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 28 Judicial Administration 2 2014-07-01 2014-07-01 false Resident education. 115.333 Section 115... STANDARDS Standards for Juvenile Facilities Training and Education § 115.333 Resident education. (a) During... provide comprehensive age-appropriate education to residents either in person or through video...

  8. 28 CFR 115.333 - Resident education.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 28 Judicial Administration 2 2013-07-01 2013-07-01 false Resident education. 115.333 Section 115... STANDARDS Standards for Juvenile Facilities Training and Education § 115.333 Resident education. (a) During... provide comprehensive age-appropriate education to residents either in person or through video...

  9. 42 CFR 483.10 - Resident rights.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... facility and as a citizen or resident of the United States. (2) The resident has the right to be free of... jurisdiction, the rights of the resident are exercised by the person appointed under State law to act on the... extent provided by State law. (b) Notice of rights and services. (1) The facility must inform......

  10. 42 CFR 483.10 - Resident rights.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... facility and as a citizen or resident of the United States. (2) The resident has the right to be free of... jurisdiction, the rights of the resident are exercised by the person appointed under State law to act on the... extent provided by State law. (b) Notice of rights and services. (1) The facility must inform......

  11. 24 CFR 964.340 - Resident compensation.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 24 Housing and Urban Development 4 2010-04-01 2010-04-01 false Resident compensation. 964.340 Section 964.340 Housing and Urban Development Regulations Relating to Housing and Urban Development...) Program § 964.340 Resident compensation. Residents employed to provide services or renovation...

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

    ERIC Educational Resources Information Center

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

    2010-01-01

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

  13. Interventional radiology residency: steps to implementation.

    PubMed

    Marx, M Victoria; Sabri, Saher S

    2015-08-01

    Implementation of an interventional radiology (IR) residency program requires significant planning, as well as clear communication and consensus among departmental and institutional stakeholders. The goal of this short article is to highlight key decisions and steps that are needed to launch an IR residency, and to illustrate a possible timeline for implementation of the integrated and independent IR residency models.

  14. 25 CFR 700.97 - Residence.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... 25 Indians 2 2013-04-01 2013-04-01 false Residence. 700.97 Section 700.97 Indians THE OFFICE OF NAVAJO AND HOPI INDIAN RELOCATION COMMISSION OPERATIONS AND RELOCATION PROCEDURES General Policies and Instructions Definitions § 700.97 Residence. (a) Residence is established by proving that the head of...

  15. 25 CFR 700.97 - Residence.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 25 Indians 2 2010-04-01 2010-04-01 false Residence. 700.97 Section 700.97 Indians THE OFFICE OF NAVAJO AND HOPI INDIAN RELOCATION COMMISSION OPERATIONS AND RELOCATION PROCEDURES General Policies and Instructions Definitions § 700.97 Residence. (a) Residence is established by proving that the head of...

  16. 25 CFR 700.97 - Residence.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... 25 Indians 2 2012-04-01 2012-04-01 false Residence. 700.97 Section 700.97 Indians THE OFFICE OF NAVAJO AND HOPI INDIAN RELOCATION COMMISSION OPERATIONS AND RELOCATION PROCEDURES General Policies and Instructions Definitions § 700.97 Residence. (a) Residence is established by proving that the head of...

  17. 25 CFR 700.97 - Residence.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 25 Indians 2 2011-04-01 2011-04-01 false Residence. 700.97 Section 700.97 Indians THE OFFICE OF NAVAJO AND HOPI INDIAN RELOCATION COMMISSION OPERATIONS AND RELOCATION PROCEDURES General Policies and Instructions Definitions § 700.97 Residence. (a) Residence is established by proving that the head of...

  18. 38 CFR 51.70 - Resident rights.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... freedom from chemical or physical restraint. (4) In the case of a resident determined incompetent under... appointed under State law to act on the resident's behalf. (5) In the case of a resident who has not been... current clinical records within 24 hours (excluding weekends and holidays); and (ii) After receipt of...

  19. Hospitalizations of nursing homes residents: the role of reimbursement policies.

    PubMed

    Ashton, Toni

    2014-01-23

    Factors which contribute to hospitalization of nursing home residents are multiple and complex. They include dimensions of the policy setting as well as patient management practices. In seeking interventions to reduce such hospitalizations, most research has focussed on changing patient management. But provider reimbursement policies may also influence the decision to hospitalize nursing home residents. This includes payments to hospitals and general practitioners as well as to the nursing homes themselves. Differences in payment methods may mean that interventions that work well in one setting do not work well in another.This is a commentary on http://www.ijhpr.org/content/3/1/2/.

  20. Resident transfers from aged care facilities to emergency departments: Can they be avoided?

    PubMed Central

    Innes, Kelli; Griffiths, Debra L; Crawford, Kimberley; Williams, Allison

    2015-01-01

    Abstract Objective Residents from aged care facilities make up a considerable proportion of ED presentations. There is evidence that many residents transferred from aged care facilities to EDs could be managed by primary care services. The present study aimed to describe the characteristics of residents transferred from residential aged care facilities to EDs, and to evaluate the appropriateness and cost of these presentations. Methods A retrospective review of ED records was undertaken for residents transferred from residential aged care facilities to two EDs in Melbourne, Victoria, in 2012. Data examined included residents' mode and time of arrival to ED, presenting complaint, triage category, procedures within ED, diagnosis, length of stay, and disposition. Data were examined against a previously established tool to identify resident transfers that might be ‘potentially avoidable’. Results There were 2880 resident transfers included in the sample, of which 408 transfers were randomly selected for scrutiny of documentation. Seventy‐one residents (17.4%) were identified as being potentially avoidable transfers. Conclusion Many resident transfers might have been avoided with better primary care services in place. Future strategies to improve resident care might include aged care staff skill mix and the availability of outreach or primary care services. PMID:26095333

  1. A Comparison between Emergency Medicine Residency Training Programs in the United States and Saudi Arabia from the Residents' Perception

    PubMed Central

    2014-01-01

    Objectives. This study was designed to compare the trainees' perception of emergency medicine (EM) training in the United States (US) and Saudi Arabia (SA) and to identify residents' levels of confidence and points of satisfaction in education, procedural skills, and work environment. Method. An IRB-exempt anonymous web-based survey was distributed to five EM residency training programs in the USA and three residency regions in SA. Results. 342 residents were polled with a 20% response rate (16.8% USA and 25.8% SA). The Saudi residents responded less positively to the questions about preparation for their boards' examinations, access to multiple educational resources, and weekly academic activities. The Saudi trainees felt less competent in less common procedures than US trainees. American trainees also more strongly agree that they have more faculty interest in their education compared to the Saudi trainees. The Saudi residents see more patients per hour compared to their US peers. Conclusion. These findings may be due to the differences in training techniques including less formal didactics and simulation experience in SA and more duty hour regulations in the USA. PMID:24563784

  2. Pain monitoring and medication assessment in elderly nursing home residents with dementia

    PubMed Central

    Tang, Mette Marie; Wollsen, Morten Gill; Aagaard, Lise

    2016-01-01

    Objective: To monitor pain intensity, pain symptoms, and medication use in elderly with dementia. Methods: Nursing home residents above 65 years of age, diagnosed with dementia, and showing pain symptoms were included in the study. The patients’ mental status was monitored through a mini-mental state examination score and observations of pain symptoms using Part 1 of the Mobilization-Observation-Behaviour-Intensity-Dementia-2 (MOBID-2) pain scale. Community pharmacists reviewed the patients’ medication use, and the prescriptions were compared with guidelines for treatment of geriatric patients. Alterations to the patients’ medicine use were forwarded to the general practitioners. Findings: Sixty-one nursing home residents diagnosed with dementia were identified, 15 of these fulfilled the inclusion criteria, and 12 agreed to participate in the study. The mean age was 87 years of age (range: 77-96), and 42% of the residents were males. The patients’ overall pain intensity was 83% for observations on the numeric pain rating scale (NRS) >0 and 67% for NRS ≥3. Most painful were the situations in which the residents were to mobilize their legs, turn around to both sides of the bed, and when sitting on the bed. The medication reviews identified a total of 95 individual prescriptions, and 33% of these were for nervous system medications, followed by medicines for the treatment of alimentary tract and metabolism disorders (31% of total). Eleven prescriptions for pain medicine were identified; the majority of these were for paracetamol and opioids. Seventeen proposals to patients’ medication use were suggested, but the general practitioners accepted only 6% of these. Conclusion: This study indicates that the MOBID-2 pain scale in combination with medication reviews can be used as a tool for optimization of patients’ medication use. However, we recommend the conduction of a larger-scale study in multiple settings, to validate our results and the generalizability

  3. The professionalism disconnect: do entering residents identify yet participate in unprofessional behaviors?

    PubMed Central

    2014-01-01

    Background Professionalism has been an important tenet of medical education, yet defining it is a challenge. Perceptions of professional behavior may vary by individual, medical specialty, demographic group and institution. Understanding these differences should help institutions better clarify professionalism expectations and provide standards with which to evaluate resident behavior. Methods Duke University Hospital and Vidant Medical Center/East Carolina University surveyed entering PGY1 residents. Residents were queried on two issues: their perception of the professionalism of 46 specific behaviors related to training and patient care; and their own participation in those specified behaviors. The study reports data analyses for gender and institution based upon survey results in 2009 and 2010. The study received approval by the Institutional Review Boards of both institutions. Results 76% (375) of 495 PGY1 residents surveyed in 2009 and 2010 responded. A majority of responders rated all 46 specified behaviors as unprofessional, and a majority had either observed or participated in each behavior. For all 46 behaviors, a greater percentage of women rated the behaviors as unprofessional. Men were more likely than women to have participated in behaviors. There were several significant differences in both the perceptions of specified behaviors and in self-reported observation of and/or involvement in those behaviors between institutions. Respondents indicated the most important professionalism issues relevant to medical practice include: respect for colleagues/patients, relationships with pharmaceutical companies, balancing home/work life, and admitting mistakes. They reported that professionalism can best be assessed by peers, patients, observation of non-medical work and timeliness/detail of paperwork. Conclusion Defining professionalism in measurable terms is a challenge yet critical in order for it to be taught and assessed. Recognition of the differences by

