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Sample records for residents receiving laxatives

  1. A qualitative study to identify reasons for Clostridium difficile testing in pediatric inpatients receiving laxatives or stool softeners.

    PubMed

    Kinlay, Joanne; Sandora, Thomas J

    2017-05-01

    To understand why clinicians send Clostridium difficile tests from hospitalized children receiving laxatives or stool softeners, we performed a mixed-methods study. We prospectively identified tested patients and surveyed their clinicians by e-mail. Reasons for testing included changes in stooling pattern on baseline bowel regimen, other changes in clinical status, and risk factors for C difficile infection. Education targeting discontinuing bowel medications before C difficile testing could improve the specificity of pediatric C difficile infection diagnosis. Copyright © 2017 Association for Professionals in Infection Control and Epidemiology, Inc. Published by Elsevier Inc. All rights reserved.

  2. Constipation and Laxative Use among Nursing Home Patients: Prevalence and Associations Derived from the Residents Assessment Instrument for Long-Term Care Facilities (interRAI LTCF)

    PubMed Central

    Blekken, Lene Elisabeth; Nakrem, Sigrid; Vinsnes, Anne Guttormsen; Mørkved, Siv; Gjeilo, Kari Hanne

    2016-01-01

    Introduction. Constipation is a common, bothersome, and potentially dangerous condition among nursing home (NH) patients. Between 50 and 74% of NH patients use laxatives. Objective. To study prevalence and associations of laxative use and constipation using the comprehensive Norwegian version of the Resident Assessment Instrument for Long-Term Care Facilities. Methods. Cross-sectional study. Patients from 20 NH units were included. Logistic regression was used to analyze the results. Data collected in NHs might be clustered. Consequently, the multivariable models were tested against a mixed effects regression model to investigate variance both on the level of patients and on the level of NH units. Results. In all, 261 patients were included. The prevalence of constipation was 23.4%, and 67.1% used laxatives regularly. Balance problems, urinary incontinence, hypothyroidism, and Parkinson's disease were associated with constipation. Reduced ability to communicate and number of drugs were associated with laxative use. Antidementia-drugs and being involved in activities 1/3 to 2/3 of daytime were protective factors for laxative use. Mixed effects analyses identified variance on the level of NH units as nonsignificant. Conclusion. Constipation and laxative use are common. Variance is mainly explained by different patient characteristics/health deficiencies. Hence, patients might benefit from individualized care to compensate for deficiencies. PMID:26884751

  3. Internal Medicine Residents' Perspectives on Receiving Feedback in Milestone Format

    PubMed Central

    Angus, Steven; Moriarty, John; Nardino, Robert J.; Chmielewski, Amy; Rosenblum, Michael J.

    2015-01-01

    Background In contrast to historical feedback, which was vague or provided residents' numerical scores without clear meaning, milestone-based feedback is focused on specific knowledge, skills, and behaviors that define developmental trajectory. It was anticipated that residents would welcome the more specific and actionable feedback provided by the milestone framework, but this has not been studied. Objective We assessed internal medicine (IM) residents' perceptions of receiving feedback in the milestone framework, particularly assessing perception of the utility of milestone-based feedback compared to non–milestone-based feedback. Methods We surveyed a total of 510 IM residents from 7 institutions. Survey questions assessed resident perception of milestone feedback in identifying strengths, weaknesses, and trajectory of professional development. Postgraduate years 2 and 3 (PGY-2 and PGY-3) residents were asked to compare milestones with prior methods of feedback. Results Of 510 residents, 356 (69.8%) responded. Slightly less than half of the residents found milestone-based feedback “extremely useful” or “very useful” in identifying strengths (44%), weaknesses (43%), specific areas for improvement (45%), and appropriate education progress (48%). Few residents found such feedback “not very useful” or “not at all useful” in these domains. A total of 51% of PGY-2 and PGY-3 residents agreed that receiving milestone-based feedback was more helpful than previous forms of feedback. Conclusions IM residents are aware of the concepts of milestones, and half of the residents surveyed found milestone feedback more helpful than previous forms of feedback. More work needs to be done to understand how milestone-based feedback could be delivered more effectively to enhance resident development. PMID:26221438

  4. Internal Medicine Residents' Perspectives on Receiving Feedback in Milestone Format.

    PubMed

    Angus, Steven; Moriarty, John; Nardino, Robert J; Chmielewski, Amy; Rosenblum, Michael J

    2015-06-01

    In contrast to historical feedback, which was vague or provided residents' numerical scores without clear meaning, milestone-based feedback is focused on specific knowledge, skills, and behaviors that define developmental trajectory. It was anticipated that residents would welcome the more specific and actionable feedback provided by the milestone framework, but this has not been studied. We assessed internal medicine (IM) residents' perceptions of receiving feedback in the milestone framework, particularly assessing perception of the utility of milestone-based feedback compared to non-milestone-based feedback. We surveyed a total of 510 IM residents from 7 institutions. Survey questions assessed resident perception of milestone feedback in identifying strengths, weaknesses, and trajectory of professional development. Postgraduate years 2 and 3 (PGY-2 and PGY-3) residents were asked to compare milestones with prior methods of feedback. Of 510 residents, 356 (69.8%) responded. Slightly less than half of the residents found milestone-based feedback "extremely useful" or "very useful" in identifying strengths (44%), weaknesses (43%), specific areas for improvement (45%), and appropriate education progress (48%). Few residents found such feedback "not very useful" or "not at all useful" in these domains. A total of 51% of PGY-2 and PGY-3 residents agreed that receiving milestone-based feedback was more helpful than previous forms of feedback. IM residents are aware of the concepts of milestones, and half of the residents surveyed found milestone feedback more helpful than previous forms of feedback. More work needs to be done to understand how milestone-based feedback could be delivered more effectively to enhance resident development.

  5. Residents as teachers: residents' perceptions before and after receiving instruction in clinical teaching.

    PubMed

    Wachtel, Julie K; Greenberg, Marna Rayl; Smith, Amy B; Weaver, Kevin R; Kane, Bryan G

    2013-01-01

    Residents play an integral role in educating junior residents, medical students, and patients. To determine how residents describe their training, proficiency, and comfort level in teaching before and after receiving instruction in clinical teaching. Emergency medicine residents at a 980-bed suburban hospital system filled out a 12-question survey on their training as teachers and their self-perceptions of themselves as teachers. The residents then participated in a 2-hour education session on adult learning principles, methods of clinical teaching, and how to give effective feedback. After the session, participants completed a second, 11-question survey on the effectiveness of the session. Thirty-seven residents completed the presession survey and 33 completed the postsession survey. In the presession survey, 23 residents (62%) identified their proficiency as a teacher and ability to give feedback as that of a novice or beginner. Fourteen (38%) felt competent or proficient as teachers. Twenty-six (70%) reported never receiving instruction in clinical teaching during their residency, and 33 (89%) were interested in learning these skills. In the postsession survey, 28 (85%) described the teaching module as very helpful to their training, and 33 (100%) reported feeling more prepared to teach. Twenty-six (79%) stated they were very likely to teach students more often, and 33 (100%) reported a better understanding of how to give effective feedback. The majority of the residents surveyed expressed an interest in learning teaching skills and felt that completing the training was helpful to their education. After instruction, this cohort of residents felt more prepared and reported they were more likely to teach.

  6. Advance Directives and Care Received by Older Nursing Home Residents.

    PubMed

    Manu, Erika R; Mody, Lona; McNamara, Sara E; Vitale, Caroline A

    2017-03-01

    Research shows variable success as to whether care provided aligns with individual patient preferences as reflected in their advance directives (AD). We aimed to study AD status and subsequent care received in older nursing home (NH) residents deemed at risk for infections and care transitions: those with a urinary catheter (UC), feeding tube (FT), or both. Design/participants/measurements: A subgroup analysis of a prospective cohort of 90 residents with a UC and/or FT from 15 NHs in southeast Michigan. Outcomes assessed at enrollment and at 30-day intervals were hospitalizations and antibiotic use. The ADs were divided as follows: (1) comfort oriented: comfort measures only, no hospital transfer; (2) palliative oriented: comfort focused, allowing hospital transfer (except intensive care unit), antibiotic use, but no cardiopulmonary resuscitation; (3) usual care: full code, no limitations to care. We calculated incidences for these outcomes. Seventy-eight (87%) residents had ADs: 18 (23%) comfort oriented, 32 (41%) palliative oriented, and 28 (36%) usual care. The groups did not differ regarding demographics, comorbidity, function, device presence, or time in study. Using the usual care group as comparison, the comfort-oriented group was hospitalized at a similar rate (Incidence rate [IR] = 15.6/1000 follow-up days vs IR = 8.8/1000 follow-up days, Incident rate ratio [IRR] 0.6 [95% confidence interval, CI, 0.3 -1.1], P value .09) but received fewer antibiotics (IR = 18.9/1000 follow-up days vs IR = 7.5/1000 follow-up days, IRR 0.4 [95% CI, 0.2-0.8], P value .005). Nursing home residents with comfort-oriented ADs were hospitalized at a rate similar to those with usual-care ADs but received fewer antibiotics, although the small sample size of this analysis suggests these findings deserve further study.

  7. Clinical use of oral laxatives in palliative care services in Spain.

    PubMed

    Noguera, Antonio; Centeno, Carlos; Librada, Silvia; Nabal, María

    2010-11-01

    This study was aimed at evaluating the clinical use of laxatives in palliative care treatment, their overall effectiveness, and their relationship to opioid treatment. A cross-sectional prospective study on patients attended by 21 palliative care teams on two pre-determined dates was carried out. The variables analyzed were demographic data, underlying disease, functional status, laxative use, use of enemas, concomitant opioid medication, and bowel movements. Of the 283 patients studied, 54 (19%) have had three or fewer bowel movements per week in the 3 weeks prior to the study, 53 patients (19%) were using rectal measures, 177 patients (63%) were being treated with opioids, and 164 patients (58%) were taking laxatives. Sixty seven percent (119/177) of the patients being treated with opioids were also being treated with laxatives, as were 43% (45/106) of those not receiving opioid treatment. The laxative most used was lactulose (65%). Only 10% used the most recommended combination of an osmotic or softener laxative mixed with another stimulant laxative. Some 24% of patients used enemas or micro enemas in addition to laxatives, 14 patients treated their constipation without laxatives, using only rectal measures. The clinical practice of the use of oral laxatives in palliative care in our environment differs widely from that recommended in the literature. Further studies are required to confirm if a revision of clinical guidelines are required.

  8. Laxative prescribing in relation to opioid use and the influence of pharmacy-based intervention.

    PubMed

    Bouvy, M L; Buurma, H; Egberts, T C G

    2002-04-01

    Opioid-induced constipation is a common problem and can cause serious complications. It is widely advised that laxatives should be started concurrently with opiates, unless there is a clear indication not to do so. This study was undertaken to estimate how often laxatives were started concurrently with opiates and to describe the effect of pharmacy-based interventions to promote the use of laxatives in patients starting opioids. Twenty-six community pharmacies identified all patients who received a first prescription for a strong opioid during January and February of 1998, 1999 or 2000. Pharmacists collected information on patient, drug and prescriber characteristics (age, gender, use of opiates and laxatives). A separate questionnaire was used to collect data on pharmacy-based interventions to promote the simultaneous prescribing of laxatives with the opiates. Overall, 37% of the patients receiving an opioid started taking laxatives within 5 days. The percentage of patients who received laxatives simultaneously with opioids increased from 31% in 1998 to 35% in 1999 and 42% in 2000. In 117 (43%) of the opioid prescriptions, pharmacy-based intervention had taken place before the prescription date. Of these, 48.7% was accompanied by a laxative. Opioid prescriptions (n=152) without a pharmacy based intervention were accompanied in 27.6%. After adjustment for covariates (including time trends), pharmacy-based intervention increased the probability of concomitant laxative use 1.9 [95% CI 1.1-3.3] times. This study shows that the widely used guideline to start a laxative when prescribing an opioid is not always followed in daily practice. In addition, we showed that pharmacy-based intervention contributed to increasing laxative use in patients receiving opioids.

  9. Polybrominated diphenyl ethers: Residence time in soils receiving biosolids application.

    PubMed

    Andrade, Natasha A; McConnell, Laura L; Anderson, Marya O; Torrents, Alba; Ramirez, Mark

    2017-03-01

    Polybrominated diphenyl ethers (PBDEs) may enter the environment because of accumulation in biosolids followed by application to agricultural lands. No published dissipation studies are available for PBDEs in agricultural soils after biosolids application. Therefore, we conducted a 3-year study to examine the fate of PBDEs in a small-scale 0.24-ha continuously cropped field after a single biosolids application at 72.3 wet tons/ha and determined dissipation half-lives for BDE-47+BDE-99 and BDE-209. In addition, we conducted a large-scale survey of soils from 26 mostly pasture fields at 10 farms with detailed information on timing and rate of biosolids applications. In the small-scale experiment, maximum soil PBDE concentrations of 43.7 ± 42.7 μg kg(-1) d.w. for BDE-209 and 6.05 ± 7.15 μg kg(-1) d.w. for BDE-47+BDE-99 were reached 1 year after application. We hypothesized that PBDEs were slowly released from the biosolids matrix into the soil over the first year. After 3 years, median BDE-47+BDE-99 concentrations were approximately equal to preapplication levels, whereas median BDE-209 concentrations remained ∼129% above preapplication levels. The estimated residence time from the small-scale experiment was 342 d for BDE-47+BDE-99 and 861 d for BDE-209. In the large-scale study, a subset of fields that received a single biosolids application was used to generate another estimate of residence time: 704 d for BDE-47+BDE-99 and 1440 d for BDE-209. These longer residence time estimates were used in three different first-order decay dissipation scenarios (continuous, limited, and no dissipation) to predict PBDE concentration in fields with single and multiple biosolids applications. Results indicate that dissipation occurs primarily in the first 2 years after application, but residues remaining in the soil after this period are likely to be much more tightly bound and less available for degradation. Copyright © 2016 Elsevier Ltd. All rights reserved.

  10. Mississippi Resident Receives First Place EPA Gulf Guardian Award

    EPA Pesticide Factsheets

    ATLANTA - The U.S. Environmental Protection Agency's (EPA) Gulf of Mexico Program recognized Mississippi resident Tracie Sempier with the First Place 2015 Gulf Guardian Award in the Individual Category. The awards ceremony was held today at the Texa

  11. Advance Directives and End-of-Life Care among Nursing Home Residents Receiving Maintenance Dialysis.

    PubMed

    Kurella Tamura, Manjula; Montez-Rath, Maria E; Hall, Yoshio N; Katz, Ronit; O'Hare, Ann M

    2017-03-07

    Little is known about the relation between the content of advance directives and downstream treatment decisions among patients receiving maintenance dialysis. In this study, we determined the prevalence of advance directives specifying treatment limitations and/or surrogate decision-makers in the last year of life and their association with end-of-life care among nursing home residents. Using national data from 2006 to 2007, we compared the content of advance directives among 30,716 nursing home residents receiving dialysis to 30,825 nursing home residents with other serious illnesses during the year before death. Among patients receiving dialysis, we linked the content of advance directives to Medicare claims to ascertain site of death and treatment intensity in the last month of life. In the last year of life, 36% of nursing home residents receiving dialysis had a treatment-limiting directive, 22% had a surrogate decision-maker, and 13% had both in adjusted analyses. These estimates were 13%-27%, 5%-11%, and 6%-13% lower, respectively, than for decedents with other serious illnesses. For patients receiving dialysis who had both a treatment-limiting directive and surrogate decision-maker, the adjusted frequency of hospitalization, intensive care unit admission, intensive procedures, and inpatient death were lower by 13%, 17%, 13%, and 14%, respectively, and hospice use and dialysis discontinuation were 5% and 7% higher compared with patients receiving dialysis lacking both components. Among nursing home residents receiving dialysis, treatment-limiting directives and surrogates were associated with fewer intensive interventions and inpatient deaths, but were in place much less often than for nursing home residents with other serious illnesses. Copyright © 2017 by the American Society of Nephrology.

  12. Therapeutic Response for Functional Abdominal Pain in Children with Occult Constipation: Laxatives versus Prokinetic Drugs

    PubMed Central

    2017-01-01

    The relationship between functional abdominal pain (FAP) and occult constipation (OC) in children who did not meet the Rome III criteria for constipation has rarely been reported. This study aimed to estimate the prevalence of OC in patients with FAP and to compare the effectiveness of prokinetic drugs and laxatives for FAP and OC. Pediatric outpatients (n = 212; aged 4–15 years) who satisfied the Rome III criteria for childhood FAP were divided into 2 groups based on Leech scores: group 1 < 8; group 2 ≥ 8. Group 2 received either prokinetic drugs or laxatives and pain severity was assessed after 2 weeks, 1 month, and 3 months. A total 52.4% (111/212) of patients had OC in this study. More patients who received laxatives had reduced pain scores compared with those who received prokinetic drugs. Those treated with laxatives in group 2 had a better response than those treated with prokinetic drugs throughout the study period (P < 0.001, P < 0.001, and P = 0.002 after 2 weeks, 1 month, and 3 months, respectively). OC was frequently encountered in children with FAP. Laxatives can be more effective than prokinetic drugs for relieving symptoms of FAP in children with a Leech score ≥ 8 and suspected OC. PMID:27914138

  13. Laxative effect of peanut sprout extract

    PubMed Central

    Seo, Ji Yeon; Kim, Seong Soon; Kim, Hyo Jung; Liu, Kwang-Hyeon; Lee, Hak-Yong

    2013-01-01

    Certain phenolic compounds are known to exhibit laxative properties. Seed sprouts, such as those of peanut, are known to promote de novo biosynthesis of phenolic compounds. This study was conducted to examine the potential laxative properties of 80% (v/v) ethanolic extract of peanut sprout (PSE), which contains a high concentration of phenolic compounds such as resveratrol. For this, SD rats were orally administered PSE while a control group was incubated with saline. Laxative effects were examined in both groups of rats. Constipation induced by loperamide in SD rats was improved by administration of PSE. Constipated rats showed increased intestinal movement of BaSO4 upon administration of PSE compared to the control, and the groups administered 100 or 1,000 mg PSE/kg bw were not significantly different in transit time of the indicator. However, colon length was not statistically different among the experimental groups, although it was longer in the group incubated with 1 g PSE/kg bw compared to other groups. Further, there was no significant difference in stool number among the experimental groups. Taken together, these findings show that PSE has a laxative effect in a rat model of loperamide-induced constipation. PMID:23964312

  14. Laxative effect of peanut sprout extract.

    PubMed

    Seo, Ji Yeon; Kim, Seong Soon; Kim, Hyo Jung; Liu, Kwang-Hyeon; Lee, Hak-Yong; Kim, Jong-Sang

    2013-08-01

    Certain phenolic compounds are known to exhibit laxative properties. Seed sprouts, such as those of peanut, are known to promote de novo biosynthesis of phenolic compounds. This study was conducted to examine the potential laxative properties of 80% (v/v) ethanolic extract of peanut sprout (PSE), which contains a high concentration of phenolic compounds such as resveratrol. For this, SD rats were orally administered PSE while a control group was incubated with saline. Laxative effects were examined in both groups of rats. Constipation induced by loperamide in SD rats was improved by administration of PSE. Constipated rats showed increased intestinal movement of BaSO4 upon administration of PSE compared to the control, and the groups administered 100 or 1,000 mg PSE/kg bw were not significantly different in transit time of the indicator. However, colon length was not statistically different among the experimental groups, although it was longer in the group incubated with 1 g PSE/kg bw compared to other groups. Further, there was no significant difference in stool number among the experimental groups. Taken together, these findings show that PSE has a laxative effect in a rat model of loperamide-induced constipation.

  15. Resident Perceptions of Giving and Receiving Peer-to-Peer Feedback

    PubMed Central

    de la Cruz, Maria Syl D.; Kopec, Michael T.; Wimsatt, Leslie A.

    2015-01-01

    Background Peer feedback is increasingly being used by residency programs to provide an added dimension to the assessment process. Studies show that peer feedback is useful, uniquely informative, and reliable compared to other types of assessments. Potential barriers to implementation include insufficient training/preparation, negative consequences for working relationships, and a perceived lack of benefit. Objective We explored the perceptions of residents involved in peer-to-peer feedback, focusing on factors that influence accuracy, usefulness, and application of the information. Methods Family medicine residents at the University of Michigan who were piloting an online peer assessment tool completed a brief survey to offer researchers insight into the peer feedback process. Focus groups were conducted to explore residents' perceptions that are most likely to affect giving and receiving peer feedback. Results Survey responses were provided by 28 of 30 residents (93%). Responses showed that peer feedback provided useful (89%, 25 of 28) and unique (89%, 24 of 27) information, yet only 59% (16 of 27) reported that it benefited their training. Focus group participants included 21 of 29 eligible residents (72%). Approaches to improve residents' ability to give and accept feedback included preparatory training, clearly defined goals, standardization, fewer and more qualitatively oriented encounters, 1-on-1 delivery, immediacy of timing, and cultivation of a feedback culture. Conclusions Residents perceived feedback as important and offered actionable suggestions to enhance accuracy, usefulness, and application of the information shared. The findings can be used to inform residency programs that are interested in creating a meaningful peer feedback process. PMID:26221436

  16. Clinical Trial: Marine Lipid Suppositories as Laxatives

    PubMed Central

    Ormarsson, Orri Thor; Geirsson, Thormodur; Bjornsson, Einar Stefan; Jonsson, Tomas; Moller, Pall; Loftsson, Thorsteinn; Stefansson, Einar

    2012-01-01

    Cod-liver oil and other marine products containing polyunsaturated fatty acids have anti-inflammatory, anti-bacterial and anti-viral effects and may be useful in the treatment of various inflammatory and infectious diseases. We developed suppositories and ointment with 30% free fatty acid (FFA) extract from omega-3 fish oil. Our purpose was to evaluate the safety of marine lipid suppositories and ointment in healthy volunteers and to explore the laxative effect of the suppositories. Thirty healthy volunteers were randomized either to a study group administrating 30% FFA suppositories and applying 30% FFA ointment to the perianal region twice per day for two weeks, or to a control group using placebo suppositories and ointment in a double blinded manner. Results: No serious toxic effects or irritation were observed. In the study group 93% felt the urge to defecate after administration of the suppositories as compared to 37% in the control group (P = 0.001). Subsequently 90% in the study group defecated, compared to 33% in the control group (P = 0.001). Conclusion: The marine lipid suppositories and ointment were well tolerated with no significant toxic side effects observed during the study period. The suppositories have a distinct laxative effect and we aim to explore this effect in further clinical trials. PMID:23118720

  17. Surgical Specialty Residents More Likely to Receive the Arnold P. Gold Humanism and Excellence in Teaching Award.

    PubMed

    Falcone, John L

    2015-01-01

    The Arnold P. Gold Humanism and Excellence in Teaching Awards are given by medical students to residents. The aim of this study is to evaluate the distribution of this award based on residency specialty. The hypothesis is that surgical residents more commonly receive this award. This was a retrospective study from 2004 to 2013. All award recipients were obtained from the Arnold P. Gold Foundation website. The specialties of award recipients were tabulated. The number of award winners per thousand specialty residents was estimated using the Accreditation Council for Graduate Medical Education Data Resource Book, adjusting for the number of awarding schools and resident specialties. All statistics used an α = 0.05. There were 2489 awards given during the study period, with 52.6% in medical specialties and 47.4% in surgical specialties (p = 0.45). The specialties most commonly awarded were General Surgery (22.3%), Internal Medicine (20.9%), and Obstetrics/Gynecology (20.4%). Adjusting for the number of eligible residents, there were 59.9 awards/1000 Obstetrics/Gynecology residents, 43.1 awards/1000 General Surgery residents, and 20.2 awards/1000 Internal Medicine residents (p < 0.001). Controlling for the number of eligible residents, the Arnold P. Gold Humanism and Excellence in Teaching Awards are more commonly given to surgical specialty residents. Copyright © 2015 Association of Program Directors in Surgery. Published by Elsevier Inc. All rights reserved.

