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Sample records for non-occupationally exposed residents

  1. A trace metal survey of non-occupationally exposed Gauteng residents.

    PubMed

    Wilson, Kerry; Kielkowski, Danuta; Theodoru, Penny; Naik, Ina

    2011-10-01

    Specific reference values for background levels of body burden of trace metals are not available for South Africa. Currently, laboratories measuring trace metal levels in workers use internationaly established values for comparison. A preliminary cross-sectional survey of 107 non-occupationally exposed volunteers of both genders and all races provided blood and urine samples. The samples were collected with consideration for possible routes of contamination. Seven metals were measured in blood and ten in urine. Reference ranges for a Gauteng population were then calculated using the central 95% of data to provide lower and upper limits, which were then compared to international limits. The trace metal levels described had both lower and higher reference ranges in blood and urine compared to international studies. This reflects the differences in the environments. Statistically significant differences in metal levels were observed by gender. The differences in detected trace metal levels in our sample as compared to other published data demonstrate the need for the establishment of local reference values for laboratories. The establishment of local 95% reference ranges would also allow South Africa to determine its exposure levels compared to those internationally. This would assist with establishing pollution control priorities.

  2. [Comparison on urinary 1-hydroxypyrene concentrations between coke oven workers and non-occupational exposed individuals].

    PubMed

    Chen, Bo; Hu, Yun-ping; Zheng, Li-xing; Wang, Qiang-yi; Zhou, Yuan-fen; Jin, Tai-yi

    2005-11-01

    To compare the urinary 1-hydroxypyrene (1-OHP) concentrations between coke oven workers and non-occupational exposed individuals and to investigate the possible impact factors. Spot end-of-shift urine samples were collected in 265 coke oven workers and spot morning urine samples in 226 non-occupational exposed individuals. External exposure levels and possible confounding factors were assessed by environmental polycyclic aromatic hydrocarbons (PAH) monitoring and uniform questionnaire, and the urinary 1-OHP concentrations determined by high performance liquid chromatography (HPLC), were used to compare the different urinary 1-OHP levels between different research populations and to explore the effects of several factors such as external exposure levels, smoking habits, alcohol consumptions, age and body mass index (BMI). The urinary 1-OHP concentrations in coke oven workers were significantly higher than those in non-occupational exposed individuals (13.49, 6.56, 1.38 and 0.35 micromol/mol creatinine for topside workers, side-oven workers, bottom side workers and references, respectively, P < 0.001; the same trends for the percentage of the level over 2.3 micromol/mol creatinine: 94.81%, 84.73%, 35.09% and 0.88%, P < 0.001). The control individuals who smoked over 20 cigarettes per day possessed higher urinary 1-OHP concentrations than the non-smokers (adjusted geometric mean: 0.47 and 0.31 micromol/mol creatinine, respectively, P < 0.05). Alcohol drinking references possessed lower urinary 1-OHP levels than the non-drinkers (adjusted geometric mean: 0.33 and 0.47 micromol/mol creatinine, respectively, P < 0.05). Coke oven workers should be exposed to a high level of urinary 1-OHP, especially for topside workers and side-oven workers. Background urinary 1-OHP levels in non-occupational exposed individuals should be related to smoking habits and alcohol consumptions.

  3. Interpretation of Urinary and Blood Benzene biomarkers of Exposure for Non-Occupationally Exposed Individuals

    EPA Science Inventory

    Non-occupational exposure to benzene occurs primarily through inhalation ofair impacted by motor vehicle exhaust, fuel sources, and cigarette smoke. This study relates published measurements ofbenzene biomarkers to air exposure concentrations. Benzene has three reliable biomar...

  4. Interpretation of Urinary and Blood Benzene biomarkers of Exposure for Non-Occupationally Exposed Individuals

    EPA Science Inventory

    Non-occupational exposure to benzene occurs primarily through inhalation ofair impacted by motor vehicle exhaust, fuel sources, and cigarette smoke. This study relates published measurements ofbenzene biomarkers to air exposure concentrations. Benzene has three reliable biomar...

  5. Non-occupational exposure to heavy metals of the residents of an industrial area and biomonitoring.

    PubMed

    Vimercati, Luigi; Baldassarre, Antonio; Gatti, Maria F; Gagliardi, Tommaso; Serinelli, Maria; De Maria, Luigi; Caputi, Antonio; Dirodi, Angelica A; Galise, Ida; Cuccaro, Francesco; Assennato, Giorgio

    2016-12-01

    In areas at high environmental risk, a major issue is the assessment of the exposure of the general population to industrial pollutants. To date, few studies have investigated exposure to heavy metals in a population residing in a high risk environmental area. The aim of this study is to evaluate the exposure to heavy metals in the industrial area of Taranto, Southern Italy, through biological monitoring techniques. We measured the levels of inorganic arsenic and methylated metabolites, lead, cadmium, chromium, and manganese in the urine samples of 279 subjects residing in Taranto and neighboring areas. After obtaining informed consent from each participant, qualified health staff administered a standardized structured questionnaire investigating lifestyle habits and assessing any confounding factors. The biological monitoring data showed high urinary concentrations of nearly all of the heavy metals investigated. These findings could be related to the presence of industrial plants and is sufficient to warrant the expectation that local and national institutions should be required to adopt preventive measures to reduce the environmental exposure of the general population to heavy metals.

  6. Particle-Associated Ambient Benzo[a]pyrene and Levels of Urinary 1-Hydroxypyrene in a Non-occupationally Exposed Population of Adults and Children in Lanzhou, China.

    PubMed

    Yu, Yunjiang; Wang, Qiong; Li, Liangzhong; Liu, Zien; Sun, Peng; Zhang, Yanping; Lin, Haipeng; Xiang, Mingdeng; Li, Hui; Lin, Bigui

    2016-03-01

    Concentrations of benzo[a]pyrene (B[a]P) in ambient air from different areas in Lanzhou city in northwest of China, and its metabolite 1-hydroxypyrene (1-OHP) in the urine of resident children and adults were determined by using gas chromatography/mass spectrometry and high performance liquid chromatography. Results showed that the atmospheric environmental concentration of B[a]P varied significantly from one part of the city to another with levels of 150 ng/m(3) in the industrial area of Xigu and 73.8 ng/m(3) in the agricultural area of Yuzhong. The geometric mean urinary 1-OHP concentration was 0.42 µmol/mol-creatinine, with a range of means between 0.067 and 2.05 for the various population sub-groups. The non-occupationally exposed populations' age, gender and area of residence were the major factors that influenced urinary 1-OHP levels. The health risks of B[a]P for adults and children in Xigu and for children in Yuzhong exceeded the acceptable level (1 × 10(-4)) of the US Environmental Protection Agency.

  7. [Exposure to persistent and non-persistent pesticides in a non-occupationally exposed population in Tenerife Island (Spain)].

    PubMed

    Burillo-Putze, Guillermo; Luzardo, Octavio P; García, Carlos Pérez; Zumbado, Manuel; Yanes, Carmen; Trujillo-Martín, María del Mar; Boada Fernández del Campo, Carlos; Boada, Luis D

    2014-01-01

    Chronic exposure to non-persistent pesticides (NPPs) is of concern because these substances have been associated with chronic diseases. However, few studies have addressed chronic exposure to NPPs in Spanish populations. We determined the presence of 24 pesticide residues by gas chromatography/mass spectrometry in 363 serum samples obtained from non-occupationally exposed adults from Tenerife island in 2007. Most of the samples (99.45%) showed detectable residues (6 ± 2 pesticides per sample). The most frequently detected pesticides were pyrethrins (96.1%), organophosphates (93.9%) and organochlorines (92.3%). The neurotoxicants bifenthrin and malathion were detected in 81% of the samples and hexachlorobenzene DDT and buprofezin in more than 50%. Malation, an "environmental obesogen", was detected in 82%, and "endocrine disrupter" pesticides were present in 97.2% of the samples. Because there is clear, continuous and inadvertent exposure to NPPs that may be inducing adverse effects on human health, NPPs should be included in biomonitoring studies. Copyright © 2013 SESPAS. Published by Elsevier Espana. All rights reserved.

  8. Chlorinated dibenzodioxins and dibenzofurans (PCDD/F) in blood and human milk of non occupationally exposed persons living in the vicinity of a municipal waste incinerator.

    PubMed

    Deml, E; Mangelsdorf, I; Greim, H

    1996-11-01

    The concentrations of chlorinated dibenzodioxins and dibenzofurans (PCDD/F) in human blood and in milk from non-occupationally exposed persons living in the vicinity of a municipal waste incinerator were determined. As compared to background levels in the general population in Germany the results give no indication of an enhanced body burden of PCDD/F. This is in agreement with earlier investigations in the same area, showing normal background concentrations in soil, fruit and vegetables. In conclusion, no direct health hazard related to PCDD/F-emissions from a local municipal waste incinerator may be expected.

  9. FIXED-SITE AIR AND BIOMARKER MEASUREMENTS OF VOCS IN A NON-OCCUPATIONALLY EXPOSED POPULATION ALONG THE ARIZONA-MEXICO BORDER

    EPA Science Inventory

    The goals of the NHEXAS-Border Study are to obtain environmental exposure and biomarker data for a representative population residing along the Arizona-Mexico border, and compare the distributions to similar distributions previously obtained for the state of Arizona (NHEXAS-Ari...

  10. FIXED-SITE AIR AND BIOMARKER MEASUREMENTS OF VOCS IN A NON-OCCUPATIONALLY EXPOSED POPULATION ALONG THE ARIZONA-MEXICO BORDER

    EPA Science Inventory

    The goals of the NHEXAS-Border Study are to obtain environmental exposure and biomarker data for a representative population residing along the Arizona-Mexico border, and compare the distributions to similar distributions previously obtained for the state of Arizona (NHEXAS-Ari...

  11. Serum levels of PCDDs, PCDFs and PCBs in non-occupationally exposed population groups living near two incineration plants in Tuscany, Italy.

    PubMed

    De Felip, Elena; Abballe, Annalisa; Casalino, Francesco; di Domenico, Alessandro; Domenici, Pierangela; Iacovella, Nicola; Ingelido, Anna Maria; Pretolani, Elisabetta; Spagnesi, Maurizio

    2008-05-01

    A pilot study was carried out in Tuscany, Italy, to provide preliminary information on the concentrations of polychlorinated dibenzodioxins (PCDDs), polychlorinated dibenzofurans (PCDFs), dioxin-like polychlorobiphenyls (DL-PCBs), and selected non-dioxin-like PCBs (NDL-PCBs) in groups of subjects living in the vicinity of two incineration plants. Seventy-four volunteers were enrolled from areas identified as under a potential impact from incinerator emissions and from not exposed areas. No significant differences were observed between subjects living in the two types of areas. Total concentrations of PCDDs, PCDFs, and DL-PCBs resulted to be in the range 23-30 pg WHO-TEQ g(-1), lipid base, for subjects in the 27-54 year age groups, while concentrations increased to 40-44 pgTEQ g(-1) for the two 55-67 year age groups. The levels of PCDDs and PCDFs were in good agreement with those observed for unexposed population groups in Italy, while the contribution to total TEQ from DL-PCBs was appreciably higher than those currently observed in the general population in Italy and other countries. As to NDL-PCBs, serum levels of the six "indicator" congeners were in the range 240-300 ng g(-1), lipid base, for subjects in the 27-54 year age groups. A raise in NDL-PCB body burden (430-470 ng g(-1), lipid base) was observed for the two 55+ year age groups, in agreement with the expected age-dependent increase. The findings from this study do not show an incremental exposure to PCDDs and PCDFs in the samples from subjects living around the two incineration plants, whereas PCB congener profiles in all samples suggest a possible impact on the area of interest of industrial activities from near industrial settlements.

  12. Exposing physicians to reduced residency work hours did not adversely affect patient outcomes after residency.

    PubMed

    Jena, Anupam B; Schoemaker, Lena; Bhattacharya, Jay

    2014-10-01

    In 2003, work hours for physicians-in-training (residents) were capped by regulation at eighty hours per week, leading to the hotly debated but unexplored issue of whether physicians today are less well trained as a result of these work-hour reforms. Using a unique database of nearly all hospitalizations in Florida during 2000-09 that were linked to detailed information on the medical training history of the physician of record for each hospitalization, we studied whether hospital mortality and patients' length-of-stay varied according to the number of years a physician was exposed to the 2003 duty-hour regulations during his or her residency. We examined this database of practicing Florida physicians, using a difference-in-differences analysis that compared trends in outcomes of junior physicians (those with one-year post-residency experience) pre- and post-2003 to a control group of senior physicians (those with ten or more years of post-residency experience) who were not exposed to these reforms during their residency. We found that the duty-hour reforms did not adversely affect hospital mortality and length-of-stay of patients cared for by new attending physicians who were partly or fully exposed to reduced duty hours during their own residency. However, assessment of the impact of the duty-hour reforms on other clinical outcomes is needed. Project HOPE—The People-to-People Health Foundation, Inc.

  13. Non-occupational exposure to paint fumes during pregnancy and fetal growth in a general population.

    PubMed

    Sørensen, Mette; Andersen, Anne-Marie N; Raaschou-Nielsen, Ole

    2010-05-01

    Occupational exposure to organic solvents during pregnancy has been associated with reduced fetal growth. Though organic solvents in the form of paint fumes are also found in the home environment, no studies have investigated the effect of such exposure in a general population. We studied associations between residential exposure to paint fumes during pregnancy and fetal growth within the Danish National Birth Cohort which consecutively recruited pregnant women from 1996 to 2002 from all over Denmark. Around the 30th pregnancy week, 19,000 mothers were interviewed about use of paint in their residence during pregnancy. The mothers were also asked about smoking habits and alcohol consumption during pregnancy, pre-pregnancy weight, height, parity and occupation. Information on birth weight and gestational age was obtained from national registers. We found that 45% of the mothers had been exposed to paint fumes in their residence during pregnancy. We found a statistically significant inverse relationship between exposure to paint fumes and the risk of being small for gestational age. There were no statistically significant associations between exposure to paint fumes and birth weight and risk of preterm birth after adjustment for potential confounders. Our results suggest that there are no causal relationship between non-occupational exposure to paint fumes in the residence during pregnancy and fetal growth.

  14. Accumulation and Clearance of Perfluorooctanoic Acid (PFOA) in Current and Former Residents of an Exposed Community

    PubMed Central

    Seals, Ryan; Bartell, Scott M.; Steenland, Kyle

    2011-01-01

    Background Perfluorooctanoic acid (PFOA) is a perfluoroalkyl acid found in > 99% of Americans. Its health effects are unknown. Prior estimates of serum half-life range from 2.3 to 3.8 years. Objectives We assessed the impact of years of residence and years since residing in the study area on serum PFOA concentration in a sample of current and former residents who were exposed to PFOA emissions from an industrial facility in six water districts in West Virginia and Ohio. Methods Serum samples and questionnaires, including residential history, were collected in 2005–2006. We modeled log serum PFOA (nanograms per milliliter) for current residents as a function of years of residence in a water district, adjusted for a variety of factors. We modeled the half-life in former residents who lived in two water districts with high exposure levels using a two-segment log-linear spline. Results We modeled serum PFOA concentration in 17,516 current residents as a function of years of residence (R2 = 0.68). Years of residence was significantly associated with PFOA concentration (1% increase in serum PFOA/year of residence), with significant heterogeneity by water district. Half-life was estimated in two water districts comprising a total of 1,573 individuals. For the participants included in our analyses, we found that years since residing in a water district was significantly associated with serum PFOA, which yielded half-lives of 2.9 and 8.5 years for water districts with higher and lower exposure levels, respectively. Conclusion Years of residence in an exposed water district is positively associated with observed serum PFOA in 2005–2006. Differences in serum clearance rate between low- and high-exposure water districts suggest a possible concentration-dependent or time-dependent clearance process or inadequate adjustment for background exposures. PMID:20870569

  15. Accumulation and clearance of perfluorooctanoic acid (PFOA) in current and former residents of an exposed community.

    PubMed

    Seals, Ryan; Bartell, Scott M; Steenland, Kyle

    2011-01-01

    Perfluorooctanoic acid (PFOA) is a perfluoroalkyl acid found in > 99% of Americans. Its health effects are unknown. Prior estimates of serum half-life range from 2.3 to 3.8 years. We assessed the impact of years of residence and years since residing in the study area on serum PFOA concentration in a sample of current and former residents who were exposed to PFOA emissions from an industrial facility in six water districts in West Virginia and Ohio. Serum samples and questionnaires, including residential history, were collected in 2005-2006. We modeled log serum PFOA (nanograms per milliliter) for current residents as a function of years of residence in a water district, adjusted for a variety of factors. We modeled the half-life in former residents who lived in two water districts with high exposure levels using a two-segment log-linear spline. We modeled serum PFOA concentration in 17,516 current residents as a function of years of residence (R2 = 0.68). Years of residence was significantly associated with PFOA concentration (1% increase in serum PFOA/year of residence), with significant heterogeneity by water district. Half-life was estimated in two water districts comprising a total of 1,573 individuals. For the participants included in our analyses, we found that years since residing in a water district was significantly associated with serum PFOA, which yielded half-lives of 2.9 and 8.5 years for water districts with higher and lower exposure levels, respectively. Years of residence in an exposed water district is positively associated with observed serum PFOA in 2005-2006. Differences in serum clearance rate between low- and high-exposure water districts suggest a possible concentration-dependent or time-dependent clearance process or inadequate adjustment for background exposures.

  16. Reproductive outcomes after non-occupational exposure to hexavalent chromium, Willits California, 1983-2014.

    PubMed

    Remy, Linda L; Byers, Vera; Clay, Ted

    2017-03-06

    From 1963-1995, a factory in Willits, Mendocino County, CA used toxic hexavalent chromium (Cr(VI)) without adequate measures to protect the population. We use longitudinal hospital data to compare reproductive outcomes for two generations in Willits and two generations in the Rest of County (ROC). This is the first study to quantify the reproductive impact of Cr(VI) in a non-occupational population. We searched California hospital discharge data (1983-2014) to find Mendocino County residents born 1950 or later. ZIP-code 95490 identifies Willits residents, with all others living in ROC. We used the Multi-Level Clinical Classification Software (CCS) to classify health outcomes. First, we calculated the crude birth rate using an external census denominator. The next two models used self-contained denominators to assess health of infants and two generations of pregnant women. Finally, we focused on non-pregnant females and, for comparison, males. Here we added admissions for people who moved, linked and summarized admissions to the person level, and calculated rates per census population. We found 29311 newborn records in ROC and 5036 from Willits. At start of period, Willits birth rate was low and did not recover until 12 years after Plant closure. While the Plant was open, respiratory conditions, perinatal jaundice, and birth defect rates were higher for Willits infants compared to ROC, but improved post-closure. Risk for abnormal birthweight and term was high and remained high over the study period. During the period under study, we identified 31444 admissions of pregnant ROC women and 5558 from Willits. Willits women had significantly higher risk of pregnancy loss compared to ROC, whether stratified by generation, age group, or pre- and post-closure. Regardless of when exposed, Willits women continued to have significantly higher rates of in-hospital terminations, as animal studies of Cr(VI) exposure predict. In life course models, non-pregnant Willits women

  17. A Biomarker Found in Cadmium Exposed Residents of Thailand by Metabolome Analysis

    PubMed Central

    Suvagandha, Dhitiwass; Nishijo, Muneko; Swaddiwudhipong, Witaya; Honda, Ruymon; Ohse, Morimasa; Kuhara, Tomiko; Nakagawa, Hideaki; Ruangyuttikarn, Werawan

    2014-01-01

    First, the urinary metabolic profiling by gas chromatography-mass spectrometry (GC-MS), was performed to compare ten cadmium (Cd) toxicosis cases from a Cd-polluted area in Mae Sot (Thailand) with gender-matched healthy controls. Orthogonal partial list square-discrimination analysis was used to identify new biomarker candidates in highly Cd exposed toxicosis cases with remarkable renal tubular dysfunction. The results of the first step of this study showed that urinary citrate was a negative marker and myo-inositol was a positive marker for Cd toxicosis in Thailand. In the second step, we measured urinary citrate in the residents (168 Cd-exposed subjects and 100 controls) and found significantly lower levels of urinary citrate and higher ratios of calcium/citrate and magnesium/citrate, which are risk factors for nephrolithiasis, in highly Cd-exposed residents. Additionally, this inverse association of urinary citrate with urinary Cd was observed after adjustment for age, smoking and renal tubular dysfunction, suggesting a direct effect of Cd on citrate metabolism. These results indicate that urinary citrate is a useful biomarker for the adverse health effects of Cd exposure in a Thai population with a high prevalence of nephrolithiasis. PMID:24699029

  18. Dual Functionality of Myeloperoxidase in Rotenone-Exposed Brain-Resident Immune Cells

    PubMed Central

    Chang, Chi Young; Song, Mi Jeon; Jeon, Sae-Bom; Yoon, Hee Jung; Lee, Dae Kee; Kim, In-Hoo; Suk, Kyungho; Choi, Dong-Kug; Park, Eun Jung

    2011-01-01

    Rotenone exposure has emerged as an environmental risk factor for inflammation-associated neurodegenerative diseases. However, the underlying mechanisms responsible for the harmful effects of rotenone in the brain remain poorly understood. Herein, we report that myeloperoxidase (MPO) may have a potential regulatory role in rotenone-exposed brain-resident immune cells. We show that microglia, unlike neurons, do not undergo death; instead, they exhibit distinctive activated properties under rotenone-exposed conditions. Once activated by rotenone, microglia show increased production of reactive oxygen species, particularly HOCl. Notably, MPO, an HOCl-producing enzyme that is undetectable under normal conditions, is significantly increased after exposure to rotenone. MPO-exposed glial cells also display characteristics of activated cells, producing proinflammatory cytokines and increasing their phagocytic activity. Interestingly, our studies with MPO inhibitors and MPO-knockout mice reveal that MPO deficiency potentiates, rather than inhibits, the rotenone-induced activated state of glia and promotes glial cell death. Furthermore, rotenone-triggered neuronal injury was more apparent in co-cultures with glial cells from Mpo−/− mice than in those from wild-type mice. Collectively, our data provide evidence that MPO has dual functionality under rotenone-exposed conditions, playing a critical regulatory role in modulating pathological and protective events in the brain. PMID:21704008

  19. Health risk assessment for residents exposed to atmospheric diesel exhaust particles in southern region of Taiwan

    NASA Astrophysics Data System (ADS)

    Chio, Chia-Pin; Liao, Chung-Min; Tsai, Ying-I.; Cheng, Man-Ting; Chou, Wei-Chun

    2014-03-01

    Evidence shows a strong association among air pollution, oxidative stress (OS), deoxyribonucleic acid (DNA) damage, and diseases. Recent studies indicated that the aging, human neurodegenerative diseases and cancers resulted from mitochondrial dysfunction and OS. The purpose of this study is to provide a probabilistic risk assessment model to quantify the atmospheric diesel exhaust particles (DEP)-induced pre-cancer biomarker response and cancer incidence risk for residents in south Taiwan. We conducted entirely monthly particulate matter sampling data at five sites in Kaohsiung of south Taiwan in the period 2002-2003. Three findings were found: (i) the DEP dose estimates and cancer risk quantification had heterogeneously spatiotemporal difference in south Taiwan, (ii) the pre-cancer DNA damage biomarker and cancer incidence estimates had a positive yet insignificant association, and (iii) all the estimates of cancer incidence in south Taiwan populations fell within and slight lower than the values from previous cancer epidemiological investigations. In this study, we successfully assessed the tumor incidence for residents posed by DEP exposure in south Taiwan compared with the epidemiological approach. Our approach provides a unique way for assessing human health risk for residences exposed to atmospheric DEP depending on specific combinations of local and regional conditions. Our work implicates the importance of incorporating both environmental and health risk impacts into models of air pollution exposure to guide adaptive mitigation strategies.

  20. Self-reported health effects among community residents exposed to perfluorooctanoate.

    PubMed

    Anderson-Mahoney, Pamela; Kotlerman, Jenny; Takhar, Harpreet; Gray, David; Dahlgren, James

    2008-01-01

    Serious health effects due to perfluorooctanoate (PFOA) exposure are suspected. The aim of this study was to evaluate the health status of nearby residents, with prolonged exposure to PFOA in their drinking water. A population of 566 white residents who were plaintiffs or potential plaintiffs in a lawsuit was evaluated by questionnaire for health history and symptoms. Standardized Prevalence Ratios were estimated using National Health and Examination Survey (NHANES) data files for comparison rates. The exposed subjects reported statistically significant greater prevalence of angina, myocardial infarction, and stroke (SPR=8.07, 95% C.I.=6.54-9.95; SPR=1.91, 95% C.I.=1.40-2.62, and SPR=2.17, 95% C.I.=1.47-3.21, respectively), chronic bronchitis, shortness of breath on stairs, asthma (SPR=3.60, 95% C.I.=2.92-4.44; SPR=2.05, 95% C.I.=1.70-2.46; SPR=1.82, 95% C.I.=1.47-2.25, respectively), and other serious health problems. The increased prevalence of adverse health effects may be due to PFOA. Further study is needed.

  1. An algorithm for quantitatively estimating non-occupational pesticide exposure intensity for spouses in the Agricultural Health Study

    EPA Science Inventory

    Purpose: Women living or working on farms may be exposed to pesticides from direct occupational use of agricultural pesticides and from non-occupational pathways, such as take-home exposure from skin, clothes and shoes of farmworkers, drift from nearby fields, and pest treatments...

  2. [Expression and significance of ERalpha mRNA of residents exposed to arsenic via drinking water].

    PubMed

    Han, Xiaohong; Guo, Zhiwei; Yang, Weihong; Wu, Kegong; Li, Yanhong; Xia, Yajuan

    2014-05-01

    To detect ERbeta mRNA expression of subjects exposed to different arsenic drinking water, and to analyze the potential relationship between their abnormal expression and heart injury caused by arsenic in order to study the endocrine disturbing effect of arsenic. Molecular epidemiological method was used. The study subjects included a total of 273 residents exposed to arsenic via drinking water,and they were divided into four groups according to arsenic concentration, and their blood ERbeta mRNA expression was detected by real-time RT-PCR. The level of ERbeta mRNA expression rose with increasing of water As and urine As (r = 0.159, 0.21, P < 0.05). The prevalence of Q-Tc interval prolongation aggravated with increasing of water As(chi2 = 4.35, P = 0.037), while according with the variation of ERbeta mRNA expression. Tp-Te interval prolonged with increasing of water As (r = 0.199, P = 0.023), as well prolonged with increasing of ERbeta mRNA expression (r = 0.205, P = 0.019). The prevalence of arrhythmia was almost according with the variation of ERbeta mRNA expression. chronic arsenic exposure can potentially disturb ERbeta mRNA expression, as well as there are possible relationship between ERbeta mRNA abnormal expression and Q-Tc interval prolongation and Tp-Te interval prolonged caused by arsenic.

  3. Are migrant and resident elk (Cervus elaphus) exposed to similar forage and predation risk on their sympatric winter range?

    PubMed

    Robinson, Barry G; Hebblewhite, Mark; Merrill, Evelyn H

    2010-09-01

    Partially migratory populations, where one portion of a population conducts seasonal migrations (migrants) while the other remains on a single range (residents), are common in ungulates. Studies that assess trade-offs between migratory strategies typically compare the amount of predation risk and forage resources migrants and residents are exposed to only while on separate ranges and assume both groups intermix completely while on sympatric ranges. Here we provide one of the first tests of this assumption by comparing the amount of overlap between home ranges of GPS-collared migrant and resident elk and fine-scale exposure to wolf predation risk and forage biomass at telemetry locations on a sympatric winter range in west-central Alberta, Canada. Overlap between migrant and resident home ranges increased throughout the winter, and both groups were generally intermixed and exposed to equal forage biomass. During the day, both migrants and residents avoided predation risk by remaining in areas far from timber with high human activity, which wolves avoided. However, at night wolves moved onto the grasslands close to humans and away from timber. Resident elk were consistently closer to areas of human activity and further from timber than migrants, possibly because of a habituation to humans. As a result, resident elk were exposed to higher night-time predation risk than migrants. Our study does not support the assumption that migrant and resident elk are exposed to equal predation risk on their sympatric range when human presence alters predation risk dynamics and habituation to humans is unequal between migratory strategies.

  4. Pleural malignant mesothelioma and non-occupational exposure to asbestos in Casale Monferrato, Italy.

    PubMed Central

    Magnani, C; Terracini, B; Ivaldi, C; Botta, M; Mancini, A; Andrion, A

    1995-01-01

    OBJECTIVES--To assess and quantify the occurrence of pleural malignant mesotheliomas in people who neither experienced occupational exposure to asbestos nor were married to (or known to live with) workers exposed to asbestos in the workplace. The study was conducted in the area of the local health authority of Casale Monferrato, in north western Italy, where a large factory that produced asbestos cement was active up to 1985. No other major activities related to asbestos have ever been present in the area. METHODS--A retrospective survey covering the period 1980 to 1991 identified 126 incident pleural malignant mesotheliomas histologically diagnosed among residents in the local health authority (population at the 1981 census 98,000). Submission of 83 of 95 cases diagnosed during 1980-9 for revision by a panel of five expert pathologists led to the exclusion of 21. The 31 cases diagnosed in 1990-1 were not submitted for revision. For 64 of the 105 retained cases, information derived from different sources (rosters of the employees in the asbestos cement factory dated back to 1907, list of their spouses, clinical records) did not suggest occupational or paraoccupational exposure to asbestos. RESULTS--Incidence excludes cases for which there was some suggestion of occupational or paraoccupational exposure to asbestos. Incidence of histologically confirmed malignant mesothelioma among residents in the local health authority (annual x 100,000; age adjusted) was 4.2 in men and 2.3 in women (based on 26 and 18 cases respectively). In both sexes, rates in 1985-9 were higher than in the previous quinquennium. Corresponding estimates for 1990-1 (based on unrevised diagnoses) suggest similar rates in men and women. CONCLUSION--Rate ratios which are four to six times those measured by conventional Italian cancer registries can hardly be totally explained by bias produced by lack of recognition of occupational or paraoccupational exposure. The problem of proving this type of

  5. Liver dysfunction in residents exposed to leachate from a toxic waste dump.

    PubMed

    Meyer, C R

    1983-02-01

    It has been estimated that there are some 30,000 chemical waste dumps in the United States. Many of these landfill operations were undertaken in the early 1950s and 1960s, when knowledge regarding the safe and prolonged containment of the waste buried was nonexistent or minimal at best. As a result, many of these dump sites were located in areas that were geologically unsuitable for toxic chemical wastes. The Love Canal area in Niagara Falls, NY, is probably the best known of these dump sites. While a few of these sites have attracted wide media coverage, the availability of objective scientific information regarding the health effects of such sites has been deficient. The present study of a large toxic waste dump located in Hardeman County, TN, its contamination of surface and underground aquifers and the health effects on the area residents exposed via ingestion of contaminated water, offers the first objective evidence of organ dysfunction in such a human population. During this study comprehensive evaluation of that population revealed multiple symptoms, evidence of hepatomegaly and elevated liver function tests apparently caused by ingestion of water contaminated by numerous organic chemicals, many of which are known to be hepatotoxins.

  6. Urinary arsenic speciation and its correlation with 8-OHdG in Chinese residents exposed to arsenic through coal burning

    SciTech Connect

    Li, X.; Pi, J.B.; Li, B.; Xu, Y.Y.; Jin, Y.P.; Sun, G.F.

    2008-10-15

    In contrast to arsenicosis caused by consumption of water contaminated by naturally occurring inorganic arsenic, human exposure to this metalloid through coal burning has been rarely reported. In this study, arsenic speciation and 8-hydroxy-2'-deoxyguanosine (8-OHdG) levels in urine were determined in the Chinese residents exposed to arsenic through coal burning in Guizhou, China, an epidemic area of chronic arsenic poisoning caused by coal burning. The urinary concentrations of inorganic arsenic (iAs), monomethylarsonic acid (MMA), dimethylarsinic acid (DMA) and total arsenic (tAs) of high-arsenic exposed subjects were significantly higher than those of low-arsenic exposed residents. A biomarker of oxidative DNA damage, urinary 8-OHdG level was significantly higher in high-arsenic exposed subjects than that of low exposed. Significant positive correlations were found between 8-OHdG levels and concentrations of iAs, MMA, DMA and tAs, respectively. In addition, a significant negative correlation was observed between 8-OHdG levels and the secondary methylation ratio (DMA/(MMA + DMA)). The results suggest that chronic arsenic exposure through burning coal rich in arsenic is associated with oxidative DNA damages, and that secondary methylation capacity is potentially related to the susceptibility of individuals to oxidative DNA damage induced by arsenic exposure through coal burning in domestic living.

  7. Traumatic stress and death anxiety among community residents exposed to an aircraft crash.

    PubMed

    Chung, M C; Chung, C; Easthope, Y

    2000-12-01

    This article examined the relationship between traumatic stress and death anxiety among community residents who lived near woodlands in which an aircraft had crashed in Coventry, England. The hypothesis was that there would be a high level of impact of the crash experienced by residents and that the residents would experience psychological distress. It was also hypothesized that the impact of the crash and distress were associated with death anxiety. Eighty-two residents were interviewed for the study. They were asked to complete the Impact of Event Scale, the General Health Questionnaire (GHQ), and the Death Anxiety Scale. The results showed that Coventry residents were found to experience intrusive thoughts and display avoidance behavior. The residents' intrusive thoughts and avoidance behavior were significantly more severe than one group of Horowitz's standardized samples (i.e., the medical students), but not significantly different from another group (i.e., the stress clinic samples). Fifty-seven percent scored at or above the GHQ cutoff point, which meant that they were considered to be psychiatric cases. Community residents scored significantly lower in death anxiety than the standardized high-death anxiety patients but no differently from the standardized control patients. Correlations were found between the impact of the event, psychological distress, and death anxiety.

  8. Health effects of non-occupational exposure to oil extraction.

    PubMed

    O'Callaghan-Gordo, Cristina; Orta-Martínez, Martí; Kogevinas, Manolis

    2016-04-26

    Oil extraction may cause extensive environmental impact that can affect health of populations living in surrounding areas. Large populations are potentially exposed to oil extraction related contamination through residence in areas where oil extraction is conducted, especially in low and middle income countries (LMICs). Health effects among people residentially exposed to upstream oil industry contaminants have been poorly studied. Health effects of exposure to oil related contamination have been mainly studied among cleanup workers after oil spills from tankers or offshore platforms.In this paper we aim to identify the type and extension of residential exposures related to oil extraction activities and to comment on the few health studies available. We estimated that 638 million persons in LMICs inhabit rural areas close to conventional oil reservoirs. It is relevant to specifically study people residentially exposed to upstream oil industry for the following reasons: First, persons are exposed during long periods of time to oil related contamination. Second, routes of exposure differ between workers and people living close to oil fields, who can be exposed by ingestion of contaminated waters/foods and by dermal contact with contaminated water and/or land during daily activities (e.g. bathing, agricultural activities, etc.). Third, individuals potentially more susceptible to the effect of oil related contamination and not normally occupationally exposed, such as infants, children, pregnant women, elderly or people with previous health conditions, are also exposed.There are few papers studying the potential health effects of residential exposure to oil related contamination, and most of them share important limitations. There is a need for more research through the conduct of methodologically robust studies in exposed populations worldwide. Despite the difficulties in the conduct of studies in remote areas, novel approaches, such as measurement of individual

  9. Cognitive impairment in agricultural workers and nearby residents exposed to pesticides in the Coquimbo Region of Chile.

    PubMed

    Corral, Sebastián A; de Angel, Valeria; Salas, Natalia; Zúñiga-Venegas, Liliana; Gaspar, Pablo A; Pancetti, Floria

    2017-07-01

    Chronic exposure to organophosphate pesticides is a worldwide public health concern associated with several psychiatric disorders and dementia. Most existing studies on the effects of pesticides only evaluate agricultural workers. Therefore, this study sought to establish if individuals indirectly exposed to pesticides, such as residents in agricultural areas, also suffer cognitive impairments. Neuropsychological evaluations were carried out on three groups (n=102): agricultural workers directly exposed to pesticides (n=32), individuals living in agricultural areas indirectly (i.e. environmentally) exposed to pesticides (n=32), and an unexposed control group (n=38). The assessed cognitive processes included memory, executive functions, attention, language praxis, and visuoconstruction. The direct exposure group performed significantly lower in executive function, verbal fluency, and visual and auditory memory tests than the indirect exposure group, which, in turn, performed worse than the unexposed group. Even after adjusting for age, gender, and educational level, both exposure groups showed higher rates of cognitive deficit than control individuals. In conclusion, both direct and indirect chronic exposure to pesticides affects cognitive functioning in adults and, consequently, actions should be taken to protect the health of not only agricultural workers, but also of residents in agricultural areas. Copyright © 2017 Elsevier Inc. All rights reserved.

  10. Knowledge, Attitudes, Practices and Biomonitoring of Farmers and Residents Exposed to Pesticides in Brazil

    PubMed Central

    Oliveira Pasiani, Juliana; Torres, Priscila; Roniery Silva, Juciê; Zago Diniz, Bruno; Dutra Caldas, Eloisa

    2012-01-01

    In this study, the knowledge, attitudes and practices regarding pesticide use and the levels of exposure of farmers and residents to organophosphorous and/or carbamates pesticides were evaluated in two rural settings in Brazil. A questionnaire was completed by 112 farm workers aged ≥18 years. Almost all farmers acknowledged that pesticides were potentially harmful to their health (87.5%); however, over half rarely (48.2%) or never (7.2%) used personal protective devices (PPDs). An association was found (p = 0.001) between the work regimen and the use of PPDs, with more frequent equipment use among hired laborers than those involved in family agriculture. A significant correlation (p = 0.027) was found between the reporting of adverse symptoms and the use of backpack sprayers. Mean AChE activities of farmers (n = 64) and residents (n = 18) during the exposure and non-exposure periods were significantly lower than their control groups. Mean BChE activities of farmers and residents were significantly lower than their controls during the exposure period. Among the 60 farmers that had blood samples collected in both the exposure and non-exposure (baseline) periods, 10 (16.7%) had AChE depletion of over 30% during the exposure period compared with the baseline level. Six residents living on the same farms also presented this depletion. AChE was over 30% higher than the baseline level for 19 farmers (31.7%), indicating a reboot effect. Special education programs are needed in these regions to promote the safe use of pesticides in the field to decrease the risks from exposure to pesticides for farmers, and from secondary exposure to these compounds for their families. PMID:23202670

  11. Effect of high dose natural ionizing radiation on the immune system of the exposed residents of Ramsar Town, Iran.

    PubMed

    Attar, Massoud; Molaie Kondolousy, Yaghob; Khansari, Nemat

    2007-06-01

    Iran is one of several countries that has regions of high dose natural ionizing radiation. Two well-known villages in the suburb of Ramsar Town in the Caspian Sea strip, Taleshmahaleh and Chaparsar, have background radiation that is 13 times higher than normal. This radiation is the result of Radium 226 and Radon gas both of which are highly water soluble. While people living in these regions do not suffer from any major health problems, we decided to study the their immune responses to infection and inflammation in order to determine if their habitat affects their immune defense mechanisms as a way of compensating for their exposure to high dose environmental ionizing radiation. Our results showed that the total serum antioxidant level in the exposed people was significantly lower than the individuals not exposed to high dose natural ionizing radiation. The exposed individuals also had higher lymphocyte-induced IL-4 and IL-10 production, and lower IL-2 and IFN-gamma production. In addition, neutrophil NBT, phagocytosis, and locomotion were higher in the exposed group. In contrast, lymphocyte proliferation in response to PHA was unaffected. We conclude that the immune system of individuals exposed to high dose ionizing radiation has adapted to its environment by shifting from a Type 1 to a Type 2 response to promote anti-inflammation. This may be because inflammatory Type 1 responses generate more free radicals than Type 2 responses, in addition to the free radicals generated as a result of high environmental radiation. Thus, the serum total antioxidant level in the exposed residents was lower than the unexposed group.

  12. [Prevention of HIV transmission (vertical, occupational and non-occupational)].

    PubMed

    Azkune, Harkaitz; Ibarguren, Maialen; Camino, Xabier; Iribarren, José Antonio

    2011-10-01

    In these almost thirty years since the epidemic of HIV infection strategies have been developed to decrease the transmission risk when a non-infected person comes into contact with HIV. One of the key landmarks was the use zidovudine was shown to reduce the risk of HIV infection by vertical transmission from 25% to 8% when given from the second trimester of pregnancy, during partum and for several weeks in the newborn. These strategies have been subsequently perfected until achieving vertical transmission rates less than 1%. Almost at the same time, strategies have been developed in an attempt to reduce the risk of transmission of infection after occupational accidents and, in the last few years prophylaxis after non-occupational exposure has been a field of particular concern. Even in this past year several experiments on pre-exposure prophylaxis have been published, which are generating an intense debate on is applicability. In this article, we analyse the state of the art in the prevention of vertical transmission and occupational and non-occupational prophylaxis, from a perspective of applying this in the developed world. We also review the published data on pre-exposure prophylaxis.

  13. Early Career Outcomes of Family Medicine Residency Graduates Exposed to Innovative Flexible Longitudinal Tracks.

    PubMed

    Young, Richard A; Casey, Dan; Singer, Diana; Waller, Elaine; Carney, Patricia A

    2017-05-01

    The Preparing the Personal Physician for Practice (P4) project used a case series design to study innovations in the content, length, structure, and location of residency training in 14 geographically diverse family medicine programs between 2007 and 2012. We aimed to explore how offering flexible longitudinal tracks (FLT) affected graduates' scope of practice, particularly in maternal child health (MCH), which included at least 17 months of focused training that increased each year over 4 years. We administered a cross-sectional survey to graduates of P4 residencies approximately 18 months after they completed training (2011-2014) and compared graduates of the John Peter Smith (JPS) Family Medicine Residency MCH FLT to all other P4 graduates. The overall response rate was 81.8% (365/446). JPS graduates who completed the flexible MCH track (n=15) compared to all other P4 graduates (n=332) were more likely to deliver babies (13/15, 86.7% versus 48/324, 14.6%) and perform C-sections as the primary surgeon (12/15, 80.0% versus 15/322, 4.7%). Additional areas of expanded scope associated with the MCH track included endoscopy (4/15, 26.7% versus 10/323, 3.1%), the care of hospitalized adults and associated procedures (central lines, eg: 8/15, 53.3% versus 47/322, 14.6%), and the care of hospitalized children (13/15, 86.7% versus 111/323, 34.4%). Graduating from the JPS MCH FLT was associated with a higher provision of maternal, child, and ill adult patient care services, including associated procedures.

  14. Pregnancy outcome among women exposed to pesticides through work or residence in an agricultural area.

    PubMed

    Willis, W O; de Peyster, A; Molgaard, C A; Walker, C; MacKendrick, T

    1993-09-01

    The study population consisted of women enrolled in a southern California community clinic perinatal program. All women entering the program between January 1987 and December 1989 were asked to participate, and a cohort of 535 women was included in the study. Primarily Hispanic, of low income and educational level, many had recently immigrated from Mexico. They were potentially exposed to pesticides and other agricultural chemicals occupationally and/or environmentally because agricultural production in San Diego County is among the highest in the state. Study methods consisted of biologic assay of maternal blood samples for determination of cholinesterase activity and concurrent patient interviews to determine exposure history by self report. These assessments were conducted on each participant approximately once each trimester. Self-report and blood assay data were analyzed using chi 2, the Mantel-Haenszel extension of chi 2, and risk ratios to determine the association between pesticide exposure and spontaneous abortion, preterm birth, low birth weight and toxemia. No difference between exposed and unexposed women was noted for risk of preterm birth or toxemia. Subjects who experienced spontaneous abortion were all unexposed, and the rate of spontaneous abortion was 2.1%, less than generally expected. A greater incidence of low birth weight among unexposed women indicates that exposure may have had a "protective" effect.

  15. Pleural mesothelioma and occupational and non-occupational asbestos exposure: a case-control study with quantitative risk assessment.

    PubMed

    Ferrante, Daniela; Mirabelli, Dario; Tunesi, Sara; Terracini, Benedetto; Magnani, Corrado

    2016-03-01

    Casale Monferrato (north west Italy) is an area with an exceptionally high incidence of mesothelioma caused by asbestos contamination at work and in the general environment from the asbestos-cement Eternit plant that was operational until 1986. The purpose of this study was to quantify the association between pleural malignant mesothelioma (PMM) and asbestos cumulative exposure using individual assessment of environmental and domestic exposure, as well as of occupational exposure. This population-based case-control study included cases of PMM diagnosed between January 2001 and June 2006 among residents in the Casale Monferrato Local Health Authority. Population controls were randomly sampled, matched by age and sex to cases. Cumulative exposure was estimated to account for the lifelong exposure history. Analyses were conducted using unconditional logistic regression models adjusting for gender, age at diagnosis and type of interview (direct or proxy respondents). 200 PMM cases of 223 eligible cases (89.7%) and 348 (63%) of 552 eligible controls accepted to be interviewed. ORs increased with cumulative exposure index (p<0.0001) from 4.4 (CI 95% 1.7 to 11.3) (<1 f/mL-years) to 62.1 (CI 95% 22.2 to 173.2) (≥10 f/mL-years). Among subjects never occupationally exposed, corresponding ORs were 3.8 (CI 95% 1.3 to 11.1) and 23.3 (CI 95% 2.9 to 186.9) (reference: background level of asbestos exposure). ORs of about 2, statistically significant, were observed for domestic exposure and for living in houses near buildings with large asbestos cement parts. Risk of PMM increased with cumulative asbestos exposure and also in analyses limited to subjects non-occupationally exposed. Our results also provide indication of risk associated with common sources of environmental exposure and are highly relevant for the evaluation of residual risk after the cessation of asbestos industrial use. Published by the BMJ Publishing Group Limited. For permission to use (where not already

  16. Biological monitoring involving children exposed to mercury from a barometer in a private residence.

    PubMed

    Scheepers, Paul T J; van Ballegooij-Gevers, Marieke; Jans, Henk

    2014-12-15

    A small spill of approximately 3 mL of mercury from a broken barometer in a residential setting resulted in blood values of 32 μg/L in a boy of 9 months and 26 μg/L in a girl of 2.5 years in samples collected within 6h after the start of the incident. A nanny who attempted to remove the spill had a blood mercury value of 20 μg/L at the same time point. These elevated blood values were attributed to inhalation rather than dermal uptake or ingestion. Exposure was aggravated by the use of a vacuum cleaner in an early attempt to remove the spill and incomplete decontamination of involved persons, leading to a continuation of exposure. Over a period of three months general cleaning was followed by targeted cleaning of hot spots until the indoor air mercury levels reached a median value of 0.090 μg/m(3) with a range of 0.032-0.140 μg/m(3). Meanwhile the family was staying in a shelter home. Human biological monitoring (HBM) was motivated by the complex exposure situation and the involvement of young children. Initially high blood values triggered alertness for clinical signs of intoxication, that (as it turned out) were not observed in any of the exposed individuals. Despite continued exposure from hair and clothes, within six weeks after the incident, blood levels returned to a background level normally seen in children. HBM contributed to reassurance of the parents of the young children that quick elimination of the mercury did not require medical treatment. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

  17. Mineral particles in the lungs of subjects resident in the Rome area and not occupationally exposed to mineral dust

    SciTech Connect

    Paoletti, L.; Batisti, D.; Caiazza, S.; Petrelli, M.G.; Taggi, F.; De Zorzi, L.; Dina, M.A.; Donelli, G.

    1987-10-01

    We studied the inorganic particulate contained in the lung parenchyma of 10 subjects (5 males and 5 females) residing in an urban area and not occupationally exposed to dusts. A total of 17 mineral types were identified, along with 16 metal elements in the form of oxides and sulfides. Approximately 70% of the minerals were made up of phyllosilicates, in particular clay, mica, and talc; three metal elements, Fe, Al, and Ti, accounted for more than 75% of the recovered oxide particles. The mean concentration of the observed inorganic particles was approximately 1.8 X 10(5) pp/mg dry tissue. No significant differences were observed in terms of total particulate concentration in the various areas of the lungs and between the right and left lung. Instead we observed a larger concentration of fibrous particles in the upper lobes. The analysis of the data made it possible to determine the presence of a high degree of correlation between the concentrations of silicates and the concentrations of metal oxides and sulfides, implying the existence of a ubiquitous environmental source of these mineral particles. The frequent observation of tremolite fibers is remarkable. This finding, confirmed elsewhere, indicates that the magnitude of the sources of these fibers in the environment, constituted by contaminated talc dusts, has been underestimated until today.

  18. Non-occupational contact sensitization to epoxy resin of bisphenol A among general dermatology patients.

    PubMed

    Majasuo, Susanna; Liippo, Jussi; Lammintausta, Kaija

    2012-03-01

    Sensitization to epoxy resins often results from occupational exposure in various fields of construction and industry. Non-occupational sensitization sources and environments have remained overlooked. To analyse non-occupational and occupational contact sensitization to epoxy resin of bisphenol A among general dermatology patients. Special attention was paid to patients sensitized from non-occupational sources. During a 10-year period, 6042 general dermatology patients were patch tested with epoxy resin (bisphenol A) in the Dermatology Clinic of Turku University Hospital. The clinical data and the sources of occupational and non-occupational exposure to epoxy resin were analysed in sensitized patients. Epoxy resin sensitization was found in 59 patients. Non-occupational sensitization was found in 21 (35%) patients, whereas the number of occupational cases was 38 (65%). The most common sources of non-occupational epoxy resin sensitization were materials used in domestic renovation and construction projects and in boat repair. Non-occupational sensitization sources account for approximately one-third of epoxy resin sensitization cases, and therefore represent an important risk among hobbies and leisure activities. © 2011 John Wiley & Sons A/S.

  19. [Consensus Conference "Health surveillance of resident population exposed to tremolite in Local Health Unit 3 territory Lagonegro, PZ". Rome 22-23 February 2005].

    PubMed

    Musti, Marina; Bruno, Caterina; Cassano, Filippo; Caputo, Angelo; Cauzillo, Gabriella; Cavone, Domenica; Convertini, Luca; De Blasio, Antonio; De Mei, Barbara; Marra, Mario; Montagano, Giuseppe; Schettino, Biagio; Zona, Amerigo; Comba, Pietro

    2006-01-01

    Herein is reported the health surveillance document agreed upon during the Consensus Conference held in Rome at the Istituto Superiore di Sanità last year. The aim of the consensus conference was to define guidelines for epidemiologic and health surveillance of the resident population in the area of the Basilicata region exposed to tremolite pollution (Local Health Unit 3 territory Lagonegro, PZ). The health surveillance program for residents and the nested epidemiologic study evaluates for each resident willing to participate, individual exposure with a personal dosimeter, as well as the prevalence of obstructive, restrictive or mixed pulmonary functional patterns, searching for fiber and asbestos bodies in induced-sputum, the prevalence of non malignant asbestos disturbances related to pleural anomalies and, last but not least, provides information on risks and sensitization, advising on personal behaviour that could reduce the risks.

  20. Variations in Intensity, Fundamental Frequency, and Voicing for Teachers in Occupational Versus Non-Occupational Settings

    PubMed Central

    Hunter, Eric J.; Titze, Ingo R.

    2012-01-01

    Purpose This study creates a more concise picture of the vocal demands placed on teachers by comparing occupational voice use with non-occupational voice use. Methods The National Center for Voice and Speech voice dosimetry databank was used to calculate voicing percentage per hour, as well as average dB SPL and F0. Occupational voice use (9am-3 PM, weekdays) and non-occupational voice use (4 PM-10 PM, weekends) were compared (57 teachers, two weeks each). Results Five key findings were uncovered: [1] similar to previous studies, occupational voicing percentage per hour is more than twice that of non-occupational; [2] teachers experienced a wide range of occupational voicing percentages per hour (30±11%/hr); [3] average occupational voice was about 1 dB SPL louder than the non-occupational voice and remained constant throughout the day; [4] occupational voice exhibited an increased pitch and trended upward throughout the day; [5] some apparent gender differences were shown. Conclusions Data regarding voicing percentages, F0 and dB SPL provide critical insight into teachers’ vocal health. Further, because non-occupational voice use is added to an already overloaded voice, it may add key insights into recovery patterns, and should be the focus of future studies. PMID:20689046

  1. Relationship of Occupational and Non-Occupational Stress with Smoking in Automotive Industry Workers

    PubMed Central

    Hassani, Somayeh; Yazdanparast, Taraneh; Ghaffari, Mostafa; Attarchi, Mirsaeed; Bahadori, Baharak

    2014-01-01

    Background Tobacco use is the second cause of death and first cause of preventable mortality worldwide. Smoking in the workplace is particularly concerning. Smoking-free workplaces decrease the risk of exposure of non-smoking personnel to cigarette smoke. Recent studies have mostly focused on the effect of daily or non-occupational stressors (in comparison with occupational stress) on prevalence of smoking. Occupational stress is often evaluated in workplaces for smoking cessation or control programs, but the role of non-occupational stressors is often disregarded in this respect. Materials and Methods This cross-sectional study was conducted in an automobile manufacturing company. The response of automotive industry workers to parts of the validated, reliable, Farsi version of Musculoskeletal Intervention Center (MUSIC)-Norrtalje questionnaire was evaluated. A total of 3,536 factory workers participated in this study. Data were analyzed using SPSS and P<0.05 was considered statistically significant. Results The correlation of smoking with demographic factors, occupational stressors and life events was evaluated. The results of logistic regression analysis showed that even after adjusting for the confounding factors, cigarette smoking was significantly correlated with age, sex, level of education, job control and life events (P<0.05). Conclusion The results showed that of occupational and non-occupational stressors, only job control was correlated with cigarette smoking. Non-occupational stressors had greater effect on cigarette smoking. Consideration of both non-occupational and occupational stressors can enhance the success of smoking control programs. On the other hand, a combination of smoking control and stress (occupational and non-occupational) control programs can be more effective than smoking cessation interventions alone. PMID:25506374

  2. Relationship of occupational and non-occupational stress with smoking in automotive industry workers.

    PubMed

    Hassani, Somayeh; Yazdanparast, Taraneh; Seyedmehdi, Seyed Mohammad; Ghaffari, Mostafa; Attarchi, Mirsaeed; Bahadori, Baharak

    2014-01-01

    Tobacco use is the second cause of death and first cause of preventable mortality worldwide. Smoking in the workplace is particularly concerning. Smoking-free workplaces decrease the risk of exposure of non-smoking personnel to cigarette smoke. Recent studies have mostly focused on the effect of daily or non-occupational stressors (in comparison with occupational stress) on prevalence of smoking. Occupational stress is often evaluated in workplaces for smoking cessation or control programs, but the role of non-occupational stressors is often disregarded in this respect. This cross-sectional study was conducted in an automobile manufacturing company. The response of automotive industry workers to parts of the validated, reliable, Farsi version of Musculoskeletal Intervention Center (MUSIC)-Norrtalje questionnaire was evaluated. A total of 3,536 factory workers participated in this study. Data were analyzed using SPSS and P<0.05 was considered statistically significant. The correlation of smoking with demographic factors, occupational stressors and life events was evaluated. The results of logistic regression analysis showed that even after adjusting for the confounding factors, cigarette smoking was significantly correlated with age, sex, level of education, job control and life events (P<0.05). The results showed that of occupational and non-occupational stressors, only job control was correlated with cigarette smoking. Non-occupational stressors had greater effect on cigarette smoking. Consideration of both non-occupational and occupational stressors can enhance the success of smoking control programs. On the other hand, a combination of smoking control and stress (occupational and non-occupational) control programs can be more effective than smoking cessation interventions alone.

  3. Psychological symptoms and quality of life among residents exposed to long-term, low-dose environmental manganese (Mn)

    EPA Science Inventory

    Objective: Elevated levels of air manganese (air-Mn) exposure have been associated with adverse health effects. This study examined the relationship of air-Mn concentrations with mood and quality of life.Participants and methods: 185 residents (age mean (M)=55.13±10.88; ed...

  4. Psychological symptoms and quality of life among residents exposed to long-term, low-dose environmental manganese (Mn)

    EPA Science Inventory

    Objective: Elevated levels of air manganese (air-Mn) exposure have been associated with adverse health effects. This study examined the relationship of air-Mn concentrations with mood and quality of life.Participants and methods: 185 residents (age mean (M)=55.13±10.88; ed...

  5. [Level and pattern of morbidity of children residing in the Ukrainian S.S.R. exposed to radioactive pollution as the result of the Chernobyl AES accident].

    PubMed

    Bugaev, V N; Treskunova, T V; Bomko, E I

    1991-01-01

    It has been shown that there is a significant increase in total morbidity in children residing in the areas exposed to radioactive pollution due to the accident at the Chernobyl Atomic Power Station. This is due largely to higher morbidity of respiratory disease. There is also an increased in the incidence of digestive diseases, iron-deficiency anemias, mental disorders. The recorded growth of childhood morbidity in the areas examined is much higher than that in the children living in other areas unexposed to radioactive pollution.

  6. Risk of carotid atherosclerosis associated with genetic polymorphisms of apolipoprotein E and inflammatory genes among arsenic exposed residents in Taiwan

    SciTech Connect

    Hsieh, Y.-C.; Hsieh, F.-I; Lien, L.-M.; Chou, Y.-L.; Chiou, H.-Y. Chen, C.-J.

    2008-02-15

    Arsenic had been reported to be associated with carotid atherosclerosis. However, there were few studies to evaluate the association between the susceptible gene of lipid metabolism and inflammation and carotid atherosclerosis among arsenic exposure residents. The aim of the study was to investigate the associations between the genetic polymorphisms of APOE and MCP-1 and the risk of carotid atherosclerosis among residents of Lanyang Basin in Taiwan which was a newly confirmed arsenic-endemic area. In total, 479 residents who had been genotyped of these two genes and examined the severity of carotid atherosclerosis were included in this study. The study subjects with carotid intima media thickness (IMT) {>=} 1.0 mm or with the observable plaque in the extracranial carotid artery were diagnosed as carotid atherosclerosis. A significantly age- and gender-adjusted odds ratio of 2.0 for the development of carotid atherosclerosis was observed in study subjects with {epsilon}4 allele of APOE than those without {epsilon}4 allele. Compared with study subjects who carried wild genotypes of APOE and MCP-1, those with both risk genotypes of APOE and MCP-1 had 2.5-fold risk of carotid atherosclerosis after adjustment for age and gender, revealing a significant dose-response relationship between number of risk genotypes of these genes and risk of carotid atherosclerosis. Additionally, study subjects with two risk genotypes of APOE and MCP-1 and either had ingested well water contained arsenic level > 10 {mu}g/L or had arsenic exposure > 0.22 mg/L-year would have strikingly highest risk of 10.3-fold and 15.7-fold, respectively, for the development carotid atherosclerosis, showing significant joint effect of arsenic exposure and risk genotypes of APOE and MCP-1.

  7. Hazard perception, risk perception, and the need for decontamination by residents exposed to soil pollution: the role of sustainability and the limits of expert knowledge.

    PubMed

    Vandermoere, Frédéric

    2008-04-01

    This case study examines the hazard and risk perception and the need for decontamination according to people exposed to soil pollution. Using an ecological-symbolic approach (ESA), a multidisciplinary model is developed that draws upon psychological and sociological perspectives on risk perception and includes ecological variables by using data from experts' risk assessments. The results show that hazard perception is best predicted by objective knowledge, subjective knowledge, estimated knowledge of experts, and the assessed risks. However, experts' risk assessments induce an increase in hazard perception only when residents know the urgency of decontamination. Risk perception is best predicted by trust in the risk management. Additionally, need for decontamination relates to hazard perception, risk perception, estimated knowledge of experts, and thoughts about sustainability. In contrast to the knowledge deficit model, objective and subjective knowledge did not significantly relate to risk perception and need for decontamination. The results suggest that residents can make a distinction between hazards in terms of the seriousness of contamination on the one hand, and human health risks on the other hand. Moreover, next to the importance of social determinants of environmental risk perception, this study shows that the output of experts' risk assessments-or the objective risks-can create a hazard awareness rather than an alarming risk consciousness, despite residents' distrust of scientific knowledge.