  4. Stress and burnout in residents: impact of mindfulness-based resilience training

    PubMed Central

    Goldhagen, Brian E; Kingsolver, Karen; Stinnett, Sandra S; Rosdahl, Jullia A

    2015-01-01

    Background and objective Stress and burnout impact resident physicians. This prospective study tests the hypothesis that a mindfulness-based resilience intervention would decrease stress and burnout in residents. Methods Resident physicians from the Departments of Family Medicine, Psychiatry, and Anesthesia at Duke University, Durham, NC, USA, participated in two or three 1-hour sessions of mindfulness-based resilience activities, which introduced mindful-awareness and included practical exercises for nurturing resilience. Anonymous surveys were distributed before (completed by 47 residents) and after the intervention (both completed by 30 residents); a follow-up survey was distributed 1 month later (seven residents completed all three surveys). The survey included the Depression Anxiety Stress Scale, 21-question version (DASS-21), the Oldenburg Burnout Inventory, the Mindful Attention Awareness Scale, and ten questions from the Cognitive Failures Questionnaire. Results At baseline, most residents’ scores were in the normal range with respect to stress; however, female residents had higher DASS-21 scores than male residents (31.7, females vs 18.4, males; P=0.002). Most residents’ burnout scores were in the abnormal range, both with respect to exhaustion (38/47 residents, subscore ≥2.25) and disengagement (37/47 residents, subscore ≥2.1). Higher perceived levels of stress correlated with the instruments. Analysis of the surveys before and after the intervention showed no significant short-term change in stress, burnout, mindful-awareness, or cognitive failure. There was a trend for females and post-medical school graduate year 1 and 2 (PGY1 and PGY2) residents to have a reduction in DASS-21 scores after intervention. There was also a trend of reduced stress and burnout in residents who perceived higher stress. Conclusion Residents who are female, PGY1 and PGY2, and who perceive residency to be stressful may benefit most from a mindfulness-based resilience

  5. Experiences in end-of-life care in the Intensive Care Unit: A survey of resident physicians

    PubMed Central

    Mohamed, Zubair Umer; Muhammed, Fazil; Singh, Charu; Sudhakar, Abish

    2016-01-01

    Background and Aims: The practice of intensive care includes withholding and withdrawal of care, when appropriate, and the goals of care change around this time to comfort and palliation. We decided to survey the attitudes, training, and skills of intensive care residents in relation to end-of-life (EoL) care. All residents at our institute who has worked for at least a month in an adult Intensive Care Unit were invited to participate. Materials and Methods: After Institutional Ethics Committee approval, a Likert-scale questionnaire, divided into five composite measures of EoL skills including training and attitude, was handed over to individual residents and completed data were anonymized. Frequency and descriptive analysis was performed for the demographic variables. Central tendency, variability, and reliability were examined for the five composite measures. Scale internal consistency was checked by Cronbach's coefficient alpha. Multivariate forward conditional regression analysis was conducted to examine the association of demographic data or EoL experience to composite measures. Results: Of the 170 eligible residents, we received 120 (70.5%) responses. Conclusions: Internal medicine residents have more experience in caring for dying patients and conducting EoL discussions. Even though majority of participants reported that they are comfortable with the concept of EoL care, this does not always reflect the actual practice in the hospital. There is a need for further training in skills around EoL care. As this is a self-assessment survey, the specific measures of attitudes and skills in EoL are poorly reflected, indicating a need for further research. PMID:27630457

  6. Experiences in end-of-life care in the Intensive Care Unit: A survey of resident physicians

    PubMed Central

    Mohamed, Zubair Umer; Muhammed, Fazil; Singh, Charu; Sudhakar, Abish

    2016-01-01

    Background and Aims: The practice of intensive care includes withholding and withdrawal of care, when appropriate, and the goals of care change around this time to comfort and palliation. We decided to survey the attitudes, training, and skills of intensive care residents in relation to end-of-life (EoL) care. All residents at our institute who has worked for at least a month in an adult Intensive Care Unit were invited to participate. Materials and Methods: After Institutional Ethics Committee approval, a Likert-scale questionnaire, divided into five composite measures of EoL skills including training and attitude, was handed over to individual residents and completed data were anonymized. Frequency and descriptive analysis was performed for the demographic variables. Central tendency, variability, and reliability were examined for the five composite measures. Scale internal consistency was checked by Cronbach's coefficient alpha. Multivariate forward conditional regression analysis was conducted to examine the association of demographic data or EoL experience to composite measures. Results: Of the 170 eligible residents, we received 120 (70.5%) responses. Conclusions: Internal medicine residents have more experience in caring for dying patients and conducting EoL discussions. Even though majority of participants reported that they are comfortable with the concept of EoL care, this does not always reflect the actual practice in the hospital. There is a need for further training in skills around EoL care. As this is a self-assessment survey, the specific measures of attitudes and skills in EoL are poorly reflected, indicating a need for further research.

  7. Health Literacy Teaching in U.S. Family Medicine Residency Programs: A National Survey.

    PubMed

    Coleman, Clifford A; Nguyen, Nancy T; Garvin, Roger; Sou, Channbunmorl; Carney, Patricia A

    2016-01-01

    Health care providers, including medical residents, often lack adequate knowledge and skills to work effectively with patients who have limited health literacy. Little is known about the degree to which medical residents are trained to communicate effectively with people who have limited health literacy. This study aimed to assess the status of health literacy training for physicians in U.S. family medicine residency programs. We conducted an online survey of residency directors at 444 U.S. family medicine residencies. Among 138 respondents (31% response rate), 58 programs (42%) reported teaching residents about health literacy as part of the required curriculum. Most instruction occurred during the 1st year of training. Hours of instruction ranged from 2 to 5 during Years 1 through 3. Skills-based training (e.g., plain language techniques) was taught by most programs. Not having access to a faculty authority on health literacy was strongly associated with lack of a required health literacy curriculum. Respondents overwhelmingly agreed that increasing health literacy training for medical students and residents would help improve residents' clinical skills. This study provides a baseline snapshot of health literacy curricula in U.S. family medicine residencies and likely overestimates the prevalence of such curricula. Additional studies are needed to determine the quality of health literacy instruction in U.S. family medicine residencies and the most effective methods for teaching residents about health literacy. PMID:27043758

  8. An empirical specification of residency performance dimensions.

    PubMed

    Altmaier, E M; Johnson, S R; Tarico, V S; Laube, D

    1988-07-01

    A critical aspect of any residency is the process of selection and evaluation. However, the research literature has failed to provide an adequate behavioral specification of performance components to assist in selection and evaluation decisions. In this investigation, we applied a widely accepted method of job analysis from personnel psychology, the critical incident technique, to define those behaviors and attitudes necessary for successful resident performance in obstetrics and gynecology. Nine mutually exclusive categories of behavior were identified, including conscientiousness, recognition of limits, confidence in skills and training, ability to handle crisis/emergency situations, integration of knowledge with practice, technical skills, relationships with staff, relationships with patients, and ethical actions. These categories appear to be reliable, as physician raters were able to sort incidents into appropriate categories with 94% reliability. Identification of these categories represents a beginning step toward determining necessary aspects of performance in a structured and replicable manner and toward defining these performance aspects in a manner that allows precise and reliable measurement. PMID:3380501

  9. An empirical specification of residency performance dimensions.

    PubMed

    Altmaier, E M; Johnson, S R; Tarico, V S; Laube, D

    1988-07-01

    A critical aspect of any residency is the process of selection and evaluation. However, the research literature has failed to provide an adequate behavioral specification of performance components to assist in selection and evaluation decisions. In this investigation, we applied a widely accepted method of job analysis from personnel psychology, the critical incident technique, to define those behaviors and attitudes necessary for successful resident performance in obstetrics and gynecology. Nine mutually exclusive categories of behavior were identified, including conscientiousness, recognition of limits, confidence in skills and training, ability to handle crisis/emergency situations, integration of knowledge with practice, technical skills, relationships with staff, relationships with patients, and ethical actions. These categories appear to be reliable, as physician raters were able to sort incidents into appropriate categories with 94% reliability. Identification of these categories represents a beginning step toward determining necessary aspects of performance in a structured and replicable manner and toward defining these performance aspects in a manner that allows precise and reliable measurement.

  10. Trajectories of Posttraumatic Stress Among Urban Residents

    PubMed Central

    Galea, Sandro; Uddin, Monica; Koenen, Karestan C.

    2014-01-01

    Urban residents experience a wide range of traumatic events and are at increased risk of assaultive violence. Although previous research has examined trajectories of posttraumatic stress (PTS) through latent class growth analysis (LCGA) among persons exposed to the same index events (e.g., a natural disaster), PTS trajectories have not been documented among urban residents. The aims of this study were to conduct LGCA with a sample of trauma survivors from Detroit, Michigan (N = 981), and to explore predictors of trajectory membership. Participants completed three annual telephone surveys, each of which included the posttraumatic stress disorder (PTSD) Check-list-Civilian Version. Four PTS trajectories were detected. Although the majority evidenced a trajectory of consistently few symptoms (Low: 72.5 %), 4.6 % were in a trajectory of chronic severe PTSD (High), and the remainder were in trajectories of consistently elevated, but generally subclinical, levels of PTS (Decreasing: 12.3 %; Increasing: 10.6 %). Socioeconomic disadvantage (e.g., lower income), more extensive trauma history (e.g., childhood abuse), and fewer social resources (e.g., lower social support) were associated with membership in higher PTS trajectories, relative to the Low trajectory. The results suggest that efforts to reduce PTS in urban areas need to attend to socioeconomic vulnerabilities in addition to trauma history and risk for ongoing trauma exposure. PMID:24469249

  11. 48 CFR 3037.104-91 - Personal services contracts with individuals under the authority of 10 U.S.C. 1091 (USCG).