  18. Evaluation of the Effects of Receiving Trauma-Informed Practices on Domestic Violence Shelter Residents.

    PubMed

    Sullivan, Cris M; Goodman, Lisa A; Virden, Tyler; Strom, Jennifer; Ramirez, Rachel

    2017-08-17

    Domestic violence is a potentially traumatizing experience that has devastating psychological and physical consequences. In response, domestic violence shelter programs have focused increasing attention on helping adult and child survivors understand and heal from this trauma. What have come to be called trauma-informed practices include (a) reflecting an understanding of trauma and its many effects on health and behavior, (b) addressing both physical and psychological safety concerns, (c) using a culturally informed strengths-based approach, (d) helping to illuminate the nature and effects of abuse on survivors' everyday experience; and (e) providing opportunities for clients to regain control over their lives. Despite the proliferation of these practices, little is known about their effects on survivors. In response, the current study explored the extent to which trauma-informed practices, as experienced by shelter residents, related to changes in their levels of self-efficacy, safety-related empowerment, and depressive symptoms over the course of approximately 30 days in shelter. Fifty-seven shelter residents from 4 programs in Ohio completed surveys shortly after arriving in shelter and again before exit. Their perception of the degree to which they received trauma-informed services was associated with significant improvement in their self-efficacy and safety-related empowerment, but had no impact on depressive symptoms. Depressive symptoms decreased over time, regardless of receipt of trauma-informed practice. Implications for policy and practice are discussed. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

  19. Laxative effect of agarwood leaves and its mechanism.

    PubMed

    Hara, Hideaki; Ise, Yasuaki; Morimoto, Nobutaka; Shimazawa, Masamitsu; Ichihashi, Koji; Ohyama, Masayoshi; Iinuma, Munekazu

    2008-02-01

    We investigated the laxative activity of an extract of agarwood leaves from Aquilaria sinensis. The laxative activity was measured in mice by counting the stool frequency and stool weight, and the drugs were orally administered. An acetone extract of agarwood leaves and senna (a representative laxative drug) both increased the stool frequency and weight, but a methanol extract did not. The laxative effect of the acetone extract was milder than that of the anthraquinoid laxative, senna, and the former did not induce diarrhea as a severe side effect. We identified the main constituent contributing to the laxative effect of the acetone extract as genkwanin 5-O-beta-primeveroside (compound 4). Compound 4 strengthened the spontaneous motility and induced contraction in the ileum. This ileal contraction induced by compound 4 was inhibited by atropine, but not by azasetron, suggesting that the effect of compound 4 was mediated by acetylcholine receptors, and not by serotonin. The laxative mechanism for compound 4 may in part involve stimulation of intestinal motility via acetylcholine receptors.

  20. Over the Counter Laxatives for Constipation: Use with Caution

    MedlinePlus

    ... et al. Mothrerisk update: Treating constipation during pregnancy. Canadian Family Physician. 2012;58:836. Laxative (Oral route). ... org," "Mayo Clinic Healthy Living," and the triple-shield Mayo Clinic logo are trademarks of Mayo Foundation ...

  1. Annual effective dose of ionizing radiation from natural sources received by airline aircrew members compared with that received by non-flying residents of the United States

    NASA Astrophysics Data System (ADS)

    Friedberg, W.; Copeland, K.; O'Brien, K., III

    In evaluating health aspects of the ionizing radiation exposure of aircrews, risk estimates are normally based on the amount of cosmic radiation received in flight. Not considered is that aircrews spend most of their time on the ground. In this report, annual total effective doses of ionizing radiation from natural sources received by aircrews on and off the job, flying between Los Angeles and Tokyo or Chicago and London, are compared with doses to non-flying residents of the United States and non-flying residents of Environmental Protection Agency Region 8 (Montana, North Dakota, South Dakota, Wyoming, Utah, Colorado --- the region in the United States with the highest dose rates of natural ionizing radiation at ground level). Occupational exposure of aircrews to ionizing radiation is thought to increase their risk of fatal cancer. It may not be a significant concern if one considers: (a) the annual dose of ionizing radiation to the crewmembers in our study is only 7-41% higher than that received by non-flying residents of Region 8 (terrestrial gamma and cosmic radiation in the Denver, Colorado, area of Region 8); (b) the dose to non-flying residents of Region 8 is 87% higher than the average dose to non-flying residents of the United States; and (c) the estimated death rate from cancer in the six states in Region 8 is 3-26% lower than the average for the United States. When considering health concerns of aircrew members, one should recognize that the standard risk coefficient for radiation-induced fatal cancer is derived primarily from studies on individuals exposed to radiation at higher doses and dose rates and of generally lower energy, than the galactic cosmic radiation to which aircrews are exposed. These differences are a major reason that epidemiology studies are important in evaluating health aspects of the occupational radiation exposure of aircrews.

  2. Despite small improvement, black nursing home residents remain less likely than whites to receive flu vaccine.

    PubMed

    Cai, Shubing; Feng, Zhanlian; Fennell, Mary L; Mor, Vincent

    2011-10-01

    Vaccination is a key deterrent to influenza and its related complications and outcomes, including hospitalization and death. Using 2006-09 data, we found a small improvement in vaccination rates among nursing home residents, particularly for blacks. Nonetheless, overall vaccination rates remained well below the 90 percent target for high-quality care, and black nursing home residents remained less likely to be vaccinated than whites. Blacks were less likely to be vaccinated than were whites in the same facility and were more likely to live in facilities with lower vaccination rates. Blacks were also more likely to be noted as refusing vaccination. Strategies are needed to ensure that facilities offer vaccination to all residents and to make vaccination more acceptable to black residents and their families.

  3. Management of Obstetric Perineal Tears: Do Obstetrics and Gynaecology Residents Receive Adequate Training? Results of an Anonymous Survey

    PubMed Central

    Cornet, A.; Porta, O.; Piñeiro, L.; Ferriols, E.; Gich, I.; Calaf, J.

    2012-01-01

    Background/Aim. To evaluate the obstetrics and gynaecology residents' perspective of their training and experience in the management of perineal tears that occur during assisted vaginal delivery. We hypothesised that residents would perceive room for improvement in their knowledge of pelvic floor anatomy and the training received in tears repair. Design. Descriptive cross-sectional study. Population/Setting. Seventy-two major residents from all teaching hospitals in Catalonia. Methods. A questionnaire was designed to evaluate experience, perception of the training and supervision provided. Results. The questionnaire was sent to all residents (n = 72), receiving 46 responses (64%). The participants represented 15 out of the 16 teaching hospitals included in the study (94% of the hospitals represented). Approximately, 52% of residents were in their third year while 48% were in their fourth. The majority of them thought that their knowledge of pelvic floor anatomy was poor (62%), although 98% felt confident that they would know when an episiotomy was correctly indicated. The survey found that they lacked experience in the repair of major degree tears (70% had repaired fewer than ten), and most did not carry out followup procedures. Conclusion. The majority of them indicated that more training in this specific area is necessary (98%). PMID:21822436

  4. [Gluttony and penance--laxatives and 'liver stones'].

    PubMed

    van Hooft, Jeanin; Oude Elferink, Ronald; Seppen, Jurgen

    2010-01-01

    Gluttony is not only a mortal sin, it is also an important cause of medical problems. After sinning a penance must be paid and for this mortal sin the most obvious penance is laxation. Alternative medicine provides help: numerous types of laxative that claim to have positive effects on mental health, detoxification and aid in weight loss are to be found on the internet. The most surprising claim is that laxatives expel gall stones. These 'liver-cleansing' treatments result in the excretion of soft, stone-like structures in the faeces which may be seen by patients as being gall stones. Such 'liver stones' have been described in the literature and it is understood that they develop from the olive oil that is taken with the course of laxatives. That passing such stones is not associated with a reduction in gall stones is hardly surprising. Although laxation has been regarded as beneficial since ancient times, it is not effective in removing gall stones.

  5. Perception of physicians about medical education received during their Nephrology residency training in Peru.

    PubMed

    Herrera-Añazco, Percy; Bonilla-Vargas, Luis; Hernandez, Adrian V; Silveira-Chau, Manuela

    2015-01-01

    In Peru there are different hospitals and university programs for training of specialists in nephrology. To assess the perception of physicians who attend such programs. We carried out a descriptive cross-sectional national-level study in physicians who were in the last two years of nephrology training during February 2012 and who had graduated from it in 2010 and 2011. A self-applied questionnaire was developed along with the Peruvian Society of Nephrology based on international standards. The questionnaire evaluated: mentoring, clinical training, procedures, external rotations, research and global perception. Forty doctors were surveyed nationwide. 82.5% had tutors, 22.5% of them said their support was poor. A 27.5% described their theoretical formation as deficient. The practical training was perceived as acceptable globally; however, improvements in training on peritoneal dialysis and reading kidney transplant biopsies are necessary. A 90% have national external rotations and 65% reported to have an international rotation. In the assessment of research, 77.5% thought this is deficient. In addition, 82.5% believed that residency should last four years. However, 60% reported that their residency training was good. There is a decrease in the positive perception of the aspects studied among residents regarding graduates. The overall perception of nephrology residency training was considered good; however, areas of tutoring, and academic and research activities on average were deficient.

  6. Assessment of the genotoxic risk from laxative senna products.

    PubMed

    Brusick, D; Mengs, U

    1997-01-01

    Laxative senna products and several of their specific components have been submitted to a large number of genetic tests. While most studies gave negative responses, results from some of the studies suggest that components of senna products, particularly emodin and aloe-emodin, have genotoxic activity. Assessment of the genotoxicity profile of these substances, in light of other data from animal and human metabolism or kinetic studies, human clinical trials and rodent carcinogenicity studies do not support concerns that senna laxatives pose a genotoxic risk to humans when consumed under prescribed use conditions.

  7. Laxative-induced Diarrhoea: A Continuing Clinical Problem

    PubMed Central

    Cummings, J. H.; Sladen, G. E.; James, O. F. W.; Sarner, M.; Misiewicz, J. J.

    1974-01-01

    Seven women spent an average of 127 days in hospital and were extensively investigated, including a laparotomy, before their complaints of abdominal pain, diarrhoea, and weight loss were shown to be due to excessive taking of laxatives. All denied taking laxatives and in none were the characteristic features of the effects of cathartics on the colon seen on sigmoidoscopy or radiological examination. Hypokalaemia and other electrolyte abnormalities were common and were thought to be due to a combination of severe diarrhoea and vomiting. The rectal mucosa was seen to be abnormal on biopsy only in the three patients who had taken senna preparations. The diagnosis was not easy and was finally established either by analysis of the urine and stools or by searching the patient's ward locker. PMID:4817188

  8. Laxative effects and mechanism of action of Brazilian green propolis

    PubMed Central

    2012-01-01

    Background Brazilian green propolis is reported to have wide range of biological properties including antibacterial, anti-inflammatory, anti-influenza, and antioxidant activities. In the digestive system, a protective effect of propolis on gastric ulcer has been reported, but a laxative effect has not yet been reported. We investigated the effect and the mechanism of action of water and ethanol extracts of Brazilian green propolis. Methods We examined the laxative effect of propolis on stool frequency by administering orally an ethanol extract of propolis (EEP) or a water extract of propolis (WEP) at 10, 50, 100, or 500 mg/kg to normal mice. We then investigated the effects of propolis using constipation model mice induced by two types of drugs, loperamide (a μ opioid receptor agonist) and clonidine (an α-2 adrenergic receptor agonist). We also investigated the effects of WEP on gastrointestinal transit and contractional tension of the ileum to uncover the mechanism of action of WEP. Results Treatment with WEP, but not with EEP, significantly increased the weight of stools (p<0.01 at 500 mg/kg). WEP treatment significantly restored stool frequency and stool weight in clonidine-induced constipation model mice, but not in loperamide-induced constipation model mice. WEP treatment did not affect gastro-intestinal transit, but significantly increased the contractional tension of the isolated ileum of guinea pigs. This increase was inhibited by an acetylcholine receptor antagonist (atropine), but not by a 5-HT receptor antagonist (GR113808). Conclusion These findings indicate that WEP has laxative effects both in normal mice and in clonidine-induced constipation model mice. The laxative effects of WEP might be mediated by increased contractional tension of the ileum exerted at least in part via activation of an acetylcholine receptor. PMID:23088672

  9. Review of efficacy and safety of laxatives use in geriatrics

    PubMed Central

    Izzy, Manhal; Malieckal, Anju; Little, Erin; Anand, Sury

    2016-01-01

    AIM: To study the efficacy and safety of pharmacological treatment of constipation in geriatrics. METHODS: PubMed, MEDLINE, google scholar, and Ovid were searched to identify human studies performed on the use of laxatives in elderly with constipation, which were conducted between January 1990 and January 2013 using the specified keywords. Controlled studies that enrolled geriatric patients with a diagnosis of constipation and addressed the efficacy and/or the safety of pharmacological treatments were included. Studies were excluded from this review if they were non-controlled trials, case series, or case reports. RESULTS: Out of twenty three studies we initially retrieved in our search, only nine studies met the eligibility criteria of being controlled trials within geriatrics. The laxatives examined in the nine studies were senna, lactulose, sorbital, polyethylene glycol (PEG), lubiprostone, linaclotide, and prucalopride. In those studies, senna combinations had a higher efficacy than sorbitol or lactulose as well as, a very good adverse effect profile. PEG was also shown to be safe and effective in geriatric population. Furthermore, it has been shown that PEG is as safe in geriatrics as in general population. New agents like lubiprostone and prucalopride show promising results but the data about these agents in geriatrics are still limited which warrants further investigation. CONCLUSION: Senna combinations and PEG appear to have a more favorable profile over the other traditionally used laxatives in elderly patients with constipation. PMID:27158549

  10. Structure analysis and laxative effects of oligosaccharides isolated from bananas.

    PubMed

    Wang, Juan; Huang, Hui Hua; Cheng, Yan Feng; Yang, Gong Ming

    2012-10-01

    Banana oligosaccharides (BOS) were extracted with water, and then separated and purified using column chromatography. Gel penetration chromatography was used to determine the molecular weights. Thin layer chromatogram and capillary electrophoresis were employed to analyze the monosaccharide composition. The indican bond and structure of the BOS molecule were determined using Fourier transform infrared spectroscopy and nuclear magnetic resonance. Results showed that BOS were probably composed of eight β-D-pyran glucose units linked with 1→6 indican bonds. The laxative effects of BOS were investigated in mice using the method described in "Handbook of Technical Standards for Testing and Assessment of Health Food in China." The length of the small intestine over which a carbon suspension solution advanced in mice treated with low-, middle-, and high-dose BOS was significantly greater than that in the model group, suggesting that BOS are effective in accelerating the movement of the small intestine.

  11. Gender Conformity and Use of Laxatives and Muscle-Building Products in Adolescents and Young Adults.

    PubMed

    Calzo, Jerel P; Sonneville, Kendrin R; Scherer, Emily A; Jackson, Benita; Austin, S Bryn

    2016-08-01

    Use of laxatives for weight loss and drugs or supplements to build muscle (eg, steroids) differs by gender and sexual orientation; little is known about factors contributing to these disparities. Conformity to gender norms concerning appearance could underlie these differences. This study examined associations between childhood gender conformity and laxative and muscle-building product use from ages 13 to 25 years in a sample of 13 683 males and females in the US prospective Growing Up Today Study. Adjusted multivariable logistic regression models of repeated measures estimated odds of past-year laxative and muscle-building product use by quartiles of greater childhood gender conformity in heterosexual and sexual minority (eg, bisexual, gay) participants. By age 23 years, ∼20% of sexual minority females reported past-year laxative use. By age 19 years, 12% of all males reported past-year muscle-building product use. Sexual minority females had twice the odds of heterosexual females of using laxatives (P < .0001). The most gender-conforming females had 50% greater odds than the least-conforming females of using laxatives (P < .01). Moderate (odds ratio, 2.09; 95% confidence interval, 1.58-2.75) and highly (odds ratio, 1.79; 95% confidence interval, 1.38-2.33) gender-conforming males had higher odds than gender-nonconforming males of using muscle-building products. Sexual minority females are at high risk for laxative abuse. Regardless of sexual orientation, gender conformity increased the odds of laxative abuse among females and muscle-building product use among males. Findings can inform prevention efforts to target youth at risk for laxative or muscle-building product use. Copyright © 2016 by the American Academy of Pediatrics.

  12. Gender Conformity and Use of Laxatives and Muscle-Building Products in Adolescents and Young Adults

    PubMed Central

    Sonneville, Kendrin R.; Scherer, Emily A.; Jackson, Benita; Austin, S. Bryn

    2016-01-01

    BACKGROUND: Use of laxatives for weight loss and drugs or supplements to build muscle (eg, steroids) differs by gender and sexual orientation; little is known about factors contributing to these disparities. Conformity to gender norms concerning appearance could underlie these differences. METHODS: This study examined associations between childhood gender conformity and laxative and muscle-building product use from ages 13 to 25 years in a sample of 13 683 males and females in the US prospective Growing Up Today Study. Adjusted multivariable logistic regression models of repeated measures estimated odds of past-year laxative and muscle-building product use by quartiles of greater childhood gender conformity in heterosexual and sexual minority (eg, bisexual, gay) participants. RESULTS: By age 23 years, ∼20% of sexual minority females reported past-year laxative use. By age 19 years, 12% of all males reported past-year muscle-building product use. Sexual minority females had twice the odds of heterosexual females of using laxatives (P < .0001). The most gender-conforming females had 50% greater odds than the least-conforming females of using laxatives (P < .01). Moderate (odds ratio, 2.09; 95% confidence interval, 1.58–2.75) and highly (odds ratio, 1.79; 95% confidence interval, 1.38–2.33) gender-conforming males had higher odds than gender-nonconforming males of using muscle-building products. CONCLUSIONS: Sexual minority females are at high risk for laxative abuse. Regardless of sexual orientation, gender conformity increased the odds of laxative abuse among females and muscle-building product use among males. Findings can inform prevention efforts to target youth at risk for laxative or muscle-building product use. PMID:27418416

  13. Laxative effects of Salecan on normal and two models of experimental constipated mice

    PubMed Central

    2013-01-01

    Background Constipation is one of the most common gastrointestinal complaints with a highly prevalent and often chronic functional gastrointestinal disorder affecting health-related quality of life. The aim of the present study was to evaluate the effects of Salecan on fecal output and small intestinal transit in normal and two models of drug-induced constipation mice. Methods ICR mice were administrated intragastrically (i.g.) by gavage with 100, 200 and 300 mg/kg body weight (BW) of Salecan while the control mice were received saline. The constipated mice were induced by two types of drugs, loperamide (5 mg/kg BW, i.g.) and clonidine (200 μg/kg BW, i.g.), after Salecan treatment while the control mice were received saline. Number, weight and water content of feces were subsequently measured. Small intestinal transit was monitored by phenol red marker meal. Results Salecan (300 mg/kg BW) significantly increased the number and weight of feces in normal mice. In two models of drug-induced constipation, Salecan dose-dependently restored the fecal number and fecal weight. The water content of feces was markedly affected by loperamide, but not by clonidine. Treatment with Salecan significantly raised the fecal water content in loperamide-induced constipation mice. Moreover, Salecan markedly stimulated the small intestinal transit in both loperamide- and clonidine-induced constipation model mice. Conclusions These results suggest that Salecan has a potential to be used as a hydrophilic laxative for constipation. PMID:23514598

  14. Intestinal adsorption of levothyroxine by antacids and laxatives: case stories and in vitro experiments.

    PubMed

    Mersebach, H; Rasmussen, A K; Kirkegaard, L; Feldt-Rasmussen, U

    1999-03-01

    Two patients with hypothyroidism treated for upper dyspepsia and constipation with aluminum hydroxide and magnesium oxide, respectively, presented a marked increase in the serum concentration of thyroid stimulating hormone and low serum thyroxine on a fixed dosage of levothyroxine. After discontinuation of antacids/laxatives, thyroid stimulating hormone was again reduced indicating interaction between levothyroxine and antacids/laxatives. In vitro studies revealed a dose-related increased adsorption of levothyroxine by addition of a combination of aluminum hydroxide, magnesium hydroxide and magnesium carbonate, while no connection between levothyroxine and the addition of magnesium oxide, alone, was found. This finding has major clinical consequences since 1) many patients are treated with levothyroxine, 2) most patients do not tell physicians that they take antacids/laxatives, and 3) consumption of antacids/laxatives in patients with levothyroxine-treated hypothyroidism may lead to serious undersubstitution with levothyroxine.

  15. Severe hyperphosphatemia and hypocalcemic tetany after oral laxative administration in a 3-month-old infant.

    PubMed

    Domico, Michele B; Huynh, Van; Anand, Sudhir K; Mink, Richard

    2006-11-01

    A 3-month-old infant presented to the pediatric emergency department with respiratory distress and tetany after ingestion of a phosphate-containing oral laxative. The initial phosphorus level was 38.3 mg/dL. With aggressive fluid resuscitation and intravenous calcium administration, the infant completely recovered. Although the risks of phosphate-containing enemas are well described, life-threatening hyperphosphatemia can also result from administration of phosphate-containing oral laxatives. Aggressive fluid hydration is the mainstay of treatment. Intravenous calcium administration may be necessary to avoid hemodynamic collapse despite the theoretical possibility of metastatic calcifications. Physicians should be alerted to the possibility of phosphate toxicity and hypocalcemic tetany in young children when treated with over-the-counter laxatives. Caregivers should be advised not to administer over-the-counter laxatives to infants without physician supervision.

  16. Phenolphthalein-containing laxative use in relation to adenomatous colorectal polyps in three studies.

    PubMed Central

    Longnecker, M P; Sandler, D P; Haile, R W; Sandler, R S

    1997-01-01

    Phenolphthalein, the active ingredient in many laxatives, was recently found to be a carcinogen in animal models. Human data suggest a laxative-colon cancer association, but few data specifically address the effects of phenolthalein-containing laxatives. We examined use of phenolphtalein-containing laxatives in relation to occurrence of adenomatous colorectal polyps in data from three case-control studies. The study conducted in Los Angeles, California (1991-1993), and the two studies conducted in North Carolina (1988-1990 and 1992-1995) altogether included 866 cases and 1,066 controls. The prevalence of using phenolphthalein-containing laxatives at least once a week in the recent past, however, was less than 5% among these subjects. The multivariate-adjusted odds ratios associated with recent use of phenolphthalein-containing laxatives once a week or more were 1.8 -95% confidence interval (CI), 0.5-6.2] in Los Angeles, 1.0 (CI, 0.4-2.2) in North Carolina (1988-1990), and 1.1 (CI, 0.2-5.7) in North Carolina (1992-1995). For use of other types of laxatives, the corresponding odds ratios were 1.3 (CI, 0.9-1.9) in Los Angeles, 1.0 (CI, 0.5-1.7) in North Carolina (1988-1990), and 0.9 (CI, 0.4-1.8) in North Carolina (1992-1995). Although the low prevalence of frequent use made for relatively wide confidence intervals, overall these data suggest that use of phenolphthalein-containing laxatives does not increase risk of adenomatous colorectal polyps. PMID:9370521

  17. Systematic review of stimulant and nonstimulant laxatives for the treatment of functional constipation

    PubMed Central

    Paré, Pierre; Fedorak, Richard N

    2014-01-01

    BACKGROUND: Constipation is an uncomfortable and common condition that affects many, irrespective of age. Since 1500 BC and before, health care practitioners have provided treatments and prevention strategies to patients for chronic constipation despite the significant variation in both medical and personal perceptions of the condition. OBJECTIVE: To review relevant research evidence from clinical studies investigating the efficacy and safety of commercially available pharmacological laxatives in Canada, with emphasis on studies adopting the Rome criteria for defining functional constipation. SEARCH METHODS: PubMed, Medline, Embase and Evidence-Based Medicine Reviews databases were searched for blinded or randomized clinical trials and meta-analyses assessing the efficacy of nonstimulant and stimulant laxatives for the treatment of functional constipation. RESULTS: A total of 19 clinical studies and four meta-analyses were retrieved and abstracted regarding study design, participants, interventions and outcomes. The majority of studies focused on polyethylene glycol compared with placebo. Both nonstimulant and stimulant laxatives provided better relief of constipation symptoms than placebo according to both objective and subjective measures. Only one study compared the efficacy of a nonstimulant versus a stimulant laxative, while only two reported changes in quality of life. All studies reported minor side effects due to laxative use, regardless of treatment duration, which ranged from one week to one year. Laxatives were well tolerated by both adults and children. PMID:25390617

  18. Glycerin laxatives for prevention or treatment of feeding intolerance in very low birth weight infants.

    PubMed

    Anabrees, Jasim; Shah, Vibhuti S; AlOsaimi, Ahlam; AlFaleh, Khalid

    2015-09-30

    Feeding intolerance is a common clinical problem among preterm infants. It may be an early sign of necrotising enterocolitis, sepsis or other serious gastrointestinal conditions, or it may result from gut immaturity with delayed passage of meconium. Glycerin laxatives stimulate passage of meconium by acting as an osmotic dehydrating agent and increasing osmotic pressure in the gut; they stimulate rectal contraction, potentially reducing the incidence of feeding intolerance. To assess the effectiveness and safety of glycerin laxatives (enemas/suppositories) for prevention or treatment of feeding intolerance in very low birth weight (VLBW) infants. We searched the Cochrane Central Register of Controlled Trials (CENTRAL; 2015, Issue 4), MEDLINE, EMBASE and the Cumulative Index to Nursing and Allied Health Literature (CINAHL). We restricted our search to all randomised controlled trials and applied no language restrictions. We searched the references of identified studies and reviews on this topic and handsearched for additional articles. We searched the database maintained by the US National Institutes of Health (www.clinicaltrials.gov) and European trial registries to identify ongoing trials. We considered only randomised or quasi-randomised controlled trials that enrolled preterm infants < 32 weeks' gestational age (GA) and/or < 1500 g birth weight. We included trials if they administered glycerin laxatives and measured at least one prespecified clinical outcome. We used standard methods of The Cochrane Collaboration and its Neonatal Group to assess methodological quality of trials, to collect data and to perform analyses. We identified three trials that evaluated use of prophylactic glycerin laxatives in preterm infants. We identified no trials that evaluated therapeutic use of glycerin laxatives for feeding intolerance. Our review showed that prophylactic administration of glycerin laxatives did not reduce the time required to achieve full enteral feeds and did

  19. Estimation of sulfolax and antimicrobial preservatives in laxative drops.

    PubMed

    Tahir, Muhammad Saqlain; Mahmood, Rizwan; Shamsi, Waseemur Rahman

    2015-11-01

    A simple, fast, precise, economic, selective and accurate HPLC method for simultaneous estimation of sorbicacid, sodium picosulphate and methyl parabensodium in laxative drops has been developed and subsequently validated. Chromatographic separation was achieved using gradient elution with mix phosphate buffer pH 7.0 and acetonitrile. The column used was purospherstar C18, 5 μm, 25 cm × 4.6mm kept at 25°C with 1 ml/min flow rate using detection (PDA) at 263 nm. The retention times of sorbicacid, sodium picosulphate and methyl paraben sodium were found to be 4.6, 7.4 and 11.4 minutes respectively. The proposed method was found to be linear over a concentration range of 8-12 μg/ml for sorbic acid, 60-90 μg/ml for sodium picosulphate and 16-24 μg/ml formethyl paraben sodium respectively. The recovery was found to be 99.13-101.68% for sorbic acid, 99.81-100.21% for sodium picosulphate and 99.84-100.09% for methyl paraben sodium respectively. The limit of detection (LOD) for sorbicacid, sodium picosulphate and methyl parabensodium were found to be 0.032 μg/ml, 0.337 μg/ml and 0.131 μg/ml respectively and limit of quantitation (LOQ) for sorbicacid, sodium picosulphate and methyl parabensodium were found to be 0.097 μg/ml, 1.023 μg/ml and 0.399 μg/ml respectively. The method was validated with respect to specificity, precision, accuracy, linearity and robustness according to guidelines of ICH.