  8. One-year follow-up of perfluorinated compounds in plasma of German residents from Arnsberg formerly exposed to PFOA-contaminated drinking water.

    PubMed

    Hölzer, Jürgen; Göen, Thomas; Rauchfuss, Knut; Kraft, Martin; Angerer, Jürgen; Kleeschulte, Peter; Wilhelm, Michael

    2009-09-01

    In Arnsberg, Sauerland area Germany, 40000 residents were exposed to PFOA-contaminated drinking water (500-640ng PFOA/l; May 2006). In July 2006, the PFOA-concentrations in drinking water were lowered significantly by activated charcoal filtering in the waterworks, mostly below the limit of detection (10ng/l). A first human biomonitoring study performed in autumn 2006 revealed that PFOA-concentrations in blood plasma of residents living in Arnsberg were 4.5-8.3 times higher than in the reference groups. One year after the first survey, all participants (2006: 164 mothers, 90 children, 101 men) were invited to take part in a follow-up study. It was the aim of the study to determine the decline of the PFOA-concentrations in blood plasma. 288 persons (81%) were included in the statistical analysis. The (geometric) mean PFOA-concentrations in blood plasma of Arnsberg's residents decreased from 22.1 to 17.4 microg/l in children, from 23.4 to 18.8 microg/l in mothers and from 25.3 to 23.4 microg/l in men within one year. The average (geometric mean) changes in each individual's PFOA-concentrations were approximately 10 (men), 17 (mothers) and 20 (children) percent/year. The observed decline in PFOA-concentrations indicates a slow elimination in humans. This finding in groups of the general population is in agreement with data on long elimination half-lives observed in occupationally exposed workers.

  9. DNA methylation differences in exposed workers and nearby residents of the Ma Ta Phut industrial estate, Rayong, Thailand

    PubMed Central

    Peluso, Marco; Bollati, Valentina; Munnia, Armelle; Srivatanakul, Petcharin; Jedpiyawongse, Adisorn; Sangrajrang, Suleeporn; Piro, Sara; Ceppi, Marcello; Bertazzi, Pier Alberto; Boffetta, Paolo; Baccarelli, Andrea A

    2012-01-01

    Background Adverse biological effects from airborne pollutants are a primary environmental concern in highly industrialized areas. Recent studies linked air pollution exposures with altered blood Deoxyribo-nucleic acid (DNA) methylation, but effects from industrial sources and underlying biological mechanisms are still largely unexplored. Methods The Ma Ta Phut industrial estate (MIE) in Rayong, Thailand hosts one of the largest steel, oil refinery and petrochemical complexes in south-eastern Asia. We measured a panel of blood DNA methylation markers previously associated with air pollution exposures, including repeated elements [long interspersed nuclear element-1 (LINE-1) and Alu] and genes [p53, hypermethylated-in-cancer-1 (HIC1), p16 and interleukin-6 (IL-6)], in 67 MIE workers, 65 Ma Ta Phut residents and 45 rural controls. To evaluate the role of DNA damage and oxidation, we correlated DNA methylation measures with bulky DNA and 3-(2-deoxy-β-D-erythro-pentafuranosyl)pyrimido[1,2-α]purin-10(3H)-one deoxyguanosine (M1dG) adducts. Results In covariate-adjusted models, MIE workers, compared with rural residents, showed lower LINE-1 (74.8% vs 78.0%; P < 0.001), p53 (8.0% vs 15.7%; P < 0.001) and IL-6 methylation (39.2% vs 45.0%; P = 0.027) and higher HIC1 methylation (22.2% vs 15.3%, P < 0.001). For all four markers, Ma Ta Phut residents exhibited methylation levels intermediate between MIE workers and rural controls (LINE-1, 75.7%, P < 0.001; p53, 9.0%, P < 0.001; IL-6, 39.8%, P = 0.041; HIC1, 17.8%, P = 0.05; all P-values vs rural controls). Bulky DNA adducts showed negative correlation with p53 methylation (P = 0.01). M1dG showed negative correlations with LINE-1 (P = 0.003) and IL-6 methylation (P = 0.05). Conclusions Our findings indicate that industrial exposures may induce alterations of DNA methylation patterns detectable in blood leucocyte DNA. Correlation of DNA adducts with DNA hypomethylation suggests potential mediation by DNA damage. PMID:23064502

  10. Hematological and hepatic alterations in nonsmoking residents exposed to benzene following a flaring incident at the British petroleum plant in Texas City.

    PubMed

    D'Andrea, Mark A; Reddy, G Kesava

    2014-12-20

    Human exposure to benzene is associated with multiple adverse health effects with an increased risk of developing carcinogenesis. Benzene exposure is known to affect many critical organs including the hematological, hepatic, renal, lung, and cardiac functions. The purpose of this study is to examine the health effects of benzene exposure among nonsmoking subjects from a prolonged flaring incident that occurred at the British petroleum (BP) refinery in the Texas City, Texas. The study included nonsmoking subjects who had been exposed and unexposed to benzene. Using medical charts, clinical data including white blood cell (WBC) counts, platelet counts, hemoglobin, hematocrit, blood urea nitrogen (BUN), creatinine, alkaline phosphatase (ALP), aspartate amino transferase (AST), and alanine amino transferase (ALT) in nonsmoking subjects exposed to benzene were reviewed and analyzed and compared with unexposed adults. A total of 1422 nonsmoking subjects (benzene exposed, n=1093 and unexposed, n=329) were included. Benzene exposed subjects had significantly higher levels of WBC (×10(3) per μL) counts (7.7±2.2 versus 6.8±1.7, P=0.001) and platelet (×10(3) per μL) counts (288.8±59.0 versus 245.3±54.4, P=0.001) compared with the unexposed subjects. The mean serum creatinine (mg/dL) levels were also significantly increased in the benzene exposed group compared with the unexposed group (1.1±0.4 versus 0.8±0.2, P=0.001). Serum levels of ALP (IU/L) was significantly elevated in the benzene exposed subjects compared with the unexposed subjects (87.3±22.6 versus 69.6±16.5, P=0.001). Similarly, benzene exposed subjects had significantly higher levels of AST and ALT compared with those unexposed subjects. Benzene exposure from the prolonged BP flaring incident caused significant alterations in hematological and liver markers indicating that these nonsmoking residents exposed to refinery chemicals may be at a higher risk of developing hepatic or blood related disorders.

  11. Effect of chronic low level manganese exposure on postural balance: A pilot study of residents in southwest Ohio

    PubMed Central

    Standridge, J. S.; Bhattacharya, Amit; Succop, Paul; Cox, Cyndy; Haynes, Erin

    2009-01-01

    OBJECTIVE The objective of this study was to determine the effect of non-occupational exposure to manganese on postural balance. METHODS Residents living near a ferromanganese refinery provided hair and blood samples after postural balance testing. The relationship between hair manganese and postural balance was analyzed with logistic regression. Following covariate adjustment, postural balance was compared with control data by analysis of covariance. RESULTS Mean hair manganese was 4.4 µg/g. A significantly positive association was found between hair manganese and sway area (EO, p=0.05; EC, p=0.04) and sway length (EO, p=0.05; EC, p=0.04). Postural balance of residents was significantly larger than controls in 5 out of 8 postural balance outcomes. CONCLUSION Preliminary findings suggest subclinical impairment in postural balance among residents chronically exposed to ambient Mn. A prospective study with a larger sample size is warranted. PMID:19092498

  12. Risk of carotid atherosclerosis is associated with low serum paraoxonase (PON1) activity among arsenic exposed residents in Southwestern Taiwan

    SciTech Connect

    Li, W.-F.; Sun, C.-W.; Cheng, T.-J.; Chang, K.-H.; Chen, C.-J.; Wang, S.-L.

    2009-04-15

    To understand whether human paraoxonase 1 (PON1) would modulate the risk for arsenic-related atherosclerosis, we studied 196 residents from an arseniasis-endemic area in Southwestern Taiwan and 291 age- and sex-matched residents from a nearby control area where arsenic exposure was found low. Carotid atherosclerosis was defined by a carotid artery intima-media wall thickness (IMT) of > 1.0 mm. Prevalence of carotid atherosclerosis was increased in the arseniasis-endemic area as compared to the control area after adjustment for conventional risk factors (OR = 2.20, p < 0.01). The prevalence was positively associated with cumulative arsenic exposure (mg/L-year) in a dose-dependent manner. Multiple logistic regression analysis showed that in the endemic group, low serum PON1 activity was an independent risk factor for atherosclerosis (OR = 4.18 low vs. high, p < 0.05). For those of low PON1 activity and high cumulative arsenic exposure, the odds ratio for the prevalence of atherosclerosis was further increased up to 5.68 (p < 0.05). No significant association was found between atherosclerosis and four polymorphisms of the PON gene cluster (PON1 - 108C/T, PON1 Q192R, PON2 A148G, PON2 C311S). However, genetic frequencies of certain alleles including PON1 Q192, PON2 G148 and PON2 C311 were found increased in the endemic group as compared to the controls and a general Chinese population, indicating a possible survival selection in the endemic group after a long arsenic exposure history. Our results showed a significant joint effect between arsenic exposure and serum PON1 activity on carotid atherosclerosis, suggesting that subjects of low PON1 activity may be more susceptible to arsenic-related cardiovascular disease.

  13. Epidemiological studies of Fukushima residents exposed to ionising radiation from the Fukushima Daiichi Nuclear Power Plant prefecture--a preliminary review of current plans.

    PubMed

    Akiba, Suminori

    2012-03-01

    screening in a year or two since the expected minimum latent period among those exposed in early childhood is about 4 years. Recently, local health authorities decided to start a thyroid screening programme for those aged 18 years or younger. Any scientific efforts in Fukushima, which need to gain the trust of study subjects about the objectivity of research, may suffer from the fact that residents in Fukushima Prefecture have begun to suspect that the Japanese government and local authorities are keeping important information from them. It seems necessary to make more effort to reflect the opinions of residents when planning health care programmes and to gain the understanding of the public for the programme. In summary, there are many problems that make the evaluation of cancer and non-cancer disease risk in Fukushima difficult. The help of international colleagues will be invaluable for overcoming those problems. In this paper, these efforts are briefly summarised and some comments are made.

  14. Are the residents of former Yugoslavia still exposed to elevated PCB levels due to the Balkan wars? Part 1: Air sampling in Croatia, Serbia, Bosnia and Herzegovina.

    PubMed

    Klánová, Jana; Kohoutek, Jirí; Kostrhounová, Romana; Holoubek, Ivan

    2007-08-01

    Persistent organic pollutants (POPs) spilled into the environment as a result of damaged industrial and military targets, natural resources, and infrastructure during the Balkan wars still pose a problem several years later. The aim of this project was to investigate an extent to which the residents of former Yugoslavia are exposed to elevated levels of POPs as a consequence of the wars. The atmospheric as well as the soil levels of PCBs, OCPs and PAHs were determined in Croatia, Serbia, Bosnia and Herzegovina during five high volume air sampling campaigns in 2003 and 2004. A considerable contamination of several sites was detected (PCB concentrations in the atmosphere ranged between 67 pg m(-3) and 40 ng m(-3) for the sum of 7 indicator congeners) and the levels are reported in this article.

  15. Malignant mesothelioma due to non-occupational asbestos exposure from the Italian national surveillance system (ReNaM): epidemiology and public health issues.

    PubMed

    Marinaccio, Alessandro; Binazzi, Alessandra; Bonafede, Michela; Corfiati, Marisa; Di Marzio, Davide; Scarselli, Alberto; Verardo, Marina; Mirabelli, Dario; Gennaro, Valerio; Mensi, Carolina; Schallemberg, Gert; Merler, Enzo; Negro, Corrado; Romanelli, Antonio; Chellini, Elisabetta; Silvestri, Stefano; Cocchioni, Mario; Pascucci, Cristiana; Stracci, Fabrizio; Ascoli, Valeria; Trafficante, Luana; Angelillo, Italo; Musti, Marina; Cavone, Domenica; Cauzillo, Gabriella; Tallarigo, Federico; Tumino, Rosario; Melis, Massimo

    2015-09-01

    Italy produced and imported a large amount of raw asbestos, up to the ban in 1992, with a peak in the period between 1976 and 1980 at about 160,000 tons/year. The National Register of Mesotheliomas (ReNaM, "Registro Nazionale dei Mesoteliomi" in Italian), a surveillance system of mesothelioma incidence, has been active since 2002, operating through a regional structure. The Operating Regional Center (COR) actively researches cases and defines asbestos exposure on the basis of national guidelines. Diagnostic, demographic and exposure characteristics of non-occupationally exposed cases are analysed and described with respect to occupationally exposed cases. Standardised incidence rates for pleural mesothelioma in 2008 were 3.84 (per 100,000) for men and 1.45 for women, respectively. Among the 15,845 mesothelioma cases registered between 1993 and 2008, exposure to asbestos fibres was investigated for 12,065 individuals (76.1%), identifying 530 (4.4%) with familial exposure (they lived with an occupationally exposed cohabitant), 514 (4.3%) with environmental exposure to asbestos (they lived near sources of asbestos pollution and were never occupationally exposed) and 188 (1.6%) exposed through hobby-related or other leisure activities. Clusters of cases due to environmental exposure are mainly related to the presence of asbestos-cement industry plants (Casale Monferrato, Broni, Bari), to shipbuilding and repair activities (Monfalcone, Trieste, La Spezia, Genova) and soil contamination (Biancavilla in Sicily). Asbestos pollution outside the workplace contributes significantly to the burden of asbestos-related diseases, suggesting the need to prevent exposures and to discuss how to deal with compensation rights for malignant mesothelioma cases induced by non-occupational exposure to asbestos. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

  16. The relation between non-occupational physical activity and years lived with and without disability.

    PubMed

    Nusselder, W J; Looman, C W N; Franco, O H; Peeters, A; Slingerland, A S; Mackenbach, J P

    2008-09-01

    The effects of non-occupational physical activity were assessed on the number of years lived with and without disability between age 50 and 80 years. Using the GLOBE study and the Longitudinal Study of Aging, multi-state life tables were constructed yielding the number of years with and without disability between age 50 and 80 years. To obtain life tables by level of physical activity (low, moderate, high), hazard ratios were derived for different physical activity levels per transition (non-disabled to disabled, non-disabled to death, disabled to non-disabled, disabled to death) adjusted for age, sex and confounders. Moderate, compared to low non-occupational physical activity reduced incidence of disability (HR 0.66, 95% CI 0.51 to 0.86), increased recovery (HR 1.95, 95% CI 1.32 to 2.87), and represents a gain of disability-free years and a loss of years with disability (male 3.1 and 1.2; female 4.0 and 2.8 years). Performing high levels of non-occupational physical activity further reduced incidence, and showed a higher gain in disability-free years (male 4.1; female 4.7), but a similar reduction in years with disability. Among 50-80-year-olds promoting physical activity is a fundamental factor to achieve healthy ageing.

  17. Assessment of DNA damage by RAPD in Paracentrotus lividus embryos exposed to amniotic fluid from residents living close to waste landfill sites.

    PubMed

    Guida, Maurizio; Guida, Marco; De Felice, Bruna; Santafede, Daniela; D'Alessandro, Raffaella; Di Spiezio Sardo, Attilio; Scognamiglio, Marianna; Ferrara, Cinzia; Bifulco, Giuseppe; Nappi, Carmine

    2010-01-01

    The aim of this study was to assess the genotoxic effects of environmental chemicals on residents living near landfills. The study was based on samples of amniotic fluid from women living in the intensely polluted areas around the Campania region of Italy compared to a nonexposed control group. We evaluated the genetic effects that this amniotic fluids collected in contaminated sites had on Paracentrotus lividus embryos. DNA damage was detected through changes in RAPD (Random Amplified Polymorphism DNA) profiles. The absence of the amplified DNA fragments indicated deletions in Paracentrotus lividus DNA exposed to the contaminated amniotic fluids when compared to equal exposure to uncontaminated fluids. These results show the ability of RAPD-PCR to detect and isolate DNA sequences representing genetic alterations induced in P. lividus embryos. Using this method, we identified two candidate target regions for DNA alterations in the genome of P. lividus. Our research indicates that RAPD-PCR in P. lividus embryo DNA can provide a molecular approach for studying DNA damage from pollutants that can impact human health. To our knowledge, this is the first time that assessment of DNA damage in P. lividus embryos has been tested using the RAPD strategy after exposure to amniotic fluid from residents near waste landfill sites.

  18. Assessment of DNA Damage by RAPD in Paracentrotus lividus Embryos Exposed to Amniotic Fluid from Residents Living Close to Waste Landfill Sites

    PubMed Central

    Guida, Maurizio; Guida, Marco; De Felice, Bruna; Santafede, Daniela; D'Alessandro, Raffaella; Di Spiezio Sardo, Attilio; Scognamiglio, Marianna; Ferrara, Cinzia; Bifulco, Giuseppe; Nappi, Carmine

    2010-01-01

    The aim of this study was to assess the genotoxic effects of environmental chemicals on residents living near landfills. The study was based on samples of amniotic fluid from women living in the intensely polluted areas around the Campania region of Italy compared to a nonexposed control group. We evaluated the genetic effects that this amniotic fluids collected in contaminated sites had on Paracentrotus lividus embryos. DNA damage was detected through changes in RAPD (Random Amplified Polymorphism DNA) profiles. The absence of the amplified DNA fragments indicated deletions in Paracentrotus lividus DNA exposed to the contaminated amniotic fluids when compared to equal exposure to uncontaminated fluids. These results show the ability of RAPD-PCR to detect and isolate DNA sequences representing genetic alterations induced in P. lividus embryos. Using this method, we identified two candidate target regions for DNA alterations in the genome of P. lividus. Our research indicates that RAPD-PCR in P. lividus embryo DNA can provide a molecular approach for studying DNA damage from pollutants that can impact human health. To our knowledge, this is the first time that assessment of DNA damage in P. lividus embryos has been tested using the RAPD strategy after exposure to amniotic fluid from residents near waste landfill sites. PMID:20706694

  19. Aggregate Exposure and Cumulative Risk Assessment--Integrating Occupational and Non-occupational Risk Factors.

    PubMed

    Lentz, T J; Dotson, G S; Williams, P R D; Maier, A; Gadagbui, B; Pandalai, S P; Lamba, A; Hearl, F; Mumtaz, M

    2015-01-01

    Occupational exposure limits have traditionally focused on preventing morbidity and mortality arising from inhalation exposures to individual chemical stressors in the workplace. While central to occupational risk assessment, occupational exposure limits have limited application as a refined disease prevention tool because they do not account for all of the complexities of the work and non-occupational environments and are based on varying health endpoints. To be of greater utility, occupational exposure limits and other risk management tools could integrate broader consideration of risks from multiple exposure pathways and routes (aggregate risk) as well as the combined risk from exposure to both chemical and non-chemical stressors, within and beyond the workplace, including the possibility that such exposures may cause interactions or modify the toxic effects observed (cumulative risk). Although still at a rudimentary stage in many cases, a variety of methods and tools have been developed or are being used in allied risk assessment fields to incorporate such considerations in the risk assessment process. These approaches, which are collectively referred to as cumulative risk assessment, have potential to be adapted or modified for occupational scenarios and provide a tangible path forward for occupational risk assessment. Accounting for complex exposures in the workplace and the broader risks faced by the individual also requires a more complete consideration of the composite effects of occupational and non-occupational risk factors to fully assess and manage worker health problems. Barriers to integrating these different factors remain, but new and ongoing community-based and worker health-related initiatives may provide mechanisms for identifying and integrating risk from aggregate exposures and cumulative risks from all relevant sources, be they occupational or non-occupational.

  20. Aggregate Exposure and Cumulative Risk Assessment—Integrating Occupational and Non-occupational Risk Factors

    PubMed Central

    Lentz, T. J.; Dotson, G. S.; Williams, P. R.D.; Maier, A.; Gadagbui, B.; Pandalai, S. P.; Lamba, A.; Hearl, F.; Mumtaz, M.

    2015-01-01

    Occupational exposure limits have traditionally focused on preventing morbidity and mortality arising from inhalation exposures to individual chemical stressors in the workplace. While central to occupational risk assessment, occupational exposure limits have limited application as a refined disease prevention tool because they do not account for all of the complexities of the work and non-occupational environments and are based on varying health endpoints. To be of greater utility, occupational exposure limits and other risk management tools could integrate broader consideration of risks from multiple exposure pathways and routes (aggregate risk) as well as the combined risk from exposure to both chemical and non-chemical stressors, within and beyond the workplace, including the possibility that such exposures may cause interactions or modify the toxic effects observed (cumulative risk). Although still at a rudimentary stage in many cases, a variety of methods and tools have been developed or are being used in allied risk assessment fields to incorporate such considerations in the risk assessment process. These approaches, which are collectively referred to as cumulative risk assessment, have potential to be adapted or modified for occupational scenarios and provide a tangible path forward for occupational risk assessment. Accounting for complex exposures in the workplace and the broader risks faced by the individual also requires a more complete consideration of the composite effects of occupational and non-occupational risk factors to fully assess and manage worker health problems. Barriers to integrating these different factors remain, but new and ongoing community-based and worker health-related initiatives may provide mechanisms for identifying and integrating risk from aggregate exposures and cumulative risks from all relevant sources, be they occupational or non-occupational. PMID:26583907

  1. Non-occupational physical activity levels of shift workers compared with non-shift workers

    PubMed Central

    Loef, Bette; Hulsegge, Gerben; Wendel-Vos, G C Wanda; Verschuren, W M Monique; Bakker, Marije F; van der Beek, Allard J; Proper, Karin I

    2017-01-01

    Objectives Lack of physical activity (PA) has been hypothesised as an underlying mechanism in the adverse health effects of shift work. Therefore, our aim was to compare non-occupational PA levels between shift workers and non-shift workers. Furthermore, exposure–response relationships for frequency of night shifts and years of shift work regarding non-occupational PA levels were studied. Methods Data of 5980 non-shift workers and 532 shift workers from the European Prospective Investigation into Cancer and Nutrition-Netherlands (EPIC-NL) were used in these cross-sectional analyses. Time spent (hours/week) in different PA types (walking/cycling/exercise/chores) and intensities (moderate/vigorous) were calculated based on self-reported PA. Furthermore, sports were operationalised as: playing sports (no/yes), individual versus non-individual sports, and non-vigorous-intensity versus vigorous-intensity sports. PA levels were compared between shift workers and non-shift workers using Generalized Estimating Equations and logistic regression. Results Shift workers reported spending more time walking than non-shift workers (B=2.3 (95% CI 1.2 to 3.4)), but shift work was not associated with other PA types and any of the sports activities. Shift workers who worked 1–4 night shifts/month (B=2.4 (95% CI 0.6 to 4.3)) and ≥5 night shifts/month (B=3.7 (95% CI 1.8 to 5.6)) spent more time walking than non-shift workers. No exposure–response relationships were found between years of shift work and PA levels. Conclusions Shift workers spent more time walking than non-shift workers, but we observed no differences in other non-occupational PA levels. To better understand if and how PA plays a role in the negative health consequences of shift work, our findings need to be confirmed in future studies. PMID:27872151

  2. Non-thyroid cancer incidence in Belarusian residents exposed to Chernobyl fallout in childhood and adolescence: Standardized Incidence Ratio analysis, 1997-2011.

    PubMed

    Ostroumova, Evgenia; Hatch, Maureen; Brenner, Alina; Nadyrov, Eldar; Veyalkin, Ilya; Polyanskaya, Olga; Yauseyenka, Vasilina; Polyakov, Semion; Levin, Leonid; Zablotska, Lydia; Rozhko, Alexander; Mabuchi, Kiyohiko

    2016-05-01

    While an increased risk of thyroid cancer from post-Chernobyl exposure to Iodine-131 (I-131) in children and adolescents has been well-documented, risks of other cancers or leukemia as a result of residence in radioactively contaminated areas remain uncertain. We studied non-thyroid cancer incidence in a cohort of about 12,000 individuals from Belarus exposed under age of 18 years to Chernobyl fallout (median age at the time of Chernobyl accident of 7.9 years). During 15 years of follow-up from1997 through 2011, 54 incident cancers excluding thyroid were identified in the study cohort with 142,968 person-years at risk. We performed Standardized Incidence Ratio (SIR) analysis of all solid cancers excluding thyroid (n=42), of leukemia (n=6) and of lymphoma (n=6). We found no significant increase in the incidence of non-thyroid solid cancer (SIR=0.83, 95% Confidence Interval [CI]: 0.61; 1.11), lymphoma (SIR=0.66, 95% CI: 0.26; 1.33) or leukemia (SIR=1.78, 95% CI: 0.71; 3.61) in the study cohort as compared with the sex-, age- and calendar-time-specific national rates. These findings may in part reflect the relatively young age of study subjects (median attained age of 33.4 years), and long latency for some radiation-related solid cancers. We found no evidence of statistically significant increases in solid cancer, lymphoma and leukemia incidence 25 years after childhood exposure in the study cohort; however, it is important to continue follow-up non-thyroid cancers in individuals exposed to low-level radiation at radiosensitive ages. Copyright © 2016 Elsevier Inc. All rights reserved.

  3. Non-thyroid cancer incidence in Belarusian residents exposed to Chernobyl fallout in childhood and adolescence: Standardized Incidence Ratio analysis, 1997–2011

    PubMed Central

    Ostroumova, Evgenia; Hatch, Maureen; Brenner, Alina; Nadyrov, Eldar; Veyalkin, Ilya; Polyanskaya, Olga; Yauseyenka, Vasilina; Polyakov, Semion; Levin, Leonid; Zablotska, Lydia; Rozhko, Alexander; Mabuchi, Kiyohiko

    2016-01-01

    Background While an increased risk of thyroid cancer from post-Chernobyl exposure to Iodine-131 (I-131) in children and adolescents has been well-documented, risks of other cancers or leukemia as a result of residence in radioactively contaminated areas remain uncertain. Methods We studied non-thyroid cancer incidence in a cohort of about 12,000 individuals from Belarus exposed under age of 18 years to Chernobyl fallout (median age at the time of Chernobyl accident of 7.9 years). During 15 years of follow-up from1997 through 2011, 54 incident cancers excluding thyroid were identified in the study cohort with 142,968 person-years at risk. We performed Standardized Incidence Ratio (SIR) analysis of all solid cancers excluding thyroid (n=42), of leukemia (n=6) and of lymphoma (n=6). Results We found no significant increase in the incidence of non-thyroid solid cancer (SIR=0.83, 95% Confidence Interval [CI]: 0.61; 1.11), lymphoma (SIR=0.66, 95% CI: 0.26; 1.33) or leukemia (SIR=1.78, 95% CI: 0.71; 3.61) in the study cohort as compared with the sex-, age- and calendar-time-specific national rates. These findings may in part reflect the relatively young age of study subjects (median attained age of 33.4years), and long latency for some radiation-related solid cancers. Conclusions We found no evidence of statistically significant increases in solid cancer, lymphoma and leukemia incidence 25 years after childhood exposure in the study cohort; however, it is important to continue follow-up non-thyroid cancers in individuals exposed to low-level radiation at radiosensitive ages. PMID:26851723

  4. Non-occupational sitting and mental well-being in employed adults.

    PubMed

    Atkin, Andrew J; Adams, Emma; Bull, Fiona C; Biddle, Stuart J H

    2012-04-01

    Emerging evidence suggests that sedentary behaviour may be adversely associated with physical health, but few studies have examined the association with mental well-being. This study examined the association of four non-occupational sedentary behaviours, individually and in total, with mental well-being in employed adults. Baseline data from the evaluation of Well@Work, a national workplace health promotion project conducted in the UK, were used. Participants self-reported sitting time whilst watching television, using a computer, socialising and travelling by motorised transport. Mental well-being was assessed by the 12-item version of the general health questionnaire. Analyses were conducted using multiple linear regression. In models adjusted for multiple confounders, TV viewing, computer use and total non-occupational sitting time were adversely associated with general health questionnaire-12 assessed mental well-being in women. Computer use only was found to be adversely associated with mental well-being in men. Sedentary behaviour may be adversely associated with mental well-being in employed adults. The association may be moderated by gender.

  5. Ambient monitoring of airborne asbestos in non-occupational environments in Tehran, Iran

    NASA Astrophysics Data System (ADS)

    Kakooei, Hossein; Meshkani, Mohsen; Azam, Kamal

    2013-12-01

    Airborne asbestos fiber concentrations were monitored in the urban areas of Tehran, Iran during the period of 23 August to 21 September 2012. The airborne fiber concentrations of 110 air samples collected from 15 different sites in five regions of Tehran. The monitoring sites were located 2.5 m above ground nearby the main street and heavy traffic jam. The ambient air samples were analyzed using scanning electron microscopy (SEM), with energy-dispersive X-ray analysis and phase-contrast optical microscopy (PCM). The geometric means of the airborne asbestos fiber concentrations in the outdoor living areas was 1.6 × 10-2 SEM f ml-1 (1.18 × 10-3 PCM f ml-1). This criteria is considerably higher than those reported for the levels of asbestos in outdoor living areas in the Europe and the non-occupational environment of the Korea. No clear correlation was found between asbestos fiber concentration and the relative humidity and temperature. The SEM and PLM analysis revealed that all samples examined contained only chrysotile asbestos. It can be concluded that several factor such as heavy traffic, cement sheet and pipe consumption of asbestos, and geographical conditions play an important role for the high airborne asbestos levels in the non-occupational environments.

  6. Non-occupational physical activity levels of shift workers compared with non-shift workers.

    PubMed

    Loef, Bette; Hulsegge, Gerben; Wendel-Vos, G C Wanda; Verschuren, W M Monique; Vermeulen, Roel C H; Bakker, Marije F; van der Beek, Allard J; Proper, Karin I

    2017-05-01

    Lack of physical activity (PA) has been hypothesised as an underlying mechanism in the adverse health effects of shift work. Therefore, our aim was to compare non-occupational PA levels between shift workers and non-shift workers. Furthermore, exposure-response relationships for frequency of night shifts and years of shift work regarding non-occupational PA levels were studied. Data of 5980 non-shift workers and 532 shift workers from the European Prospective Investigation into Cancer and Nutrition-Netherlands (EPIC-NL) were used in these cross-sectional analyses. Time spent (hours/week) in different PA types (walking/cycling/exercise/chores) and intensities (moderate/vigorous) were calculated based on self-reported PA. Furthermore, sports were operationalised as: playing sports (no/yes), individual versus non-individual sports, and non-vigorous-intensity versus vigorous-intensity sports. PA levels were compared between shift workers and non-shift workers using Generalized Estimating Equations and logistic regression. Shift workers reported spending more time walking than non-shift workers (B=2.3 (95% CI 1.2 to 3.4)), but shift work was not associated with other PA types and any of the sports activities. Shift workers who worked 1-4 night shifts/month (B=2.4 (95% CI 0.6 to 4.3)) and ≥5 night shifts/month (B=3.7 (95% CI 1.8 to 5.6)) spent more time walking than non-shift workers. No exposure-response relationships were found between years of shift work and PA levels. Shift workers spent more time walking than non-shift workers, but we observed no differences in other non-occupational PA levels. To better understand if and how PA plays a role in the negative health consequences of shift work, our findings need to be confirmed in future studies. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

  7. Specific antibody responses to three schistosome-related carbohydrate structures in recently exposed immigrants and established residents in an area of Schistosoma mansoni endemicity.

    PubMed

    Naus, Cynthia W A; van Remoortere, Alexandra; Ouma, John H; Kimani, Gachuhi; Dunne, David W; Kamerling, Johannis P; Deelder, André M; Hokke, Cornelis H

    2003-10-01

    By the use of surface plasmon resonance spectroscopy, immunoglobulin G (IgG) subclass and IgM antibodies against three schistosome-derived carbohydrate structures, FLDN (Fucalpha1-3GalNAcbeta1-4GlcNAcbeta1-3Galalpha1), LDN-DF [GalNAcbeta1-4(Fucalpha1-2Fucalpha1-3)GlcNAcbeta1], and LDNF [GalNAcbeta1-4(Fucalpha1-3)GlcNAcbeta1-3Galalpha1], were measured in 184 previously unexposed Kenyan immigrants who moved into the Masongaleni area, where Schistosoma mansoni is endemic. They were sampled within their first year of exposure and again 2 years later. A cohort selected out of the original residents of the area, who had been exposed for many years, served as controls. Associations with responses to S. mansoni worm, egg (SEA), and cercarial (CERC) antigens were examined. In addition, we measured responses to keyhole limpet hemocyanin, a glycoprotein which carries glycan epitopes that are also expressed by schistosomes. Specific IgG1 responses were most pronounced against FLDN and LDN-DF and strongly associated with those previously measured to SEA and CERC. Similarly to previously published age profiles of IgG1 and IgG2 responses to SEA, levels of IgG1 against LDN-DF decreased with age. In contrast, specific IgM responses against the three schistosome-derived carbohydrate structures were most marked against LDNF. Our results indicate that, of the three glycan structures tested, the acute response against schistosome glycoconjugate antigens in young children is mainly directed against the LDN-DF epitope. The response to LDN-DF in older individuals and the responses to the two other epitopes were similar in the two cohorts, suggesting that these antigens are recognized in the early stages of infection and that the immune response persists. The biological significance of these observations needs further elucidation.

  8. Knowledge and attitudes of non-occupational HIV post-exposure prophylaxis amongst first- and second-year medical students at Stellenbosch University in South Africa

    PubMed Central

    Meintjes, Willem A.J.; Chola, Lumbwe

    2014-01-01

    Abstract Background Human immunodeficiency virus (HIV) infection is a worldwide problem, with 68% of infected people residing in sub-Saharan Africa. Antiretroviral therapy is used as post-exposure prophylaxis (PEP) to prevent infection in cases of occupational exposure, and use has recently been expanded to non-occupational exposure. Studies have demonstrated a lack of awareness of non-occupational PEP (NO-PEP) in the general population. Aim The aim of this study was to evaluate knowledge and attitudes towards availability of, access to and use of NO-PEP amongst first- and second-year medical students. Setting Participants were medical undergraduates of Stellenbosch University in the Western Cape of South Africa who were registered in 2013. Methods A descriptive cross-sectional study of 169 students was performed. Data were collected using self-administered questionnaires handed out in a classroom in August 2013. Self-reported knowledge and attitudes towards NO-PEP and barriers to access to and use of NO-PEP were analysed using frequency tables. Associations between self-reported and objective knowledge of NO-PEP were analysed by odds ratios. Results Over 90% of students had good knowledge on HIV transmission, and about 75% knew how it can be prevented. Twenty eight per cent (n = 47) of students reported knowledge of NO-PEP; 67% reported hearing about it from lecturers, whilst 1% reported hearing about it from their partner. Students who knew the correct procedure to take when a dose is forgotten were 2.4 times more likely to report knowledge of NO-PEP than those who did not know what to do when a dose is forgotten (p = 0.029). No other associations were statistically significant. Conclusion Students had positive attitudes towards the use of NO-PEP and also identified barriers to its use. Despite good knowledge of HIV prevention and transmission, knowledge on NO-PEP was poor. PMID:26245421

  9. Personal and non-occupational risk factors and occupational injury/illness.

    PubMed

    Craig, Brian N; Congleton, Jerome J; Kerk, Carter J; Amendola, Alfred A; Gaines, William G

    2006-04-01

    The materials handling industry performs is an essential function in the world economy, however, it is plagued with occupationally related injuries and illnesses. Understanding the risk factors may assist this industry in alleviating these injuries and illnesses, as well as their associated costs. Forty-eight personal and non-occupational risk factors were measured and evaluated for statistically significant relationships with occupational injury in 442 volunteer manual material handlers who worked for three different companies, at nine US locations, with 15 different job descriptions. OSHA 200 logs were used to ascertain evidence of occupational injury within this population for 1 year after the testing and measurement was completed. Higher occurrences of injury were significantly associated with six risk factors in the univariate model (odds ratios 1.51-4.00). The significantly (P < 0.05) related risk factors in the univariate model were aerobic power, smoking status, perceived fitness level, fishing/hunting as a hobby, speed limit obeyance, and witnessing or being involved in a violent fight. In the multivariate analysis, five risk factors (aerobic power, smoking status, percent body fat, body mass index, and sit-and-reach measured flexibility) were significantly (P < 0.05) associated with occupational injury. Odds ratios in the multivariate analysis varied from 1.42 to 10.11. Evidence of an association of occupational injury occurrence with certain risk factors presented in personal and non-occupational univariate and multivariate models is shown. In industry, effective injury reduction programs should go beyond traditional methods of job-related ergonomic risk factors and include personal factors such as smoking, weight control, and alcohol abuse. Copyright 2006 Wiley-Liss, Inc.

  10. Specific Antibody Responses to Three Schistosome-Related Carbohydrate Structures in Recently Exposed Immigrants and Established Residents in an Area of Schistosoma mansoni Endemicity

    PubMed Central

    Naus, Cynthia W. A.; van Remoortere, Alexandra; Ouma, John H.; Kimani, Gachuhi; Dunne, David W.; Kamerling, Johannis P.; Deelder, André M.; Hokke, Cornelis H.

    2003-01-01

    By the use of surface plasmon resonance spectroscopy, immunoglobulin G (IgG) subclass and IgM antibodies against three schistosome-derived carbohydrate structures, FLDN (Fucα1-3GalNAcβ1-4GlcNAcβ1-3Galα1), LDN-DF [GalNAcβ1-4(Fucα1-2Fucα1-3)GlcNAcβ1], and LDNF [GalNAcβ1-4(Fucα1-3)GlcNAcβ1-3Galα1], were measured in 184 previously unexposed Kenyan immigrants who moved into the Masongaleni area, where Schistosoma mansoni is endemic. They were sampled within their first year of exposure and again 2 years later. A cohort selected out of the original residents of the area, who had been exposed for many years, served as controls. Associations with responses to S. mansoni worm, egg (SEA), and cercarial (CERC) antigens were examined. In addition, we measured responses to keyhole limpet hemocyanin, a glycoprotein which carries glycan epitopes that are also expressed by schistosomes. Specific IgG1 responses were most pronounced against FLDN and LDN-DF and strongly associated with those previously measured to SEA and CERC. Similarly to previously published age profiles of IgG1 and IgG2 responses to SEA, levels of IgG1 against LDN-DF decreased with age. In contrast, specific IgM responses against the three schistosome-derived carbohydrate structures were most marked against LDNF. Our results indicate that, of the three glycan structures tested, the acute response against schistosome glycoconjugate antigens in young children is mainly directed against the LDN-DF epitope. The response to LDN-DF in older individuals and the responses to the two other epitopes were similar in the two cohorts, suggesting that these antigens are recognized in the early stages of infection and that the immune response persists. The biological significance of these observations needs further elucidation. PMID:14500488

  11. Multicentric study on malignant pleural mesothelioma and non-occupational exposure to asbestos

    PubMed Central

    Magnani, C; Agudo, A; González, C A; Andrion, A; Calleja, A; Chellini, E; Dalmasso, P; Escolar, A; Hernandez, S; Ivaldi, C; Mirabelli, D; Ramirez, J; Turuguet, D; Usel, M; Terracini, B

    2000-01-01

    Insufficient evidence exists on the risk of pleural mesothelioma from non-occupational exposure to asbestos. A population-based case–control study was carried out in six areas from Italy, Spain and Switzerland. Information was collected for 215 new histologically confirmed cases and 448 controls. A panel of industrial hygienists assessed asbestos exposure separately for occupational, domestic and environmental sources. Classification of domestic and environmental exposure was based on a complete residential history, presence and use of asbestos at home, asbestos industrial activities in the surrounding area, and their distance from the dwelling. In 53 cases and 232 controls without evidence of occupational exposure to asbestos, moderate or high probability of domestic exposure was associated with an increased risk adjusted by age and sex: odds ratio (OR) 4.81, 95% confidence interval (CI) 1.8–13.1. This corresponds to three situations: cleaning asbestos-contaminated clothes, handling asbestos material and presence of asbestos material susceptible to damage. The estimated OR for high probability of environmental exposure (living within 2000 m of asbestos mines, asbestos cement plants, asbestos textiles, shipyards, or brakes factories) was 11.5 (95% CI 3.5–38.2). Living between 2000 and 5000 m from asbestos industries or within 500 m of industries using asbestos could also be associated with an increased risk. A dose–response pattern appeared with intensity of both sources of exposure. It is suggested that low-dose exposure to asbestos at home or in the general environment carries a measurable risk of malignant pleural mesothelioma. © 2000 Cancer Research Campaign PMID:10883677

  12. A positive chemical ionization GC/MS method for the determination of airborne ethylene glycol and propylene glycols in non-occupational environments.

    PubMed

    Zhu, Jiping; Feng, Yong-Lai; Aikawa, Bio

    2004-11-01

    An analytical method for ethylene glycol and propylene glycols has been developed for measuring airborne levels of these chemicals in non-occupational environments such as residences and office buildings. The analytes were collected on charcoal tubes, solvent extracted, and analyzed by gas chromatography-mass spectrometry using a positive chemical ionization technique. The method had a method detection limit of 0.07 microg m(-3) for ethylene glycol and 0.03 microg m(-3) for 1,2- and 1,3-propylene glycols, respectively, based on a 1.44 m3 sampling volume. Indoor air samples of several residential homes and other indoor environments have been analyzed. The median concentrations of ethylene glycol and 1,2-propylene glycol in nine residential indoor air samples were 53 microg m(-3) and 13 microg m(-3) respectively with maximum values of 223 microg m(-3) and 25 microg m(-3) detected for ethylene glycol and 1,2-propylene glycol respectively. The concentrations of these two chemicals in one office and two laboratories were at low microg m(-3) levels. The maximum concentration of 1,3-propylene glycol detected in indoor air was 0.1 microg m(-3).

  13. Integrated approach to health screening of former department of energy workers detects both occupational and non-occupational illness.

    PubMed

    Stange, Bill; McInerney, John; Golden, Ashley; Benade, Wendy; Neill, Barbara; Mayer, Annyce; Witter, Roxana; Tenney, Liliana; Stinson, Kaylan; Cragle, Donna; Newman, Lee S

    2016-03-01

    The National Supplemental Screening Program (NSSP) uses a Total Worker Health(TM) approach to address U.S. Department of Energy (DOE) former worker health. This article provides the design of the integrated occupational health screening and promotion program. The NSSP implemented a web-based relational health records system to process demographic, exposure, and clinical data. We present medical findings for 12,000 DOE former workers that completed an initial NSSP medical screening between October 1, 2005 and October 4, 2013. We discuss the DOE former worker participant population and the exposure-based and non-occupational medical screening tests used. The NSSP identified potential occupationally related health conditions in 40.5% of those screened. Notably, we identified 85.8% of participants with addressable non-occupational health conditions, many of which were previously undiagnosed. The NSSP demonstrates that the identification of potential occupational health issues in conjunction with addressable non-occupational health conditions provides former workers with information to more effectively manage health. © 2016 Wiley Periodicals, Inc.

  14. Design, methods, and population for a study of PFOA health effects among highly exposed mid-Ohio valley community residents and workers.

    PubMed

    Winquist, Andrea; Lally, Cathy; Shin, Hyeong-Moo; Steenland, Kyle

    2013-08-01

    A cohort of community residents and workers is the basis for a series of epidemiologic studies of a Mid-Ohio Valley population with substantial perfluorooctanoic acid (PFOA) exposure due to releases from a chemical plant. We describe study design, methods, and study participants for a longitudinal cohort study of associations between PFOA exposure and adult chronic diseases. Two cohorts were formed, one recruited from community residents who participated in a previous community-wide survey, and one from plant workers. Study participants were interviewed during 2008-2011 regarding demographics, health-related behaviors, and personal history of chronic diseases. Reported diseases were validated through medical records review and registry matching. Here we describe cohort characteristics, compare survey respondents and nonrespondents, provide data on the number of diseases reported and validated, and describe historical estimates of serum PFOA concentrations over time. The final combined cohort included 32,254 participants (28,541 community; 3,713 worker). Participation rates were high (community, 81.5%; worker, 72.9% of target population). The final population from each cohort was representative of the target population in terms of demographic characteristics and measured serum PFOA concentrations in 2005-2006. The study had a wide exposure range and the number of reported cases of chronic diseases was high, resulting in greater power to detect associations than has been the case for many previous studies. This is the largest study to date of the health effects of PFOA. The information from this cohort is being used to examine associations between PFOA exposure and multiple adult chronic diseases.

  15. Temporal trends in non-occupational sedentary behaviours from Australian Time Use Surveys 1992, 1997 and 2006.

    PubMed

    Chau, Josephine Y; Merom, Dafna; Grunseit, Anne; Rissel, Chris; Bauman, Adrian E; van der Ploeg, Hidde P

    2012-06-19

    Current epidemiological data highlight the potential detrimental associations between sedentary behaviours and health outcomes, yet little is known about temporal trends in adult sedentary time. This study used time use data to examine population trends in sedentary behaviours in non-occupational domains and more specifically during leisure time. We conducted secondary analysis of population representative data from the Australian Time Use Surveys 1992, 1997 and 2006 involving respondents aged 20 years and over with completed time use diaries for two days. Weighted samples for each survey year were: n = 5851 (1992), n = 6419 (1997) and n = 5505 (2006). We recoded all primary activities by domain (sleep, occupational, transport, leisure, household, education) and intensity (sedentary, light, moderate). Adjusted multiple linear regressions tested for differences in time spent in non-occupational sedentary behaviours in 1992 and 1997 with 2006 as the reference year. Total non-occupational sedentary time was slightly lower in 1997 than in 2006 (mean = 894 min/2d and 906 min/2d, respectively; B = -11.2; 95%CI: -21.5, -0.9). Compared with 2006, less time was spent in 1997 in sedentary transport (B-6.7; 95%CI: -10.4, -3.0) and sedentary education (B = -6.3; 95%CI: -10.5, -2.2) while household and leisure sedentary time remained stable. Time engaged in different types of leisure-time sedentary activities changed between 1997 and 2006: leisure-time computer use increased (B = -26.7; 95%CI: -29.5, -23.8), while other leisure-time sedentary behaviours (e.g., reading, listening to music, hobbies and crafts) showed small concurrent reductions. In 1992, leisure screen time was lower than in 2006: TV-viewing (B = -24.2; 95%CI: -31.2, -17.2), computer use (B = -35.3; 95%CI: -37.7, -32.8). In 2006, 90 % of leisure time was spent sedentary, of which 53 % was screen time. Non-occupational sedentary time has increased slightly from 1997 to 2006 in

  16. Cerebrospinal Fluid Biomarkers in Highly Exposed PM2.5 Urbanites: The Risk of Alzheimer's and Parkinson's Diseases in Young Mexico City Residents.

    PubMed

    Calderón-Garcidueñas, Lilian; Avila-Ramírez, José; Calderón-Garcidueñas, Ana; González-Heredia, Tonatiuh; Acuña-Ayala, Hilda; Chao, Chih-Kai; Thompson, Charles; Ruiz-Ramos, Rubén; Cortés-González, Victor; Martínez-Martínez, Luz; García-Pérez, Mario Alberto; Reis, Jacques; Mukherjee, Partha S; Torres-Jardón, Ricardo; Lachmann, Ingolf

    2016-09-06

    Exposure to fine particulate matter (PM2.5) and ozone (O3) above US EPA standards is associated with Alzheimer's disease (AD) risk, while Mn toxicity induces parkinsonism. Mexico City Metropolitan Area (MCMA) children have pre- and postnatal sustained and high exposures to PM2.5, O3, polycyclic aromatic hydrocarbons, and metals. Young MCMA residents exhibit frontal tau hyperphosphorylation and amyloid-β (Aβ)1 - 42 diffuse plaques, and aggregated and hyperphosphorylated α-synuclein in olfactory nerves and key brainstem nuclei. We measured total prion protein (TPrP), total tau (T-tau), tau phosphorylated at threonine 181 (P-Tau), Aβ1-42, α-synuclein (t-α-syn and d-α-synuclein), BDNF, insulin, leptin, and/or inflammatory mediators, in 129 normal CSF samples from MCMA and clean air controls. Aβ1-42 and BDNF concentrations were significantly lower in MCMA children versus controls (p = 0.005 and 0.02, respectively). TPrP increased with cumulative PM2.5 up to 5 μg/m3 and then decreased, regardless of cumulative value or age (R2 = 0.56). TPrP strongly correlated with T-Tau and P-Tau, while d-α-synuclein showed a significant correlation with TNFα, IL10, and IL6 in MCMA children. Total synuclein showed an increment in childhood years related to cumulated PM2.5, followed by a decrease after age 12 years (R2 = 0.47), while d-α-synuclein exhibited a tendency to increase with cumulated PM2.5 (R2 = 0.30). CSF Aβ1-42, BDNF, α-synuclein, and TPrP changes are evolving in young MCMA urbanites historically showing underperformance in cognitive processes, odor identification deficits, downregulation of frontal cellular PrP, and neuropathological AD and PD hallmarks. Neuroprotection of young MCMA residents ought to be a public health priority.

  17. Ulcerative Colitis and Perfluorooctanoic Acid (PFOA) in a Highly Exposed Population of Community Residents and Workers in the Mid-Ohio Valley

    PubMed Central

    Zhao, Liping; Winquist, Andrea; Parks, Christine

    2013-01-01

    Background: Little is known about environmental determinants of autoimmune diseases. Objectives: We studied autoimmune diseases in relation to level of exposure to perfluorooctanoic acid (PFOA), which was introduced in the late 1940s and is now ubiquitous in the serum of residents of industrialized countries. Methods: In 2008–2011 we interviewed 32,254 U.S. adults with high serum PFOA serum levels (median, 28 ng/mL) associated with drinking contaminated water near a chemical plant. Disease history was assessed retrospectively from 1952 or birth (if later than 1952) until interview. Self-reported history of autoimmune disease was validated via medical records. Cumulative exposure to PFOA was derived from estimates of annual mean serum PFOA levels during follow-up, which were based on plant emissions, residential and work history, and a fate-transport model. Cox regression models were used to estimate associations between quartiles of cumulative PFOA serum levels and the incidence of autoimmune diseases with ≥ 50 validated cases, including ulcerative colitis (n = 151), Crohn’s disease (n = 96), rheumatoid arthritis (n = 346), insulin-dependent diabetes (presumed to be type 1) (n = 160), lupus (n = 75), and multiple sclerosis (n = 98). Results: The incidence of ulcerative colitis was significantly increased in association with PFOA exposure, with adjusted rate ratios by quartile of exposure of 1.00 (referent), 1.76 (95% CI: 1.04, 2.99), 2.63 (95% CI: 1.56, 4.43), and 2.86 (95% CI: 1.65, 4.96) (ptrend < 0.0001). A prospective analysis of ulcerative colitis diagnosed after the baseline 2005–2006 survey (n = 29 cases) suggested a positive but non-monotonic trend (ptrend = 0.21). Discussion: To our knowledge, this is the first study of associations between this common environmental exposure and autoimmune diseases in humans. We found evidence that PFOA is associated with ulcerative colitis. PMID:23735465

  18. Occupational and non-occupational factors associated with work-related injuries among construction workers in the USA.

    PubMed

    Dong, Xiuwen Sue; Wang, Xuanwen; Largay, Julie A

    2015-01-01

    Many factors contribute to occupational injuries. However, these factors have been compartmentalized and isolated in most studies. To examine the relationship between work-related injuries and multiple occupational and non-occupational factors among construction workers in the USA. Data from the 1988-2000 National Longitudinal Survey of Youth, 1979 cohort (N = 12,686) were analyzed. Job exposures and health behaviors were examined and used as independent variables in four multivariate logistic regression models to identify associations with occupational injuries. After controlling for demographic variables, occupational injuries were 18% (95% CI: 1.04-1.34) more likely in construction than in non-construction. Blue-collar occupations, job physical efforts, multiple jobs, and long working hours accounted for the escalated risk in construction. Smoking, obesity/overweight, and cocaine use significantly increased the risk of work-related injury when demographics and occupational factors were held constant. Workplace injuries are better explained by simultaneously examining occupational and non-occupational characteristics.

  19. Occupational and non-occupational factors associated with work-related injuries among construction workers in the USA

    PubMed Central

    Dong, Xiuwen Sue; Wang, Xuanwen; Largay, Julie A.

    2015-01-01

    Background: Many factors contribute to occupational injuries. However, these factors have been compartmentalized and isolated in most studies. Objective: To examine the relationship between work-related injuries and multiple occupational and non-occupational factors among construction workers in the USA. Methods: Data from the 1988–2000 National Longitudinal Survey of Youth, 1979 cohort (N = 12,686) were analyzed. Job exposures and health behaviors were examined and used as independent variables in four multivariate logistic regression models to identify associations with occupational injuries. Results: After controlling for demographic variables, occupational injuries were 18% (95% CI: 1.04–1.34) more likely in construction than in non-construction. Blue-collar occupations, job physical efforts, multiple jobs, and long working hours accounted for the escalated risk in construction. Smoking, obesity/overweight, and cocaine use significantly increased the risk of work-related injury when demographics and occupational factors were held constant. Conclusions: Workplace injuries are better explained by simultaneously examining occupational and non-occupational characteristics. PMID:25816923

  20. Associations between the polymorphisms of GSTT1, GSTM1 and methylation of arsenic in the residents exposed to low-level arsenic in drinking water in China.

    PubMed

    Yang, Jinyou; Yan, Li; Zhang, Min; Wang, Yijun; Wang, Chun; Xiang, Quanyong

    2015-07-01

    We carry out a study to analyze the relation between polymorphisms of GSTT1, GSTM1 and the capacity of arsenic methylation in a human population exposed to arsenic in drinking water. 230 randomly chose subjects were divided into four subgroups based on the arsenic levels, and then the associations between the polymorphisms of GSTT1, GSTM1 and methylation of arsenic were investigated. The levels of inorganic arsenic (iAs), monomethylated arsenic (MMA), dimethylated arsenic (DMA) and total arsenic (TAs) in urine were higher in males than that in females. Moreover, the levels of iAs and TAs in urine in the subjects with genotype of GSTM1(+) were significantly higher than those with GSTM1(-); the level of DMA in the subjects with GSTT1(+) and GSTM1(+) were higher than those with GSTT1(-) and GSTM1(-), although it is not statistically significant. Secondary methylation index (SMI) was significantly higher in the subjects with genotype of GSTT1(+) than those with GSTT1(-). The levels of TAs in urine, together with the genotypes of GSTT1/GSTM1 were associated with the levels of MMA and DMA. Our results suggested that the polymorphisms of GSTT1 and GSTM1 were associated with the methylation of arsenic, especially the levels of DMA and SMI.

  1. Leadership Training in Otolaryngology Residency.

    PubMed

    Bent, John P; Fried, Marvin P; Smith, Richard V; Hsueh, Wayne; Choi, Karen

    2017-06-01

    Although residency training offers numerous leadership opportunities, most residents are not exposed to scripted leadership instruction. To explore one program's attitudes about leadership training, a group of otolaryngology faculty (n = 14) and residents (n = 17) was polled about their attitudes. In terms of self-perception, more faculty (10 of 14, 71.4%) than residents (9 of 17, 52.9%; P = .461) considered themselves good leaders. The majority of faculty and residents (27 of 31) thought that adults could be taught leadership ability. Given attitudes about leadership ability and the potential for improvement through instruction, consideration should be given to including such training in otolaryngology residency.

  2. Non-occupational exposure to paint fumes during pregnancy and risk of congenital anomalies: a cohort study.

    PubMed

    Hjortebjerg, Dorrit; Andersen, Anne-Marie Nybo; Garne, Ester; Raaschou-Nielsen, Ole; Sørensen, Mette

    2012-08-14

    Occupational exposure to organic solvents during the 1st trimester of pregnancy has been associated with congenital anomalies. Organic solvents are also used in the home environments in paint products, but no study has investigated the effect of such exposure in a general population. We studied associations between residential exposure to paint fumes during the 1st trimester of pregnancy and predefined subgroups of congenital anomalies, using data from the Danish National Birth Cohort (DNBC). During 2001 and 2003, a total of 20,103 pregnant women, enrolled in the DNBC, were interviewed in the 30th week of gestation about the use of paint in their residence during pregnancy. By the end of first trimester, information about smoking habits, alcohol consumption and occupation were collected. Information on congenital anomalies was obtained from national registers. Associations were examined by estimating odds ratios (OR) using logistic regression. In total 1404 women (7%) had been exposed to paint fumes during the 1st trimester of pregnancy and 1086 children were diagnosed with congenital anomalies; 73 children with congenital anomalies had been exposed to paint fumes in utero. Exposure to paint fumes seemed positively associated with congenital anomalies of the nervous system (OR 2.19, 95% confidence interval (CI) 0.76 to 6.32), ear, face and neck (OR 2.15, 95% CI 0.84 to 5.55) and the renal system (OR 2.16, 95% CI 1.02 to 4.58) after adjustment for maternal age, smoking, alcohol consumption and occupational solvent exposure. Congenital anomalies in the remaining subgroups were not associated with the exposure. Our results suggest that in the general population, exposure to paint fumes during the 1st trimester of pregnancy may increase the risk of some types of congenital anomalies, but the findings need to be confirmed.

  3. Non-occupational exposure to paint fumes during pregnancy and risk of congenital anomalies: a cohort study

    PubMed Central

    2012-01-01

    Background Occupational exposure to organic solvents during the 1st trimester of pregnancy has been associated with congenital anomalies. Organic solvents are also used in the home environments in paint products, but no study has investigated the effect of such exposure in a general population. Methods We studied associations between residential exposure to paint fumes during the 1st trimester of pregnancy and predefined subgroups of congenital anomalies, using data from the Danish National Birth Cohort (DNBC). During 2001 and 2003, a total of 20 103 pregnant women, enrolled in the DNBC, were interviewed in the 30th week of gestation about the use of paint in their residence during pregnancy. By the end of first trimester, information about smoking habits, alcohol consumption and occupation were collected. Information on congenital anomalies was obtained from national registers. Associations were examined by estimating odds ratios (OR) using logistic regression. Results In total 1404 women (7%) had been exposed to paint fumes during the 1st trimester of pregnancy and 1086 children were diagnosed with congenital anomalies; 73 children with congenital anomalies had been exposed to paint fumes in utero. Exposure to paint fumes seemed positively associated with congenital anomalies of the nervous system (OR 2.19, 95% confidence interval (CI) 0.76 to 6.32), ear, face and neck (OR 2.15, 95% CI 0.84 to 5.55) and the renal system (OR 2.16, 95% CI 1.02 to 4.58) after adjustment for maternal age, smoking, alcohol consumption and occupational solvent exposure. Congenital anomalies in the remaining subgroups were not associated with the exposure. Conclusions Our results suggest that in the general population, exposure to paint fumes during the 1st trimester of pregnancy may increase the risk of some types of congenital anomalies, but the findings need to be confirmed. PMID:22892023

  4. [Comparison of perfluorooctane sulfonate and perfluorooctane acid in serum of non-occupational human from Shenyang and Chongqing areas].

    PubMed

    Jin, Yi-He; Dong, Guang-Hui; Shu, Wei-Qun; Ding, Mei; Zhai, Cheng; Wang, Lie; Liu, Xiao; Saitou, Norimistu; Sasaki, Kazuaki

    2006-09-01

    The purpose of this investigation was to illustrate the perfluorooctane sulfonate (PFOS) and perfluorooctane acid (PFOA) levels in serum of non-occupational exposure human from Shenyang and Chongqing areas and to compare the distributing character and region difference of PFOS and PFOA in those two region human. Sera samples of non-occupational human from Shenyang and Chongqing areas were collected, and the concentration of PFOS and PFOA in serum were measured by High Performance Liquid Chromatography/Mass Selective Detector (HPLC/MS-MIS). The average Shenyang and Chongqing fluorochemical concentrations, respectively, were as follows: PFOS, 22.40 microg/L vs 7.40 microg/L, PFOA, 4.32 microg/L vs 1.00 microg/L. Statistical analysis indicated that serum concentrations of PFOS and PFOA were significantly (P < 0.01) higher in Shenyang human than in Chongqing human. Furthermore, there are sex differences in PFOS and PFOA concentrations in serum at all location. In Shenyang the concentration of PFOS in females were significantly (P < 0.05) higher than in males. The correlations of PFOS (r = 0.298) and PFOA (r = 0.271) with age were significant in females from Chongqing area, and especially the correlations were higher in older females (age t 50) than the groups of age < 13 and 13 - 50 years old. This finding suggests that there are predominant regional differences and distributing character for both PFOS and PFOA concentrations in Shenyang and Chongqing areas, and the concentrations of PFOS and PFOA in serum were correlated with age and sex.