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... section. Selections made using the procedures in this section are exempt by statute from (HSAR) 48 CFR part 3006 competition requirements (see (HSAR) 48 CFR 3006.9000 (USCG)) and from (FAR) 48 CFR Part 6... opportunities to individuals residing in the area of the facility. The notice should include the...

  12. Urinary and Fecal Incontinence in Nursing Home Residents

    PubMed Central

    Leung, Felix W.; Schnelle, John F.

    2008-01-01

    Urinary and fecal incontinence (UI, FI) are co-morbid conditions affecting over 50% of nursing home residents. Both forms of incontinence are risk factors for elderly persons to be placed in the nursing home, and such institutionalization itself is a risk factor for developing incontinence. Management should focus on identifying and treating underlying causes, such as detrusor instability, urinary tract infections, diet- or medication-induced diarrhea, constipation and fecal impaction. Despite appropriate management, residents may remain incontinent because of dementia and health or restraint-related immobility. Nursing homes lack the staff and financial resources to provide residents with sufficiently frequent toileting assistance (including prompted voiding). Use of special undergarments and absorbent pads is the usual practice. The article reviews the results of studies that have documented how prompted voiding programs can significantly reduce UI and FI, particularly if the intervention includes dietary and exercise components. Recent systematic anorectal testing of nursing home residents with FI has documented impaired sphincter function (risk factor for FI), decreased rectal sensation and sphincter dyssynergia (risk factor for constipation and impaction). The data suggest that the use of laxatives and stool softeners for prophylaxis against constipation and impaction related to underlying dyssynergia may have produced sufficient fluidity in the stool to predispose the residents with impaired sphincter function to manifest FI. Documentation of non-invasive and efficacious interventions by RCT and the labor costs of implementing these measures can lead to changes in how nursing home care is provided and funded. PMID:18794004

  13. Nurse manager residency program: an innovative leadership succession plan.

    PubMed

    Watkins, Amy; Wagner, Jennifer; Martin, Christina; Grant, Brandy; Maule, Katrina; Resh, Kimberly; King, Lisa; Eaton, Holly; Fetter, Katrina; King, Stacey L; Thompson, Elizabeth J

    2014-01-01

    To ensure succession planning within the ranks of nurse managers meet current and projected nursing management needs and organizational goals, we developed and implemented a nurse manager residency program at our hospital. By identifying, supporting, and mentoring clinical experts who express a desire and display an aptitude for nursing leadership, we are graduating individuals who can transition to a nurse manager position with greater ease and competence.

  14. Nurse manager residency program: an innovative leadership succession plan.

    PubMed

    Watkins, Amy; Wagner, Jennifer; Martin, Christina; Grant, Brandy; Maule, Katrina; Resh, Kimberly; King, Lisa; Eaton, Holly; Fetter, Katrina; King, Stacey L; Thompson, Elizabeth J

    2014-01-01

    To ensure succession planning within the ranks of nurse managers meet current and projected nursing management needs and organizational goals, we developed and implemented a nurse manager residency program at our hospital. By identifying, supporting, and mentoring clinical experts who express a desire and display an aptitude for nursing leadership, we are graduating individuals who can transition to a nurse manager position with greater ease and competence. PMID:24704735

  15. Field-based generation and social validation managers and staff competencies for small community residences.

    PubMed

    Thousand, J S; Burchard, S N; Hasazi, J E

    1986-01-01

    Characteristics and competencies for four staff positions in community residences for individuals with mental retardation were identified utilizing multiple empirical and deductive methods with field-based practitioners and field-based experts. The more commonly used competency generation methods of expert opinion and job performance analysis generated a high degree of knowledge and skill-based competencies similar to course curricula. Competencies generated by incumbent practitioners through open-ended methods of personal structured interview and critical incident analysis were ones which related to personal style, interpersonal interaction, and humanistic orientation. Although seldom included in staff, paraprofessional, or professional training curricula, these latter competencies include those identified by Carl Rogers as essential for developing an effective helping relationship in a therapeutic situation (i.e., showing liking, interest, and respect for the clients; being able to communicate positive regard to the client). Of 21 core competency statements selected as prerequisites to employment for all four staff positions, the majority (17 of 21) represented interpersonal skills important to working with others, including responsiveness to resident needs, personal valuation of persons with mental retardation, and normalization principles.

  16. Field-based generation and social validation managers and staff competencies for small community residences.

    PubMed

    Thousand, J S; Burchard, S N; Hasazi, J E

    1986-01-01

    Characteristics and competencies for four staff positions in community residences for individuals with mental retardation were identified utilizing multiple empirical and deductive methods with field-based practitioners and field-based experts. The more commonly used competency generation methods of expert opinion and job performance analysis generated a high degree of knowledge and skill-based competencies similar to course curricula. Competencies generated by incumbent practitioners through open-ended methods of personal structured interview and critical incident analysis were ones which related to personal style, interpersonal interaction, and humanistic orientation. Although seldom included in staff, paraprofessional, or professional training curricula, these latter competencies include those identified by Carl Rogers as essential for developing an effective helping relationship in a therapeutic situation (i.e., showing liking, interest, and respect for the clients; being able to communicate positive regard to the client). Of 21 core competency statements selected as prerequisites to employment for all four staff positions, the majority (17 of 21) represented interpersonal skills important to working with others, including responsiveness to resident needs, personal valuation of persons with mental retardation, and normalization principles. PMID:3752986

  17. The Impact of the Physical Environment on the Social Integration of Individuals with Disabilities in Community

    ERIC Educational Resources Information Center

    Christensen, Keith M.

    2010-01-01

    Social integration in community is especially important for individuals with disabilities well-being. Although individuals with disabilities reside within the community's physical environment, they are often marginalized in the social environment. This may be the result of individuals with disabilities residing in physical environments that…

  18. Urban birth and residence as risk factors for psychoses: an analysis of 1880 data.

    PubMed

    Torrey, E F; Bowler, A E; Clark, K

    1997-06-20

    It is known that social drift to cities increases the urban prevalence for severe mental illnesses. Recent studies in England and Sweden have reported that being born in, or raised in, an urban area is also a risk factor for later developing schizophrenia. The present study utilized 1880 census data, the most complete enumeration of severely mentally ill individuals ever done in the United States, to examine the association of urban residence and severe mental illnesses. Individuals identified as having one of seven forms of 'insanity' (n = 91959) were allocated to their county of origin (n = 2661) in the census. Rates of 'insane' persons per 1000 population were calculated for each county. The counties were then divided by degree of urbanization based on the largest cities and the percentage of population living in towns of 4000 or more. The point prevalence of 'insanity' in the United States as a whole in 1880 was 1.8 per 1000. There was a significant association between 'insanity' by county and degree of urbanization, with odds ratios of 1.66 for urban, 1.46 for semi-urban, and 1.44 for semi-rural, and 1.37 for rural, using completely rural counties as a baseline. Most completely rural counties with high rates included mining camps, lumbering camps, or fishing villages, and not farming areas. In addition to urban drift, urban birth and residence appear to be risk factors for developing severe mental illnesses. Psychological and biological explanations have both been proposed. However, recent studies reporting winter birth and urban birth or residence as synergistic risk factors favor the latter.

  19. Individualized Medicine

    SciTech Connect

    Mariella, R.

    2000-08-29

    The recent focus of microelectromechanical-systems (MEMS) based instrumentation has largely dealt with increasing the throughput of established processes, including drug screening/drug discovery/combinatorial chemistry, or the miniaturization of accepted bench-top instruments. The miniaturization and automation of procedures that were previously performed manually are included in these activities. We suggest that BioMEMS instrumentation will adopt an additional direction, that of providing information and capabilities to the physician that are not available, today.

  20. Improving kidney care for residents in nursing facilities: a national model.

    PubMed

    Neumann, Mark E

    2016-02-01

    The RRC Staff Assisted Home Hemodialysis Program started in September 2013 with the target of improving care for the frail elderly residents in skilled facilities by offering hemodialysis in their home setting. Residents all receive short time, frequent dialysis. The residents no longer need to be transported to a local dialysis center three times per week in all types of weather and subject to long waits by the transport company. In addition, Medicare/Medicaid save significant dollars on transportation expenses. Residents needing rehabilitation services can receive their therapy while their dialysis schedule is adjusted around the resident's therapy. Residents no longer miss meals and medications or family visits. Collaboration between RRC and the skilled facility is patient centric whereby the care of each patient is consistent and individualized. The most meaningful measure of the success of this program is the residents themselves. They have self-reported how much better they feel with more energy. The residents can increase their socialization activities within the skilled facility. The dietitians report that the residents are eating better because there are fewer restrictions on foods and fluids. PMID:26983182

  1. Design and fabrication of a prototype system for photovoltaic residences in the Southwest

    NASA Astrophysics Data System (ADS)

    1982-06-01

    Described are the design of a photovoltaic powered residence for the American Southwest, dubbed Casa fotovoltaica, and the construction of a prototype building at the Southwest Residential Experiment Station for testing the performance of the full size photovoltaic (PV) system. Included are architectural drawings of both the residence and the prototype, analysis of the energy requirements of the residence, prediction of PV system output, description of the electrical system, and history of the construction process of the prototype.