  20. Alterations in colonic anatomy induced by chronic stimulant laxatives: the cathartic colon revisited.

    PubMed

    Joo, J S; Ehrenpreis, E D; Gonzalez, L; Kaye, M; Breno, S; Wexner, S D; Zaitman, D; Secrest, K

    1998-06-01

    Cathartic colon is a historic term for the anatomic alteration of the colon secondary to chronic stimulant laxative use. Because some have questioned whether this is a real entity, we investigated changes occurring on barium enema in patients ingesting stimulant laxatives. Our study consisted of two parts. In part 1, a retrospective review of consecutive barium enemas performed on two groups of patients with chronic constipation (group 1, stimulant laxative use [n=29]; group 2, no stimulant laxative use [n=26]) was presented to a radiologist who was blinded to the patient group. A data sheet containing classic descriptions of cathartic colon was completed for each study. Chronic stimulant laxative use was defined as stimulant laxative ingestion more than three times per week for 1 year or longer. To confirm the findings of the retrospective study, 18 consecutive patients who were chronic stimulant laxative users underwent barium enema examination, and data sheets for cathartic colon were completed by another radiologist (part 2). Colonic redundancy (group 1, 34.5%; group 2, 19.2%) and dilatation (group 1, 44.8%; group 2, 23.1%) were frequent radiographic findings in both patient groups and were not significantly different in the two groups. Loss of haustral folds, however, was a common finding in group 1 (27.6%) but was not seen in group 2 (p < 0.005). Loss of haustral markings occurred in 15 (40.5%) of the total stimulant laxative users in the two parts of the study and was seen in the left colon of 6 (40%) patients, in the right colon of 2 (13.3%) patients, in the transverse colon of 5 (33.3%) patients, and in the entire colon of 2 (13.3%) patients. Loss of haustra was seen in patients chronically ingesting bisacodyl, phenolpthalein, senna, and casanthranol. We conclude that long-term stimulant laxative use results in anatomic changes in the colon characterized by loss of haustral folds, a finding that suggests neuronal injury or damage to colonic longitudinal

  1. Assessment of indoor radiation dose received by the residents of natural high background radiation areas of coastal villages of Kanyakumari district, Tamil Nadu, India

    NASA Astrophysics Data System (ADS)

    Deva Jayanthi, D.; Maniyan, C. G.; Perumal, S.

    2011-07-01

    Radiation exposure and effective dose received through two routes of exposure, viz. external and internal, via inhalation, by residents of 10 villages belonging to Natural High Background Radiation Areas (NHBRA) of coastal regions of Kanyakumari District and Tamil Nadu in India were studied. While the indoor gamma radiation levels were monitored using Thermo Luminescent Dosimeters (TLDs), the indoor radon and thoron gas concentrations were measured using twin chamber dosimeters employing Solid State Nuclear Track Detectors (SSNTDs, LR-115-II). The average total annual effective dose was estimated and found to be varying from 2.59 to 8.76 mSv.

  2. Fluorosis and dental caries in Mexican schoolchildren residing in areas with different water fluoride concentrations and receiving fluoridated salt.

    PubMed

    García-Pérez, A; Irigoyen-Camacho, M E; Borges-Yáñez, A

    2013-01-01

    To explore the association between fluoride in drinking water and the prevalence and severity of fluorosis and dental caries in children living in communities receiving fluoridated salt. Participants were schoolchildren (n = 457) living in two rural areas of the State of Morelos, Mexico, where the water fluoride concentration was 0.70 or 1.50 ppm. Dental caries status was assessed using Pitts' criteria. Lesions that were classified as D3 (decayed) were identified to determine the decayed, missing, and filled teeth index (D3MFT). Fluorosis was assessed using the Thylstrup-Fejerskov Index (TFI). Information regarding drinking water source and oral hygiene practices (tooth brushing frequency, dentifrice use, and oral hygiene index) was obtained. The prevalence of fluorosis (TFI ≥1) in communities with 0.70 and 1.50 ppm water fluoride was 39.4 and 60.5% (p = 0.014), respectively, while the prevalence of more severe forms (TFI ≥4) was 7.9 and 25.5% (p < 0.001), respectively. The mean D3MFT was 0.49 (±1.01) in the 0.70 ppm community and 0.61 (±1.47) in the 1.50 ppm community (p = 0.349). A logistic regression model for caries (D3 >1) showed that higher fluorosis categories (TFI 5-6 OR = 6.81, p = 0.001) were associated with higher caries experience, adjusted by age, number of teeth present, tooth brushing frequency, bottled water use, and natural water fluoride concentration. The prevalence of fluorosis was associated with the water fluoride concentration. Fluorosis at moderate and severe levels was associated with a higher prevalence of dental caries, compared with lesser degrees of fluorosis. The impact of dental fluorosis should be considered in dental public health programs. Copyright © 2013 S. Karger AG, Basel.

  3. Is Senna Laxative Use Associated to Cathartic Colon, Genotoxicity, or Carcinogenicity?

    PubMed Central

    Morales, M. A.; Hernández, D.; Bustamante, S.; Bachiller, I.; Rojas, A.

    2009-01-01

    Due to their natural origin, apparent low oral toxicity, effectiveness, and accessibility without a medical prescription, the anthranoid laxatives are a popular remedy for constipation and are frequently used abusively. Therefore, it is important to characterize its harmful and/or toxic effects. The sennosides, main active metabolites of senna, exhibit a very low toxicity in rats, and its genotoxic activity in bacterial strains as well as mammal cells was classified as weak in those cases where it was shown to be significant. The toxicological and mutagenic status of the crude extract of senna, however, is not as well characterized, and it is necessary to do so since it is frequently, and at the same time incorrectly, believed that the chronic use of anthranoid laxatives is a risk factor for the development of colorectal cancer. The objective of this article was to review the information that arises in various scientific medical databases using key words such as senna, sen, Senna alexandrina, Cassia angustifolia, sennosides, laxative toxicity, mainly ISI and non-ISI articles of journals with an editorial committee. Web pages of products or companies that publicize or commercialize this type of laxative were not included. This analysis establishes that (1) there is no convincing evidence that the chronic use of senna has, as a consequence, a structural and/or functional alteration of the enteric nerves or the smooth intestinal muscle, (2) there is no relation between long-term administration of a senna extract and the appearance of gastrointestinal tumors or any other type in rats, (3) senna is not carcinogenic in rats even after a two-year daily dose of up to 300 mg/kg/day, and (4) the current evidence does not show that there is a genotoxic risk for patients who take laxatives containing senna extracts or sennosides. PMID:20107583

  4. Is senna laxative use associated to cathartic colon, genotoxicity, or carcinogenicity?

    PubMed

    Morales, M A; Hernández, D; Bustamante, S; Bachiller, I; Rojas, A

    2009-01-01

    Due to their natural origin, apparent low oral toxicity, effectiveness, and accessibility without a medical prescription, the anthranoid laxatives are a popular remedy for constipation and are frequently used abusively. Therefore, it is important to characterize its harmful and/or toxic effects. The sennosides, main active metabolites of senna, exhibit a very low toxicity in rats, and its genotoxic activity in bacterial strains as well as mammal cells was classified as weak in those cases where it was shown to be significant. The toxicological and mutagenic status of the crude extract of senna, however, is not as well characterized, and it is necessary to do so since it is frequently, and at the same time incorrectly, believed that the chronic use of anthranoid laxatives is a risk factor for the development of colorectal cancer. The objective of this article was to review the information that arises in various scientific medical databases using key words such as senna, sen, Senna alexandrina, Cassia angustifolia, sennosides, laxative toxicity, mainly ISI and non-ISI articles of journals with an editorial committee. Web pages of products or companies that publicize or commercialize this type of laxative were not included. This analysis establishes that (1) there is no convincing evidence that the chronic use of senna has, as a consequence, a structural and/or functional alteration of the enteric nerves or the smooth intestinal muscle, (2) there is no relation between long-term administration of a senna extract and the appearance of gastrointestinal tumors or any other type in rats, (3) senna is not carcinogenic in rats even after a two-year daily dose of up to 300 mg/kg/day, and (4) the current evidence does not show that there is a genotoxic risk for patients who take laxatives containing senna extracts or sennosides.

  5. Quantifying rigidity of Parkinson's disease in relation to laxative treatment: a service evaluation

    PubMed Central

    Augustin, Aisha D.; Charlett, André; Weller, Clive; Taylor, David; Bjarnason, Ingvar; Dobbs, R. John

    2016-01-01

    Aim To estimate whether laxatives prescribed for constipation in Parkinson's disease (PD) could moderate rigidity. Constipation predates diagnosis of PD by decades. Deposition of misfolded protein may begin in the gut, driven by dysbiosis. Successive antimicrobial exposures are associated with cumulative increase in rigidity, and rigidity has biological gradients on circulating leukocyte‐subset counts. Methods Retrospective service evaluation, in a gut/brain axis clinic, yielded an interrupted time series, relating maintenance laxative and other medication to rigidity, in consecutive outpatients identified by inclusion and exclusion criteria. Objective assessment of rigidity was used to bring greater sensitivity to change, validated against subjective gold standard (UPDRS). Results There were 1493 measurements of torque required to extend (flexor rigidity) and flex (extensor rigidity) the forearm in 79 PD patients over 374 person‐years. Both were strongly associated with UPDRS (P < 0.001 and P = 0.008, respectively). Before exhibition of laxative, flexor rigidity increased by 6% (95% CI 1, 10) per year, plateauing at −2% (−4, 1) per year after, with no shift at initiation. Change in slope was significant (P = 0.002), and manifest in those naïve to antiparkinsonian medication. The change was replicated for individual laxative classes (bulk, osmotic, enterokinetic). There was no temporal change in extensor rigidity. Limited experience with a quanylate cyclase‐C receptor agonist (17 patients, 6 person‐years) indicated a large and significant step down in flexor and extensor rigidity, of 19% (1, 34) and 16% (6, 24) respectively (P = 0.04 and <0.001). Conclusions Maintenance laxative usage was associated with apparent stemming of the temporal increase in rigidity in PD, adding to indicative evidence of a continuing role of gastrointestinal dysbiosis in pathogenesis. PMID:27062674

  6. The basic data for residents aged 16 years or older who received a comprehensive health check examinations in 2011-2012 as a part of the Fukushima Health Management Survey after the great East Japan earthquake.

    PubMed

    Kawasaki, Yukihiko; Hosoya, Mitsuaki; Yasumura, Seiji; Ohira, Tetsuya; Satoh, Hiroaki; Suzuki, Hitoshi; Sakai, Akira; Ohtsuru, Akira; Takahashi, Atsushi; Ozasa, Kotaro; Kobashi, Gen; Kamiya, Kenji; Yamashita, Shunichi; Abe, Masafumi

    2014-01-01

    To assist in the long-term health management of residents and evaluate health impacts after the Tokyo Electric Power Company's Fukushima Daiichi Nuclear Power Plant accident in Fukushima Prefecture, the Fukushima prefectural government decided to conduct the Fukushima Health Management Survey. This report describes the results for residents aged 16 years or older who received the health check examinations and evaluates the data obtained from 2011 and 2012. The target group consisted of residents aged 16 years or older who had lived in the evacuation zone. The health check examinations were performed on receipt of an application for a health check examination from any of the residents. The examinations, including measurements of height, weight, abdominal circumference/body mass index (BMI), blood pressure, biochemical laboratory findings, and peripheral blood findings, were performed as required. 1) A total of 56,399 (30.9%) and 47,009 (25.4%) residents aged 16 years or older received health checks in 2011 and 2012, respectively. 2) In both years, a number of male and female residents in the 16-39 year age group were found to suffer obesity, hyperlipidemia, hyperuricemia, or liver dysfunction, and the prevalence of obesity and hyperlipidemia among residents increased with age. Furthermore, the proportion of residents with hypertension, glucose metabolic abnormalities or renal dysfunction was higher in those aged 40 years or older. 3) The frequencies of obesity, hypertension and hyperlipidemia among residents in 2012 were lower than those in 2011. However, the prevalence of liver dysfunction, hyperuricemia, glucose metabolic abnormalities and renal dysfunction among residents was higher in 2012 than in 2011. These results suggested the number of residents who had lived in the evacuation zone with obesity, hyperlipidemia, hyperuricemia, liver dysfunction, hypertension, glucose metabolic abnormalities, or renal dysfunction increased with age in all age groups

  7. Testing the effectiveness of in-home behavioral economics strategies to increase vegetable intake, liking, and variety among children residing in households that receive food assistance.

    PubMed

    Leak, Tashara M; Swenson, Alison; Vickers, Zata; Mann, Traci; Mykerezi, Elton; Redden, Joseph P; Rendahl, Aaron; Reicks, Marla

    2015-01-01

    To test the effectiveness of behavioral economics strategies for increasing vegetable intake, variety, and liking among children residing in homes receiving food assistance. A randomized controlled trial with data collected at baseline, once weekly for 6 weeks, and at study conclusion. Family homes. Families with a child (9-12 years) will be recruited through community organizations and randomly assigned to an intervention (n = 36) or control (n = 10) group. The intervention group will incorporate a new behavioral economics strategy during home dinner meal occasions each week for 6 weeks. Strategies are simple and low-cost. The primary dependent variable will be child's dinner meal vegetable consumption based on weekly reports by caregivers. Fixed independent variables will include the strategy and week of strategy implementation. Secondary dependent variables will include vegetable liking and variety of vegetables consumed based on data collected at baseline and study conclusion. Mean vegetable intake for each strategy across families will be compared using a mixed-model analysis of variance with a random effect for child. In additionally, overall mean changes in vegetable consumption, variety, and liking will be compared between intervention and control groups. Copyright © 2015 Society for Nutrition Education and Behavior. Published by Elsevier Inc. All rights reserved.

  8. Polyethylene glycol, unique among laxatives, suppresses aberrant crypt foci, by elimination of cells

    PubMed Central

    Taché, Sylviane; Parnaud, Géraldine; Van Beek, Erik; Corpet, Denis E.

    2006-01-01

    Background Polyethylene glycol (PEG), an osmotic laxative, is a very potent inhibitor of colon cancer in rats. In a search for mechanisms, we tested the hypothesis that fecal bulking and moisture decreases colon carcinogenesis. We also looked for PEG effects on crypt cells in vivo. Methods Fischer 344 rats (N=272) were given an injection of the colon carcinogen azoxymethane. They were then randomized to a standard AIN76 diet containing one of 19 laxative agents (5% w/w in most cases): PEG 8000 and other PEG-like compounds, carboxymethylcellulose, polyvinylpyrrolidone, sodium polyacrylate, calcium polycarbophil, karaya gum, psyllium, mannitol, sorbitol, lactulose, propylene glycol, magnesium hydroxide, sodium phosphate, bisacodyl, docusate, and paraffin oil. Aberrant crypt foci (ACF) and fecal values were measured blindly after a 30-day treatment. Proliferation, apoptosis, and the removal of cells from crypts were studied in control and PEG-fed rats by various methods, including TUNEL and fluorescein dextran labeling. Results PEG 8000 reduced nine-fold the number of ACF in rats (p<0.001). The other PEGs and magnesium-hydroxide modestly suppressed ACF, but not the other laxatives. ACF number did not correlate with fecal weight or moisture. PEG doubled the apoptotic bodies per crypt (p<0.05), increased proliferation by 25–50% (p<0.05) and strikingly increased (>40-fold) a fecal marker of epitheliolysis in the gut (p<0.001). PEG normalized the percentage of fluorescein dextran labeled cells on the top of ACF (p<0.001). Conclusions Among laxatives, only PEG afforded potent chemoprevention. PEG protection was not due to increased fecal bulking, but likely to the elimination of cells from precancerous lesions. PMID:16716974

  9. Laxative activities of Mareya micrantha (Benth.) Müll. Arg. (Euphorbiaceae) leaf aqueous extract in rats

    PubMed Central

    2010-01-01

    Background Mareya micrantha (Benth.) Müll. Arg. (Euphorbiaceae) is a shrub that is commonly used in Côte d'Ivoire (West Africa) for the treatment of constipation and as an ocytocic drug. The present study was carried out to investigate the laxative activity of Mareya micrantha in albino's Wistar rats. Methods Rats were divided in 5 groups of 5 animals each, first group as control, second group served as standard (sodium picosulfate) while group 3, 4 and 5 were treated with leaf aqueous extract of Mareya micrantha at doses of 100, 200 and 400 mg/kg body weight (b.w.), per os respectively. The laxative activity was determined based on the weight of the faeces matter. The effects of the leaves aqueous extract of Mareya micrantha and castor oil were also evaluated on intestinal transit, intestinal fluid accumulation and ions secretion. Results Phytochemicals screening of the extract revealed the presence of flavonoids, alkaloids, tannins, polyphenols, sterols and polyterpenes. The aqueous extract of Mareya micrantha applied orally (100, 200 and 400 mg/kg; p.o.), produced significant laxative activity and reduced loperamide induced constipation in dose dependant manner. The effect of the extract at 200 and 400 mg/kg (p.o.) was similar to that of reference drug sodium picosulfate (5 mg/kg, p.o). The same doses of the extract (200 and 400 mg/kg, p.o.) produced a significant increase (p < 0.01) of intestinal transit in comparison with castor oil (2 mL) (p < 0.01). Moreover, the extract induced a significant enteropooling and excretion of Cl-, Na+, K+ and Ca2+ in the intestinal fluid (p < 0.01). Conclusions The results showed that the aqueous extract of Mareya micrantha has a significant laxative activity and supports its traditional use in herbal medicine. PMID:20158903

  10. Laxative effects of fermented rice extract in rats with loperamide-induced constipation

    PubMed Central

    CHOI, JAE-SUK; KIM, JOO WAN; CHO, HYUNG-RAE; KIM, KI-YOUNG; LEE, JONG-KWANG; SOHN, JAE HAK; KU, SAE-KWANG

    2014-01-01

    Constipation is a common problem in males and females. The aim of the present study was to evaluate the laxative effects of fermented rice extract (FRe) on rats with loperamide-induced constipation. FRe (100, 200 and 300 mg/kg) was administered orally once per day for six days following 1 h loperamide treatment. The laxative effects of FRe were compared with those of sodium picosulfate (S. picosulfate). Following the induction of constipation in the rats, a marked decrease was observed in the fecal pellet number and water content discharged over 24 h, the surface mucus thickness in the colonic lumen, intestinal charcoal transit ratio, thickness of the colonic mucosa and the number of mucus-producing cells, while an increase was observed in the number of fecal pellets remaining in the colonic lumen and their mean diameter, as compared with the normal vehicle control rats. These conditions were significantly alleviated following the administration of the three doses of FRe when compared with the loperamide control group. However, the alleviating effects were lower than those of S. picosulfate, with the exception of the intestinal charcoal transit ratio. Similar effects on the intestinal charcoal transit ratio were detected for the three doses of FRe when compared with the S. picosulfate-treated rats. In conclusion, the results indicated that FRe exhibits a laxative effect without causing diarrhea, as compared with sodium picosulfate; thus, FRe may be effective as a complementary medicine in patients suffering from lifestyle-induced constipation. PMID:25371743

  11. Castor oil induces laxation and uterus contraction via ricinoleic acid activating prostaglandin EP3 receptors

    PubMed Central

    Tunaru, Sorin; Althoff, Till F.; Nüsing, Rolf M.; Diener, Martin; Offermanns, Stefan

    2012-01-01

    Castor oil is one of the oldest drugs. When given orally, it has a laxative effect and induces labor in pregnant females. The effects of castor oil are mediated by ricinoleic acid, a hydroxylated fatty acid released from castor oil by intestinal lipases. Despite the wide-spread use of castor oil in conventional and folk medicine, the molecular mechanism by which ricinoleic acid acts remains unknown. Here we show that the EP3 prostanoid receptor is specifically activated by ricinoleic acid and that it mediates the pharmacological effects of castor oil. In mice lacking EP3 receptors, the laxative effect and the uterus contraction induced via ricinoleic acid are absent. Although a conditional deletion of the EP3 receptor gene in intestinal epithelial cells did not affect castor oil-induced diarrhea, mice lacking EP3 receptors only in smooth-muscle cells were unresponsive to this drug. Thus, the castor oil metabolite ricinoleic acid activates intestinal and uterine smooth-muscle cells via EP3 prostanoid receptors. These findings identify the cellular and molecular mechanism underlying the pharmacological effects of castor oil and indicate a role of the EP3 receptor as a target to induce laxative effects. PMID:22615395

  12. Effect of Food Thickener on Dissolution and Laxative Activity of Magnesium Oxide Tablets in Mice.

    PubMed

    Tomita, Takashi; Goto, Hidekazu; Yoshimura, Yuya; Kato, Kazushige; Yoshida, Tadashi; Tanaka, Katsuya; Sumiya, Kenji; Kohda, Yukinao

    2016-01-01

    The present study examined the dissolution of magnesium oxide (MgO) from MgO tablets placed in a food thickening agent (food thickener) and its effects on laxative activity. We prepared mixtures of MgO tablets suspended in an aqueous suspension and food thickeners in order to evaluate the dissolution of MgO. The results of the dissolution tests revealed that agar-based food thickeners did not affect the MgO dissolution. In contrast, some xanthan gum-based food-thickener products show dissolution rates with certain mixtures containing disintegrated MgO tablets suspended in a food thickener that decrease over time. However, other xanthan gum-based food-thickener products show dissolution rates that decrease immediately after mixing, regardless of the time they were allowed to stand. In order to investigate the laxative activity of MgO, we orally administered a mixture of MgO suspension and food thickener to mice and observed their bowel movements. The animal experiments showed that when agar-based food thickeners were used, the laxative activity of MgO was not affected, but it decreased when xanthan gum-based food thickeners were used.

  13. Castor oil induces laxation and uterus contraction via ricinoleic acid activating prostaglandin EP3 receptors.

    PubMed

    Tunaru, Sorin; Althoff, Till F; Nüsing, Rolf M; Diener, Martin; Offermanns, Stefan

    2012-06-05

    Castor oil is one of the oldest drugs. When given orally, it has a laxative effect and induces labor in pregnant females. The effects of castor oil are mediated by ricinoleic acid, a hydroxylated fatty acid released from castor oil by intestinal lipases. Despite the wide-spread use of castor oil in conventional and folk medicine, the molecular mechanism by which ricinoleic acid acts remains unknown. Here we show that the EP(3) prostanoid receptor is specifically activated by ricinoleic acid and that it mediates the pharmacological effects of castor oil. In mice lacking EP(3) receptors, the laxative effect and the uterus contraction induced via ricinoleic acid are absent. Although a conditional deletion of the EP(3) receptor gene in intestinal epithelial cells did not affect castor oil-induced diarrhea, mice lacking EP(3) receptors only in smooth-muscle cells were unresponsive to this drug. Thus, the castor oil metabolite ricinoleic acid activates intestinal and uterine smooth-muscle cells via EP(3) prostanoid receptors. These findings identify the cellular and molecular mechanism underlying the pharmacological effects of castor oil and indicate a role of the EP(3) receptor as a target to induce laxative effects.