  5. [Relationship of blood aryl hydrocarbon receptor mRNA and cytochrome P450 1A1 mRNA expression with corrected QT interval among residents exposed to arsenic via drinking water].

    PubMed

    Cui, N; Li, Y H; Liu, J P; Wu, K G; Xia, Y J

    2016-03-01

    To investigate the relationship between blood aryl hydrocarbon receptor(AhR)mRNA and cytochrome P450(CYP)1A1 mRNA expression and corrected QT interval among residents exposed to arsenic via drinking water. Arsenic exposure area in Bayannao'er city of Nei Monggol Autonomous Region was selected as the survey point, and the residents living more than 10 years in this area were investigated from December 2012 to January 2015.A total of 233 residents were divided into four groups according to drinking water arsenic concentration (ranged from 0.8 to 824.7 μg/L): control group (drinking water arsenic concentration <10.0 μg/L, n=55), low exposure group (drinking water arsenic concentration 10.0-99.9 μg/L, n=47), middle exposure group (drinking water arsenic concentration 100.0-199.9 μg/L, n=45), high exposure group (drinking water arsenic concentration ≥200.0 μg/L, n=86). Epidemiological investigation was performed.Real-time PCR technology was used to detect the expression levels of blood AhR mRNA and CYP1A1 mRNA, and the relationship between expression levels of blood AhR mRNA and CYP1A1 mRNA and corrected QT interval was analyzed. (1) Blood AhR mRNA and CYP1A1 mRNA expression levels were similar among control group, low exposure group and middle exposure group (all P>0.05) while blood AhR mRNA (3.18×10(-3)(2.42×10(-3), 4.45×10(-3)) vs.2.30×10(-3)(1.53×10(-3), 3.20×10(-3)), P<0.05) and CYP1A1 mRNA (1.58×10(-3)(0.80×10(-3), 2.73×10(-3))vs.1.00×10(-3)(0.59×10(-3), 2.09×10(-3)), P<0.05) expression levels were significantly higher in high dose group than in control group.(2) AhR mRNA expression level was similar between residents with longer corrected QT interval and residents with normal corrected QT interval (2.89×10(-3)(1.90×10(-3), 3.71×10(-3)) vs.2.58×10(-3)(1.85×10(-3), 3.57×10(-3)), P>0.05). CYP1A1 mRNA expression level was significantly higher in residents with longer corrected QT interval than in residents with normal corrected QT interval (1

  6. A systematic review of the physical health impacts from non-occupational exposure to wildfire smoke

    PubMed Central

    Liu, Jia C.; Pereira, Gavin; Uhl, Sarah A.; Bravo, Mercedes A.; Bell, Michelle L.

    2014-01-01

    Background Climate change is likely to increase threat of wildfires, and little is known about how wildfires affect health in exposed communities. A better understanding of the impacts of the resulting air pollution has important public health implications for the present day and the future. Method We performed a systematic search to identify peer-reviewed scientific studies published since 1986 regarding impacts of wildfire smoke on health in exposed communities. We reviewed and synthesized the state of science of this issue including methods to estimate exposure, and identified limitations in current research. Results We identified 61 epidemiological studies linking wildfire and human health in communities. The U.S. and Australia were the most frequently studied countries (18 studies on the U.S., 15 on Australia). Geographic scales ranged from a single small city (population about 55,000) to the entire globe. Most studies focused on areas close to fire events. Exposure was most commonly assessed with stationary air pollutant monitors (35 of 61 studies). Other methods included using satellite remote sensing and measurements from air samples collected during fires. Most studies compared risk of health outcomes between 1) periods with no fire events and periods during or after fire events, or 2) regions affected by wildfire smoke and unaffected regions. Daily pollution levels during or after wildfire in most studies exceeded U.S. EPA regulations. Levels of PM10, the most frequently studied pollutant, were 1.2 to 10 times higher due to wildfire smoke compared to non-fire periods and/or locations. Respiratory disease was the most frequently studied health condition, and had the most consistent results. Over 90% of these 45 studies reported that wildfire smoke was significantly associated with risk of respiratory morbidity. Conclusion Exposure measurement is a key challenge in current literature on wildfire and human health. A limitation is the difficulty of estimating

  7. Levels of polychlorinated dibenzo-p-dioxins and dibenzofurans (PCDD/Fs) and trace metals in the blood of nonoccupationally exposed residents living in the vicinity of a municipal solid waste incinerator and electric arc furnace.

    PubMed

    Chen, Yan-Min; Lin, Yuan-Chung; Wu, Tzi-Yi; Chang-Chien, Guo-Ping; Ma, Wen-Feng

    2010-06-01

    This study examines levels of polychlorinated dibenzo-p-dioxins (PCDDs), polychlorinated dibenzofurans (PCDFs), and trace metals in the blood of the nonoccupationally exposed residents living in the vicinity of municipal solid waste incinerators (MSWIs) and electric arc furnaces (EAFs). The analysis found that older females had higher concentrations of PCDD/Fs and older males had higher body mass index (BMI) values and higher concentrations of PCDD/Fs. Moreover, sex appeared to affect the levels of PCDD/Fs because, overall, females showed higher levels of PCDD/Fs. The results of a principal component analysis indicated that the characteristics of the blood were more similar to the characteristics of the stack flux gas in MSWIs than those in EAFs. When sex, age, and BMI values were taken into consideration, none of the factors appeared to significantly affect PCDD/F and trace metal blood levels. However, when participants were divided into eight categories and analyzed, it was found that sex was the most important factor affecting levels of trace metals in blood and that males had higher concentrations of Pb, Al, Cd, and Cu.

  8. Estimated exposure of hands inside the protective gloves used by non-occupational handlers of agricultural pesticides.

    PubMed

    Beránková, Martina; Hojerová, Jarmila; Peráčková, Zuzana

    2016-08-31

    Exposure of handlers'/operators' hands is a main route of agricultural pesticides entry into their body. Non-occupational handlers still lack information about appropriate selection of protective gloves to minimize exposure and reduce adverse effects of these chemicals. According to the results of our previous survey, six commercially available, water-resistant gloves commonly used by non-professional gardeners were evaluated for permeation of Acetamiprid, Pirimicarb, and Chlorpyrifos-methyl (Chlorp-m) pesticides by means of in vitro testing. In-use conditions were mimicked as close as possible. Chlorp-m through latex was observed inside the glove from >10 to ⩽15 min; however, Acetamiprid and Pirimicarb through neoprene/latex and all the three pesticides through butyl were not observed inside gloves for the duration of the experiments (the Breakthrough time (BT)>8 h). The 1-h exposure proved the interior glove contamination with Chlorp-m through disposable latex, vinyl, and nitrile gloves (51, 33, and 41% of applied dose (AD), respectively) just as with Acetamiprid and Pirimicarb through latex glove (11 and 14%AD, respectively). However, when storing the used gloves for 4 days after the exposure, no release of the three pesticides from the butyl and Acetamiprid from neoprene/latex gloves was detected. In all other cases, pesticides were found in the interior glove (36-79, 31-63, and 51-81%AD for Acetamiprid, Pirimicarb, and Chlorp-m, respectively). If used repeatedly, gloves contaminated in this way lose their protective function but give the user a false sense of security. The results suggest that (i) water-resistant gloves are not necessarily pesticide resistant; (ii) disposable latex gloves commonly worn by non-professional gardeners provide inadequate protection even for a short-time contact with pesticides; (iii) to assess the efficiency of reusable gloves, not only BT value but also the reservoir/release effect of parent pesticide and its degradation

  9. Resident resistance.

    PubMed

    Price, J L; Cleary, B

    1999-01-01

    Clearly, faculty must work hard with residents to explore the nature of their resistance to a program's learning and growth opportunities. Initial steps to a deeper, more effective, and longer-lasting change process must be pursued. If resident resistance is mishandled or misunderstood, then learning and professional growth may be sidetracked and the purposes of residency training defeated. Listening to the whole person of the resident and avoiding the trap of getting caught up in merely responding to select resident behaviors that irritate us is critical. Every faculty member in the family practice residency program must recognize resistance as a form of defense that cannot immediately be torn down or taken away. Resident defenses have important purposes to play in stress reduction even if they are not always healthy. Residents, especially interns, use resistance to avoid a deeper and more truthful look at themselves as physicians. A family practice residency program that sees whole persons in their residents and that respects resident defenses will effectively manage the stress and disharmony inherent to the resistant resident.

  10. A review of epidemiologic studies of low-level exposures to organophosphorus insecticides in non-occupational populations.

    PubMed

    Reiss, Richard; Chang, Ellen T; Richardson, Rudy J; Goodman, Michael

    2015-01-01

    This paper systematically reviews epidemiologic studies related to low-level non-occupational exposures to organophosphorus (OP) insecticides. Many of the studies evaluate levels of maternal OP metabolites and subsequent health outcomes in offspring. The studies focused primarily on birth outcomes (e.g., infant body weight or head circumference) and neurodevelopmental (e.g., mental and psychomotor) testing results. The evidence from these studies was reviewed under the Bradford Hill guidelines. Most of the studies assessing exposure based on urinary levels of OP insecticide metabolites used only one or two measurements during pregnancy. The potential for exposure misclassification with this method is largely due to (1) preformed metabolites that are ingested with food, (2) the short elimination half-life of OP insecticides, and (3) lack of specificity to particular OP insecticides for many of the metabolites. For birth outcomes, the majority of reported results are not statistically significant, and the associations are inconsistent within and across studies. There is more within-study consistency for some of the neurodevelopmental testing results, although few associations were examined across several studies. These associations are generally weak, have been replicated only to a limited extent, and require further confirmation before they can be considered established. The OP insecticide levels measured in the epidemiologic studies are too low to cause biologically meaningful acetylcholinesterase inhibition, the most widely used metric for OP insecticide toxicity. Overall, the available evidence does not establish that low-level exposures to OP insecticides cause adverse birth outcomes or neurodevelopmental problems in humans.

  11. Analytical Method Developed for Measurement of Dialkylphosphate Metabolites in Urine Collected from Children Non-Occupationally Exposed to Organophosphate Pesticides in an Agricultural Community in Thailand

    PubMed Central

    Petchuay, Chidhathai; Thoumsang, Somkiet; Visuthismajarn, Parichart; Vitayavirasak, Banjong; Buckley, Brian; Hore, Paromita; Borjan, Marija; Robson, Mark

    2015-01-01

    There has been increasing concern in regards to organophosphate (OP) pesticide exposure among farm workers and their families in Thailand's agricultural areas. Therefore, the development of an analytical method for estimating OP pesticide exposure is necessary to allow for monitoring of OP pesticide exposures within these populations. This paper describes an analytical method developed to measure dialkylphosphate (DAP) metabolites in urine. The methods in this study are important in the biological monitoring of OP metabolites in agricultural families in Thailand and can be used as an initial guidance procedure in any environmental toxicological laboratory in Thailand. PMID:18766287

  12. Assessment of blood and urine lead levels of some pregnant women residing in Lagos, Nigeria.

    PubMed

    Adekunle, Iheoma M; Ogundele, Joseph A; Oguntoke, Olusegun; Akinloye, Oluseyi A

    2010-11-01

    Assessment of lead in blood (BLL) and lead in urine (ULL) of some non-occupationally exposed, nonsmoking 214 pregnant Nigerian women, aged 17 to 49 years, and resident in Lagos was carried out using atomic absorption spectrometry with control subjects consisting of 113 nonpregnant women. From results, the mean BLL and ULL (μg/dL) for pregnant women (59.5±2.1; 29.4±1.1) were significantly (p<0.01) higher than the values obtained for nonpregnant women (27.7±1.1; 9.2±0.6). BLL found in women in the first, second, and third trimesters were 57.2±2.3, 61.6±2.2, and 63.1±1.8, respectively. ULL could not serve to predict BLL due to weak correlations (r=-0.06 to +0.15; p>0.10). Study is a contribution to blood and urine lead status of Nigerian pregnant women, being relevant for healthcare management purposes, public health decision making, and possible primary prevention activities.

  13. [Recommendations for non-occupational postexposure HIV prophylaxis. Spanish Working Group on Non-Occupational Postexposure HIV Prophylaxis of the Catalonian Center for Epidemiological Studies on AIDS and the AIDS Study Group].

    PubMed

    Almeda, Jesús; Casabona, Jordi; Allepuz, Alejandro; García-Alcaide, Felipe; del Romero, Jorge; Tural, Cristina; Colm, Joan; Bolao, Ferrán; Campins, Magda; Domínguez, Angela; Force, Lluís; Giménez, Albert; Guerra-Romero, Luis

    2002-10-01

    Evidence is lacking on the possible efficacy and effectiveness of non-occupational postexposure prophylaxis (PEP). However, because of its biological plausibility, the use of antiretroviral (ARV) drugs to prevent the development of infection in certain cases of accidental or sporadic exposure has begun to be considered as common clinical practice. Previous studies performed in Spain have demonstrated both the demand and the prescription of ARV as PEP and especially the diversity and inconsistency in the criteria used. In this context, in April of 2000 the Centre for Epidemiological Studies on AIDS of Catalonia (CEESCAT) (Department of Health and Social Security of the Autonomous Government of Catalonia), in collaboration with the National AIDS Plan and the AIDS Study Group (GESIDA), promoted the creation of a working group for the drafting of recommendations for PEP against HIV outside the occupational health context. The recommendations have been made bearing in mind the exceptional character of the exposure, the time elapsed since exposure, as well as evaluation of the risk of infection according to the type of exposure and the information available on the source of infection. In addition, the recommendations include the immediate measures necessary, as well as the preventive measures and clinical follow-up required both for HIV and for other infectious agents. All PEP regimens should be started within 72 hours of exposure and appropriate daily doses of two nucleoside reverse transcriptase inhibitors (NRTIs) and a protease inhibitor (PI), or two NRTIs and a non-nucleoside reverse transcriptase inhibitor (NNRTIs), should be administered for four weeks, bearing in mind the pharmacological and clinical situation of the source person. These recommendations should be updated periodically.

  14. Comparing non-occupational post-exposure prophylaxis drug regimens for HIV: insights from a linked HIV surveillance system.

    PubMed

    Pierce, Anna B; El-Hayek, Carol; McCarthy, Damien; Armishaw, Jude; Watson, Kerrie; Wilkinson, Anna; Price, Brian; Wright, Edwina J; Hoy, Jennifer F; Stoové, Mark A

    2016-12-05

    Background: International non-occupational post-exposure prophylaxis (NPEP) guidelines recommend routine use of three drug NPEP regimens, despite absence of evidence for greater prevention efficacy compared with two drug regimens. This study examines the potential for excess HIV seroconversions among high-risk men who have sex with men (MSM) reporting receptive anal intercourse with a source of unknown HIV serostatus (RAIU) following a two-drug versus a three-drug NPEP regimen. Methods: Data for MSM in the Victorian NPEP service database between 10 August 2005 and 31 December 2012 were linked with all Victorian HIV notifications up to 31 December 2013. The primary outcome was NPEP failure following NPEP presentation among MSM reporting RAIU, stratified by the number of drugs prescribed. Results: Among 1482 MSM reporting 2002 episodes of RAIU and prescribed two- or three-drug NPEP, 70 seroconverted to HIV, but only 19 were considered possible NPEP failures. HIV diagnosis incidence among men reporting RAIU was 1.2/100 person years (PY) (95%CI=1.0-1.6); 1.1/100 PY (95%CI=0.8-1.4) among MSM prescribed two drugs and 2.2/100 PY (95%CI=1.4-3.7) among MSM prescribed three drugs (P<0.01). Of the 19 possible NPEP failures, 13 (0.7%) were prescribed two drugs and six (2.7%) three drugs (P<0.001). Conclusions: This study suggests that two-drug NPEP regimens do not result in excess seroconversions compared with three-drug regimens when used following RAIU. Clinical services should carefully consider their use of three drug NPEP and whether resources might be better invested in other prevention strategies, particularly pre-exposure prophylaxis (PrEP).

  15. Prevalence of foot eczema and associated occupational and non-occupational factors in patients with hand eczema.

    PubMed

    Brans, Richard; Hübner, Anja; Gediga, Günther; John, Swen M

    2015-08-01

    Foot eczema often occurs in combination with hand eczema. However, in contrast to the situation with hand eczema, knowledge about foot eczema is scarce, especially in occupational settings. To evaluate the prevalence of foot eczema and associated factors in patients with hand eczema taking part in a tertiary individual prevention programme for occupational skin diseases. In a retrospective cohort study, the medical records of 843 patients taking part in the tertiary individual prevention programme were evaluated. Seven hundred and twenty-three patients (85.8%) suffered from hand eczema. Among these, 201 patients (27.8%) had concomitant foot eczema, mainly atopic foot eczema (60.4%). An occupational irritant component was possible in 38 patients with foot eczema (18.9%). In the majority of patients, the same morphological features were found on the hands and feet (71.1%). The presence of foot eczema was significantly associated with male sex [odds ratio (OR) 1.78, 95% confidence interval (CI) 1.29-2.49], atopic hand eczema (OR 1.60, 95%CI: 1.15-2.22), hyperhidrosis (OR 1.73, 95%CI: 1.33-2.43), and the wearing of safety shoes/boots at work (OR 2.04, 95%CI: 1.46-2.87). Tobacco smoking was associated with foot eczema (OR 1.79, 95%CI: 1.25-2.57), in particular with the vesicular subtype. Foot eczema is common in patients with hand eczema, and is related to both occupational and non-occupational factors. © 2015 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  16. Correlation between preconception maternal non-occupational exposure to interior decoration or oil paint odour and average birth weight of neonates: findings from a nationwide cohort study in China's rural areas.

    PubMed

    Liu, Huiting; Chen, Shi; Zhu, Huijuan; Yang, Hongbo; Gong, Fengying; Wang, Linjie; Jiang, Yu; Lian, Bill Q; Yan, Chengsheng; Li, Jianqang; Wang, Qing; Zhang, Shikun; Pan, Hui

    2017-08-21

    Birth weight is a critical indicator of neonatal health and foretells people's health in adolescence and even adulthood. Some researchers have warned against the adverse effects on babies' birth weight of exposure to pollutants in interior decoration or oil paint by odour intake. This study evaluated the effects of maternal exposure to such factors before conception on the birth weights of neonates. Data on 213 461 cases in this study were from the database of the free National Pre-pregnancy Checkups Project. Defined as 'exposed' were those women exposed to oil paint odour or interior decoration at home or in the workplace within 6 months before their pregnancy. The study focused on revealing the correlation between such exposure and the birth weight of the neonates of these women, especially the incidence of macrosomia and low birth weight (LBW). Statistical analysis was conducted using the Kruskal-Wallis H test, the Mann-Whitney U test and logistic regression. The birth weight of babies from mothers non-occupationally exposed to such settings averaged 3465 g (range 3150-3650 g), whereas the birth weight of those from mothers free of such exposure averaged 3300 g (range 3000-3600g). Maternal exposure preconception to interior decoration or oil paint odour reduced the incidence of LBW in their babies (p=0.003, OR 0.749, 95% CI 0.617 to 0.909). Such exposure may also augment the probability of macrosomia (p<0.001, OR 1.297, 95% CI 1.133 to 1.484). Maternal exposure to interior decoration or oil paint odour preconception may increase the average birth weight of neonates, as well as the incidence of macrosomia. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

  17. Correlation between preconception maternal non-occupational exposure to interior decoration or oil paint odour and average birth weight of neonates: findings from a nationwide cohort study in China’s rural areas

    PubMed Central

    Liu, Huiting; Chen, Shi; Zhu, Huijuan; Yang, Hongbo; Gong, Fengying; Wang, Linjie; Jiang, Yu; Lian, Bill Q; Yan, Chengsheng; Li, Jianqang; Wang, Qing; Zhang, Shikun; Pan, Hui

    2017-01-01

    Background Birth weight is a critical indicator of neonatal health and foretells people’s health in adolescence and even adulthood. Some researchers have warned against the adverse effects on babies’ birth weight of exposure to pollutants in interior decoration or oil paint by odour intake. This study evaluated the effects of maternal exposure to such factors before conception on the birth weights of neonates. Methods Data on 213 461 cases in this study were from the database of the free National Pre-pregnancy Checkups Project. Defined as ‘exposed’ were those women exposed to oil paint odour or interior decoration at home or in the workplace within 6 months before their pregnancy. The study focused on revealing the correlation between such exposure and the birth weight of the neonates of these women, especially the incidence of macrosomia and low birth weight (LBW). Statistical analysis was conducted using the Kruskal–Wallis H test, the Mann–Whitney U test and logistic regression. Results The birth weight of babies from mothers non-occupationally exposed to such settings averaged 3465 g (range 3150–3650 g), whereas the birth weight of those from mothers free of such exposure averaged 3300 g (range 3000–3600g). Maternal exposure preconception to interior decoration or oil paint odour reduced the incidence of LBW in their babies (p=0.003, OR 0.749, 95% CI 0.617 to 0.909). Such exposure may also augment the probability of macrosomia (p<0.001, OR 1.297, 95% CI 1.133 to 1.484). Conclusion Maternal exposure to interior decoration or oil paint odour preconception may increase the average birth weight of neonates, as well as the incidence of macrosomia. PMID:28827230

  18. 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.

  19. Biomonitorization of cadmium, chromium, manganese, nickel and lead in whole blood, urine, axillary hair and saliva in an occupationally exposed population.

    PubMed

    Gil, Fernando; Hernández, Antonio F; Márquez, Claudia; Femia, Pedro; Olmedo, Pablo; López-Guarnido, Olga; Pla, Antonio

    2011-02-15

    Heavy metal contamination from occupational origin is a cause for concern because of its potential accumulation in the environment and in living organisms leading to long term toxic effects. This study was aimed to assess Cd, Cr, Mn, Ni and Pb levels in whole blood, urine, axillary hair and saliva from 178 individuals with occupational exposure to heavy metals. Levels of metal compounds were determined by atomic absorption spectrometry. We collected information on occupation, lifestyle habits and food intake by questionnaire. Multiple linear regression analyses for metal ion concentration in whole blood, urine, axillary hair and saliva were adjusted for age, gender, smoking and alcohol consumption, lifetime workplace exposure, residence area and food habits. Overall, blood and urine median concentrations found for the five metals analyzed do not exceed biological exposure indexes, so that they are very similar to a non-occupationally exposed population. Toxicokinetic differences may account for the lack of correlations found for metal levels in hair and saliva with those in blood or urine. For those heavy metals showing higher median levels in blood with respect to hair (Cd, Mn and Pb) indicating lesser hair incorporation from blood, the lifetime working experience was inversely correlated with their hair levels. The longer the lifetime working experience in industrial environments, the higher the Mn and Ni concentration in saliva. Axillary hair and saliva may be used as additional and/or alternative samples to blood or urine for biomonitoring hair Mn, and saliva Ni in subjects with occupational exposure.

  20. Post-exposure prophylaxis for non-occupational exposure to HIV: current clinical practice and opinions in the UK

    PubMed Central

    Giele, C; Maw, R; Carne, C; Evans, B

    2002-01-01

    Method: A retrospective survey was carried out of physicians representative of all UK GUM clinics using self completed questionnaires requesting information for January to December 1999. The number of requests for NONOPEP, reasons for the requests, the number prescribed, and physician opinions regarding the justification for its administration were noted. Results: The number of requests and prescriptions for NONOPEP increased fourfold and sevenfold respectively in comparison with a survey from 1997. Of 242 requests, 130 people were prescribed NONOPEP. Half the requests followed sexual exposures between known HIV discordant couples. Requests for NONOPEP were received by 56 of 132 (42%) clinics, with nine clinics receiving over half of them (145/242, 60%). Similarly, over half the prescriptions for NONOPEP (83/130, 64%) were given by six of 39 prescribing clinics. Most physicians thought that post-exposure prophylaxis (PEP) was justified for people exposed to a known HIV positive source patient resulting from sexual assault or unprotected receptive anal or peno-vaginal sex. Conclusion: The use of NONOPEP has increased since the last survey and there is considerable variation between GUM clinics in practice and beliefs regarding administration of NONOPEP. PMID:12081175

  1. Two cases of asbestosis and one case of rounded atelectasis due to non-occupational asbestos exposure.

    PubMed

    Candura, S M; Binarelli, A; Ragno, G; Scafa, F

    2008-03-01

    Asbestos is a well-known cause of several neoplastic (malignant mesothelioma, lung cancer) and non-neoplastic (asbestosis, pleuropathies) occupational diseases. Lower-level exposure in the general environment may induce pleural plaques and thickenings, and is associated with an increased mesothelioma risk. We present two patients (a 68-year-old man and a 72-year-old woman) who developed asbestosis (in association with pleural plaques and calcifications), and a 78-year-old man who developed rounded atelectasis (with pleural plaques and benign effusion), after living for several decades in the proximity of large Italian asbestos-cement plant. None of them had been exposed to asbestos occupationally. Besides living in a contaminated area, the woman used to clean the work clothes of her brother, who was employed in the local asbestos factory. The three cases indicate that non-neoplastic, long-latency asbestos-related diseases which are usually observed as a consequence of occupational exposures, may rarely develop in subjects living in contaminated geographical sites and buildings. These unusual environmental diseases raise the diagnostic problem of differentiating them from other, more common respiratory illnesses, and impose the duties of patient notification, assessment and follow-up, to assess the possibility of progression of disease and increased neoplastic risk.

  2. [Perception of mistreatment during medical residency training].

    PubMed

    Mejía, Raul; Diego, Andrea; Alemán, María; Maliandi, María del Rosario; Lasala, Fernando

    2005-01-01

    Because previous investigations show that mistreatment during residency is frequent we undertook this research to assess the prevalence of psychological abuse, physical violence and sexual harassment in residency training programs and the professional status of perpetrators. Through a literature review and a previous qualitative study we developed a self-administered questionnaire. Thirteen events that could be experienced by residents and ten possible perpetrators were described in the questionnaire. Residents were asked to record whether they had experienced these events, at least once, and who was responsible. This survey was distribuided among the residents from three hospitals of Buenos Aires city. A total of 322 residents answered the questionnaire (55% women) 72% of whom worked in clinical programs, 22% in surgical programs, and 6% in diagnostic programs. Mistreatment was reported by 89% of the residents. On average each resident recorded 8 different episodes of mistreatment, such as being criticized for not completing administrative work (75%), being shouted at (64%), being humiliated in public (57%), sexual harassment (10%), being exposed to pornographic material without permission (7%), being hit or pushed (15%), suffering racial or religious discrimination (10%). The most common perpetrators were senior residents (26%), chief resident (19%), attending physicians (14%), and nurses (8%). Mistreatment and abuse are commonly experienced by residents in training programs. A multidisciplinary approach is needed to address this problem in the training environment.

  3. Non-occupational physical activity during pregnancy and the risk of preterm birth: a meta-analysis of observational and interventional studies

    PubMed Central

    Wen, Ju; Xun, Pengcheng; Chen, Cheng; Quan, Minghui; Wang, Ru; Liu, Yu; He, Ka

    2017-01-01

    A meta-analysis was conducted to evaluate the association between non-occupational physical activity (PA) during pregnancy and the risk of preterm birth (PTB). By searching PubMed and EMBASE from inception to August 20, 2016, 25 observational studies (18 cohorts and 7 case-controls) and 12 interventional studies were identified. Comparing the highest to the lowest category of leisure-time PA during pregnancy, the pooled relative risk (RR) of PTB was 0.83 [95% confidence interval (CI) = 0.74–0.93] for cohort studies and 0.60 (95% CI = 0.43–0.84) for case-control studies. No overall significant association was found between domestic or commuting PA and the risk of PTB. In addition, PA intervention did not indicate significant beneficial effect on the risk of PTB. Evidence from the observational studies suggested that leisure-time, but not domestic or commuting, PA during pregnancy was inversely associated with the risk of PTB. The findings were not supported by small-scale and short-term interventional studies. Further research with objective measurement on leisure-time PA is warranted. PMID:28327589

  4. HIV medical providers’ perceptions of the use of antiretroviral therapy as non-occupational post- exposure prophylaxis (nPEP) in two major metropolitan areas

    PubMed Central

    Rodriguez, Allan; Castel, Amanda D.; Parish, Carrigan L.; Willis, Sarah; Feaster, Daniel J.; Kharfen, Michael; Cardenas, Gabriel A.; Villamizar, Kira; Kolber, Michael; Vázquez-Rivera, Liliana; Metsch, Lisa R.

    2013-01-01

    Intro In 2005, the Centers for Disease Control and Prevention expanded its recommendation of post exposure prophylaxis (PEP) use in the workplace to include non-occupational exposures (nPEP). The availability and extensive use of nPEP has not achieved widespread acceptance among health care providers of high-risk populations, and public health and primary care agencies have been sparse in their implementation of nPEP promotion, protocols, and practices. Methods We conducted a survey of HIV providers (n=142, response rate = 61%) in Miami-Dade County (Florida) and the District of Columbia (DC) that focused on their knowledge, attitudes, beliefs and practices related to the delivery of nPEP. We then analyzed differences in survey responses by site and by history of prescribing nPEP using bivariate and multivariate logistic regression. Results More DC providers (59.7%) reported ever prescribing nPEP than in Miami (39.5%%, p < 0.048). The majority of practices in both cities did not have a written nPEP protocol and rarely or never had patients request nPEP. Multivariable analysis for history of prescribing nPEP was dominated by having patients request nPEP (OR = 21.53) and the belief that nPEP would lead to antiretroviral resistance (OR = 0.14), as well as having an nPEP written protocol (OR = 7.49). Discussion Our findings are consistent with earlier studies showing the underuse of nPEP as a prevention strategy. The significance of having an nPEP written protocol and of patient requests for nPEP speaks to the importance of using targeted strategies to promote widespread awareness of the use of HIV antiretroviral medications as a prevention intervention. PMID:24126450

  5. Radiology residents' experience with intussusception reduction.

    PubMed

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

    2011-06-01

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

  6. Window contamination on Expose-R

    NASA Astrophysics Data System (ADS)

    Demets, R.; Bertrand, M.; Bolkhovitinov, A.; Bryson, K.; Colas, C.; Cottin, H.; Dettmann, J.; Ehrenfreund, P.; Elsaesser, A.; Jaramillo, E.; Lebert, M.; van Papendrecht, G.; Pereira, C.; Rohr, T.; Saiagh, K.

    2015-01-01

    Expose is a multi-user instrument for astrobiological and astrochemical experiments in space. Installed at the outer surface of the International Space Station, it enables investigators to study the impact of the open space environment on biological and biochemical test samples. Two Expose missions have been completed so far, designated as Expose-E (Rabbow et al. 2012) and Expose-R (Rabbow et al. this issue). One of the space-unique environmental factors offered by Expose is full-spectrum, ultraviolet (UV)-rich electromagnetic radiation from the Sun. This paper describes and analyses how on Expose-R, access of the test samples to Solar radiation degraded during space exposure in an unpredicted way. Several windows in front of the Sun-exposed test samples acquired a brown shade, resulting in a reduced transparency in visible light, UV and vacuum UV (VUV). Post-flight investigations revealed the discolouration to be caused by a homogenous film of cross-linked organic polymers at the inside of the windows. The chemical signature varied per sample carrier. No such films were found on windows from sealed, pressurized compartments, or on windows that had been kept out of the Sun. This suggests that volatile compounds originating from the interior of the Expose facility were cross-linked and photo-fixed by Solar irradiation at the rear side of the windows. The origin of the volatiles was not fully identified; most probably there was a variety of sources involved including the biological test samples, adhesives, plastics and printed circuit boards. The outer surface of the windows (pointing into space) was chemically impacted as well, with a probable effect on the transparency in VUV. The reported analysis of the window contamination on Expose-R is expected to help the interpretation of the scientific results and offers possibilities to mitigate this problem on future missions - in particular Expose-R2, the direct successor of Expose-R.

  7. Differentiating posttraumatic stress between elderly and younger residents.

    PubMed

    Chung, Man Cheung; Dennis, Ian; Easthope, Yvette; Farmer, Steven; Werrett, Julie

    2005-01-01

    This study aimed to differentiate between the posttraumatic stress responses of elderly and younger community residents who had been exposed to two technological disasters (a train collision and an aircraft crash). One hundred and forty-eight community residents were assessed using the Impact of Event Scale (IES) and the General Health Questionnaire (GHQ-28). The results showed that age differences were not affected by impact of disaster (IES), suggesting that elderly and younger community residents responded to the disasters similarly. Instead, the community residents exposed to the aircraft crash experienced significantly more intrusion and avoidance than those exposed to the train collision. Also, the community residents who had experienced high exposure to the disasters had significantly more intrusive thoughts and exhibited significantly more avoidance behavior than the low/medium exposure group. The results also showed no main effects in general health between the elderly and younger community residents, suggesting that their health status was similar. Instead, the community residents exposed to the aircraft crash had significantly more general health problems than the train disaster residents and the control group. Also, the community residents in either the low/medium or the high exposure group experienced more general health problems than the control group. Correlation coefficients showed that intrusion, avoidance, and the total impact of the disasters were significantly correlated with all general health subscales for both elderly and younger groups.

  8. Reconceptualizing Benchmarks for Residency Training

    PubMed Central

    2017-01-01

    Postgraduate medical education (PGME) is currently transitioning to a competency-based framework. This model clarifies the desired outcome of residency training - competence. However, since the popularization of Ericsson's work on the effect of time and deliberate practice on performance level, his findings have been applied in some areas of residency training. Though this may be grounded in a noble effort to maximize patient well-being, it imposes unrealistic expectations on trainees. This work aims to demonstrate the fundamental flaws of this application and therefore the lack of validity in using Ericsson's work to develop training benchmarks at the postgraduate level as well as expose potential harms in doing so. PMID:28409072

  9. Improved awareness and appropriate use of non-occupational post-exposure prophylaxis (nPEP) for HIV prevention following a multi-modal communication strategy.

    PubMed

    Minas, Byron; Laing, Sue; Jordan, Helen; Mak, Donna B

    2012-10-25

    In May 2005, the Western Australian Department of Health (WA Health) developed a communication strategy to improve the awareness and appropriate use of non-occupational post-exposure prophylaxis (nPEP) in WA. The communication strategy included the development of an nPEP information pamphlet, the establishment of a 24 hour nPEP phone line and the distribution of the WA Health nPEP guidelines to health professionals. The communication strategy was aimed at gay men, people in sero-discordant relationships, people living with HIV, injecting drug users and health care providers with patients from these populations. This evaluation aimed to assess the awareness and appropriate use of nPEP in WA before and after the commencement of the nPEP communication strategy. A program logic method was used to identify the immediate (short-term) and ultimate (long-term) outcomes of the communication strategy. The achievement of these outcomes was evaluated using data from website statistics, a survey of 'sexuality sensitive' doctors, statistics published in Perth Gay Community Periodic Surveys (PGCPS) and data from the WA nPEP database. A χ(2) test for trend was conducted to identify any significant changes in the ultimate outcome indicators pre- and post-strategy. nPEP awareness among gay men in the PGCPS initially increased from 17.2% in 2002 to 54.9% in 2008, then decreased to 39.9% in 2010. After the commencement of the communication strategy, the proportion of nPEP prescriptions meeting the eligibility criteria for nPEP significantly increased (61.2% in 2002-2005 to 90.0% in 2008-2010 (p < .001)). The proportion of nPEP recipients who completed the prescribed course of nPEP (46.6% in 2002-2005 to 66.9% in 2008-2010 (p = .003)) and the proportion who received a post-nPEP HIV test three to four months after the first visit for nPEP (38.8% in 2002-2005 to 51.9% in 2008-2010 (p = .023)) also increased. Since the introduction of the nPEP communication strategy, the delivery and

  10. Improved awareness and appropriate use of non-occupational post-exposure prophylaxis (nPEP) for HIV prevention following a multi-modal communication strategy

    PubMed Central

    2012-01-01

    Background In May 2005, the Western Australian Department of Health (WA Health) developed a communication strategy to improve the awareness and appropriate use of non-occupational post-exposure prophylaxis (nPEP) in WA. The communication strategy included the development of an nPEP information pamphlet, the establishment of a 24 hour nPEP phone line and the distribution of the WA Health nPEP guidelines to health professionals. The communication strategy was aimed at gay men, people in sero-discordant relationships, people living with HIV, injecting drug users and health care providers with patients from these populations. This evaluation aimed to assess the awareness and appropriate use of nPEP in WA before and after the commencement of the nPEP communication strategy. Methods A program logic method was used to identify the immediate (short-term) and ultimate (long-term) outcomes of the communication strategy. The achievement of these outcomes was evaluated using data from website statistics, a survey of ‘sexuality sensitive’ doctors, statistics published in Perth Gay Community Periodic Surveys (PGCPS) and data from the WA nPEP database. A χ2 test for trend was conducted to identify any significant changes in the ultimate outcome indicators pre- and post-strategy. Results nPEP awareness among gay men in the PGCPS initially increased from 17.2% in 2002 to 54.9% in 2008, then decreased to 39.9% in 2010. After the commencement of the communication strategy, the proportion of nPEP prescriptions meeting the eligibility criteria for nPEP significantly increased (61.2% in 2002-2005 to 90.0% in 2008-2010 (p < .001)). The proportion of nPEP recipients who completed the prescribed course of nPEP (46.6% in 2002-2005 to 66.9% in 2008-2010 (p = .003)) and the proportion who received a post-nPEP HIV test three to four months after the first visit for nPEP (38.8% in 2002-2005 to 51.9% in 2008-2010 (p = .023)) also increased. Conclusions Since the introduction of

  11. 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…

  12. 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…

  13. 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.

  14. Training for Hospital Practice: Internships, Residencies, and Credentials.

    ERIC Educational Resources Information Center

    Resnick, Robert J.

    Benefits of hospital-based internship and residency programs for training psychologists are discussed, along with issues concerning licensing or certification. In hospitals, interns and residents are exposed to unusual and diverse forms of physical and mental pathology, as well as contact with a diverse patient population crossing all ages, racial…

  15. Training for Hospital Practice: Internships, Residencies, and Credentials.

    ERIC Educational Resources Information Center

    Resnick, Robert J.

    Benefits of hospital-based internship and residency programs for training psychologists are discussed, along with issues concerning licensing or certification. In hospitals, interns and residents are exposed to unusual and diverse forms of physical and mental pathology, as well as contact with a diverse patient population crossing all ages, racial…

  16. Establishing a new radiology residency research track.

    PubMed

    Costello, James R; Mullins, Mark E; Votaw, John R; Karolyi, Dan R; Kalb, Bobby; Gonzales, Patrick; Fornwalt, Brandon; Meltzer, Carolyn C

    2013-02-01

    The authors describe the establishment of a radiology residency research track at their institution. Based on growing biomedical technology needs and the tremendous increase in imaging-based research, the importance of training and cultivating future clinical investigators continues to grow. Within the framework of a supportive environment, a residency research track exposes motivated radiologists-in-training to the tools, challenges, and successes of a career in academics. The authors describe their program's design, admissions process, curriculum, and expectations. Lastly, the authors share the insight of their experience and seek feedback from readers who have been involved in similar endeavors.

  17. Program for developing leadership in pharmacy residents.

    PubMed

    Fuller, Patrick D

    2012-07-15

    An innovative, structured approach to incorporating leadership development activities into pharmacy residency training is described. The American Society of Health-System Pharmacists (ASHP) has called for increased efforts to make leadership development an integral component of the training of pharmacy students and new practitioners. In 2007, The Nebraska Medical Center (TNMC) took action to systematize leadership training in its pharmacy residency programs by launching a new Leadership Development Series. Throughout the residency year, trainees at TNMC participate in a variety of activities: (1) focused group discussions of selected articles on leadership concepts written by noted leaders of the past and present, (2) a two-day offsite retreat featuring trust-building exercises and physical challenges, (3) a self-assessment designed to help residents identify and use their untapped personal strengths, (4) training on the effective application of different styles of communication and conflict resolution, and (5) education on the history and evolution of health-system pharmacy, including a review and discussion of lectures by recipients of ASHP's Harvey A. K. Whitney Award. Feedback from residents who have completed the series has been positive, with many residents indicating that it has stimulated their professional growth and helped prepared them for leadership roles. A structured Leadership Development Series exposes pharmacy residents to various leadership philosophies and principles and, through the study of Harvey A. K. Whitney Award lectures, to the thoughts of past and present pharmacy leaders. Residents develop an increased self-awareness through a resident fall retreat, a StrengthsFinder assessment, and communication and conflict-mode assessment tools.

  18. Engaging Pediatric Resident Physicians in Quality Improvement Through Resident-Led Morbidity and Mortality Conferences.

    PubMed

    Destino, Lauren A; Kahana, Madelyn; Patel, Shilpa J

    2016-03-01

    Increasingly, medical disciplines have used morbidity and mortality conferences (MMCs) to address quality improvement and patient safety (QI/PS), as well as teach systems-based improvement to graduate trainees. The goal of this educational intervention was to establish a pediatric resident physician–led MMC that not only focused on QI/PS principles but also engaged resident physicians in QI/ PS endeavors in their clinical learning environments. Following a needs assessment, pediatric resident physicians at the Stanford University School of Medicine (Stanford, California) established a new MMC model in February 2010 as part of a required QI rotation. Cases were identified, explored, analyzed, and presented by resident physicians using the Johns Hopkins Learning from Defects tool. Discussions during the MMCs were resident physician– directed and systems-based, and resulted in projects to address care delivery. Faculty advisors assessed resident physician comprehension of QI/PS. Conferences were evaluated through the end of the 2012–2013 academic year and outcomes tracked through the 2013–2014 academic year to determine trainee involvement in systems change resulting from the MMCs. The MMC was well received and the number of MMCs increased over time. By the end of the 2013–2014 academic year, resident physicians were involved in address ing 14 systems-based issues resulting from 25 MMCs. Examples of the resident physician–initiated improvement work included increasing use of the rapid response team, institution of a gastrostomy (g)-tube order set, and establishing a face-to-face provider handoff for pediatric ICU–to-acute-care-floor transfers. A resident physician–run MMC exposes resident physicians to QI/PS concepts and principles, enables direct faculty assessment of QI/PS knowledge, and can propel resident physicians into real-time engagement in the culture of safety in a complex hospital environment.

  19. Optimizing the customized residency plan.

    PubMed

    Phillips, Holly; Wilkinson, Samaneh T; Buck, Brian

    2013-06-01

    Residents and residency program directors (RPDs) understand that the goal of the residency year is to earn a residency certificate through achievement of established goals and objectives. The customized residency plan provides a map for the resident and RPD to follow throughout the course of the residency year, helping to keep everyone on track to accomplish the established goals and objectives of the program. It also provides information that allows preceptors to take the individual resident's plan into consideration when customizing a learning experience. This article will focus on the process for developing a customized residency plan and implementing it over the course of the residency year.

  20. Rain Forest Dance Residency.

    ERIC Educational Resources Information Center

    Watson, Dawn

    1997-01-01

    Outlines the author's experience as a dancer and choreographer artist-in-residence with third graders at a public elementary school, providing a cultural arts experience to tie in with a theme study of the rain forest. Details the residency and the insights she gained working with students, teachers, and theme. (SR)

  1. 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…

  2. 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…

  3. Biological monitoring of foundry workers exposed to polycyclic aromatic hydrocarbons.

    PubMed Central

    Sherson, D; Sabro, P; Sigsgaard, T; Johansen, F; Autrup, H

    1990-01-01

    This investigation describes benzo(a)pyrene (BP) serum protein adduct concentrations in 45 foundry workers and 45 matched non-occupationally exposed controls. High and low BP exposure groups were defined using breathing zone hygienic samples for both quartz and BP exposures. A newly developed enzyme linked immunosorbent assay detected benzo(a)pyrenediolepoxide-I binding to serum protein. Mean BP protein adduct concentrations (SD) for non-smoking (24.0 BP equivalents/100 micrograms protein (21.0] and smoking (28.0 (18.2] foundry workers were significantly higher than mean values for non-smoking (7.23 (8.72] and smoking (14.2 (24.4] controls. Foundry workers with high exposures to either quartz (28.4 (15.5] or BP (30.7 (19.3] had slightly raised mean adduct concentrations compared with foundry workers with low exposure for quartz (23.9 (23.1] or BP (24.5 (19.4). Highest mean adduct concentrations were found among a small group of workers with simultaneous high exposures to both quartz and BP (39.2 (6.5] suggesting an additive effect. These data support the ideas of a possible aetiological connection between an increased risk of lung cancer and BP exposure among foundry workers, and an additive effect between BP and quartz. Measurement of BP serum protein adduct concentrations appears to be a useful method by which groups exposed to BP may be biologically monitored. PMID:2383513

  4. Telepathy: maximizing resident exposure to surgical pathology decision making.

    PubMed

    McLemore, Elisabeth C; Schlinkert, Richard T; Schlinkert, Denise K; Williams, James W; Bailey, David P

    2006-04-01

    General surgery residents are often not present for the critical intraoperative discussion between surgeon and pathologist regarding surgical pathology findings. A prospective pilot study analyzed general surgery resident exposure to surgical pathology. Thereafter, an operating room was equipped to view frozen section images in real time and verbally communicate with the pathologist (TelePATHy). Total operative cases, cases using frozen sections, and use of TelePATHy were recorded. Most residents (78%) reported they were exposed to frozen-section surgical pathology < or =10% of the time. Overall, 202 operations were performed over the 123-day period. Forty-four cases had frozen-section specimens. General surgery residents were present for 40 cases. TelePATHy was successfully used in 32 cases (80%). General surgery resident exposure to intraoperative pathology findings increased from a reported < or =10% to an observed 80%. TelePATHy is a novel intraoperative tool capable of maximizing the intraoperative experience of the surgical resident.

  5. 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

    1993-08-15

    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.

  6. Facility Focus: Residence Halls.

    ERIC Educational Resources Information Center

    College Planning & Management, 2001

    2001-01-01

    Explores the designs of three university residence halls that are intended to stimulate social and academic interaction, create a sense of community, and foster a feeling of belonging among students. Includes eleven photographs and a typical floor plan. (GR)

  7. Facilty Focus: Residence Halls.

    ERIC Educational Resources Information Center

    Hunnewell, James F., Jr.

    2002-01-01

    Describes the Western Ridge Residence at Colorado College and Beard Hall at Wheaton College. The buildings feature multiple levels that take advantage of views and also help create a "homey" feeling. (EV)

  8. Facilty Focus: Residence Halls.

    ERIC Educational Resources Information Center

    Hunnewell, James F., Jr.

    2002-01-01

    Describes the Western Ridge Residence at Colorado College and Beard Hall at Wheaton College. The buildings feature multiple levels that take advantage of views and also help create a "homey" feeling. (EV)

  9. 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)

  10. Predictors of cadmium and lead concentrations in the blood of residents from the metropolitan area of Athens (Greece).

    PubMed

    Sakellari, Aikaterini; Karavoltsos, Sotirios; Kalogeropoulos, Nick; Theodorou, Dimitrios; Dedoussis, George; Chrysohoou, Christina; Dassenakis, Manos; Scoullos, Michael

    2016-10-15

    The Cd and Pb blood contents of healthy adult subjects who are non-occupationally exposed and living in the metropolitan area of Athens (Greece) have not been assessed thus far. Additionally, Greeks rank first among EU27 in terms of smoking habits. To fill the existing gap, we aimed to evaluate the predictors and propose reference values (RVs) of the Cd (CdB) and Pb (PbB) blood concentrations in residents of the metropolitan area of Athens (Greece). Age, sex, smoking, alcohol drinking, educational status and nutritional habits were used as variables, with an emphasis on smoking. CdB and PbB determinations were performed directly by graphite furnace atomic absorption spectrometry (GFAAS) following the appropriate dilution of the samples with Triton-X-100. The RVs of CdB and PbB proposed for the general adult population of the Metropolitan area of Athens, Greece (upper limit of the 95% CI of the 95th percentile of the distribution of values), were 2.3 and 88μgL(-1) (P95: 1.8 and 77μgL(-1); 95% CI (P95): 1.5-2.3 and 70-88μgL(-1)), respectively. Males had a higher median CdB (0.69μgL(-1)) than females (0.55μgL(-1)). Subjects aged <40years had a lower median CdB (0.51μgL(-1)) than the elderly (≥60years; 0.60μgL(-1)). The CdB in smokers (1.2μgL(-1)) was almost threefold higher than in non-smokers (0.46μgL(-1)). The PbB levels were higher in males (31μgL(-1)) than females (20μgL(-1)). Subjects aged <40years had a lower median PbB (17μgL(-1)) than the elderly (≥60years; 32μgL(-1)). A multiple linear regression analysis demonstrated that the predictor variables for the CdB levels were the standardized beta weight, smoking, age, alcohol consumption, and intake of leafy vegetables, whereas for the PbB levels they were sex and age. Copyright © 2016 Elsevier B.V. All rights reserved.

  11. Residents' Perspectives on Professionalism

    PubMed Central

    Krain, Lewis P.; Lavelle, Ellen

    2009-01-01

    Background Research defining professionalism exists, yet little is known about how residents view this important attribute for medical practice. Knowing more about residents' interpretations of professionalism and about how they value professionalism would enhance definitions and facilitate support for the development of professionalism skills and behaviors at the graduate level. Purpose The purpose of this phenomenological study was to investigate how residents think about professionalism, how they value it, and how it plays out in their educational lives. Methods This study uses qualitative methods, employing 5 focus groups representative of a range of disciplines. Methods include providing unstructured prompts, member checking and informant feedback to support credibility, and content analysis to discern significant patterns. Results Content analysis supported that residents highly value professionalism and see it as a complex construct, dependent on the situation, discipline, and on personal experience. Challenges to professionalism are common in graduate medical education and a great concern for residents. Conclusions Physician educators often discuss professionalism as an overarching concept in medicine, especially in classes during the preclinical years. Although some general principles are applicable, residents relate more deeply to aspects of professionalism that concern their own clinical practice, situation, and specialty. Implications for measurement of professional skills and for further research are included in this report. PMID:21975982

  12. Positive and cost-effectiveness effect of spa therapy on the resumption of occupational and non-occupational activities in women in breast cancer remission: a French multicentre randomised controlled trial.

    PubMed

    Mourgues, Charline; Gerbaud, Laurent; Leger, Stéphanie; Auclair, Candy; Peyrol, Fleur; Blanquet, Marie; Kwiatkowski, Fabrice; Leger-Enreille, Anne; Bignon, Yves-Jean

    2014-10-01

    The main aim was to assess the effects of a spa treatment on the resumption of occupational and non-occupational activities and the abilities of women in breast cancer remission. A cost-effectiveness analysis (CEA) was also performed. A multicentre randomised controlled trial was carried out between 2008 and 2010 in the University Hospital of Auvergne and two private hospitals in Clermont-Ferrand, France. Eligible patients were women in complete breast cancer remission without contraindication for physical activities or cognitive disorders and a body mass index between 18.5 and 40 kg/m(2). The intervention group underwent spa treatment combined with consultation with dietician whereas the control underwent consultations with the dietician only. Of the 181 patients randomised, 92 and 89 were included in the intervention and the control groups, respectively. The CEA involved 90 patients, 42 from the intervention group and 48 from the control group. The main results showed a higher rate of resumption of occupational activities in the intervention group (p = 0.0025) and a positive effect of the intervention on the women's ability to perform occupational activities 12 months after the beginning of the study (p = 0.0014), and on their ability to perform family activities (p = 0.033). The stay in a thermal centre was cost-effective at 12 months. Spa treatment is a cost-effective strategy to improve resumption of occupational and non-occupational activities and the abilities of women in breast cancer remission. Copyright © 2014 Elsevier Ltd. All rights reserved.

  13. Satisfaction among residents in ASHP-accredited pharmacy residency programs.

    PubMed

    VanDenBerg, C; Murphy, J E

    1997-07-01

    The level of work satisfaction among pharmacists in ASHP-accredited residencies was studied. In March 1996 a questionnaire designed to measure residency satisfaction was mailed to 697 individuals in ASHP-accredited pharmacy practice and specialty practice residencies. Subjects responded to 16 statements relating to intrinsic and extrinsic determinants of work satisfaction on a scale of 1 to 5, where 1 = strongly disagree and 5 = strongly agree. Questionnaires were returned by 413 (59%) of the residents. The respondents were predominantly women (76%), and most (86%) had at least a Pharm. D. degree. Hospitals were the primary work setting (88%). Of the 413 residents, 305 were in pharmacy practice residencies and 108 were in specialized residencies. None of the mean scores indicated disagreement (scores < 3) with the positively worded statements or agreement (scores > 3) with the negatively worded statements. The median and mode were equal to 2 (disagree) for the three negatively worded items and 4 (agree) for all but three positively worded items. Only 8% of the residents indicated that they would not accept the residency again if given the chance. Specialized residents tended to rate positively worded statements higher and negatively worded statements lower than pharmacy practice residents. Female residents indicated greater satisfaction than male residents. Pay and benefits were rated slightly better than neutral. Pharmacy residents appeared generally satisfied with their residencies. Specialized pharmacy residents were more satisfied than pharmacy practice residents, and women were more satisfied than men.

  14. Burnout Syndrome During Residency.

    PubMed

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

    2016-10-01

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

  15. Burnout Syndrome During Residency

    PubMed Central

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

    2016-01-01

    Objective The aim of this study is identified the degree of Burnout Syndrome (BOS) and find out its correlation with years of recidency and sociodemograpfic chareacteristics, training, sleeping habits, such as smoking and alcohol consumption. Methods After approval from the Hospital Ethics Committee and obtaining informed consent, First, second, third, fourth and fifth year of recidency staff (n=127) working in our hospital were involved in this study. The standardized Maslach Burnout Inventory (MBI) was used in this study. Results Fifty six male (44.1%) and seventy one female (55.9%) residents were enroled in this study (Coranbach Alfa(α)=0.873). 57% of the first year residents smokes cigaret and 54% of them use alcohol. 2% of them gets one day off after hospital night shift, 61% of them suffers from disturbed sleep. 60% of them had been stated that they willingly selected their profession. 61% of them prefers talking to friends and 32% of them prefers shopping to overcome stress. There were statistical difference acording to years of recidency in MBI, Emotional Burnout (EB) and desensitisation scale (DS) points. EB scale points of the second year of residency group was statisticaly higher than fourth year of residency group. DS points of second year of residency group was also statisticaly higher than the third and fourth year of residency group. There was no statistical difference between any groups in Personal Success. Conclusion BOS is a frequent problem during residency in anaesthesia. Appropriate definition and awareness are the first important steps to prevent this syndrome. Further administrative approaches should be evaluated with regard to their effects. PMID:27909607

  16. Radiology report turnaround time: effect on resident education.

    PubMed

    England, Eric; Collins, Jannette; White, Richard D; Seagull, F Jacob; Deledda, John

    2015-05-01

    To compare resident workload from Emergency Department (ED) studies before and after the implementation of a required 1-hour report turnaround time (TAT) and to assess resident and faculty perception of TAT on resident education. Resident study volume will be compared for 3 years before and 1 year after the implementation of a required 1-hour TAT. Changes to resident workload will be compared among the different radiology divisions (body, muscuolskeletal (MSK), chest, and neuro), as well as during different shifts (daytime and overnight). Residents and faculty at two Midwest institutions, both of which have a required report TAT, will be invited to participate in an online survey to query the perceived effect on resident education by implementation of this requirement. A P < .05 was considered statistically significant. A significant decrease in resident involvement in ED studies was noted in the MSK, chest, and neuro sections with average involvement of the 3 years before the 1-hour TAT of 89%, 88%, and 82%, respectively, which decreased to 66%, 68%, and 51% after the 1-hour TAT requirement (P < .05). The resident involvement in ED studies only mildly decreased in the body section from an average before the 1-hour TAT of 87% to 80% after the 1-hour TAT requirement (P < .1). There was an overall significant decrease in resident ED study involvement during the daytime (P = .01) but not after hours during resident call (P = .1). Seventy percent of residents (43 of 61) and 55% of faculty (63 of 114) responded to our surveys. Overall, residents felt their education from ED studies during the daytime and overnight were good. However, residents who were present both before and after the implementation of a required TAT felt their education had been significantly negatively affected. Faculty surveyed thought that the required TAT negatively affected their ability to teach and decreased the quality of resident education. Residents are exposed to fewer ED studies after the

  17. 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.

  18. An assigned teaching resident rotation.

    PubMed

    Daniels-Brady, Catherine; Rieder, Ronald

    2010-01-01

    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 specialty board exam and to develop teaching skills in preparation for attending positions. Changing the residency program structure and implementing a Teaching Resident rotation addressed these needs simultaneously. The authors describe the responsibilities of the teaching resident, the role of the teaching resident in the program, and instruction in educational methods. Residents shared their perceptions of the new teaching resident rotation in an anonymous survey. PGY-1, PGY-2, and the PGY-4 residents found the teaching resident rotation helpful in many areas of their learning. Service requirements were not compromised and highly valuable educational objectives were achieved for both the PGY-4 teaching residents and the PGY-1 and PGY-2 residents whom they taught. An intensive teaching rotation for senior residents who teach junior residents and medical students is an effective way to deal with systemic changes in psychiatric education.

  19. Financing Residency Training Redesign

    PubMed Central

    Carney, Patricia A.; Waller, Elaine; Green, Larry A.; Crane, Steven; Garvin, Roger D.; Pugno, Perry A.; Kozakowski, Stanley M.; Douglass, Alan B.; Jones, Samuel; Eiff, M. Patrice

    2014-01-01

    Background Redesign in the health care delivery system creates a need to reorganize resident education. How residency programs fund these redesign efforts is not known. Methods Family medicine residency program directors participating in the Preparing Personal Physicians for Practice (P4) project were surveyed between 2006 and 2011 on revenues and expenses associated with training redesign. Results A total of 6 university-based programs in the study collectively received $5,240,516 over the entire study period, compared with $4,718,943 received by 8 community-based programs. Most of the funding for both settings came from grants, which accounted for 57.8% and 86.9% of funding for each setting, respectively. Department revenue represented 3.4% of university-based support and 13.1% of community-based support. The total average revenue (all years combined) per program for university-based programs was just under $875,000, and the average was nearly $590,000 for community programs. The vast majority of funds were dedicated to salary support (64.8% in university settings versus 79.3% in community-based settings). Based on the estimated ratio of new funding relative to the annual costs of training using national data for a 3-year program with 7 residents per year, training redesign added 3% to budgets for university-based programs and about 2% to budgets for community-based programs. Conclusions Residencies undergoing training redesign used a variety of approaches to fund these changes. The costs of innovations marginally increased the estimated costs of training. Federal and local funding sources were most common, and costs were primarily salary related. More research is needed on the costs of transforming residency training. PMID:26140119

  20. Knowledge and attitude of European urology residents about ionizing radiation.

    PubMed

    Söylemez, Haluk; Sancaktutar, Ahmet Ali; Silay, Mesrur Selcuk; Penbegül, Necmettin; Bozkurt, Yaşar; Atar, Murat; Altunoluk, Bülent; Bodakci, Mehmet Nuri; Hatipoglu, Namık Kemal

    2013-01-01

    To evaluate the attitude and knowledge of urology residents concerning ionizing radiation, we undertook a survey of European urology residents. The questionnaire was sent to 1184 urology residents within the database of the European Society of Residents in Urology (ESRU) by e-mail between November 2011 and January 2012. The questionnaire was composed of demographic questions and questions about the frequency of radiation exposure and use of radiation safety measures during fluoroscopy-guided endourologic procedures. In addition, there were questions about education programs and respondents' knowledge about diagnostic imaging modalities. A total of 124 questionnaires were returned from urology residents in 20 different European countries. All of the respondents reported that they were routinely exposed to ionizing radiation, and 69 (72.5%) were exposed more than 3 times per week. Despite the common but not sufficient use of lead aprons (75%), use of other radiation protection measures was very low. Although 55% of the respondents had attended an education program in Europe about radiation safety, attendance was highest in Poland (82.6%). The level of knowledge about ionizing radiation was low among urology residents, and approximately half of responders had no idea that commonly used imaging modalities have a fatal cancer risk. The results of this study showed the lack of knowledge and awareness about the importance of ionizing radiation protection among urology residents in Europe. We therefore suggest radiation safety courses in every step of medical life for doctors, especially for endourologists. Copyright © 2013 Elsevier Inc. All rights reserved.