  2. What is a wiki, and how can it be used in resident education?

    PubMed

    Kohli, Marc D; Bradshaw, John K

    2011-02-01

    Training as a radiology resident is a complex task. Residents frequently encounter multiple hospital systems, each with unique workflow patterns and heterogenous information systems. We identified an opportunity to ease some of the resulting anxiety and frustration by centralizing high-quality resources using a wiki. In this manuscript, we describe our choice of wiki software, give basic information about hardware requirements, detail steps for configuration, outline information included on the wiki, and present the results of a resident acceptance survey.

  3. Effect of family medicine residents on use of diagnostic investigations

    PubMed Central

    Seong, Augene; Osmun, W.E.

    2014-01-01

    Abstract Objective To determine the effect of the presence of family medicine residents on the use of laboratory and imaging investigations in a rural emergency department (ED). Design A retrospective cross-sectional electronic chart audit was completed. Background characteristics, as well as type and number of ordered investigations, were compared between study groups. Setting Strathroy Middlesex General Hospital in Strathroy, Ont, a rural community hospital that sees approximately 20 000 ED visits per year. Participants A total of 2000 sequential ED visits, including adult and pediatric patients. The test group consisted of patients seen while a resident was present in the ED. The control group consisted of patients seen while no residents were present in the ED. Main outcome measures Twenty-two distinct categories of common ED investigations were studied. Results There was no statistically significant difference between study groups for 19 of the 22 categories of investigations. There were significant differences in 3 categories: an increased number of D-dimer assays for patients seen while there were no residents in the ED (1.7% of patients vs 0.5% of patients, P = .03) and increased computed tomography and ultrasound imaging for patients seen while a resident was in the ED (4.8% vs 1.8%, P = .0012, and 5.3% and 1.7%, P < .001, respectively). These differences are likely not owing to resident involvement but are explained by a difference in test availability between groups. Conclusion The study was underpowered for most categories of studied investigations. However, the trends demonstrated in this study suggest that the presence of family medicine residents in a rural community ED does not substantially affect the overall use of diagnostic investigations. PMID:25217692

  4. Project ASPIRE: Incorporating Integrative Medicine Into Residency Training.

    PubMed

    Nawaz, Haq; Via, Christina M; Ali, Ather; Rosenberger, Lisa D

    2015-11-01

    Griffin Hospital, a community hospital affiliated with Yale School of Public Health and Yale School of Medicine, received Health Resources and Services Administration funding to strengthen and improve its combined internal medicine and general preventive medicine residency program by incorporating an integrative medicine curriculum. The purpose of project ASPIRE (Advancing Skills of Preventive medicine residents through Integrative medicine Education, Research and Evaluation) was to create, implement, and evaluate a needs-based, innovative training curriculum in integrative medicine. Through this robust new training, the authors aimed to produce preventive medicine-trained physicians with competencies in integrative medicine to collaboratively work with other integrative medicine practitioners in interdisciplinary teams to provide holistic, patient-centered care. The multifaceted collaborative curriculum was composed of didactics, grand rounds, journal club, objective structured clinical examinations, and two new practicum rotations in integrative medicine. The new practicum rotations included block rotations at the Integrative Medicine Center at Griffin Hospital and the Yale Stress Center. Between 2012 and 2014, three cohorts participated in the curriculum; two of these cohorts included three advanced preventive medicine residents each and the fourth included four residents. Project faculty conducted 14 lectures and journal clubs, and two grand rounds. Six of the ten participating residents (60%) completed integrative medicine clinical rotations. Residents' attitudes toward integrative medicine were evaluated through self-assessment using the Complementary, Alternative, and Integrative Medicine Attitudes Questionnaire; data were analyzed in 2015. This article describes the results of this prospective observational study based on single-institution experience over the course of the 2-year project period.

  5. Project ASPIRE: Incorporating Integrative Medicine Into Residency Training.

    PubMed

    Nawaz, Haq; Via, Christina M; Ali, Ather; Rosenberger, Lisa D

    2015-11-01

    Griffin Hospital, a community hospital affiliated with Yale School of Public Health and Yale School of Medicine, received Health Resources and Services Administration funding to strengthen and improve its combined internal medicine and general preventive medicine residency program by incorporating an integrative medicine curriculum. The purpose of project ASPIRE (Advancing Skills of Preventive medicine residents through Integrative medicine Education, Research and Evaluation) was to create, implement, and evaluate a needs-based, innovative training curriculum in integrative medicine. Through this robust new training, the authors aimed to produce preventive medicine-trained physicians with competencies in integrative medicine to collaboratively work with other integrative medicine practitioners in interdisciplinary teams to provide holistic, patient-centered care. The multifaceted collaborative curriculum was composed of didactics, grand rounds, journal club, objective structured clinical examinations, and two new practicum rotations in integrative medicine. The new practicum rotations included block rotations at the Integrative Medicine Center at Griffin Hospital and the Yale Stress Center. Between 2012 and 2014, three cohorts participated in the curriculum; two of these cohorts included three advanced preventive medicine residents each and the fourth included four residents. Project faculty conducted 14 lectures and journal clubs, and two grand rounds. Six of the ten participating residents (60%) completed integrative medicine clinical rotations. Residents' attitudes toward integrative medicine were evaluated through self-assessment using the Complementary, Alternative, and Integrative Medicine Attitudes Questionnaire; data were analyzed in 2015. This article describes the results of this prospective observational study based on single-institution experience over the course of the 2-year project period. PMID:26477907

  6. Living longer and better than expected. A wellness-based model keeps CCRC residents active, healthy, and out of nursing homes.

    PubMed

    Crowley, M

    1992-12-01

    The McCauley, a continuing care retirement community in West Hartford, CT, promotes a wellness philosophy that helps its residents retain their health and independence and extend their lives. The wellness program centers around the individual, not around the services provided. The residents have significant input and initiative in maintaining their own health. The health program is based on a nursing model, with each resident relating to a primary nurse as needs become evident. The nurses' goal is to know each person's holistic needs--to assist in maintaining physical, emotional, and spiritual balance. The program's approach to physical health requires a strong emphasis on prevention, including individualized fitness programs. The McCauley fosters mental and social well-being by allowing patients to maintain independent living for as long as they are able and by maximizing their self-direction. Another contributor to mental well-being is the opportunity for personal growth and intellectual stimulation. The McCauley promotes spiritual well-being by supporting continued participation in churches or synagogues from previous neighborhoods, fostering a supportive network within the community, and recognizing the value of residents' volunteer activities. PMID:10122524

  7. Pain Management Among Nursing Home Residents with Cancer

    PubMed Central

    Pimentel, Camilla B.; Briesacher, Becky A.; Gurwitz, Jerry H.; Rosen, Allison B.; Pimentel, Marc T.; Lapane, Kate L.

    2015-01-01

    BACKGROUND In the mid-1990s, 29.4% of nursing home (NH) residents with cancer suffered from daily pain, and among them 26% failed to receive any analgesics. OBJECTIVES To assess improvements in pain management of NH residents with cancer since the implementation of pain management quality indicators. DESIGN Cross-sectional study. SETTING 1,382 US NHs. PARTICIPANTS 8,094 newly-admitted, Medicare-eligible NH residents with cancer. MEASUREMENTS Nationwide data on NH resident health from the Minimum Data Set 2.0 linked to all-payer pharmacy dispensing records (February 2006–June 2007) were used to determine prevalence of pain, including frequency and intensity, and receipt of non-opioid and opioid analgesics. Multinomial logistic regression evaluated resident-level correlates of pain and binomial logistic regression identified correlates of untreated pain. RESULTS More than 65% of NH residents with cancer had any pain (28.3% daily, 37.3% less than daily), among whom 13.5% had severe and 61.3% had moderate pain. Women, residents admitted from acute care or who were bedfast, and those with compromised activities of daily living, depressed mood, indwelling catheter, or terminal prognosis were more likely to have pain. More than 17% of residents in daily pain (95% confidence interval [CI]: 16.0–19.1%) received no analgesics, including 11.7% with daily severe pain (95% CI: 8.9–14.5%) and 16.9% with daily moderate pain (95% CI: 15.1–18.8%). Treatment was negatively associated with age >85 years (adjusted odds ratio [aOR]=0.67, 95% CI: 0.55–0.81 versus aged 65–74), cognitive impairment (aOR=0.71, 95% CI: 0.61–0.82), presence of feeding tube (aOR=0.77, 95% CI: 0.60–0.99), and restraints (aOR=0.50, 95% CI: 0.31–0.82). CONCLUSION Untreated pain is still common among NH residents with cancer and persists despite pain management quality indicators. PMID:25900481

  8. Evaluation of serum immunoglobulins among individuals living near six Superfund sites.

    PubMed

    Williamson, Dhelia M; White, Mary C; Poole, Charles; Kleinbaum, David; Vogt, Robert; North, Kari

    2006-07-01

    Residents living in communities near Superfund sites have expressed concern that releases from these facilities affect their health, including adverse effects on their immune systems. We used data from six cross-sectional studies to evaluate whether people who live near several Superfund sites are more likely to have individual immunoglobulin test results (IgA, IgG, and IgM) below or above the reference range than those who live in comparison areas with no Superfund site. Study participants consisted of target-area residents who lived close to a Superfund site and comparison-area residents who were not located near any Superfund or hazardous waste sites. A consistent modeling strategy was used across studies to assess the magnitude of the relationship between area of residence and immunoglobulin test results, adjusting for potential confounders and effect modifiers. In all study areas, the results suggest that people who live near a Superfund site may have been more likely to have IgA test results above the reference range than comparison areas residents regardless of modeling strategy employed. The effect measures were larger for residents who lived in communities near military bases with groundwater contamination. For all analyses the wide confidence intervals reflect uncertainty in the magnitude of these effects. To adequately address the question of whether the immune system is affected by low-level exposures to hazardous substances, we recommend that more functional immunotoxicity tests be conducted in human populations where individual exposure information is available or when it can be reasonably estimated from environmental exposure measurements.