  14. Prevalence of surreptitious laxative abuse in patients with diarrhoea of uncertain origin: a cost benefit analysis of a screening procedure.

    PubMed Central

    Bytzer, P; Stokholm, M; Andersen, I; Klitgaard, N A; Schaffalitzky de Muckadell, O B

    1989-01-01

    The costs and medical benefits of an early, routine laxative screening test in patients with diarrhoea of uncertain origin was evaluated. During a two year period 200 consecutive, unselected patients complaining of diarrhoea were considered for the study in whom a three day faecal collection was undertaken. Fifty four patients denying laxative consumption had diarrhoea (mean daily stool weight greater than 200 g) of uncertain origin at their initial visit of whom 47 were screened to detect ingestion of anthraquinones, bisacodyl, phenolphthalein, and magnesium salts. Seven patients had positive tests. No single clinical feature could have predicted the outcome of the test. The possible cost savings of the programme were estimated by not releasing the results of the test to the clinicians until the patient's investigations were complete. The seven patients with laxative abuse spent a total of 35 days in hospital and were seen on 29 occasions in the outpatient clinic after the laxative screening test was positive. The cost of the screening programme was cheaper than the costs of the diagnostic procedures in patients with laxative abuse. We recommend the use of a comprehensive, early laxative screening programme in all patients with diarrhoea of uncertain origin as a cost effective procedure. PMID:2511089

  15. 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.

  16. Laxative effects of agarwood on low-fiber diet-induced constipation in rats

    PubMed Central

    2010-01-01

    Background Agarwood (Aquilaria sinensis), well known as incense in Southeast Asia, has been used as a digestive in traditional medicine. We investigated the laxative effects of an ethanol extract of agarwood leaves (EEA) in a rat model of low-fiber diet-induced constipation. Methods A set of rats was bred on a normal diet while another set was placed on a low-fiber diet to induce constipation. The laxative effect of agarwood was then investigated on both sets of rats. Results Pretreatment of normal rats with single dose of EEA (600 mg/kg, p.o.) significantly increased frequency and weight of stools. Also, treatments with EEA (300 and 600 mg/kg, p.o.) for 14 days caused a significant increase in stool frequency and weight. Feeding of the animals with a low-fiber diet resulted in a decrease in stool weight, frequency, and water content and also delayed carmine egestion. A single treatment with EEA (600 mg/kg) or senna (150 and 300 mg/kg) significantly increased stool frequency, weight, and water content and also accelerated carmine egestion in the model rats. Once daily administrations of EEA (150 mg/kg), for 14 days, caused a significant increase in water content of stools. The higher doses of EEA (300 and 600 mg/kg) significantly increased frequency, weight, and water content of the stools while accelerating carmine egestion in the constipated rats. Senna (150 and 300 mg/kg) produced similar effect as the higher doses of EEA but, in addition, induced severe diarrhea. Conclusion These findings indicate that EEA has a laxative effect, without causing diarrhea, in a rat model of low-fiber diet-induced constipation. These findings suggest that EEA may be highly effective on constipation as a complementary medicine in humans suffering from life style-induced constipation. PMID:21078136

  17. Fermented Fiber Supplements Are No Better Than Placebo for a Laxative Effect.

    PubMed

    McRorie, Johnson W; Chey, William D

    2016-11-01

    Misconceptions about the effects of dietary fiber and 'functional' fiber on stool parameters and constipation persist in the literature. A comprehensive literature review was conducted with the use of the Scopus and PubMed scientific databases to identify and objectively assess well-controlled clinical studies that evaluated the effects of fiber on stool parameters and constipation. The totality of well-controlled randomized clinical studies show that, to exert a laxative effect, fiber must: (1) resist fermentation to remain intact throughout the large bowel and present in stool, and (2) significantly increase stool water content and stool output, resulting in soft/bulky/easy-to-pass stools. Poorly fermented insoluble fiber (e.g., wheat bran) remains as discreet particles which can mechanically irritate the gut mucosa, stimulating water & mucous secretion if the particles are sufficiently large/coarse. For soluble fibers, some have no effect on viscosity (e.g., inulin, wheat dextrin) while others form high viscosity gels (e.g., β-glucan, psyllium). If the soluble fiber is readily fermented, whether non-viscous or gel-forming, it has no effect on stool output or stool water content, and has no laxative effect. In contrast, a non-fermented, gel-forming soluble fiber (e.g., psyllium) retains its gelled nature and high water-holding capacity throughout the large bowel, resulting in soft/bulky/easy-to-pass stools. When considering a recommendation for a fiber supplement regimen to treat and/or prevent constipation, it is important to consider which fibers have the physical characteristics to exert a laxative effect, and which fiber supplements have rigorous clinical evidence of a significant benefit in patients with constipation.

  18. Prokinetic and laxative effects of the crude methanolic extract of Viola betonicifolia whole plant in rodents.

    PubMed

    Muhammad, Naveed; Rehman, Najeeb ur; Khan, Haroon; Saeed, Muhammad; Gilani, Anwarul-Hassan

    2013-03-27

    The present study was aimed to provide ethnopharmacological basis for the medicinal use of Viola betonicifolia whole plant in indigestion and constipation. Mice were used in in-vivo prokinetic and laxative studies while in-vitro experiments were conducted on isolated tissues of rabbit and guinea-pig gut preparations suspended in a tissue bath to measure isotonic contractions. The crude methanolic extract of Viola betonicifolia (VBME) showed partially atropine-sensitive prokinetic (50 and 100 mg/kg) and laxative (30 and 100 mg/kg) activities in mice. When tested in isolated rabbit jejunum and guinea-pig ileum, VBME caused dose-dependent contractions at 0.01-0.3 mg/mL and 0.03-5 mg/mL, respectively. The spasmogenic effect was partially sensitive to atropine, while the presence of pyrilamine, SB203186 or hexamethonium had no effect in both gut preparations. VBME partially inhibited acetylcholinesterase enzyme (19%) in the in-vitro assay. The spasmodic effect of VBME was more efficacious in guinea-pig ileum than rabbit jejunum preparation. The phytochemical analysis of the crude methanolic extract for total alkaloids and saponins revealed that the VBME is a rich source of alkaloids and saponins. This study showed the prokinetic and laxative effects of Viola betonicifolia in mice, partially mediated through cholinergic action. The in-vitro spasmodic effect of the plant extract was also partially sensitive to atropine indicating more than one mechanisms in the gut stimulant effect. This study provides a rationale for the medicinal use of Viola betonicifolia in indigestion and constipation.

  19. Laxative overdose

    MedlinePlus

    ... Gastrointestinal and Liver Disease. 8th ed. Philadelphia, PA: Elsevier Saunders; 2006:chap 8. Pfennig CL, Slovis CM. ... Concepts and Clinical Practice. 8th ed. Philadelphia, PA: Elsevier Saunders; 2014:chap 125. Schwaab JL, Bravender T, ...

  20. THE BASIC DATA FOR RESIDENTS AGED 15 YEARS OR YOUNGER WHO RECEIVED A COMPREHENSIVE HEALTH CHECK IN 2011-2012 AS A PART OF THE FUKUSHIMA HEALTH MANAGEMENT SURVEY AFTER THE GREAT EAST JAPAN EARTHQUAKE.

    PubMed

    Kawasaki, Yukihiko; Hosoya, Mitsuaki; Yasumura, Seiji; Ohira, Tetsuya; Satoh, Hiroaki; Suzuki, Hitoshi; Sakai, Akira; Ohtsuru, Akira; Takahashi, Atsushi; Ozasa, Kotaro; Kobashi, Gen; Kamiya, Kenji; Yamashita, Shunichi; Abe, Masafumi

    2015-01-01

    To assist in the long-term health management of residents and evaluate the health impacts after the Tokyo Electric Power Company's Fukushima Daiichi Nuclear Power Plant accident in Fukushima Prefecture, the Fukushima prefectural government decided to implement the Fukushima Health Management Survey. This report describes the results for residents aged 15 years or younger who received health checks and evaluates the data obtained from 2011 and 2012. The target group consisted of residents aged 15 years or younger who had lived in the evacuation zone. The health checks were performed on receipt of an application from any of the residents. The checks, which included the measurements of height, weight, blood pressure, biochemical laboratory findings, and peripheral blood findings, were performed as required. 1) A total of 17,934 (64.5%) and 11,780 (43.5%) residents aged 15 years or younger received health checks in 2011 and 2012, respectively. 2) In both years, a number of male and female residents in the 7-15 year age group were found to suffer from obesity, hyperlipidemia, hyperuricemia, or liver dysfunction. Furthermore, pediatric aged 15 years or younger were commonly observed to suffer from hypertension or glucose metabolic abnormalities. 3) A comparison of data from 2012 and 2011 demonstrated that both males and females frequently showed increased body height and decreased body weight in 2012. The prevalence of hypertension, glucose metabolic abnormalities, or high γ-GTP values in males and females in the 7-15 year age group in 2012 was lower than that in 2011. However, the prevalence of hyperuricemia among residents in the 7-15 year age group was higher in 2012 than in 2011. These results suggested that some residents aged 15 years or under who had lived in the evacuation zone had developed obesity, hyperlipidemia, hyperuricemia, liver dysfunction, hypertension, or glucose metabolic abnormalities. Therefore, we think that it is necessary to continue the health

  1. THE BASIC DATA FOR RESIDENTS AGED 15 YEARS OR YOUNGER WHO RECEIVED A COMPREHENSIVE HEALTH CHECK IN 2011-2012 AS A PART OF THE FUKUSHIMA HEALTH MANAGEMENT SURVEY AFTER THE GREAT EAST JAPAN EARTHQUAKE

    PubMed Central

    KAWASAKI, YUKIHIKO; HOSOYA, MITSUAKI; YASUMURA, SEIJI; OHIRA, TETSUYA; SATOH, HIROAKI; SUZUKI, HITOSHI; SAKAI, AKIRA; OHTSURU, AKIRA; TAKAHASHI, ATSUSHI; OZASA, KOTARO; KOBASHI, GEN; KAMIYA, KENJI; YAMASHITA, SHUNICHI; ABE, MASAFUMI

    2015-01-01

    ABSTRACT Aim: To assist in the long-term health management of residents and evaluate the health impacts after the Tokyo Electric Power Company’s Fukushima Daiichi Nuclear Power Plant accident in Fukushima Prefecture, the Fukushima prefectural government decided to implement the Fukushima Health Management Survey. This report describes the results for residents aged 15 years or younger who received health checks and evaluates the data obtained from 2011 and 2012. Methods: The target group consisted of residents aged 15 years or younger who had lived in the evacuation zone. The health checks were performed on receipt of an application from any of the residents. The checks, which included the measurements of height, weight, blood pressure, biochemical laboratory findings, and peripheral blood findings, were performed as required. Results: 1) A total of 17,934 (64.5%) and 11,780 (43.5%) residents aged 15 years or younger received health checks in 2011 and 2012, respectively. 2) In both years, a number of male and female residents in the 7-15 year age group were found to suffer from obesity, hyperlipidemia, hyperuricemia, or liver dysfunction. Furthermore, pediatric aged 15 years or younger were commonly observed to suffer from hypertension or glucose metabolic abnormalities. 3) A comparison of data from 2012 and 2011 demonstrated that both males and females frequently showed increased body height and decreased body weight in 2012. The prevalence of hypertension, glucose metabolic abnormalities, or high γ-GTP values in males and females in the 7-15 year age group in 2012 was lower than that in 2011. However, the prevalence of hyperuricemia among residents in the 7-15 year age group was higher in 2012 than in 2011. Conclusions: These results suggested that some residents aged 15 years or under who had lived in the evacuation zone had developed obesity, hyperlipidemia, hyperuricemia, liver dysfunction, hypertension, or glucose metabolic abnormalities. Therefore, we

  2. Agarwood induced laxative effects via acetylcholine receptors on loperamide-induced constipation in mice.

    PubMed

    Kakino, Mamoru; Izuta, Hiroshi; Ito, Tetsuro; Tsuruma, Kazuhiro; Araki, Yoko; Shimazawa, Masamitsu; Oyama, Masayoshi; Iinuma, Munekazu; Hara, Hideaki

    2010-01-01

    Agarwood (Aquilaria sinensis, Aquilaria crasna) is well known as an incense in the oriental region such as Thailand, Taiwan, and Cambodia, and is used as a digestive in traditional medicine. We investigated the laxative effects and mechanism of agarwood leaves extracted with ethanol (EEA-1, Aquilaria sinensis; EEA-2, Aquilaria crasna). EEA-1, EEA-2, the main constituents of EEAs (mangiferin, and genkwanin-5-O-primeveroside), and senna increased the frequency and weight of stools in loperamide-induced constipation model mice. EEA-1 and EEA-2 did not induce diarrhea as a side effect, but senna induced severe diarrhea. EEA-1 and senna increased gastro-intestinal (GI) transit in the model mice. EEA-1, but not senna, also increased the intestinal tension of isolated jejunum and ileum in guinea pigs, and the tension increase was blocked by atropine, a muscarinic receptor antagonist, but not by other inhibitors (granicetron, pyrilamine, or bradykinin-antagonist peptide). Furthermore, the increase in frequency and weight of stools induced by EEA-1 were blocked by pre-administration of atropine in the model mice. These findings indicate that EEAs exerted a laxative effect via acetylcholine receptors in the mouse constipation model.

  3. Does the use of glycerin laxatives decrease feeding intolerance in preterm infants?

    PubMed

    Shah, Vibhuti; Chirinian, Nevart; Lee, Shoo

    2011-11-01

    Glycerin laxatives are often prescribed in the neonatal population for meconium evacuation and to promote enteral feeding. However, the literature regarding their effectiveness has not been systematically reviewed. To assess the effectiveness of glycerin enema or suppository in preventing feeding intolerance in preterm infants at ≤32 weeks' gestational age or weighing ≤1500 g at birth. The Medline, Embase, Cochrane Library, Scopus and Web of Science databases were searched to identify studies that evaluated glycerin enemas/suppositories for feeding intolerance. Using the Evidence Evaluation Worksheet adapted from the American Heart Association's International Liaison Committee on Resuscitation, eligible studies were scored for quality, level of evidence and direction of support. Two clinical studies that evaluated meconium evacuation and feeding intolerance were included. One study showed no difference in the time to complete meconium evacuation or establishment of full enteral feeds, while the other showed that the times to first meconium passage and full enteral feeding were significantly shorter, and the rate of sepsis was lower in the glycerin enema group. The evidence regarding the effectiveness of glycerin laxatives for improving feeding tolerance is inconclusive in infants at ≤32 weeks' gestational age or weighing ≤1500 g at birth.

  4. CT colonography: patient tolerance of laxative free fecal tagging regimen versus traditional cathartic cleansing.

    PubMed

    Buccicardi, Duccio; Grosso, Massimo; Caviglia, Ilaria; Gastaldo, Alessandro; Carbone, Sabrina; Neri, Emanuele; Bartolozzi, Carlo; Quadri, Piergiorgio

    2011-10-01

    The aim of our prospective study was to compare patient tolerance of laxative free fecal tagging regimen (LFT) versus traditional cathartic cleansing (TC). 264 patients, at average risk for development of colorectal cancer (105 men and 159 women; mean age 62 years ± 5 SD), underwent 32 rows CT colonography. Patients were alternatively placed into 2 study groups: Group 1 (n = 132) followed TC and Group 2 (n = 132) LFT. TC protocol consisted of no fiber diet and Phospho-lax(®) 80 mL in 2 L of water the day before imaging. LFT protocol consisted of no fiber diet and ingestion with meals of 30 mL of water-soluble iodinated contrast agent (Gastrografin(®)) for 2 days before imaging. No frank laxative drugs were administered. All studies were reviewed in a combined fashion, primary 2D followed by 3D endoluminal and dissected views. After the examination all patients were asked to provide a feedback about tolerance to the each bowel preparation. The first 30 patients of each group were also investigated with optical colonoscopy (OC) used as gold standard to confirm our diagnosis (Group 1* and Group 2*). LFT reduces discomfort and seems to improve diagnostic accuracy of CTC.

  5. Does the use of glycerin laxatives decrease feeding intolerance in preterm infants?

    PubMed Central

    Shah, Vibhuti; Chirinian, Nevart; Lee, Shoo

    2011-01-01

    BACKGROUND: Glycerin laxatives are often prescribed in the neonatal population for meconium evacuation and to promote enteral feeding. However, the literature regarding their effectiveness has not been systematically reviewed. OBJECTIVE: To assess the effectiveness of glycerin enema or suppository in preventing feeding intolerance in preterm infants at ≤32 weeks’ gestational age or weighing ≤1500 g at birth. METHODS: The Medline, Embase, Cochrane Library, Scopus and Web of Science databases were searched to identify studies that evaluated glycerin enemas/suppositories for feeding intolerance. Using the Evidence Evaluation Worksheet adapted from the American Heart Association’s International Liaison Committee on Resuscitation, eligible studies were scored for quality, level of evidence and direction of support. RESULTS: Two clinical studies that evaluated meconium evacuation and feeding intolerance were included. One study showed no difference in the time to complete meconium evacuation or establishment of full enteral feeds, while the other showed that the times to first meconium passage and full enteral feeding were significantly shorter, and the rate of sepsis was lower in the glycerin enema group. CONCLUSION: The evidence regarding the effectiveness of glycerin laxatives for improving feeding tolerance is inconclusive in infants at ≤32 weeks’ gestational age or weighing ≤1500 g at birth. PMID:23115504

  6. Studies on prokinetic, laxative and spasmodic activities of Phyllanthus emblica in experimental animals.

    PubMed

    Mehmood, Malik Hassan; Rehman, Abdul; Rehman, Najeeb-Ur; Gilani, Anwarul-Hassan

    2013-07-01

    This study was aimed to provide pharmacological basis for the medicinal use of Phyllanthus emblica fruit in indigestion and constipation using the in-vivo and in-vitro assays. The crude extract of the dried fruits of Phyllanthus emblica (Pe.Cr) and its fractions were tested positive for alkaloids, saponins, tannins, terpenes, flavonoids, sterols and coumarins. Pe.Cr at the doses of 100 and 300 mg/kg exhibited the prokinetic and laxative activities in mice, which were found partially sensitive to atropine. In isolated guinea-pig ileum and rabbit jejunum, the crude extract and its aqueous fraction (Pe.Aq) caused concentration-dependent and partially atropine-sensitive stimulatory effects followed by relaxation at higher tested concentrations, being more efficacious in guinea pig, while more potent in rabbit tissues. The petroleum fraction (0.003-0.1 mg/mL) exhibited fully atropine-sensitive contractions in both guinea-pig and rabbit tissues. However, the ethyl acetate and chloroform fractions (0.003-1.0 mg/mL) showed only spasmolytic activity when studied in spontaneously contracting rabbit jejunum. This study showed that the Phyllanthus emblica possesses prokinetic and laxative activities in mice along with spasmodic effect in the isolated tissues of guinea pig and rabbit, mediated partially through activation of muscarinic receptors; thus, this study provides a rationale for the medicinal use of Phyllanthus emblica fruits in indigestion and constipation.

  7. Species and tissue-specificity of prokinetic, laxative and spasmodic effects of Fumaria parviflora

    PubMed Central

    2012-01-01

    Background Fumaria parviflora Linn. (Fumariaceae), is a small branched annual herb found in many parts of the world including Saudi Arabia and Pakistan. This study was designed to provide pharmacological basis for the medicinal use of Fumaria parviflora in gut motility disorders. Methods The in-vivo prokinetic and laxative assays were conducted in mice. Isolated intestinal preparations (ileum and jejunum) from different animal species (mouse, guinea-pig and rabbit) were separately suspended in tissue baths containing Tyrode's solution bubbled with carbogen and maintained at 37°C. The spasmogenic responses were recorded using isotonic transducers coupled with PowerLab data acquisition system. Results The aqueous-methanol extract of Fumaria parviflora (Fp.Cr), which tested positive for the presence of alkaloids, saponins, tannins and anthraquinones showed partially atropine-sensitive prokinetic and laxative activities in the in-vivo in mice at 30 and 100 mg/kg. In the in-vitro studies, Fp.Cr (0.01-1 mg/ml) caused a concentration-dependent atropine-sensitive stimulatory effect both in mouse tissues (jejunum and ileum), and rabbit jejunum but had no effect in rabbit ileum. In guinea-pig tissues (ileum and jejunum), the crude extract showed a concentration-dependent stimulatory effect with higher efficacy in ileum and the effect was partially blocked by atropine, indicating the involvement of more than one types of gut-stimulant components (atropine-sensitive and insensitive). This could be a plausible reason for the greater efficacy of Fp.Cr in gut preparations of guinea-pig than in rabbit or mouse. Conclusions This study shows the prokinetic, laxative and spasmodic effects of the plant extract partially mediated through cholinergic pathways with species and tissue-selectivity, and provides a sound rationale for the medicinal use of Fumaria parviflora in gut motility disorders such as, indigestion and constipation. This study also suggests using different species to

  8. Use of Pharmacist Consultations for Nonprescription Laxatives in Japan: An Online Survey.

    PubMed

    Shibata, Keita; Matsumoto, Arisa; Nakagawa, Ayumi; Akagawa, Keiko; Nakamura, Akihiro; Yamamoto, Toshinori; Kurata, Naomi

    2016-01-01

    Community pharmacies in Japan have long been advocated as effective sources of nonprescription medicines and health-related advice. Consumers sometimes self-treat symptoms of minor illnesses without consulting a pharmacist because the benefits of such consultations are not adequately recognized. The aim of this study was to investigate the use and impact of pharmacist consultations before purchase of nonprescription laxatives. An online survey was conducted July 14-22, 2012 with 500 respondents (250 men, 250 women), ranging 20-60 years old. All participants had purchased nonprescription laxatives for constipation within the past year. Stratified analysis was used to compare responses in groups that had and had not consulted a pharmacist before purchase. Consulting a pharmacist appears to improve consumers' awareness and makes them more likely to use appropriate medication. Those who consulted a pharmacist were better able to identify side effects and take appropriate action than the group that did not consult the pharmacist. Those who consulted a pharmacist were also significantly more likely to say that they would consult a pharmacist in the future. These results indicate that it is important for consumers to be able to consult with pharmacists, to improve consumers' awareness of side effects and to self-medicate appropriately, and hence improve their quality of life. Pharmacists in community pharmacy could be more active in health promotion campaigns, such as drug safety, campaigns, to raise their public profile. Increased public awareness of what pharmacists in community pharmacy do will make it easier for patients to consult with them.

  9. A feasibility study on laxative-free bowel preparation for virtual colonoscopy

    NASA Astrophysics Data System (ADS)

    Liang, Zhengrong; Chen, Dongqing; Wax, Mark; Lakare, Sarang; Li, Lihong; Anderson, Joseph; Kaufman, Arie; Harrington, Donald

    2005-04-01

    Objective: To investigate the feasibility of laxative-free bowel preparation to relieve the patient stress in colon cleansing for virtual colonoscopy. Materials and Methods: Three different bowel-preparation protocols were investigated by 60 study cases from 35 healthy male volunteers. All the protocols utilize low-residue diet for two days and differ in diet for the third day - the day just prior to image acquisition in the fourth day morning. Protocol Diet-1 utilizes fluid or liquid diet in the third day, Diet-2 utilizes a food kit, and Diet-3 remains the low-residue diet. Oral contrast of barium sulfate (2.1%, 250 ml) was added respectively to the dinner in the second day and the three meals in the third day. Two doses of MD-Gastroview (60 ml) were ingested each in the evening of the third day and in the morning before image acquisition. Images were acquired by a single-slice detector spiral CT (computed tomography) scanner with 5 mm collimation, 1 mm reconstruction, 1.5-2.0:1.0 pitch, 100-150 mA, and 120 kVp after the colons were inflated by CO2. The contrasted colonic residue materials were electronically removed from the CT images by specialized computer-segmentation algorithms. Results: By assumptions that the healthy young volunteers have no polyp and the image resolution is approximately 4 mm, a successful electronic cleansing is defined as "no more than five false positives and no removal of a colon fold part greater than 4 mm" for each study case. The successful rate is 100% for protocol Diet-1, 77% for Diet-2 and 57% for Diet-3. Conclusion: A laxative-free bowel preparation is feasible for virtual colonoscopy.