  1. Does research participation make a difference in residency training?

    PubMed

    Macknin, Jonathan B; Brown, Amy; Marcus, Randall E

    2014-01-01

    The American Board of Orthopaedic Surgery requirements state that an orthopaedic residency must offer at least 5 years of clinical education and some exposure to research. To expose residents to basic research, some programs, including ours, have a research track that allows for 1 year of basic science research. The degree to which research productivity during residency-which may be something that can perhaps be influenced by interventions like research tracks during residency-affects residency graduates' future research contributions is unknown. Our research goals were to determine whether (1) residents who published in a peer-reviewed journal during residency were more likely to publish in their careers after graduation; (2) residents who participated in an elective research year were more likely to publish at least one paper in a peer-reviewed journal during residency; and (3) residents who participated in the research year were more likely to choose academic careers. Using questionnaires, online PubMed searches, and office contact, the career paths (academic versus private practice) and publications in peer-reviewed journals of all 122 Case Western Reserve University orthopaedics residents who completed training from 1987 to 2006 were analyzed. Seventy-five percent of residents who published peer-reviewed research during residency continued with peer-reviewed publications in their careers versus 55% of residents who did not publish during residency (p = 0.02). No difference in career paths was observed between the Case Western Reserve University research and traditional track-trained surgeons. During residency, however, research track-trained surgeons were more likely to publish in peer-reviewed journals (71% versus 41% of traditional track-trained surgeons, p < 0.01). Residents who publish in a peer-reviewed journal during residency are more likely to continue publishing in their future careers as orthopaedic surgeons. Future studies are needed to elucidate

  2. The pediatric resident training on tobacco project: interim findings.

    PubMed Central

    Hymowitz, Norman; Schwab, Joseph; Haddock, Christopher Keith; Pyle, Sara; Meshberg, Sarah

    2006-01-01

    OBJECTIVES: The Pediatric Residency Training on Tobacco Project is a four-year randomized prospective study of the efficacy of training pediatric residents to intervene on tobacco. At the start of the study (baseline), the pediatric residents uniformly agreed that environmental tobacco smoke (ETS) and tobacco use pose serious threats to the health of young people, and pediatricians should play a leadership role in the antismoking arena. However, very few went beyond advising patients and parents to modify their behavior by providing actual assistance, and many of them lacked necessary tobacco intervention skills and knowledge. We hypothesized that both standard training and special training programs would yield positive changes in intervention skills and activities, although the changes would be greater in residents exposed to the special training condition. In the present report, we present two-year outcome data from the resident tobacco surveys and objective structured clinical examinations (OSCEs) administered to independent waves of third-year residents in each experimental condition at baseline and year 2. METHODS: Fifteen pediatric residency training programs in the New York/New Jersey metropolitan area were assigned randomly to special and standard training conditions (eight to special and seven to standard training). Resident tobacco surveys and OSCEs were administered to third-year residents at the start of the training programs (baseline) and at years 1 and 2 of the study. Comparisons between sequential waves of third-year residents with no (baseline) or two-year exposure to the training programs permitted assessment of changes in resident beliefs, intervention activities and intervention skills within each experimental condition. RESULTS: By year 2, the residents associated with each training condition benefited from the training program, but the annual surveys and OSCEs revealed more significant positive changes for waves of residents in the special

  3. Observing Community Residences.

    ERIC Educational Resources Information Center

    Taylor, Steven J.; Bogdan, Robert

    The document offers guidelines effectively monitoring the quality of care provided in community residences serving people with disabilities. An initial section offers suggestions on observation and evaluation procedures. The remainder of the document lists possible questions to be asked in 19 areas: location, building and yard, relations with the…

  4. Residence Hall Fires.

    ERIC Educational Resources Information Center

    Wright, Dorothy

    1999-01-01

    Discusses how one college's experience with a tragic fire in one of its residence halls prompted a reevaluation of its fire-prevention-and-response strategies. Staff training, sprinkler installation, new alarm systems, and exit hardware to help make building exiting more efficient are discussed. (GR)

  5. Residence Hall Fires.

    ERIC Educational Resources Information Center

    Wright, Dorothy

    1999-01-01

    Discusses how one college's experience with a tragic fire in one of its residence halls prompted a reevaluation of its fire-prevention-and-response strategies. Staff training, sprinkler installation, new alarm systems, and exit hardware to help make building exiting more efficient are discussed. (GR)

  6. Researchers in Residence.

    ERIC Educational Resources Information Center

    Richards, Julian

    1996-01-01

    Describes a program that is part of the Pupil Researcher Initiative (PRI) where volunteer Ph.D. students visit schools to help bring the excitement and wonder of science and engineering research to the classroom. The purpose of the Researchers in Residence program is to bring students and teachers in schools into contact with research scientists…

  7. 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.…

  8. 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.…

  9. A Fine Arts Residency.

    ERIC Educational Resources Information Center

    Riggs, Patricia L.

    1982-01-01

    A four-week writer-in-residence program designed to stimulate the creativity of K-5 students was held in the Briar Glen Library Media Center, Wheaton, Illinois, with poet Joan Colby. This description of the program includes information on planning, funding, and future plans. (CHC)

  10. 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

  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. VOCs in representative canadian residences

    NASA Astrophysics Data System (ADS)

    Otson, Rein; Fellin, Philip; Tran, Quang

    Stored extracts of passive samplers exposed in 757 randomly selected Canadian residences provided a unique opportunity for retrospective determination of the occurrence of airborne volatile organic compounds (VOCs). Aliquots of the individual extracts were pooled to form a composite exposure sample and a corresponding blank sample. To identify and quantitate potentially hazardous organics in the samples, GC-MS analyses were conducted by several approaches. The amounts of 52 target compounds in the the composite sample were estimated based on selected ion monitoring (SIM) results, extraction recoveries, average air volume sampled, and 3M OVM 3500 passive sampling rates. Forty of the organics were detected and were present in amounts equivalent to airborne concentrations ranging from <1 to 104 μg m -3. Several other compounds were also tentatively identified by full scan analysis. Many of the detected organics have been reported to be associated with activities such as tobacco smoking and the presence of consumer products and plastic materials indoors. The analytical results have been useful in risk assessments and establishment of a new Canadian priority substances list (PSL).

  13. Interprofessional Integrative Medicine Training for Preventive Medicine Residents.

    PubMed

    Cowen, Virginia S; Thomas, Pauline A; Gould-Fogerite, Susan E; Passannante, Marian R; Mahon, Gwendolyn M

    2015-11-01

    Integrative medicine training was incorporated into the Rutgers New Jersey Medical School Preventive Medicine residency at the Rutgers Biomedical and Health Sciences Newark Campus as a collaboration between the Rutgers New Jersey Medical School and the School of Health Related Professions. Beginning in 2012, an interdisciplinary faculty team organized an Integrative Medicine program in a Preventive Medicine residency that leveraged existing resources across Rutgers Biomedical and Health Sciences. The overarching aim of the programs was to introduce residents and faculty to the scope and practice of integrative medicine in the surrounding Newark community and explore evidence-based research on integrative medicine. The faculty team tapped into an interprofessional network of healthcare providers to organize rotations for the preventive medicine residents that reflected the unique nature of integrative medicine in the greater Newark area. Residents provided direct care as part of interdisciplinary teams at clinical affiliates and shadowed health professionals from diverse disciplines as they filled different roles in providing patient care. The residents also participated in research projects. A combination of formal and informal programs on integrative medicine topics was offered to residents and faculty. The Integrative Medicine program, which ran from 2013 through 2014, was successful in exposing residents and faculty to the unique nature of integrative medicine across professions in the community served by Rutgers Biomedical and Health Sciences. Copyright © 2015 American Journal of Preventive Medicine. Published by Elsevier Inc. All rights reserved.

  14. The Fundamentals of Resident Dismissal.

    PubMed

    Schenarts, Paul J; Langenfeld, Sean

    2017-02-01

    Residents have the rights and responsibilities of both students and employees. Dismissal of a resident from a training program is traumatic and has lasting repercussions for the program director, the faculty, the dismissed resident, and the residency. A review of English language literature was performed using PUBMED and OVID databases, using the search terms, resident dismissal, resident termination, student dismissal, student and resident evaluation, legal aspects of education, and remediation. The references of each publication were also reviewed to identify additional appropriate citations. If the Just Cause threshold has been met, educators have the absolute discretion to evaluate academic and clinical performance. Legal opinion has stated that it is not necessary to wait until a patient is harmed to dismiss a resident. Evaluations should be standard and robust. Negative evaluations are not defamatory as the resident gave consent to be evaluated. Provided departmental and institutional polices have been followed, a resident can be dismissed without a formal hearing. Residencies are entitled to modify academic requirements and dismissal is not considered a breach of contract. Although there is anxiety regarding resident dismissal, the courts have uniformly supported faculty having this role. When indicated, failure to dismiss a resident also places the program director and the faculty at risk for educational malpractice.

  15. The Fundamentals of Resident Dismissal.

    PubMed

    Schenarts, Paul J; Langenfeld, Sean

    2017-02-01

    Residents have the rights and responsibilities of both students and employees. Dismissal of a resident from a training program is traumatic and has lasting repercussions for the program director, the faculty, the dismissed resident, and the residency. A review of English language literature was performed using PUBMED and OVID databases, using the search terms, resident dismissal, resident termination, student dismissal, student and resident evaluation, legal aspects of education, and remediation. The references of each publication were also reviewed to identify additional appropriate citations. If the Just Cause threshold has been met, educators have the absolute discretion to evaluate academic and clinical performance. Legal opinion has stated that it is not necessary to wait until a patient is harmed to dismiss a resident. Evaluations should be standard and robust. Negative evaluations are not defamatory as the resident gave consent to be evaluated. Provided departmental and institutional polices have been followed, a resident can be dismissed without a formal hearing. Residencies are entitled to modify academic requirements and dismissal is not considered a breach of contract. Although there is anxiety regarding resident dismissal, the courts have uniformly supported faculty having this role. When indicated, failure to dismiss a resident also places the program director and the faculty at risk for educational malpractice.

  16. Resident vascular progenitor cells.

    PubMed

    Torsney, Evelyn; Xu, Qingbo

    2011-02-01

    Homeostasis of the vessel wall is essential for maintaining its function, including blood pressure and patency of the lumen. In physiological conditions, the turnover rate of vascular cells, i.e. endothelial and smooth muscle cells, is low, but markedly increased in diseased situations, e.g. vascular injury after angioplasty. It is believed that mature vascular cells have an ability to proliferate to replace lost cells normally. On the other hand, recent evidence indicates stem/progenitor cells may participate in vascular repair and the formation of neointimal lesions in severely damaged vessels. It was found that all three layers of the vessels, the intima, media and adventitia, contain resident progenitor cells, including endothelial progenitor cells, mesenchymal stromal cells, Sca-1+ and CD34+ cells. Data also demonstrated that these resident progenitor cells could differentiate into a variety of cell types in response to different culture conditions. However, collective data were obtained mostly from in vitro culture assays and phenotypic marker studies. There are many unanswered questions concerning the mechanism of cell differentiation and the functional role of these cells in vascular repair and the pathogenesis of vascular disease. In the present review, we aim to summarize the data showing the presence of the resident progenitor cells, to highlight possible signal pathways orchestrating cell differentiation toward endothelial and smooth muscle cells, and to discuss the data limitations, challenges and controversial issues related to the role of progenitors. This article is part of a special issue entitled, "Cardiovascular Stem Cells Revisited".

  17. HIV-Negative Partnered Men's Willingness to Use Non-Occupational Post-Exposure Prophylaxis and Associated Factors in a U.S. Sample of HIV-Negative and HIV-Discordant Male Couples

    PubMed Central

    Sophus, Amber I.; Petroll, Andrew E.

    2016-01-01

    Abstract Purpose: Non-occupational post-exposure prophylaxis (nPEP) is an underutilized biomedical option for HIV prevention. Few studies have assessed male couples' knowledge of and willingness to use nPEP. Methods: Cross-sectional dyadic data from 275 HIV-negative and 58 HIV-discordant male couples were used to describe HIV-negative, partnered men's awareness of and willingness to use nPEP, and factors associated with their willingness to use nPEP. Data were analyzed with the use of multivariate multilevel modeling. Results: Less than a third of the men were aware of nPEP, yet 73% were very-to-extremely likely to use nPEP. Partnered men's willingness to use nPEP was positively associated with having an individual income less than $30,000 USD and serosorting within the relationship. Willingness to use nPEP was negatively associated with greater age difference between primary partners and with higher scores on measures of couples' investment in their relationship. Conclusion: Efforts should be made to increase male couples' awareness of nPEP and how to access nPEP. Uptake of nPEP has the potential to help avert new HIV infections among male couples. PMID:26789400

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

    PubMed

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

    2016-01-01

    Resident fatigue has become a point of emphasis in medical education and its effects on otolaryngology residents and their patients require further study. The purpose of our study was to evaluate the prevalence and nature of fatigue in otolaryngology residents, evaluate various quality of life measures, and investigate associations of increased fatigue with resident safety. Anonymous survey. Internet based. United States allopathic otolaryngology residents. None. The survey topics included demographics, residency structure, sleep habits and perceived stress. Responses were correlated with a concurrent Epworth Sleep Scale questionnaire to evaluate effects of fatigue on resident training and quality of life. 190 residents responded to the survey with 178 completing the Epworth Sleep Scale questionnaire. Results revealed a mean Epworth Sleep Scale score of 9.9±5.1 with a median of 10.0 indicating a significant number of otolaryngology residents are excessively sleepy. Statistically significant correlations between Epworth Sleep Scale and sex, region, hours of sleep, and work hours were found. Residents taking in-house call had significantly fewer hours of sleep compared to home call (p=0.01). Residents on "head and neck" (typically consisting of a large proportion of head and neck oncologic surgery) rotations tended to have higher Epworth Sleep Scale and had significantly fewer hours of sleep (p=.003) and greater work hours (p<.001). Additionally, residents who reported no needle stick type incidents or near motor vehicle accidents had significantly lower mean Epworth Sleep Scale scores. Only 37.6% of respondents approve of the most recent Accreditation Council for Graduate Medical Education work hour restrictions and 14% reported averaging greater than 80hours of work/week. A substantial number of otolaryngology residents are excessively sleepy. Our data suggest that the effects of fatigue play a role in resident well-being and resident safety. Copyright © 2016

  19. Challenges to publishing pharmacy resident research projects from the perspectives of residency program directors and residents

    PubMed Central

    Irwin, Adriane N.; Olson, Kari L.; Joline, Brigitte R.; Witt, Daniel M.; Patel, Rachana J.

    Objective To identify barriers to completing and publishing pharmacy residency research projects from the perspective of program directors and former residents. Methods This was a cross-sectional survey of pharmacy residency program directors and former post-graduate year one and two residents. Directors of pharmacy residency programs whose residents present their projects at the Western States Conference (n=216) were invited to complete an online survey and asked to forward the survey to former residents of their program in 2009, 2010, or 2011. The survey focused on four broad areas: 1) demographic characteristics of the residency programs, directors, and residents; 2) perceived value of the research project; 3) perceived barriers with various stages of research; and 4) self-identified barriers to successful research project completion and publication. Results A total of 32 program directors and 98 residents completed the survey. The minority of programs offered formal residency research training. Both groups reported value in the research project as part of residency training. Significantly more directors reported obtaining institutional review board approval and working through the publication process as barriers to the research project (46.7% vs. 22.6% and 73.3% vs. 43.0%, respectively p<0.05) while residents were more likely to report collecting and analyzing the data as barriers (34.4% vs. 13.3% and 39.8% vs. 20.0%, respectively, p<0.05). Both groups self-identified time constraints and limitations in study design or quality of the study as barriers. However, while program directors also indicated lack of resident motivation (65.5%), residents reported lack of mentorship or program structural issues (43.3%). Conclusions Overall, while both groups found value in the residency research projects, there were barriers identified by both groups. The results of this study may provide areas of opportunity for improving the quality and publication rates of resident

  20. 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.

  1. Psychological symptoms and quality of life among residents ...

    EPA Pesticide Factsheets

    Objective: Elevated levels of air manganese (air-Mn) exposure have been associated with adverse health effects. This study examined the relationship of air-Mn concentrations with mood and quality of life.Participants and methods: 185 residents (age mean (M)=55.13±10.88; education yrs M=13.77±2.60; residence yrs M=41.01±16.91) exposed to long-term air-Mn from two Ohio towns, and 90 residents (age M=55.53±10.96; education yrs M=15.18±3.04; residence yrs M=33.59±17.25) from an unexposed Ohio town completed the Healthy Days Measures of the BRFSS, and the Symptom Checklist-90-Revised (SCL-90-R). In the SCL-90-R, “caseness” is defined as at least two symptom dimensions at or above 90th percentile of the normative population. Air-Mn concentrations were estimated over ten years using the U.S. EPA’s AERMOD dispersion model. ANCOVA, chi-square and regression analyses were used with years of residence and education as covariates.Results: The exposed towns had proportionally more residents with ≥2 elevated SCL-90-R dimensions (“cases”) than the unexposed town (χ²=3.602, p=.058). Air-Mn concentrations were associated with higher levels of Anxiety (β=.162, p=.031) and higher Positive Symptom Distress (β=.147, p=.048). Obsessive-compulsive (β=.137, p=.071) and Psychoticism (β=.136, p=.072) approached significance. Air-Mn concentrations were associated with poor mental health in the past 30 days (β=.168, p=.026). Exposed “case” residents compared to

  2. Victim or Initiator? Certified Nursing Assistants’ Perceptions of Resident Characteristics that Contribute to Resident-to-Resident Violence in Nursing Homes

    PubMed Central

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

    2014-01-01

    The purpose of this portion of a larger qualitative study was to explore certified nursing assistants’ (CNA) perceptions of the characteristics of both the victims and initiators of resident-to-resident violence (RRV) in order to identify resident characteristics that influence the development of RRV. Data were collected using a demographic form and semi-structured interviews. Demographic data were analyzed using descriptive statistics and interview data were analyzed using content analysis and constant comparison. The results revealed that CNAs perceive initiators of RRV to be “more with it,” to have “stronger personalities,” “shorter fuses,” and “life history” that makes them prone to inflict harm on other residents. Certified nursing assistants described victims of RRV using phrases such as, “they don’t know,” “can’t communicate,” and “gets around good.” These results indicate that there are resident characteristics that may indicate whether a resident is likely to commit, or become involved as a victim in, RRV. The results also revealed that, in some situations, residents who were normally easy going and even tempered might strike out with violence if exposed to a large number of triggers over time. This study provides the first detailed description of nursing home residents who initiate violence against other residents. Knowledge gained from this study may be useful in developing models of RRV, a precursor to developing interventions for the prevention of RRV. PMID:21678883

  3. [Resident foreigners in Spain].

    PubMed

    Solana, A M; Pascual De Sans, A

    1994-01-01

    The authors review trends in the size of the resident foreign population in Spain over time since the 1940s. A continuing growth over time, with temporal fluctuations, is noted, with a rapid rise in immigration in the 1980s, leading to new legislation designed to control immigration in 1985-1986 and 1991. The authors note that Europeans, particularly from countries of the European Union, make up a large percentage of the foreign population, but that the number of immigrants from developing countries has increased significantly in the last 10 years.

  4. The effect of ACGME resident duty hour reforms on outcomes of physicians after completion of residency

    PubMed Central

    Jena, Anupam B.; Schoemaker, Lena; Bhattacharya, Jayanta

    2014-01-01

    In 2003, work hours for physicians in training (residents) were mandatorily reduced to be no more than 80 hours per week, leading to the hotly debated but unexplored issue of whether physicians today are less well trained as a result of these work hour reforms. Using a unique database of nearly all hospitalizations in Florida during 2000–2009 which were linked to detailed information on the medical training history of the physician of record for each hospitalization, we studied whether hospital mortality and length of stay for internists varied according to the number of years an internist was exposed to the 2003 duty hour regulations during their own residency. Using a difference-in-difference analysis which compared trends in outcomes of junior physicians pre- and post-2003 to a control group of senior physicians who were not exposed to these reforms during their own residency, we found that the 2003 reforms did not affect the quality of physician training reflected by hospital mortality and length of stay. PMID:25288430

  5. Simulation Improves Resident Performance in Catheter-Based Intervention

    PubMed Central

    Chaer, Rabih A.; DeRubertis, Brian G.; Lin, Stephanie C.; Bush, Harry L.; Karwowski, John K.; Birk, Daniel; Morrissey, Nicholas J.; Faries, Peter L.; McKinsey, James F.; Kent, K Craig

    2006-01-01

    Objectives: Surgical simulation has been shown to enhance the training of general surgery residents. Since catheter-based techniques have become an important part of the vascular surgeon's armamentarium, we explored whether simulation might impact the acquisition of catheter skills by surgical residents. Methods: Twenty general surgery residents received didactic training in the techniques of catheter intervention. Residents were then randomized with 10 receiving additional training with the Procedicus, computer-based, haptic simulator. All 20 residents then participated in 2 consecutive mentored catheter-based interventions for lower extremity occlusive disease in an OR/angiography suite. Resident performance was graded by attending surgeons blinded to the resident's training status, using 18 procedural steps as well as a global rating scale. Results: There were no differences between the 2 resident groups with regard to demographics or scores on a visuospatial test administered at study outset. Overall, residents exposed to simulation scored higher than controls during the first angio/OR intervention: procedural steps (simulation/control) (50 ± 6 vs. 33 ± 9, P = 0.0015); global rating scale (30 ± 7 vs. 19 ± 5, P = 0.0052). The advantage provided by simulator training persisted with the second intervention (53 ± 6 vs. 36 ± 7, P = 0.0006); global rating scale (33 ± 6 vs. 21 ± 6, P = 0.0015). Moreover, simulation training, particularly for the second intervention, led to enhancement in almost all of the individual measures of performance. Conclusion: Simulation is a valid tool for instructing surgical residents and fellows in basic endovascular techniques and should be incorporated into surgical training programs. Moreover, simulators may also benefit the large number of vascular surgeons who seek retraining in catheter-based intervention. PMID:16926560

  6. Interactions between Medical Residents and Drug Companies: A National Survey after the Mediator® Affair

    PubMed Central

    Montastruc, François; Moulis, Guillaume; Palmaro, Aurore; Gardette, Virginie; Durrieu, Geneviève; Montastruc, Jean-Louis

    2014-01-01

    Background The present study aimed to describe exposure and attitudes of French medical residents towards pharmaceutical industry. The study was performed shortly after the Mediator affair which revealed several serious conflicts of interest inside the French health system. Methods and Findings A cross-sectional study was implemented among residents from 6 French medical faculties. Independent education in pharmacology, attitudes towards the practices of pharmaceutical sales representatives, opinions concerning the pharmaceutical industry, quality of information provided by the pharmaceutical industry, and opinions about pharmaceutical company sponsorship were investigated through a web-based questionnaire. We also assessed potential changes in resident attitudes following the Mediator affair. The mean value of exposure to drug companies was 1.9 times per month. Global opinions towards drug company information were negative for 42.7% of the residents and positive for only 8.2%. Surprisingly, 81.6% of residents claimed that they had not changed their practices regarding drug information since the Mediator affair. Multivariate analyses found that residents in anesthesiology were less likely to be exposed than others (OR = 0.17 CI95% [0.05–0.61]), exposure was significantly higher at the beginning of residence (p<0.001) and residents who had a more positive opinion were more frequently exposed to drug companies (OR = 2.12 CI95% [1.07–4.22]). Conclusions Resident exposure to drug companies is around 1 contact every 2 weeks. Global opinion towards drug information provided by pharmaceutical companies was negative for around 1 out of 2 residents. In contrast, residents tend to consider the influences of the Mediator affair on their practice as relatively low. This survey enabled us to identify profiles of residents who are obviously less exposed to pharmaceutical industry. Current regulatory provisions are not sufficient, indicating that further efforts are

  7. Recruiting strategies for potential 0+5 vascular residency applicants.

    PubMed

    Illig, Karl A; Kalata, Emily; Reed, Amy; Glass, Carolyn; Gillespie, David L

    2012-01-01

    The 0+5 integrated vascular residency training pathway was established in 2006 to allow for trainee-focused training culminating in vascular surgery certification only. An early concern was whether enough medical students could be recruited directly into a vascular internship without the exposure that a general surgery residency provides. We hypothesized that programs that send a large percentage of their general surgical graduates to vascular fellowships have models that can be adapted to medical student recruitment. Opinions and practices were sought from program directors through survey and from trainees taking the Vascular Surgery In-Training Examination. Eight programs were identified that sent 20% or more of their residents to vascular fellowships over the past 5 years (projecting a mean of 1.6 residents entering vascular fellowships in 2011). Almost all such programs have a formal mentoring system in place that match mentors to residents by interest, and almost all send residents to academic meetings before their senior year. Seventy-five percent of such programs have formal vascular lecture exposure to the first and second year medical student classes, offer clinical shadowing experiences, and have time on the vascular service during the MS3 clerkship; 83% offer a third- or fourth-year elective in vascular surgery. Vascular Surgery In-Training Examination responses were collected from 156 fellows and 13 "0+5" residents. Although fellows had initially been attracted to vascular surgery by the technical aspects of the field learned during residency (43%), the most important factor initially attracting medical students was an interested mentor (46%). However, the most important factor for both residents and students in making a final decision was the technical aspects of the field (66% and 63%, respectively). Although residents are automatically exposed to the field during residency, students can only be exposed to vascular surgery if a conscious effort is

  8. 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

  9. High levels of concomitant behavioral health disorders among patients presenting for HIV non-occupational post-exposure prophylaxis at a Boston community health center between 1997 and 2013

    PubMed Central

    Jain, Sachin; Oldenburg, Catherine E.; Mimiaga, Matthew J.; Mayer, Kenneth H.

    2015-01-01

    A paucity of information regarding mental health exists for patients presenting for HIV non occupational post-exposure prophylaxis (nPEP). We reviewed electronic medical records of 894 adult nPEP patients seen at a large Boston community health center between 1997 and 2013. Of 821 patients with consensual sexual exposures, 88.3% were men who have sex with men, and 40.0% had a mental health diagnosis. Diagnoses included: depression (24.4%), anxiety (21.9%), attention deficit disorder (7.8%), post-traumatic stress disorder (3.3%), and psychotic disorders (3.3%). Of 129 patients with substance use disorders, alcohol dependence (65.9%) and crystal methamphetamine (43.4%) predominated. Unprotected receptive anal intercourse was associated with psychotic disorders (aOR=4.86;95%CI:1.76–13.5) and substance use disorders (aOR=1.89;95%CI:1.28–2.80). Substance use at the time of exposure was associated with: depression (aOR=1.95;95%CI:1.36–2.80), anxiety (aOR=2.22;95%CI:1.51–3.25), attention deficit disorder (aOR=1.96;95%CI:1.18–3.27), and substance use disorder (aOR=4.78;95%CI:3.30–6.93). Mental illness should be screened for and addressed at nPEP visits to optimize HIV risk-reduction. PMID:25689892

  10. Improving methods of resident selection.

    PubMed

    Prager, Jeremy D; Myer, Charles M; Hayes, Kay M; Myer, Charles M; Pensak, Myles L

    2010-12-01

    Applying the concept of the ACGME general competencies, it is possible to define the essential job objectives and competencies of a junior otolaryngology resident. The objective of this study is to incorporate commercially available tools of business in the identification of competencies specific to the junior otolaryngology resident and develop behavioral-based interview questions and techniques designed to identify these qualities in candidates for residency. Institution of a pilot program involving a focus group within an otolaryngology department, a professional development consultant, commercial business software for occupational analysis and personnel selection, and an interview technique training seminar for faculty and residents. In coordination with a university-based professional development consultant, a formal job analysis was conducted to define the job objectives and competencies of a junior otolaryngology resident. These results were used to generate behavioral-based interview questions for use in the resident selection process. All interviewing faculty and residents were trained in behavioral-based interviewing. Occupational objectives for the junior resident position specific to a particular university department of otolaryngology were identified. Additionally, the essential skills, areas of knowledge, and competencies were identified. Behavioral-based questions specific to the competencies were created and incorporated into the current resident selection interview. Using tools of occupational analysis and personnel selection, a list of job objectives and competencies for the junior otolaryngology resident can be created. Using these results, behavioral-based interviews may be implemented to complement traditional interviews with the ultimate goal of improving candidate selection.

  11. Guidelines for resident teaching experiences.

    PubMed

    Havrda, Dawn E; Engle, Janet P; Anderson, Keri C; Ray, Shaunta' M; Haines, Seena L; Kane-Gill, Sandra L; Ballard, Stephanie L; Crannage, Andrew J; Rochester, Charmaine D; Parman, Malinda G

    2013-07-01

    Postgraduate year one (PGY1) and postgraduate year two (PGY2) residencies serve to develop pharmacists into skillful clinicians who provide advanced patient-centered care in various general and specialized areas of pharmacy practice. Pharmacy residencies are a minimum requirement for many clinical pharmacy positions, as well as for positions in academia. The role of clinical pharmacists typically includes teaching, regardless of whether they pursue an academic appointment. Common teaching duties of pharmacist-clinicians include giving continuing education or other invited presentations, providing education to colleagues regarding clinical initiatives, precepting pharmacy students (early and advanced experiences) and residents, and educating other health care professionals. Although ASHP provides accreditation standards for PGY1 and PGY2 residencies, the standards pertaining to teaching or education training are vague. Through the years, teaching certificate programs that develop residents' teaching skills and better prepare residents for a diverse pharmacy job market have increased in popularity; moreover, teaching certificate programs serve as an attractive recruitment tool. However, the consistency of requirements for teaching certificate programs is lacking, and standardization is needed. The Task Force on Residencies developed two sets of guidelines to define teaching experiences within residencies. The first guideline defines the minimum standards for teaching experiences in any residency-training program. The second guideline is for programs offering a teaching certificate program to provide standardization, ensuring similar outcomes and quality on program completion. One of the main differences between the guidelines is the recommendation that residency programs offering a teaching certificate program be affiliated with an academic institution to provide the pedagogy and variety of teaching experiences for the resident. Residency program directors should

  12. Cancer Incidence among Former Love Canal Residents

    PubMed Central

    Gensburg, Lenore J.; Pantea, Cristian; Kielb, Christine; Fitzgerald, Edward; Stark, Alice; Kim, Nancy

    2009-01-01

    Background The Love Canal was a rectangular 16-acre, 10-ft-deep chemical waste landfill situated in a residential neighborhood in Niagara Falls, New York. This seriously contaminated site came to public attention in 1978. Only one prior study examined cancer incidence in former residents of the Love Canal neighborhood (LC). Objective In this study we aimed to describe cancer incidence in former LC residents from 1979 to 1996 and to investigate whether it differs from that of New York State (NYS) and Niagara County (NC). Methods From 1978 to 1982, we interviewed 6,181 former residents, and 5,052 were eligible to be included in this study. In 1996, we identified 304 cancer diagnoses in this cohort using the NYS Cancer Registry. We compared LC cancer incidence with that of NYS and NC using standardized incidence ratios (SIRs), and we compared risks within the LC group by potential exposure to the landfill using survival analysis. Results SIRs were elevated for cancers of the bladder [SIRNYS = 1.44; 95% confidence interval (CI), 0.91–2.16] and kidney (SIRNYS = 1.48; 95% CI, 0.76–2.58). Although CIs included 1.00, other studies have linked these cancers to chemicals similar to those found at Love Canal. We also found higher rates of bladder cancer among residents exposed as children, based on two cases. Conclusions In explaining these excess risks, the role of exposure to the landfill is unclear given such limitations as a relatively small and incomplete study cohort, imprecise exposure measurements, and the exclusion of cancers diagnosed before 1979. Given the relatively young age of the cohort, further surveillance is warranted. PMID:19672407

  13. Advocacy skills in resident doctors.

    PubMed

    DeCesare, Julie; Jackson, Jessica

    2016-02-01

    The objective of this project was to study whether a standardised patient clinical encounter learning exercise improved an Obstetrics and Gynaecology (OBGYN) resident's ability to perform patient advocacy, a systems-based practice skill. Case-control study: each of the 12 residents functioned as their own control. Additionally, aggregate data from the programme was reviewed. Twelve residents from a mid-sized OBGYN residency programme performed a standardised patient clinical encounter exercise in March of 2014. As demonstrated by the Assessment for Professional Behavior (APB) 360° evaluation, the overall total scores for the programme on patient advocacy improved, with statistical significance, when analysed by the signed ranked test. Additionally, the residents' self-identified capability to perform advocacy improved after the programme, with statistical significance, when analysed by the signed rank test. A standardised patient clinical encounter, used as a learning exercise, can demonstrate meaningful improvement in the advocacy skills of a resident doctor. © 2015 John Wiley & Sons Ltd.

  14. Education Research: Neurology resident education

    PubMed Central

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

    2016-01-01

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

  15. Pathology Informatics Essentials for Residents

    PubMed Central

    Karcher, Donald S.; Harrison, James H.; Sinard, John H.; Riben, Michael W.; Boyer, Philip J.; Plath, Sue; Thompson, Arlene; Pantanowitz, Liron

    2016-01-01

    Context: Recognition of the importance of informatics to the practice of pathology has surged. Training residents in pathology informatics has been a daunting task for most residency programs in the United States because faculty often lacks experience and training resources. Nevertheless, developing resident competence in informatics is essential for the future of pathology as a specialty. Objective: To develop and deliver a pathology informatics curriculum and instructional framework that guides pathology residency programs in training residents in critical pathology informatics knowledge and skills, and meets Accreditation Council for Graduate Medical Education Informatics Milestones. Design: The College of American Pathologists, Association of Pathology Chairs, and Association for Pathology Informatics formed a partnership and expert work group to identify critical pathology informatics training outcomes and to create a highly adaptable curriculum and instructional approach, supported by a multiyear change management strategy. Results: Pathology Informatics Essentials for Residents (PIER) is a rigorous approach for educating all pathology residents in important pathology informatics knowledge and skills. PIER includes an instructional resource guide and toolkit for incorporating informatics training into residency programs that vary in needs, size, settings, and resources. PIER is available at http://www.apcprods.org/PIER (accessed April 6, 2016). Conclusions: PIER is an important contribution to informatics training in pathology residency programs. PIER introduces pathology trainees to broadly useful informatics concepts and tools that are relevant to practice. PIER provides residency program directors with a means to implement a standardized informatics training curriculum, to adapt the approach to local program needs, and to evaluate resident performance and progress over time. PMID:28725772

  16. Career interest and perceptions of nephrology: A repeated cross-sectional survey of internal medicine residents.

    PubMed

    Daniels, Michael N; Maynard, Sharon; Porter, Ivan; Kincaid, Hope; Jain, Deepika; Aslam, Nabeel

    2017-01-01

    Interest in nephrology careers among internal medicine residents in the United States is declining. Our objective was to assess the impact of the presence of a nephrology fellowship training program on perceptions and career interest in nephrology among internal medicine residents. A secondary objective was to identify commonly endorsed negative perceptions of nephrology among internal medicine residents. This was a repeated cross-sectional survey of internal medicine residents before (Group 1) and 3 years after (Group 2) the establishment of nephrology fellowship programs at two institutions. The primary outcome was the percentage of residents indicating nephrology as a career interest in Group 1 vs. Group 2. Secondary outcomes included the frequency that residents agreed with negative statements about nephrology. 131 (80.9%) of 162 residents completed the survey. 19 (14.8%) residents indicated interest in a nephrology career, with 8 (6.3%) indicating nephrology as their first choice. There was no difference in career interest in nephrology between residents who were exposed to nephrology fellows during residency training (Group 2) and residents who were not (Group 1). The most commonly endorsed negative perceptions of nephrology were: nephrology fellows have long hours/burdensome call (36 [28.1%] of residents agreed or strongly agreed), practicing nephrologists must take frequent/difficult call (35 [27.6%] agreed or strongly agreed), and nephrology has few opportunities for procedures (35 [27.3%] agreed or strongly agreed). More residents in Group 2 agreed that nephrology is poorly paid (8.9% in Group 1 vs. 20.8% in Group 2, P = 0.04), whereas more residents in Group 1 agreed that nephrologists must take frequent/difficult call (40.0% in Group 1 vs. 18.1% in Group 2, P = 0.02). The initiation of a nephrology fellowship program was not associated with an increase in internal medicine residents' interest in nephrology careers. Residents endorsed several negative

  17. Incorporating resident research into the dermatology residency program

    PubMed Central

    Wagner, Richard F; Raimer, Sharon S; Kelly, Brent C

    2013-01-01

    Programmatic changes for the dermatology residency program at The University of Texas Medical Branch were first introduced in 2005, with the faculty goal incorporating formal dermatology research projects into the 3-year postgraduate training period. This curriculum initially developed as a recommendation for voluntary scholarly project activity by residents, but it evolved into a program requirement for all residents in 2009. Departmental support for this activity includes assignment of a faculty mentor with similar interest about the research topic, financial support from the department for needed supplies, materials, and statistical consultation with the Office of Biostatistics for study design and data analysis, a 2-week elective that provides protected time from clinical activities for the purpose of preparing research for publication and submission to a peer-reviewed medical journal, and a departmental award in recognition for the best resident scholarly project each year. Since the inception of this program, five classes have graduated a total of 16 residents. Ten residents submitted their research studies for peer review and published their scholarly projects in seven dermatology journals through the current academic year. These articles included three prospective investigations, three surveys, one article related to dermatology education, one retrospective chart review, one case series, and one article about dermatopathology. An additional article from a 2012 graduate about dermatology education has also been submitted to a journal. This new program for residents was adapted from our historically successful Dermatology Honors Research Program for medical students at The University of Texas Medical Branch. Our experience with this academic initiative to promote dermatology research by residents is outlined. It is recommended that additional residency programs should consider adopting similar research programs to enrich resident education. PMID:23901305

  18. [Burnout syndrome in multiprofessional residents of a public university].

    PubMed

    Guido, Laura de Azevedo; da Silva, Rodrigo Marques; Goulart, Carolina Tonini; Bolzan, Maria Elaine de Oliveira; Lopes, Luiz Felipe Dias

    2012-12-01

    The multiprofessional residency programs seek to break paradigms regarding the education and training of professionals for the Unified Health System (Sistema Único de Saúde - SUS) and contribute to qualify health services by promoting innovative strategies. However, specific features of these programs can add stress to residents and lead to the Burnout Syndrome. Therefore, we assessed the occurrence of burnout syndrome among the multiprofessional residents at the Federal University of Santa Maria. This is a descriptive, cross-sectional and quantitative study. A sociodemographic data form and the Version Human Service Survey of Marlash Burnout Inventort were administered to 37 residents between April and June of 2011. It was observed that 37.84% presented with High Emotional Stress, 43.24% with High Depersonalization and 48.65% with Low Professional Fulfillment. In terms of the association between domains, it was found that 27% of the residents presented with signs of Burnout Syndrome. The studied residents will be exposed to the stressors of the profession and education/training, which may favor the occurrence of the syndrome in these professionals.

  19. Medical Residency Goes to School

    ERIC Educational Resources Information Center

    Boatright, Beth; Gallucci, Chrysan; Swanson, Judy; Van Lare, Michelle; Yoon, Irene

    2009-01-01

    The Highline School District, located roughly 10 miles south of Seattle, Washington, has begun to implement a residency model for professional learning. Like the medical model, current teachers often traveled from other schools to be "in residency" at a previously selected classroom for six half-day sessions during the 2005-06 school year. Some…

  20. The Artist-in-Residence

    ERIC Educational Resources Information Center

    Hall, James W.

    1977-01-01

    Institutions are bringing the professional artist into their instructional and cultural environments through five approaches: concert performances, extended performances, master classes, part-time residencies, and full-time residencies. The effect of each program on the artist and the college or university is examined. (Author/LBH)

  1. 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)

  2. The Challenge of Problem Residents

    PubMed Central

    Yao, David C; Wright, Scott M

    2001-01-01

    Internal medicine residency training is demanding and residents can experience a wide variety of professional and personal difficulties. Residency programs everywhere have had and will continue to have problem residents. Training programs should be equipped to effectively identify and manage residents who experience problems. Previous articles that have been published on the topic of problem residents primarily addressed concerns such as impairment due to depression and substance abuse. The content of this article is derived from a comprehensive review of the literature as well as other data sources such as interviews with program directors and workshops at national professional meetings. This article focuses primarily on four issues related to problem residents: their identification, underlying causes, management, and prevention. The study attempts to be evidence-based, wherever possible, highlighting what is known. Recommendations based on the synthesis of the data are also made. Future ongoing studies of problem residents will improve our understanding of the matters involved, and may ultimately lead to improved outcomes for these trainees. PMID:11520388

  3. 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…

  4. 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)

  5. 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…

  6. Advice for my chief resident.

    PubMed

    Panush, Richard S

    2017-05-16

    I have been privileged to have served as a division of rheumatology chief and/or program director for 18 years and as a department of medicine chair and medicine residency program director for another 22 years. During the latter, I collected and codified advice for my chief residents. Selected highlights are presented as follows.

  7. Resident Care Guide. Third Edition.

    ERIC Educational Resources Information Center

    Woodbridge State School, NJ.

    The third edition of the Woodbridge State School Cottage Life Department Resident Care Guide is explained to be a developmental status scale devised in 1969 as part of a 5-year study for the purposes of measuring the entire population's self-help training abilities. The department is said to serve 954 residents; 424 are non-ambulatory and 530 are…

  8. Crater with Exposed Layers

    NASA Image and Video Library

    2017-01-17

    On Earth, geologists can dig holes and pull up core samples to find out what lies beneath the surface. On Mars, geologists cannot dig holes very easily themselves, but a process has been occurring for billions of years that has been digging holes for them: impact cratering. Impact craters form when an asteroid, meteoroid, or comet crashes into a planet's surface, causing an explosion. The energy of the explosion, and the resulting size of the impact crater, depends on the size and density of the impactor, as well as the properties of the surface it hits. In general, the larger and denser the impactor, the larger the crater it will form. The impact crater in this image is a little less than 3 kilometers in diameter. The impact revealed layers when it excavated the Martian surface. Layers can form in a variety of different ways. Multiple lava flows in one area can form stacked sequences, as can deposits from rivers or lakes. Understanding the geology around impact craters and searching for mineralogical data within their layers can help scientists on Earth better understand what the walls of impact craters on Mars expose. http://photojournal.jpl.nasa.gov/catalog/PIA12328

  9. Sun exposed skin disease.

    PubMed

    Lehmann, Percy

    2011-01-01

    A wide variety of dermatoses may arise in exposed areas and are at the same time induced or exacerbated by irradiation from the sun. The spectrum may range from acute sunburn to chronic effects of sun damage, including elastosis and ultraviolet-induced skin cancer. Inflammatory ultraviolet-induced dermatoses have a confusing nomenclature and classification that often leads to difficulties in the differential diagnosis. Modern nosology differentiates primary from secondary photodermatoses. Primary photodermatoses are believed to be mainly irradiation-induced and immunologically mediated. If the pathophysiology is not clearly defined, they are also called idiopathic. In cases of a known photosensitizer, local and systemic phototoxic or photoallergic reactions can be differentiated. Secondary photodermatoses have an established pathophysiology; for example, an enzyme defect such as occurs in the porphyrias or xeroderma pigmentosum, which leads to the abnormal sun sensitivity. Finally, preexisting dermatoses may be exacerbated by irradiation from the sun, as in systemic lupus erythematosus or Darier disease. Copyright © 2011 Elsevier Inc. All rights reserved.

  10. 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. Copyright © 2014 American College of Radiology. Published by Elsevier Inc. All rights reserved.

  11. Insights from outstanding rural internal medicine residency rotations at the University of Washington.

    PubMed

    DeWitt, D E; Migeon, M; LeBlond, R; Carline, J D; Francis, L; Irby, D M

    2001-03-01

    Despite being well suited to provide the breadth of care needed in rural areas, few general internists become rural physicians. Little formal rural residency training is available and no formal curricula exist. For over 25 years the University of Washington School of Medicine has provided elective WWAMI (Washington, Wyoming, Alaska, Montana, Idaho) rural residency rotations to expose residents to the rewards and challenges of rural practice. This study identified the characteristics of outstanding rural residency rotations. The key preceptors at three outstanding rural residency sites were interviewed about their experiences, teaching strategies, and opinions about curriculum. Their responses were categorized. Seven university-based residents and eight training at WWAMI sites recorded and rated the value of over 1,500 learning encounters. The preceptors agreed that outstanding rotations were led by enthusiastic preceptors who served as role models for excellence. These preceptors provided residents with meaningful responsibilities and emphasized independent decision making based on the history and physical examination. They stressed supervised independence and self-directed learning with frequent structured feedback for residents. The residents rated the learning value of patient encounters in rural locations significantly higher than that of those in university clinics. Exceptional rural residency experiences involve excellent role models who provide meaningful responsibility and emphasize core skills using a learner-centered approach. Rural training experiences should be supported, and the suggestions of outstanding preceptors should be used to develop and disseminate a curriculum that will better prepare residents for rural practice.

  12. Psychometric Properties of the Modified RESIDE Physical Activity Questionnaire among Low-Income Overweight Women

    PubMed Central

    Jones, Sydney A.; Evenson, Kelly R.; Johnston, Larry F.; Trost, Stewart G.; Samuel-Hodge, Carmen; Jewell, David A.; Kraschnewski, Jennifer L.; Keyserling, Thomas C.

    2014-01-01

    Objective This study explored the criterion-related validity and test-retest reliability of the modified RESIDential Enviroment (RESIDE) physical activity questionnaire and whether the instrument’s validity varied by body mass index (BMI), education, race/ethnicity, or employment status. Design Validation study using baseline data collected for randomized trial of a weight loss intervention. Method Participants recruited from health departments wore an ActiGraph accelerometer and self-reported non-occupational walking, moderate and vigorous physical activity on the modified RESIDE questionnaire. We assessed validity (n=152) using Spearman correlation coefficients (SCC), and reliability (n=57) using intraclass correlation coefficients (ICC). Results When compared to steps, moderate physical activity, and bouts of moderate/vigorous physical activity measured by accelerometer, these questionnaire measures showed fair evidence for validity: recreational walking (SCC 0.23–0.36), total walking (SCC 0.24–0.37), and total moderate physical activity (SCC 0.18–0.36). Correlations for self-reported walking and moderate physical activity were higher among unemployed participants and women with lower BMIs. Generally no other variability in the validity of the instrument was found. Evidence for reliability of RESIDE measures of recreational walking, total walking, and total moderate physical activity was substantial (ICC 0.56–0.68). Conclusions Evidence for questionnaire validity and reliability varied by activity domain and was strongest for walking measures. The questionnaire may capture physical activity less accurately among women with higher BMIs and employed participants. Capturing occupational activity, specifically walking at work, may improve questionnaire validity. PMID:24462117

  13. 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.

  14. 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

  15. International rotations during residency: spine deformity surgery in Ghana.

    PubMed

    Daniels, Alan H

    2013-05-01

    International elective rotations are becoming increasingly common in residency training programs. These experiences offer a tremendous opportunity to help patients in medically underserved nations, and can enhance training by exposing participants to pathology not often encountered in developed countries. Additionally, there is emerging evidence that international training exposure develops a broader appreciation of cultural diversity in patient care, offers personal and professional development, and teaches residents to use limited resources more efficiently, giving them a unique perspective on the ordering of tests and delivery of care when they return. This paper highlights the author's experience on a volunteer trip to Ghana that was focused on treating pediatric spinal deformity, and reviews notable international medical volunteers, and highlights the evidence supporting the benefits of international residency rotations.

  16. Personal finances of urology residents in Canada.

    PubMed

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

    2000-12-01

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

  17. The World Trade Center residents' respiratory health study: new-onset respiratory symptoms and pulmonary function.

    PubMed

    Reibman, Joan; Lin, Shao; Hwang, Syni-An A; Gulati, Mridu; Bowers, James A; Rogers, Linda; Berger, Kenneth I; Hoerning, Anne; Gomez, Marta; Fitzgerald, Edward F

    2005-04-01

    The destruction of the World Trade Center (WTC) on 11 September 2001 in New York City resulted in the massive release of pulverized dust and combustion products. The dust and smoke settled in the surrounding area, which encompassed a large residential community. We hypothesized that previously normal residents in the community surrounding the former WTC would have an increased incidence of persistent respiratory symptoms and abnormalities in screening spirometry. A hybrid cross-sectional and retrospective cohort study using a symptom-based questionnaire and onsite screening spirometry in residents in an exposed area and in a control area was performed 12 +/- 4 months after the collapse. Surveys were analyzed from 2,812 residents. New-onset respiratory symptoms were described by 55.8% of residents in the exposed area, compared with 20.1% in the control area after the event. Persistent new-onset symptoms were identified in 26.4 versus 7.5% of residents in the exposed area versus control area, respectively. No differences in screening spirometry between the groups were detected. A small pilot study suggested the possibility of an increase in bronchial hyperresponsiveness in exposed participants with persistent symptoms. The data demonstrate an increased rate of new-onset and persistent respiratory health effects in residents near the former WTC compared with a control population.

  18. 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.

  19. Motor and Executive Function Profiles in Adult Residents ...

    EPA Pesticide Factsheets

    Objective: Exposure to elevated levels of manganese (Mn) may be associated with tremor, motor and executive dysfunction (EF), clinically resembling Parkinson’s disease (PD). PD research has identified tremor-dominant (TD) and non-tremor dominant (NTD) profiles. NTD PD presents with bradykinesia, rigidity, and postural sway, and is associated with EF impairment with lower quality of life (QoL). Presence and impact of tremor, motor, and executive dysfunction profiles on health-related QoL and life satisfaction were examined in air-Mn exposed residents of two Ohio, USA towns. Participants and Methods: From two Ohio towns exposed to air-Mn, 186 residents (76 males) aged 30-75 years were administered measures of EF (Animal Naming, ACT, Rey-O Copy, Stroop Color-Word, and Trails B), motor and tremor symptoms (UPDRS), QoL (BRFSS), life satisfaction (SWLS), and positive symptom distress (SCL-90-R). Air-Mn exposure in the two towns was modeled with 10 years of air-monitoring data. Cluster analyses detected the presence of symptom profiles by grouping together residents with similar scores on these measures. Results: Overall, mean air-Mn concentration for the two towns was 0.53 µg/m3 (SD=.92). Two-step cluster analyses identified TD and NTD symptom profiles. Residents in the NTD group lacked EF impairment; EF impairment represented a separate profile. An unimpaired group also emerged. The NTD and EF impairment groups were qualitatively similar, with relatively lo

  20. 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

  1. Mean sediment residence time in barchan dunes

    NASA Astrophysics Data System (ADS)

    Zhang, D.; Yang, X.; Rozier, O.; Narteau, C.

    2014-03-01

    When a barchan dune migrates, the sediment trapped on its lee side is later mobilized when exposed on the stoss side. Then sand grains may undergo many dune turnover cycles before their ejection along the horns, but the amount of time a sand grain contributes to the dune morphodynamics remains unknown. To estimate such a residence time, we analyze sediment particle motions in steady state barchans by tracking individual cells of a 3-D cellular automaton dune model. The overall sediment flux may be decomposed into advective and dispersive fluxes to estimate the relative contribution of the underlying physical processes to the barchan shape. The net lateral sediment transport from the center to the horns indicates that dispersion on the stoss slope is more efficient than the convergent sediment fluxes associated with avalanches on the lee slope. The combined effect of these two antagonistic dispersive processes restricts the lateral mixing of sediment particles in the central region of barchans. Then, for different flow strengths and dune sizes, we find that the mean residence time of sediment particles in barchans is equal to the surface of the central longitudinal dune slices divided by the input sand flux. We infer that this central slice contains most of the relevant information about barchan morphodynamics. Finally, we initiate a discussion about sediment transport and memory in the presence of bed forms using the advantages of the particle tracking technique.

  2. The use of the lymphocyte cytokinesis-block micronucleus assay for monitoring pesticide-exposed populations.

    PubMed

    Bolognesi, Claudia; Holland, Nina

    Pesticides are widely used around the world, and hundreds of millions of people are exposed annually in occupational and environmental settings. Numerous studies have demonstrated relationships between pesticide exposure and increased risk of cancers, neurodegenerative and neurodevelopmental disorders, respiratory diseases and diabetes. Assessment of genotoxicity of pesticides and biomonitoring their effect in exposed populations is critical for a better regulation and protection, but it can be complicated because pesticides are often used as complex mixtures. The cytokinesis-block micronucleus assay in human lymphocytes (L-CBMN) is a validated method of assessment of DNA damage induced by clastogenic and aneuploidogenic mechanisms. The goal of this review is to provide an updated summary of publications on biomonitoring studies using this assay in people exposed to pesticides in different settings, and to identify gaps in knowledge, and future directions. A literature search was conducted through MedLine/PubMed and TOXLINE electronic databases up to December 2015. A total of 55 full-text articles, related to 49 studies, excluding reviews, were selected for in depth analysis, divided by the settings where exposures occurred, such as chemical plant workers, pesticide sprayers, floriculturists, agricultural workers and non-occupationally exposed groups. Majority of studies (36 out of 49) reported positive findings with L-CBMN assay. However, most of the studies of professional applicators that used single pesticide or few compounds in the framework of specific programs did not show significant increases in MN frequency. A decreased level of pesticide-induced genotoxicity was associated with the proper use of personal protection. In contrast, subjects working in greenhouses or during intensive spraying season and having acute exposure, showed consistent increases in MN frequency. Overall, this analysis confirmed that L-CBMN is an excellent tool for pesticide

  3. Pulmonary nodules in workers exposed to urban stressor

    SciTech Connect

    Sancini, A.; Fioravanti, M.; Ciarrocca, M.; Palermo, P.; Fiaschetti, M.; Schifano, M.P.; Tomei, G.; Tomei, F.

    2010-07-15

    By multilayer spiral low-dose computed tomography (LD-CT) of the chest this study assesses the early detection of lung lesions on a sample of 100 traffic policemen of a big Italian city professionally exposed to urban pollutants and 100 controls non-occupationally exposed to urban pollutants matched by sex, age, length of service and cigarette smoking habit. Exposure to urban pollutants in traffic policemen was characterized using the annual average concentrations of PM{sub 10}, NO{sub 2} and benzene in the period 1998-2008 measured by fixed monitoring stations located in different areas of the city. A significant and increasing number of suspicious lung nodules with diameters between 5 and 10 mm was observed: in traffic policemen (including smokers and non-smokers) vs. controls (including smokers and non-smokers); in total smokers (including traffic policemen and controls) vs. total non-smokers (traffic policemen and controls); in smoker traffic policemen vs. smoker controls and vs. non-smoker traffic policemen; in non-smoker traffic policemen vs. non-smoker controls. The RR of finding cases with at least one lung nodule with diameters between 5 and 10 mm in traffic policemen (including smokers and non-smokers) compared to controls (including smokers and non-smokers) is 1.94 (CI 1.13-3.31); in total smokers vs. non-smokers the RR is 1.96 (CI 1.20-3.19). The comparison between the interaction exposure and smoking shows an increase in smoker traffic policemen than in smoker controls (RR=2.14; CI 1.02-4.52). The RR for smoker traffic policemen was higher than in non-smoker traffic policemen (RR=2.09; CI 1.19-3.66). The results of our study show that: (1) while smoker workers have a higher risk for developing solid suspicious lung nodules, the simple routinely exposure to urban pollutants is unable to produce the same kind of increased risk; (2) the interaction of smoking and exposure to urban pollutants greatly increases the risk for the development of solid

  4. Genetic Predisposition for Dermal Problems in Hexavalent Chromium Exposed Population

    PubMed Central

    Sharma, Priti; Bihari, Vipin; Agarwal, Sudhir K.; Goel, Sudhir K.

    2012-01-01

    We studied the effect of genetic susceptibility on hexavalent chromium induced dermal adversities. The health status of population was examined from the areas of Kanpur (India) having the elevated hexavalent chromium levels in groundwater. Blood samples were collected for DNA isolation to conduct polymorphic determination of genes, namely: NQO1 (C609T), hOGG1 (C1245G), GSTT1, and GSTM1 (deletion). Symptomatic exposed subjects (n = 38) were compared with asymptomatic exposed subjects (n = 108) along with asymptomatic controls (n = 148) from a non contaminated reference community. Exposed symptomatic group consisted of 36.8% subjects who were GSTM1 null genotyped as compared to asymptomatic where only 19.4% subjects were null. The exposed subjects with GSTM1 null genotype were more susceptible to dermal adversities in comparison with wild genotyped subjects (OR = 2.42; 95% CI = 1.071–5.451). Age, smoking, gender or duration of residence were not found to have any confounding effect towards this association. Association with other genes was not statistically significant, nonetheless, possible contribution by these genes cannot be ruled out. In conclusion, variation in the polymorphic status of GSTM1 gene may influence dermal outcomes among residents from Cr(VI) contaminated areas. Further studies are therefore, needed to examine these observations among different population groups. PMID:22919465

  5. 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.

  6. The psychiatry resident research experience.

    PubMed

    MacMaster, Frank P; Cohen, Jordan; Waheed, Waqar; Magaud, Emilie; Sembo, Mariko; Langevin, Lisa Marie; Rittenbach, Katherine

    2016-11-14

    Research activity is especially critical in the field of psychiatry as it is evolving rapidly thanks to advances in neuroscience. We administered a 34-item survey regarding research experiences targeted at psychiatry residents and postgraduate residency program directors in Canada. One hundred and nineteen participants answered the survey (16 program directors, 103 residents) allowing for a margin of error of 8.4% at a 95% confidence interval. Research was rated as important in informing clinical practice (87.0% yes, 13.0% no), but only 28.7% of respondents reported that it was taught well at their home institution (33.0% no, 38.3% neutral). Only a small proportion was enthusiastic or very enthusiastic about participating in research (21.7%). While the importance of research is recognized, there is little consensus with respect to whether a standardized research practicum component is included in the resident curriculum.

  7. Helping Residents Protect Water Sources

    EPA Pesticide Factsheets

    Building on the successful early engagement of the Plain Sect agricultural community, the Eastern Lancaster County Source Water Protection Collaborative is expanding its efforts to involve local residents in the work of protecting drinking water sources.

  8. Center Gets Commuters, Residents Together.

    ERIC Educational Resources Information Center

    American School and University, 1979

    1979-01-01

    The new student center at Trenton State College is situated on the walkway between the central campus and the commuter parking areas. The location brings resident and commuter students together. (Author/MLF)

  9. 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)

  10. 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 meet...

  11. 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 meet...

  12. A Comparative Study of the Efficacy of Intervention Strategies on Student Electricity Use in Campus Residence Halls

    ERIC Educational Resources Information Center

    Wisecup, Allison K.; Grady, Dennis; Roth, Richard A.; Stephens, Julio

    2017-01-01

    Purpose: The purpose of this study was to determine whether, and how, electricity consumption by students in university residence halls were impacted through three intervention strategies. Design/methodology/approach: The current investigation uses a quasi-experimental design by exposing freshman students in four matched residence halls and the…

  13. Selection criteria of residents for residency programs in Kuwait

    PubMed Central

    2013-01-01

    Background In Kuwait, 21 residency training programs were offered in the year 2011; however, no data is available regarding the criteria of selecting residents for these programs. This study aims to provide information about the importance of these criteria. Methods A self-administered questionnaire was used to collect data from members (e.g. chairmen, directors, assistants …etc.) of residency programs in Kuwait. A total of 108 members were invited to participate. They were asked to rate the importance level (scale from 1 to 5) of criteria that may affect the acceptance of an applicant to their residency programs. Average scores were calculated for each criterion. Results Of the 108 members invited to participate, only 12 (11.1%) declined to participate. Interview performance was ranked as the most important criteria for selecting residents (average score: 4.63/5.00), followed by grade point average (average score: 3.78/5.00) and honors during medical school (average score: 3.67/5.00). On the other hand, receiving disciplinary action during medical school and failure in a required clerkship were considered as the most concerning among other criteria used to reject applicants (average scores: 3.83/5.00 and 3.54/5.00 respectively). Minor differences regarding the importance level of each criterion were noted across different programs. Conclusions This study provided general information about the criteria that are used to accept/reject applicants to residency programs in Kuwait. Future studies should be conducted to investigate each criterion individually, and to assess if these criteria are related to residents' success during their training. PMID:23331670

  14. Interactive Palliative and End-of-Life Care Modules for Pediatric Residents

    PubMed Central

    Doshi, Ami; Carrasca, London; Pian, Patricia; Auger, JoAnne; Baker, Amira; Proudfoot, James A.; Pian, Mark S.