  9. Cross-Cultural Psychiatric Residency Training: The Oregon Experience

    ERIC Educational Resources Information Center

    Boehnlein, James K.; Leung, Paul K.; Kinzie, John David

    2008-01-01

    Objective: The purpose of this article is to describe the goals and structure of cross-cultural psychiatric training at Oregon Health and Science University (OHSU). This training in core knowledge, skills, and attitudes of cultural psychiatry over the past three decades has included medical students, residents, and fellows, along with allied…

  10. 8 CFR 216.1 - Definition of conditional permanent resident.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ..., whichever is applicable, and part 216 of this chapter. Unless otherwise specified, the rights, privileges... permanent residents, including but not limited to the right to apply for naturalization (if otherwise eligible), the right to file petitions on behalf of qualifying relatives, the privilege of...

  11. 8 CFR 216.1 - Definition of conditional permanent resident.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ..., whichever is applicable, and part 216 of this chapter. Unless otherwise specified, the rights, privileges... permanent residents, including but not limited to the right to apply for naturalization (if otherwise eligible), the right to file petitions on behalf of qualifying relatives, the privilege of...

  12. 8 CFR 216.1 - Definition of conditional permanent resident.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ..., whichever is applicable, and part 216 of this chapter. Unless otherwise specified, the rights, privileges... permanent residents, including but not limited to the right to apply for naturalization (if otherwise eligible), the right to file petitions on behalf of qualifying relatives, the privilege of...

  13. 8 CFR 216.1 - Definition of conditional permanent resident.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ..., whichever is applicable, and part 216 of this chapter. Unless otherwise specified, the rights, privileges... permanent residents, including but not limited to the right to apply for naturalization (if otherwise eligible), the right to file petitions on behalf of qualifying relatives, the privilege of...

  14. 8 CFR 216.1 - Definition of conditional permanent resident.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ..., whichever is applicable, and part 216 of this chapter. Unless otherwise specified, the rights, privileges... permanent residents, including but not limited to the right to apply for naturalization (if otherwise eligible), the right to file petitions on behalf of qualifying relatives, the privilege of...

  15. Indiana Residents' Perceptions of Driving and Lower Blood Alcohol Concentration

    ERIC Educational Resources Information Center

    Seo, Dong-Chul; Torabi, Mohammed R.

    2005-01-01

    Since Congress passed .08 blood alcohol concentration (BAC) as the national standard for impaired driving in October 2000, 28 U.S. States including Indiana have enacted .08 BAC law. This study investigated perceived impact of the .08 law among Indiana residents and their attitudinal and perceptional changes since the enforcement of the law. The…

  16. 42 CFR 483.356 - Protection of residents.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 42 Public Health 5 2013-10-01 2013-10-01 false Protection of residents. 483.356 Section 483.356 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES... psychiatric condition; and personal history (including any history of physical or sexual abuse)....

  17. 42 CFR 483.356 - Protection of residents.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 42 Public Health 5 2014-10-01 2014-10-01 false Protection of residents. 483.356 Section 483.356 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES... psychiatric condition; and personal history (including any history of physical or sexual abuse)....

  18. Pottery as Art Therapy with Elderly Nursing Home Residents.

    ERIC Educational Resources Information Center

    Doric-Henry, Lee

    1997-01-01

    Reports on an art therapy intervention which was implemented with 20 elderly nursing home residents so as to improve their psychological well-being. Program evaluation included self-evaluations, case progress notes, journal notes, and photography. Results indicate that participants showed significantly improved measures of self-esteem, and reduced…

  19. The new residency curriculum: professionalism, patient safety, and more.

    PubMed

    Deitte, Lori

    2013-08-01

    Graduate medical education programs are facing unprecedented challenges. Public expectations for professionalism and patient safety are at an all-time high. A new graduate medical education accreditation system is under way. The author discusses ways to modify the current residency curriculum and assessment tools to include greater emphasis on professionalism and patient safety in the learning environment.

  20. Hands-On Sports Medicine Training for Residents.

    ERIC Educational Resources Information Center

    Tanji, Jeffrey L.

    1989-01-01

    Describes the development of a hands-on sports medicine training program for residents at the University of California, Davis, Medical Center. Education strategies include clinical teaching, on-the-field education, experiential learning, and didactic instruction. Programs focusing exclusively on sports medicine are needed because the number of…

  1. Training Resident Assistants to Make Effective Referrals to Counseling

    ERIC Educational Resources Information Center

    Taub, Deborah J.; Servaty-Seib, Heather L.

    2011-01-01

    Increasing numbers of college and university students are experiencing psychological distress, including depression, anxiety, and suicide ideation. Yet students in distress are unlikely to seek counseling services. Resident assistants (RAs) can serve an important function in identifying and referring students in distress. However, adequate…

  2. Residency and Fellowship Programs for RNs and Advanced Practice RNs.

    PubMed

    Cosme, Sheryl

    2015-09-01

    In this month's column, the Senior Accreditation Operations Manager of the American Nurses Credentialing Center (ANCC) discusses the value of nursing residency programs and current discussion in the profession, along with criteria offered by the ANCC to support this imperative for both RNs and advanced practice RNs including new graduates and those transitioning between clinical settings.

  3. 42 CFR 483.356 - Protection of residents.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 42 Public Health 5 2011-10-01 2011-10-01 false Protection of residents. 483.356 Section 483.356 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES... psychiatric condition; and personal history (including any history of physical or sexual abuse)....

  4. 42 CFR 483.356 - Protection of residents.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 42 Public Health 5 2012-10-01 2012-10-01 false Protection of residents. 483.356 Section 483.356 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES... psychiatric condition; and personal history (including any history of physical or sexual abuse)....

  5. Circulating and tissue resident endothelial progenitor cells.

    PubMed

    Basile, David P; Yoder, Mervin C

    2014-01-01

    Progenitor cells for the endothelial lineage have been widely investigated for more than a decade, but continue to be controversial since no unique identifying marker has yet been identified. This review will begin with a discussion of the basic tenets originally proposed for proof that a cell displays properties of an endothelial progenitor cell. We then provide an overview of the methods for putative endothelial progenitor cell derivation, expansion, and enumeration. This discussion includes consideration of cells that are present in the circulation as well as cells resident in the vascular endothelial intima. Finally, we provide some suggested changes in nomenclature that would greatly clarify and demystify the cellular elements involved in vascular repair.

  6. SU-E-E-03: Shared Space Fosters Didactic and Professional Learning Across Professions for Medical and Physics Residents

    SciTech Connect

    Dieterich, S; Perks, J; Fragoso, R

    2015-06-15

    Purpose: Medical Physicists and Radiation Oncologists are two professions who should be working as a team for optimal patient care, yet lack of mutual understanding about each others respective role and work environment creates barriers To improve collaboration and learning, we designed a shared didactic and work space for physics and radiation oncology residents to maximize interaction throughout their professional training. Methods: Physician and Physics residents are required to take the same didactic classes, including journal clubs and respective seminars. The residents also share an office environment among the seven physician and two physic residents. Results: By maximizing didactic overlap and sharing office space, the two resident groups have developed a close professional relationship and supportive work environment. Several joint research projects have been initiated by the residents. Awareness of physics tasks in the clinic has led to a request by the physician residents to change physics didactics, converting the physics short course into a lab-oriented course for the medical residents which is in part taught by the physics residents. The physics seminar is given by both residency groups; increased motivation and interest in learning about physics has led to several medical resident-initiated topic selections which generated lively discussion. The physics long course has changed toward including more discussion among residents to delve deeper into topics and study beyond what passing the boards would require. A supportive work environment has developed, embedding the two physics residents into a larger residents group, allowing them to find mentor and peers more easily. Conclusion: By creating a shared work and didactic environment, physician and physics residents have improved their understanding of respective professional practice. Resident-initiated changes in didactic practice have led to improved learning and joint research. A strong social

  7. Living in institutional care: residents' experiences and coping strategies.

    PubMed

    Timonen, Virpi; O'Dwyer, Ciara

    2009-01-01

    Insights into daily living in residential care settings are rare. This article draws on a qualitative dataset (semi-structured interviews and recordings of residents' council meetings) that gives a glimpse of the experiences and coping strategies of (older) people living in residential care. The data highlight the range of unmet needs of the residents, similar to the categories of physiological, safety, love, esteem, and self-actualization needs in Maslow's hierarchy of needs theory. Our analysis indicates that "higher" and "lower" needs are closely intertwined and mutually reinforcing and should therefore be accorded equal emphasis by professionals (including social workers) employed within residential care settings.