  10. Influence of laxatives on gastric emptying in healthy warmblood horses evaluated with the acetaminophen absorption test.

    PubMed

    Snyder, Alice; Koeller, Gábor; Seiwert, Bettina; Abraham, Getu; Schusser, Gerald Fritz

    2014-01-01

    The use of laxatives is crucial in the treatment of horses with caecal or large colon impaction.To reach the large intestinal contents and resolve the impaction, laxatives must leave the stomach and pass through the small intestine.The aim of this study was to prove whether isotonic solutions of saline cathartics do not affect gastric emptying rate in contrast to hypertonic solutions. Six, fasted, healthy, adult Warmblood horses were used in a randomized study design with 1.8% sodium sulfate (1.8% Na2SO4), 4.2% magnesium sulfate (4.2% MgSO4), 25% sodium sulfate (25% Na2SO4), 25% magnesium sulfate (25% MgSO4) and water at either 20 ml/kg BW (Water 20) or 4 ml/kg BW (Water 4), administered via nasogastric intubation. For indirect measurement of liquid-phase gastric emptying, the liquid-phase passage marker acetaminophen (20 mg/kg BW in 200 ml water) was added to each trial. Serum samples were collected at predetermined time points for pharmacokinetic analysis. The time to reach maximum serum concentration (Tmax) was considered as gastric emptying rate. Compared to Water 4, Tmax of 25% Na2SO4 and 25% MgSO4 was reached significantly later, the maximum serum concentration (Cmax) of acetaminophen was significantly lower and the area under the curve determined up to 90 min (AUC90) was significantly smaller. Isotonic solutions of saline cathartics (1.8% Na2SO4, 4.2% MgSO4) did not influence the gastric emptying rate. Hypertonic solutions of saline cathartics (25% Na2SO4, 25% MgSO4) significantly delayed the gastric emptying rate.

  11. Determination of diuretics and laxatives as adulterants in herbal formulations for weight loss.

    PubMed

    Moreira, Ana Paula Lançanova; Motta, Monique Jung; Dal Molin, Thaís Ramos; Viana, Carine; de Carvalho, Leandro Machado

    2013-01-01

    A new method is described for the determination of the most common diuretic and laxative adulterants found in formulations of anorexics and antidepressants. The method is based on the separation of furosemide, hydrochlorothiazide, chlorthalidone and amiloride (diuretics), phenolphthalein (laxative), amfepramone (anorexic) and fluoxetine and paroxetine (antidepressants) by capillary zone electrophoresis with capacitively coupled contactless conductivity detection. The method showed a precision ranging from 1.9% to 6.9% for a concentration of 25 mg/L, 0.6% to 5.3% for a concentration of 50 mg/L and 1.6% to 6.0% for a concentration of 100 mg/L for all analytes. The accuracy was 99% for amiloride, 102% for chlorthalidone, 101% for hydrochlorothiazide, 101% for furosemide, 94% for phenolphthalein, 105% for fluoxetine, 114% for paroxetine and 117% for amfepramone. The method allowed the drugs to be determined in the formulations at concentrations higher than 5.1 mg/kg for amiloride, 7.7 mg/kg for chlorthalidone, 6.8 mg/kg for hydrochlorothiazide, 10.7 mg/kg for furosemide, 8.4 mg/kg for phenolphthalein, 11.0 mg/kg for fluoxetine, 9.4 mg/kg for paroxetine and 11.0 mg/kg for amfepramone. Three of the 26 analysed herbal formulations were found to be adulterated (not declared on the label) with the diuretic hydrochlorothiazide. Five other samples contained diuretics declared on the label on the formulation. Thus, a total of eight samples, which were marketed as natural products, contained diuretics (declared or not) on the formulation.

  12. Intermediate bioelectrolyte changes after phospho-soda or polyethylene glycol precolonoscopic laxatives in a population undergoing health examinations.

    PubMed

    Kan, Wei-Chih; Wang, Hsien-Yi; Chien, Chih-Chiang; Tan, Che-Kim; Lin, Ching-Yih; Su, Shih-Bin

    2012-02-01

    Colonoscopy is a common procedure for diagnosing and screening colon cancer and other bowel-related diseases. Many studies have pointed out that using phospho-soda as a bowel preparation can cause obvious electrolyte abnormalities or acute kidney injury. Nonetheless, there are few studies related to its prevalence and risk factors in the population undergoing health examinations. Our aim was to compare the biochemical and electrolyte changes after using two commonly used bowel preparation regimens in this population. In this retrospective study, we collected data about participants who, before a screening colonoscopy, used oral phospho-soda laxatives in 2006, and those who used polyethylene glycol-based laxatives in 2005. Several serum biochemical and electrolyte profiles were compared between the two groups. Additional risk factors of hyperphosphatemia, a well-known side effect of phospho-soda, were also derived. We enrolled a total of 2270 participants (1321 in 2005; 1449 in 2006). The basic demographic data of the two groups were not statistically different. Nonetheless, between the two groups, some serum biochemical and electrolytic data differed significantly: in those using oral phospho-soda laxatives, we found a higher prevalence of hyperuricemia, hypocalcemia, hypokalemia, hypernatremia and hyperphosphatemia. Further analyses showed that using oral phospho-soda laxatives was a risk factor for hyperphosphatemia; conversely, being male was a protective factor. Oral phospho-soda laxatives indeed influence the biochemical and electrolyte profiles of persons undergoing health examinations. One should be careful when interpreting bioelectrolytic data while using phospho-soda as a bowel preparation.

  13. Select mortality and cancer incidence among residents in various U.S. communities that received asbestos-contaminated vermiculite ore from Libby, Montana.

    PubMed

    Horton, D Kevin; Bove, Frank; Kapil, Vikas

    2008-06-01

    In response to the significantly elevated asbestosis mortality rates found in Libby, Montana, in 2000, this analysis evaluated whether other communities throughout the United States that received asbestos-contaminated vermiculite ore from Libby experienced similar excess rates of asbestos-related diseases. Standardized mortality ratios were calculated using state death certificates, and standardized incidence ratios were calculated using cancer registry records for populations living near facilities that processed or received Libby vermiculite. This analysis focused primarily on diseases that are directly associated with asbestos exposure (e.g., asbestosis; cancer of the peritoneum, retroperitoneum, and pleura, including mesothelioma; and mesothelioma). Lung cancer and cancers of the digestive system, also associated with asbestos exposure, were not included in the analysis because they have additional risk factors for which exposure information was not available. Data from 70 unique sites in 23 states were evaluated. No statistically significant excesses of asbestosis mortality similar to those in Libby were noted; however, 11 sites (plus a state with 6 pooled sites that were counted as 1 site) had excess rates of mesothelioma and cancer of the peritoneum, retroperitoneum, and pleura. Further investigation should be conducted at these sites with excess rates of mesothelioma and cancer of the peritoneum, retroperitoneum, and pleura by participating state health departments to determine whether exposure to Libby vermiculite might have been a contributing factor.

  14. Random control trial of hot compresses for women those who used laxatives on severity of constipation and quality of life.

    PubMed

    Kira, Izumi

    2016-01-01

    The purpose of this study was to determine the effectiveness of hot compresses for constipation and quality of life (QOL), with a focus on taking laxatives. Meeting the inclusion criteria were 60 women, who had taken over-the-counter laxatives for constipation. Sixty women were randomly assigned to either the intervention (n = 30) or control (n = 30) group. The study period was 4 weeks: the first 2 weeks (baseline) without intervention and the last 2 weeks (intervention) with heat stimulus using a commercially available thermic sheet (40°C). Women affixed the sheet to the lumbar area with the Jacoby line in the center immediately after waking and were instructed to remove the sheet after 5 h during the intervention period every day. During the intervention, women recorded their daily defecation and completed the Constipation Assessment Scale (CAS), Constipation QOL 15 (CQ), and 36 Item Short Form Survey. The author excluded incomplete records and study protocol deviations; as a result, a total of 39 subjects (21 hot compresses group, 18 control group) was used for the analysis. Significant improvement was seen in days of defecation and the number of defecations per week for the intervention group. Significant improvement was also seen in physical and psychological subcategory of CQ15. No significant differences were found in the amount of laxatives used. The lumbar application of a 40°C hot compresses in female adults with constipation improved their conditions of defecation and QOL, even though it did not reduce the amount of laxatives. © 2015 Japan Academy of Nursing Science.

  15. A cross-sectional study of constipation and laxative use in advanced cancer patients: insights for revision of current practice.

    PubMed

    Cheng, Chung Wah; Kwok, Annie Ol; Bian, Zhao Xiang; Tse, Doris Mw

    2013-01-01

    This study aimed to evaluate the bowel habit and laxative use in advanced cancer patients with constipation in palliative care unit. It was a cross-sectional study using a self-designed questionnaire. A total of 225 patients were analysed. Among all patients, 92.0 % (207 patients) had any intervention for relief of constipation, including laxatives, suppositories, enemas, digital evacuation and Chinese herbal medicine, and 65.3 % (147 patients) were on laxatives prescribed by our doctors. The severity of constipation as assessed by the constipation visual analogue scale (CVAS) (0-7, 7 = most severe) was reported as no constipation (0-1) in 19.6 % of patients, constipation (2-4) in 50.7 % and severe constipation (5-7) in 29.8 %. More patients with severe constipation, as compared with patients with constipation and no constipation, reported inadequate pushing force (83.6 vs. 47.4 vs. 6.8 %), sense of incomplete defecation (40.3 vs. 14.9 vs. 6.8 %) and difficult defecation (58.2 vs. 26.3 vs. 0 %), all p < 0.001, but there was no difference in stool types as assessed by Bristol Stool Scale (p = 0.303). Patients not on opioids, as compared with patients on strong opioids, had similar CVAS scores and description of constipation but had least laxatives prescribed (60.2 vs. 78.9 %, p = 0.012). Evaluation of constipation should not rely on stool form or consistency alone, and patient's description of constipation is worth consideration. Constipation is also a problem in patients not on opioids and more attention is required. A revisit to existing guidelines is needed.

  16. Effects of laxative and N-acetylcysteine on mucus accumulation, bacterial load, transit, and inflammation in the cystic fibrosis mouse small intestine.

    PubMed

    De Lisle, Robert C; Roach, Eileen; Jansson, Kyle

    2007-09-01

    The accumulation of mucus in affected organs is characteristic of cystic fibrosis (CF). The CF mouse small intestine has dramatic mucus accumulation and exhibits slower interdigestive intestinal transit. These factors are proposed to play cooperative roles that foster small intestinal bacterial overgrowth (SIBO) and contribute to the innate immune response of the CF intestine. It was hypothesized that decreasing the mucus accumulation would reduce SIBO and might improve other aspects of the CF intestinal phenotype. To test this, solid chow-fed CF mice were treated with an osmotic laxative to improve gut hydration or liquid-fed mice were treated orally with N-acetylcysteine (NAC) to break mucin disulfide bonds. Treatment with laxative or NAC reduced mucus accumulation by 43% and 50%, respectively, as measured histologically as dilation of the intestinal crypts. Laxative and NAC also reduced bacterial overgrowth in the CF intestine by 92% and 63%, respectively. Treatment with laxative normalized small intestinal transit in CF mice, whereas NAC did not. The expression of innate immune response-related genes was significantly reduced in laxative-treated CF mice, whereas there was no significant effect in NAC-treated CF mice. In summary, laxative and NAC treatments of CF mice reduced mucus accumulation to a similar extent, but laxative was more effective than NAC at reducing bacterial load. Eradication of bacterial overgrowth by laxative treatment was associated with normalized intestinal transit and a reduction in the innate immune response. These results suggest that both mucus accumulation and slowed interdigestive small intestinal transit contribute to SIBO in the CF intestine.

  17. Laxative effects of partially defatted flaxseed meal on normal and experimental constipated mice.

    PubMed

    Xu, Jiqu; Zhou, Xiaoqi; Chen, Chang; Deng, Qianchun; Huang, Qingde; Yang, Jin'e; Yang, Nianhong; Huang, Fenghong

    2012-03-09

    Constipation is a very common health problem in the world. Intake of sufficient amount of dietary fibers is a cornerstone in the prevention and treatment of constipation. As a traditional medicine, flaxseed has been used to treat constipation for centuries, but the controlled trials are rare. The purpose of the present study was to assess that whether partially defatted flaxseed meal (PDFM) has the potential role to facilitate fecal output in normal and experimental constipated mice. After supplemented with 2.5%, 5% and 10% (w/w) PDFM (L-, M- and H-PDFM) for 14 days, the constipation models of mice were induced by atropine-diphenoxylate. The small intestinal transit rates, start time of defecation, amount of defecation and wet weight of feces were researched in normal and constipation model mice. M- and H-PDFM significantly increase small intestinal transit rates in constipation model mice. All dose of PDFM markedly shortened the start time of defecation and M- and H-PDFM significantly increase stool frequency and weight in both normal and constipation model mice. PDFM may be a useful laxative to facilitate fecal output in normal and constipation conditions.

  18. Laxative and anti-diarrheal activity of polycarbophil in mice and rats.

    PubMed

    Saito, Takaharu; Mizutani, Fujie; Iwanaga, Yuji; Morikawa, Kouji; Kato, Hideo

    2002-06-01

    We investigated the laxative and anti-diarrheal activity of polycarbophil, an insoluble hydrophilic polymer, in comparison with other agents used for treating functional bowel disorder (FBD). In naive rats, polycarbophil (500 mg/kg) increased fecal weight and water contents without producing diarrhea. Carboxymethylcellulose (CMC) did not produce evident changes in bowel movement. Picosulfate markedly produced diarrhea. Loperamide, trimebutine and granisetron decreased stool output dose-dependently. Constipation, indicated by decrease in fecal weight, was produced by loperamide and clonidine in rats. Polycarbophil (500 mg/kg) and CMC increased fecal weight without diarrhea. Conversely trimebutine further decreased fecal weight in constipated rats. Polycarbophil (500 mg/kg) suppressed diarrhea induced by castor oil, and at 250-500 mg/kg, it produced shaped stools in animals with stools loosened by prostaglandin E2, serotonin or carbachol in mice. Polycarbophil (500 mg/kg) also reduced stools in rats with stool output increased by wrap restraint stress (WRS). CMC had no effect in the diarrhea models, except for carbachol-induced diarrhea, and WRS-induced evacuation. Loperamide, trimebutine and granisetron inhibited diarrhea production and WRS-induced evacuation, except for carbachol-induced diarrhea. The results show that polycarbophil prevents constipation and diarrhea without inducing diarrhea or constipation, which is different from the other agents. Hydrophilic polymers such as polycarbophil will be promising agents for the treatment of FBD.

  19. Laxative effects of partially defatted flaxseed meal on normal and experimental constipated mice

    PubMed Central

    2012-01-01

    Background Constipation is a very common health problem in the world. Intake of sufficient amount of dietary fibers is a cornerstone in the prevention and treatment of constipation. As a traditional medicine, flaxseed has been used to treat constipation for centuries, but the controlled trials are rare. The purpose of the present study was to assess that whether partially defatted flaxseed meal (PDFM) has the potential role to facilitate fecal output in normal and experimental constipated mice. Methods After supplemented with 2.5%, 5% and 10% (w/w) PDFM (L-, M- and H -PDFM) for 14 days, the constipation models of mice were induced by atropine-diphenoxylate. The small intestinal transit rates, start time of defecation, amount of defecation and wet weight of feces were researched in normal and constipation model mice. Results M- and H-PDFM significantly increase small intestinal transit rates in constipation model mice. All dose of PDFM markedly shortened the start time of defecation and M- and H-PDFM significantly increase stool frequency and weight in both normal and constipation model mice. Conclusions PDFM may be a useful laxative to facilitate fecal output in normal and constipation conditions. PMID:22400899

  20. Failure of rectal expulsion as a cause of constipation: why fibre and laxatives sometimes fail.

    PubMed

    Turnbull, G K; Lennard-Jones, J E; Bartram, C I

    1986-04-05

    High-fibre diet and laxatives are not always successful in the treatment of severe constipation. In a group of thirteen women with intractable constipation three experimental models of rectal evacuation showed that all had a disorder of defaecation. None could expel 120 ml barium paste as fast or as completely as could ten normal women; six could expel hardly any barium. Only three of the thirteen could expel a balloon containing 50 ml water from the rectum, whereas all of six normal subjects could do so easily. Four of the patients with repeated straining efforts could expel no more than 10% of a 500 ml saline enema, whereas six normal subjects rapidly passed 40-80%. It is postulated that dietary and drug treatment designed to soften and increase the bulk of the stools fails to help some patients because they find it difficult to expel even semi-solid or liquid stool. Electromyography showed that these patients tend to contract rather than relax the striated muscle of the pelvic floor on attempted defaecation. Their failure to defaecate is due to incoordination of the pelvic floor rather than an abnormality of the stool or a disorder of the colon.

  1. Macrogol (polyethylene glycol) laxatives in children with functional constipation and faecal impaction: a systematic review

    PubMed Central

    Candy, D; Belsey, J

    2009-01-01

    As the evidence base supporting the use of laxatives in children is very limited, we undertook an updated systematic review to clarify the issue. A comprehensive literature search was carried out to identify randomised controlled trials of polyethylene glycol (PEG) versus either placebo or active comparator, in patients aged <18 years with primary chronic constipation. Outcomes were assessed as either global assessments of effectiveness or differences in defaecation rates. Seven qualifying studies involving 594 children were identified. Five were comparisons of PEG with lactulose, one with milk of magnesia and one with placebo. Study duration ranged from 2 weeks to 12 months. PEG was significantly more effective than placebo and either equivalent to (two studies) or superior to (four studies) active comparator. Differences in study design precluded meaningful meta-analysis. Lack of high quality studies has meant that the management of childhood constipation has tended to rely on anecdote and empirical treatment choice. Recent publication of well designed randomised trials now permits a more evidence-based approach, with PEG-based treatments having been proven to be effective and well-tolerated first-line treatment. PMID:19019885

  2. Influence of atomic bonds on the properties of the laxative drug sodium picosulphate.

    PubMed

    Romani, Davide; Tonello, Isabel Salas; Brandán, Silvia Antonia

    2016-11-01

    In this work, the influence of the different S═O, S-O, N⋯H, O⋯H, Na⋯O bonds present in the structures of the powerful laxative drug, sodium picosulphate in gas and aqueous solution phases were studied combining the density functional theory (DFT) calculations with the experimental available infrared, (1)H NMR and UV-visible spectra. The structural, topological, electronic and vibrational properties were investigated in both media by using the hybrid B3LYP/6-31G* method and the integral equation formalism variant polarised continuum model (IEFPCM). Here, the characteristics of the S═O, S-O, N⋯H, O⋯H, Na⋯O bonds were completely revealed by using atomic charges, natural bond orbital (NBO) and atoms in molecules (AIM) studies. The infrared, (1)H NMR, (13)C NMR and UV-visible spectra are in reasonable concordance with those experimental available in the literature. The vibrational analysis of sodium picosulphate was performed considering C3V symmetries for both SO4(2-) groups and the complete assignments of the 126 vibration modes were reported in gas phase and aqueous solution together with their corresponding force fields. In addition, the reactivities of sodium picosulfate increase in solution due to their ionic characteristic which probably justifies their behaviour as a stimulant cathartic and their easy metabolic conversion, as reported in the literature.

  3. Non-laxative CT colonography with barium-based faecal tagging: is additional phosphate enema beneficial and well tolerated?

    PubMed

    Davis, W; Nisbet, P; Hare, C; Cooke, P; Taylor, S A

    2011-02-01

    The purpose of this study was to investigate the efficacy and tolerance of an additional phosphate enema prior to non-laxative CT colonography (CTC). 71 patients (mean age 80 years, 28 male, 43 female) underwent non-laxative CTC following 4 oral doses of diluted 2% w/w barium sulphate. Patients were invited to self-administer a phosphate enema 2 h before CTC. An experienced observer graded the volume of retained stool (1 (nil) to 4 (>75% bowel circumference coated)), retained fluid ((1 (nil) to 4 (>50% circumference obscured)), retained stool tagging quality (1 (untagged) to 5 (≥75% to 100%) tagged) and confidence a polyp ≥6 mm could be excluded (yes/no) for each of six colonic segments. Tolerance of the enema was assessed via questionnaire. Data were analysed between those using and not using the enema by Mann-Whitney and Fisher's exact test. 18/71 patients declined the enema. There was no reduction in residual stool volume with enema use compared with non-use either overall (mean score 2.6 vs 2.7, p = 0.76) or in the left colon (mean 2.3 vs 2.4, p = 0.47). Overall tagging quality was no different (mean score 4.4 vs 4.3, p = 0.43). There was significantly more retained left colonic fluid post enema (mean score 1.9 vs 1.1, p<0.0001), and diagnostic confidence in excluding polyps was significantly reduced (exclusion not possible in 35% segments vs 21% without enema, p = 0.006). Of 53 patients, 30 (56%) found the enema straightforward to use, but 4 (8%) found it unpleasant. Phosphate enema use prior to non-laxative CTC leads to greater retained fluid, reducing diagnostic confidence, and is not recommended.

  4. CT colonography: optimisation, diagnostic performance and patient acceptability of reduced-laxative regimens using barium-based faecal tagging

    PubMed Central

    Slater, Andrew; Burling, David N.; Tam, Emily; Greenhalgh, Rebecca; Gartner, Louise; Scarth, Julia; Pearce, Robert; Bassett, Paul; Halligan, Steve

    2007-01-01

    To establish the optimum barium-based reduced-laxative tagging regimen prior to CT colonography (CTC). Ninety-five subjects underwent reduced-laxative (13 g senna/18 g magnesium citrate) CTC prior to same-day colonoscopy and were randomised to one of four tagging regimens using 20 ml 40%w/v barium sulphate: regimen A: four doses, B: three doses, C: three doses plus 220 ml 2.1% barium sulphate, or D: three doses plus 15 ml diatriazoate megluamine. Patient experience was assessed immediately after CTC and 1 week later. Two radiologists graded residual stool (1: none/scattered to 4: >50% circumference) and tagging efficacy for stool (1: untagged to 5: 100% tagged) and fluid (1: untagged, 2: layered, 3: tagged), noting the HU of tagged fluid. Preparation was good (76–94% segments graded 1), although best for regimen D (P = 0.02). Across all regimens, stool tagging quality was high (mean 3.7–4.5) and not significantly different among regimens. The HU of layered tagged fluid was higher for regimens C/D than A/B (P = 0.002). Detection of cancer (n = 2), polyps ≥6 mm (n = 21), and ≤5 mm (n = 72) was 100, 81 and 32% respectively, with only four false positives ≥6 mm. Reduced preparation was tolerated better than full endoscopic preparation by 61%. Reduced-laxative CTC with three doses of 20 ml 40% barium sulphate is as effective as more complex regimens, retaining adequate diagnostic accuracy. PMID:17404739

  5. Correlation between Colon Transit Time Test Value and Initial Maintenance Dose of Laxative in Children with Chronic Functional Constipation.

    PubMed

    Kim, Mock Ryeon; Park, Hye Won; Son, Jae Sung; Lee, Ran; Bae, Sun Hwan

    2016-09-01

    To evaluate the correlation between colon transit time (CTT) test value and initial maintenance dose of polyethylene glycol (PEG) 4000 or lactulose. Of 415 children with chronic functional constipation, 190 were enrolled based on exclusion criteria using the CTT test, defecation diary, and clinical chart. The CTT test was performed with prior disimpaction. The laxative dose for maintenance was determined on the basis of the defecation diary and clinical chart. The Shapiro-Wilk test and Pearson's and Spearman's correlations were used for statistical analysis. The overall group median value and interquartile range of the CTT test was 43.8 (31.8) hours. The average PEG 4000 dose for maintenance in the overall group was 0.68±0.18 g/kg/d; according to age, the dose was 0.73±0.16 g/kg/d (<8 years), 0.53±0.12 g/kg/d (8 to <12 years), and 0.36±0.05 g/kg/d (12 to 15 years). The dose of lactulose was 1.99±0.43 mL/kg/d (<8 years) or 1.26±0.25 mL/kg/d (8 to <12 years). There was no significant correlation between CTT test value and initial dose of laxative, irrespective of the subgroup (encopresis, abnormal CTT test subtype) for either laxative. Even in the largest group (overall, n=109, younger than 8 years and on PEG 4000), the correlation was weak (Pearson's correlation coefficient [R]=0.268, p=0.005). Within the abnormal transit group, subgroup (n=73, younger than 8 years and on PEG 4000) correlation was weak (R=0.267, p=0.022). CTT test value cannot predict the initial maintenance dose of PEG 4000 or lactulose with linear correlation.