    2017-01-01

    Background. There is a need for increased palliative care training during pediatric residency. Objective. In this pilot study, we created a comprehensive experiential model to teach palliative care skills to pediatric residents. Our Comfort Care Modules (CCMs) address pediatric palliative care (PPC) topics of breaking bad news, dyspnea, anxiety, pain management, and the dying child. We also evaluated a scoring system and gathered qualitative data. Methods. The CCMs are part of the University of California San Diego pediatric residency's second-year curriculum. Comparisons were made for statistical trends between residents exposed to the modules (n = 15) and those not exposed (n = 4). Results. Nineteen of 36 residents (52%) completed surveys to self-rate their preparedness, knowledge, and confidence about PPC before and after the intervention. Resident scores increased in all areas. All improvements reached statistical significance except confidence when breaking bad news. Overall, the resident feedback about the CCMs was positive. Conclusions. This study demonstrates that the CCMs can be performed effectively in an academic setting and can benefit residents' self-perception of preparedness, confidence, and knowledge about pediatric palliative care. In the future, we plan to implement the modules on a larger scale. We encourage their use in interprofessional settings and across institutions. PMID:28286527

  15. Biomarker monitoring of a population residing near uranium mining activities.

    PubMed Central

    Au, W W; Lane, R G; Legator, M S; Whorton, E B; Wilkinson, G S; Gabehart, G J

    1995-01-01

    We investigated whether residents residing near uranium mining operations (target population), who are potentially exposed to toxicants from mining waste, have increased genotoxic effects compared with people residing elsewhere (reference population). Population surveys were conducted, and 24 target and 24 reference residents were selected. The selected subjects and controls were matched on age and gender and they were nonsmokers. Blood samples were collected for laboratory studies. The standard cytogenetic assay was used to determine chromosome aberration frequencies, and the challenge assay was used to investigate DNA repair responses. We found that individuals who resided near uranium mining operations had a higher mean frequency of cells with chromosome aberrations and higher deletion frequency but lower dicentric frequency than the reference group, although the difference was not statistically significant. After cells were challenged by exposure to gamma-rays, the target population had a significantly higher frequency of cells with chromosome aberrations and deletion frequency than the reference group. The latter observation is indicative of abnormal DNA repair response in the target population. PMID:7656876

  16. Exposures to Transit and Other Sources of Noise among New York City Residents

    PubMed Central

    Neitzel, Richard L.; Gershon, Robyn R. M.; McAlexander, Tara P.; Magda, Lori A.; Pearson, Julie M.

    2015-01-01

    To evaluate the contributions of common noise sources to total annual noise exposures among urban residents and workers, we estimated exposures associated with five common sources (use of mass transit, occupational and non-occupational activities, MP3 player and stereo use, and time at home and doing other miscellaneous activities) among a sample of over 4500 individuals in New York City (NYC). We then evaluated the contributions of each source to total noise exposure and also compared our estimated exposures to the recommended 70 dBA annual exposure limit. We found that one in ten transit users had noise exposures in excess of the recommended exposure limit from their transit use alone. When we estimated total annual exposures, 90% of NYC transit users and 87% of nonusers exceeded the recommended limit. MP3 player and stereo use, which represented a small fraction of the total annual hours for each subject on average, was the primary source of exposure among the majority of urban dwellers we evaluated. Our results suggest that the vast majority of urban mass transit riders may be at risk of permanent, irreversible noise-induced hearing loss and that, for many individuals, this risk is driven primarily by exposures other than occupational noise. PMID:22088203

  17. 24 CFR 964.140 - Resident training.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... Resident Management Corporations and duly elected Resident Councils; (3) Public housing policies, programs, rights and responsibilities training; and (4) Business entrepreneurial training, planning and job...

  18. EXPOSE-R on Mission on the ISS

    NASA Astrophysics Data System (ADS)

    Panitz, Corinna; Rabbow, Elke; Rettberg, Petra; Barczyk, Simon; Kloss, Maria; Reitz, Guenther

    Currently EXPOSE-R is on mission! This astrobiological exposure facility was accommodated at the universal workplace URM-D Zenith payload site, located outside the Russian Svezda Module of the International Space Station (ISS) by extravehicular activity (EVA) on March 10th 2009. It contains 3 trays accommodating 12 sample compartments with sample carriers in three levels either open to space vacuum or kept in a defined gas environment. In its 8 experiments of biological and chemical content, more than 1200 individual samples are exposed to solar ultraviolet (UV) radiations, vacuum, cosmic rays or extreme temperature variations. In their different experiments the involved scientists are studying the question of life's origin on Earth and the results of their experiments are contributing to different aspects of the evolution and distribution of life in the Universe. Additionally integrated into the EXPOSE-R facility are several dosimeters monitoring the ionising and the solar UV-radiation during the mission to deliver useful information to complement the sample analysis. In close cooperation with the DLR and the Technical University Munich (TUM), the Rheinisch -Westfülische Technischen Hochschule Aachen (RWTH Aachen) operates the experiment "Spores". a This is one of the 6 astrobiological experiments of the ROSE-Consortium" (Response of Or-ganisms to Space Environment) of the EXPOSE-R mission. In these experiments spores of bacteria, fungi and ferns are being over layered or mixed with meteorite material. The analysis of the effect of the space parameters on different biological endpoints of the spores of the mi-croorganism Bacillus subtilis will be performed after the retrieval of the experiment scheduled for the end of 2010. Parallel to the space mission an identical set of samples was accommodated into EXPOSE-R trays identical in construction to perform the Mission Ground Reference (MGR) Test. Currently this MGR Test is carried out in the Planetary and Space

  19. Choosing family medicine residency programs

    PubMed Central

    Lee, Joseph; Alfieri, Marg; Patel, Tejal; Lee, Linda

    2011-01-01

    Abstract Objective To describe key determinants for residents’ selection of a new community-based, interprofessional site for their family medicine training, and to evaluate residents’ satisfaction with their programs. Design Combined qualitative and quantitative methods using in-depth interviews and a survey. Setting McMaster University, including the new site of the Centre for Family Medicine in Kitchener-Waterloo, Ont, and a long-established site in Hamilton, Ont. Participants Eleven first-year and second-year family medicine residents from the Kitchener-Waterloo site participated in in-depth interviews. Forty-four first-year and second-year family medicine residents completed the survey, 22 in Kitchener-Waterloo and 22 in Hamilton. Methods Kitchener-Waterloo residents participated in in-depth interviews during their residency programs in 2008 to 2009 using a semistructured format to explore their choice of site and the effect of an interprofessional environment on their education. Common themes were established using qualitative analysis techniques; based on these themes, a survey was developed and distributed to residents from both sites to further explore factors influencing site selection, satisfaction, and effects of interprofessional education. Main findings Residents identified several reasons for selecting a new community-based, interprofessional family medicine residency program. Reasons included preference for the location and opportunities to learn in an interprofessional teaching environment. A less hierarchical structure and greater opportunities for one-on-one teaching also influenced their choices. Perception of poor communication from the well established site was identified as a challenge. Residents at both sites indicated similarly high levels of program satisfaction. Conclusion Residents selected the new community-based family medicine site for reasons of geographic location and the potential for clinical learning experiences and

  20. Psychiatry Resident Quality of Life.

    PubMed

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

    2016-02-01

    The objective of this study was to evaluate psychiatry resident physician quality of life. A voluntary, anonymous, 10-min survey was e-mailed to residents from all 14 Accreditation Council for Graduate Medical Education (ACGME)-accredited programs in Pennsylvania, New Jersey, and Delaware. Included in the survey was the Multi-Cultural Quality of Life Inventory (MQLI). Response rate was 112 (34.1%). Internal consistency of the MQLI was high (Cronbach's alpha 0.92), and follow-up exploratory factor analysis extracted only one underlying factor (60.1% variance among all 10 items). Average total MQLI score was 80.6. No significant difference in MQLI total was found for therapy status, sex, or race. Post-graduate year (PGY) 4 residents scored higher on total MQLI score (86.7) (F = 2.80, p = 0.04) and ranked occupational functioning and community and services support subscales significantly higher (occupation F = 2.73, p = 0.048, community F = 3.11, p = 0.030). Total MQLI score for residents over the age of 40 (n = 3) was significantly lower (F = 3.45, p = 0.019). Despite the stresses of residency training, residents from a variety of programs in one geographic area report an encouraging quality of life on the MQLI. Psychiatry resident quality of life is similar to that reported in other populations of mental health professionals.

  1. Assessment of medical residents' satisfaction.

    PubMed

    González-Martínez, José Francisco; García-García, José Antonio; Del Rosario Arnaud-Viñas, María; Arámbula-Morales, Enna Gabriela; Uriega-González Plata, Silvia; Mendoza-Guerrero, José Antonio

    2011-01-01

    Modern medical education is focused on students, and it is necessary to assess its level of satisfaction. A questionnaire was validated and we then conducted a study about the educational satisfaction level of medical residents of the Hospital General of Mexico. An observational, descriptive, cross-sectional and prospective study was conducted. A questionnaire of 21 items was validated and then applied to a representative sample of medical residents. Each item was evaluated with a scale from 0 to 10 and then gathered in groups: 0-5 = poor, 6-7 = average, 8 = good, 9 = very good, and 10 = excellent. Descriptive and inferential statistics were carried out using SPSS v.17.0. The questionnaire had internal validity with Cronbach's alpha >0.91 by item. Included in the study were 355 medical residents representing 37 different specialties. The performance perception of the ìheadî professors showed a wide heterogeneity: excellent (23.7%), very good (20.6%), good (16.9%), average (23.1%), poor (15.8%). Fourth-year residents and upward valued the educational performance higher (p = 0.001) as well as medical/surgical residents (p = 0.02). Intermediate-level residents valued the professor higher (p = 0.001), similar to students who were married or living with a partner (p <0.001). Upon contrasting the evaluation of the teacher's performance with the overall course performance, a linear, direct and significant correlation was obtained with Spearman's correlation coefficient = 0.78 and regression coefficient (p <0.001). We found a wide range of heterogeneity of results. Performance of the professors was the basic component to judge the quality of the residents' courses.

  2. Metallothionein induction, growth, and survival of chinook salmon exposed to zinc, copper, and cadmium

    SciTech Connect

    Roch, M.; McCarter, J.A.

    1984-04-01

    Resident salmon in the Campbell River are exposed to heavy metal contamination which originates from the Westmin Resources Ltd. mine along Myra Creek near the south end of Buttle Lake. In addition, salmon raised by the Quinsam River hatchery must pass through the Campbell River during their migration to salt water. In order to assess the hazards of metal contamination in the Campbell River to resident and transitory salmonids, chinook salmon eggs obtained from the Quisam hatchery were exposed to varying degrees of metal contamination to determine survival, effects on growth and hepatic metallothionein concentrations after long term exposure.

  3. Crossing the Rubicon. Preparing residents for professional life after residency.

    PubMed

    McCombs, Peter R

    2004-01-01

    In addition to clinical skill and knowledge of basic science, graduating residents need decision-making and communication skills, and an understanding of the cultural and prejudicial divides that sometimes create conflicts and misunderstandings in the clinical arena. This paper summarizes a program that one institution has adopted, which attempts to introduce topics in the humanities into the conventional curriculum. The goal is to enable graduating residents to think and to express their views more creatively and assertively, and to give them a greater understanding of some of the individual and cultural attitudes they are certain to encounter in practice.

  4. Welding tritium exposed stainless steel

    SciTech Connect

    Kanne, W.R. Jr.

    1994-11-01

    Stainless steels that are exposed to tritium become unweldable by conventional methods due to buildup of decay helium within the metal matrix. With longer service lives expected for tritium containment systems, methods for welding on tritium exposed material will become important for repair or modification of the systems. Solid-state resistance welding and low-penetration overlay welding have been shown to mitigate helium embrittlement cracking in tritium exposed 304 stainless steel. These processes can also be used on stainless steel containing helium from neutron irradiation, such as occurs in nuclear reactors.

  5. DNA DAMAGE IN BUCCAL EPITHELIAL CELLS FROM INDIVIDUALS CHRONICALLY EXPOSED TO ARSENIC VIA DRINKING WATER IN INNER MONGOLIA, CHINA

    EPA Science Inventory

    The purpose of this pilot study was to assess DNA damage in buccal cells from individuals chronically exposed to arsenic via drinking water in Ba Men, Inner Mongolia. Buccal cells were collected from 19 Ba Men residents exposed to arsenic at 527.5 ? 23.7 g/L (mean ? SEM) and ...

  6. DNA DAMAGE IN BUCCAL EPITHELIAL CELLS FROM INDIVIDUALS CHRONICALLY EXPOSED TO ARSENIC VIA DRINKING WATER IN INNER MONGOLIA, CHINA

    EPA Science Inventory

    The purpose of this pilot study was to assess DNA damage in buccal cells from individuals chronically exposed to arsenic via drinking water in Ba Men, Inner Mongolia. Buccal cells were collected from 19 Ba Men residents exposed to arsenic at 527.5 ? 23.7 g/L (mean ? SEM) and ...

  7. Hospitalist workload and resident evaluations.

    PubMed

    Robinson, Robert

    2015-02-01

    Most academic hospitalists fulfil the role of clinician educator and have many opportunities for the bedside clinical teaching of resident physicians; however, hospitalists are promoted at lower rates than traditional internal medicine faculty staff. The conflict between the demands of clinical productivity and time to teach may be central to understanding the lower rates of academic promotion seen in hospitalists. This investigation explores the relationship between clinical productivity and learner evaluations of hospitalist clinician educators. A retrospective review of clinical productivity and learner evaluations of hospitalists by residents was collected during the 2009-2012 academic years at Southern Illinois University School of Medicine. Correlation analysis between annual work relative value units (wRVUs), patient encounters and duty days with resident evaluations of faculty staff in the Accreditation Council for Graduate Medical Education core competencies was performed. Forty-one annual data sets, representing 18 individual hospitalists, were analysed. No significant correlations between clinical productivity, in terms of annual work RVUs, patient encounters and duty days, and resident learner evaluation scores was found. This investigation explores the relationship between clinical productivity and learner evaluations of hospitalist clinician educators This study found no significant influence of measures of annual clinical service workload on resident learner evaluations of hospitalist clinical educators. These results are consistent with data reported for emergency medicine doctors and anaesthesiologists. These results may have significant implications for the staffing requirements for academic hospitalists. © 2015 John Wiley & Sons Ltd.

  8. To Evacuate or Shelter in Place: Implications of Universal Hurricane Evacuation Policies on Nursing Home Residents

    PubMed Central

    Dosa, David; Hyer, Kathryn; Thomas, Kali; Swaminathan, Shailender; Feng, Zhanlian; Brown, Lisa; Mor, Vincent

    2011-01-01

    Objective To examine the differential morbidity/mortality associated with evacuation versus sheltering in place for nursing home (NH) residents exposed to the 4 most recent Gulf-hurricanes Methods Observational study using Medicare claims, and NH data sources. We compared the differential mortality/morbidity for long-stay residents exposed to 4 recent hurricanes (Katrina, Rita, Gustav, and Ike) relative to those residing at the same NHs over the same time periods during the prior 2 non-hurricane years as a control. Using an instrumental variable analysis, we then evaluated the independent effect of evacuation on outcomes at 90 days. Results Among 36,389 NH residents exposed to a storm, the 30 and 90 day mortality/hospitalization rates increased compared to non-hurricane control years. There were a cumulative total of 277 extra deaths and 872 extra hospitalizations at 30 days. At 90 days, 579 extra deaths and 544 extra hospitalizations were observed. Using the instrumental variable analysis, evacuation increased the probability of death at 90 days from 2.7-5.3% and hospitalization by 1.8-8.3%, independent of other factors. Conclusion Among residents exposed to hurricanes, evacuation significantly exacerbated subsequent morbidity/mortality. PMID:21885350

  9. To evacuate or shelter in place: implications of universal hurricane evacuation policies on nursing home residents.

    PubMed

    Dosa, David; Hyer, Kathryn; Thomas, Kali; Swaminathan, Shailender; Feng, Zhanlian; Brown, Lisa; Mor, Vincent

    2012-02-01

    To examine the differential morbidity/mortality associated with evacuation versus sheltering in place for nursing home (NH) residents exposed to the 4 most recent Gulf hurricanes. Observational study using Medicare claims and NH data sources. We compared the differential mortality/morbidity for long-stay residents exposed to 4 recent hurricanes (Katrina, Rita, Gustav, and Ike) relative to those residing at the same NHs over the same time periods during the prior 2 nonhurricane years as a control. Using an instrumental variable analysis, we then evaluated the independent effect of evacuation on outcomes at 90 days. Among 36,389 NH residents exposed to a storm, the 30- and 90-day mortality/hospitalization rates increased compared with nonhurricane control years. There were a cumulative total of 277 extra deaths and 872 extra hospitalizations at 30 days. At 90 days, 579 extra deaths and 544 extra hospitalizations were observed. Using the instrumental variable analysis, evacuation increased the probability of death at 90 days from 2.7% to 5.3% and hospitalization by 1.8% to 8.3%, independent of other factors. Among residents exposed to hurricanes, evacuation significantly exacerbated subsequent morbidity/mortality. Published by Elsevier Inc.

  10. Grand rounds: outbreak of hematologic abnormalities in a community of people exposed to leakage of fire extinguisher gas.

    PubMed

    Lo, Shih-Hsiang; Chan, Chang-Chuan; Chen, Wei-Chin; Wang, Jung-Der

    2006-11-01

    Although there are ample data on the respiratory effects of exposure to fire extinguisher gas, the potential hematologic effects have not been fully documented. We conducted this study to determine the possible etiologic agent(s) for a decrease in red blood cells among community residents in Taipei, Taiwan, after they were exposed to leakage of mixed fire extinguishants containing bromotrifluoromethane (CF3Br, Halon 1301), bromochlorodifluoromethane (CF2BrCl, Halon 1211), and dichlorodifluoromethane (CCl2F2, CFC-12). We studied 117 exposed residents who came into one hospital for physical examinations. We also selected age- and sex-matched referents for comparison from residents who came to the same hospital for health examinations. Nine months after the exposure to mixed fire extinguishants, 91 of the exposed residents came back for a second physical examination. In the first examination of the exposed residents, we found a significant reduction in red blood cell count and hemoglobin and a relationship between dose and response. After excluding iron-deficiency anemia, thalassemia, and other possible agents, we suspected that the hematologic effects might have resulted from pyrolytic products of CFC-12 and Halon 1211, which may contain phosgene, among other products. The acute transient hematologic effects observed in the exposed residents were associated with the incident of leakage of mixed fire-extinguisher gases and were most likely caused by a small amount of pyrolytic products, probably phosgene. Nine months after the exposure, we found a significant improvement in the abnormalities without any specific treatment.

  11. 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. © The Author(s) 2016.

  12. 28 CFR 115.251 - Resident reporting.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... agency shall provide multiple internal ways for residents to privately report sexual abuse and sexual harassment, retaliation by other residents or staff for reporting sexual abuse and sexual harassment, and... forward resident reports of sexual abuse and sexual harassment to agency officials, allowing the resident...

  13. 28 CFR 115.251 - Resident reporting.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... agency shall provide multiple internal ways for residents to privately report sexual abuse and sexual harassment, retaliation by other residents or staff for reporting sexual abuse and sexual harassment, and... forward resident reports of sexual abuse and sexual harassment to agency officials, allowing the resident...

  14. 28 CFR 115.251 - Resident reporting.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... agency shall provide multiple internal ways for residents to privately report sexual abuse and sexual harassment, retaliation by other residents or staff for reporting sexual abuse and sexual harassment, and... forward resident reports of sexual abuse and sexual harassment to agency officials, allowing the resident...

  15. Evaluation of Emergency Medicine Residents by Nurses.

    ERIC Educational Resources Information Center

    Tintinalli, Judith E.

    1989-01-01

    Emergency medicine residents at William Beaumont Hospital are evaluated quarterly by the nursing staff. The nurses discuss each resident and reach consensus on each evaluation item and copies are given to each resident. Although the residents' attitudes have not been favorable, overall their behavioral interactions have improved markedly.…

  16. 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.…

  17. 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.…

  18. Nutrition Education for Family Practice Residents.

    ERIC Educational Resources Information Center

    Dappen, Alan; And Others

    1986-01-01

    The American Academy of Family Practice requires that nutrition be taught to residents throughout their three-year residencies, although it does not specify a block of nutrition instruction. The nutrition knowledge of residents in eight family practice residencies in California were examined. (MLW)

  19. 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...

  20. 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...

  1. 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...

  2. Sleep Quality Among Psychiatry Residents

    PubMed Central

    das Chagas Medeiros, Francisco; Meireles Sales de Bruin, Veralice; Pinheiro Santana, José Abraão; Bastos Lima, Alexandre; De Francesco Daher, Elizabeth

    2016-01-01

    Objective: Medical residency programs are traditionally known for long working hours, which can be associated with a poor quality of sleep and daytime sleepiness. However, few studies have focused on this theme. Our objective was to investigate sleep quality, daytime sleepiness, and their relation with anxiety, social phobia, and depressive symptoms. Methods: This cross-sectional observational study involved 59 psychiatry residents. The Pittsburgh Sleep Quality Index (PSQI) and the Epworth Sleepiness Scale (ESS) were used to measure the quality of sleep and excessive daytime sleepiness ([EDS] and ESS > 10), respectively. Results: Among the 59 psychiatry residents, 59.3% had poor sleep quality (PSQI > 5) and 28.8% had EDS. Poor sleep quality was associated with higher EDS (P = 0.03) and the year of residency program (P = 0.03). Only 20% of residents with poor sleep had consulted at least once for sleep problems; 54.2% had used medications for sleep; and 16.9% were using medications at the time of interview. Only 30% obtained medication during medical consultations. Poor sleep was associated with irregular sleep hours (P = 0.001) and long periods lying down without sleep (P = 0.03). Poor sleep quality was also associated with high scores of anxiety symptoms (P < 0.001) and social phobia symptoms (P = 0.02). Conclusion: Psychiatry residents frequently have poor sleep quality and EDS. Considering that sleep disorders can affect quality of life, predispose to metabolic syndrome, and be associated with worse performance at work, attention to this clinical problem is needed. PMID:27582452

  3. Plagiarism in residency application essays.

    PubMed

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

    2010-07-20

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

  4. Sleep Quality Among Psychiatry Residents.

    PubMed

    Carvalho Aguiar Melo, Matias; das Chagas Medeiros, Francisco; Meireles Sales de Bruin, Veralice; Pinheiro Santana, José Abraão; Bastos Lima, Alexandre; De Francesco Daher, Elizabeth

    2016-01-01

    Medical residency programs are traditionally known for long working hours, which can be associated with a poor quality of sleep and daytime sleepiness. However, few studies have focused on this theme. Our objective was to investigate sleep quality, daytime sleepiness, and their relation with anxiety, social phobia, and depressive symptoms. This cross-sectional observational study involved 59 psychiatry residents. The Pittsburgh Sleep Quality Index (PSQI) and the Epworth Sleepiness Scale (ESS) were used to measure the quality of sleep and excessive daytime sleepiness ([EDS] and ESS > 10), respectively. Among the 59 psychiatry residents, 59.3% had poor sleep quality (PSQI > 5) and 28.8% had EDS. Poor sleep quality was associated with higher EDS (P = 0.03) and the year of residency program (P = 0.03). Only 20% of residents with poor sleep had consulted at least once for sleep problems; 54.2% had used medications for sleep; and 16.9% were using medications at the time of interview. Only 30% obtained medication during medical consultations. Poor sleep was associated with irregular sleep hours (P = 0.001) and long periods lying down without sleep (P = 0.03). Poor sleep quality was also associated with high scores of anxiety symptoms (P < 0.001) and social phobia symptoms (P = 0.02). Psychiatry residents frequently have poor sleep quality and EDS. Considering that sleep disorders can affect quality of life, predispose to metabolic syndrome, and be associated with worse performance at work, attention to this clinical problem is needed. © The Author(s) 2016.

  5. Simulation Activity in Otolaryngology Residencies.

    PubMed

    Deutsch, Ellen S; Wiet, Gregory J; Seidman, Michael; Hussey, Heather M; Malekzadeh, Sonya; Fried, Marvin P

    2015-08-01

    Simulation has become a valuable tool in medical education, and several specialties accept or require simulation as a resource for resident training or assessment as well as for board certification or maintenance of certification. This study investigates current simulation resources and activities in US otolaryngology residency programs and examines interest in advancing simulation training and assessment within the specialty. Web-based survey. US otolaryngology residency training programs. An electronic web-based survey was disseminated to all US otolaryngology program directors to determine their respective institutional and departmental simulation resources, existing simulation activities, and interest in further simulation initiatives. Descriptive results are reported. Responses were received from 43 of 104 (43%) residency programs. Simulation capabilities and resources are available in most respondents' institutions (78.6% report onsite resources; 73.8% report availability of models, manikins, and devices). Most respondents (61%) report limited simulation activity within otolaryngology. Areas of simulation are broad, addressing technical and nontechnical skills related to clinical training (94%). Simulation is infrequently used for research, credentialing, or systems improvement. The majority of respondents (83.8%) expressed interest in participating in multicenter trials of simulation initiatives. Most respondents from otolaryngology residency programs have incorporated some simulation into their curriculum. Interest among program directors to participate in future multicenter trials appears high. Future research efforts in this area should aim to determine optimal simulators and simulation activities for training and assessment as well as how to best incorporate simulation into otolaryngology residency training programs. © American Academy of Otolaryngology—Head and Neck Surgery Foundation 2015.

  6. Restructuring Residence Hall Programming: Residence Hall Educators with a Curriculum

    ERIC Educational Resources Information Center

    Buckner, Donald R.

    1977-01-01

    Development of residence hall learning environments through comprehensive educational programming has been inhibited by both the generalist nature of live-in professional staff positions and the retention of a student committee-centered programming philosophy. A rationale is developed in this article for a revised staffing pattern and a different…

  7. Enhancing Mutual Respect among Nursing Assistants, Residents, and Residents' Families.

    ERIC Educational Resources Information Center

    Heiselman, Terry; Noelker, Linda S.

    1991-01-01

    Interviewed nursing assistants (n=40) and nursing facility residents (n=37) regarding ways they experienced respect, disrespect, attachment, and distancing in their relationships with each other. As a result of finding evidence of disrespect, an inservice session on gaining respect as a nursing assistant was presented. (ABL)

  8. 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.

  9. Teaching physics to radiology residents.

    PubMed

    Hendee, William R

    2009-04-01

    The complexity of diagnostic imaging has expanded dramatically over the past two decades. Over the same period, the time and effort devoted to teaching physics (the science and technology of the discipline) have diminished. This paradox compromises the ability of future radiologists to master imaging technologies so that they are used in an efficient, safe, and cost-effective manner. This article addresses these issues. Efforts involving many professional organizations are under way to resolve the paradox of the expanding complexity of medical imaging contrasted with the declining emphasis on physics in radiology residency programs. These efforts should help to reestablish physics education as a core value in radiology residency programs.

  10. Training in Buprenorphine and Office-Based Opioid Treatment: A Survey of Psychiatry Residency Training Programs.

    PubMed

    Suzuki, Joji; Ellison, Tatyana V; Connery, Hilary S; Surber, Charles; Renner, John A

    2016-06-01

    Psychiatrists are well suited to provide office-based opioid treatment (OBOT), but the extent to which psychiatry residents are exposed to buprenorphine training and OBOT during residency remains unknown. Psychiatry residency programs in the USA were recruited to complete a survey. Forty-one programs were included in the analysis for a response rate of 23.7 %. In total, 75.6 % of the programs currently offered buprenorphine waiver training and 78.1 % provided opportunities to treat opioid dependence with buprenorphine under supervision. Programs generally not only reported favorable beliefs about OBOT and buprenorphine waiver training but also reported numerous barriers. The majority of psychiatry residency training programs responding to this survey offer buprenorphine waiver training and opportunities to treat opioid-dependent patients, but numerous barriers continue to be cited. More research is needed to understand the role residency training plays in impacting future practice of psychiatrists.

  11. Bone lead content assessed by L-line x-ray fluorescence in lead-exposed and non-lead-exposed suburban populations in the United States.

    PubMed Central

    Rosen, J F; Crocetti, A F; Balbi, K; Balbi, J; Bailey, C; Clemente, I; Redkey, N; Grainger, S

    1993-01-01

    Measurements of lead (Pb) in bone reflect cumulative Pb exposure, whereas blood Pb levels are indices of absorption during the previous 21-30 days. This study was undertaken to estimate bone Pb concentrations by L-line x-ray fluorescence (LXRF) in a United States suburban population which was exposed to unusually high levels of Pb in emissions from an adjacent factory during 1963-1981, compared with concentrations similarly estimated in a matched suburban community without unusual Pb exposure. The mean bone Pb value in 269 residents of the highly exposed suburb (15 ppm) was 3-fold greater than that of the reference suburb (5 ppm). LXRF estimates of bone Pb identified those individuals at risk for adverse effects of Pb, whereas blood Pb levels were uninformative. Average LXRF-estimated bone Pb concentrations in residents of the unusually exposed suburb approximated estimated values in workers at Pb-processing factories. Images Fig. 1 PMID:8464891

  12. Bone lead content assessed by L-line x-ray fluorescence in lead-exposed and non-lead-exposed suburban populations in the United States

    SciTech Connect

    Rosen, J.F.; Balbi, K.; Balbi, J.; Bailey, C.; Clemente, I.; Redkey, N.; Grainger, S. ); Crocetti, A.F. )

    1993-04-01

    Measurements of lead (Pb) in bone reflect cumulative Pb exposure, whereas blood Pb levels are indices of absorption during the previous 21-30 days. This study was undertaken to estimate bone Pb concentrations by L-line x-ray fluorescence (LXRF) in a United States suburban population which was exposed to unusually high levels of Pb in emissions from an adjacent factory during 1963-1981, compared with concentrations similarly estimated in a matched suburban community without unusual Pb exposure. The mean bone Pb value in 269 residents of the highly exposed suburb (15 ppm) was 3-fold greater than that of the reference suburb (5 ppm). LXRF estimates of bone Pb identified those individuals at risk for adverse effects of Pb, whereas blood Pb levels were uninformative. Average LXRF-estimated bone Pb concentrations in residents of the unusually exposed suburb approximated estimated values in workers at Pb-processing factories. 44 refs., 1 fig., 1 tab.

  13. Population exposed to landslide risk in Italy

    NASA Astrophysics Data System (ADS)

    Trigila, Alessandro; Iadanza, Carla; Munafò, Michele; Baiocco, Fabio; Marinosci, Ines; Chiocchini, Raffaella; Mugnoli, Stefano

    2013-04-01

    Italy is one of the European countries most affected by landslides counting over 486,000 mass movements with a total area of 20,700 square kilometres equal to 6.9% of the national territory. Moreover Italy is a densely urbanized country: 8101 municipalities, about 200 inhabitants per sq. km, 16,000 km of rail network and 180,000 km of road network. Landslides caused more than 5000 fatalities in the last century and considerable damage to urban areas, transport infrastructure and facilities, environmental and cultural heritage. The aim of this work is to estimate the population exposed to landslide risk in Italy. The input data are: the Italian Landslide Inventory, the Italian Population Census data and the high-resolution Artificial surfaces-Imperviousness Layer (Geoland2). The Italian Landslide Inventory (Progetto IFFI) realised by ISPRA (Italian National Institute for Environmental Protection and Research) and the Regions and Self-governing Provinces, identifies landslides occurred in the national territory in accordance with standardized methods and using a detailed landslide mapping (1:10,000 scale). The 14th Population Census, made by ISTAT (Italian National Institute of Statistics) in 2001, contains data of resident population for the 382,534 census tracts in which Italy is divided. The pan-European high-resolution (HR) Artificial surfaces-Imperviousness Layer, realized using remote sensing data within the GMES initiative (Global Monitoring for Environment and Security) by European Commission and European Space Agency, contains the degree of imperviousness (between 0 and 100%). GIS overlay of this information layer (20 x 20 m grid) with census tracts has allowed the spatialization of population within urban settlements of each census tract. This methodology has been particularly useful in the case of rural census tracts characterized by large surface area and low population density. The methodology could be also applied to estimate the population exposed to

  14. Survey of resident education in intensity-modulated radiation therapy.

    PubMed

    Malik, Renuka; Oh, Julia L; Roeske, John C; Mundt, Arno J

    2005-06-01

    Intensity-modulated radiation therapy (IMRT) has been gaining increasing popularity among practicing physicians in the U.S., but the extent to which radiation oncology residents are taught the principles of this technology and are trained to use IMRT remains unknown. In this paper, we assessed the current level of resident education in IMRT in the United States. Chief residents at all 77 accredited radiation oncology programs were sent a 13-question survey addressing formal didactics and hands-on experience in IMRT. The survey assessed the frequency, subject, and format of IMRT didactics. Questions also addressed the number of IMRT patients and anatomical sites treated, resident involvement in the IMRT process, and the intent of IMRT use. Finally, residents were asked for their opinions on their IMRT education. Sixty-one surveys (79%) were completed. Overall, forty-three respondents (71%) reported receiving formal IMRT didactics, with nearly one-third reporting extensive didactics (> or = 3 lectures/seminars et cetera per year). The most common didactic formats were lectures (95%) and journal clubs (63%), most commonly supervised by physicists (98%). Involvement by physicians and radiobiologists were reported by 63% and 7% of respondents, respectively. Overall, 87% of respondents had hands-on IMRT training, with nearly one-half having treated > 25 patients. The most common sites treated were head and neck (94%) and prostate (81%). Involvement in all aspects of the IMRT process was common, particularly target and tissue delineation (98%) and plan evaluation (93%). Most respondents (79%) with hands-on experience reported receiving formal didactics. However, nearly one-third received no or only minimal formal didactics. The percentage of respondents desiring increased IMRT didactics and hands-on experience were 70% and 47%, respectively. Our results suggest that the great majority of radiation oncology residents in the United States are currently exposed to didactics

  15. 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…

  16. Teaching Medical Ethics during Residency.

    ERIC Educational Resources Information Center

    Perkins, Henry S.

    1989-01-01

    Three reasons for teaching medical ethics during residency are presented. Key ethical concepts to be addressed include moral aspects of medical practice, obtaining informed consent, dealing with incompetent patients and those who refuse treatment, knowing when to withhold or disclose clinical information, and using medical resources properly. (MSE)

  17. 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.

  18. Teaching Medical Ethics during Residency.

    ERIC Educational Resources Information Center

    Perkins, Henry S.

    1989-01-01

    Three reasons for teaching medical ethics during residency are presented. Key ethical concepts to be addressed include moral aspects of medical practice, obtaining informed consent, dealing with incompetent patients and those who refuse treatment, knowing when to withhold or disclose clinical information, and using medical resources properly. (MSE)

  19. Staff Liability in Residence Halls.

    ERIC Educational Resources Information Center

    Roe, Betty

    1979-01-01

    The inherent nature of their jobs makes residence hall personnel susceptible to tort claims. While past legal rulings have been kind to staff employees, the legalistic mood of the times indicates that this situation may not continue. Significant changes legislated in recent years have increased the probability of tort actions. (Author/BEF)

  20. The Student as University Resident.

    ERIC Educational Resources Information Center

    Van Alstyne, William W.

    1968-01-01

    The distinction between the student as campus resident (if the residential relationship is viewed as one of contract) and the student as private citizen appears to be fair to both university and student. But, whether the university is considered primarily an academic institution or an instrument of government, the off campus/on campus distinction…

  1. 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,…

  2. Assessment of musculoskeletal physical examination skills and attitudes of orthopaedic residents.

    PubMed

    Beran, Matthew C; Awan, Hisham; Rowley, David; Samora, Julie Balch; Griesser, Michael J; Bishop, Julie Y

    2012-03-21

    Although the musculoskeletal physical examination is an essential part of patient encounters, we believe that it is underemphasized in residency education and that residents' physical examination skills may be lacking. We sought to assess attitudes regarding teaching of the physical examination in orthopaedic residencies, to assess physical examination knowledge and skills among residents, and to develop a method to track the skill level of residents in order to improve our physical examination curriculum. We created a thirty-question multiple-choice musculoskeletal physical examination test and administered it to our residents. We created a five-question survey assessing attitudes toward physical examination teaching in orthopaedic residencies and distributed it to U.S. orthopaedic department chairs We developed an Objective Structured Clinical Examination (OSCE), in which standardized patients enact four clinical scenarios, to observe and assess physical examination skills. The mean score on the multiple-choice physical examination test was 76% despite the fact that our residents consistently scored above 90% on the Orthopaedic In-Training Examination. Department chairs and residents agreed that, although learning to perform the physical examination is important, there is not enough time in the clinical setting to observe and critique a resident's patient examination. The overall score of our residents on the OSCE was 66%. We have exposed a deficiency in the physical examination knowledge and skills of our residents. Although the musculoskeletal physical examination is a vital practice component, our data indicate that it is likely underemphasized in training. Clinic time alone is likely insufficient for the teaching and learning of the musculoskeletal physical examination.

  3. Attitude toward xenotransplantation among residents.

    PubMed

    Ríos, A; Conesa, C; Ramírez, P; Galindo, P J; Rodríguez, J M; Montoya, M J; Parrilla, P

    2005-11-01

    The deficit in transplant organs has made it necessary to search for alternatives, among them research into xenotransplantation. However, the use of animal organs may cause rejection in society and among health professionals. The objective was to analyze the acceptance of this therapy among Residents, given that they would be the professionals most involved in its application if such a therapy proves to be useful. A random sample stratified by the services of the Residents in a third-level hospital with an organ transplant program and accredited for teaching at undergraduate and postgraduate levels (n = 171). The attitude toward xenotransplantation was evaluated using a questionnaire that analyzes different pychosocial variables that may influence such attitude.(5) The sample consisted of 171 residents (mean age 28 +/- 4 years; 56% women). Attitudes toward xenotransplantation, whether the results were similar to those obtained with human organs, were positive in 81% (n = 138) of cases, with 16% (n = 27) having doubts and 3% (n = 6) being against. The attitude was more favorable among residents in favor of cadaveric donation (83% vs 57%; P < .05) and of living donation either of the kidney (90% vs 55%; P < .001) or of the liver (88% vs 56%; P < .001), and among those who consider that they might need a transplant at a given point in the future (88% vs 73%; P < .05). Residents have a positive attitude toward the application of a possible xenotransplantation in safe conditions similar to those that currently exist in human organ donation. Such a favorable attitude was greatly influenced by a positive attitude toward human organ donation, in cadaveric as well as in living donation, and when considering oneself to be a possible candidate for a transplant.

  4. Ethics education for pediatric residents: a review of the literature.

    PubMed

    Deonandan, Raywat; Khan, Hafsa

    2015-01-01

    Ethics education and research on medical residents is needed because, unlike medical students or experienced doctors, medical residents have to perform multiple roles simultaneously - student, teacher and clinician - thus exposing them to unique ethical stressors. In this paper we reviewed the literature concerning ethics education in postgraduate pediatrics training programs. Our goal was not to simply describe educational strategies and programs, but also to explore measurements and experiences of current practices to address gaps in ethics education during residency. We conducted a structured literature review to explore the extent of ethics education in pediatric residency programs. Twelve relevant studies were found. The studies suggest that existing training regimens are insufficient to meet the real life ethical challenges experienced in actual practice, particularly with respect to palliative care and the commission of clinical errors. The increasing diversity of culture and beliefs in the clinical workplace is also serving to complicate educational needs. An interdisciplinary approach, spread over the entirety of a physician's training, is a proposed solution worthy of more attention.

  5. Ethics education for pediatric residents: a review of the literature

    PubMed Central

    Deonandan, Raywat; Khan, Hafsa

    2015-01-01

    Background Ethics education and research on medical residents is needed because, unlike medical students or experienced doctors, medical residents have to perform multiple roles simultaneously – student, teacher and clinician – thus exposing them to unique ethical stressors. In this paper we reviewed the literature concerning ethics education in postgraduate pediatrics training programs. Our goal was not to simply describe educational strategies and programs, but also to explore measurements and experiences of current practices to address gaps in ethics education during residency. Method We conducted a structured literature review to explore the extent of ethics education in pediatric residency programs. Results Twelve relevant studies were found. The studies suggest that existing training regimens are insufficient to meet the real life ethical challenges experienced in actual practice, particularly with respect to palliative care and the commission of clinical errors. Conclusions The increasing diversity of culture and beliefs in the clinical workplace is also serving to complicate educational needs. An interdisciplinary approach, spread over the entirety of a physician’s training, is a proposed solution worthy of more attention. PMID:26451231

  6. Guidelines for the Sound Insulation of Residences Exposed to Aircraft Operations

    DTIC Science & Technology

    1992-10-01

    4-15 4.2.1.10 Gypsum Drywall . ..................... 4-16 4.2.1.11 Painting ............ ............ 4-16 4.2.1.12 " Conditioning. Heating, and...already encouraged a shift toward using trapping and absorbing noise. The ceiling drywall in the early 1980s. The formaldehyde insulation rating varies...andmanufacturer’sspecifications. plaster, masonry, and drywall . B. Re-use of existing subframe, 2.3 Cleanup molding, and trim. 2.4 Warranty C. Alignment and

  7. Motor and Executive Function Profiles in Adult Residents Environmentally Exposed to Manganese

    EPA Science Inventory

    Objective: Exposure to elevated levels of manganese (Mn) may be associated with tremor, motor and executive dysfunction (EF), clinically resembling Parkinson’s disease (PD). PD research has identified tremor-dominant (TD) and non-tremor dominant (NTD) profiles. NTD PD pres...

  8. Motor and Executive Function Profiles in Adult Residents Environmentally Exposed to Manganese

    EPA Science Inventory

    Objective: Exposure to elevated levels of manganese (Mn) may be associated with tremor, motor and executive dysfunction (EF), clinically resembling Parkinson’s disease (PD). PD research has identified tremor-dominant (TD) and non-tremor dominant (NTD) profiles. NTD PD pres...

  9. Dormitory Residents Reduce Electricity Consumption when Exposed to Real-Time Visual Feedback and Incentives

    ERIC Educational Resources Information Center

    Petersen, John E.; Shunturov, Vladislav; Janda, Kathryn; Platt, Gavin; Weinberger, Kate

    2007-01-01

    Purpose: In residential buildings, personal choices influence electricity and water consumption. Prior studies indicate that information feedback can stimulate resource conservation. College dormitories provide an excellent venue for controlled study of the effects of feedback. The goal of this study is to assess how different resolutions of…

  10. Dormitory Residents Reduce Electricity Consumption when Exposed to Real-Time Visual Feedback and Incentives

    ERIC Educational Resources Information Center

    Petersen, John E.; Shunturov, Vladislav; Janda, Kathryn; Platt, Gavin; Weinberger, Kate

    2007-01-01

    Purpose: In residential buildings, personal choices influence electricity and water consumption. Prior studies indicate that information feedback can stimulate resource conservation. College dormitories provide an excellent venue for controlled study of the effects of feedback. The goal of this study is to assess how different resolutions of…

  11. Validation of Self-Reported Cognitive Problems with Objective Neuropsychological Performance in Manganese-Exposed Residents

    EPA Science Inventory

    There is a lack of validation of self-reported cognitive problems with objective neuropsychological measures. The validity of four self-reported cognitive items from a health questionnaire (HQ) and the Symptoms Checklist 90-Revised (SCL-90-R) was examined with objective clinical ...

  12. Validation of Self-Reported Cognitive Problems with Objective Neuropsychological Performance in Manganese-Exposed Residents

    EPA Science Inventory

    There is a lack of validation of self-reported cognitive problems with objective neuropsychological measures. The validity of four self-reported cognitive items from a health questionnaire (HQ) and the Symptoms Checklist 90-Revised (SCL-90-R) was examined with objective clinical ...

  13. Teaching residents to write a research paper.

    PubMed

    Coleridge, S T

    1993-09-01

    Medical writing and publications are important in developing a scholarly basis for residency programs and in providing a learning experience for both resident and faculty mentors. Residency directors must provide the stimulus and support for both faculty and residents' varied creative activities. This support manifests itself in a commitment to scholarly activity (including a dedicated research person), the procurement of available research materials, the establishment of a process or plan for beginning a research project, and the development of a method for rewarding or recognizing faculty and residents who produce scholarly works. Some osteopathic residency programs may need to train faculty in research skills at the same time that residents are learning to write. Trained faculty are better models and coaches for residents engaged in research. Beginning with a fundamental, but disciplined, writing program, both faculty and residents may learn methods for sharing new knowledge or acquiring those skills necessary to critically analyze the medical literature.

  14. Pharmacy residents' attitudes toward pharmaceutical industry promotion.

    PubMed

    Ashker, Sumer; Burkiewicz, Jill S

    2007-08-15

    The attitudes of pharmacy residents toward pharmaceutical industry promotion and the perceived effects of such promotion on the knowledge and professional practice of the residents were studied. A questionnaire study of current postgraduate year 1 and postgraduate year 2 pharmacy residents was conducted. Questions were adapted from instruments used in studies of medical student or physician attitudes regarding the pharmaceutical industry. The questionnaire requested demographic information about the resident, information regarding the resident's exposure to specific types of pharmaceutical company-related activities, and the resident's perception of whether the residency program or department had policies or guidelines regarding interactions with the pharmaceutical industry. Questions investigated the attitudes toward pharmaceutical industry promotion and the perceived influence of pharmaceutical industry promotion on the professional knowledge and behavior of the residents. Responses were received from 496 pharmacy residents. Nearly all (89%) residents agreed that pharmaceutical company-sponsored educational events enhance knowledge. Almost half (43%) of the respondents reported that information from educational events influences therapeutic recommendations. One quarter (26%) of the pharmacy residents indicated prior training regarding pharmacist-industry interactions, and most (60%) residents indicated that their institution's residencies or departments have policies regarding interactions with the pharmaceutical industry. Most surveyed pharmacy residents believed that educational events sponsored by pharmaceutical companies enhance knowledge. Respondents whose institutions had policies or who had received training about such events were less likely than other respondents to perceive an influence of the events on their knowledge and behavior.

  15. Serious Emotional Disturbance among Youths Exposed to Hurricane Katrina 2 Years Postdisaster

    ERIC Educational Resources Information Center

    McLaughlin, Katie A.; Fairbank, John A.; Gruber, Michael J.; Jones, Russell T.; Lakoma, Matthew D.; Pfefferbaum, Betty; Sampson, Nancy A.; Kessler, Ronald C.

    2009-01-01

    Objective: To estimate the prevalence of serious emotional disturbance (SED) among children and adolescents exposed to Hurricane Katrina along with the associations of SED with hurricane-related stressors, sociodemographics, and family factors 18 to 27 months after the hurricane. Method: A probability sample of prehurricane residents of areas…

  16. Trends in Serious Emotional Disturbance among Youths Exposed to Hurricane Katrina

    ERIC Educational Resources Information Center

    McLaughlin, Katie A.; Fairbank, John A.; Gruber, Michael J.; Jones, Russell T.; Osofsky, Joy D.; Pfefferbaum, Betty; Sampson, Nancy A.; Kessler, Ronald C.

    2010-01-01

    Objective: To examine patterns and predictors of trends in "DSM-IV" serious emotional disturbance (SED) among youths exposed to Hurricane Katrina. Method: A probability sample of adult pre-hurricane residents of the areas affected by Katrina completed baseline and follow-up telephone surveys 18 to 27 months post-hurricane and 12 to 18…

  17. Serious Emotional Disturbance among Youths Exposed to Hurricane Katrina 2 Years Postdisaster

    ERIC Educational Resources Information Center

    McLaughlin, Katie A.; Fairbank, John A.; Gruber, Michael J.; Jones, Russell T.; Lakoma, Matthew D.; Pfefferbaum, Betty; Sampson, Nancy A.; Kessler, Ronald C.

    2009-01-01

    Objective: To estimate the prevalence of serious emotional disturbance (SED) among children and adolescents exposed to Hurricane Katrina along with the associations of SED with hurricane-related stressors, sociodemographics, and family factors 18 to 27 months after the hurricane. Method: A probability sample of prehurricane residents of areas…

  18. Trends in Serious Emotional Disturbance among Youths Exposed to Hurricane Katrina

    ERIC Educational Resources Information Center

    McLaughlin, Katie A.; Fairbank, John A.; Gruber, Michael J.; Jones, Russell T.; Osofsky, Joy D.; Pfefferbaum, Betty; Sampson, Nancy A.; Kessler, Ronald C.

    2010-01-01

    Objective: To examine patterns and predictors of trends in "DSM-IV" serious emotional disturbance (SED) among youths exposed to Hurricane Katrina. Method: A probability sample of adult pre-hurricane residents of the areas affected by Katrina completed baseline and follow-up telephone surveys 18 to 27 months post-hurricane and 12 to 18…

  19. Teaching professionalism in orthopaedic residency.

    PubMed

    Cornwall, R

    2001-04-01

    Two residents, wearing white coats with their names and "Department of Orthopaedics" conspicuously embroidered on them, boarded a hospital elevator crowded with physicians, employees, and visitors. In a clearly audible voice, one resident began a story: "You should have seen the patient I saw in my clinic the other day. She was beautiful. I should send her to see Dr. W. He would love to see her!" This comment drew the undivided attention of everyone in the elevator and cast a ghastly silence over the rest of the ride. In recent years, interest has expanded regarding professionalism and its importance in medicine and surgery. Orthopaedic surgery is no exception, as the topic has recently reached prominence in our literature and policies. It is unlikely that professionalism is a universal and innate characteristic of college students entering medical school, yet it becomes a necessary value in medical practice. Somewhere in the ongoing process of medical education, the issue must be addressed.

  20. [Evaluating resident training in radiology].

    PubMed

    Aquerreta Beola, J Dámaso; del Cura Rodríguez, J L

    2011-01-01

    Evaluation plays a key role in both the educational process and in its results. The evaluation established in the regulations for the Spanish residency system (MIR) is a two-step process that aims to teach. These steps are: a) continuous evaluation by the tutor and specialists at the training unit and b) an annual review by the evaluating committee. The resident's handbook and evaluation sheets from the rotations are the tools used for this task. Other techniques for evaluation, such as 360-degree feedback, examinations (conventional, case-based, and/or Objective Structured Clinical Examination [OSCE]), checklists, reviewing reports, or public presentation, can also complement or enhance the official evaluation. This article aims to provide information about the evaluation process and to open new possibilities to make evaluation more objective. Copyright © 2011 SERAM. Published by Elsevier Espana. All rights reserved.

  1. Redesigning journal club in residency

    PubMed Central

    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

  2. How do residents manage personal finances?

    PubMed

    Teichman, Joel M H; Cecconi, Patricia P; Bernheim, B Douglas; Novarro, Neva K; Monga, Manoj; DaRosa, Debra; Resnick, Martin I

    2005-02-01

    We examined three research questions: How do residents' debts and savings compare to the general public? How do surgical residents' financial choices compare to other residents? How may institutions help residents' personal financial decisions? The Survey of Consumer Finances was modified and piloted tested to elicit financial information. The instrument was completed by 612 residents at 8 programs. Only 60% of residents budgeted expenses, and 25% and 10% maintained cash balances <611 dollars and unpaid credit card balances >10,000 dollars, respectively. Compared with controls, residents held greater median ratios of debt to household income (2.46 vs. 1.06, P <0.0001), fewer assets to income (0.64 vs. 2.28, P <0.0001), less net wealth to income -1.43 vs. 0.90, P <0.0001), and lower retirement savings balance to household income (0.01 vs. 0.12, P <0.0001). Surgery residents were the least financially conservative group. Mean annual resident contributions to retirement accounts were $1532 higher at institutions with versus without retirement plans (P <0.01). Resident debts are higher and savings lower than the general public. This behavior is most common among surgery residents. Residents save more for retirement when they are eligible for tax-deferred retirement plans. Graduate medical programs should instruct residents on financial management.

  3. Resident Role Modeling: "It Just Happens".

    PubMed

    Sternszus, Robert; Macdonald, Mary Ellen; Steinert, Yvonne

    2016-03-01

    Role modeling by staff physicians is a significant component of the clinical teaching of students and residents. However, the importance of resident role modeling has only recently emerged, and residents' understanding of themselves as role models has yet to be explored. This study sought to understand residents' perceptions of themselves as role models, describe how residents learn about role modeling, and identify ways to improve resident role modeling. Fourteen semistructured interviews were conducted with residents in internal medicine, general surgery, and pediatrics at the McGill University Faculty of Medicine between April and September 2013. Interviews were audio-recorded and subsequently transcribed for analysis; iterative analysis followed principles of qualitative description. Four primary themes were identified through data analysis: residents perceived role modeling as the demonstration of "good" behaviors in the clinical context; residents believed that learning from their role modeling "just happens" as long as learners are "watching"; residents did not equate role modeling with being a role model; and residents learned about role modeling from watching their positive and negative role models. While residents were aware that students and junior colleagues learned from their modeling, they were often not aware of role modeling as it was occurring; they also believed that learning from role modeling "just happens" and did not always see themselves as role models. Helping residents view effective role modeling as a deliberate process rather than something that "just happens" may improve clinical teaching across the continuum of medical education.

  4. Global health training in ophthalmology residency programs.

    PubMed

    Coombs, Peter G; Feldman, Brad H; Lauer, Andreas K; Paul Chan, Robison V; Sun, Grace

    2015-01-01

    To assess current global health education and international electives in ophthalmology residency programs and barriers to global health implementation in ophthalmology resident education. A web-based survey regarding participation in global health and international electives was emailed to residency program directors at 116 accredited ophthalmology residency programs via an Association of University Professors in Ophthalmology (AUPO) residency program director listserv. Fifty-nine (51%) ophthalmology residency program directors responded. Thirty-seven program directors (63%) said global health was important to medical students when evaluating residency programs. Thirty-two program directors (55%) reported developing international electives. Reported barriers to resident participation in international electives were: 1) insufficient financial support, 2) inadequate resident coverage at home, and 3) lack of ACGME approval for international electives. Program directors requested more information about resident international electives, funding, and global ophthalmology educational resources. They requested ACGME recognition of international electives to facilitate resident participation. More than half (54%) of program directors supported international electives for residents. This survey demonstrates that program directors believe global health is an important consideration when medical students evaluate training programs. Despite perceived barriers to incorporating global health opportunities into residency training, program directors are interested in development of global health resources and plan to further develop global health opportunities. Copyright © 2015 Association of Program Directors in Surgery. Published by Elsevier Inc. All rights reserved.

  5. Beyond requirements: residency management through the Internet.

    PubMed

    Civetta, J M; Morejón, O V; Kirton, O C; Reilly, P J; Serebriakov, I I; Dobkin, E D; D'Angelica, M; Antonetti, M

    2001-04-01

    An Internet application could collect information to satisfy documentation required by the Residency Review Committee. Beyond replacing a difficult and inefficient paper system, it would collect, process, and distribute information to administration, faculty, and residents. Descriptive study. An integrated residency of 18 services at a university teaching hospital with 4 affiliated institutions. Residency administrators, faculty, and residents. The application included a procedure recorder, resident evaluation of faculty and rotations, goals and objectives (stratified by service and resident level), and matching faculty evaluation of residents with these goals as competencies. Policies, schedules, research opportunities, clinical site information, and curriculum support were created. Degree of compliance with Residency Review Committee standards, number of deficiencies corrected, and quantity and quality of information available to administration, faculty, and residents. The Internet system increased resident compliance for faculty and rotation evaluations from 20% and 34%, respectively, to 100%, which was maintained for 22 months. These evaluations can be displayed individually, in summary grids, and as postgraduate year-specific averages. Faculty evaluations of residents can be reviewed throughout the system. The defined category report for procedures, which had deficiencies in the preceding 6 years, had none for the last 2 years. The Internet application provides Accreditation Council for Graduate Medical Education-validated operative logs to regulatory agencies. A Web-based system can satisfy requirements and provide processed data that are of better quality and more complete than our paper system. We are now able to use scarce time and personnel to nurture developing surgical residents instead of shuffling paper.

  6. Brucellosis in Occupationally Exposed Groups

    PubMed Central

    Sajjan, Annapurna G.; Mohite, Shivajirao T.; Gajul, Shivali

    2016-01-01

    Introduction In India, high incidence of human brucellosis may be expected, as the conditions conducive for human brucellosis exist. Limited studies have been undertaken on human brucellosis especially in occupationally-exposed groups. Aim To estimate prevalence of anti-brucellar antibodies, evaluate the clinical manifestations, risk factors and Knowledge, Attitude and Practices (KAP) levels about brucellosis among occupationally exposed groups. Materials and Methods Blood samples were collected from 2337 occupationally exposed individuals. The serum samples were screened for the presence of anti-brucellar antibodies by Rose Bengal Plate Test (RBPT), Serum Agglutination Test (SAT) and 2-Mercaptoethanol test (2-ME). Clinical manifestations, risk factors and KAP levels were evaluated by personal interview using a structured questionnaire. Results Seroprevalence of brucellosis by RBPT, SAT and 2-ME test was 9.46%, 4.45% and 3.64 % respectively. Clinical symptoms resembling brucellosis were seen in 91 subjects. The major risk factors were animal exposure in veterinarians and abattoirs, both animal exposure and raw milk ingestion in farmers and shepherds, exposure to raw milk and its ingestion in dairy workers and exposure to Brucella culture in laboratory workers. Except laboratory workers, few veterinarians and dairy workers none had heard about brucellosis. KAP levels regarding brucellosis were too poor in all the groups except laboratory workers. Conclusion Brucellosis most of the times was missed or misdiagnosed. Regular screenings for brucellosis and awareness programmes to increase KAP levels are necessary to control brucellosis in occupationally exposed groups. PMID:27190804

  7. Manganese in Air: Associations in Residents with Tremor and Motor Function

    EPA Science Inventory

    Objective: An environmental study examined air manganese (Mn) exposed residents of two towns in Ohio: Marietta (near a ferro-manganese smelter) and East Liverpool (EL)(adjacent to an open-storage ore packaging facility). Air Mn inhalation is associated with neuropsychological/neu...

  8. Manganese in Air: Associations in Residents with Tremor and Motor Function

    EPA Science Inventory

    Objective: An environmental study examined air manganese (Mn) exposed residents of two towns in Ohio: Marietta (near a ferro-manganese smelter) and East Liverpool (EL)(adjacent to an open-storage ore packaging facility). Air Mn inhalation is associated with neuropsychological/neu...

  9. Effects of Hurricane Katrina on nursing facility resident mortality, hospitalization, and functional decline.

    PubMed

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

    2010-09-01

    The study was designed to examine the 30- and 90-day mortality and hospitalization rates among nursing facility (NF) residents in the affected areas of Louisiana and Mississippi following Hurricane Katrina and to assess the rate of significant posthurricane functional decline. A secondary data analysis was conducted using Medicare claims merged with NF resident data from the Minimum Data Set. Thirty- and 90-day mortality and hospitalization rates for long-stay (>90 days) residents residing in 141 at-risk NFs during Hurricane Katrina were compared to rates for residents residing at the same facilities during the same time period in prior nonhurricane years (2003 and 2004). Functional decline was assessed as a 4+ drop in function using a 28-point Minimum Data Set Activities of Daily Living Scale. There were statistically significant differences (all P < .0001) in mortality, hospitalization, and functional decline among residents exposed to Hurricane Katrina. At 30 days, the mortality rate was 3.88% among the exposed cohort compared with 2.10% and 2.28% for residents in 2003 and 2004, respectively. The 90-day mortality rate was 9.27% compared with 6.71% and 6.31%, respectively. These mortality differences translated into an additional 148 deaths at 30 days and 230 deaths at 90 days. The 30-day hospitalization rate was 9.87% compared with 7.21% and 7.53%, respectively. The 90-day hospitalization rate was 20.39% compared with 18.61% and 17.82%, respectively. Finally, the rate of significant functional decline among survivors was 6.77% compared with 5.81% in 2003 and 5.10% in 2004. NF residents experienced a significant increase in mortality, hospitalization, and functional decline during Hurricane Katrina.