  8. Satisfiers and Hygiene Factors: Residents' Perceptions of Strengths and Limitations of Their Learning Environment

    PubMed Central

    Philibert, Ingrid

    2012-01-01

    Background Efforts are underway to enhance learner input into the accreditation of educational programs, including residencies and fellowships. Objectives To aggregate the perspectives of residents and fellows from a cross-section of specialties to highlight common dimensions in learners' perceptions of strengths and opportunities for improvement (OFIs) in their program and to assess whether the ACGME Resident Survey captures areas important to residents' perceptions of their learning environment. Results The data set included 206 core and 193 subspecialty programs representing a wide range of specialties and subspecialties. Comments on strengths and OFIs addressed most of the items in the Resident Survey, with items not addressed in the survey also not represented in the ACGME requirements. The findings suggest that some program attributes are mentioned only in their absence (hygiene factors), whereas other dimensions (satisfiers), particularly quality and quantity of residents' interactions with faculty, procedural volume, and variety and didactic offerings, are critical to learners' perceptions of the quality of their learning environment. For some strengths, residents indicated their programs exceeded the ACGME standards, and for areas identified as OFIs, comments suggested programs were in compliance, but the residents desired more. Mentioned in this context were opportunities to perform research, access to board preparation courses and career counseling, and availability of new technology, including new patient care modalities. Conclusions The findings allow insight into program attributes important to residents' perceptions of their learning environment. Programs may find the results helpful in suggesting areas for improvement in their learning environment. PMID:23451325

  9. Does the Neighborhood Area of Residence Influence Non-Attendance in an Urban Mammography Screening Program? A Multilevel Study in a Swedish City

    PubMed Central

    Lagerlund, Magdalena; Merlo, Juan; Vicente, Raquel Pérez; Zackrisson, Sophia

    2015-01-01

    Background and aim The public health impact of population-based mammography screening programs depends on high participation rates. Thus, monitoring participation rates, as well as understanding and considering the factors influencing attendance, is important. With the goal to acquire information on the appropriate level of intervention for increasing screening participation our study aimed to (1) examine whether, over and above individual factors, the neighborhood of residence influences a woman’s mammography non-attendance, and (2) evaluate, whether knowing a woman’s neighborhood of residence would be sufficient to predict non-attendance. Methods We analyze all women invited to mammography screening in 2005–09, residing in the city of Malmö, Sweden. Information regarding mammography screening attendance was linked to data on area of residence, demographic and socioeconomic characteristics available from Statistics Sweden. The influence of individual and neighborhood factors was assessed by multilevel logistic regression analysis with 29,901 women nested within 212 neighborhoods. Results The prevalence of non-attendance among women was 18.3%. After adjusting for individual characteristics, the prevalence in the 212 neighborhoods was 3.6%. Neighborhood of residence had little influence on non-attendance. The multilevel analysis indicates that 8.4% of the total individual differences in the propensity of non-attendance were at the neighborhood level. However, when adjusting for specific individual characteristics this general contextual effect decreased to 1.8%. This minor effect was explained by the sociodemographic characteristic of the neighborhoods. The discriminatory accuracy of classifying women according to their non-attendance was 0.747 when considering only individual level variables, and 0.760 after including neighborhood level as a random effect. Conclusion Our results suggest that neighborhoods of residence in Malmö, Sweden (as defined by small

  10. The validity and reliability of attending evaluations of medicine residents

    PubMed Central

    Kay, Cynthia; Frank, Michael

    2015-01-01

    Objectives: To assess the reliability and validity of faculty evaluations of medicine residents. Methods: We conducted a retrospective study (2004–2012) involving 228 internal medicine residency graduates at the Medical College of Wisconsin who were evaluated by 334 attendings. Measures included evaluations of residents by attendings, based on six competencies and interns and residents’ performance on the American Board of Internal Medicine certification exam and annual in-service training examination. All residents had at least one in-service training examination result and 80% allowed the American Board of Internal Medicine to release their scores. Results: Attending evaluations had good consistency (Cronbach’s α = 0.96). There was poor construct validity with modest inter-rater reliability and evidence that attendings were rating residents on a single factor rather than the six competencies intended to be measured. There was poor predictive validity as attending ratings correlated weakly with performance on the in-service training examination or American Board of Internal Medicine certification exam. Conclusion: We conclude that attending evaluations are poor measures for assessing progress toward competency. It may be time to move beyond evaluations that rely on global, end-of-rotation appraisals. PMID:26770788

  11. [The new residency program in neurological surgery in Spain].

    PubMed

    Lobato, R D; Fernandez Alen, J; Alday, R; Gómez, P A; Lagares, A

    2003-09-01

    A new Residency Program in Neurological Surgery has been recently elaborated by the "Comisión Nacional de Neurocirugía" following the requirement of the National Council of Specialities. This new Program, which will replace the one proposed in 1992, has been designed in a similar way as those applied in countries providing the best neurosurgical training. Changes included deal with the definition of the speciality, and the introduction of new rotations,a resident Log Book, a Tutor with a well defined profil and commitments, a structured planning of academic and clinical objectives, a rotation or training in research, and a planning for continuous evaluation of the progress of the resident. It is likely that an appropriate application of the new Program in Spanish neurosurgical units with accreditation for training will result in formation of highly competent neurosurgeons. However, there are new challenges for improving neurosurgical training and the development of our speciality in Spain, as those related with new legislation regulating resident working hours, or some political decisions changing the mechanisms for controlling the number of resident positions per year. PMID:14506551

  12. Community partners as co-teachers in resident continuity clinics.

    PubMed

    Sturm, Lynne A; Shultz, Janet; Kirby, Rebecca; Stelzner, Sarah M

    2011-12-01

    Standard approaches to teaching the management of psychosocial issues in pediatrics--visits to community-based organizations and stand-alone block rotations in developmental-behavioral pediatrics and community pediatrics--neither expose residents to models of interdisciplinary collaboration between faculty preceptors and community providers nor take advantage of the efficacy of learning in continuity clinics. The authors describe their project, developed from an existing Community Pediatrics Training Initiative with long-standing relationships with a domestic violence shelter, a community center for Latino families, and a special needs resource organization for parents. They lay out in detail the project's innovative use of partners from community-based organizations, colocated within pediatric continuity clinics, who teach both residents and faculty about community resources and linkages with multidisciplinary providers. The authors present lessons learned by faculty preceptors, residents, the community partners, and project staff that can guide future applications of this model in other residency training programs. Faculty and residents indicated an increased awareness of available community resources and how linkages can be incorporated into pediatric outpatient visits. Community partners identified keys to successful co-teaching, including readiness to adopt an assertive communication style and frequent presence in the clinics. Project staff recognized the challenges of staff turnover at community-based organizations and the need to choose community partners with expertise that fits the sociodemographic issues of the clinic's patients. PMID:22030765

  13. The teaching of liberal arts in internal medicine residency training.

    PubMed

    Povar, G J; Keith, K J

    1984-09-01

    Forty-four members of the Association of Program Directors in Internal Medicine and 58 members of the Society for Research and Education in Primary Care Internal Medicine completed questionnaires on the teaching of liberal arts in internal medicine residency programs and the importance of liberal arts to the practice of medicine. They rated economics of medical care and bioethics as essential to residency training. Law and organization of the health care system as well as economics and bioethics were rated as essential to medical practice. Although there was great variability in the curricula represented, over 40 percent of the respondents reported having formal lecture and/or seminar exposure to these topics in their programs. Problems encountered in implementing liberal arts programs included lack of curriculum time, limited-faculty members, and a lack of interest on the part of residents. There is a need both to arrive at a consensus among residency directors and to explore means of developing interdisciplinary faculties if the liberal arts are to form an established part of internal medicine residency training.

  14. Regulation and mindful resident care in nursing homes.

    PubMed

    Colón-Emeric, Cathleen S; Plowman, Donde; Bailey, Donald; Corazzini, Kirsten; Utley-Smith, Queen; Ammarell, Natalie; Toles, Mark; Anderson, Ruth

    2010-09-01

    Regulatory oversight is intended to improve the health outcomes of nursing home residents, yet evidence suggests that regulations can inhibit mindful staff behaviors that are associated with effective care. We explored the influence of regulations on mindful staff behavior as it relates to resident health outcomes, and offer a theoretical explanation of why regulations sometimes enhance mindfulness and other times inhibit it. We analyzed data from an in-depth, multiple-case study including field notes, interviews, and documents collected in eight nursing homes. We completed a conceptual/thematic description using the concept of mindfulness to reframe the observations. Shared facility mission strongly impacted staff perceptions of the purpose and utility of regulations. In facilities with a resident-centered culture, regulations increased mindful behavior, whereas in facilities with a cost-focused culture, regulations reduced mindful care practices. When managers emphasized the punitive aspects of regulation we observed a decrease in mindful practices in all facilities. PMID:20479137

  15. Learning objectives in resident training. Objectives in clinical chemistry.

    PubMed

    Barrett, D A

    1976-06-01

    The use of learning objectives has recently found extensive application in the evolution of medical school curricula; however, they have not been utilized systematically in the education of pathology residents. In attempting to define the end-point behavior or objectives of a resident during a rotation in clinical biochemistry, 567 midwestern pathologists, clinical chemists and medical technologists working in chemistry sections rated proposed objectives as essentail, desirable but not essential, or not needed. Twenty-four of 52 objectives were considered essential for the resident to achieve by 75% or more of the respondents. These included 10 of 33 related to technical knowledge, 5 to 10 related to business and supervisory skills, 5 of 5 related to investigative problem solving, and 4 of 4 related to communicating with persons outside of the laboratory. In general, respondents considered knowledge of principles more important than technical skills. Management, business and communicative skills were highly rated.