  6. Correlation between Colon Transit Time Test Value and Initial Maintenance Dose of Laxative in Children with Chronic Functional Constipation

    PubMed Central

    Kim, Mock Ryeon; Park, Hye Won; Son, Jae Sung; Lee, Ran

    2016-01-01

    Purpose To evaluate the correlation between colon transit time (CTT) test value and initial maintenance dose of polyethylene glycol (PEG) 4000 or lactulose. Methods Of 415 children with chronic functional constipation, 190 were enrolled based on exclusion criteria using the CTT test, defecation diary, and clinical chart. The CTT test was performed with prior disimpaction. The laxative dose for maintenance was determined on the basis of the defecation diary and clinical chart. The Shapiro-Wilk test and Pearson's and Spearman's correlations were used for statistical analysis. Results The overall group median value and interquartile range of the CTT test was 43.8 (31.8) hours. The average PEG 4000 dose for maintenance in the overall group was 0.68±0.18 g/kg/d; according to age, the dose was 0.73±0.16 g/kg/d (<8 years), 0.53±0.12 g/kg/d (8 to <12 years), and 0.36±0.05 g/kg/d (12 to 15 years). The dose of lactulose was 1.99±0.43 mL/kg/d (<8 years) or 1.26±0.25 mL/kg/d (8 to <12 years). There was no significant correlation between CTT test value and initial dose of laxative, irrespective of the subgroup (encopresis, abnormal CTT test subtype) for either laxative. Even in the largest group (overall, n=109, younger than 8 years and on PEG 4000), the correlation was weak (Pearson's correlation coefficient [R]=0.268, p=0.005). Within the abnormal transit group, subgroup (n=73, younger than 8 years and on PEG 4000) correlation was weak (R=0.267, p=0.022). Conclusion CTT test value cannot predict the initial maintenance dose of PEG 4000 or lactulose with linear correlation. PMID:27738600

  7. 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.

  8. Aqueous extracts of Liriope platyphylla induced significant laxative effects on loperamide-induced constipation of SD rats

    PubMed Central

    2013-01-01

    Background Liriope platyphylla has long been reported as a therapeutic drug for treatment of various human chronic diseases including inflammation, diabetes, neurodegenerative disorders, obesity, and atopic dermatitis. To investigate the laxative effects of L. platyphylla, alterations in excretion parameters, histological structure, mucin secretion, and related protein levels were investigated in rats with loperamide (Lop)-induced constipation after treatment with aqueous extract of L. platyphylla (AEtLP). Methods Alterations on constipation phenotypes were measured in rats with Lop-induced constipation after treatment with AEtLP using excretion parameter analysis, histological analysis, RT-PCR, western blot and transmission electron microscope (TEM) analysis. Results The amounts of stool and urine excretion were significantly higher in the Lop + AEtLP-treated group than in the Lop + vehicle-treated group, whereas food intake and water consumption were maintained at constant levels. AEtLP treatment also induced an increase in villus length, crypt layer, and muscle thickness in the constipation model. Total mucin secretion was higher in the Lop + AEtLP-treated group than in the Lop + vehicle-treated group, although mucin secretion per crypt was very similar among all groups. Furthermore, RT-PCR and western blot revealed a dramatic reduction of key factors level on the muscarinic acetylcholine receptors (mAChRs) signaling pathway in the Lop + AEtLP-treated group relative to the Lop + vehicle-treated group. Especially, the accumulation of lipid droplets in enterocytes of crypts following Lop treatment was improved to the level of the No-treated group in response to AEtLP treatment. Conclusion These results suggest that AEtLP improves constipation induced by Lop treatment through an increase in crypt layer and stimulation of lipid droplet secretions. These data are the first to show that the laxative effects of AEtLP are closely related to the

  9. Low-volume hybrid bowel preparation combining saline laxatives with oral contrast agents versus standard polyethylene glycol lavage for colonoscopy.

    PubMed

    Lawrence, Edward M; Pickhardt, Perry J

    2010-08-01

    The aim of this study was to compare the quality of low-volume hybrid computed tomography colonography bowel preparation, using both laxatives and oral contrast, with standard polyethylene glycol lavage. The study group consisted of 300 consecutive adults (mean age, 58.3 years) who underwent colonoscopy immediately after positive computed tomography colonography. Hybrid bowel preparation for study group was <1 L in total volume, consisting of osmotic cathartic (sodium phosphate or magnesium citrate) in conjunction with oral contrast (2% barium and diatrizoate). A control group of 300 adults (mean age, 58.3 years) underwent primary colonoscopy after standard 4-liter polyethylene glycol lavage without oral contrast. The prospective preparation quality rating by the endoscopist served as the reference standard. A rating of poor/marginal was considered inadequate and adequate/good/excellent was considered diagnostic. The frequency of inadequate bowel preparation was 4.3% (13/300) in the study group vs 12.3% (37/300) for the control group (P < .001). Specifically, preparation was poor or marginal in 10 and 3 cases in the hybrid cohort, respectively, and in 29 and 8 cases in the polyethylene glycol cohort, respectively. Preparation quality was scored as excellent in 32% (96/300) in the hybrid cohort and 23.3% (70/300) in the polyethylene glycol cohort (P < .05). At colonoscopy, low-volume laxative-oral contrast hybrid preparations are effective for bowel cleansing, perhaps even more so than polyethylene glycol lavage. Beyond improvements in quality, the low-volume preparation may improve patient compliance and would allow for immediate computed tomography colonography if colonoscopy is incomplete, without the need for additional oral contrast tagging.

  10. Aqueous extracts of Liriope platyphylla induced significant laxative effects on loperamide-induced constipation of SD rats.

    PubMed

    Kim, Ji Eun; Lee, Young Ju; Kwak, Moon Hwa; Ko, Jun; Hong, Jin Tae; Hwang, Dae Youn

    2013-11-26

    Liriope platyphylla has long been reported as a therapeutic drug for treatment of various human chronic diseases including inflammation, diabetes, neurodegenerative disorders, obesity, and atopic dermatitis. To investigate the laxative effects of L. platyphylla, alterations in excretion parameters, histological structure, mucin secretion, and related protein levels were investigated in rats with loperamide (Lop)-induced constipation after treatment with aqueous extract of L. platyphylla (AEtLP). Alterations on constipation phenotypes were measured in rats with Lop-induced constipation after treatment with AEtLP using excretion parameter analysis, histological analysis, RT-PCR, western blot and transmission electron microscope (TEM) analysis. The amounts of stool and urine excretion were significantly higher in the Lop + AEtLP-treated group than in the Lop + vehicle-treated group, whereas food intake and water consumption were maintained at constant levels. AEtLP treatment also induced an increase in villus length, crypt layer, and muscle thickness in the constipation model. Total mucin secretion was higher in the Lop + AEtLP-treated group than in the Lop + vehicle-treated group, although mucin secretion per crypt was very similar among all groups. Furthermore, RT-PCR and western blot revealed a dramatic reduction of key factors level on the muscarinic acetylcholine receptors (mAChRs) signaling pathway in the Lop + AEtLP-treated group relative to the Lop + vehicle-treated group. Especially, the accumulation of lipid droplets in enterocytes of crypts following Lop treatment was improved to the level of the No-treated group in response to AEtLP treatment. These results suggest that AEtLP improves constipation induced by Lop treatment through an increase in crypt layer and stimulation of lipid droplet secretions. These data are the first to show that the laxative effects of AEtLP are closely related to the down-regulation of mAchRs and their downstream signals.

  11. Efficacy and safety of naloxegol in patients with opioid-induced constipation and laxative-inadequate response

    PubMed Central

    Tack, Jan; Lappalainen, Jaakko; Diva, Ulysses; Tummala, Raj

    2015-01-01

    Background Treatment options for patients with opioid-induced constipation (OIC) and inadequate response to laxatives (LIR) are few. Objective Assess the efficacy and safety of orally administered naloxegol in patients with prospectively confirmed OIC and LIR Methods We analyzed pooled data from two identical randomized, double-blind, placebo-controlled, Phase 3 trials of naloxegol in patients with non-cancer pain, OIC and LIR in which naloxegol (12.5 mg, n = 240; 25 mg, n = 241) or placebo (n = 239) were administered daily. We assessed the response rates, time to first post-dose laxation, spontaneous bowel movements (SBMs), OIC symptoms and patient-reported outcomes over 12 weeks. Results OIC response rates for the naloxegol 25-mg (p < 0.001) and the 12.5-mg (p = 0.005) LIR dose groups were higher than placebo. Median times to first post-dose SBM were 7.6, 19.2 and 41.1 hours for the naloxegol 25 mg, naloxegol 12.5 mg and placebo groups, respectively. Other SBM measures, daily symptoms of OIC, and both the Patient Assessment of Constipation - Symptoms and Patient Assessment of Constipation-Quality of Life scores improved from baseline with naloxegol treatment. Changes from baseline in opioid dose, pain scores and opioid withdrawal scores were similar among treatment groups. Conclusions Naloxegol was efficacious, generally safe and well tolerated in the patients with OIC and LIR, while preserving opioid analgesia. ClinicalTrials.gov identifiers: NCT01309841; NCT01323790 PMID:26535126

  12. Bowel Movement Frequency, Laxative Use, and Mortality From Coronary Heart Disease and Stroke Among Japanese Men and Women: The Japan Collaborative Cohort (JACC) Study.

    PubMed

    Kubota, Yasuhiko; Iso, Hiroyasu; Tamakoshi, Akiko

    2016-05-05

    The associations of bowel movement frequency and laxative use with cardiovascular disease (CVD) are unclear. A total of 72 014 subjects (29 668 men and 42 346 women) aged 40 to 79 years, without a history of CVD or cancer, completed a lifestyle questionnaire at baseline between 1988 and 1990 that included information on bowel movement frequency (daily, every 2-3 days, or once every 4 or more days) and laxative use (yes or no), and were followed-up until 2009. During the subjects' 1 165 569 person-years of follow-up, we documented 977 deaths from coronary heart disease (561 men and 416 women), 2024 from total stroke (1028 men and 996 women), 1127 from ischemic stroke (606 men and 521 women), and 828 from hemorrhagic stroke (388 men and 440 women). The prevalence of CVD risk factors, such as diabetes, stress, depression, and physical inactivity, was higher in laxative users and in those with a lower frequency of bowel movements. The multivariable HRs (95% confidence intervals [CIs]) of laxative users were as follows: 1.56 (95% CI, 1.21-2.03) for coronary heart disease and 1.37 (95% CI, 1.07-1.76) for ischemic stroke in men, and 1.27 (95% CI, 1.08-1.49) for total stroke, and 1.45 (95% CI, 1.17-1.79) for ischemic stroke in women. Similar results were observed even after the exclusion of deaths that occurred early in the follow-up period. A significant association between bowel movement frequency and mortality from CVD was not observed. Constipation could be a marker of exposure to CVD risk factors, and laxative use could be a risk factor for mortality from coronary heart disease and ischemic stroke.

  13. CALUTRON RECEIVER

    DOEpatents

    Barnes, S.W.

    1959-06-16

    An improved receiver and receiver mount for calutrons are described. The receiver can be manipulated from outside the tank by a single control to position it with respect to the beam. A door can be operated exteriorly also to prevent undesired portions of the beam from entering the receiver. The receiver has an improved pocket which is more selective in the ions collected. (T.R.H.)

  14. CALUTRON RECEIVER

    DOEpatents

    Brunk, W.O.

    1959-09-29

    A description is given for an improved calutron receiver having a face plate lying at an angle to the direction of the entering ion beams but having an opening, the plane of which is substantially perpendicular to that of the entering ion beams. By so positioning the opening in the receiver, the effective area through which the desired material may enter the receiver is increased, and at the same time the effective area through which containattng material may enter the receiver is reduced.

  15. CALUTRON RECEIVER

    DOEpatents

    York, H.F.

    1959-07-01

    A receiver construction is presented for calutrons having two or more ion sources and an individual receiver unit for each source. Design requirements dictate that the face plate defining the receiver entrance slots be placed at an angle to the approaching beam, which means that ions striking the face plate are likely to be scattcred into the entrance slots of other receivers. According to the present invention, the face plate has a surface provided with parallel ridges so disposed that one side only of each ridge's exposed directly to the ion beam. The scattered ions are directed away from adjacent receivers by the ridges on the lace plate.

  16. 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.

  17. CALUTRON RECEIVERS

    DOEpatents

    Schmidt, F.H.; Stone, K.F.

    1958-09-01

    S>This patent relates to improvements in calutron devices and, more specifically, describes a receiver fer collecting the ion curreot after it is formed into a beam of non-homogeneous isotropic cross-section. The invention embodies a calutron receiver having an ion receiving pocket for separately collecting and retaining ions traveling in a selected portion of the ion beam and anelectrode for intercepting ions traveling in another selected pontion of the ion beam. The electrode is disposed so as to fix the limit of one side of the pontion of the ion beam admitted iato the ion receiving pocket.

  18. School Facilities: Physical Conditions in School Districts Receiving Impact Aid for Students Residing on Indian Lands. Report to the Chairman, Committee on Indian Affairs, U.S. Senate. GAO-10-32

    ERIC Educational Resources Information Center

    Ashby, Cornelia M.; Dorn, Terrell G.

    2009-01-01

    State and local governments spend billions of dollars annually on the construction, renovation, and maintenance of public school facilities, yet concerns persist about the condition of some school facilities, particularly in school districts serving students residing on Indian lands. The Department of Education's (Education) Impact Aid Program…

  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. Synergistic Effect of Fermented Rice Extracts on the Probiotic and Laxative Properties of Yoghurt in Rats with Loperamide-Induced Constipation

    PubMed Central

    Choi, Jae-Suk; Kim, Joo Wan; Kim, Ki-Young; Lee, Jong-Kwang; Sohn, Jae Hak; Ku, Sae-Kwang

    2014-01-01

    Aim. The objective was to evaluate the synergistic effects of fermented rice extracts (FRe) on the laxative and probiotic properties of yoghurt in rats with loperamide-induced constipation. Methods. After constipation induction, yoghurt containing FRe (BFRe; 0.05%, 0.1%, or 1%) was administered orally once per day for 6 days. Results. Loperamide treatment caused marked decreases in fecal pellet numbers and water content discharged, as well as in the surface mucosal thickness of the colonic lumen, intestinal charcoal transit ratio, thickness, and number of mucous-producing goblet cells in the colonic mucosa, whereas it increased the remnant fecal pellet number and the mean diameter of the colonic lumen. However, this loperamide-induced constipation was ameliorated by treatment with FRe, yoghurt single formula, or 0.05%, 0.1%, or 1% BFRe (10 mL/kg). Additionally, the viable numbers of Lactobacillus in the cecal contents and feces were markedly higher than those in constipated rats. Moreover, greater probiotic and laxative effects were detected in BFRe-treated rats than in rats treated with equivalent doses of yoghurt or FRe single formula. Conclusion. The results suggest that addition of FRe to liquid yoghurt will enhance the probiotic and beneficial laxative effects of yoghurt in the digestive tract, without causing side effects. PMID:25214876

  1. Urinary and Fecal Incontinence in Nursing Home Residents

    PubMed Central

    Leung, Felix W.; Schnelle, John F.

    2008-01-01

    Urinary and fecal incontinence (UI, FI) are co-morbid conditions affecting over 50% of nursing home residents. Both forms of incontinence are risk factors for elderly persons to be placed in the nursing home, and such institutionalization itself is a risk factor for developing incontinence. Management should focus on identifying and treating underlying causes, such as detrusor instability, urinary tract infections, diet- or medication-induced diarrhea, constipation and fecal impaction. Despite appropriate management, residents may remain incontinent because of dementia and health or restraint-related immobility. Nursing homes lack the staff and financial resources to provide residents with sufficiently frequent toileting assistance (including prompted voiding). Use of special undergarments and absorbent pads is the usual practice. The article reviews the results of studies that have documented how prompted voiding programs can significantly reduce UI and FI, particularly if the intervention includes dietary and exercise components. Recent systematic anorectal testing of nursing home residents with FI has documented impaired sphincter function (risk factor for FI), decreased rectal sensation and sphincter dyssynergia (risk factor for constipation and impaction). The data suggest that the use of laxatives and stool softeners for prophylaxis against constipation and impaction related to underlying dyssynergia may have produced sufficient fluidity in the stool to predispose the residents with impaired sphincter function to manifest FI. Documentation of non-invasive and efficacious interventions by RCT and the labor costs of implementing these measures can lead to changes in how nursing home care is provided and funded. PMID:18794004

  2. 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.

  3. Laxative treatment with polyethylene glycol decreases microbial primary bile salt dehydroxylation and lipid metabolism in the intestine of rats.

    PubMed

    van der Wulp, Mariëtte Y M; Derrien, Muriel; Stellaard, Frans; Wolters, Henk; Kleerebezem, Michiel; Dekker, Jan; Rings, Edmond H H M; Groen, Albert K; Verkade, Henkjan J

    2013-10-01

    Polyethylene glycol (PEG) is a frequently used osmotic laxative that accelerates gastrointestinal transit. It has remained unclear, however, whether PEG affects intestinal functions. We aimed to determine the effect of PEG treatment on intestinal sterol metabolism. Rats were treated with PEG in drinking water (7%) for 2 wk or left untreated (controls). We studied the enterohepatic circulation of the major bile salt (BS) cholate with a plasma stable isotope dilution technique and determined BS profiles and concentrations in bile, intestinal lumen contents, and feces. We determined the fecal excretion of cholesterol plus its intestinally formed metabolites. Finally, we determined the cytolytic activity of fecal water (a surrogate marker of colorectal cancer risk) and the amount and composition of fecal microbiota. Compared with control rats, PEG treatment increased the pool size (+51%; P < 0.01) and decreased the fractional turnover of cholate (-32%; P < 0.01). PEG did not affect the cholate synthesis rate, corresponding with an unaffected fecal primary BS excretion. PEG reduced fecal excretion of secondary BS and of cholesterol metabolites (each P < 0.01). PEG decreased the cytolytic activity of fecal water [54 (46-62) vs. 87 (85-92)% erythrocyte potassium release in PEG-treated and control rats, respectively; P < 0.01]. PEG treatment increased the contribution of Verrucomicrobia (P < 0.01) and decreased that of Firmicutes (P < 0.01) in fecal flora. We concluded that PEG treatment changes the intestinal bacterial composition, decreases the bacterial dehydroxylation of primary BS and the metabolism of cholesterol, and increases the pool size of the primary BS cholate in rats.

  4. Cytotoxicity of rhein, the active metabolite of sennoside laxatives, is reduced by multidrug resistance-associated protein 1

    PubMed Central

    van Gorkom, B A P; Timmer-Bosscha, H; de Jong, S; van der Kolk, D M; Kleibeuker, J H; de Vries, E G E

    2002-01-01

    Anthranoid laxatives, belonging to the anthraquinones as do anthracyclines, possibly increase colorectal cancer risk. Anthracyclines interfere with topoisomerase II, intercalate DNA and are substrates for P-glycoprotein and multidrug resistance-associated protein 1. P-glycoprotein and multidrug resistance-associated protein 1 protect colonic epithelial cells against xenobiotics. The aim of this study was to analyse the interference of anthranoids with these natural defence mechanisms and the direct cytotoxicity of anthranoids in cancer cell lines expressing these mechanisms in varying combinations. A cytotoxicity profile of rhein, aloe emodin and danthron was established in related cell lines exhibiting different levels of topoisomerases, multidrug resistance-associated protein 1 and P-glycoprotein. Interaction of rhein with multidrug resistance-associated protein 1 was studied by carboxy fluorescein efflux and direct cytotoxicity by apoptosis induction. Rhein was less cytotoxic in the multidrug resistance-associated protein 1 overexpressing GLC4/ADR cell line compared to GLC4. Multidrug resistance-associated protein 1 inhibition with MK571 increased rhein cytotoxicity. Carboxy fluorescein efflux was blocked by rhein. No P-glycoprotein dependent rhein efflux was observed, nor was topoisomerase II responsible for reduced toxicity. Rhein induced apoptosis but did not intercalate DNA. Aloe emodin and danthron were no substrates for MDR mechanisms. Rhein is a substrate for multidrug resistance-associated protein 1 and induces apoptosis. It could therefore render the colonic epithelium sensitive to cytotoxic agents, apart from being toxic in itself. British Journal of Cancer (2002) 86, 1494–1500. DOI: 10.1038/sj/bjc/6600255 www.bjcancer.com © 2002 Cancer Research UK PMID:11986786

  5. Automated image-based colon cleansing for laxative-free CT colonography computer-aided polyp detection

    SciTech Connect

    Linguraru, Marius George; Panjwani, Neil; Fletcher, Joel G.; Summer, Ronald M.

    2011-12-15

    Purpose: To evaluate the performance of a computer-aided detection (CAD) system for detecting colonic polyps at noncathartic computed tomography colonography (CTC) in conjunction with an automated image-based colon cleansing algorithm. Methods: An automated colon cleansing algorithm was designed to detect and subtract tagged-stool, accounting for heterogeneity and poor tagging, to be used in conjunction with a colon CAD system. The method is locally adaptive and combines intensity, shape, and texture analysis with probabilistic optimization. CTC data from cathartic-free bowel preparation were acquired for testing and training the parameters. Patients underwent various colonic preparations with barium or Gastroview in divided doses over 48 h before scanning. No laxatives were administered and no dietary modifications were required. Cases were selected from a polyp-enriched cohort and included scans in which at least 90% of the solid stool was visually estimated to be tagged and each colonic segment was distended in either the prone or supine view. The CAD system was run comparatively with and without the stool subtraction algorithm. Results: The dataset comprised 38 CTC scans from prone and/or supine scans of 19 patients containing 44 polyps larger than 10 mm (22 unique polyps, if matched between prone and supine scans). The results are robust on fine details around folds, thin-stool linings on the colonic wall, near polyps and in large fluid/stool pools. The sensitivity of the CAD system is 70.5% per polyp at a rate of 5.75 false positives/scan without using the stool subtraction module. This detection improved significantly (p = 0.009) after automated colon cleansing on cathartic-free data to 86.4% true positive rate at 5.75 false positives/scan. Conclusions: An automated image-based colon cleansing algorithm designed to overcome the challenges of the noncathartic colon significantly improves the sensitivity of colon CAD by approximately 15%.

  6. A Cinematic Magnetic Resonance Imaging Study of Milk of Magnesia Laxative and an Antiflatulent Diet to Reduce Intrafraction Prostate Motion

    SciTech Connect

    Nichol, Alan M.; Warde, Padraig R.; Lockwood, Gina A.

    2010-07-15

    Purpose: To determine the reduction of prostate motion during a typical radiotherapy (RT) fraction from a bowel regimen comprising an antiflatulent diet and daily milk of magnesia. Methods and Materials: Forty-two patients with T1c-T2c prostate cancer voided the bladder and rectum before three cinematic magnetic resonance imaging scans obtained every 9 s for 9 min in a vacuum immobilization device. The MRIs were at baseline without bowel regimen (MRI-BL), before CT planning with bowel regimen (MRI-CT), and before a randomly assigned RT fraction (1-42) with bowel regimen (MRI-RT). A single observer tracked displacement of the posterior midpoint (PM) of the prostate. The primary endpoints were comparisons of the proportion of time that the PM was displaced >3 mm (PTPM3) from its initial position, and the secondary endpoints were comparisons of the reduction of initial rectal area, with and without the bowel regimen. Results: The mean rectal area was: 13.5 cm{sup 2} at MRI-BL, 12.7 cm{sup 2} at MRI-CT, and 12.3 cm{sup 2} at MRI-RT (MRI-BL vs. MRI-CT, p = 0.11; MRI-BL vs. MRI-CT, p = 0.07). Moving rectal gas alone (56%) and moving gas and stool (18%) caused 74% of intrafraction prostate motion. The PTPM3 was 11.3% at MRI-BL, 4.8% at MRI-CT, and 12.0% at MRI-RT (MRI-BL vs. MRI-CT, p = 0.12; MRI-BL vs. MRI-RT, p = 0.89). Conclusion: For subjects voiding their rectum before imaging, an antiflatulent diet and milk of magnesia laxative did not significantly reduce initial rectal area or intrafraction prostate motion.

  7. CALUTRON RECEIVER

    DOEpatents

    Barnes, S.W.

    1959-08-25

    An improvement in a calutron receiver for collecting the isotopes ts described. The electromagnetic separation of the isotopes produces a mass spectrum of closely adjacent beams of ions at the foci regions, and a dividing wall between the two pockets is arranged at an angle. Substantially all of the tons of the less abundant isotope enter one of the pockets and strike one side of the wall directly, while substantially none of the tons entering the other pocket strikes the wall directly.