  10. Effects of Hurricane Katrina on Nursing Facility Resident Mortality, Hospitalization, and Functional Decline

    PubMed Central

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

    2013-01-01

    Background The study was designed to examine the 30- and 90-day mortality and hospitalization rates among nursing facility (NF) residents in the affected areas of Louisiana and Mississippi following Hurricane Katrina and to assess the rate of significant posthurricane functional decline. Methods A secondary data analysis was conducted using Medicare claims merged with NF resident data from the Minimum Data Set. Thirty- and 90-day mortality and hospitalization rates for long-stay (>90 days) residents residing in 141 at-risk NFs during Hurricane Katrina were compared to rates for residents residing at the same facilities during the same time period in prior nonhurricane years (2003 and 2004). Functional decline was assessed as a 4+ drop in function using a 28-point Minimum Data Set Activities of Daily Living Scale. Results There were statistically significant differences (all P<.0001) in mortality, hospitalization, and functional decline among residents exposed to Hurricane Katrina. At 30 days, the mortality rate was 3.88% among the exposed cohort compared with 2.10% and 2.28% for residents in 2003 and 2004, respectively. The 90-day mortality rate was 9.27% compared with 6.71% and 6.31%, respectively. These mortality differences translated into an additional 148 deaths at 30 days and 230 deaths at 90 days. The 30-day hospitalization rate was 9.87% compared with 7.21% and 7.53%, respectively. The 90-day hospitalization rate was 20.39% compared with 18.61% and 17.82%, respectively. Finally, the rate of significant functional decline among survivors was 6.77% compared with 5.81% in 2003 and 5.10% in 2004. Conclusions NF residents experienced a significant increase in mortality, hospitalization, and functional decline during Hurricane Katrina. PMID:23105032

  11. [Medical ethics in residency training].

    PubMed

    Civaner, Murat; Sarikaya, Ozlem; Balcioğlu, Harun

    2009-04-01

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

  12. Evaluation and comparison of a 1-month versus a 2-week community pediatrics and advocacy rotation for pediatric residents.

    PubMed

    Delago, Cynthia; Gracely, Edward

    2007-11-01

    This prospective study was conducted to assess the effects of a 4-week community pediatrics and advocacy rotation with a unique project (Curriculum A), a 2-week community pediatrics rotation with advocacy training and unique project throughout residency (Curriculum B), or no curriculum exposure on residents' attitudes, perceived competence, knowledge, and behaviors. A 27-item questionnaire was used to assess attitudes, competence, and knowledge. Examination of residents' patients' use of Early Intervention services during the 5-year period after curricula introduction assessed behaviors. Seventy percent of questionnaires distributed over several years were completed by 105 of 111 eligible residents. Residents exposed to Curriculum A or B demonstrated improved competence and knowledge but no significant increase in positive attitudes toward community pediatrics and advocacy. Residents' patients' use of Early Intervention services increased 65% during the 5-year period after curriculum introduction. No significant differences in outcome measures were observed between Curriculum A and Curriculum B.

  13. Implementation of an objective structured clinical exam (OSCE) into orthopedic surgery residency training.

    PubMed

    Griesser, Michael J; Beran, Matthew C; Flanigan, David C; Quackenbush, Michael; Van Hoff, Corey; Bishop, Julie Y

    2012-01-01

    While the musculoskeletal (MSK) physical examination (PE) is an essential part of a patient encounter, we believe it is an underemphasized component of orthopedic residency education and that resident PE skills may be lacking. The purpose of this investigation was to (1) assess the attitudes regarding PE teaching in orthopedic residencies today; (2) develop an MSK objective structured clinical examination (OSCE) to assess the MSK PE knowledge and skills of our orthopedic residents. Prospective, uncontrolled, observational. A major Midwestern tertiary referral center and academic medical center. The orthopedic surgery residents in our program. Twenty-two of 24 completed the OSCE. Surveys showed that residents agreed that although learning the PE is important, there is not enough time in clinic to actually observe and critique a resident examining a patient. For the 22 residents (postgraduate year [PGY] 2-5) who participated in the OSCE, the overall score was 66%. Scores were significantly better for the trauma scenario (78%; p < 0.05) than for the shoulder (67%), spine (64%), and knee (59%) encounters. The overall scores for each component of the OSCE were: (1) history 53%; (2) PE 60%; (3) 5-question posttest 64%; and (4) communication skills 90%. We have exposed a deficiency in the PE knowledge and skills of our residents. Clinic time alone may be insufficient to both teach and learn the MSK PE. The use of a MSK OSCE, while novel in orthopedics, will allow more direct observation of our residents MSK PE skills and also allow us to follow resident skills longitudinally through their training. We hope that our efforts will encourage other programs to assess their PE curriculum and perhaps prompt change. Copyright © 2012 Association of Program Directors in Surgery. Published by Elsevier Inc. All rights reserved.

  14. Health status among urban residents living in proximity to petroleum coke storage: a first examination.

    PubMed

    Hendryx, Michael; Entwhistle, Jennifer; Kenny, Emily; Illyn, Peter

    2016-01-01

    We conducted an in-person survey in neighborhoods in south Chicago to examine whether residence near outdoor petroleum coke storage piles was associated with poorer health status and illness symptoms. A total of 223 adults (≥18) completed the surveys in English or Spanish, including 136 from a neighborhood exposed to the petroleum coke and 87 from a nearby comparison neighborhood. Exposure was defined based on prevailing winds and distance. We conducted a propensity score regression analysis, and found that residents in the exposed neighborhood were significantly more likely to report poor self-rated health, more unhealthy physical and mental health days, more illness symptoms including in particular respiratory and neurological symptoms, and worse perceived environmental conditions. The survey is limited by the small sample and the self-report nature of the data, but provides initial quantitative evidence that residence near outdoor petroleum coke storage piles may pose a public health risk.

  15. 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...) Review of assessments. The nursing facility management must examine each resident no less than once every...

  16. 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...) Review of assessments. The nursing facility management must examine each resident no less than once every...

  17. 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...) Review of assessments. The nursing facility management must examine each resident no less than once every...

  18. 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...) Review of assessments. The nursing facility management must examine each resident no less than once every...

  19. 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...) Review of assessments. The nursing facility management must examine each resident no less than once every...

  20. Clinical Evaluation in a Family Medicine Residency.

    ERIC Educational Resources Information Center

    Herman, James M.; And Others

    1985-01-01

    A study assessed (1) the validity of the Bowman Gray School of Medicine evaluation instrument regarding the occurrence of halo effects and (2) possible relationships between the faculty's evaluations of the residents and the residents' cognitive knowledge and productivity. (MLW)

  1. Clinical Evaluation in a Family Medicine Residency.

    ERIC Educational Resources Information Center

    Herman, James M.; And Others

    1985-01-01

    A study assessed (1) the validity of the Bowman Gray School of Medicine evaluation instrument regarding the occurrence of halo effects and (2) possible relationships between the faculty's evaluations of the residents and the residents' cognitive knowledge and productivity. (MLW)

  2. Genotoxicity and apoptosis in Drosophila melanogaster exposed to benzene, toluene and xylene: Attenuation by quercetin and curcumin

    SciTech Connect

    Singh, Mahendra P.; Mishra, M.; Sharma, A.; Shukla, A.K.; Mudiam, M.K.R.; Patel, D.K.; Ram, K. Ravi; Chowdhuri, D. Kar

    2011-05-15

    Monocyclic aromatic hydrocarbons (MAHs) such as benzene, toluene and xylene are being extensively used for various industrial and household purposes. Exposure to these hydrocarbons, occupationally or non-occupationally, is harmful to organisms including human. Several studies tested for toxicity of benzene, toluene and xylene, and interestingly, only a few studies looked into the attenuation. We used Drosophila model to test the genotoxic and apoptotic potential of these compounds and subsequently evaluated the efficiency of two phytochemicals, namely, quercetin and curcumin in attenuating test chemical induced toxicity. We exposed third instar larvae of wild type Drosophila melanogaster (Oregon R{sup +}) to 1.0-100.0 mM benzene, toluene or xylene, individually, for 12, 24 and 48 h and examined their apoptotic and genotoxic potential. We observed significantly (P < 0.001) increased apoptotic markers and genotoxicity in a concentration- and time-dependent manner in organisms exposed to benzene, toluene or xylene. We also observed significantly (P < 0.001) increased cytochrome P450 activity in larvae exposed to test chemicals and this was significantly reduced in the presence of 3',4'-dimethoxyflavone, a known Aryl hydrocarbon receptor (AhR) blocker. Interestingly, we observed a significant reduction in cytochrome P450 activity, GST levels, oxidative stress parameters, genotoxic and apoptotic endpoints when organisms were exposed simultaneously to test chemical along with quercetin or curcumin. The study further suggests the suitability of D. melanogaster as an alternate animal model for toxicological studies involving benzene, toluene and xylene and its potential in studying the protective role(s) of phytochemicals.

  3. Embryo- and fetotoxicity of chromium in pregestationally exposed mice

    SciTech Connect

    Junaid, M.; Murthy, R.C.; Saxena, D.K.

    1996-10-01

    Chromium, an essential element in the human body required for proper carbohydrate, protein, and fat metabolism, is reported to impair gestational development of offspring of workers chronically exposed to this metal in the work place. Workers in chromium based industries can be exposed to concentrations two orders of magnitude higher than the general population. Among the general population, residents living near chromate production sites may be exposed to high levels of chromium (VI) in air or to elevated levels (40 - 50,000 ppm) of chromium in effluents. Shmitova reported afterbirth and puerperal hemorrhages in women industrially exposed to this metal and observed high chromium levels in blood and urine of pregnant women and in fetal and cord blood. Chromium readily passes the placental barrier and reaches the growing fetus. Exposure of mice to chromium during various gestational periods resulted in embryo and fetotoxic effects. This study looks at the role of body chromium accumulated pregestationally on embryo and fetal development and its subsequent transfer to feto-placental sites. 25 refs., 3 tabs.

  4. The ORGANIC Experiment on the ISS EXPOSE-R

    NASA Astrophysics Data System (ADS)

    Bryson, K.; Peeters, Z.; Salama, F.; Foing, B.; Ehrenfreund, P.; Jessberger, E.; Bischoff, A.; Breitfellner, M.; Schmidt, W.

    2011-05-01

    Polycyclic aromatic hydrocarbons (PAHs) and aromatic networks are among the most abundant organic material in space. PAHs and fullerenes have been identified in meteorites and are proposed as carriers for numerous astronomical absorption and emission features. Recently the fullerenes C60 and C70 have been discovered in a young planetary nebula, Tc 1 and in other astronomical environments. Thin films of selected PAHs and fullerenes have been subjected to the low Earth orbit environment as part of the ORGANIC experiment on the multi-user facility EXPOSE-R, which was deployed onboard the International Space Station (ISS) in March 2009 and retrieved by extra-vehicular activity (EVA) in January 2011. The ORGANIC experiment monitors the chemical evolution, survival, destruction, and chemical modification of PAHs and fullerenes exposed to solar illumination and cosmic radiation. The radiation dose that is collected on the ISS by the samples cannot be accurately simulated in Earth laboratories. Dark samples are shielded from the UV photons and will enable us to differentiate between the effects of exposure to photons and cosmic rays. The samples are monitored before and after space exposure; ground control samples were continuously monitored. We describe the ORGANIC experiment on the Space Station and report on laboratory ground-control measurements in the UV-Vis-NIR at NASA-Ames. Extended space exposure allows us to collect data on multiple samples which can be extrapolated to other astrophysical environments and thus greatly enhance our knowledge on the evolution of organic compounds in space environment.

  5. 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

  6. Residents' experience of scholarly activities is associated with higher satisfaction with residency training.

    PubMed

    Takahashi, Osamu; Ohde, Sachiko; Jacobs, Joshua L; Tokuda, Yasuharu; Omata, Fumio; Fukui, Tsuguya

    2009-06-01

    The Ministry of Health, Labour and Welfare of Japan has been promoting participation in scholarly activities for physicians during residency training. However, there is debate regarding whether this is worthwhile for residents. To evaluate residents' opinions of engaging in scholarly activities and identify factors associated with overall satisfaction with their training program. Cross-sectional national survey. 1,124 second-year residents in teaching hospitals in Japan in 2007 Collected data included demographics, teaching hospital characteristics and resources, residents' research experiences, including type of activities, barriers to performing scholarly activities, residents' opinions of scholarly requirements, and resident satisfaction with their residency program. 1,124 residents/1,500 responded for a response rate of 74.9%. Our data showed that 60.2% of Japanese residents engaged in some type of scholarly activity. Barriers included: "No resident time"; "No mentor;" and "No resident interest." Sixty-three percent of residents thought that research should be a residency requirement. In multivariate logistic analysis, residents' overall satisfaction with their residency program was significantly associated with participation in research activity (odds ratio (OR), 1.5; 95% confidence interval (CI), 1.1-2.1); male gender (OR, 1.5; 95% CI: 1.1-2.2); satisfaction with residency compensation (OR, 3.8; 95% CI, 2.6-5.0), and satisfaction with the residency curriculum (OR, 19.5; 95% CI, 13.7-27.7). The majority of residents surveyed thought that research activity was worthwhile. Residents' participation in research activity was associated with higher levels of satisfaction with residency training. Implementing measures to overcome existing barriers may have educational benefits for residents.

  7. 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…

  8. Perceived value and outcomes of residency projects.

    PubMed

    Murphy, J E; Downhour, N

    2001-05-15

    Residency program directors' attitudes toward residency projects were studied. A questionnaire about the residency project experience was mailed in January 2000 to 446 pharmacy practice residency program and specialty residency program directors in the program database of the American Society of Health-System Pharmacists. Recipients responded to opinion statements on a 5-point scale. Responses to the opinion statements were separated into seven categories for analysis. A total of 278 usable questionnaires were returned, for a raw response rate of 63.6%. During the preceding three years, residency directors had served as primary advisors on 917 projects; 171 had served as advisor on at least one of every type of project allowed in the accreditation standards. Of the 917 projects, 364 were presented at national professional meetings, 124 were published, and 484 were believed to have resulted in a positive change in pharmacy services. There were no significant differences in total response scores among any of the subgroups analyzed. There was strong agreement that residency projects were valuable and should continue to be part of the residency program experience. The directors' views of the importance of original research as a project option were more neutral. Overall residency program directors had positive perceptions of the value of residency projects to both residents and institutions and believed that they should continue to be a requirement of residency programs.

  9. 28 CFR 115.351 - Resident reporting.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... provide multiple internal ways for residents to privately report sexual abuse and sexual harassment, retaliation by other residents or staff for reporting sexual abuse and sexual harassment, and staff neglect or... sexual abuse and sexual harassment to agency officials, allowing the resident to remain anonymous upon...

  10. 28 CFR 115.351 - Resident reporting.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... provide multiple internal ways for residents to privately report sexual abuse and sexual harassment, retaliation by other residents or staff for reporting sexual abuse and sexual harassment, and staff neglect or... sexual abuse and sexual harassment to agency officials, allowing the resident to remain anonymous upon...

  11. 28 CFR 115.351 - Resident reporting.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... provide multiple internal ways for residents to privately report sexual abuse and sexual harassment, retaliation by other residents or staff for reporting sexual abuse and sexual harassment, and staff neglect or... sexual abuse and sexual harassment to agency officials, allowing the resident to remain anonymous upon...

  12. 24 CFR 206.39 - Principal residence.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 24 Housing and Urban Development 2 2011-04-01 2011-04-01 false Principal residence. 206.39 Section... CONVERSION MORTGAGE INSURANCE Eligibility; Endorsement Eligible Mortgagors § 206.39 Principal residence. The property must be the principal residence of each mortgagor at closing. For purposes of this section, the...

  13. 24 CFR 206.39 - Principal residence.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 24 Housing and Urban Development 2 2010-04-01 2010-04-01 false Principal residence. 206.39 Section... CONVERSION MORTGAGE INSURANCE Eligibility; Endorsement Eligible Mortgagors § 206.39 Principal residence. The property must be the principal residence of each mortgagor at closing. For purposes of this section, the...

  14. Resident camp directors, spirituality, and wilderness

    Treesearch

    Michael Rule; Edward Udd

    2002-01-01

    A vast majority of resident camp directors in this study perceived wilderness to hold spiritual qualities. In addition, resident camp directors also valued educational components for campers and staff as important before they ventured into wilderness areas. Resident camp directors influence the lives of millions of youth and they are an important provider of wilderness...

  15. Continuity Clinics in Psychiatric Residency Training

    ERIC Educational Resources Information Center

    Steinbook, Richard M.

    2007-01-01

    Objective: This article evaluates the impact of establishing extensive continuity clinics on a psychiatry residency training program. Method: The PGY-2 , -3, and -4 residents completed a 15-item attitude survey, and patients were surveyed for their satisfaction. Results: The residency survey revealed increasing satisfaction with the continuity…

  16. Specialty competencies for residents in aerospace medicine.

    PubMed

    Yasuhara, T T; Dodge, R E; Jennings, R T; Valdez, M R

    1999-06-01

    The American College of Preventive Medicine (ACPM), with sponsorship from the Health Resources Administration (HRSA), has published core competencies that are common to all preventive medicine residencies-aerospace medicine (ASM), occupational medicine (OM), and general preventive medicine/public health (GPM/PH). Further development of specialty area competencies for ASM residents was addressed by a working group comprised of representatives from each of the four ASM residency programs. Representatives from the U.S. Air Force School of Aerospace Medicine, Wright State University, University of Texas Medical Branch-Galveston, and the Naval Operational Medicine Institute convened to develop a set of broad competency statements for ASM residents that would encompass the breadth of ASM residency training as it is currently provided in the U.S. A listing of six ASM resident competencies, with supporting skill sets, are presented. In combination with the ACPM core competencies, the ASM resident competencies represent a refocusing of educational objectives on skills attainment. The ASM resident competencies identify the capabilities of graduating ASM residents as distinct from OM and GPM/PH residents. At the same time, they are broad enough to permit specific areas of emphasis (e.g., military, civil, or space) to be pursued within the various ASM residencies. This represents the first successful attempt to draft a consolidated statement of educational objectives that has universal acceptance and applicability across all U.S. aerospace medicine residencies.

  17. Recommendations for nurse practitioner residency programs.

    PubMed

    Brown, Kameka; Poppe, Anne; Kaminetzky, Catherine; Wipf, Joyce; Woods, Nancy Fugate

    2015-01-01

    The purpose of this study was to identify and prioritize critical aspects needed in the design and execution of new nurse practitioner (NP) residency programs. Subjects answered a series of questions on formulating residency programs and on key outcomes and cost measures related to their sustainability. These results serve as potential guideposts for future work in NP residency standardization and sustainability development.

  18. 24 CFR 964.140 - Resident training.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 24 Housing and Urban Development 4 2011-04-01 2011-04-01 false Resident training. 964.140 Section... training. (a) Resident training opportunities. HUD encourages a partnership between the residents, the HA and HUD, as well as with the public and non-profit sectors to provide training opportunities for...

  19. 24 CFR 964.140 - Resident training.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... 24 Housing and Urban Development 4 2013-04-01 2013-04-01 false Resident training. 964.140 Section... training. (a) Resident training opportunities. HUD encourages a partnership between the residents, the HA and HUD, as well as with the public and non-profit sectors to provide training opportunities for...

  20. Acculturation of Korean Residents in Georgia.

    ERIC Educational Resources Information Center

    Lee, Don Chang

    This report explores the acculturation of Korean residents; both Korean families and Korean American families who reside in an academic community (Athens, Georgia) and an urban community (Atlanta, Georgia). The study is based on the view that Korean residents in the United States are a distinctive subgroup that has not yet been studied in terms of…

  1. 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…

  2. Does Targeted Training Improve Residents' Teaching Skills?

    ERIC Educational Resources Information Center

    Polreis, Sean; D'Eon, Marcel F.; Premkumar, Kalyani; Trinder, Krista; Bonnycastle, Deirdre

    2015-01-01

    Resident doctors have an important and integral responsibility of teaching a number of individuals. The purpose of this study was to measure the effectiveness of the University of Saskatchewan's resident-as-teacher training course--Teaching Improvement Project Systems (TIPS). Residents who attended the TIPS course from January, 2010 through June,…

  3. 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…

  4. 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.

  5. 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…

  6. 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...

  7. 24 CFR 964.340 - Resident compensation.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 24 Housing and Urban Development 4 2011-04-01 2011-04-01 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...

  8. 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 regarding...

  9. 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 regarding...

  10. 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 regarding...

  11. 19 CFR 141.38 - Resident corporations.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 19 Customs Duties 2 2010-04-01 2010-04-01 false Resident corporations. 141.38 Section 141.38... TREASURY (CONTINUED) ENTRY OF MERCHANDISE Powers of Attorney § 141.38 Resident corporations. A power of attorney shall not be required if the person signing Customs documents on behalf of a resident...

  12. Tracking Cumulative Radiation Exposure in Orthopaedic Surgeons and Residents: What Dose Are We Getting?

    PubMed

    Gausden, Elizabeth B; Christ, Alexander B; Zeldin, Roseann; Lane, Joseph M; McCarthy, Moira M

    2017-08-02

    The purpose of this study was to determine the amount of cumulative radiation exposure received by orthopaedic surgeons and residents in various subspecialties. We obtained dosimeter measures over 12 months on 24 residents and 16 attending surgeons. Monthly radiation exposure was measured over a 12-month period for 24 orthopaedic residents and 16 orthopaedic attending surgeons. The participants wore a Landauer Luxel dosimeter on the breast pocket of their lead apron. The dosimeters were exchanged every rotation (5 to 7 weeks) for the resident participants and every month for the attending surgeon participants. Radiation exposure was compared by orthopaedic subspecialty, level of training, and type of fluoroscopy used (regular C-arm compared with mini C-arm). Orthopaedic residents participating in this study received monthly mean radiation exposures of 0.2 to 79 mrem/month, lower than the dose limits of 5,000 mrem/year recommended by the United States Nuclear Regulatory Commission (U.S. NRC). Senior residents rotating on trauma were exposed to the highest monthly radiation (79 mrem/month [range, 15 to 243 mrem/month]) compared with all other specialty rotations (p < 0.001). Similarly, attending orthopaedic surgeons who specialize in trauma or deformity surgery received the highest radiation exposure of their peers, and the mean exposure was 53 mrem/month (range, 0 to 355 mrem/month). Residents and attending surgeons performing trauma or deformity surgical procedures are exposed to significantly higher doses of radiation compared with all other subspecialties within orthopaedic surgery, but the doses are still within the recommended limits. The use of ionizing radiation in the operating room has become an indispensable part of orthopaedic surgery. Although all surgeons in our study received lower than the yearly recommended dose limit, it is important to be aware of how much radiation we are exposed to as surgeons and to take measures to further limit that exposure.

  13. Reprocessing of nonoptimally exposed holograms

    SciTech Connect

    Phipps, G.S.; Robertson, C.E.; Tamashiro, F.M.

    1980-03-01

    Two reprocessing techniques have been investigated that are capable of correcting the effects of nonoptimum optical density of photographic amplitude holograms recorded on Agfa-Gevaert type 10E75 plates. In some cases a reprocessed hologram will exhibit a diffraction efficiency even higher than that obtainable from a hologram exposed and processed to the optimum density. The SNR of the reprocessed holograms is much higher than that of the same holograms belached with cupric bromide. In some cases the SNR approaches the optimum value for a properly exposed amplitude hologram. Subjective image quality and resolution of reprocessed hologram reconstructins appear to be no different than for normal single-development holograms. Repeated reprocessing is feasible and in some cases desirable as a means of increasing diffraction efficiency.

  14. How do urology residents manage personal finances?

    PubMed

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

    2001-05-01

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

  15. Psychotherapy Training: Residents' Perceptions and Experiences.

    PubMed

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

    2015-10-01

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

  16. Research by residents: obstacles and opportunities.

    PubMed

    Torous, John; Padmanabhan, Jaya

    2015-02-01

    As the psychiatric field continues to evolve in a world with nascent mobile technology (Hilty et al., 2014), novel neuroscience and genetic research, and new payment and care models (Fried et al., 2014) it is likely that the psychiatry residents learn today will not match what they will be practicing tomorrow. Residents have the opportunity to help shape that future through conducting research today. While the prospect of research can initially seem daunting to the busy resident, here we examine, from psychiatry residents' perspective, the common pitfalls and rewards of research during residency.

  17. A Time Study of Plastic Surgery Residents.

    PubMed

    Lau, Frank H; Sinha, Indranil; Jiang, Wei; Lipsitz, Stuart R; Eriksson, Elof

    2016-05-01

    Resident work hours are under scrutiny and have been subject to multiple restrictions. The studies supporting these changes have not included data on surgical residents. We studied the workday of a team of plastic surgery residents to establish prospective time-study data of plastic surgery (PRS) residents at a single tertiary-care academic medical center. Five trained research assistants observed all residents (n = 8) on a PRS service for 10 weeks and produced minute-by-minute activity logs. Data collection began when the team first met in the morning and continued until the resident being followed completed all non-call activities. We analyzed our data from 3 perspectives: 1) time spent in direct patient care (DPC), indirect patient care, and didactic activities; 2) time spent in high education-value activities (HEAs) versus low education-value activities; and 3) resident efficiency. We defined HEAs as activities that surgeons must master; other activities were LEAs. We quantified resident efficiency in terms of time fragmentation and time spent waiting. A total of 642.4 hours of data across 50 workdays were collected. Excluding call, residents worked an average of 64.2 hours per week. Approximately 50.7% of surgical resident time was allotted to DPC, with surgery accounting for the largest segment of this time (34.8%). Time spent on HEAs demonstrated trended upward with higher resident level (P = 0.086). Time in spent in surgery was significantly associated with higher resident levels (P < 0.0001); 57.7% of activities require 4 minutes or less, suggesting that resident work was highly fragmented. Residents spent 10.7% of their workdays waiting for other services. In this first-time study of PRS residents, we found that compared with medicine trainees, surgical residents spent 3.23 times more time on DPC. High education-value activities comprised most of our residents' workdays. Surgery was the leading component of both DPC and HEAs. Our residents were highly

  18. Career interest and perceptions of nephrology: A repeated cross-sectional survey of internal medicine residents

    PubMed Central

    Daniels, Michael N.; Porter, Ivan; Kincaid, Hope; Jain, Deepika; Aslam, Nabeel

    2017-01-01

    Background Interest in nephrology careers among internal medicine residents in the United States is declining. Our objective was to assess the impact of the presence of a nephrology fellowship training program on perceptions and career interest in nephrology among internal medicine residents. A secondary objective was to identify commonly endorsed negative perceptions of nephrology among internal medicine residents. Methods This was a repeated cross-sectional survey of internal medicine residents before (Group 1) and 3 years after (Group 2) the establishment of nephrology fellowship programs at two institutions. The primary outcome was the percentage of residents indicating nephrology as a career interest in Group 1 vs. Group 2. Secondary outcomes included the frequency that residents agreed with negative statements about nephrology. Results 131 (80.9%) of 162 residents completed the survey. 19 (14.8%) residents indicated interest in a nephrology career, with 8 (6.3%) indicating nephrology as their first choice. There was no difference in career interest in nephrology between residents who were exposed to nephrology fellows during residency training (Group 2) and residents who were not (Group 1). The most commonly endorsed negative perceptions of nephrology were: nephrology fellows have long hours/burdensome call (36 [28.1%] of residents agreed or strongly agreed), practicing nephrologists must take frequent/difficult call (35 [27.6%] agreed or strongly agreed), and nephrology has few opportunities for procedures (35 [27.3%] agreed or strongly agreed). More residents in Group 2 agreed that nephrology is poorly paid (8.9% in Group 1 vs. 20.8% in Group 2, P = 0.04), whereas more residents in Group 1 agreed that nephrologists must take frequent/difficult call (40.0% in Group 1 vs. 18.1% in Group 2, P = 0.02). Conclusions The initiation of a nephrology fellowship program was not associated with an increase in internal medicine residents’ interest in nephrology

  19. Misrepresentation by ophthalmology residency applicants.

    PubMed

    Wiggins, Michael N

    2010-07-01

    To determine the percentage of publication misrepresentation among applicants to an ophthalmology residency, to compare that percentage with published percentages from other specialties, and to compare the number of US-trained applicants vs non-US-trained applicants found to misrepresent published articles. Published articles in peer-reviewed journals listed on residency applications to the Jones Eye Institute from October 10, 2000, to December 1, 2004, were searched, excluding applications that were unavailable or were from current residents and faculty. The type of misrepresentation of published articles and the country of medical school training were recorded. Compared were US-trained applicants vs non-US-trained applicants to determine which group was more likely to list published articles and which group was more likely to have a misrepresented published article. Eight hundred twenty-one of 852 applications (96.4%) were reviewed. Five hundred fifty applicants (67.0%) were from US medical schools, and 271 applicants (33.0%) were from non-US medical schools. Two hundred one applicants (24.5%) listed peer-reviewed published articles. Misrepresentation of published articles was found in 15 applicants (5 US trained and 10 non-US trained). The mean percentage of applicants with misrepresentation per applicant pool was 1.9%, while the mean percentage per applicants listing published articles was 8.1%. The most common misrepresentation found was self-promotion on the author list (50.0%), followed by omission of other authors (25.0%), nonexistent articles (12.5%), and nonauthorship (12.5%). Foreign medical graduates were more likely to list published articles (P = .008) and to have a misrepresented published article (P = .01). Ophthalmology has one of the lowest reported percentages of applicant publication misrepresentation in the literature. Foreign medical graduates were more likely to list published articles and to misrepresent published articles. Self-promotion on

  20. Evaluating surgical resident selection procedures.

    PubMed

    Gilbart, M K; Cusimano, M D; Regehr, G

    2001-03-01

    The purposes of this study were to develop and assess a rating form for selection of surgical residents, determine the criteria most important in selection, determine the reliability of the assessment form and process both within and across sites, and document differences in procedure and structure of resident selection processes across Canada. Twelve of 13 English-speaking orthopedic surgery training programs in Canada participated during the 1999 selection year. The critical incident technique was utilized to determine the criteria most important in selection. From these criteria a 10-item rating form was developed with each item on a 5-point scale. Sixty-six candidates were invited for interviews across the country. Each interviewer completed one assessment form for each candidate, and independently ranked all candidates at the conclusion of all interviews. Consensus final rank orders were then created for each residency program. Across all programs, pairwise program-by-program correlations for each assessment parameter were made. The internal consistency of assessment form ratings for each interviewer was moderately high (mean Cronbach's alpha = 0.71). A correlation between each item and the final rank order for each program revealed that the items work ethic, interpersonal qualities, orthopedic experience, and enthusiasm correlated most highly with final candidate rank orders (r = 0.5, 0.48, 0.48, 0.45, respectively). The interrater reliabilities (within panels) and interpanel reliabilities (within programs) for the rank orders were 0.67 and 0.63, respectively. Using the Spearman-Brown prophecy formula, it was found that two panels with two interviewers on each panel are required to obtain a stable measure of a given candidate (reliabilities of 0.80). The average pairwise program-by-program correlations were low for the final candidate rank orders (0.14). A method was introduced to develop a standard, reliable candidate assessment form to evaluate residency

  1. 2003 survey of Canadian radiation oncology residents

    SciTech Connect

    Yee, Don . E-mail: donyee@cancerboard.ab.ca; Fairchild, Alysa; Keyes, Mira; Butler, Jim; Dundas, George

    2005-06-01

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

  2. Perioperative self-reflection among surgical residents.

    PubMed

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

    2017-09-01

    We studied prevalence and predictors of meaningful self-reflection among surgical residents and with prompting/structured interventions, sought to improve/sustain resident skills. Residents from six programs recorded 1032 narrative self-reflective comments (120 residents), using a web-based platform. If residents identified something learned or to be improved, self-reflection was deemed meaningful. Independent variables PGY level, resident/surgeon gender, study site/Phase1: July2014-August2015 vs. Phase2: September2015-September2016) were analyzed. Meaningful self-reflection was documented in 40.6% (419/1032) of entries. PGY5's meaningfully self-reflected less than PGY1-4's, 26.1% vs. 49.6% (p = 0.002). In multivariate analysis, resident narratives during Phase 2 were 4.7 times more likely to engage in meaningful self-reflection compared to Phase1 entries (p < 0.001). Iterative changes during Phase2 showed a 236% increase in meaningful self-reflection, compared to Phase1. Surgical residents uncommonly practice meaningful self-reflection, even when prompted, and PGY5/chief residents reflect less than more junior residents. Substantial/sustained improvements in resident self-reflection can occur with both training and interventions. Copyright © 2017 Elsevier Inc. All rights reserved.

  3. Predictors of success in an anesthesiology residency.

    PubMed

    Warrick, S S; Crumrine, R S

    1986-07-01

    The selection of residents in medical specialty programs is a difficult task facing all selection committees. The present authors examined factors that contribute to successful residency performance by 26 anesthesiology residents in order to assist the program's selection committee in developing selection criteria. The best predictor of a resident's academic average in the anesthesiology program was the number of years the resident had spent in other specialties. Comparison of the residents' scores on the Anesthesiology In-Training Examination (ITE) and their scores on Part I of the examinations of the National Board of Medical Examiners (NBME) showed a statistically significant negative correlation. The higher that residents scored on the NBME Part I examination, the lower they scored on the ITE. No significant correlations were found between the residents' ITE scores and undergraduate grade-point average or nonacademic variables such as the residents' age or parents' level of education. The residents' composite grade-point average (GPA) for the residency and their interview scores had a strong positive relationship significant at the 0.06 level.

  4. Radiogenic Risk of Malignant Neoplasms for Techa Riverside Residents

    SciTech Connect

    Akleyev, A. V.; Krestinina, L. Y.; Preston, D. L.; Davis, Faith; Degteva, M. O.; Anspaugh, L. R.; Startsev, N. V.; Napier, Bruce A.; Ron, E.

    2008-11-01

    As a result of releases of liquid radioactive waste into the Techa River from the Mayak PA in the 1950s, residents of the riverside villages were for decades exposed to external and internal radiation resulting from consumption of locally produced food and river water. Presented in the paper is a brief description of the radiation conditions, organization of medical follow-up of the exposed population, principles for dose estimation, epidemiological analyses of cancer mortality and incidence for residents of the Techa RIverside villages. The estimates of excess relative risk of radiation-related leukemia and solid cancer mortality and incidence obtained for members of the Techa River cohort point to a clear-cut dependence of the rates on radiation exposure. Attributive risk of cancer incidence characterizing the proportion of radiation-related cancer cases among the total cancers was comparable with that for mortality: 3.2% derived for cancer incidence and 2.5% for cancer mortality. Based on the non-CLL leukemia excess relative risk (ERR) estimates calculated using the linear dose-effect model and the nature of the cohort, it was estimated that 31 (60%) out of 49 leukemia death cases (with the exclusion of 12 cases of chronic lymphatic leukemia) can be related to a long-term radiation exposure due to the contamination of the Techa River.

  5. Emotional problems of residents in psychiatry.

    PubMed

    Russell, A T; Pasnau, R O; Taintor, Z C

    1975-03-01

    The authors used a questionnaire technique to determine the magnitude of the problem of emotional illness and poor performance during psychiatric residency, the procedures that are used to screen for or help disturbed residents, and characteristics that differentiate residents who are at risk. The data indicated that residents who have problems that lead to termination are rarely free of emotional disturbance. The general belief that women, foreign medical graduates, and minority group members are at higher risk for problems during residency was not supported; however, younger residents and transfers from other programs appeared to be at risk. A disturbing finding was the high rate of suicide reported. The authors stress the need for further work with the "marginal" resident and for research on screening and supportive procedures.

  6. An internet-based learning portfolio in resident education: the KOALA multicentre programme.

    PubMed

    Fung, M F; Walker, M; Fung, K F; Temple, L; Lajoie, F; Bellemare, G; Bryson, S C

    2000-06-01

    To describe the Computerized Obstetrics and Gynecology Automated Learning Anaalysis (KOALAtrade mark), a multicentre, Internet-based learning portfolio and to determine its effects on residents' perception of their self-directed learning abilities. The KOALA programme allows residents to record their obstetrical, surgical, ultrasound, and ambulatory patient encounters and to document critical incidents of learning or elements of surprise that arose during these encounters. By prompting the student to reflect on these learning experiences, KOALA encourages residents to articulate questions which can be directly pursued through hypertext links to evidence-based literature. Four Canadian residency training programmes participated in the pilot project, from February to May 1997, using a dynamic relational database with a central server. All participants completed the Self-directed Learning Readiness Scale and a learning habits questionnaire. The impact of the KOALA programme on residents' perception of their self-directed learning abilities was measured by comparing KOALA-naive schools (schools 2, 3, and 4) with school 1 (exposed to the KOALA prototype for 1 year). Ordered variables were compared using the Mann-Whitney U test and continuous variables with the Student t test (statistical significance P < 0. 05). During the study period, 7049 patient and 1460 critical incidents of learning were recorded by 41 residents in the four participating universities. Residents at the exposed school (school 1) had a significantly higher perception of their self-directed learning (P < 0.05) and believed their future learning was less likely to be from continuing medical education (P < 0.028), textbooks (P < 0.04), and didactic lectures (P < 0.011) and would be derived from a learning portfolio with online resources. This Internet-based, multi-user, multicentre learning portfolio has a significant effect on residents' perception of their self-directed learning abilities.

  7. Resident productivity: does shift length matter?

    PubMed

    Jeanmonod, Rebecca; Jeanmonod, Donald; Ngiam, Ryan

    2008-09-01

    It has been established that residents are able to evaluate more patients per hour as they progress through training. However, it is unknown if shift length influences resident productivity. The aim of this study is to assess whether there is a difference in second-year resident productivity as a function of shift length. This is a retrospective chart review of patients evaluated in the emergency department (ED) by second-year residents in a 65,000 volume center; 9- and 12-hour shifts were included. Nine-hour shifts provide a 1-hour overlap, such that three 9-hour shifts provide 24 hours of resident coverage. Shifts on weekly conference day were excluded. A patient was determined as having been evaluated by a resident if the resident initiated care on the patient and dictated the chart. Data were analyzed using 2-tailed t test. A total of 193 nine-hour shifts and 90 twelve-hour shifts met inclusion criteria. Residents working 12-hour shifts evaluated 1.06 patients per hour, and residents working 9-hour shifts evaluated 1.15 patients per hour (95% confidence interval, 0.031-0.151). In an ED with 120 hours of resident coverage per day, this results in 10 additional patients seen by residents working 9-hour shifts. In our department with 9 ED months in the second year of residency, this results in 180 additional patient encounters per resident during that year. Shorter shift lengths appear to result in more patients evaluated per hour by second-year residents and an increase in patient encounters.

  8. Pediatrics Residents' Perspectives on Family-Centered Rounds: A Qualitative Study at 2 Children's Hospitals

    PubMed Central

    Mittal, Vineeta; Krieger, Evelina; Lee, Benjamin C.; Kind, Terry; McCavit, Timothy; Campbell, Joyce; Ottolini, Mary C.; Flores, Glenn

    2013-01-01

    Background Many academic hospitals have incorporated family-centered rounds, yet little is known about pediatrics residents' perspectives on the educational impact of these rounds. Objective To identify pediatrics residents' knowledge, attitudes, and beliefs about family-centered rounds, including perceived benefits and barriers. Methods We conducted focus groups of residents exposed to family-centered rounds at 2 university-affiliated, freestanding children's hospitals. Focus group data were analyzed using grounded theory. Results A total of 24 residents participated in 4 focus groups. Residents reported that family-centered rounds enhance education by increasing patient encounters and improving physical exam skills, direct observation, real-time feedback, and attending role modeling; improve parent satisfaction, interpersonal and communication skills, and safety; and reduce length of stay. Physical constraints (large teams and small rooms), lack of uniform approaches to family-centered rounds, variable attending teaching styles, and specific conditions (child abuse, patients on isolation) were cited barriers. Conclusions Pediatrics residents report that well-conducted family-centered rounds improve their education and the quality of patient care, including parent satisfaction, communication with families, and patients' length of stay. Standardizing family-centered rounds and reducing attending variability in teaching style might further enhance residents' educational experiences. PMID:24404232

  9. More learning in less time: optimizing the resident educational experience with limited clinical and educational work hours.

    PubMed

    Sedney, Cara L; Spirou, Eleni; Voelker, Joseph L; Rosen, Charles L

    2017-08-23

    Resident education in the United States and elsewhere has required significant changes in recent years due to work hour restrictions, requiring didactics to fit within a limited schedule while being increasingly effective at accomplishing educational goals. Compounding these changes are an altered clinical milieu and generational changes among learners. Residents can be exposed to both clinical material and specialty-specific mores utilizing focused mentorship, curricula for intangibles, asynchronous education, and independent curricula. Copyright © 2017. Published by Elsevier Inc.

  10. Florida Red Tide Perception: Residents versus Tourists

    PubMed Central

    Nierenberg, Kate; Byrne, Margaret; Fleming, Lora E.; Stephan, Wendy; Reich, Andrew; Backer, Lorraine C.; Tanga, Elvira; Dalpra, Dana R.; Kirkpatrick, Barbara

    2010-01-01

    The west coast of Florida has annual blooms of the toxin-producing dinoflagellate, Karenia brevis with Sarasota, FL considered the epicenter for these blooms. Numerous outreach materials, including Frequently Asked Question (FAQ) cards, exhibits for local museums and aquaria, public beach signs, and numerous websites have been developed to disseminate information to the public about this natural hazard. In addition, during intense onshore blooms, a great deal of media attention, primarily via newspaper (print and web) and television, is focused on red tide. However to date, the only measure of effectiveness of these outreach methods has been counts of the number of people exposed to the information, e.g., visits to a website or number of FAQ cards distributed. No formal assessment has been conducted to determine if these materials meet their goal of informing the public about Florida red tide. Also, although local residents have the opinion that they are very knowledgeable about Florida red tide, this has not been verified empirically. This study addressed these issues by creating and administering an evaluation tool for the assessment of public knowledge about Florida red tide. A focus group of Florida red tide outreach developers assisted in the creation of the evaluation tool. The location of the evaluation was the west coast of Florida, in Sarasota County. The objective was to assess the knowledge of the general public about Florida red tide. This assessment identified gaps in public knowledge regarding Florida red tides and also identified what information sources people want to use to obtain information on Florida red tide. The results from this study can be used to develop more effective outreach materials on Florida red tide. PMID:20824108

  11. Florida Red Tide Perception: Residents versus Tourists.

    PubMed

    Nierenberg, Kate; Byrne, Margaret; Fleming, Lora E; Stephan, Wendy; Reich, Andrew; Backer, Lorraine C; Tanga, Elvira; Dalpra, Dana R; Kirkpatrick, Barbara

    2010-09-01

    The west coast of Florida has annual blooms of the toxin-producing dinoflagellate, Karenia brevis with Sarasota, FL considered the epicenter for these blooms. Numerous outreach materials, including Frequently Asked Question (FAQ) cards, exhibits for local museums and aquaria, public beach signs, and numerous websites have been developed to disseminate information to the public about this natural hazard. In addition, during intense onshore blooms, a great deal of media attention, primarily via newspaper (print and web) and television, is focused on red tide. However to date, the only measure of effectiveness of these outreach methods has been counts of the number of people exposed to the information, e.g., visits to a website or number of FAQ cards distributed. No formal assessment has been conducted to determine if these materials meet their goal of informing the public about Florida red tide. Also, although local residents have the opinion that they are very knowledgeable about Florida red tide, this has not been verified empirically. This study addressed these issues by creating and administering an evaluation tool for the assessment of public knowledge about Florida red tide. A focus group of Florida red tide outreach developers assisted in the creation of the evaluation tool. The location of the evaluation was the west coast of Florida, in Sarasota County. The objective was to assess the knowledge of the general public about Florida red tide. This assessment identified gaps in public knowledge regarding Florida red tides and also identified what information sources people want to use to obtain information on Florida red tide. The results from this study can be used to develop more effective outreach materials on Florida red tide.

  12. Neurocritical care education during neurology residency

    PubMed Central

    Drogan, O.; Manno, E.; Geocadin, R.G.; Ziai, W.

    2012-01-01

    Objective: Limited information is available regarding the current state of neurocritical care education for neurology residents. The goal of our survey was to assess the need and current state of neurocritical care training for neurology residents. Methods: A survey instrument was developed and, with the support of the American Academy of Neurology, distributed to residency program directors of 132 accredited neurology programs in the United States in 2011. Results: A response rate of 74% (98 of 132) was achieved. A dedicated neuroscience intensive care unit (neuro-ICU) existed in 64%. Fifty-six percent of residency programs offer a dedicated rotation in the neuro-ICU, lasting 4 weeks on average. Where available, the neuro-ICU rotation was required in the vast majority (91%) of programs. Neurology residents' exposure to the fundamental principles of neurocritical care was obtained through a variety of mechanisms. Of program directors, 37% indicated that residents would be interested in performing away rotations in a neuro-ICU. From 2005 to 2010, the number of programs sending at least one resident into a neuro-ICU fellowship increased from 14% to 35%. Conclusions: Despite the expansion of neurocritical care, large proportions of US neurology residents have limited exposure to a neuro-ICU and neurointensivists. Formal training in the principles of neurocritical care may be highly variable. The results of this survey suggest a charge to address the variability of resident education and to develop standardized curricula in neurocritical care for neurology residents. PMID:22573636

  13. [Pediatric residency programs in Latin America].

    PubMed

    Mendoza, H

    1991-01-01

    Prior to 1960 pediatric hospital residency programs were scarce in Latin America, but at present only one country lacks such a program. The first push for development of pediatric residency programs began in the 1960s and was aided by visits of Latin American medical professionals to the US under sponsorship of the Committee for Development of Pediatric Residency Programs (COPREP) of the American Academy of Pediatrics. COPREP meetings in Colombia in 1970 and in Brazil in 1975 coincided with a stage of accelerated progress in establishing and improving pediatric residency programs. After the 1975 meeting, COPREP activity declined, probably because of loss of financial support from the American Academy of Pediatrics. The Pediatric Residency Committee of the Latin American Pediatric Association (ALAPE) met in Santo Domingo in 1981 to approve an outline of objectives and activities, set minimum requirements for pediatric residency programs, and establish elements for quality control. The ALAPE Pediatric Residency Committee has also been greatly weakened since 1981, probably because of inadequate financial assistance and an overly ambitious program. The weakness of the Pediatric Residency Committees has impeded development of programs in Latin America. Pediatric residency programs in the region are heterogeneous in objectives and structure because of the differing national health structures in which they are embedded. Periodic exchanges of experience at the national and regional levels might help strengthen the pediatric residency programs.

  14. Unique needs of women pharmacy residents.

    PubMed

    Johnson, M W

    1982-12-01

    The needs of women residents in hospital pharmacy programs are discussed with respect to the responsibilities of preceptors to help residents prepare for a successful career. Women were a small minority within the profession of pharmacy until recently. More than half of the current hospital pharmacy residents are women, while over 95% of the preceptors of residency training programs are men. Hospital pharmacy preceptors can help meet the unique needs of women residents, so that women pharmacists can achieve the career successes of which they are capable. Preceptors can help women residents make career decisions and develop career goals and strategies. Preceptors should ensure that women residents develop the broad base of knowledge and skills necessary for advancement. Women residents should be encouraged to get involved in pharmacy organizations, and the importance of networking should be stressed. It is important that women residents develop a business style so that they are perceived as confident and competent. Preceptors must recognize that most women will have conflicts in their roles of career woman, wife, and mother. Preceptors can also help women residents by making managerial changes (e.g., offering part-time positions and flexible scheduling) that will facilitate integration of the professional and personal responsibilities of women.

  15. 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.

  16. Blood cadmium concentration of residents living near abandoned metal mines in Korea.

    PubMed

    Hong, Young-Seoub; Lee, Byung-Kook; Park, Jung-Duck; Sakong, Joon; Choi, Jae-Wook; Moon, Jai-Dong; Kim, Dae-Seon; Kim, Byoung-Gwon

    2014-05-01

    The purpose of this study was to investigate demographic and lifestyle variables and blood cadmium concentrations in residents living near abandoned metal mines in Korea. Blood cadmium concentrations were measured in 15,161 subjects living around abandoned metal mines (exposed group, n = 14,464) and compared with those living in designated control areas (control group, n = 697). A questionnaire was provided to all subjects to determine age, gender, mine working history, times of residence, smoking habits and dietary water type. The geometric mean (95% confidence intervals) of blood cadmium concentration (1.25 [1.24-1.27] µg/L) in the exposed group was significantly higher than in the control group (1.17 [1.13-1.22] µg/L). Mean residence time and mine working history in the exposed group were significantly higher than in the control group. Blood cadmium concentrations increased with increasing age, and residence time in both groups, and blood cadmium concentrations were higher in current-smokers than in non-smokers in both groups. This study shows the geometric mean of blood cadmium concentration in abandoned mining areas are higher than in non-mining areas in the general adult Korean population.

  17. A case-control study of tobacco use and other non-occupational risk factors for lymphoma subtypes defined by t(14;18) translocations and bcl-2 expression

    PubMed Central

    Chang, Cindy M.; Schroeder, Jane C.; Olshan, Andrew F.; Dunphy, Cherie H.; Huang, Wen-Yi; Baric, Ralph S.; Conway, Kathleen; Cerhan, James R.; Lynch, Charles F.; Rothman, Nathaniel; Cantor, Kenneth P.; Blair, Aaron

    2011-01-01

    Objective We re-evaluated reported associations between tobacco use and other factors and non-Hodgkin lymphoma (NHL) t(14;18)-subtypes based on fluorescence in situ hybridization (FISH) assays believed to be more sensitive than polymerase chain reaction (PCR), previously used for detecting t(14;18). Methods Commercial FISH assays and bcl-2 immunostaining were performed on paraffin sections to determine t(14;18) and bcl-2 case-subtypes. Polytomous logistic regression models estimated associations between NHL case-subtypes (versus 1,245 population-based controls) and tobacco use as well as other factors. Results Adjusting for age, state, and proxy status, t(14;18)-negative NHL was associated with any tobacco use (vs. no tobacco use, OR=1.9, 95% CI=1.0-3.5), including current smoking (vs. no cigarette use, OR= 1.9, 95% CI=1.1-3.2). Tobacco exposures were not clearly associated with t(14;18)-positive NHL or bcl-2 case-subtypes. Hair dye use and family history of a hemolymphatic cancer were associated with t(14;18)-negative NHL, but the number of exposed cases was small. Conclusions The association between t(14;18)-negative NHL and cigarette smoking was unexpected given previous evidence of associations between smoking and follicular lymphoma (which is largely t(14;18)-positive). Future studies characterizing additional molecular characteristics of t(14;18)-negative NHL may help determine whether the association with smoking may have been causal versus an artifact of chance or bias. PMID:20232134

  18. Does anesthesiology residency training result in decreasing intraoperative drug cost from a resident's first to second month's experience in adult cardiac anesthesiology?

    PubMed

    Steyn, Johannes W; Broussard, David M; DiGiovanni, Neil; Babin, Sheena; Dornelles, Adrianna C

    2012-01-01

    All physicians bear the responsibility of minimizing cost while providing care that meets or exceeds national quality benchmarks. Intraoperative anesthetic drug costs constitute a small but significant fraction of the total cost in the perioperative period. Previous studies have revealed that anesthesiologists are generally unaware of drug costs. In order to determine if experience and education improve anesthetic drug cost containment, we compared the total anesthetic drug cost per case as residents progressed through their rotations in cardiac anesthesia. We considered the total anesthetic drug cost for 202 adult cardiac cases, including coronary artery bypass grafting, mitral valve repair/replacement, and aortic valve repair/replacement. 77 of the cases analyzed were done by residents in their first month of cardiac anesthesia, and 125 were done by residents in their second month of cardiac anesthesia. In the interval between these rotations, residents participate in didactics and other educational activities including a practice management rotation in the CA-3 year where they are exposed to financial topics in healthcare. The average total drug cost per case for residents in their first month was $193.50; SD= $82.00. The average total cost per case for residents in their second month was $223.30; SD=$96.10. With multivariate analysis considering case type, length of procedure and patient age, the resident training level did not impact the cost in a significant way (p=0.062). In the multivariate analysis considering case type, length of procedure and patient age, more experienced residents did not have a significantly different total drug cost per case. This finding suggests that didactic educational efforts and implicit modeling over time did not reduce drug costs in the operating room during adult cardiac surgery.

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

    PubMed

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

    2017-06-01

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

  20. Implementing a resident research program to overcome barriers to resident research.

    PubMed

    Rothberg, Michael B; Kleppel, Reva; Friderici, Jennifer L; Hinchey, Kevin

    2014-08-01

    Internal medicine residents are required to participate in scholarly activity, but conducting original research during residency is challenging. Following a poor Match at Baystate Medical Center, the authors implemented a resident research program to overcome known barriers to resident research. The multifaceted program addressed the following barriers: lack of interest, lack of time, insufficient technical support, and paucity of mentors. The program consisted of evidence-based medicine training to stimulate residents' interest in research and structural changes to support their conduct of research, including protected time for research during ambulatory blocks, a research assistant to help with tasks such as institutional review board applications and data entry, a research nurse to help with data collection, easily accessible biostatistical support, and a resident research director to provide mentorship. Following implementation in the fall of 2005, there was a steady rise in the number of resident presentations at national meetings, then in the number of resident publications. From 2001 to 2006, the department saw 3 resident publications. From 2006 to 2012, that number increased to 39 (P< .001). The department also saw more original research (29 publications) and resident first authors (12 publications) after program implementation. The percentage of residents accepted into fellowships rose from 33% before program implementation to 49% after (P = .04). This comprehensive resident research program, which focused on evidence-based medicine and was tailored to overcome specific barriers, led to a significant increase in the number of resident Medline publications and improved the reputation of the residency program.

  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. Costs Associated With Residency Training.

    PubMed

    Bready, Lois L; Luber, M Philip

    2016-02-01

    Texas needs more physicians to care for a rapidly growing population, and new physicians who complete medical training in Texas are likely to remain in the state to practice. The expansion of existing Texas medical schools, along with the development of new schools, has created a need for a corresponding increase in residency and fellowship (graduate medical education, or GME) positions in Texas, and the 2013 and 2015 legislative sessions have funded expanded GME support. While the Centers for Medicare & Medicaid Services pays for the majority of GME positions nationally, those numbers were capped in 1997. Growing populations, particularly in the southern states, have led many institutions--when funds are available--to increase GME positions "over the cap." Texas physicians need to be aware of costs associated with development of accredited GME positions, as well as other measures being taken to support the growth of the physician workforce in the state.

  3. The surgical residency baby boom: changing patterns of childbearing during residency over a 30-year span.

    PubMed

    Smith, Caitlin; Galante, Joseph M; Pierce, Jonathan L; Scherer, Lynette A

    2013-12-01

    Birthrates during surgical residency appear to be rising. One assumption is that this is due to changes in the structure of surgical residencies. The purpose of our study was to explore whether an increase in birthrates has occurred and the reasons for this. We conducted an anonymous survey of current residents and alumni from 1976 to 2009 at a single university-based surgery training program. Alumni (46 of 116) and current residents (38 of 51) were surveyed, and our response rate was approximately 50% (84 of 167). Respondents were grouped into cohorts based on their residency start year. The early cohort consisted of residents starting residency between 1976 and 1999, and the late cohort consisted of residents starting residency between 2000 and 2009. The percentage of male residents with children during residency training was similar for the early and late cohorts (34% [10 of 29] versus 41% [9 of 22]). For female residents, there was a substantial increase in childbearing for the late cohort (7% [1 of 15] versus 35% [6 of 18]). Fifty-two percent (44 of 84) of the respondents who had children during residency reported that work hours and schedule had a negative effect on their decision to have children. Most respondents reported that availability or cost of child care, impact on residency, support from the program, increased length of training, or availability of family leave did not factor as concerns. Childbearing during residency has increased in female residents in our study. Surgical residency programs may need to accommodate this change if they want to continue to recruit and retain talented residents.

  4. Obstetrics and gynaecology chief resident attitudes toward teaching junior residents under normal working conditions.

    PubMed

    Gil, Karen M; Savitski, Jennifer L; Bazan, Sara; Patterson, Laurene R; Kirven, Melissa

    2009-09-01

    This study aimed to identify factors that chief residents believe impact the teaching of junior residents under normal working conditions and the areas in which they believe education on the role of resident as teacher would be beneficial. Obstetrics and gynaecology (O&G) chief residents were asked to rate the importance of teaching various skills, how often conflict situations arose, and to identify training that would be helpful through a national web-based survey. An e-mail was sent to coordinators of the Residency Review Committee (RRC) O&G residency programmes with a request that they forward the link to their chief residents three times from January through March 2006. Responses were received from 204 postgraduate Year 4 (PGY4) residents (18% of all PGY4 residents) from 133 programmes (54% of all residency programmes) and 33 states. Teaching junior residents how to prioritise patient care and obtain critical information in an emergent situation was considered very to extremely important by 97%. Conflict situations with junior residents were reported to occur between one and five times by 41-58%; an additional 26-28% reported that these situations occurred six or more times. Residents felt it would be helpful to extremely helpful to have training in resolving conflicts that involved patient care (48-59%), as well as in resolving conflict among junior residents, communicating effectively with them and becoming an effective leader (65-78%). The skills that chief residents considered most important to teach junior residents involved direct patient care. Chief residents would like training in how to resolve conflict with, and among, junior residents, and in how to become an effective leader.

  5. 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.