  16. Infectious diseases and death among nursing home residents: results of surveillance in 13 nursing homes.

    PubMed

    Beck-Sague, C; Villarino, E; Giuliano, D; Welbel, S; Latts, L; Manangan, L M; Sinkowitz, R L; Jarvis, W R

    1994-07-01

    An increasing proportion of the U.S. population resides in nursing homes (NHs). No surveillance system exists for infections in these facilities. To determine the incidence and types of infections in NH residents, and to identify predictors of death among residents with infections, we initiated a surveillance system at 13 NHs in California during a 6-month period from October 1989 through March 1990. The study included 1754 residents, among whom 835 infections were identified during the study period. The most common infections were urinary tract infections (UTIs; 286, 34.2%), respiratory tract infections (RTIs; 259, 31%), and skin infections (150, 17.9%). Of the 259 residents with respiratory tract infections, 69 (27%) had pneumonia. Antimicrobials were prescribed for 646 (77%) of the infectious episodes. Residents with pneumonia were more likely to die than residents with other infections (4 of 69 versus 12 of 766; P = 0.04). Symptoms of altered body temperature (fever, hypothermia, chills) and change in mental status also were associated with an increased risk of a fatal outcome (10 of 260 versus 6 of 575; P = 0.01) and (7 of 127 versus 9 of 708; P = 0.004). This study suggests that the most common infections among NH residents are UTIs, RTIs, and skin infections. Pneumonia, symptoms of fever, and mental status changes all were associated with increased mortality. The frequency of infections among NH residents and their impact on resident outcome highlights the need for infectious disease surveillance in this population. PMID:7963443

  17. Maintaining a Twitter Feed to Advance an Internal Medicine Residency Program’s Educational Mission

    PubMed Central

    Narang, Akhil; Arora, Vineet M

    2015-01-01

    Background Residency programs face many challenges in educating learners. The millennial generation’s learning preferences also force us to reconsider how to reach physicians in training. Social media is emerging as a viable tool for advancing curricula in graduate medical education. Objective The authors sought to understand how social media enhances a residency program’s educational mission. Methods While chief residents in the 2013-2014 academic year, two of the authors (PB, AN) maintained a Twitter feed for their academic internal medicine residency program. Participants included the chief residents and categorical internal medicine house staff. Results At the year’s end, the authors surveyed residents about uses and attitudes toward this initiative. Residents generally found the chief residents’ tweets informative, and most residents (42/61, 69%) agreed that Twitter enhanced their overall education in residency. Conclusions Data from this single-site intervention corroborate that Twitter can strengthen a residency program’s educational mission. The program’s robust following on Twitter outside of the home program also suggests a need for wider adoption of social media in graduate medical education. Improved use of data analytics and dissemination of these practices to other programs would lend additional insight into social media’s role in improving residents’ educational experiences.

  18. Family Medicine Residency Program Directors Attitudes and Knowledge of Family Medicine CAM Competencies

    PubMed Central

    Gardiner, Paula; Filippelli, Amanda C.; Lebensohn, Patricia; Bonakdar, Robert

    2013-01-01

    Context Little is known about the incorporation of integrative medicine (IM) and complementary and alternative medicine (CAM) into family medicine residency programs. Objective The Society for Teachers of Family Medicine (STFM) approved a set of CAM/IM competencies for family medicine residencies. We hope to evaluate with an online survey tool, whether residency programs are implementing such competencies into their curriculum. We also hope to assess the knowledge and attitudes of Residency Directors (RDs) on the CAM/IM competencies. Design A survey was distributed by the CAFM (Council of Academic Family Medicine) Educational Research Alliance to RDs via email. The survey was distributed to 431 RDs. Of those who received it, 212 responded for a response rate of 49.1%. Questions assessed the knowledge and attitudes of CAM/IM competencies and incorporation of CAM/IM into residency curriculum. Results Forty-five percent of RDs were aware of the competencies. In term of RD attitudes, 58% reported that CAM/IM is an important component of residents' curriculum yet, 60% report not having specific learning objectives for CAM/IM in their residency curriculum. Among all programs, barriers to CAM/IM implementation included: time in residents' schedules (77%); faculty training (75%); access to CAM experts (43%); lack of reimbursement (43%), and financial resources (29%). Conclusions While many RDs are aware of the STFM CAM/IM competencies and acknowledge their role in residence education, there are many barriers preventing residencies to implementing the STFM CAM/IM competencies. PMID:24021471

  19. 20 CFR 628.320 - Services for older individuals.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ..., taking into account the relative share of the population of eligible older individuals residing in each... to assisting programs involving training for jobs in growth industries and jobs reflecting the use...

  20. 20 CFR 628.320 - Services for older individuals.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ..., taking into account the relative share of the population of eligible older individuals residing in each... to assisting programs involving training for jobs in growth industries and jobs reflecting the use...

  1. 20 CFR 628.320 - Services for older individuals.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ..., taking into account the relative share of the population of eligible older individuals residing in each... to assisting programs involving training for jobs in growth industries and jobs reflecting the use...

  2. Influence of Anesthesiology Residents' Noncognitive Skills on the Occurrence of Critical Incidents and the Residents' Overall Clinical Performances.

    ERIC Educational Resources Information Center

    Rhoton, M. Frances; And Others

    1991-01-01

    Analysis of medical residents' clinical performances in five teaching hospital anesthesiology departments revealed that noncognitive performance in some areas was a powerful predictor of overall clinical performance and was related to the occurrence of critical incidents. Noncognitive predictors included conscientiousness, management, confidence,…

  3. 17 Y-STR haplotype data for a population sample of Residents in the Basque Country.

    PubMed

    Valverde, Laura; Köhnemann, Stephan; Rosique, Melania; Cardoso, Sergio; Zarrabeitia, Maite; Pfeiffer, Heidi; de Pancorbo, Marian M

    2012-07-01

    Non autochthonous population is the most numerous group in the Basque Country. This group is named "Residents" to distinguish them from the "Autochthonous Basque" population. In this work, the 17 Y-STR loci distribution of Resident population was studied in a sample of 197 individuals, who were concretely genotyped for DYS19, DYS389I, DYS389II, DYS390, DYS391, DYS392, DYS393, DYS385, DYS439, DYS438, DYS437, DYS448, DYS456, DYS458, DYS635 and Y GATA H4. Resident population showed a high haplotype diversity and discrimination capacity. The distribution of Y-STRs haplotypes of the Resident population was statistically significant different to the one of the Autochthonous Basque population. The genetic substructure found between Resident and Autochthonous Basque 17 Y-STR haplotype distributions advises for the use of two different databases in the Basque Country, to ensure the most trustworthy frequency estimate in casework. PMID:22342392

  4. Resident guide to advocacy in dermatology.

    PubMed

    Park, Kelly K

    2015-12-01

    Many opportunities exist for residents to get involved in advocacy in dermatology, from national to grassroots levels. Residents also should be aware of opportunities to get involved in patient advocacy and become familiar with the myriad of patient advocacy groups that exist. These groups offer support and education for patients and initiate research efforts for specific dermatologic conditions that provide support for patients beyond what can be offered during a standard office visit. The value of resident involvement in advocacy also is discussed.

  5. Sources of indoor air pollution in New York City residences of asthmatic children.

    PubMed

    Habre, Rima; Coull, Brent; Moshier, Erin; Godbold, James; Grunin, Avi; Nath, Amit; Castro, William; Schachter, Neil; Rohr, Annette; Kattan, Meyer; Spengler, John; Koutrakis, Petros

    2014-01-01

    Individuals spend ∼90% of their time indoors in proximity to sources of particulate and gaseous air pollutants. The sulfur tracer method was used to separate indoor concentrations of particulate matter (PM) PM2.5 mass, elements and thermally resolved carbon fractions by origin in New York City residences of asthmatic children. Enrichment factors relative to sulfur concentrations were used to rank species according to the importance of their indoor sources. Mixed effects models were used to identify building characteristics and resident activities that contributed to observed concentrations. Significant indoor sources were detected for OC1, Cl, K and most remaining OC fractions. We attributed 46% of indoor PM2.5 mass to indoor sources related to OC generation indoors. These sources include cooking (NO2, Si, Cl, K, OC4 and OP), cleaning (most OC fractions), candle/incense burning (black carbon, BC) and smoking (K, OC1, OC3 and EC1). Outdoor sources accounted for 28% of indoor PM2.5 mass, mainly photochemical reaction products, metals and combustion products (EC, EC2, Br, Mn, Pb, Ni, Ti, V and S). Other indoor sources accounted for 26% and included re-suspension of crustal elements (Al, Zn, Fe, Si and Ca). Indoor sources accounted for ∼72% of PM2.5 mass and likely contributed to differences in the composition of indoor and outdoor PM2.5 exposures. PMID:24169876

  6. Sources of indoor air pollution in New York City residences of asthmatic children.

    PubMed

    Habre, Rima; Coull, Brent; Moshier, Erin; Godbold, James; Grunin, Avi; Nath, Amit; Castro, William; Schachter, Neil; Rohr, Annette; Kattan, Meyer; Spengler, John; Koutrakis, Petros

    2014-01-01

    Individuals spend ∼90% of their time indoors in proximity to sources of particulate and gaseous air pollutants. The sulfur tracer method was used to separate indoor concentrations of particulate matter (PM) PM2.5 mass, elements and thermally resolved carbon fractions by origin in New York City residences of asthmatic children. Enrichment factors relative to sulfur concentrations were used to rank species according to the importance of their indoor sources. Mixed effects models were used to identify building characteristics and resident activities that contributed to observed concentrations. Significant indoor sources were detected for OC1, Cl, K and most remaining OC fractions. We attributed 46% of indoor PM2.5 mass to indoor sources related to OC generation indoors. These sources include cooking (NO2, Si, Cl, K, OC4 and OP), cleaning (most OC fractions), candle/incense burning (black carbon, BC) and smoking (K, OC1, OC3 and EC1). Outdoor sources accounted for 28% of indoor PM2.5 mass, mainly photochemical reaction products, metals and combustion products (EC, EC2, Br, Mn, Pb, Ni, Ti, V and S). Other indoor sources accounted for 26% and included re-suspension of crustal elements (Al, Zn, Fe, Si and Ca). Indoor sources accounted for ∼72% of PM2.5 mass and likely contributed to differences in the composition of indoor and outdoor PM2.5 exposures.

  7. Developing resident learning profiles: Do scientific evidence epistemology beliefs, EBM self-efficacy beliefs and EBM skills matter?

    NASA Astrophysics Data System (ADS)

    Robert, Nancy J.