  8. Laxative effects of Liriope platyphylla are tightly correlated with suppression of endoplasmic reticulum stress in loperamide-induced constipation of SD rats

    PubMed Central

    Kim, Ji-Eun; Go, Jun; Sung, Ji-Eun; Lee, Hyun-Ah; Seo, Eun-Ji; Yun, Woo-Bin

    2016-01-01

    A dysfunction of endoplasmic reticulum (ER) stress response can result in various diseases, including cancer, inflammation, diabetes and neurodegenerative disorders. To investigate whether ER stress response can play an essential role in the induction and treatment of chronic constipation, alterations in the key parameters for ER stress were measured in loperamide (Lop) induced constipation Sprague Dawley (SD) rats treated with aqueous extracts of Liriope platyphylla (AEtLP), which has been shown to have a laxative effect. Symptoms of chronic constipation including alteration of stool parameters and the transverse colon's structure were successfully induced by Lop treatment. Laxative effects such as enhancement of stools parameters, recovery of the mucosa thickness, increased muscle thickness and recovery of flat luminal surface were also observed in the Lop+AEtLP treated group. Furthermore, enhancement of eukaryotic initiation factor 2 alpha (eIF2α) phosphorylation and inositol-requiring enzyme 1 beta (IRE1β) expression, key indicators for ER stress, that were observed in the Lop+vehicle treated group were significantly recovered in the Lop+AEtLP treated group, although the phosphorylation level of c-Jun N-terminal protein kinase (JNK) remained constant. Moreover, alterations in the transcription level of the marker genes X-box binding protein 1 (XBP-1) and growth arrest and DNA damage-inducible protein (GADD34) were similar to those of eIF2α and IRE1β. However, their level was slightly or completely recovered after AEtLP treatment. Overall, this study provides the first evidence that ER stress response may be tightly correlated with chronic constipation induced by Lop treatment, as well as the laxative effects of AEtLP. PMID:27051439

  9. Laxative effects of Liriope platyphylla are tightly correlated with suppression of endoplasmic reticulum stress in loperamide-induced constipation of SD rats.

    PubMed

    Kim, Ji-Eun; Go, Jun; Sung, Ji-Eun; Lee, Hyun-Ah; Seo, Eun-Ji; Yun, Woo-Bin; Hwang, Dae-Youn

    2016-03-01

    A dysfunction of endoplasmic reticulum (ER) stress response can result in various diseases, including cancer, inflammation, diabetes and neurodegenerative disorders. To investigate whether ER stress response can play an essential role in the induction and treatment of chronic constipation, alterations in the key parameters for ER stress were measured in loperamide (Lop) induced constipation Sprague Dawley (SD) rats treated with aqueous extracts of Liriope platyphylla (AEtLP), which has been shown to have a laxative effect. Symptoms of chronic constipation including alteration of stool parameters and the transverse colon's structure were successfully induced by Lop treatment. Laxative effects such as enhancement of stools parameters, recovery of the mucosa thickness, increased muscle thickness and recovery of flat luminal surface were also observed in the Lop+AEtLP treated group. Furthermore, enhancement of eukaryotic initiation factor 2 alpha (eIF2α) phosphorylation and inositol-requiring enzyme 1 beta (IRE1β) expression, key indicators for ER stress, that were observed in the Lop+vehicle treated group were significantly recovered in the Lop+AEtLP treated group, although the phosphorylation level of c-Jun N-terminal protein kinase (JNK) remained constant. Moreover, alterations in the transcription level of the marker genes X-box binding protein 1 (XBP-1) and growth arrest and DNA damage-inducible protein (GADD34) were similar to those of eIF2α and IRE1β. However, their level was slightly or completely recovered after AEtLP treatment. Overall, this study provides the first evidence that ER stress response may be tightly correlated with chronic constipation induced by Lop treatment, as well as the laxative effects of AEtLP.

  10. 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.

  11. Nursing Effort and Quality of Care for Nursing Home Residents

    ERIC Educational Resources Information Center

    Arling, Greg; Kane, Robert L.; Mueller, Christine; Bershadsky, Julie; Degenholtz, Howard B.

    2007-01-01

    Purpose: The purpose of this study was to determine the relationship between nursing home staffing level, care received by individual residents, and resident quality-related care processes and functional outcomes. Design and Methods: Nurses recorded resident care time for 5,314 residents on 156 units in 105 facilities in four states (Colorado,…

  12. Nursing Effort and Quality of Care for Nursing Home Residents

    ERIC Educational Resources Information Center

    Arling, Greg; Kane, Robert L.; Mueller, Christine; Bershadsky, Julie; Degenholtz, Howard B.

    2007-01-01

    Purpose: The purpose of this study was to determine the relationship between nursing home staffing level, care received by individual residents, and resident quality-related care processes and functional outcomes. Design and Methods: Nurses recorded resident care time for 5,314 residents on 156 units in 105 facilities in four states (Colorado,…

  13. 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.

  14. 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.

  15. Radiation receiver

    DOEpatents

    Hunt, A.J.

    1983-09-13

    The apparatus for collecting radiant energy and converting same to alternate energy form includes a housing having an interior space and a radiation transparent window allowing, for example, solar radiation to be received in the interior space of the housing. Means are provided for passing a stream of fluid past said window and for injecting radiation absorbent particles in said fluid stream. The particles absorb the radiation and because of their very large surface area, quickly release the heat to the surrounding fluid stream. The fluid stream particle mixture is heated until the particles vaporize. The fluid stream is then allowed to expand in, for example, a gas turbine to produce mechanical energy. In an aspect of the present invention properly sized particles need not be vaporized prior to the entrance of the fluid stream into the turbine, as the particles will not damage the turbine blades. In yet another aspect of the invention, conventional fuel injectors are provided to inject fuel into the fluid stream to maintain the proper temperature and pressure of the fluid stream should the source of radiant energy be interrupted. In yet another aspect of the invention, an apparatus is provided which includes means for providing a hot fluid stream having hot particles disbursed therein which can radiate energy, means for providing a cooler fluid stream having cooler particles disbursed therein, which particles can absorb radiant energy and means for passing the hot fluid stream adjacent the cooler fluid stream to warm the cooler fluid and cooler particles by the radiation from the hot fluid and hot particles. 5 figs.

  16. Radiation receiver

    DOEpatents

    Hunt, Arlon J.

    1983-01-01

    The apparatus for collecting radiant energy and converting same to alternate energy form includes a housing having an interior space and a radiation transparent window allowing, for example, solar radiation to be received in the interior space of the housing. Means are provided for passing a stream of fluid past said window and for injecting radiation absorbent particles in said fluid stream. The particles absorb the radiation and because of their very large surface area, quickly release the heat to the surrounding fluid stream. The fluid stream particle mixture is heated until the particles vaporize. The fluid stream is then allowed to expand in, for example, a gas turbine to produce mechanical energy. In an aspect of the present invention properly sized particles need not be vaporized prior to the entrance of the fluid stream into the turbine, as the particles will not damage the turbine blades. In yet another aspect of the invention, conventional fuel injectors are provided to inject fuel into the fluid stream to maintain the proper temperature and pressure of the fluid stream should the source of radiant energy be interrupted. In yet another aspect of the invention, an apparatus is provided which includes means for providing a hot fluid stream having hot particles disbursed therein which can radiate energy, means for providing a cooler fluid stream having cooler particles disbursed therein, which particles can absorb radiant energy and means for passing the hot fluid stream adjacent the cooler fluid stream to warm the cooler fluid and cooler particles by the radiation from the hot fluid and hot particles.

  17. Evaluation of a quality improvement curriculum for family medicine residents.

    PubMed

    Tudiver, Fred; Click, Ivy A; Ward, Patricia; Basden, Jeri Ann

    2013-01-01

    East Tennessee State University's (ETSU) Department of Family Medicine initiated Quality Improvement (QI) training in its three residency programs in 2008. The purpose of the project was to develop, implement, and assess a formal curriculum and experiential learning process to train family medicine residents in QI knowledge and skills. Family medicine faculty members received training in QI theory and design. Rising second-year residents received a day-long workshop on the basics of QI principles. Residents worked in teams to develop and implement QI projects. Self-assessed QI proficiency was measured prior to and immediately following the workshop. QI knowledge was assessed with the Quality Improvement Knowledge Application Tool (QIKAT) at baseline and following project completion. Two groups of residents (n=37) received training and completed at least 1 year on their projects. Analyses revealed that residents' self-assessed QI proficiency improved after receiving a day-long training workshop and was consistent for both groups of resident training. Application of QI knowledge as assessed by the QIKAT did not improve following QI project participation in resident Group 1 but did improve in resident Group 2. A formal QI curriculum was successfully developed and implemented into three family medicine residency programs. Residents' QI knowledge and skills improved following training and experience conducting QI projects. Faculty and resident commitment to the program and competing time demands proved challenging to the introduction of QI training. Future studies should assess residents' sustained learning and translating QI residency experiences into practice.

  18. The effect of medical student feedback about resident teaching on resident teaching identity: a randomized controlled trial.

    PubMed

    Yuan, David; Bridges, Michael; D'Amico, Frank J; Wilson, Stephen A

    2014-01-01

    Residents often teach medical students, other residents, and patients. However, few residents get feedback about their teaching. This study's objective was to determine if feedback from medical students increases resident teaching identity. This was a stratified, single blinded, randomized controlled trial of an educational intervention. Residents were stratified based on year of residency and then randomized to receive feedback by medical students or not. Medical students evaluated resident teaching effectiveness by ranking resident ability to apply the five microskills for clinical teaching and to role model being an effective clinician. Residents were surveyed to determine their level of teacher identity before and after the intervention. Allocation concealment and intention to treat principles were used. All residents (n=32) that met inclusion criteria participated with complete response rate to both pre-intervention and post-intervention surveys. There was no difference in teaching identity between residents who received feedback and those who did not, except in one subscale of the Teacher Identity Scale-global teaching identity, where residents who received medical student feedback scored lower. There was no difference between intervention and control group in resident teaching identity over time. The residents found feedback important. This was a randomized controlled trial with strong methodology that helps advance understanding of the importance of medical student feedback on resident teaching.

  19. 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.

  20. 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.

  1. Fixed ratio (2:1) prolonged-release oxycodone/naloxone combination improves bowel function in patients with moderate-to-severe pain and opioid-induced constipation refractory to at least two classes of laxatives.

    PubMed

    Koopmans, Gineke; Simpson, Karen; De Andrés, Javier; Lux, Eberhard Albert; Wagemans, Michel; Van Megen, Yvonne

    2014-11-01

    The effects of combined oxycodone/naloxone prolonged release tablets (OXN PR) were investigated in patients with moderate-to-severe chronic cancer-related or non-cancer pain. All patients had opioid-induced constipation (OIC) which persisted despite substantial laxative therapy. This pooled analysis included 75 patients with OIC at study entry that was refractory to at least two laxatives with different modes of action. Patients completed randomized, double-blind treatment with OXN PR 20-120 mg/day for either 12 weeks (OXN 9001: non-cancer pain study) or 4 weeks (OXN 2001: cancer-related pain study). Analgesia and bowel function were assessed using the Brief Pain Inventory Short Form and Bowel Function Index (BFI), respectively. Use of laxative medication and safety were assessed throughout the studies. NCT00513656, EudraCT 2005-002398-57, EudraCT 2005-003510-15. Statistically and clinically significant improvements in bowel function were observed following double-blind treatment with OXN PR. Mean (SD) reduction in BFI score was 21.2 (28.8) and comparable in patients with cancer-related (19.0 [28.9]) and non-cancer pain (23.3.[29.0]; P ≤ 0.0002). Furthermore, the proportion of patients with a BFI score within normal range (≤28.8) increased from 9.5% at screening to 43.1% at Day 15 of OXN PR. While all patients used ≥2 laxatives of different classes at screening, during study treatment 36% stopped using laxatives (P < 0.001). OXN PR provided effective analgesia, evidenced by stable pain scores during study treatment, and there were no unanticipated adverse events. OXN PR significantly improved bowel function and reduced the use of laxatives in patients with OIC, previously unresponsive to at least two different classes of laxatives. OXN also provided effective analgesia for patients with moderate-to-severe cancer-related pain and non-cancer-related pain.

  2. 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

  3. 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.

  4. 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.

  5. 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

  6. Advanced airway management teaching in otolaryngology residency programs in Canada: A survey of residents.

    PubMed

    Côté, Valérie; Kus, Lukas H; Zhang, Xun; Richardson, Keith; Nguyen, Lily H

    2015-01-01

    We conducted a study to assess residents' levels of comfort with advanced airway management in Canadian otolaryngology residency programs. In October 2008, an electronic questionnaire was sent to all otolaryngology residents in Canada. Responses were voluntary and anonymous. The response rate was 64.8% (94 of 145 residents). Residents were asked about the amount of teaching they received and the amount they would like to receive each year in four areas: emergency surgical airway, pediatric airway, airway trauma, and management of complications during laryngoscopy/bronchoscopy. They were also asked how comfortable they were with their current level of knowledge in these areas. Overall, residents were not comfortable with difficult airway situations, scoring a mean of 3.08 on a 5-point Likert scale. Residents were most comfortable with the emergency airway and least comfortable with the pediatric airway. Overall, residents indicated that they had not received adequate teaching on advanced airway management, and they consistently desired more. With respect to the type of instruction, most residents requested more teaching via simulations, mannequins, and cadaver or animal models. Linear regression models revealed a positive relationship between their overall comfort with airway management and the number of airway teaching hours they received. Their consensus was that formal airway training should occur during postgraduate year (PGY) 2, with refresher courses offered every 2 years. This is the first wide-scale assessment of the status of airway teaching in otolaryngology residency programs in Canada. Overall, our findings suggest that otolaryngology residents in these programs are not comfortable with advanced airway management early in their training and feel they would benefit from a significant increase in airway teaching time. Comfort levels improved with increasing levels of training such that PGY5 residents indicated they were indeed comfortable with advanced

  7. 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.

  8. 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

  9. Effects of intravenous methylnaltrexone on opioid-induced gut motility and transit time changes in subjects receiving chronic methadone therapy: a pilot study.

    PubMed

    Yuan, C S; Foss, J F; O'Connor, M; Osinski, J; Roizen, M F; Moss, J

    1999-12-01

    In this preliminary study, we evaluated the effects of methylnaltrexone, a peripheral opioid-receptor antagonist, on chronic opioid-induced gut motility and transit changes in four subjects with chronic methadone-induced constipation. Subjects participated in this single blind, placebo controlled study for up to 8 days. We gave placebo the first day; for the remainder of the study, we gave intravenous methylnaltrexone (0.05-0.45 mg/kg) twice daily. During the study period, we recorded oral-cecal transit time and opioid withdrawal symptoms, as well as laxation response based on the frequency and consistency of the stools. Subjects 1 and 2 who were administered methylnaltrexone 0.45 mg/kg, a dose previously administered in normal volunteers, showed immediate positive laxation. Subject 2, after positive laxation response, had severe abdominal cramping, but showed no opioid systemic signs of withdrawal. The subject was discontinued due to the cramping. In Subjects 3 and 4, we reduced the methylnaltrexone dose to 0.05-0.15 mg/kg. The latter two subjects also had an immediate laxation response during and after intravenous medication without significant side effects. The stool frequency of these four subjects increased from 1-2 times per week before the study to approximately 1.5 stool per day during the treatment period. Oral-cecal transit times of Subjects 1, 3, and 4 were reduced from 150, 150 and 150 min (after placebo) to 90, 60 and 60 min (with methylnaltrexone), respectively. Our preliminary results demonstrate that low dose intravenous methylnaltrexone effectively reversed chronic methadone-induced constipation and delay in gut transit time. Thus, we anticipate that cancer patients receiving chronic opioids may also have increased sensitivity to methylnaltrexone, and that low dose methylnaltrexone may have clinical utility in managing opioid-induced constipation in chronic-pain patients.

  10. Next Generation Sequencing and Transcriptome Analysis Predicts Biosynthetic Pathway of Sennosides from Senna (Cassia angustifolia Vahl.), a Non-Model Plant with Potent Laxative Properties.

    PubMed

    Rama Reddy, Nagaraja Reddy; Mehta, Rucha Harishbhai; Soni, Palak Harendrabhai; Makasana, Jayanti; Gajbhiye, Narendra Athamaram; Ponnuchamy, Manivel; Kumar, Jitendra

    2015-01-01

    Senna (Cassia angustifolia Vahl.) is a world's natural laxative medicinal plant. Laxative properties are due to sennosides (anthraquinone glycosides) natural products. However, little genetic information is available for this species, especially concerning the biosynthetic pathways of sennosides. We present here the transcriptome sequencing of young and mature leaf tissue of Cassia angustifolia using Illumina MiSeq platform that resulted in a total of 6.34 Gb of raw nucleotide sequence. The sequence assembly resulted in 42230 and 37174 transcripts with an average length of 1119 bp and 1467 bp for young and mature leaf, respectively. The transcripts were annotated using NCBI BLAST with 'green plant database (txid 33090)', Swiss Prot, Kyoto Encylcopedia of Genes & Genomes (KEGG), Cluster of Orthologous Gene (COG) and Gene Ontology (GO). Out of the total transcripts, 40138 (95.0%) and 36349 (97.7%) from young and mature leaf, respectively, were annotated by BLASTX against green plant database of NCBI. We used InterProscan to see protein similarity at domain level, a total of 34031 (young leaf) and 32077 (mature leaf) transcripts were annotated against the Pfam domains. All transcripts from young and mature leaf were assigned to 191 KEGG pathways. There were 166 and 159 CDS, respectively, from young and mature leaf involved in metabolism of terpenoids and polyketides. Many CDS encoding enzymes leading to biosynthesis of sennosides were identified. A total of 10,763 CDS differentially expressing in both young and mature leaf libraries of which 2,343 (21.7%) CDS were up-regulated in young compared to mature leaf. Several differentially expressed genes found functionally associated with sennoside biosynthesis. CDS encoding for many CYPs and TF families were identified having probable roles in metabolism of primary as well as secondary metabolites. We developed SSR markers for molecular breeding of senna. We have identified a set of putative genes involved in various

  11. Next Generation Sequencing and Transcriptome Analysis Predicts Biosynthetic Pathway of Sennosides from Senna (Cassia angustifolia Vahl.), a Non-Model Plant with Potent Laxative Properties

    PubMed Central

    Rama Reddy, Nagaraja Reddy; Mehta, Rucha Harishbhai; Soni, Palak Harendrabhai; Makasana, Jayanti; Gajbhiye, Narendra Athamaram; Ponnuchamy, Manivel; Kumar, Jitendra

    2015-01-01

    Senna (Cassia angustifolia Vahl.) is a world’s natural laxative medicinal plant. Laxative properties are due to sennosides (anthraquinone glycosides) natural products. However, little genetic information is available for this species, especially concerning the biosynthetic pathways of sennosides. We present here the transcriptome sequencing of young and mature leaf tissue of Cassia angustifolia using Illumina MiSeq platform that resulted in a total of 6.34 Gb of raw nucleotide sequence. The sequence assembly resulted in 42230 and 37174 transcripts with an average length of 1119 bp and 1467 bp for young and mature leaf, respectively. The transcripts were annotated using NCBI BLAST with ‘green plant database (txid 33090)’, Swiss Prot, Kyoto Encylcopedia of Genes & Genomes (KEGG), Cluster of Orthologous Gene (COG) and Gene Ontology (GO). Out of the total transcripts, 40138 (95.0%) and 36349 (97.7%) from young and mature leaf, respectively, were annotated by BLASTX against green plant database of NCBI. We used InterProscan to see protein similarity at domain level, a total of 34031 (young leaf) and 32077 (mature leaf) transcripts were annotated against the Pfam domains. All transcripts from young and mature leaf were assigned to 191 KEGG pathways. There were 166 and 159 CDS, respectively, from young and mature leaf involved in metabolism of terpenoids and polyketides. Many CDS encoding enzymes leading to biosynthesis of sennosides were identified. A total of 10,763 CDS differentially expressing in both young and mature leaf libraries of which 2,343 (21.7%) CDS were up-regulated in young compared to mature leaf. Several differentially expressed genes found functionally associated with sennoside biosynthesis. CDS encoding for many CYPs and TF families were identified having probable roles in metabolism of primary as well as secondary metabolites. We developed SSR markers for molecular breeding of senna. We have identified a set of putative genes involved in various

  12. 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.

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

    PubMed

    Shofler, David; Chuang, Taijung; Argade, Nina

    2015-01-01

    The podiatric medicine and surgery residency is currently characterized by 3 years of comprehensive training. Contemporary issues have recently influenced the direction of training in the profession of podiatric medicine. Formal investigation into the residency training experience has, nonetheless, been limited. The purpose of the present study was to conduct a learning needs assessment of podiatric residency training. An electronic survey was developed, with comparable versions for program directors and residents. The specific topics investigated included the use of minimum activity volume numbers, learning resources, duty hours, strengths and weaknesses of residents, motivation of hosting student externship positions, noncognitive residency traits, meetings between residents and directors, resident satisfaction, and director satisfaction. A total of 197 program directors nationwide were sent the survey electronically, and 109 (53%) responded. Of 230 residents receiving the survey, 159 (78%) responded. Several statistically significant differences, and notable similarities, were observed between the 2 groups encompassing many aspects of the survey. A majority opinion, among both directors and residents, was found that the use of procedural assessment tools might improve resident evaluation. The responding directors and residents agreed that the following 3 topics were weaknesses in podiatric training: practice management, biomechanics, and performing podiatric research. Direct feedback immediately after surgery was the most valuable learning resource reported by the residents. The results of our study reflect the current status of the podiatric medicine and surgery residency and could facilitate improvement in the residency training experience. Copyright © 2015 American College of Foot and Ankle Surgeons. Published by Elsevier Inc. All rights reserved.

  14. The LUCK study: Laxative Usage in patients with GP-diagnosed Constipation in the UK, within the general population and in pregnancy. An epidemiological study using the General Practice Research Database (GPRD)

    PubMed Central

    Shafe, Anna C. E.; Lee, Sally; Dalrymple, Jamie S. O.; Whorwell, Peter J.

    2011-01-01

    Background: Despite the high prevalence of constipation and its related public health implications, there is relatively little research available on the condition from large epidemiological studies. The aim of this study was to investigate the epidemiology of general practitioner (GP)-diagnosed constipation and the prescribing trends for laxatives in the UK, within the general population and during pregnancy. Methods: A cohort study for the period from 2005 to 2009 was performed using the UK primary care database (General Practice Research Database), which contains information on over 3 million individuals. Results: The prevalence of GP-diagnosed constipation ranged from 12 per 1000 persons in 2005 (0.012 per person year) to 12.8 per 1000 in 2009 (0.013 per person year). The prevalence was almost twice as high in women as in men, and was higher in older patients. In 2005 the most commonly prescribed laxatives were lactulose (37%), senna (26%), macrogol (19%), ispaghula (6%), docusate sodium (5%), bisacodyl (4%) and glycerol suppositories (2%). By 2009, this pattern had changed: macrogol (31%), lactulose (29%), senna (22%), ispaghula (5%), docusate sodium (6%), bisacodyl (3%) and glycerol suppositories (3%). In pregnancy, lactulose accounted for 81% of laxative use in 2005, falling to 64% by 2009. In contrast, macrogol use in pregnancy rose from 13% in 2005 to 32% in 2009. Conclusions: GP-diagnosed constipation is common, accounting for a large number of consultations. Laxative prescribing trends have changed over the 5-year study period, prescriptions for macrogol becoming increasingly common and prescriptions for lactulose and senna less common. Macrogol also appears to have been replacing lactulose for treating constipation in pregnant women. PMID:22043228

  15. 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.

  16. Global health education in emergency medicine residency programs.

    PubMed

    Havryliuk, Tatiana; Bentley, Suzanne; Hahn, Sigrid

    2014-06-01

    Interest in global health and international electives is growing among Emergency Medicine (EM) residents in the United States (US). The majority of EM residency programs offer opportunities for international electives. The degree of participation among residents and type of support provided by the residency program, however, remains unclear. To explore the current state of global health education among EM residents who participate in international electives. A 12-question survey was e-mailed to the program directors of the 192 EM residency programs in the US. The survey included questions about the number of residents participating in international electives and the types of preparation, project requirements, supervision, and feedback participating residents receive. The response rate was 53% with 102 responses. Seventy-five of 102 (74%) programs reported that at least one resident participated in an international elective in the 2010-2011 academic year. Forty-three programs (42%) report no available funding to support any resident on an international elective. Residents receive no preparation for international work in 41 programs (40%). Only 25 programs (26%) required their residents to conduct a project while abroad. Forty-nine programs (48%) reported no formal debriefing session, and no formal feedback was collected from returning residents in 57 of 102 (59%) programs. The majority of EM residencies have residents participating in international electives. However, the programs report variable preparation, requirements, and resident supervision. These results suggest a need for an expanded and more structured approach to international electives undertaken by EM residents. Copyright © 2014 Elsevier Inc. All rights reserved.

  17. 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.