  6. Factors associated with resident aggression toward caregivers in nursing homes.

    PubMed

    Zeller, Adelheid; Dassen, Theo; Kok, Gerjo; Needham, Ian; Halfens, Ruud J G

    2012-09-01

    Caregivers in nursing homes often experience aggressive behavior of residents. The aim of this study was to explore the caregivers' experiences with aggressive behavior from residents and to identify environmental factors as well as caregiver and resident characteristics related to aggressive behavior in Swiss nursing homes. A retrospective cross-sectional survey was conducted between November 2010 and April 2011 with a sample of caregivers working in various nursing homes in the German-speaking part of Switzerland. In total, 814 caregivers (response rate 51.8%) of 21 nursing homes participated in the study. Data were collected using the German version of the Survey of Violence Experienced by Staff (SOVES-G-R). Standard descriptive statistics were used to describe and summarize the date. To identify risk factors related to the experience of aggression by residents, multilevel logistic regression analysis was applied. The prevalence of participants reporting an aggressive incident during the 12-month period prior to data collection was 81.6%. Of these, 76.5% had experienced verbal aggression, 27.6% threats, and 54.0% physical aggression. The predictive variables in the multiple regression model for physical aggression were: staff education level (odds ratio [OR]= 1.82), gender (OR = 1.82), age (< 30 years vs. 30-45 years: OR = 1.46; < 30 years vs. > 45 years: OR = 2.13), and confidence in managing physical aggression (OR = 1.49). The predictive variables for threatening behavior were staff education level (registered nurses vs. non-registered nurses: OR = 1.70; nonstudent vs. student: OR = 1.89) and age (< 30 years vs. 30-45 years: OR = 2.00; < 30 years vs. > 45 years: OR = 2.04). Caregivers in nursing homes are at high risk for experiencing aggressive behavior. The identified risk factors are in line with earlier investigations, but some contradictory results also were observed. The high risk for registered nurses exposed to aggressive behavior and the increased

  7. Pediatric resident and faculty knowledge of the Denver II.

    PubMed

    Barratt, M S; Moyer, V A

    2000-04-01

    To assess knowledge of the Denver II, the revised developmental screening tool recommended by the American Academy of Pediatrics, in residents and faculty, and to evaluate a teaching intervention for incoming postgraduate year 1 (PGY-1) trainees. A cross-sectional test of knowledge for all subjects and pretesting and posttesting of the incoming PGY- 1 trainees. University of Texas-Houston Medical School Department of Pediatrics. Faculty (n = 9) and residents (n = 78), including an intervention group (n = 45), of incoming PGY-1 trainees over 2 years. Postgraduate year 1 trainees in both 1994 through 1995 and 1995 through 1996 viewed the Denver II training videotape on entry into a continuity clinic. Trainees were encouraged to perform Denver II evaluations on at least 1 appropriate patient at each pediatric clinic session and had access to Denver II support materials. Scores on the Denver II Proficiency Written Test, self-reported measures of comfort, and number of Denver II evaluations performed. The mean (SD) test scores for incoming, preintervention PGY-1 trainees (n = 45) (41.3 [9.6]) did not differ from scores for outgoing PGY-1 trainees (n = 13) (38.5 [10.4]) who had not received the intervention. Postintervention PGY-1 test results were significantly improved (59.4 [10.6]) (P<.001). Test scores for upper-level residents who had participated in the developmental pediatrics rotation (n = 14) were better (55.3 [9.31), but all scored below passing. Residents who had not yet participated in the developmental pediatrics rotation (n = 19) and members of the general pediatric faculty (n = 9) had scores similar to those of PGY-1 trainees (40.9 [13.4] and 39.0 [15.1], respectively). Residents had a greater knowledge of the Denver II after completing a developmental pediatrics rotation. Our intervention produced significant improvement in PGY-1 trainees' knowledge, raising it to levels similar to those of upper-level residents exposed to developmental pediatrics

  8. Continuous Certification Within Residency: An Educational Model.

    PubMed

    Rachlin, Susan; Schonberger, Alison; Nocera, Nicole; Acharya, Jay; Shah, Nidhi; Henkel, Jacqueline

    2015-10-01

    Given that maintaining compliance with Maintenance of Certification is necessary for maintaining licensure to practice as a radiologist and provide quality patient care, it is important for radiology residents to practice fulfilling each part of the program during their training not only to prepare for success after graduation but also to adequately learn best practices from the beginning of their professional careers. This article discusses ways to implement continuous certification (called Continuous Residency Certification) as an educational model within the residency training program.

  9. Risk of spontaneous abortion in women occupationally exposed to anaesthetic gases: a meta-analysis.

    PubMed Central

    Boivin, J F

    1997-01-01

    OBJECTIVES: To determine the association between maternal occupational exposure to anaesthetic gases and risk of spontaneous abortion. METHODS: A meta-analysis was performed of published epidemiological studies identified from literature reviews, unsystematic perusal of reference lists of relevant publications, and two Medline searches (1984-92, keywords: anaesthetic gases; anaesthetics; anaesthetics, local; operating rooms; operating room nursing; pregnancy; abortion; 1985-92, keywords: anaesthetics; adverse effects; occupational exposure; anaesthesia, inhalation; operating room nursing; pregnancy; abortion). All peer reviewed studies were retained. Student theses were excluded, as were conference abstracts, unpublished material, and two studies in which data on paternal and maternal occupational exposures were pooled. The relative risk of spontaneous abortion was estimated. RESULTS: One study found no increase in risk of abortion when gases were scavenged or when the exposure to unscavenged gases was low. None of the studies included ambient gas sampling. 24 comparisons between exposed and unexposed women, obtained from 19 reports, were included. The overall relative risk was 1.48 (95% confidence interval (95% CI), 1.4 to 1.58). To test whether this result was influenced by the quality of the studies, the validity of the reviewed papers was rated on the basis of three criteria: appropriateness of the unexposed comparison group, control for non-occupational confounding variables, and response rate. The estimate of risk increased to 1.9 (95% CI, 1.72 to 2.09) when analysis was restricted to the six comparisons which were rated the most rigorous. CONCLUSIONS: Epidemiological studies based on data obtained in the prescavenging era indicate an increased risk of spontaneous abortion. The estimated increased risk was not diminished but rather increased by exclusion of the more methodologically flawed studies. PMID:9326157

  10. Risk of spontaneous abortion in women occupationally exposed to anaesthetic gases: a meta-analysis.

    PubMed

    Boivin, J F

    1997-08-01

    To determine the association between maternal occupational exposure to anaesthetic gases and risk of spontaneous abortion. A meta-analysis was performed of published epidemiological studies identified from literature reviews, unsystematic perusal of reference lists of relevant publications, and two Medline searches (1984-92, keywords: anaesthetic gases; anaesthetics; anaesthetics, local; operating rooms; operating room nursing; pregnancy; abortion; 1985-92, keywords: anaesthetics; adverse effects; occupational exposure; anaesthesia, inhalation; operating room nursing; pregnancy; abortion). All peer reviewed studies were retained. Student theses were excluded, as were conference abstracts, unpublished material, and two studies in which data on paternal and maternal occupational exposures were pooled. The relative risk of spontaneous abortion was estimated. One study found no increase in risk of abortion when gases were scavenged or when the exposure to unscavenged gases was low. None of the studies included ambient gas sampling. 24 comparisons between exposed and unexposed women, obtained from 19 reports, were included. The overall relative risk was 1.48 (95% confidence interval (95% CI), 1.4 to 1.58). To test whether this result was influenced by the quality of the studies, the validity of the reviewed papers was rated on the basis of three criteria: appropriateness of the unexposed comparison group, control for non-occupational confounding variables, and response rate. The estimate of risk increased to 1.9 (95% CI, 1.72 to 2.09) when analysis was restricted to the six comparisons which were rated the most rigorous. Epidemiological studies based on data obtained in the prescavenging era indicate an increased risk of spontaneous abortion. The estimated increased risk was not diminished but rather increased by exclusion of the more methodologically flawed studies.

  11. [Etiological factors of carpal tunnel syndrome in subjects occupationally exposed to monotype wrist movements].

    PubMed

    Lewańska, Magdalena; Walusiak-Skorupa, Jolanta

    2014-01-01

    Carpal tunnel syndrome (CTS) is the most common neuropathy of upper limbs and a leading cause of upper extremity musculoskeletal disorders, in terms of work exposure, repetitive and forceful exertions of the hand and use of vibrating hand tools. The aim of the study was to evaluate etiological factors of carpal tunnel syndrome in subjects occupationally exposed to monotype movements in wrist. We conducted the retrospective analysis of 300 patients (261 women, 39 men), mean age 52 years (standard deviation: +/-6.93) hospitalized with the suspicion of occupational CTS. The study revealed high percentage (68.7%) of diseases and systemic factors involved in the pathogenesis of CTS in the analyzed population, especially obesity (32%), thyroid diseases (28.7%), hormone replacement therapy and/or oophorectomy (16.3%) and diabetes mellitus (12%). In 111 patients the coexistence of at least a couple of potential etiological factors of the neuropathy was recognized. Clinical analysis and occupational exposure allowed to diagnose occupational carpal tunnel syndrome in 18 (6%) patients only. The undeniable long-term (20(.2+/-9.3 years) occupational exposure to repetitive, forceful movements in the wrist was observed in this group. The results of our study indicated that non-occupational etiological factors of CTS predominated and in 37% of patients at least several factors were found. The analysis showed the high prevalence of CTS in workers employed in various sectors of industry, including so called "blue collar" workers. Our study confirmed the multifactorial etiology of carpal tunnel syndrome, however, occupational agents contributed to only 6% of cases.

  12. Temporal patterns of agitated nursing home residents.

    PubMed

    Cohen-Mansfield, J; Marx, M S; Werner, P; Freedman, L

    1992-01-01

    Twenty-four highly agitated, cognitively impaired nursing home residents were studied in depth to determine whether they manifested temporal patterns of agitation. Results demonstrated that agitated behaviors were significantly associated with temporal factors. For instance, residents made more requests for attention during lunch than other time periods, and residents screamed most often during the night. Some agitated behaviors (e.g., aggression) were manifested more frequently in the evening than in the day, consistent with the notion of sundowning in the nursing home. Implications of temporal patterns of agitation for caregivers of severely cognitively impaired and agitated nursing home residents are discussed.

  13. Hyperactive and Nonhyperactive Institutionalized Retarded Residents

    ERIC Educational Resources Information Center

    Talkington, Larry W.; Hutton, W. Oran

    1973-01-01

    Two hundred twenty-one predominantly adolescent institutionalized retarded residents, classified as hyperactive, were compared on 15 variables to a matched group classified as nonhyperactive. (Author/MC)

  14. Community health training for internal medicine residents working with community partners.

    PubMed

    Saravanan, Yamini; Pels, Richard

    2011-10-01

    Graduate and undergraduate medical training are incorporating public health curricula into their programs to enable future physicians to participate in public health activities and improve the health of the communities. This paper highlights two approaches to a community health curriculum implemented at the Cambridge Health Alliance Internal Medicine Training Program from 2008-2010. Between 2008 and 2009, the residency program incorporated a longitudinal curriculum for first-year residents. The goal of the curriculum was to expose residents to basic community health research models while giving them time to participate in a 1-year practicum with the Cambridge Public Health Department. Strengths included increasing resident knowledge about the local public health department and providing residents with an opportunity to work with staff and patients in that setting. Limitations of such a design included staff time constraints for coordinating with community partners as well as resident dissatisfaction with being involved in only select portions of an evolving project. This curriculum was therefore revised into a 1-month ambulatory block consisting of didactics and a practicum with the local YWCA in September 2010. Residents felt that this design yielded more time in didactics than in the practicum. Both designs offer important learning points in terms of practically incorporating public health activities in a tightly scheduled residency-training program. The current paper highlights the importance of partnering with a community organization such as a public health department or the YWCA. Emphasis is placed on the contributions that residents can make to these organizations while they learn how to integrate clinical and community health activities. Copyright © 2011 American Journal of Preventive Medicine. Published by Elsevier Inc. All rights reserved.

  15. Advances in treating exposed fractures.

    PubMed

    Nogueira Giglio, Pedro; Fogaça Cristante, Alexandre; Ricardo Pécora, José; Partezani Helito, Camilo; Lei Munhoz Lima, Ana Lucia; Dos Santos Silva, Jorge

    2015-01-01

    The management of exposed fractures has been discussed since ancient times and remains of great interest to present-day orthopedics and traumatology. These injuries are still a challenge. Infection and nonunion are feared complications. Aspects of the diagnosis, classification and initial management are discussed here. Early administration of antibiotics, surgical cleaning and meticulous debridement are essential. The systemic conditions of patients with multiple trauma and the local conditions of the limb affected need to be taken into consideration. Early skeletal stabilization is necessary. Definitive fixation should be considered when possible and provisional fixation methods should be used when necessary. Early closure should be the aim, and flaps can be used for this purpose.

  16. Allergy education in otolaryngology residency: a survey of program directors and residents.

    PubMed

    Bailey, Sarah E; Franzese, Christine; Lin, Sandra Y

    2014-02-01

    The purpose of this study was to survey program directors of the accredited otolaryngology residency programs and resident attendees of the 2013 American Academy of Otolaryngic Allergy (AAOA) Basic/MOC Course regarding resident education and participation as well as assessment of competency in otolaryngic allergy and immunotherapy. A multiple-choice questionnaire was sent to all accredited otolaryngology residency training programs in the United States as part of resident attendance at the 2013 AAOA CORE Basic/MOC Course. Following this, a similar multiple-choice survey was sent to all resident attendees from the programs that responded positively. Program directors reported that 73% of their academic institutions offer allergy testing and immunotherapy. More PDs than residents indicated that residents participate in allergy practice and perform/interpret skin testing and in vitro testing, and more residents (85%) than program directors (63%) reported inadequate or no allergy training. Program directors and residents equally indicated that residents do not calculate immunotherapy vial formulations or administer immunotherapy injections. The majority of program directors indicated that resident competency in allergy was assessed through direct observation, whereas residents more commonly perceived that no assessment of competency was being performed for any portion of allergy practice. This survey demonstrates a discrepancy between program directors and residents regarding resident involvement and adequacy of training in the allergy practice. Although the majority of otolaryngology residencies report offering otolaryngic allergy services and education, the vast majority of residents report inadequate allergy training and less participation in an allergy practice compared to the majority of program directors. © 2013 ARS-AAOA, LLC.

  17. Audition electives during surgical residency and selection for post-residency fellowship positions.

    PubMed

    Tzarnas, Chris D; Fessenden, John

    2002-01-01

    This study sought to determine the impact of surgical resident elective rotations, termed "audition" electives, upon the selection processes of surgical subspecialty residency positions, and to establish the incidence and character of resident personal contact before selection with the program where they ultimately located in order to appropriately council residents in achieving their educational and professional goals. A national survey of all surgical subspecialty programs for academic year 1999/2000 was conducted to determine whether the current first-year subspecialty residents had been on a clinical rotation of the subspecialty at their institution during their general surgery residency, had participated in research efforts of the specific subspecialty at their institution, and whether the resident's prerequisite general surgery training was obtained at their parent sponsoring institution. Seventy-two percent of 348 programs responded, representing 396 beginning surgical subspecialty residents for the surveyed academic year. Overall, 73% of first-year surgical subspecialty residents did not have direct prior personal contact with their subspecialty program either through a clinical rotation at the institution or through research as a general surgery resident. Eighty-four percent of first-year surgical subspecialty residents did not complete their general surgery residency at the parent sponsoring institution of the subspecialty program. An audition elective does not appear to significantly influence the process of surgical subspecialty resident selection. The findings further validate the fairness of the selection processes.

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

    PubMed

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

    2010-10-01

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

  19. Improving resident education in quality improvement: role for a resident quality improvement director.

    PubMed

    Sarwar, Ammar; Eisenberg, Ronald L; Boiselle, Phillip M; Siewert, Bettina; Kruskal, Jonathan B

    2013-04-01

    As a component of the practice-based core competency of the Accreditation Council for Graduate Medical Education, all residents must receive training to be able to evaluate and improve their patient care practices. To further enhance our overall resident quality improvement (QI) educational experience, and to ensure resident involvement in the many aspects of a quality assurance program, we have established a resident educational leadership role and have appointed a resident as resident QI director. We have designed and implemented a resident leadership position in QI in our department. A senior resident (postgraduate year 4 and above) is provided with dedicated training in QI methods, mentored opportunities to develop professional skills in QI, and didactic teaching in applications of QI to other residents. A leadership position in QI for trainees introduces this important concept early in their career. The resident QI director is provided dedicated training, receives a broader perspective of QI and is optimally positioned to introduce the concept to junior residents leading to greater acceptance of QI at a resident level. The introduction of a resident QI director enhances the importance of QI for trainees, prepares the individual for a strong academic and QI career, and improves acceptance of QI methods among trainees. Copyright © 2013 AUR. Published by Elsevier Inc. All rights reserved.

  20. Awareness of Infectious Diseases in Obstetrics and Gynecology Among Residents and Residency Directors

    PubMed Central

    Beigi, Richard H.; Switzer, Galen E.; Presley, Larraine; Soper, David E.

    2006-01-01

    Awareness of the subspecialty of infectious diseases in obstetrics and gynecology is low among United States residents and residency directors. Objective. Given the burden of infectious diseases on women's health, we sought to assess current awareness, interest, and perceived value of the subspecialty of infectious diseases in obstetrics and gynecology among current United States obstetrics and gynecology residents and residency directors. Methods. Two separate surveys addressing awareness, perceived value and interest in the subspecialty were sent to (1) a random 20% sample of obstetrics and gynecology residents and (2) all obstetrics and gynecology residency directors. Results. Seventy percent of the residency directors were familiar with the subspecialty and 67.0% placed value on infectious disease specialists in an academic department. Thirty percent of the residents reported awareness of the subspecialty. Thirty-six percent of residency directors reported that medical infectious disease specialists deliver formal education to the obstetrics and gynecology residents. Conclusion. United States obstetrics and gynecology residents and residency directors have a low awareness of the subspecialty. An open niche exists for formal education of residents in infectious diseases in obstetrics and gynecology by department specialists. These findings can be incorporated into ongoing recruitment efforts for the subspecialty of infectious diseases in obstetrics and gynecology. PMID:17485801

  1. Biomonitoring for chromium and arsenic in timber treatment plant workers exposed to CCA wood Preservatives.

    PubMed

    Cocker, J; Morton, J; Warren, N; Wheeler, J P; Garrod, A N I

    2006-07-01

    This study reports a survey of occupational exposure to copper chrome arsenic (CCA) based wood preservatives during vacuum pressure timber impregnation. The survey involved biological monitoring based on analysis of chromium and arsenic in urine samples collected from UK workers. The aim of the study was to determine the extent of occupational exposure to arsenic and chromium in the UK timber treatment industry. The objectives were to collect and analyse urine samples from as many workers as possible, where CCA wood preservatives might be used, at 6 monthly intervals for 2 years. In addition, to investigate day-to-day variations in urinary excretion of chrome and arsenic by collecting and analysing three samples a week for 3 weeks in subsets of workers and controls (people not occupationally exposed). All urine samples were analysed for chromium and inorganic arsenic. To investigate any residual interference every sample was accompanied by a short questionnaire about recent consumption of seafood and smoking. The analytical methods for arsenic used a hydride generation technique to reduce interference from dietary sources of arsenic and also a technique that would measure total arsenic concentration in urine. The main findings show that workers exposed to CCA wood preservatives have concentrations of inorganic arsenic and chromium in urine that are significantly higher than those from non-occupationally exposed people but below biological monitoring guidance values that would indicate inhalation exposure at UK occupational exposure limits for chromium and arsenic. The effects of consumption of seafood on urinary arsenic were not significant using the hydride generation method for inorganic arsenic but were significant if 'total' arsenic was measured. The 'total' arsenic method could not distinguish CCA workers from controls and is clearly unsuitable for assessment of occupational exposure to arsenic. There was a significant increase in the urinary concentration of

  2. Environmental exposures to polychlorinated biphenyls (PCBs) among older residents of upper Hudson River communities.

    PubMed

    Fitzgerald, Edward F; Belanger, Erin E; Gomez, Marta I; Hwang, Syni-an; Jansing, Robert L; Hicks, Heraline E

    2007-07-01

    The upper Hudson River has been heavily contaminated with polychlorinated biphenyls (PCBs) due to discharges from former electrical capacitor plants in Hudson Falls and Fort Edward, NY. An epidemiologic study was conducted to assess the impact of dietary and residential exposure on PCB body burden among older, long-term, non-occupationally exposed adults living in the vicinity of these former capacitor plants. The study population consisted of 133 persons 55-74 years of age who had lived in Hudson Falls or Fort Edward for 25 years or more. The comparison group consisted of 120 persons from Glens Falls, which is upriver. Both groups were interviewed, and blood samples were obtained for congener-specific PCB analysis. Persons from the study area reported greater past consumption of Hudson River fish than did the comparison area, but current rates were very low in both areas. The geometric mean serum PCB concentrations for the study and comparison populations did not differ significantly (3.07 ppb wet weight and 3.23 ppb, respectively, for total PCB). Serum PCB concentrations increased with cumulative lifetime exposure to PCBs from Hudson River fish consumption (p<0.10). Persons who lived within 800 m of the river did not have significantly greater serum PCB concentrations than the control population, nor did persons who lived downwind and within 800 m of a PCB-contaminated site. The results indicate no detectable differences in serum PCB levels according to proximity or wind direction relative to local point sources, but lifetime consumption of Hudson River fish was positively associated with serum PCB concentrations.

  3. Putting Residents First: Strategies Developed by CNAs to Prevent and Manage Resident-to-Resident Violence in Nursing Homes.

    PubMed

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

    2015-06-01

    Resident-to-resident violence (RRV) in nursing homes (NHs) is common and threatens the safety and quality of life of both residents and caregivers. The purpose of this portion of a larger qualitative study was to explore strategies developed by certified nurses' assistants (CNAs) to prevent and manage RRV in NHs. Semistructured interviews were used to collect data. Data were analyzed utilizing content analysis and constant comparison. Analysis revealed one overriding theme, "Putting Residents First" which the CNAs described as a conscious effort to put themselves or a beloved family member in the place of the resident while administering care. Within this theme, there were three related subthemes: (a) Knowing the Residents, (b) Keeping Residents Safe, and (c) Spending Quality Time. Together, these themes suggest that the formulation of strategies for decreasing and managing RRV was influenced significantly by the ability of the CNAs to empathize with the residents for whom they were caring. The results indicate that in the absence of evidence-based interventions, CNAs have developed their own strategies for the management and prevention of RRV. These strategies may provide a foundation for the development and testing of interventions aimed at preventing and managing RRV in NHs. © The Author 2015. Published by Oxford University Press on behalf of The Gerontological Society of America. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

  4. Putting Residents First: Strategies Developed by CNAs to Prevent and Manage Resident-to-Resident Violence in Nursing Homes

    PubMed Central

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

    2015-01-01

    Purpose of the Study: Resident-to-resident violence (RRV) in nursing homes (NHs) is common and threatens the safety and quality of life of both residents and caregivers. The purpose of this portion of a larger qualitative study was to explore strategies developed by certified nurses’ assistants (CNAs) to prevent and manage RRV in NHs. Design and Methods: Semistructured interviews were used to collect data. Data were analyzed utilizing content analysis and constant comparison. Results: Analysis revealed one overriding theme, “Putting Residents First” which the CNAs described as a conscious effort to put themselves or a beloved family member in the place of the resident while administering care. Within this theme, there were three related subthemes: (a) Knowing the Residents, (b) Keeping Residents Safe, and (c) Spending Quality Time. Implications: Together, these themes suggest that the formulation of strategies for decreasing and managing RRV was influenced significantly by the ability of the CNAs to empathize with the residents for whom they were caring. The results indicate that in the absence of evidence-based interventions, CNAs have developed their own strategies for the management and prevention of RRV. These strategies may provide a foundation for the development and testing of interventions aimed at preventing and managing RRV in NHs. PMID:26055786

  5. Fire resistance of exposed wood members

    Treesearch

    Robert H. White

    2004-01-01

    Fire resistance data on exposed wood beams and columns are plentiful, but few studies have been done on exposed wood members in tension and in decks. To provide data to verify the application of a new calculation procedure, a limited series of fire resistance tests were conducted on wood members loaded in tension and on exposed wood decks.

  6. [Drug Exposed Infants and Their Families.

    ERIC Educational Resources Information Center

    Fenichel, Emily, Ed.

    1992-01-01

    This bulletin issue addresses the theme of drug-exposed infants and the services required by these infants and their families. "Cocaine-Exposed Infants: Myths and Misunderstandings" (Barbara J. Myers and others) comments on the negative accounts of drug-exposed babies presented by mass media and reviews the mix of positive and negative…

  7. Grand Rounds: Outbreak of Hematologic Abnormalities in a Community of People Exposed to Leakage of Fire Extinguisher Gas

    PubMed Central

    Lo, Shih-Hsiang; Chan, Chang-Chuan; Chen, Wei-Chin; Wang, Jung-Der

    2006-01-01

    Context Although there are ample data on the respiratory effects of exposure to fire extinguisher gas, the potential hematologic effects have not been fully documented. We conducted this study to determine the possible etiologic agent(s) for a decrease in red blood cells among community residents in Taipei, Taiwan, after they were exposed to leakage of mixed fire extinguishants containing bromotrifluoromethane (CF3Br, Halon 1301), bromochlorodifluoromethane (CF2BrCl, Halon 1211), and dichlorodifluoromethane (CCl2F2, CFC-12). Case presentation We studied 117 exposed residents who came into one hospital for physical examinations. We also selected age- and sex-matched referents for comparison from residents who came to the same hospital for health examinations. Nine months after the exposure to mixed fire extinguishants, 91 of the exposed residents came back for a second physical examination. In the first examination of the exposed residents, we found a significant reduction in red blood cell count and hemoglobin and a relationship between dose and response. Discussion After excluding iron-deficiency anemia, thalassemia, and other possible agents, we suspected that the hematologic effects might have resulted from pyrolytic products of CFC-12 and Halon 1211, which may contain phosgene, among other products. Relevance to clinical practice The acute transient hematologic effects observed in the exposed residents were associated with the incident of leakage of mixed fire-extinguisher gases and were most likely caused by a small amount of pyrolytic products, probably phosgene. Nine months after the exposure, we found a significant improvement in the abnormalities without any specific treatment. PMID:17107857

  8. Global health training in pediatric residency programs.

    PubMed

    Nelson, Brett D; Lee, Anne Cc; Newby, P K; Chamberlin, M Robert; Huang, Chi-Cheng

    2008-07-01

    Our goal was to describe current resident interest, participation, curricula, resources, and obstacles related to global health training within pediatric residency programs. We conducted a cross-sectional survey of the 201 accredited pediatric residency programs in the United States, Puerto Rico, and the Caribbean from October 2006 to January 2007. Survey topics included resident interest and participation in electives, training opportunities, program support, and educational curricular content related to global health. Of the 201 surveyed pediatric residency programs, 106 (53%) responded. Fifteen percent of responding programs reported that a majority of their residents were interested in global health. Fifty-two percent offered a global health elective within the previous year, and 47% had formally incorporated global health into their training curricula. Six percent of the programs reported a formalized track or certificate in global health. The median number of residents per program participating in global health electives within the previous year was 0 during postgraduate year 1, 1 during postgraduate year 2, and 2 during postgraduate year 3. The median number of all residents per program participating in a global health elective in the previous year was 3 (7.4% of program size). Among programs that offered a global health elective, support to participating residents included prerequisite clinical training (36%), cultural orientation (36%), language training (15%), faculty mentorship (82%), and post-elective debriefing (77%). Fourteen percent of the programs provided full funding for resident electives. Characteristics of pediatric residency programs that were significantly associated with higher resident participation in a global health elective were larger program size, university affiliation, greater reported resident interest, and faculty involvement in global health. More than half of the pediatric residency programs surveyed offered a global health

  9. Contemporary Trends in Radiation Oncology Resident Research.

    PubMed

    Verma, Vivek; Burt, Lindsay; Gimotty, Phyllis A; Ojerholm, Eric

    2016-11-15

    To test the hypothesis that recent resident research productivity might be different than a decade ago, and to provide contemporary information about resident scholarly activity. We compiled a list of radiation oncology residents from the 2 most recent graduating classes (June 2014 and 2015) using the Association of Residents in Radiation Oncology annual directories. We queried the PubMed database for each resident's first-authored publications from postgraduate years (PGY) 2 through 5, plus a 3-month period after residency completion. We abstracted corresponding historical data for 2002 to 2007 from the benchmark publication by Morgan and colleagues (Int J Radiat Oncol Biol Phys 2009;74:1567-1572). We tested the null hypothesis that these 2 samples had the same distribution for number of publications using the Wilcoxon rank-sum test. We explored the association of demographic factors and publication number using multivariable zero-inflated Poisson regression. There were 334 residents publishing 659 eligible first-author publications during residency (range 0-17; interquartile range 0-3; mean 2.0; median 1). The contemporary and historical distributions were significantly different (P<.001); contemporary publication rates were higher. Publications accrued late in residency (27% in PGY-4, 59% in PGY-5), and most were original research (75%). In the historical cohort, half of all articles were published in 3 journals; in contrast, the top half of contemporary publications were spread over 10 journals-most commonly International Journal of Radiation Oncology • Biology • Physics (17%), Practical Radiation Oncology (7%), and Radiation Oncology (4%). Male gender, non-PhD status, and larger residency size were associated with higher number of publications in the multivariable analysis. We observed an increase in first-author publications during training compared with historical data from the mid-2000s. These contemporary figures may be useful to medical students

  10. Instituting a radiology residency scholarly activity program.

    PubMed

    Amrhein, Timothy J; Tabesh, Ali; Collins, Heather R; Gordon, Leonie L; Helpern, Joseph A; Jensen, Jens H

    2015-01-01

    The purpose of this manuscript is to present a newly instituted program for resident scholarly activity that includes a curriculum designed to enhance resident training with regard to research while meeting requirements established by the Accreditation Council for Graduate Medical Education (ACGME), the governing body responsible for regulation of post-graduate medical education and training in the United States. A scholarly activity program was designed with the following goals: (i) enhance the academic training environment for our residents; (ii) foster interests in research and academic career paths; (iii) provide basic education on research methodology and presentation skills. To guide program design, an electronic survey was created and distributed to the residents and faculty in the Department of Radiology and Radiological Sciences at the Medical University of South Carolina (MUSC), a 750-bed public teaching hospital in the state of South Carolina in the United States. Survey respondents were in strong support of a required resident scholarly activity project (70% in favor), felt non-traditional projects were valuable (84.1% of respondents), and were proponents of required scholarly activity summary presentations (58%). This program requires that residents engage in a scholarly activity project under the guidance of a mentor. Resident success is maximized through in-house education initiatives focusing on presentation and research skills, protected time to work on the project, and oversight by a radiology research committee. All residents present a summary of their work near the end of their residency training. Changes to the radiology resident certification process create an opportunity for incorporating new policies aimed at enhancing resident education. The scholarly activity program outlined in this manuscript is one such initiative designed to meet ACGME requirements, provide an introduction to research, and establish a scholarly activity project

  11. The Knowledge, Attitudes, and Behavior Concerning Alcohol Use of Resident Assistants and Residence Hall Students.

    ERIC Educational Resources Information Center

    Andrews, Marsha L.

    1987-01-01

    Examined relationship between knowledge, attitudes, and behavior toward alcohol among resident assistants and residence hall students at midwestern university. Found no statistically significant difference between assistants and students. Data revealed statistically significant relationship between students' knowledge, attitudes, and behavior…

  12. 0 + 5 Vascular Surgery Residents' Operative Experience in General Surgery: An Analysis of Operative Logs from 12 Integrated Programs.

    PubMed

    Smith, Brigitte K; Kang, P Chulhi; McAninch, Chris; Leverson, Glen; Sullivan, Sarah; Mitchell, Erica L

    2016-01-01

    Integrated (0 + 5) vascular surgery (VS) residency programs must include 24 months of training in core general surgery. The Accreditation Council for Graduate Medical Education currently does not require specific case numbers in general surgery for 0 + 5 trainees; however, program directors have structured this time to optimize operative experience. The aim of this study is to determine the case volume and type of cases that VS residents are exposed to during their core surgery training. Accreditation council for graduate medical education operative logs for current 0 + 5 VS residents were obtained and retrospectively reviewed to determine general surgery case volume and distribution between open and laparoscopic cases performed. Standard statistical methods were applied. A total of 12 integrated VS residency programs provided operative case logs for current residents. A total of 41 integrated VS residents in clinical years 2 through 5. During the postgraduate year-1 training year, residents participated in significantly more open than laparoscopic general surgery cases (p < 0.0001). This difference was consistent over the first 3 years of training. The most frequently logged open general surgery cases are hernia repair (20%), skin and soft tissue (7.4%), and breast (6.3%). Residents in programs with core surgery over 3 years participated in significantly more general surgery operations compared with residents in programs with core surgery spread out over 4 years (p = 0.035). 0 + 5 VS residents perform significantly more open operations than laparoscopic operations during their core surgery training. The majority of these operations are minor, nonabdominal procedures. The 0 + 5 VS residency program general surgery operative training requirements should be reevaluated and case minimums defined. The general surgery training component of 0 + 5 VS residencies may need to be restructured to meet the needs of current and future trainees. Copyright © 2016 Association of

  13. Radiology resident teaching skills improvement: impact of a resident teacher training program.

    PubMed

    Donovan, Andrea

    2011-04-01

    Teaching is considered an essential competency for residents to achieve during their training. Instruction in teaching skills may assist radiology residents in becoming more effective teachers and increase their overall satisfaction with teaching. The purposes of this study were to survey radiology residents' teaching experiences during residency and to assess perceived benefits following participation in a teaching skills development course. Study participants were radiology residents with membership in the American Alliance of Academic Chief Residents in Radiology or the Siemens AUR Radiology Resident Academic Development Program who participated in a 1.5-hour workshop on teaching skills development at the 2010 Association of University Radiologists meeting. Participants completed a self-administered, precourse questionnaire that addressed their current teaching strategies, as well as the prevalence and structure of teaching skills training opportunities at their institutions. A second postcourse questionnaire enabled residents to evaluate the seminar and assessed new knowledge and skill acquisition. Seventy-eight residents completed the precourse and postcourse questionnaires. The vast majority of respondents indicated that they taught medical students (72 of 78 [92.3%]). Approximately 20% of residency programs (17 of 78) provided residents with formal didactic programs on teaching skills. Fewer than half (46.8%) of the resident respondents indicated that they received feedback on their teaching from attending physicians (36 of 77), and only 18% (13 of 78) routinely gave feedback to their own learners. All of the course participants agreed or strongly agreed that this workshop was helpful to them as teachers. Few residency programs had instituted resident teacher training curricula. A resident teacher training workshop was perceived as beneficial by the residents, and they reported improvement in their teaching skills. Copyright © 2011 AUR. Published by

  14. Radiology residents as teachers: Current status of teaching skills training in United States residency programs.

    PubMed

    Donovan, Andrea

    2010-07-01

    Radiology residents often teach medical students and other residents. Workshops developed with the goal of improving resident teaching skills are becoming increasingly common in various fields of medicine. The purpose of this study was to determine the prevalence and structure of resident-teacher training opportunities within radiology programs in the United States. Program directors with membership in the Association of Program Directors in Radiology (APDR) were surveyed to determine views on a panel of topics related to resident-teacher training programs. A total of 114 (56%) of 205 APDR members completed an online survey. Approximately one-third (32%) stated that their program provided instruction to residents on teaching skills. The majority of these programs (72%) were established within the last 5 years. Residents provided teaching to medical students (94%) and radiology residents (90%). The vast majority of program directors agreed that it is important for residents to teach (98%) and that these teaching experiences helped residents become better radiologists (85%). Ninety-four percent of program directors felt that the teaching skills of their residents could be improved, and 85% felt that residents would benefit from instruction on teaching methods. Only one-third of program directors felt their program adequately recognized teaching provided by residents. Program directors identified residents as being active contributors to teaching in most programs. Although teaching was viewed as an important skill to develop, few programs had instituted a resident-teacher curriculum. Program directors felt that residents would benefit from structured training to enhance teaching skills. Future studies are needed to determine how best to provide teaching skills training for radiology trainees. 2010 AUR. Published by Elsevier Inc. All rights reserved.

  15. Integrating psychosocial concepts into psychopharmacology training: a survey study of program directors and chief residents.

    PubMed

    Mallo, C Jason; Mintz, David L; Lewis, Katie C

    2014-06-01

    A growing body of evidence suggests that psychiatric medication outcomes are shaped significantly by psychological and social factors surrounding the prescribing process. Little, however, is known about the extent to which psychiatry programs integrate this evidence base into residency training or the methods by which this is accomplished. Psychiatry residency program directors and chief residents participated in an exploratory online survey to establish how psychosocial factors known to impact medication outcomes are integrated into psychopharmacology education. While participants highly valued the importance of psychosocial factors in the prescribing process, there was limited emphasis of these factors in psychopharmacology training. Additionally, some teaching methods that could advance understanding of complex interactions in the psychopharmacology relationship were found to be underutilized. Given that medication outcomes are significantly influenced by psychosocial factors, psychiatric educators have a responsibility to teach residents about the evidence base available. Residents exposed to this evidence base will be better equipped to manage the complexities of the psychopharmacology role. The results of this study offer clues as to how psychosocial factors may be more fully integrated into residency psychopharmacology training.

  16. Urinary 1-hydroxypyrene in children living in city and rural residences in Denmark.

    PubMed

    Hansen, Ase Marie; Raaschou-Nielsen, Ole; Knudsen, Lisbeth Ehlert

    2005-07-15

    The present study aims to assess the biological uptake in children of polycyclic aromatic hydrocarbons measured as 1-hydroxypyrene in urine from children living in city and rural residences. 103 children living in Copenhagen and 101 children living in rural residences of Denmark collected urine samples Monday to Friday morning. Each day, the family filled in a printed diary that included questions about the time and activity patterns of the child. Multiple regression analyses were used to identify predictors of the excreted 1-hydroxypyrene level. During the week, the children excreted on average 0.07 [95% CI: 0.01-0.41] mumol urinary 1-hydroxypyrene per mol creatinine. Children living in urban residences excreted 0.02 [95% CI: 0.01-0.05] mumol more 1-hydroxypyrene than children living in rural residences. This was confirmed in the multiple regression analysis showing a 29% (95% CI: 2-64%) higher excretion among urban children than rural children. Moreover, the regression analysis showed that for each hour per day spent outside the children excreted 58% (1.58 [1.22-2.03]) more 1-hydroxypyrene in urine. The present study indicates that children living in urban residences are more exposed to PAH than children living in rural residences. Time spent outdoors increased the excretion of 1-hydroxypyrene, which was most evident among urban children. Higher concentrations of ambient air pollution in urban areas may explain this finding. No influence of environmental tobacco smoke, cooking habits, and heating facilities was detected.

  17. Urinary 1-hydroxypyrene in children living in city and rural residences in Denmark.

    PubMed

    Hansen, Ase Marie; Raaschou-Nielsen, Ole; Knudsen, Lisbeth Ehlert

    2006-06-15

    The present study aims to assess the biological uptake in children of polycyclic aromatic hydrocarbons measured as 1-hydroxypyrene in urine from children living in city and rural residences. 103 children living in Copenhagen and 101 children living in rural residences of Denmark collected urine samples Monday to Friday morning. Each day, the family filled in a printed diary that included questions about the time and activity patterns of the child. Multiple regression analyses were used to identify predictors of the excreted 1-hydroxypyrene level. During the week, the children excreted on average 0.07 [95% CI: 0.01-0.41] micromol urinary 1-hydroxypyrene per mol creatinine. Children living in urban residences excreted 0.02 [95% CI: 0.01-0.05] micromol more 1-hydroxypyrene than children living in rural residences. This was confirmed in the multiple regression analysis showing a 29% (95% CI: 2-64%) higher excretion among urban children than rural children. Moreover, the regression analysis showed that for each hour per day spent outside the children excreted 58% (1.58 [1.22-2.03]) more 1-hydroxypyrene in urine. The present study indicates that children living in urban residences are more exposed to PAH than children living in rural residences. Time spent outdoors increased the excretion of 1-hydroxypyrene, which was most evident among urban children. Higher concentrations of ambient air pollution in urban areas may explain this finding. No influence of environmental tobacco smoke, cooking habits, and heating facilities was detected.

  18. Effectiveness of iterative interventions to increase research productivity in one residency program

    PubMed Central

    Alweis, Richard; Wenderoth, Suzanne; Donato, Anthony

    2015-01-01

    Background The Accreditation Council for Graduate Medical Education requires residency programs to expose residents to research opportunities. Objective The purpose of this study was to assess the impact of a series of iterative interventions to increase scholarly activity in one internal medicine residency. Methods Retrospective analysis of the effectiveness of a series of interventions to increase resident and faculty scholarly productivity over a 14-year period was performed using quality improvement methodology. Outcomes measured were accepted regional and national abstracts and PubMed indexed manuscripts of residents and faculty. Results Initially, regional meeting abstracts increased and then were supplanted by national meeting abstracts. Sustained gains in manuscript productivity occurred in the eighth year of interventions, increasing from a baseline of 0.01 publications/FTE/year to 1.57 publications/FTE/year in the final year measured. Run chart analysis indicated special cause variation associated with the interventions performed. Conclusions Programs attempting to stimulate research production among faculty and residents can choose among many interventions cited in the literature. Since success of any group of interventions is likely additive and may take years to show benefit, measuring outcomes using quality improvement methodology may be an effective way to determine success. PMID:26653689

  19. 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. Copyright © 2014 Elsevier Ltd. All rights reserved.

  20. Orthopaedic resident and program director opinions of resident duty hours: a national survey.

    PubMed

    Mir, Hassan R; Cannada, Lisa K; Murray, Jayson N; Black, Kevin P; Wolf, Jennifer M

    2011-12-07

    The Accreditation Council for Graduate Medical Education (ACGME) established national guidelines for resident duty hours in July 2003. Following an Institute of Medicine report in December 2008, the ACGME recommended further restrictions on resident duty hours that went into effect in July 2011. We conducted a national survey to assess the opinions of orthopaedic residents and of directors of residency and fellowship programs in the U.S. regarding the 2003 and 2011 ACGME resident duty-hour regulations and the effects of these regulations on resident education and patient care. A fifteen-item questionnaire was electronically distributed by the Candidate, Resident, and Fellow Committee of the American Academy of Orthopaedic Surgeons (AAOS) to all U.S. orthopaedic residents (n = 3860) and directors of residency programs (n = 184) and fellowship programs (n = 496) between January and April 2011. Thirty-four percent (1314) of the residents and 27% (185) of the program directors completed the questionnaire. Statistical analyses were performed to detect differences between the responses of residents and program directors and between the responses of junior and senior residents. The responses of orthopaedic residents and program directors differed significantly (p < 0.001) for fourteen of the fifteen survey items. The responses of residents and program directors were divergent for questions regarding the 2003 rules. Overall, 71% of residents thought that the eighty-hour work week was appropriate, whereas only 38% of program directors agreed (p < 0.001). Most program directors (70%) did not think that the 2003 duty-hour rules had improved patient care, whereas only 24% of residents responded in the same way (p < 0.001). The responses of residents and program directors to questions regarding the 2011 duty-hour rules were generally compatible, but the degree to which they perceived the issues was different. Only 18% of residents and 19% of program directors thought

  1. The value of mentorship in orthopaedic surgery resident education: the residents' perspective.

    PubMed

    Flint, John H; Jahangir, A Alex; Browner, Bruce D; Mehta, Samir

    2009-04-01

    The concept of mentoring is believed to be influential in an effective medical and surgical educational environment. Several authors have discussed the issue of mentorship and its challenges, yet no one has studied the prevalence of mentoring among orthopaedic residency programs and its perceived value from the orthopaedic residents' perspective. Between January 1, 2008, and February 1, 2008, a survey created by the American Academy of Orthopaedic Surgeons was distributed by mail and e-mail to 3655 orthopaedic residents to obtain their opinion of the value of and their experience with mentorship. Five hundred and six (14%) of the surveyed residents responded. Nearly half of the responding residents either had a mentor or were involved in a mentoring program. Nearly all ranked the value of mentorship as very high and anticipated substantial help from their mentor in their career, research, and education. Only 44% were satisfied with their mentoring environment, and only 17% were highly satisfied. The residents were most satisfied with mentoring when there was a formal program in place. Ninety-six percent of the respondents thought that mentors were either critical or beneficial to their training. Residents who had selected their own mentor were more satisfied with their mentor than were those who had their mentor assigned. Residents with mentors, residents in mentoring programs, and residents who selected their own mentors had higher satisfaction with their mentoring environment than did those with no formal mentoring program. Residency programs should consider establishing formal mentorship programs and encourage residents to select their own mentors.

  2. Community Residences for Mentally Retarded People: A Study of Seven Community Residences.

    ERIC Educational Resources Information Center

    Wehbring, Kurt; Ogren, Ciele

    The report describes the distinctive characteristics and styles of seven community residences for retarded children or adults and provides a comparative analysis with emphasis on common themes of successful group homes. The homes are compared in terms of original initiation of the residence; the development of the residence; operations (such as…

  3. Current Perspectives on Chief Residents in Psychiatry

    ERIC Educational Resources Information Center

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

    2007-01-01

    Objective: The authors examine qualitative data from outgoing chief residents in psychiatry from the 2004-2005 academic year to 1) determine common characteristics between programs, 2) examine the residents' perspectives on their experiences, and 3) determine their common leadership qualities. Method: The authors sent out self-report surveys via…

  4. An Environmental Redesign Program for Residence Halls

    ERIC Educational Resources Information Center

    Daher, Douglas M.; And Others

    1977-01-01

    The Resident Environment Adaptation Program (REAP) is a five-stage service designed to enable students to heighten the match between their needs and their residence hall environment. In addition to a description of the program, the article includes pilot project conclusions and further recommendations for development. (Author)

  5. Arthroscopic training resources in orthopedic resident education.

    PubMed

    Koehler, Ryan; John, Tamara; Lawler, Jeffrey; Moorman, Claude; Nicandri, Gregg

    2015-02-01

    The purpose of this study was to determine the frequency of use, perceived effectiveness, and preference for arthroscopic surgical skill training resources. An electronic survey was sent to orthopedics residents, residency program directors, and orthopedic sports medicine attending physicians in the United States. The frequency and perceived effectiveness of 10 types of adjunctive arthroscopic skills training was assessed. Residents and faculty members were asked to rate their confidence in resident ability to perform common arthroscopic procedures. Surveys were completed by 40 of 152 (26.3%) orthopedic residency program directors, 70 of 426 (16.4%) sports medicine faculty, and 235 of 3,170 (7.4%) orthopedic residents. The use of adjunctive methods of training varied from only 9.8% of programs with virtual reality training to 80.5% of programs that used reading of published materials to develop arthroscopic skill. Practice on cadaveric specimens was viewed as the most effective and preferred adjunctive method of training. Residents trained on cadaveric specimens reported increased confidence in their ability to perform arthroscopic procedures. The resources for developing arthroscopic surgical skill vary considerably across orthopedic residency programs in the United States. Adjunctive training methods were perceived to be effective at supplementing traditional training in the operating room. Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

  6. Putting "Rural" into Psychiatry Residency Training Programs

    ERIC Educational Resources Information Center

    Nelson, William A.; Pomerantz, Andrew; Schwartz, Jonathan

    2007-01-01

    Objective: Evidence indicates disparities in the number of psychiatrists practicing in rural America compared to urban areas suggesting the need for a greater emphasis on rural psychiatry in residency training programs. The authors offer suggestions for integrating a rural focus in psychiatry residency training to foster greater competency and…

  7. 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... and/or his/her immediate family were legal residents as of December 22, 1974, of the lands partitioned...

  8. A Sexuality Curriculum for Gynecology Residents

    ERIC Educational Resources Information Center

    Levine, Stephen B.; And Others

    1978-01-01

    The summary report of an educational research program conducted with the obstetrics and gynecology residents at University Hospitals of Cleveland in 1976 is presented. The goals were to provide residents with basic knowledge about female sexual problems, assess skill and comfort in interviewing patients with sexual problems, document the effects…

  9. Study of Teaching Residents How to Teach.

    ERIC Educational Resources Information Center

    Edwards, Janine C.; And Others

    1988-01-01

    The effectiveness of a teaching skills program for residents at Louisiana State University Medical Center was evaluated among 22 residents in obstetrics and gynecology, medicine, and family medicine who were randomly assigned to control and experimental groups. There was greater increase in the scores of the experimental than the control groups.…

  10. Accommodating to Restrictions on Residents' Working Hours.

    ERIC Educational Resources Information Center

    Foster, Henry W., Jr.; Seltzer, Vicki L.

    1991-01-01

    In response to New York State legislation limiting house staff working hours, a survey of obstetrics and gynecology resident programs (n=26) was conducted. Results were used to construct a prototype call schedule and a hypothetical monthly schedule indicating how a single resident would function without violating any state regulations. (MSE)

  11. 7 CFR 273.3 - Residency.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... of the Department of Agriculture (Continued) FOOD AND NUTRITION SERVICE, DEPARTMENT OF AGRICULTURE... 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...

  12. 20th Annual Residence Hall Construction Report

    ERIC Educational Resources Information Center

    Agron, Joe

    2009-01-01

    Even in difficult economic times, colleges and universities continue to invest in residence hall construction projects as a way to attract new students and keep existing ones on campus. According to data from "American School & University"'s 20th annual Residence Hall Construction Report, the median new project completed in 2008 was…

  13. 19th Annual Residence Hall Construction Report

    ERIC Educational Resources Information Center

    Agron, Joe

    2008-01-01

    The construction of residence hall facilities at colleges and universities continues to be strong, as institutions scramble to meet the housing needs and varied demands of a growing student population. This article presents data collected from 39 new residence hall projects completed in 2007. According to American School & University's 19th…

  14. 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.

  15. Putting "Rural" into Psychiatry Residency Training Programs

    ERIC Educational Resources Information Center

    Nelson, William A.; Pomerantz, Andrew; Schwartz, Jonathan

    2007-01-01

    Objective: Evidence indicates disparities in the number of psychiatrists practicing in rural America compared to urban areas suggesting the need for a greater emphasis on rural psychiatry in residency training programs. The authors offer suggestions for integrating a rural focus in psychiatry residency training to foster greater competency and…

  16. Co-Dependency and Resident Assistants.

    ERIC Educational Resources Information Center

    Hetherington, Cheryl; Kerr, Barbara

    1988-01-01

    Proposes that an important psychological variable, codependence, may help to account for the phenomenon of burnout among resident assistants and other high-achieving, socially able college students. Explores characteristics of codependency. Suggests ways that institutional policy can help to decrease resident assistant burnout and related…

  17. Selected Health Practices Among Ohio's Rural Residents.

    ERIC Educational Resources Information Center

    Phillips, G. Howard; Pugh, Albert

    Using a stratified random sample of 12 of Ohio's 88 counties, this 1967 study had as its objectives (1) to measure the level of participation in selected health practices by Ohio's rural residents, (2) to compare the level of participation in selected health practices of farm and rural nonfarm residents, and (3) to examine levels of participation…

  18. Emotional intelligence in orthopedic surgery residents.

    PubMed

    Chan, Kevin; Petrisor, Brad; Bhandari, Mohit

    2014-04-01

    Emotional intelligence (EI) is the ability to understand and manage emotions in oneself and others. It was originally popularized in the business literature as a key attribute for success that was distinct from cognitive intelligence. Increasing focus is being placed on EI in medicine to improve clinical and academic performance. Despite the proposed benefits, to our knowledge, there have been no previous studies on the role of EI in orthopedic surgery. We evaluated baseline data on EI in a cohort of orthopedic surgery residents. We asked all orthopedic surgery residents at a single institution to complete an electronic version of the Mayer-Salovey-Caruso Emotional Intelligence Test (MSCEIT). We used completed questionnaires to calculate total EI scores and 4 branch scores. Data were analyzed according to a priori cutoff values to determine the proportion of residents who were considered competent on the test. Data were also analyzed for possible associations with age, sex, race and level of training. Thirty-nine residents (100%) completed the MSCEIT. The mean total EI score was 86 (maximum score 145). Only 4 (10%) respondents demonstrated competence in EI. Junior residents (p = 0.026), Caucasian residents (p = 0.009) and those younger than 30 years (p = 0.008) had significantly higher EI scores. Our findings suggest that orthopedic residents score low on EI based on the MSCEIT. Optimizing resident competency in noncognitive skills may be enhanced by dedicated EI education, training and testing.

  19. 19th Annual Residence Hall Construction Report

    ERIC Educational Resources Information Center

    Agron, Joe

    2008-01-01

    The construction of residence hall facilities at colleges and universities continues to be strong, as institutions scramble to meet the housing needs and varied demands of a growing student population. This article presents data collected from 39 new residence hall projects completed in 2007. According to American School & University's 19th…

  20. 20th Annual Residence Hall Construction Report

    ERIC Educational Resources Information Center

    Agron, Joe

    2009-01-01

    Even in difficult economic times, colleges and universities continue to invest in residence hall construction projects as a way to attract new students and keep existing ones on campus. According to data from "American School & University"'s 20th annual Residence Hall Construction Report, the median new project completed in 2008 was…

  1. 42 CFR 436.403 - State residence.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... Intellectual Disability agency in the State; (2) Is judged legally incompetent; or (3) Is found incapable of... licensed by the State in the field of intellectual disability. (d) Who is a State resident. A resident of a... institution as defined in paragraph (b) whose Medicaid eligibility is based on blindness or disability,...

  2. Medical Decision-Making by Psychiatry Residents

    ERIC Educational Resources Information Center

    El-Mallakh, Rif; Zinner, Jill; Mackey, Amanda; Tamas, Rebecca L.; Martin, Chanley M.; Dalton, Jerad; Dhaliwal, Nitu; Luddington, Nicole; Numan, Farhad U.; Nunes, Ross; Taylor, Stephen; Ye, Lu

    2007-01-01

    Objective: Several conspiring factors have resulted in an increase in the level of medical burden in psychiatric patients. Psychiatry residents require increasing levels of medical sophistication. To assess the medical decision-making of psychiatry residents, the authors examined the outcome in subjects initially seen in the emergency psychiatric…

  3. Resident Performance and Sleep Deprivation: A Review.

    ERIC Educational Resources Information Center

    Asken, Michael J.; Raham, David C.

    1983-01-01

    A review of the literature on resident performance and sleep deprivation suggests that current research is sparse and inconclusive, and existing research suggests potentially severe negative effects. It is proposed that justifications for sleep-depriving night call schedules remain untested, and their use as part of residency training should be…

  4. Co-Dependency and Resident Assistants.

    ERIC Educational Resources Information Center

    Hetherington, Cheryl; Kerr, Barbara

    1988-01-01

    Proposes that an important psychological variable, codependence, may help to account for the phenomenon of burnout among resident assistants and other high-achieving, socially able college students. Explores characteristics of codependency. Suggests ways that institutional policy can help to decrease resident assistant burnout and related…

  5. Teaching Forensic Psychiatry to General Psychiatry Residents

    ERIC Educational Resources Information Center

    Lewis, Catherine F.

    2004-01-01

    Objective: The Accreditation Council on Graduate Medical Education (ACGME) requires that general psychiatry residency training programs provide trainees with exposure to forensic psychiatry. Limited information is available on how to develop a core curriculum in forensic psychiatry for general psychiatry residents and few articles have been…

  6. A Clinical Evaluation System for Anesthesiology Residents.

    ERIC Educational Resources Information Center

    Viets, J. L.; Foster, Scot D.

    1988-01-01

    Baylor College of Medicine's system for evaluating the clinical progress of anesthesiology residents, developed in response to problems of standards, staff cooperation, and student dissatisfaction with evaluation, assesses resident progress in terms of performance levels based on case complexity and degree of staff intervention. (Author/MSE)

  7. Suicide Intervention Skills among Japanese Medical Residents

    ERIC Educational Resources Information Center

    Fujisawa, Daisuke; Suzuki, Yuriko; Kato, Takahiro A.; Hashimoto, Naoki; Sato, Ryoko; Aoyama-Uehara, Kumi; Fukasawa, Maiko; Tomita, Masayuki; Watanabe, Koichiro; Kashima, Haruo; Otsuka, Kotaro

    2013-01-01

    Objectives: Patient suicide is a tragic occurrence, and it can be a demoralizing experience for medical residents. Few studies, however, have assessed suicide management skills among these front-line healthcare professionals. This study evaluated the self-assessed competence and confidence of medical residents with regard to the management of…

  8. Medical Decision-Making by Psychiatry Residents

    ERIC Educational Resources Information Center

    El-Mallakh, Rif; Zinner, Jill; Mackey, Amanda; Tamas, Rebecca L.; Martin, Chanley M.; Dalton, Jerad; Dhaliwal, Nitu; Luddington, Nicole; Numan, Farhad U.; Nunes, Ross; Taylor, Stephen; Ye, Lu

    2007-01-01

    Objective: Several conspiring factors have resulted in an increase in the level of medical burden in psychiatric patients. Psychiatry residents require increasing levels of medical sophistication. To assess the medical decision-making of psychiatry residents, the authors examined the outcome in subjects initially seen in the emergency psychiatric…

  9. A Clinical Evaluation System for Anesthesiology Residents.

    ERIC Educational Resources Information Center

    Viets, J. L.; Foster, Scot D.

    1988-01-01

    Baylor College of Medicine's system for evaluating the clinical progress of anesthesiology residents, developed in response to problems of standards, staff cooperation, and student dissatisfaction with evaluation, assesses resident progress in terms of performance levels based on case complexity and degree of staff intervention. (Author/MSE)

  10. Suicide Intervention Skills among Japanese Medical Residents

    ERIC Educational Resources Information Center

    Fujisawa, Daisuke; Suzuki, Yuriko; Kato, Takahiro A.; Hashimoto, Naoki; Sato, Ryoko; Aoyama-Uehara, Kumi; Fukasawa, Maiko; Tomita, Masayuki; Watanabe, Koichiro; Kashima, Haruo; Otsuka, Kotaro

    2013-01-01

    Objectives: Patient suicide is a tragic occurrence, and it can be a demoralizing experience for medical residents. Few studies, however, have assessed suicide management skills among these front-line healthcare professionals. This study evaluated the self-assessed competence and confidence of medical residents with regard to the management of…

  11. 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,…

  12. Resident Performance and Sleep Deprivation: A Review.

    ERIC Educational Resources Information Center

    Asken, Michael J.; Raham, David C.

    1983-01-01

    A review of the literature on resident performance and sleep deprivation suggests that current research is sparse and inconclusive, and existing research suggests potentially severe negative effects. It is proposed that justifications for sleep-depriving night call schedules remain untested, and their use as part of residency training should be…

  13. Encountering Patient Suicide: A Resident's Experience

    ERIC Educational Resources Information Center

    Fang, Farrah; Kemp, Janet; Jawandha, Arshdeep; Juros, Jakub; Long, Laura; Nanayakkara, Sonali; Stepansky, Christian; Thompson, L. Brian; Anzia, Joan

    2007-01-01

    Objective: The authors reviewed the current literature for psychiatry residents' reactions to the suicide of a patient. This review also examines the responses of training programs to residents after such an incident. Method: Using Ovid Medline, the authors conducted a review of the scientific literature from 1966 to 2006, with search phrases…

  14. A Program of Management Training for Residents.

    ERIC Educational Resources Information Center

    Cordes, D. H.; And Others

    1989-01-01

    To help prepare residents in preventive medicine and occupational medicine for their future management roles, the University of Arizona College of Medicine incorporated administrative training into its residency programs. Training focuses on seven skill areas seen as needed to meet the management demands of the physicians' future specialties.…

  15. Delinking resident duty hours from patient safety

    PubMed Central

    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

  16. Current Practices in Resident Assistant Training

    ERIC Educational Resources Information Center

    Koch, Virginia Albaneso

    2016-01-01

    Developing resident assistant (RA) training is a challenge for most housing and residence life staff. Grounded in the author's doctoral research on the curricular design of RA training programs, this study summarizes current practices in three types of RA training programs--preservice training, in-service training, and academic courses--and…

  17. Assessment of Residents' Attitudes toward Patient Education.

    ERIC Educational Resources Information Center

    Falvo, Donna; Wright, W. Russel

    1981-01-01

    A questionnaire was developed at Southern Illinois University School of Medicine to elicit information from residents regarding their perceptions of and expectations of patient education. Responding residents generally felt patient education was an asset to total medical care, and that the physician should determine what information should be…

  18. Current Practices in Resident Assistant Training

    ERIC Educational Resources Information Center

    Koch, Virginia Albaneso

    2016-01-01

    Developing resident assistant (RA) training is a challenge for most housing and residence life staff. Grounded in the author's doctoral research on the curricular design of RA training programs, this study summarizes current practices in three types of RA training programs--preservice training, in-service training, and academic courses--and…

  19. Creating a Career Hotline for Rural Residents.

    ERIC Educational Resources Information Center

    Heppner, Mary J.; And Others

    1988-01-01

    Describes a career information hotline for rural and farm residents affected by the farm crisis as one way a university career center and extension division can make resources more generally available to residents. Discusses typical callers and benefits to the career center. (Author/ABL)

  20. Survey of Residence Hall Life at NCSU.

    ERIC Educational Resources Information Center

    Dolin, Nancy C.

    A 1977 North Carolina State University survey of a sample of on-campus students determined their attitudes toward residence hall activities, facilities, and staff. Information is shown by sex, class, and residence hall, and totals are weighted to reflect actual proportions in each dorm. Among the findings are the following: cookouts, movies, beer…

  1. Teaching Forensic Psychiatry to General Psychiatry Residents

    ERIC Educational Resources Information Center

    Lewis, Catherine F.

    2004-01-01

    Objective: The Accreditation Council on Graduate Medical Education (ACGME) requires that general psychiatry residency training programs provide trainees with exposure to forensic psychiatry. Limited information is available on how to develop a core curriculum in forensic psychiatry for general psychiatry residents and few articles have been…

  2. Contrasting Attitudes of Dormitory and Apartment Residents.

    ERIC Educational Resources Information Center

    Chase, Clinton I.; Wolosin, Myrna A.