    This study investigated resident scientific evidence epistemology beliefs, evidence based medicine (EBM) self-efficacy beliefs, and EBM skills. A convenience sample of fifty-one residents located in six U.S. based residency programs completed an online instrument. Hofer's epistemology survey questionnaire was modified to test responses based on four types of scientific evidence encountered in medical practice (Clinical Trial Phase 1, Clinical Trial Phase 3, Meta-analysis and Qualitative). It was hypothesized that epistemology beliefs would differ based on the type of scientific evidence considered. A principal components analysis produced a two factor solution that was significant across type of scientific evidence suggesting that when evaluating epistemology beliefs context does matter. Factor 1 is related to the certainty of research methods and the certainty of medical conclusions and factor 2 denotes medical justification. For each type of scientific evidence, both factors differed on questions comprising the factor structure with significant differences found for the factor 1 and 2 questions. A justification belief case problem using checklist format was triangulated with the survey results, and as predicted the survey and checklist justification z scores indicated no significant differences, and two new justification themes emerged. Modified versions of Finney and Schraw's statistical self-efficacy and skill instruments produced expected significant EBM score correlations with unexpected results indicating that the number of EBM and statistics courses are not significant for EBM self-efficacy and skill scores. The study results were applied to the construction of a learning profile that provided residents belief and skill feedback specific to individual learning needs. The learning profile design incorporated core values related to 'Believer' populations that focus on art, harmony, tact and diplomacy. Future research recommendations include testing context

  8. The pregnant plastic surgical resident: results of a survey of women plastic surgeons and plastic surgery residency directors.

    PubMed

    Eskenazi, L; Weston, J

    1995-02-01

    Pregnancy during plastic surgery residency poses unique challenges to the resident herself, to her resident colleagues, and to her residency director. Studies of the effects of pregnancy have been conducted that have combined all medical specialties or have included all surgeons as a statistically uniform group. The Women Plastic Surgeons' Caucus Committee of the American Society of Plastic and Reconstructive Surgeons has conducted a survey in order to obtain objective data on maternal fetal complications, time off work, maternal leave policies, call coverage, and other important issues. Response rates were 40 percent for the women residents and 45 percent for the program directors surveyed. The results show a 57 percent overall complication rate (excluding miscarriages), a 26 percent elective abortion rate, and a 33 percent infertility rate in women plastic surgeons, numbers that are higher than those currently in the literature. Data obtained regarding issues such as time off work, planning of pregnancy, call coverage, productivity and income, perceived peer support, program directors' opinions and policies, and possible solutions that might provide a mutually rewarding outcome are presented for discussion.

  9. 43 CFR 3862.2-2 - Citizenship of individuals.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 43 Public Lands: Interior 2 2014-10-01 2014-10-01 false Citizenship of individuals. 3862.2-2... Claim Patent Applications § 3862.2-2 Citizenship of individuals. (a) In case of an individual or an... which his certificate of citizenship issued, and present residence....

  10. 43 CFR 3862.2-2 - Citizenship of individuals.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 43 Public Lands: Interior 2 2011-10-01 2011-10-01 false Citizenship of individuals. 3862.2-2... Claim Patent Applications § 3862.2-2 Citizenship of individuals. (a) In case of an individual or an... which his certificate of citizenship issued, and present residence....

  11. 43 CFR 3862.2-2 - Citizenship of individuals.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 43 Public Lands: Interior 2 2012-10-01 2012-10-01 false Citizenship of individuals. 3862.2-2... Claim Patent Applications § 3862.2-2 Citizenship of individuals. (a) In case of an individual or an... which his certificate of citizenship issued, and present residence....

  12. 43 CFR 3862.2-2 - Citizenship of individuals.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 43 Public Lands: Interior 2 2013-10-01 2013-10-01 false Citizenship of individuals. 3862.2-2... Claim Patent Applications § 3862.2-2 Citizenship of individuals. (a) In case of an individual or an... which his certificate of citizenship issued, and present residence....

  13. Balancing act: approaches to healthy eating and physical activity among Boston public housing residents.

    PubMed

    Scammell, Madeleine Kangsen; Torres, Shioban; Wayman, Julie; Greenwood, Nechama; Thomas, Gerry; Kozlowski, Lauren; Bowen, Deborah

    2015-01-01

    Boston public housing residents are more likely to report fair or poor health status, been diagnosed with obesity, and to be physically inactive compared with other Boston residents (Digenis-Bury, Brooks, Chen, Ostrem, & Horsburgh, 2008 ). Little is known about perceptions of and opportunities for healthy eating and physical activity in this population. We conducted eight focus groups at public housing developments to explore residents' views regarding opportunities and barriers to healthy eating and physical activity. Sixty-seven English- and Spanish-speaking residents participated. Transcripts were analyzed using qualitative content analysis. All residents described the challenge of balancing considerations of food quality, access, and affordability. Other findings included underutilized nutritional resources; abundant availability of unhealthy food; and economic and structural barriers to exercise. Transportation-related challenges were a dominant theme. Building opportunities for physical activity and providing access to affordable and quality food choices may be important interventions for promoting health among public housing residents.

  14. Littering dynamics in a coastal industrial setting: the influence of non-resident populations.

    PubMed

    Campbell, Marnie L; Paterson de Heer, Chloe; Kinslow, Amber

    2014-03-15

    We examined if there is truth to the preconceptions that non-resident workers (including FIFO/DIDO's) detract from communities. We used marine debris to test this, specifically focussing on littering behaviour and evidence of awareness of local environmental programs that focus on marine debris. Littering was most common at recreational areas, then beaches and whilst boating. Twenty-five percent of respondents that admit to littering, reported no associated guilt with their actions. Younger respondents litter more frequently. Thus, non-resident workers litter at the same rate as permanent residents, visitors and tourists in this region, within this study. Few respondents are aware of the environmental programs that operate in their local region. Awareness was influenced by a respondent's residency (non-residents are less aware), age, and level of education. To address this failure we recommend that industries, that use non-resident workers, should develop inductions that expose new workers to the environmental programs in their region.

  15. Developing and successfully implementing a competency-based portfolio assessment system in a postgraduate family medicine residency program.

    PubMed

    McEwen, Laura A; Griffiths, Jane; Schultz, Karen

    2015-11-01

    The use of portfolios in postgraduate medical residency education to support competency development is increasing; however, the processes by which these assessment systems are designed, implemented, and maintained are emergent. The authors describe the needs assessment, development, implementation, and continuing quality improvement processes that have shaped the Portfolio Assessment Support System (PASS) used by the postgraduate family medicine program at Queen's University since 2009. Their description includes the impetus for change and contextual realities that guided the effort, plus the processes used for selecting assessment components and developing strategic supports. The authors discuss the identification of impact measures at the individual, programmatic, and institutional levels and the ways the department uses these to monitor how PASS supports competency development, scaffolds residents' self-regulated learning skills, and promotes professional identity formation. They describe the "academic advisor" role and provide an appendix covering the portfolio elements. Reflection elements include learning plans, clinical question logs, confidence surveys, and reflections about continuity of care and significant incidents. Learning module elements cover the required, online bioethics, global health, and consult-request modules. Assessment elements cover each resident's research project, clinical audits, presentations, objective structured clinical exam and simulated office oral exam results, field notes, entrustable professional activities, multisource feedback, and in-training evaluation reports. Document elements are the resident's continuing medical education activities including procedures log, attendance log, and patient demographic summaries.The authors wish to support others who are engaged in the systematic portfolio-design process or who may adapt aspects of PASS for their local programs.

  16. 26 CFR 1.6049-8 - Interest and original issue discount paid to residents of Canada.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ..., the term interest means interest paid to a Canadian nonresident alien individual after December 31... the certificate is in Canada, or if the payor has actual knowledge of the individual's residence... (within the meaning of section 163(f) and the regulations thereunder); is part of a larger single...

  17. Differences between Newly Admitted Nursing Home Residents in Rural and Nonrural Areas in a National Sample

    ERIC Educational Resources Information Center

    Bolin, Jane Nelson; Phillips, Charles D.; Hawes, Catherine

    2006-01-01

    Purpose: Previous research in specific locales indicates that individuals admitted to rural nursing homes have lower care needs than individuals admitted to nursing homes in urban areas, and that rural nursing homes differ in their mix of short-stay and chronic-care residents. This research investigates whether differences in acuity are a function…

  18. Child Rearing and Individuality Among Suburban Malays.

    ERIC Educational Resources Information Center

    Banks, David J.; Banks, Ellen

    This study focuses on Malaysians' perceptions of individuality in their children and on general characteristics of Malaysian child training practices. Research was carried out in three adjoining villages where well over half of the income of residents is derived from wage and salaried employment in industrial towns. The study consisted of…

  19. 24 CFR 965.508 - Individual relief.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 24 Housing and Urban Development 4 2010-04-01 2010-04-01 false Individual relief. 965.508 Section 965.508 Housing and Urban Development Regulations Relating to Housing and Urban Development (Continued... PHA-OWNED OR LEASED PROJECTS-GENERAL PROVISIONS Resident Allowances for Utilities § 965.508...

  20. Residents' annoyance responses to aircraft noise events

    NASA Technical Reports Server (NTRS)

    Dempsey, T. K.; Stephens, D. G.; Fields, J. M.; Shepherd, K. P.

    1983-01-01

    In a study conducted in the vicinity of Salt Lake City International Airport, community residents reported their annoyance with individual aircraft flyovers during rating sessions conducted in their homes. Annoyance ratings were obtained at different times of the day. Aircraft noise levels were measured, and other characteristics of the aircraft were noted by trained observers. Metrics commonly used for assessing aircraft noise were compared, but none performed significantly better than A-weighted sound pressure level. A significant difference was found between the ratings of commercial jet aircraft and general aviation propeller aircraft, with the latter being judged less annoying. After the effects of noise level were accounted for, no significant differences were found between the ratings of landings and takeoffs. Aircraft noise annoyance reactions are stronger in lowered ambient noise conditions. This is consistent with the theory that reduced nighttime and evening ambient levels could create different reactions at different times of day. After controlling for ambient noise in a multiple regression analysis, no significant differences were found between the ratings of single events obtained during the three time periods: morning, afternoon, and evenings.