    This study was designed to discover the attitudes that distinguish apartment-dwelling students from dormitory residents at Indiana University. The study appears to support the following conclusions. Apartment dwellers see independence as a major factor in their choice of residence. They also believe that apartments are more convenient than…

  3. Adult neurology training during child neurology residency.

    PubMed

    Schor, Nina F

    2012-08-21

    As it is currently configured, completion of child neurology residency requires performance of 12 months of training in adult neurology. Exploration of whether or not this duration of training in adult neurology is appropriate for what child neurology is today must take into account the initial reasons for this requirement and the goals of adult neurology training during child neurology residency.

  4. Accreditation of residency training in the US.

    PubMed Central

    Armbruster, J. S.

    1996-01-01

    In the US, accreditation and certification of residency training are functions of separate public sector agencies. Accrediting decisions are made directly by 26 Residency Review Committees, which represent the primary medical specialties and function under the authority of the Accreditation Council for Graduate Medical Education. The accrediting bodies may consider only educational issues and are prohibited by the government from controlling physician supply. Only the programme, not the institution in which it is conducted, is accredited. The US residency is a structured educational programme that is expected to provide comparable experience to all enrolled residents. Length of training may vary from two to six years depending on the specialty. Additional training may be obtained in subspecialty programmes, which are subsets of the primary specialty residencies and are also reviewed for accreditation. These have increased in significant number in recent years as subspecialisation has proliferated in the US. PMID:8935597

  5. Simulation and resident education in spinal neurosurgery.

    PubMed

    Bohm, Parker E; Arnold, Paul M

    2015-01-01

    A host of factors have contributed to the increasing use of simulation in neurosurgical resident education. Although the number of simulation-related publications has increased exponentially over the past two decades, no studies have specifically examined the role of simulation in resident education in spinal neurosurgery. We performed a structured search of several databases to identify articles detailing the use of simulation in spinal neurosurgery education in an attempt to catalogue potential applications for its use. A brief history of simulation in medicine is given, followed by current trends of spinal simulation utilization in residency programs. General themes from the literature are identified that are integral for implementing simulation into neurosurgical residency curriculum. Finally, various applications are reported. The use of simulation in spinal neurosurgery education is not as ubiquitous in comparison to other neurosurgical subspecialties, but many promising methods of simulation are available for augmenting resident education.

  6. Simulation and resident education in spinal neurosurgery

    PubMed Central

    Bohm, Parker E.; Arnold, Paul M.

    2015-01-01

    Background: A host of factors have contributed to the increasing use of simulation in neurosurgical resident education. Although the number of simulation-related publications has increased exponentially over the past two decades, no studies have specifically examined the role of simulation in resident education in spinal neurosurgery. Methods: We performed a structured search of several databases to identify articles detailing the use of simulation in spinal neurosurgery education in an attempt to catalogue potential applications for its use. Results: A brief history of simulation in medicine is given, followed by current trends of spinal simulation utilization in residency programs. General themes from the literature are identified that are integral for implementing simulation into neurosurgical residency curriculum. Finally, various applications are reported. Conclusion: The use of simulation in spinal neurosurgery education is not as ubiquitous in comparison to other neurosurgical subspecialties, but many promising methods of simulation are available for augmenting resident education. PMID:25745588

  7. Child Neurology Education for Pediatric Residents.

    PubMed

    Albert, Dara V F; Patel, Anup D; Behnam-Terneus, Maria; Sautu, Beatriz Cunill-De; Verbeck, Nicole; McQueen, Alisa; Fromme, H Barrett; Mahan, John D

    2017-03-01

    The aim of this study was to evaluate whether the current state of child neurology education during pediatric residency provides adequate preparation for pediatric practice. A survey was sent to recent graduates from 3 pediatric residency programs to assess graduate experience, perceived level of competence, and desire for further education in child neurology. Responses from generalists versus subspecialists were compared. The response rate was 32%, half in general pediatric practice. Only 22% feel very confident in approaching patients with neurologic problems. This may represent the best-case scenario as graduates from these programs had required neurology experiences, whereas review of Accreditation Council of Graduate Medical Education-accredited residency curricula revealed that the majority of residencies do not. Pediatric neurologic problems are common, and pediatric residency graduates do encounter such problems in practice. The majority of pediatricians report some degree of confidence; however, some clear areas for improvement are apparent.

  8. Evolution of the Pathology Residency Curriculum

    PubMed Central

    Powell, Suzanne Z.; Black-Schaffer, W. Stephen

    2016-01-01

    The required medical knowledge and skill set for the pathologist of 2020 are different than in 2005. Pathology residency training curriculum must accordingly change to fulfill the needs of these ever-changing requirements. In order to make rational curricular adjustments, it is important for us to know the current trajectory of resident training in pathology—where we have been, what our actual current training curriculum is now—to understand how that might change in anticipation of meeting the needs of a changing patient and provider population and to fit within the evolving future biomedical and socioeconomic health-care setting. In 2013, there were 143 Accreditation Council for Graduate Medical Education-accredited pathology residency training programs in the United States, with approximately 2400 residents. There is diversity among residency training programs not only with respect to the number of residents but also in training venue(s). To characterize this diversity among pathology residency training programs, a curriculum survey was conducted of pathology residency program directors in 2013 and compared with a similar survey taken almost 9 years previously in 2005 to identify trends in pathology residency curriculum. Clinical pathology has not changed significantly in the number of rotations over 9 years; however, anatomic pathology has changed dramatically, with an increase in the number of surgical pathology rotations coupled with a decline in stand-alone autopsy rotations. With ever-expanding medical knowledge that the graduating pathology resident must know, it is necessary to (1) reflect upon what are the critical need subjects, (2) identify areas that have become of lesser importance, and then (3) prioritize training accordingly. PMID:28725779

  9. Obstetrics and Gynecology Residency and Fertility Needs.

    PubMed

    Aghajanova, Lusine; Hoffman, Jacquelyn; Mok-Lin, Evelyn; Herndon, Christopher N

    2017-03-01

    Infertility is a common reproductive disease, with a prevalence of 9% to 18% of the general population. To date, no studies have attempted to examine the prevalence and experience of infertility among resident physicians in the United States. In female obstetrics and gynecology (Ob/Gyn) residents of age where infertility becomes more prevalent, ability to seek fertility may be influenced by rigorous professional demands and low remuneration. We seek to understand the prevalence of infertility, as well as experience and utilization of infertility services among Ob/Gyn residents. Cross-sectional descriptive survey was distributed among US Accreditation Council for Graduate Medical Education-accredited Ob/Gyn programs. Demographics, intentions to conceive during residency, fertility problems, fertility treatment, affordability of care, and perceptions of support were surveyed. A total of 241 responses were received in an equal distribution between junior (n = 120) and senior (n = 121) residents. The majority of respondents were female (91%), 25 to 35 years old (94%), and married (54%). Eighty-five percent (195 of 230) did not actively pursue fertility during residency. Twenty-nine percent (68 of 235) considered fertility preservation, but only 2% sought consultation. Twenty-nine percent of those interested in fertility (22 of 75) experienced infertility of some degree. Sixty-three percent felt low or no support from the program. Thirty-five percent reported stigma associated with their infertility. In conclusion, infertility is a prevalent reproductive health impairment among Ob/Gyn residents. The majority of residents defer childbearing during residency despite advancing reproductive age. A majority felt little or no support from training programs in addressing their fertility care. Further studies are indicated to understand the barriers and impact among resident trainees.

  10. Integrated flexible endoscopy training during surgical residency.

    PubMed

    Morales, Mario P; Mancini, Gregory J; Miedema, Brent W; Rangnekar, Nitin J; Koivunen, Debra G; Ramshaw, Bruce J; Eubanks, W Stephen; Stephenson, Hugh E

    2008-09-01

    New advances in endoscopic surgery make it imperative that future gastrointestinal surgeons obtain adequate endoscopy skills. An evaluation of the 2001-02 general surgery residency endoscopy experience at the University of Missouri revealed that chief residents were graduating with an average of 43 endoscopic cases. This met American Board of Surgery (ABS) and Accreditation Council for Graduate Medical Education (ACGME) requirements but is inadequate preparation for carrying out advanced endoscopic surgery. Our aim was to determine if endoscopy volume could be improved by dedicating specific staff surgeon time to a gastrointestinal diagnostic center at an affiliated Veterans Administration Hospital. During the academic years 2002-05, two general surgeons who routinely perform endoscopy staffed the gastrointestinal endoscopy center at the Harry S. Truman Hospital two days per week. A minimum of one categorical surgical resident participated during these endoscopy training days while on the Veterans Hospital surgical service. A retrospective observational review of ACGME surgery resident case logs from 2001 to 2005 was conducted to document the changes in resident endoscopy experience. The cases were compiled by postgraduate year (PGY). Resident endoscopy case volume increased 850% from 2001 to 2005. Graduating residents completed an average of 161 endoscopies. Endoscopic experience was attained at all levels of training: 26, 21, 34, 23, and 26 mean endoscopies/year for PGY-1 to PGY-5, respectively. Having specific endoscopy training days at a VA Hospital under the guidance of a dedicated staff surgeon is a successful method to improve surgical resident endoscopy case volume. An integrated endoscopy training curriculum results in early skills acquisition, continued proficiency throughout residency, and is an efficient way to obtain endoscopic skills. In addition, the foundation of flexible endoscopic skill and experience has allowed early integration of surgery

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

    PubMed

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

    2011-12-01

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

  12. Enhancing Teamwork Between Chief Residents and Residency Program Directors: Description and Outcomes of an Experiential Workshop

    PubMed Central

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

    2011-01-01

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

  13. Health survey on workers and residents near the municipal waste and industrial waste incinerators in Korea.

    PubMed

    Leem, Jong-Han; Hong, Yun-Cul; Lee, Kwan-Hee; Kwon, Ho-Jang; Chang, Yoon-Seok; Jang, Jae-Yeon

    2003-07-01

    industrial waste incinerator were the EDI within the tolerable daily intake range (1-4 pg I-TEQ/kg bw/day) suggested by WHO (1997). The oxidative stress of residents near the industrial waste incinerator was higher than that in workers and residents from the area around MSW incinerator. This oxidative stress may have been caused by hazardous substances, such as PCDD/Fs emitted by incinerators. The residents from the area around industrial waste incinerator were exposed to hazardous substances such as PCDD/ Fs. Proper protection strategies against these hazardous chemicals are needed.

  14. Generalized Anxiety and Major Depressive syndrome measured by the SCL-90-R in Two Manganese (Mn) Exposed Ohio Towns

    EPA Science Inventory

    Objective: Environmental exposure to manganese (Mn) may cause generalized anxiety (GA) and major depression (MD) in residents living in Mn-exposed areas. Marietta and East Liverpool are two Ohio towns identified as having elevated levels of Mn. The objective was to determine if l...

  15. Generalized Anxiety and Major Depressive syndrome measured by the SCL-90-R in Two Manganese (Mn) Exposed Ohio Towns

    EPA Science Inventory

    Objective: Environmental exposure to manganese (Mn) may cause generalized anxiety (GA) and major depression (MD) in residents living in Mn-exposed areas. Marietta and East Liverpool are two Ohio towns identified as having elevated levels of Mn. The objective was to determine if l...

  16. Effect of high-fidelity shoulder dystocia simulation on emergency obstetric skills and crew resource management skills among residents.

    PubMed

    Mannella, Paolo; Palla, Giulia; Cuttano, Armando; Boldrini, Antonio; Simoncini, Tommaso

    2016-12-01

    To determine the effect of a simulation training program for residents in obstetrics and gynecology in terms of technical and nontechnical skills for the management of shoulder dystocia. A prospective study was performed at a center in Italy in April-May 2015. Thirty-two obstetrics and gynecology residents were divided into two groups. Residents in the control group were immediately exposed to an emergency shoulder dystocia scenario, whereas those in the simulation group completed a 2-hour training session with the simulator before being exposed to the scenario. After 8weeks, the residents were again exposed to the shoulder dystocia scenario and reassessed. Participants were scored on their demonstration of technical and nontechnical skills. In the first set of scenarios, the mean score was higher in the simulation group than the control group in terms of both technical skills (P=0.008) and nontechnical skills (P<0.001). This difference was retained after 8weeks. High-fidelity simulation programs could be used for the training of residents in obstetrics and gynecology to diagnose and manage obstetric emergencies such as shoulder dystocia. Copyright © 2016 International Federation of Gynecology and Obstetrics. Published by Elsevier Ireland Ltd. All rights reserved.

  17. Using lean methodology to teach quality improvement to internal medicine residents at a safety net hospital.

    PubMed

    Weigel, Charlene; Suen, Winnie; Gupte, Gouri

    2013-01-01

    The overall objective of this initiative was to develop a quality improvement (QI) curriculum using Lean methodology for internal medicine residents at Boston Medical Center, a safety net academic hospital. A total of 90 residents and 8 School of Public Health students participated in a series of four, 60- to 90-minute interactive and hands-on QI sessions. Seventeen QI project plans were created and conducted over a 4-month period. The curriculum facilitated internal medicine residents' learning about QI and development of positive attitudes toward QI (assessed using pre- and post-attitude surveys) and exposed them to an interprofessional team structure that duplicates future working relationships. This QI curriculum can be an educational model of how health care trainees can work collaboratively to improve health care quality.

  18. Migratory and resident blue tits Cyanistes caeruleus differ in their reaction to a novel object.

    PubMed

    Nilsson, Anna L K; Nilsson, Jan-Åke; Alerstam, Thomas; Bäckman, Johan

    2010-11-01

    Individuals differ consistently in their behavioural reactions towards novel objects and new situations. Reaction to novelty is one part of a suit of individually consistent behaviours called coping strategies or personalities and is often summarised as bold or shy behaviour. Coping strategies could be particularly important for migrating birds exposed to novel environments on their journeys. We compared the average approach latencies to a novel object among migrants and residents in partially migratory blue tits Cyanistes caeruleus. In this test, we found migrating blue tits to have shorter approach latencies than had resident ones. Behavioural reactions to novelty can affect the readiness to migrate and short approach latency may have an adaptive value during migration. Individual behaviour towards novelty might be incorporated among the factors associated with migratory or resident behaviour in a partially migratory population.

  19. Migratory and resident blue tits Cyanistes caeruleus differ in their reaction to a novel object

    NASA Astrophysics Data System (ADS)

    Nilsson, Anna L. K.; Nilsson, Jan-Åke; Alerstam, Thomas; Bäckman, Johan

    2010-11-01

    Individuals differ consistently in their behavioural reactions towards novel objects and new situations. Reaction to novelty is one part of a suit of individually consistent behaviours called coping strategies or personalities and is often summarised as bold or shy behaviour. Coping strategies could be particularly important for migrating birds exposed to novel environments on their journeys. We compared the average approach latencies to a novel object among migrants and residents in partially migratory blue tits Cyanistes caeruleus. In this test, we found migrating blue tits to have shorter approach latencies than had resident ones. Behavioural reactions to novelty can affect the readiness to migrate and short approach latency may have an adaptive value during migration. Individual behaviour towards novelty might be incorporated among the factors associated with migratory or resident behaviour in a partially migratory population.

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

    PubMed

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

    2012-08-01

    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. 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. 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. 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.

  1. Mating success of resident versus non-resident males in a territorial butterfly

    PubMed Central

    Bergman, Martin; Gotthard, Karl; Berger, David; Olofsson, Martin; Kemp, Darrell J; Wiklund, Christer

    2007-01-01

    Male–male competition over territorial ownership suggests that winning is associated with considerable benefits. In the speckled wood butterfly, Pararge aegeria, males fight over sunspot territories on the forest floor; winners gain sole residency of a sunspot, whereas losers patrol the forest in search of females. It is currently not known whether residents experience greater mating success than non-residents, or whether mating success is contingent on environmental conditions. Here we performed an experiment in which virgin females of P. aegeria were allowed to choose between a resident and a non-resident male in a large enclosure containing one territorial sunspot. Resident males achieved approximately twice as many matings as non-residents, primarily because matings were most often preceded by a female being discovered when flying through a sunspot. There was no evidence that territorial residents were more attractive per se, with females seen to reject them as often as non-residents. Furthermore, in the cases where females were discovered outside of the sunspot, they were just as likely to mate with non-residents as residents. We hypothesize that the proximate advantage of territory ownership is that light conditions in a large sunspot greatly increase the male's ability to detect and intercept passing receptive females. PMID:17472909

  2. Preventing Alcohol-Exposed Pregnancies

    PubMed Central

    Floyd, R. Louise; Sobell, Mark; Velasquez, Mary M.; Ingersoll, Karen; Nettleman, Mary; Sobell, Linda; Mullen, Patricia Dolan; Ceperich, Sherry; von Sternberg, Kirk; Bolton, Burt; Skarpness, Bradley; Nagaraja, Jyothi

    2010-01-01

    Background Prenatal alcohol exposure is a leading preventable cause of birth defects and developmental disabilities in the United States. Design A randomized controlled trial (2002–2005; data analyzed 2005–2006) of a brief motivational intervention to reduce the risk of an alcohol-exposed pregnancy (AEP) in preconceptional women by focusing on both risk drinking and ineffective contraception use. Setting/Participants A total of 830 nonpregnant women, aged 18–44 years, and currently at risk for an AEP were recruited in six diverse settings in Florida, Texas, and Virginia. Combined settings had higher proportions of women at risk for AEP (12.5% overall) than in the general population (2%). Interventions Participants were randomized to receive information plus a brief motivational intervention (n=416) or to receive information only (n=414). The brief motivational intervention consisted of four counseling sessions and one contraception consultation and services visit. Main Outcome Measures Women consuming more than five drinks on any day or more than eight drinks per week on average, were considered risk drinkers; women who had intercourse without effective contraception were considered at risk of pregnancy. Reversing either or both risk conditions resulted in reduced risk of an AEP. Results Across the follow-up period, the odds ratios (ORs) of being at reduced risk for AEP were twofold greater in the intervention group: 3 months, 2.31 (95% confidence interval [CI]=1.69–3.20); 6 months, 2.15 (CI=1.52–3.06); 9 months, 2.11 (CI=1.47–3.03). Between-groups differences by time phase were 18.0%, 17.0%, and 14. 8%, respectively. Conclusions A brief motivational intervention can reduce the risk of an AEP. PMID:17218187

  3. Family medicine residency directors' perceptions of the position of chief resident.

    PubMed

    Susman, J; Gilbert, C

    1992-03-01

    This report describes a survey that explored the selection, training, duties, skills, and evaluation of chief residents as perceived by the program directors of the 381 family medicine residencies in the United States in 1989. A response rate of 79% (300 programs) was achieved. In 70% of the programs the chief resident received no formal training, and in 41% no formal evaluation. The program directors believed the most important duties and skills of a chief resident were acting as a liaison and advocate for residents, scheduling, and leadership. The directors thought that the most exciting aspects of being a chief resident included the development of leadership skills and the ability to influence curriculum; the aspects that caused the most concern included time pressures and demands that detract from clinical learning. The authors suggest that more attention should be directed to the nurturing and development of chief residents, who are the future leaders in academic medicine.

  4. Development of a residency interviewing preparatory seminar.

    PubMed

    Caballero, Joshua; Benavides, Sandra; Steinberg, Jennifer G; Clauson, Kevin A; Gauthier, Timothy; Borja-Hart, Nancy L; Marino, Jehan

    2012-03-01

    The development of a residency interviewing preparatory seminar (RIPS) is described. The RIPS elective at Nova Southeastern University College of Pharmacy was designed to assist pharmacy students during their last professional year in preparing for the residency application process. The learning objectives of the course focused on improving students' interviewing and presentation skills, professionalism, and developing their curriculum vitae (CV) and personal statement. Course and instructor evaluations and demographic data collected via anonymous surveys were used to ascertain students' perspectives about the course. The class was purposely scheduled to begin in October and end in November, right before the ASHP Midyear Clinical Meeting in early December. Due to limited faculty availability on the scheduled evenings and the desire to provide tailored, in-depth feedback, enrollment was limited. The RIPS was an intensive eight-week elective completed by 10 fourth-year pharmacy students. The course began with an overview of the residency application process, and students submitted their CVs and personal statements to faculty mentors for critique. To simulate residency interview components, students completed several timed activities in class and participated in mock interviews. Students stated that the course improved their application materials, interview skills, and confidence in their ability to obtain a residency. Overall, 78% of RIPS participants matched with a residency program. The RIPS elective was successful in improving residency candidate confidence at the ASHP Midyear Clinical Meeting. Students reported that the course was helpful and improved their confidence and ability to interview.

  5. Do otolaryngology residency applicants relocate for training?

    PubMed

    Gebhard, Grant M; Hauser, Leah J; Dally, Miranda J; Weitzenkamp, David A; Cabrera-Muffly, Cristina

    2016-04-01

    To determine whether there is an association between the geographic location of an applicant's undergraduate school, medical school, and residency program among matched otolaryngology residency applicants. Observational. Otolaryngology residency program applications to our institution from 2009 to 2013 were analyzed. The geographic location of each applicant's undergraduate education and medical education were collected. Online public records were queried to determine the residency program location of matched applicants. Applicants who did not match or who attended medical school outside the United States were excluded. Metro area, state, and region were determined according to US Census Bureau definitions. From 2009 to 2013, 1,089 (78%) of 1,405 applicants who matched into otolaryngology residency applied to our institution. The number of subjects who attended medical school and residency in the same geographic region was 241 (22%) for metropolitan area, 305 (28%) for state, and 436 (40%) for region. There was no difference in geographic location retention by gender or couples match status of the subject. United States Medical Licensing Exam step 1 scores correlated with an increased likelihood of subjects staying within the same geographic region (P = .03). Most otolaryngology applicants leave their previous geographic area to attend residency. Based on these data, the authors recommend against giving weight to geography as a factor when inviting applicants to interview. NA. © 2015 The American Laryngological, Rhinological and Otological Society, Inc.

  6. Problem neurology residents: a national survey.

    PubMed

    Tabby, David S; Majeed, Muhammed H; Schwartzman, Robert J

    2011-06-14

    Problem residents are found across most medical specialties at a prevalence of about 10%. This study was designed to explore the prevalence and causes of problem neurology residents and to compare neurology programs' responses and outcomes. Directors of 126 US neurology residency programs were sent an electronic survey. We collected data on demographics, first and all "identifiers" of problem residents, and year of training in which the problem was found. We asked about observable signs, etiology, and who performed remediation. We asked what resources were used and what outcomes occurred. Ninety-five program directors completed surveys (75% response rate). Almost all neurology programs have problem residents (81%). Age, sex, marital status, being a US native, or attending a US medical school had no effect on problem status. Being a parent carried a lower likelihood of problems (32%). Most commonly the problem is acted on during the first year of training. Faculty members without defined educational roles were the most frequent first identifiers. Program directors were the most common remediators. The most common remediation techniques were increasing supervision and assigning a faculty mentor. Graduate medical education office and psychiatric or psychological counseling services were most often used. Eleven percent of problem residents required a program for impaired physicians and 14% required a leave of absence. Sixteen percent were dismissed from their programs. The prevalence of problem residents in neurology is similar to other disciplines, and various resources are available to remediate them.

  7. Do Otolaryngology Residency Applicants Relocate for Training?

    PubMed Central

    Gebhard, Grant M.; Hauser, Leah J.; Dally, Miranda J.; Weitzenkamp, David A.; Cabrera-Muffly, Cristina

    2015-01-01

    Objective To determine whether there is an association between the geographic location of an applicant’s undergraduate school, medical school, and residency program among matched otolaryngology residency applicants. Study Design Observational. Methods Otolaryngology residency program applications to our institution from 2009 to 2013 were analyzed. The geographic location of each applicant’s undergraduate education and medical education were collected. Online public records were queried to determine the residency program location of matched applicants. Applicants who did not match or who attended medical school outside the US were excluded. Metro area, state, and region were determined according to United States Census Bureau definitions. Results From 2009-2013, 1,089 (78%) of 1,405 applicants who matched into otolaryngology residency applied to our institution. The number of subjects who attended medical school and residency in the same geographic region was 241 (22%) for metropolitan area, 305 (28%) for state, and 436 (40%) for region. There was no difference in geographic location retention by gender or couples match status of the subject. USMLE step 1 scores correlated with an increased likelihood of subjects staying within the same geographic region (p=0.03). Conclusion Most otolaryngology applicants leave their previous geographic area to attend residency. Based on these data, the authors recommend against giving weight to geography as a factor when inviting applicants to interview. PMID:26228114

  8. Canadian residents' perceived manager training needs.

    PubMed

    Stergiopoulos, Vicky; Lieff, Susan; Razack, Saleem; Lee, A Curtis; Maniate, Jerry M; Hyde, Stacey; Taber, Sarah; Frank, Jason R

    2010-01-01

    Despite widespread endorsement for administrative training during residency, teaching and learning in this area remains intermittent and limited in most programmes. To inform the development of a Manager Train-the-Trainer program for faculty, the Royal College of Physicians and Surgeons of Canada undertook a survey of perceived Manager training needs among postgraduate trainees. A representative sample of Canadian specialty residents received a web-based questionnaire in 2009 assessing their perceived deficiencies in 13 Manager knowledge and 11 Manager skill domains, as determined by gap scores (GSs). GSs were defined as the difference between residents' perceived current and desired level of knowledge or skill in selected Manager domains. Residents' educational preferences for furthering their Manager knowledge and skills were also elicited. Among the 549 residents who were emailed the survey, 199 (36.2%) responded. Residents reported significant gaps in most knowledge and skills domains examined. Residents' preferred educational methods for learning Manager knowledge and skills included workshops, web-based formats and interactive small groups. The results of this national survey, highlighting significant perceived gaps in multiple Manager knowledge and skills domains, may inform the development of Manager curricula and faculty development activities to address deficiencies in training in this important area.

  9. Prognostic value of resident clinical performance ratings.

    PubMed

    Williams, Reed G; Dunnington, Gary L

    2004-10-01

    This study investigated the concurrent and predictive validity of end-of-rotation (EOR) clinical performance ratings. Surgeon EOR ratings of residents were collected and compared with end-of-year (EOY) progress decisions and to EOR and EOY confidential judgments of resident ability to provide patient care without direct supervision. Eighty percent to 85% of EOR ratings were Excellent or Very Good. Five percent or fewer were Fair or Poor. Almost all residents receiving Excellent or Very Good EOR ratings also received positive EOR judgments about ability to provide patient care without direct supervision. Residents rated Fair or Poor received negative EOR judgments about ability to provide patient care without direct supervision. As the cumulative percent of Good, Fair, and Poor EOR ratings increased, the number of residents promoted without stipulations at the end of the year decreased and the percentage of faculty members who judged the residents capable of providing effective patient care without direct supervision at the end of the year declined. All residents receiving 40% or more EOR ratings below Very Good had stipulations associated with their promotion. Despite use of descriptive anchors on the scale, clinical performance ratings have no direct meaning. Their meaning needs to be established in the same manner as is done in setting normal values for diagnostic tests, ie, by establishing the relationship between EOR ratings and practice outcomes.

  10. Evaluating obstetrical residency programs using patient outcomes.

    PubMed

    Asch, David A; Nicholson, Sean; Srinivas, Sindhu; Herrin, Jeph; Epstein, Andrew J

    2009-09-23

    Patient outcomes have been used to assess the performance of hospitals and physicians; in contrast, residency programs have been compared based on nonclinical measures. To assess whether obstetrics and gynecology residency programs can be evaluated by the quality of care their alumni deliver. A retrospective analysis of all Florida and New York obstetrical hospital discharges between 1992 and 2007, representing 4 906 169 deliveries performed by 4124 obstetricians from 107 US residency programs. Nine measures of maternal complications from vaginal and cesarean births reflecting laceration, hemorrhage, and all other complications after vaginal delivery; hemorrhage, infection, and all other complications after cesarean delivery; and composites for vaginal and cesarean deliveries and for all deliveries regardless of mode. Obstetricians' residency program was associated with substantial variation in maternal complication rates. Women treated by obstetricians trained in residency programs in the bottom quintile for risk-standardized major maternal complication rates had an adjusted complication rate of 13.6%, approximately one-third higher than the 10.3% adjusted rate for women treated by obstetricians from programs in the top quintile (absolute difference, 3.3%; 95% confidence interval, 2.8%-3.8%). The rankings of residency programs based on each of the 9 measures were similar. Adjustment for medical licensure examination scores did not substantially alter the program ranking. Obstetrics and gynecology training programs can be ranked by the maternal complication rates of their graduates' patients. These rankings are stable across individual types of complications and are not associated with residents' licensing examination scores.

  11. Implementation of a Resident-Led Osteopathic Manipulative Treatment Clinic in an Allopathic Residency.

    PubMed

    Busey, Blake; Newsome, Jelaun; Raymond, Tyler; O'Mara, Heather

    2015-12-01

    With the growing number of osteopathic physicians practicing in the United States and the creation of a single graduate medical education system, a continued need exists for focused education in osteopathic principles, philosophy, and treatment modalities in primarily allopathic residency programs. To create and integrate a resident-led osteopathic manipulative treatment (OMT) clinic in an allopathic residency program. After an informal needs assessment on the basis of resident survey data, a resident-led OMT clinic was created within a military allopathic family medicine residency program. A standard operating procedure, resident survey, and scheduling system were created by the residents for approval by the departmental and hospital leadership. Resident survey data pertaining to the time available to perform OMT, education, and faculty supervision of OMT were obtained before the clinic implementation and 1 year after implementation. Nine osteopathic residents were surveyed before the OMT clinic implementation to illustrate a need for continued osteopathic medical education, faculty support, and skill maintenance. Sixteen osteopathic residents were surveyed after the OMT clinic implementation. More residents indicated that the establishment of an osteopathic curriculum was important (3 of 9 in the preclinic survey vs 9 of 16 in the postclinic survey) and that the program promoted the use of OMT (0 of 9 in the preclinic survey vs 13 of 16 in the postclinic survey). A resident-led OMT clinic can be successfully implemented, maintained, and expanded in an allopathic residency program by implementing an OMT curriculum, offering elective rotations, and encouraging regular use of OMT. The current project can be used as a framework for implementing an OMT clinic.

  12. Hebei spirit oil spill exposure and subjective symptoms in residents participating in clean-up activities.

    PubMed

    Cheong, Hae-Kwan; Ha, Mina; Lee, Jong Seong; Kwon, Hojang; Ha, Eun-Hee; Hong, Yun-Chul; Choi, Yeyong; Jeong, Woo-Chul; Hur, Jongil; Lee, Seung-Min; Kim, Eun-Jung; Im, Hosub

    2011-01-01

    This study was conducted to examine the relationship between crude oil exposure and physical symptoms among residents participating in clean-up work associated with the Hebei Spirit oil spill, 2007 in Korea. A total of 288 residents responded to a questionnaire regarding subjective physical symptoms, sociodemographic characteristics and clean-up activities that occurred between two and eight weeks after the accident. Additionally, the urine of 154 of the respondents was analyzed for metabolites of volatile organic compounds (VOCs) and polycyclic aromatic hydrocarbons (PAHs) and heavy metals. To compare the urinary levels of exposure biomarkers, the urine of 39 inland residents who were not directly exposed to the oil spill were analyzed. Residents exposed to oil remnants through clean-up work showed associations between physical symptoms and the exposure levels defined in various ways, including days of work, degree of skin contamination, and levels of some urinary exposure biomarkers of VOCs, metabolites and metals, although no major abnormalities in urinary exposure biomarkers were observed. This study provides evidence of a relationship between crude oil exposure and acute human health effects and suggests the need for follow-up to evaluate the exposure status and long-term health effects of clean-up participants.

  13. Hebei Spirit Oil Spill Exposure and Subjective Symptoms in Residents Participating in Clean-Up Activities

    PubMed Central

    Cheong, Hae-Kwan; Lee, Jong Seong; Kwon, Hojang; Ha, Eun-Hee; Hong, Yun-Chul; Choi, Yeyong; Jeong, Woo-Chul; Hur, Jongil; Lee, Seung-Min; Kim, Eun-Jung; Im, Hosub

    2011-01-01

    Objectives This study was conducted to examine the relationship between crude oil exposure and physical symptoms among residents participating in clean-up work associated with the Hebei Spirit oil spill, 2007 in Korea. Methods A total of 288 residents responded to a questionnaire regarding subjective physical symptoms, sociodemographic characteristics and clean-up activities that occurred between two and eight weeks after the accident. Additionally, the urine of 154 of the respondents was analyzed for metabolites of volatile organic compounds (VOCs) and polycyclic aromatic hydrocarbons (PAHs) and heavy metals. To compare the urinary levels of exposure biomarkers, the urine of 39 inland residents who were not directly exposed to the oil spill were analyzed. Results Residents exposed to oil remnants through clean-up work showed associations between physical symptoms and the exposure levels defined in various ways, including days of work, degree of skin contamination, and levels of some urinary exposure biomarkers of VOCs, metabolites and metals, although no major abnormalities in urinary exposure biomarkers were observed. Conclusions This study provides evidence of a relationship between crude oil exposure and acute human health effects and suggests the need for follow-up to evaluate the exposure status and long-term health effects of clean-up participants. PMID:22125768

  14. The Chief Resident in Psychiatry: Roles and Responsibilities

    ERIC Educational Resources Information Center

    Lim, Russell F.; Schwartz, Eric; Servis, Mark; Cox, Paul D.; Lai, Alan; Hales, Robert E.

    2009-01-01

    Objective: Psychiatric residency programs have had chief residents for many years, and several articles previously published describe the chief residents' unique role as both faculty and resident. This article describes chief resident roles and responsibilities and explores trends in academic psychiatry departments from 1995 to 2006. Methods: The…

  15. The Chief Resident in Psychiatry: Roles and Responsibilities

    ERIC Educational Resources Information Center

    Lim, Russell F.; Schwartz, Eric; Servis, Mark; Cox, Paul D.; Lai, Alan; Hales, Robert E.

    2009-01-01

    Objective: Psychiatric residency programs have had chief residents for many years, and several articles previously published describe the chief residents' unique role as both faculty and resident. This article describes chief resident roles and responsibilities and explores trends in academic psychiatry departments from 1995 to 2006. Methods: The…

  16. Resident perceptions of advanced laparoscopic skills training.

    PubMed

    Palter, Vanessa N; Orzech, Neil; Aggarwal, Rajesh; Okrainec, Allan; Grantcharov, Teodor P

    2010-11-01

    The purpose of this study was to explore resident perceptions regarding four current models for teaching laparoscopic suturing and to assess the current quality of training in advanced minimally invasive surgical techniques at an academic teaching center. This study included 14 senior general surgery residents (PGY 3-5) participating in a workshop in advanced laparoscopy. Four training tools were used in the course curriculum: the Fundamentals of Laparoscopic Surgery (FLS) black box suturing model, a synthetic Nissen fundoplication model, a virtual reality (VR) simulator suturing task, and a porcine jejuno-jejunostomy model. After the workshop, residents were asked to complete a questionnaire relating to their experience with laparoscopic surgery, and their opinions regarding the four training models. Model rank was analyzed with one-way ANOVA, and χ(2) analysis with Fisher's exact test was used to analyze model effectiveness. The majority of residents had strong experience in basic laparoscopic cases such as cholecystectomy and appendectomy; however, few participants had experience in advanced cases. As a group, the residents ranked the porcine model first (average 1.6, median 1), followed by the synthetic Nissen model (average 2.0, median 2), the FLS model (average 2.5, median 3), and the VR trainer (average 3.2, median 4). Finally, each resident was asked to rate the four models individually with respect to their educational value. Scores were on a Likert scale from 1 to 5. Nine of 11 (81.8%) residents rated the animal model as "extremely helpful" while only 3 of 14 (21.4%) participants rated the VR model as "extremely helpful" (p = 0.048). This study demonstrates that operative experience in advanced laparoscopy for senior residents is suboptimal. Residents learning this skill in a simulated environment prefer animal or video-trainers as teaching models rather than virtual reality. This has implications when designing a curriculum for advanced endoscopy.

  17. Pediatric residents' knowledge of the community.

    PubMed

    Northrip, Kimberly D; Bush, Heather M; Li, Hsin-Fang; Marsh, Jennifer; Chen, Candice; Guagliardo, Mark F

    2012-01-01

    The purpose of this study was to examine pediatric residents' knowledge of the communities they serve through their continuity clinics. The community was identified for each of 6 continuity clinics at an urban children's hospital by geocoding patient addresses using GIS software (1 hospital-based [n = 36], 1 primary care track site [n = 10], and 4 community clinics [n = 12]). We assessed resident and attending knowledge with a survey examining 7 content areas with basic questions about these communities. The survey answers were compared with publicly available community data. A total of 37 of 57 eligible residents (65%) and 21 of their 23 attendings (91%) completed the survey. The residents achieved an overall mean score of 28.9% correct (SD 9.2) and attendings scored 42.6% (SD 19.7). Scores were significantly greater for community-based attendings overall (P < .002) and for community-based residents only in the questions of schools (P < 0.001). However, community-based residents had poorer scores in the demographics/economics content area (P < 0.001). Scores were not correlated with year of residency. Our pediatric professional organizations have recognized the importance of training residents in community pediatrics. This study is the first to describe resident community knowledge and to demonstrate that this knowledge is generally poor, with specific gaps in the content areas of schools, daycares, and health care access. There are differences in areas of knowledge between those working in hospital versus community clinics, suggesting this is an area for further investigation. Copyright © 2012 Academic Pediatric Association. Published by Elsevier Inc. All rights reserved.

  18. Are neurology residents interested in headache?

    PubMed

    Gago-Veiga, A B; Santos-Lasaosa, S; Viguera Romero, J; Pozo-Rosich, P

    2016-06-18

    The years of residency are the pillars of the subsequent practice in every medical specialty. The aim of our study is to evaluate the current situation, degree of involvement, main interests, and perceived quality of the training received by Spanish residents of neurology, specifically in the area of headache. A self-administered survey was designed by the Headache Study Group of the Spanish Society of Neurology (GECSEN) and was sent via e-mail to all residents who were members of the Society as of May 2015. Fifty-three residents completed the survey (N = 426, 12.4%): 6% were first year residents, 25.5% second year, 23.5% third year, and 45% fourth year residents, all from 13 different Spanish autonomous communities. The areas of greatest interest are, in this order: Vascular neurology, headache, and epilepsy. Of them, 85% believe that the area of headache is undervalued. More than half of residents (52.8%) do not rotate in specific Headache Units and only 35.8% complete their training dominating anaesthetic block and toxin infiltration techniques. Of them, 81.1% believe that research is scarce or absent; 69.8% have never made a poster/presentation, 79.3% have not published and only 15% collaborate on research projects in this area. Lastly, 40% believe that they have not received adequate training. Headache is among the areas that interest our residents the most; however, we believe that we must improve their training both at a patient healthcare level and as researchers. Thus, increasing the number of available courses, creating educational web pages, involving residents in research, and making a rotation in a specialised unit mandatory are among the fundamental objectives of the GECSEN. Copyright © 2016 Sociedad Española de Neurología. Published by Elsevier España, S.L.U. All rights reserved.

  19. The Language Abilities of Resident Physicians

    PubMed Central

    Guerrero, Lourdes R.; Morales, Leo S.; Moreno, Gerardo

    2015-01-01

    PURPOSE The Joint Commission mandates that health care systems provide culturally and linguistically appropriate care for patients. Similarly, the Accreditation Council for Graduate Medical Education (ACGME) requires that resident physicians learn to communicate effectively across cultures. The purpose of this study was to analyze residents’ self-report of fluency in a second language and level of training in the use of interpreters to assess the institution’s preparation of residents to meet mandates regarding the delivery of cross-cultural care. METHODS Seven hundred and twenty two (722) surveys were analyzed from resident physicians in 62 different ACGME accredited programs. Language ability was measured with a survey question asking about comfort providing patient care in a language other than English. Knowledge of working with interpreters was measured by a survey question asking about amount of training received. Survey questions on gender, post-graduate year (PGY), specialty, and underrepresented minority (URM) status were examined using c2 and independent samples Mann-Whitney U test. Logistic regression was used to estimate the adjusted odds ratio by variable. RESULTS Fifty-five percent of all of the resident physicians endorsed feeling comfortable providing patient care in a language other than English, and Spanish was the most common language (77%). Almost 20% percent of residents reported little or no training in the use of interpreters. In bivariate analysis, race-ethnicity was associated (P-value <.001) with comfort in providing patient care in a language other than English. Primary care resident physicians had a 1.67 adjusted odds ratio (95% confidence interval [CI] 1.18, 2.37; p value = 0.004) of feeling comfortable providing patient care in a language other than English compared to resident physicians from other specialties. CONCLUSIONS Primary care resident physicians are more likely to report feeling comfortable in providing patient care in a

  20. Internal medicine residency training and outcomes.

    PubMed

    Griffith, C H; Rich, E C; Hillson, S D; Wilson, J F

    1997-06-01

    To review the impact of the clinical education of internal medicine residents on patients' outcomes. English-language studies of the relation between internal medicine housestaff training and patients' outcomes were systematically identified by a MEDLINE search and from bibliographies and reference lists of recently published articles. We hypothesized that the primary impact of internal medicine residency training on patients' outcomes would be the result of: (1) the inexperience of the residents; (2) the heavy workload these inexperienced residents are expected to manage: or (3) some structural feature of the internal medicine teaching services, such as the discontinuity of patient care inherent in night float systems and the fact that residents rotate to different services each month. We also hypothesized that residents may in may ways provide superior care, and many actually improve certain patient outcomes. Housestaff inexperience, workload, and structural features that promote discontinuity have been shown to affect especially outcomes of resource utilization, length of stay, and patient satisfaction. No study has demonstrated that internal medicine residents contribute to excess patient morbidity or mortality. However, the published studies in this area are for the most part retrospective and were conducted 10 to 15 years ago. The full extent of the untoward (or the beneficial) effects of internal medicine residency training on patients' outcomes is unknown. Multisite, prospective studies would remedy the deficiencies in the published research in this area and would yield the most valid insight into the range and extent of the effects of housestaff training on patients' outcomes. In the absence of such studies and in a rapidly changing managed care environment, academic medical centers and departments of medicine need to be aware of those aspects of the clinical education of residents that are most likely to affect patients' outcomes.

  1. Characterization of dioxin exposure in residents of Chapaevsk, Russia.

    PubMed

    Akhmedkhanov, Arslan; Revich, Boris; Adibi, Jennifer J; Zeilert, Vladimir; Masten, Scott A; Patterson, Donald G; Needham, Larry L; Toniolo, Paolo

    2002-11-01

    Since 1967, a chemical plant in the town of Chapaevsk (Samara province, Russia) has produced large amounts of chlorinated compounds and is suspected to be a major source of local environmental dioxin contamination. Dioxins have been detected in the local air, soil, drinking water, vegetables, and cow's milk. Human exposure to dioxins is suspected as a factor in the deteriorating local public health. In an effort to characterize nonoccupational dioxin exposure among local residents, during the summer of 1998, 24 volunteers were recruited to donate blood and to provide information about their residence, employment, demographics, medical history, and dietary habits. Selected polychlorinated dibenzodioxins, dibenzofurans, and coplanar biphenyls were measured in blood serum samples. The mean concentration of total dioxin World Health Organization toxic equivalents (WHO-TEQ(98)) based on polychlorinated dibenzo-para-dioxins (PCDDs), polychlorinated dibenzofurans (PCDFs), and coplanar polychlorinated biphenyls (PCBs) was 61.2 (range 16.4-168.1) pg/g lipid. Subjects living in close proximity to the plant (less than 5 km) had significantly higher dioxin levels (mean WHO-TEQ(98), 75.7 pg/g lipid), as compared to subjects living more than 5 km from the plant (mean WHO-TEQ(98), 44.1 pg/g lipid) (P<0.04). Comparisons of the study results with available published data indicate that average blood dioxin levels were substantially higher in Chapaevsk residents than in nonoccupationally exposed populations of other parts of Russia, Europe, and North America. Chronic exposures of such magnitude may have appreciable adverse effects on public health.

  2. 27-Hydroxycholesterol accelerates cellular senescence in human lung resident cells.

    PubMed

    Hashimoto, Yuichiro; Sugiura, Hisatoshi; Togo, Shinsaku; Koarai, Akira; Abe, Kyoko; Yamada, Mitsuhiro; Ichikawa, Tomohiro; Kikuchi, Takashi; Numakura, Tadahisa; Onodera, Katsuhiro; Tanaka, Rie; Sato, Kei; Yanagisawa, Satoru; Okazaki, Tatsuma; Tamada, Tsutomu; Kikuchi, Toshiaki; Hoshikawa, Yasushi; Okada, Yoshinori; Ichinose, Masakazu

    2016-06-01

    Cellular senescence is reportedly involved in the pathogenesis of chronic obstructive pulmonary disease (COPD). We previously showed that 27-hydroxycholesterol (27-OHC) is elevated in the airways of COPD patients compared with those in healthy subjects. The aim of this study was to investigate whether lung fibroblasts of COPD patients are senescent and to determine the effects of 27-OHC on senescence of lung resident cells, including fibroblasts and airway epithelial cells. Localization of senescence-associated proteins and sterol 27-hydroxylase was investigated in the lungs of COPD patients by immunohistochemical staining. To evaluate whether 27-OHC accelerates cellular senescence, lung resident cells were exposed to 27-OHC. Senescence markers and fibroblast-mediated tissue repair were investigated in the 27-OHC-treated cells. Expression of senescence-associated proteins was significantly enhanced in lung fibroblasts of COPD patients. Similarly, expression of sterol 27-hydroxylase was significantly upregulated in lung fibroblasts and alveolar macrophages in these patients. Treatment with the concentration of 27-OHC detected in COPD airways significantly augmented expression of senescence-associated proteins and senescence-associated β-galactosidase activity, and delayed cell growth through the prostaglandin E2-reactive nitrogen species pathway. The 27-OHC-treated fibroblasts impaired tissue repair function. Fibroblasts from lungs of COPD patients showed accelerated senescence and were more susceptible to 27-OHC-induced cellular senescence compared with those of healthy subjects. In conclusion, 27-OHC accelerates cellular senescence in lung resident cells and may play a pivotal role in cellular senescence in COPD. Copyright © 2016 the American Physiological Society.

  3. Health and environmental assessment among residents of a community near a battery recycling plant

    NASA Astrophysics Data System (ADS)

    Cortes-Maramba, N. P.; Panganiban, L. R.; Castille, E. S.; Dioquino, C. C.; Francisco-Rivera, A. T.

    2003-05-01

    A battery-recycling plant in a small town near Manila has been the subject of health complaints, mostly respiratory symptoms among the residents. Records showed that the plant had imported 24,000 units of used batteries and 60% of the load was handled by the recycling plant. This cross-sectional study was conducted to evaluate the health and environmental impact of lead battery recycling plant among the residents in the area. Study population was composed of 105 exposed and 41 non-exposed adults and children coming from 12 villages, randomly selected based on a set criteria. Results showed that children were more affected than adults with elevated blood lead levels in 65%, with a mean of 12.9ug/dL (range of 7-25). This was statistically significant (p=0.00). Common complaints were mostly respiratory in nature among the exposed population. These were supported by the physical examination findings together with bluish/grayish gingival deposits. Air and soil monitoring showed elevated lead levels. Analysis revealed that the nearer the residence from the plant, the higher were the blood lead levels and that there was a very good inverse correlation between the ambient air lead levels and the distance of the village from the plant.

  4. Stress and the residency program director.

    PubMed

    Barton, L L; Friedman, A D

    1994-01-01

    A survey of pediatric program directors was performed to identify stressors on pediatric residents as perceived by the directors and to ascertain the relationship of stress experienced by house staff and faculty. Major stressors for pediatric residents were acuity/complexity of patient diseases and financial concerns. Major stressors for program directors were administrative duties. Although nearly three fourths of the program directors had completed a fellowship, only one half were on the tenured track. The majority of program directors believed that as resident working hours and stress decreased, faculty workload and stress increased. Stress experienced by faculty appears to require further investigation and remediation.

  5. A novel resident-as-teacher training program to improve and evaluate obstetrics and gynecology resident teaching skills.

    PubMed

    Ricciotti, Hope A; Dodge, Laura E; Head, Julia; Atkins, K Meredith; Hacker, Michele R

    2012-01-01

    Residents play a significant role in teaching, but formal training, feedback, and evaluation are needed. Our aims were to assess resident teaching skills in the resident-as-teacher program, quantify correlations of faculty evaluations with resident self-evaluations, compare resident-as-teacher evaluations with clinical evaluations, and evaluate the resident-as-teacher program. The resident-as-teacher training program is a simulated, videotaped teaching encounter with a trained medical student and standardized teaching evaluation tool. Evaluations from the resident-as-teacher training program were compared to evaluations of resident teaching done by faculty, residents, and medical students from the clinical setting. Faculty evaluation of resident teaching skills in the resident-as-teacher program showed a mean total score of 4.5 ± 0.5 with statistically significant correlations between faculty assessment and resident self-evaluations (r = 0.47; p < 0.001). However, resident self-evaluation of teaching skill was lower than faculty evaluation (mean difference: 0.4; 95% CI 0.3-0.6). When compared to the clinical setting, resident-as-teacher evaluations were significantly correlated with faculty and resident evaluations, but not medical student evaluations. Evaluations from both the resident-as-teacher program and the clinical setting improved with duration of residency. The resident-as-teacher program provides a method to train, give feedback, and evaluate resident teaching.

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

    PubMed

    Hsieh, Cindy M; Nolan, Norris J

    2015-01-01

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

  7. 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

  8. The Radiology Resident iPad Toolbox: an educational and clinical tool for radiology residents.

    PubMed

    Sharpe, Emerson E; Kendrick, Michael; Strickland, Colin; Dodd, Gerald D

    2013-07-01

    Tablet computing and mobile resources are the hot topics in technology today, with that interest spilling into the medical field. To improve resident education, a fully configured iPad, referred to as the "Radiology Resident iPad Toolbox," was created and implemented at the University of Colorado. The goal was to create a portable device with comprehensive educational, clinical, and communication tools that would contain all necessary resources for an entire 4-year radiology residency. The device was distributed to a total of 34 radiology residents (8 first-year residents, 8 second-year residents, 9 third-year residents, and 9 fourth-year residents). This article describes the process used to develop and deploy the device, provides a distillation of useful applications and resources decided upon after extensive evaluation, and assesses the impact this device had on resident education. The Radiology Resident iPad Toolbox is a cost-effective, portable, educational instrument that has increased studying efficiency; improved access to study materials such as books, radiology cases, lectures, and web-based resources; and increased interactivity in educational conferences and lectures through the use of audience-response software, with questions geared toward the new ABR board format. This preconfigured tablet fully embraces the technology shift into mobile computing and represents a paradigm shift in educational strategy. Copyright © 2013 American College of Radiology. Published by Elsevier Inc. All rights reserved.

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

    PubMed

    Riesenberg, Lee Ann; Berg, Katherine; Berg, Dale; Morgan, Charity J; Davis, Joshua; Davis, Robyn; Schaeffer, Arielle; Hargraves, Robert; Little, Brian W

    2014-01-01

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

  10. Characteristics That Define a Successful Pharmacy Resident as Perceived by Residency Programs

    PubMed Central

    Cohen, Victor; Rab, Saba; Likourezos, Antonios

    2015-01-01

    Purpose: To identify the subjective and objective characteristics that pharmacy residency programs use to define a successful resident and to determine what percentage of their 2009-2010 residency class they felt were successful. Methods: An electronic survey was sent via e-mail to all residency program directors (RPDs) of postgraduate year 1 (PGY1) and postgraduate year 2 (PGY2) pharmacy residency programs in the United States. A 3-part survey instrument was developed following validation of questions for clarity and reliability using a pilot survey. Respondents were asked to rank the importance of 20 subjective characteristics for a resident to possess in order to be considered successful and the importance of different objective measurements of accomplishment in the definition of a “successful” resident using a Likert scale where 1 = not at all important, 2 = some importance, 3 = very important, and 4 = critical. Results: Of the 1,081 surveys sent to RPDs, 473 respondents answered at least one question, yielding a response rate of 43.8%. The most critically important subjective characteristics in defining a successful resident as ranked among PGY1 residency programs are dependability, professionalism, self-motivation/initiative, and work ethic. PGY2 programs ranked clinical knowledge and skills, critical thinking, and dependability as the most important. The most critically important objective characteristic in defining a successful resident as ranked among both PGY1 and PGY2 programs is obtaining a clinical position. The majority of PGY1 and PGY2 respondents felt that 76% to 100% of their 2009-2010 residency class was successful based on the characteristics they rated most important. Conclusion: Identification of the characteristics that pharmacy residency programs use to define success will allow them to identify predictors of success and optimal methods of selecting residents who possess these characteristics. PMID:27729675

  11. Characteristics That Define a Successful Pharmacy Resident as Perceived by Residency Programs.

    PubMed

    Jellinek-Cohen, Samantha P; Cohen, Victor; Rab, Saba; Likourezos, Antonios

    2015-11-01

    To identify the subjective and objective characteristics that pharmacy residency programs use to define a successful resident and to determine what percentage of their 2009-2010 residency class they felt were successful. An electronic survey was sent via e-mail to all residency program directors (RPDs) of postgraduate year 1 (PGY1) and postgraduate year 2 (PGY2) pharmacy residency programs in the United States. A 3-part survey instrument was developed following validation of questions for clarity and reliability using a pilot survey. Respondents were asked to rank the importance of 20 subjective characteristics for a resident to possess in order to be considered successful and the importance of different objective measurements of accomplishment in the definition of a "successful" resident using a Likert scale where 1 = not at all important, 2 = some importance, 3 = very important, and 4 = critical. Of the 1,081 surveys sent to RPDs, 473 respondents answered at least one question, yielding a response rate of 43.8%. The most critically important subjective characteristics in defining a successful resident as ranked among PGY1 residency programs are dependability, professionalism, self-motivation/initiative, and work ethic. PGY2 programs ranked clinical knowledge and skills, critical thinking, and dependability as the most important. The most critically important objective characteristic in defining a successful resident as ranked among both PGY1 and PGY2 programs is obtaining a clinical position. The majority of PGY1 and PGY2 respondents felt that 76% to 100% of their 2009-2010 residency class was successful based on the characteristics they rated most important. Identification of the characteristics that pharmacy residency programs use to define success will allow them to identify predictors of success and optimal methods of selecting residents who possess these characteristics.

  12. Pediatric Residents' Perceptions of Potential Professionalism Violations on Social Media: A US National Survey.

    PubMed

    Dawkins, Rachel; King, William D; Boateng, Beatrice; Nichols, Michele; Desselle, Bonnie C

    2017-01-31

    The ubiquitous use of social media by physicians poses professionalism challenges. Regulatory bodies have disseminated guidelines related to physicians' use of social media. This study had 2 objectives: (1) to understand what pediatric residents view as appropriate social media postings, and (2) to recognize the degree to which these residents are exposed to postings that violate social media professionalism guidelines. We distributed an electronic survey to pediatric residents across the United States. The survey consisted of 5 postings from a hypothetical resident's personal Facebook page. The vignettes highlighted common scenarios that challenge published social media professionalism guidelines. We asked 2 questions for each vignette regarding (1) the resident's opinion of the posting's appropriateness, and (2) their frequency of viewing similar posts. We also elicited demographic data (age, sex, postgraduate year level), frequency of Facebook use, awareness of their institutional policies, and prior social media training. Of 1628 respondents, 1498 (92.01%) of the pediatric residents acknowledged having a Facebook account, of whom 888/1628 (54.55%) reported daily use and 346/1628 (21.25%) reported using Facebook a few times a week. Residents frequently viewed posts that violated professionalism standards, including use of derogatory remarks about patients (1756/3256, 53.93%) and, much less frequently, about attending physicians (114/1628, 7.00%). The majority of the residents properly identified these postings as inappropriate. Residents had frequently viewed a post similar to one showing physicians drinking alcoholic beverages while in professional attire or scrubs and were neutral on this post's appropriateness. Residents also reported a lack of knowledge about institutional policies on social media (651/1628, or 40.00%, were unaware of a policy; 204/1628, or 12.53%, said that no policy existed). A total of 372/1628 respondents (22.85%) stated that they had

  13. 38 CFR 51.70 - Resident rights.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... freedom from chemical or physical restraint. (4) In the case of a resident determined incompetent under... of financial security. The facility management must purchase a surety bond, or otherwise...

  14. 38 CFR 51.70 - Resident rights.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... freedom from chemical or physical restraint. (4) In the case of a resident determined incompetent under... of financial security. The facility management must purchase a surety bond, or otherwise...

  15. 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... of financial security. The facility management must purchase a surety bond, or otherwise...

  16. The Residency Application Abyss: Insights and Advice

    PubMed Central

    Olson, Douglas P.; Oatts, Julius T.; Fields, Barry G.; Huot, Stephen J.

    2011-01-01

    Most medical students apply for residency training upon completion of medical school. The choice of specialty is one of a student’s first major career decisions, and the application process often results in considerable anxiety, as it is competitive, unpredictable, and requires a significant investment of time and money. This article, which addresses several important facets of the residency application using both experiential and evidence-based data, is organized chronologically into sections that describe a logical approach to applying for residency: choice of a specialty, the personal statement, the interview day, and developing a rank list. A list of relevant websites is also included. This paper is a resource that provides timely and tangible guidance to medical students applying for residency training. PMID:21966036

  17. Protecting Your Residence Hall Furniture Investment.

    ERIC Educational Resources Information Center

    Wiens, Janet

    2003-01-01

    Asserting that residence hall furniture takes abuse simply through use, discusses a three-part approach--student involvement and education, creating the right environment, and ongoing maintenance--that helps reduce normal wear and tear. (EV)

  18. [Urology training in Mexico: Residents' perspective].

    PubMed

    Linden-Castro, Edgar; Pelayo-Nieto, Marcela; Ramírez-Galindo, Iván; Guzmán-Hernández, Felipe; Catalán-Quinto, Gabriel; Rodríguez-Covarrubias, Francisco; Morales-Covarrubias, Jesús; Cortez-Betancourt, Roberto

    2016-01-01

    To assess and identify from the resident's perspective the current state of the urology residency training in the surgical, research, affective domain and its working future. We performed an anonymous survey of 98 urology residents during 2014. The survey included 62 questions and assesses the surgical, the clinical research, and the affective domain, and also its working future. We reviewed a total of 98 surveys, average age 29 years, 92% men and 8% women. The scholarship average was 12,000-14,000 pesos. Most of them have had at least one research work in a national congress, but not in an international one. Less than 10% has published papers in PubMed, although most consider clinical research as mandatory in their urology training programs. Most residents consider their training in laparoscopy to be inadequate, but they consider the relationship between partners and teachers is adequate and most of them are satisfied with their program.

  19. Sexual abuse of nursing home residents.

    PubMed

    Burgess, A W; Dowdell, E B; Prentky, R A

    2000-06-01

    1. A new subgroup of rape victims resides in nursing homes. 2. Nursing home victims can suffer both compounded and silent rape trauma. 3. Innovative therapies are needed for treating elder rape trauma.

  20. Hallmarks of Tissue-Resident Lymphocytes

    PubMed Central

    Fan, Xiying; Rudensky, Alexander Y.

    2016-01-01

    Although they are classically viewed as continuously recirculating through the lymphoid organs and blood, lymphocytes also establish residency in non-lymphoid tissues, most prominently at barrier sites, including the mucosal surfaces and skin. These specialized tissue-resident lymphocyte subsets span the innate-adaptive continuum and include innate lymphoid cells (ILCs), unconventional T cells (e.g., NKT, MAIT, γδ T cells, and CD8αα+IELs), and tissue-resident memory T (TRM) cells. Although these diverse cell types differ in the particulars of their biology, they nonetheless exhibit important shared features, including a role in the preservation of tissue integrity and function during homeostasis, infection, and non-infectious perturbations. In this Review, we discuss the hallmarks of tissue-resident innate, innate-like, and adaptive lymphocytes, as well as their potential functions in non-lymphoid organs. PMID:26967286