  18. Characterization of Changes in Global Genes Expression in the Distal Colon of Loperamide-Induced Constipation SD Rats in Response to the Laxative Effects of Liriope platyphylla

    PubMed Central

    Kim, Ji Eun; Park, So Hae; Kwak, Moon Hwa; Go, Jun; Koh, Eun Kyoung; Song, Sung Hwa; Sung, Ji Eun; Lee, Hee Seob; Hong, Jin Tae; Hwang, Dae Youn

    2015-01-01

    To characterize the changes in global gene expression in the distal colon of constipated SD rats in response to the laxative effects of aqueous extracts of Liriope platyphylla (AEtLP), including isoflavone, saponin, oligosaccharide, succinic acid and hydroxyproline, the total RNA extracted from the distal colon of AEtLP-treated constipation rats was hybridized to oligonucleotide microarrays. The AEtLP treated rats showed an increase in the number of stools, mucosa thickness, flat luminal surface thickness, mucin secretion, and crypt number. Overall, compared to the controls, 581 genes were up-regulated and 216 genes were down-regulated by the constipation induced by loperamide in the constipated rats. After the AEtLP treatment, 67 genes were up-regulated and 421 genes were down-regulated. Among the transcripts up-regulated by constipation, 89 were significantly down-regulated and 22 were recovered to the normal levels by the AEtLP treatment. The major genes in the down-regulated categories included Slc9a5, klk10, Fgf15, and Alpi, whereas the major genes in the recovered categories were Cyp2b2, Ace, G6pc, and Setbp1. On the other hand, after the AEtLP treatment, ten of these genes down-regulated by constipation were up-regulated significantly and five were recovered to the normal levels. The major genes in the up-regulated categories included Serpina3n, Lcn2 and Slc5a8, whereas the major genes in the recovered categories were Tmem45a, Rerg and Rgc32. These results indicate that several gene functional groups and individual genes as constipation biomarkers respond to an AEtLP treatment in constipated model rats. PMID:26151867

  19. National CT Colonography Trial (ACRIN 6664): Comparison of Three Full-Laxative Bowel Preparations in More Than 2500 Average-Risk Patients

    PubMed Central

    Hara, Amy K.; Kuo, Mark D.; Blevins, Meridith; Chen, Mei-Hsiu; Yee, Judy; Dachman, Abraham; Menias, Christine O.; Siewert, Betina; Cheema, Jugesh I.; Obregon, Richard G.; Fidler, Jeff L.; Zimmerman, Peter; Horton, Karen M.; Coakley, Kevin; Iyer, Revathy B.; Halvorsen, Robert A.; Casola, Giovanna; Johnson, C. Daniel

    2011-01-01

    OBJECTIVE The purpose of our study was to compare the effect of three different full-laxative bowel preparations on patient compliance, residual stool and fluid, reader confidence, and polyp detection at CT colonography (CTC). SUBJECTS AND METHODS A total of 2531 patients underwent CTC followed by colonoscopy for the American College of Radiology Imaging Network (ACRIN) National CTC Trial. Of this total, 2525 patients used one of three bowel preparations with bisacodyl tablets and stool and fluid tagging: 4 L of polyethylene glycol (PEG); 90 mL of phosphosoda; or 300 mL of magnesium citrate. Patients reported percent compliance with the bowel preparation and radiologists graded each CTC examination for the amount of residual fluid and stool on a scale from 1 (none) to 4 (nondiagnostic). Reader confidence for true-positive findings was reported on a 5-point scale: 1 (low) to 5 (high). Sensitivity and specificity for detecting polyps ≥ 6 mm and ≥ 1 cm compared with colonoscopy were calculated for each preparation. RESULTS The most commonly prescribed preparation was phosphosoda (n = 1403) followed by PEG (n = 1020) and magnesium citrate (n = 102). Phosphosoda had the highest patient compliance (p = 0.01), least residual stool (p < 0.001), and highest reader confidence versus PEG for examinations with polyps (p = 0.06). Magnesium citrate had significantly more residual fluid compared with PEG and phosphosoda (p = 0.006). The sensitivity and specificity for detecting colon polyps ≥ 6 mm and ≥ 1 cm did not differ significantly between preparations. CONCLUSION Polyp detection was comparable for all three preparations, although phosphosoda had significantly higher patient compliance and the least residual stool. PMID:21512073

  20. Gallotannin-Enriched Extract Isolated from Galla Rhois May Be a Functional Candidate with Laxative Effects for Treatment of Loperamide-Induced Constipation of SD Rats.

    PubMed

    Kim, Ji Eun; Go, Jun; Koh, Eun Kyoung; Song, Sung Hwa; Sung, Ji Eun; Lee, Hyun Ah; Lee, Young Hee; Hong, Jin Tae; Hwang, Dae Youn

    2016-01-01

    Several natural products containing tannins are used as traditional medicines for treatment of constipation; however, their pharmacological mechanism is not well understood. The laxative effects of gallotannin-enriched extract isolated from Galla Rhois (GEGR) were investigated using a constipation model induced by loperamide (Lop) injection. After analysis for antioxidant activity of GEGR, alterations in the excretion parameters, histological structure, mucin secretion, and related protein levels were measured in the transverse colon of Sprague Dawley (SD) rats with Lop-induced constipation following treatment with 250, 500 and 1,000 mg/ml of GEGR. The number and weight of feces increased significantly by 48-79% and 128-159%, respectively, in the Lop+GEGR treated group relative to the Lop+vehicle treated group, while food intake and water consumption were maintained at a constant level. The thickness of mucosa, muscle and flat luminal surface, as well as the number of goblet cells and crypt of lieberkuhn were enhanced in the Lop+GEGR treated group. Moreover, mucin secretion increased significantly in a dose dependent manner in the Lop+GEGR treated group. Furthermore, the downstream signaling pathway of the muscarinic acetylcholine receptors (mAChR) M2 and M3 was recovered by GEGR treatment, although the expression level varied. The levels of Gα expression and inositol triphosphate (IP3) concentration were also recovered in the Lop+GEGR treated group relative to the Lop+vehicle treated group. The results of the present study provide strong evidence that tannins distributed in various medicinal plants are important candidates for improving chronic constipation induced by Lop treatment in animal models.

  1. Uridine stimulate laxative effect in the loperamide-induced constipation of SD rats through regulation of the mAChRs signaling pathway and mucin secretion.

    PubMed

    Kim, Ji Eun; Go, Jun; Sung, Ji Eun; Lee, Hyun Ah; Yun, Woo Bin; Hong, Jin Tae; Hwang, Dae Youn

    2017-01-26

    Uridine (Urd), which has been reported as a major component of RNA, plays an important role in various biological process including neuroprotection, biochemical modulation and glycolysis, although its role in constipation has yet to be established. Therefore, in this study, we investigated the laxative effects of Urd on chronic constipation. The constipation phenotypes and their related mechanisms were investigated in the transverse colons of SD rats with loperamide (Lop)-induced constipation after treatment with 100 mg/kg of Urd. The number, weight and water contents of stools were significantly higher in the Lop + Urd treated group than the Lop + Vehicle treated group, while food intake and water consumption of the same group were maintained at a constant level. The thickness of the mucosa layer, muscle and flat luminal surface, as well as the number of goblet cells, paneth cells and lipid droplets were enhanced in the Lop + Urd treated group. Furthermore, the expression of the muscarinic acetylcholine receptors M2 and M3 (mAChR M2 and M3) at the transcriptional and translational level was recovered in the Lop + Urd treated group, while some markers such as Gα and inositol triphosphate (IP3) in their downstream signaling pathway were completely recovered by Urd treatment. Moreover, the ability for mucin secretion and the expression of membrane water channel (aquaporine 8, AQP8) were increased significantly in the Lop + Urd treated group compared with Lop + Vehicle treated group. Finally, the activity of Urd was confirmed in primary smooth muscle of rat intestine cells (pRISMC) based on Gα expression and IP3 concentration. The results of the present study provide the first strong evidence that Urd can be considered an important candidate for improving chronic constipation induced by Lop treatment in animal models.

  2. Gallotannin-Enriched Extract Isolated from Galla Rhois May Be a Functional Candidate with Laxative Effects for Treatment of Loperamide-Induced Constipation of SD Rats

    PubMed Central

    Kim, Ji Eun; Go, Jun; Koh, Eun Kyoung; Song, Sung Hwa; Sung, Ji Eun; Lee, Hyun Ah; Lee, Young Hee; Hong, Jin Tae; Hwang, Dae Youn

    2016-01-01

    Several natural products containing tannins are used as traditional medicines for treatment of constipation; however, their pharmacological mechanism is not well understood. The laxative effects of gallotannin-enriched extract isolated from Galla Rhois (GEGR) were investigated using a constipation model induced by loperamide (Lop) injection. After analysis for antioxidant activity of GEGR, alterations in the excretion parameters, histological structure, mucin secretion, and related protein levels were measured in the transverse colon of Sprague Dawley (SD) rats with Lop-induced constipation following treatment with 250, 500 and 1,000 mg/ml of GEGR. The number and weight of feces increased significantly by 48–79% and 128–159%, respectively, in the Lop+GEGR treated group relative to the Lop+vehicle treated group, while food intake and water consumption were maintained at a constant level. The thickness of mucosa, muscle and flat luminal surface, as well as the number of goblet cells and crypt of lieberkuhn were enhanced in the Lop+GEGR treated group. Moreover, mucin secretion increased significantly in a dose dependent manner in the Lop+GEGR treated group. Furthermore, the downstream signaling pathway of the muscarinic acetylcholine receptors (mAChR) M2 and M3 was recovered by GEGR treatment, although the expression level varied. The levels of Gα expression and inositol triphosphate (IP3) concentration were also recovered in the Lop+GEGR treated group relative to the Lop+vehicle treated group. The results of the present study provide strong evidence that tannins distributed in various medicinal plants are important candidates for improving chronic constipation induced by Lop treatment in animal models. PMID:27618438

  3. 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.

  4. Residents' and standardized patients' perspectives on empathy: issues of agreement.

    PubMed

    Grosseman, Suely; Novack, Dennis H; Duke, Pamela; Mennin, Stewart; Rosenzweig, Steven; Davis, Tiffany J; Hojat, Mohammadreza

    2014-07-01

    We investigated correlations between residents' scores on the Jefferson Scale of Empathy (JSE), residents' perceptions of their empathy during standardized-patient encounters, and the perceptions of standardized patients. Participants were 214 first-year residents in internal medicine or family medicine from 13 residency programs taking standardized patient-based clinical skills assessment in 2011. We analyzed correlations between residents' JSE scores; standardized patients' perspectives on residents' empathy during OSCE encounters, using the Jefferson Scale of Patient Perceptions of Physician Empathy; and residents' perspectives on their own empathy, using a modified version of this scale. Residents' JSE scores correlated with their perceptions of their own empathy during encounters but correlated poorly with patients' assessments of resident empathy. The poor correlation between residents' and standardized patients' assessments of residents' empathy raises questions about residents' abilities to gauge the effectiveness of their empathic communications. The study also points to a lack of congruence between the assessment of empathy by standardized patients and residents as receivers and conveyors of empathy, respectively. This study adds to the literature on empathy as a teachable skill set and raises questions about use of OSCEs to assess trainee empathy. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

  5. 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.

  6. A psychoeducational program for caregivers of the chronic mentally ill residing in community residencies.

    PubMed

    Raskin, A; Mghir, R; Peszke, M; York, D

    1998-08-01

    The objective of this study was to develop a psychoeducational program for caregivers of the chronically mentally ill residing in community residencies. An evaluative component was added to determine how well the program was received by caregivers and what impact the program had on the residents. A total of 20 caregivers and 63 residents participated in the program. In general, the psychoeducational program was well received by the caregivers. They especially liked the mental health component and opportunity to meet and interact with other caregivers. There was a significant drop in hospital admissions following the program. There was also improvement in a number of quality of life activities such as trips to the local coffee shop and mall.

  7. Polypharmacy, potentially inappropriate medication and cognitive status in Austrian nursing home residents: results from the OSiA study.

    PubMed

    Alzner, Reinhard; Bauer, Ulrike; Pitzer, Stefan; Schreier, Maria Magdalena; Osterbrink, Jürgen; Iglseder, Bernhard

    2016-04-01

    There is little research investigating polypharmacy and potentially inappropriate medications (PIM) in connection with cognitive status in residents of Austrian nursing homes. Our findings result from a cross-sectional survey of 425 residents (315 women, 110 men, mean 83.6 years) from 12 Austrian nursing homes. The number of systemically administered permanent prescription drugs was 8.99 ± 3.9 and decreased significantly with increasing cognitive impairment. Irrespective of cognitive status, polypharmacy (> 5 individual substances) was present in approximately 75% of the residents. Hyper-polypharmacy (> 10 individual substances) was present among almost 50% of the cognitively intact residents, and hence, significantly more frequent as compared with the group with the lowest cognitive performance (23.4%). At least one PIM was found in 72.4% of residents regardless of cognitive status. Predominantly, PIMs consisted of tranquilizers, antipsychotics, osmotic laxatives, non-steroidal anti-inflammatory drugs (NSAIDs) and anticholinergics, where only the number of NSAIDs decreased significantly with increasing cognitive impairment. In summary, our study shows a continued high prevalence of polypharmacy and PIM in long-term care institutions in Austria.

  8. Training Experiences of Family Medicine Residents on Behavioral Health Rotations.

    PubMed

    Zubatsky, Max; Brieler, Jay; Jacobs, Christine

    2017-09-01

    Although accreditation guidelines for residency in family medicine include behavioral health curriculum, little is known about resident learning activities in real world training. Our study explored residents' perceptions about and exposure to specific activities during their behavioral health rotations. Family medicine residents (N=84) recruited via faculty list serves completed a survey about their experiences during behavioral health rotations. The survey included quantitative Likert scale questions, along with open-ended questions on which a qualitative content analysis was performed. Open-ended responses indicated that many residents receive constructive observation and collaboration opportunities during their training month. However, residents wanted more time to practice behavioral health skills beyond the rotation, more practice in psychotherapy skills, and additional education on medication management. Most residents (62%) received either limited or no training in couples or family therapy during their behavioral health rotation. Residents who reported more behavioral health knowledge gain during the rotation also reported higher self-perceived competency using Motivational Interviewing (M=3.82, P<.01). While family medicine as a discipline is based on the biopsychosocial model of care, residents reported deficits in education about family systems. Residents desire additional opportunities to learn psychotherapy techniques and practice counseling skills. Family medicine residency programs and faculty may consider supplementing their core behavioral curriculum to include these content areas.

  9. 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.

  10. 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)

  11. 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…

  12. 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…

  13. Ontario Radiation Oncology Residents' Needs in the First Postgraduate Year-Residents' Perspective Survey

    SciTech Connect

    Szumacher, Ewa Warner, Eiran; Zhang Liying; Kane, Gabrielle; Ackerman, Ida; Nyhof-Young, Joyce; Agboola, Olusegun; Metz, Catherine de; Rodrigues, George; Rappolt, Susan

    2007-10-01

    Purpose: To assess radiation oncology residents' needs and satisfaction in their first postgraduate year (PGY-1) in the province of Ontario. Methods and Materials: Of 62 radiation oncology residents, 58 who had completed their PGY-1 and were either enrolled or had graduated in 2006 were invited to participate in a 31-item survey. The questionnaire explored PGY-1 residents' needs and satisfaction in four domains: clinical workload, faculty/learning environment, stress level, and discrimination/harassment. The Fisher's exact and Wilcoxon nonparametric tests were used to determine relationships between covariate items and summary scores. Results: Of 58 eligible residents, 44 (75%) responded. Eighty-four percent of residents felt that their ward and call duties were appropriate. More than 50% of respondents indicated that they often felt isolated from their radiation oncology program. Only 77% agreed that they received adequate feedback, and 40% received sufficient counseling regarding career planning. More than 93% of respondents thought that faculty members had contributed significantly to their learning experience. Approximately 50% of residents experienced excessive stress and inadequate time for leisure or for reading the medical literature. Less than 10% of residents indicated that they had been harassed or experienced discrimination. Eighty-three percent agreed or strongly agreed that their PGY-1 experience had been outstanding. Conclusions: Most Ontario residents were satisfied with their PGY-1 training program. More counseling by radiation oncology faculty members should be offered to help residents with career planning. The residents might also benefit from more exposure to 'radiation oncology' and an introduction to stress management strategies.

  14. Putting the "receive" in accounts receivable.

    PubMed

    McDaniel, John W; Baum, Neil

    2006-01-01

    There isn't a practice in the United States that doesn't have a concern about accounts receivable. The financial success of any practice depends on the care and feeding of the accounts receivable. This is not an area of practice management that can be taken lightly or delegated to someone who is not attentive to detail and doggedly persistent. In this article, we will discuss how to identify problematic accounts receivable and what can be done to bring the accounts receivable under control. We will provide you with a plan of action that can be adopted by any practice regardless of size, number of physicians, or whether the practice uses in-house billing or outsources its billing arrangements.

  15. 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

  16. Differences in Preventive Health Quality by Residency Year

    PubMed Central

    Willett, Lisa L; Palonen, Katri; Allison, Jeroan J; Heudebert, Gustavo R; Kiefe, Catarina I; Stanford Massie, F; Wall, Terry C; Houston, Thomas K

    2005-01-01

    Background It is assumed that the performance of more senior residents is superior to that of interns, but this has not been assessed objectively. Objective To determine whether adherence to national guidelines for outpatient preventive health services differs by year of residency training. Design Cross-sectional study. Participants One hundred twenty Internal Medicine residents, postgraduate year (PGY)- 1 and PGY -2, attending a University Internal Medicine teaching clinic between June 2000 and May 2003. Measurements We studied 6 preventive health care services offered or received by patients by abstracting data from 1,017 patient records. We examined the differences in performance between PGY-1 and PGY-2 residents. Results Postgraduaute year-2 residents did not statistically outperform PGY-1 residents on any measure. The overall proportion of patients receiving appropriate preventive health services for pneumococcal vaccination, advising tobacco cessation, breast and colon cancer screening, and lipid screening was similar across levels of training. PGY-1s outperformed PGY-2s for tobacco use screening (58%, 51%, P=.03). These results were consistent after accounting for clustering of patients within provider and adjusting for patient age, gender, race and insurance, resident gender, and number of visits during the measurement year. Conclusions Overall, patients cared for by PGY-2 residents did not receive more outpatient preventive health services than those cared for by PGY-1 residents. Efforts should be made to ensure quality patient care in the outpatient setting for all levels of training. PMID:16117750

  17. 24 CFR 902.52 - Distribution of survey to residents.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... URBAN DEVELOPMENT PUBLIC HOUSING ASSESSMENT SYSTEM PHAS Indicator #4: Resident Service and Satisfaction... be chosen to receive the Resident Service and Satisfaction Survey. These units will be randomly... Satisfaction assessment takes into account the different properties managed by a PHA by organizing the...

  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. [Responsibilities of the resident in anesthesiology and postoperative care].

    PubMed

    Barrios Flores, L F

    2004-01-01

    Among medical specialties, anesthesiology/postoperative care has one of the highest rates of malpractice claims. This article treats the responsibilities of interns and residents in anesthesiology, their supervisors, and the institutions where they practice and receive training.

  20. Development of ASTRI high-temperature solar receivers

    NASA Astrophysics Data System (ADS)

    Coventry, Joe; Arjomandi, Maziar; Asselineau, Charles-Alexis; Chinnici, Alfonso; Corsi, Clotilde; Davis, Dominic; Kim, Jin-Soo; Kumar, Apurv; Lipiński, Wojciech; Logie, William; Nathan, Graham; Pye, John; Saw, Woei

    2017-06-01

    Three high-temperature solar receiver design concepts are being evaluated as part of the Australian Solar Thermal Research Initiative (ASTRI): a flux-optimised sodium receiver, a falling particle receiver, and an expanding-vortex particle receiver. Preliminary results from performance modelling of each concept are presented. For the falling particle receiver, it is shown how particle size and flow rate have a significant influence on absorptance. For the vortex receiver, methods to reduce particle deposition on the window and increase particle residence time are discussed. For the sodium receiver, the methodology for geometry optimisation is discussed, as well as practical constraints relating to containment materials.

  1. 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)

  2. 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)

  3. 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)

  4. 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)

  5. 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

  6. Spaceborne receivers: Basic principles

    NASA Technical Reports Server (NTRS)

    Stacey, J. M.

    1984-01-01

    The underlying principles of operation of microwave receivers for space observations of planetary surfaces were examined. The design philosophy of the receiver as it is applied to operate functionally as an efficient receiving system, the principle of operation of the key components of the receiver, and the important differences among receiver types are explained. The operating performance and the sensitivity expectations for both the modulated and total power receiver configurations are outlined. The expressions are derived from first principles and are developed through the important intermediate stages to form practicle and easily applied equations. The transfer of thermodynamic energy from point to point within the receiver is illustrated. The language of microwave receivers is applied statistics.

  7. Solar heat receiver

    DOEpatents

    Hunt, A.J.; Hansen, L.J.; Evans, D.B.

    1982-09-29

    A receiver is described for converting solar energy to heat a gas to temperatures from 700 to 900/sup 0/C. The receiver is formed to minimize impingement of radiation on the walls and to provide maximum heating at and near the entry of the gas exit. Also, the receiver is formed to provide controlled movement of the gas to be heated to minimize wall temperatures. The receiver is designed for use with gas containing fine heat absorbing particles, such as carbon particles.

  8. Solar heat receiver

    DOEpatents

    Hunt, Arlon J.; Hansen, Leif J.; Evans, David B.

    1985-01-01

    A receiver for converting solar energy to heat a gas to temperatures from 700.degree.-900.degree. C. The receiver is formed to minimize impingement of radiation on the walls and to provide maximum heating at and near the entry of the gas exit. Also, the receiver is formed to provide controlled movement of the gas to be heated to minimize wall temperatures. The receiver is designed for use with gas containing fine heat absorbing particles, such as carbon particles.

  9. 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.

  10. Comparison of Male vs Female Resident Milestone Evaluations by Faculty During Emergency Medicine Residency Training.

    PubMed

    Dayal, Arjun; O'Connor, Daniel M; Qadri, Usama; Arora, Vineet M

    2017-05-01

    evaluator-evaluatee gender pairing (effect size difference, -0.02 milestone levels; 95% CI for interaction, -0.05 to 0.01). Although male and female residents receive similar evaluations at the beginning of residency, the rate of milestone attainment throughout training was higher for male than female residents across all EM subcompetencies, leading to a gender gap in evaluations that continues until graduation. Faculty should be cognizant of possible gender bias when evaluating medical trainees.

  11. [Knowledge of health care ethics in paediatric residents].

    PubMed

    Hernández González, A; Rodríguez Núñez, A; Cambra Lasaosa, F J; Quintero Otero, S; Ramil Fraga, C; García Palacios, M V; Hernández Rastrollo, R; Ruiz Extremera, M A

    2014-02-01

    Bioethics has been recently incorporated in to the educational programs of both medical students and medical residents as part of their curriculum. However, its training based on clinical practice is not well structured. To evaluate the knowledge of bioethics in Spanish paediatric residents, and to analyse how this relates to the medical education during graduate and post-graduate training. A questionnaire with 20 multiple choice questions was designed to evaluate the knowledge in basic ethics with potential implications in clinical practice. We evaluated the education received during graduate and post-graduate training, and the main ethical conflicts faced. A total of 210 completed questionnaires were received from medical residents in paediatrics from 20 different Spanish hospitals, of whom 47 of these were first year residents (R1), 49 were second year residents (R2), 57 were third year residents (R3), and the remaining 57 were final year residents (R4). The mean number of correct answers was 16.8 out of 20. No differences were found between residents in different years of training, nor were there any differences between the group that had received specific training in bioethics versus those who had not. Residents were more likely to give wrong answers related with informed consent, the law on the freedom of the patient, principles of quality of life, the case analysis system, and the dimension of distributive justice. Limitation of therapeutic efforts was identified as the main ethical problem faced in clinical practice by Spanish residents in paediatrics. Most of the knowledge of bioethics is acquired during graduate training, and improved very little throughout the period of medical residence. Our results suggest that efforts are required in organising and structuring the education in bioethics during the training of residents in paediatrics. Copyright © 2012 Asociación Española de Pediatría. Published by Elsevier Espana. All rights reserved.

  12. Balancing clinical experience in outpatient residency training.

    PubMed

    Stahl, James E; Balasubramanian, Hari Jagannathan; Gao, Xiaoling; Overko, Steven; Fosburgh, Blair

    2014-05-01

    To receive adequate training experience, resident panels in teaching clinics must have a sufficiently diverse patient case-mix. However, case-mix can differ from one resident panel to another, resulting in inconsistent training. Encounter data from primary care residency clinics at Massachusetts General Hospital from July 2008 to May 2010 (64 residents and ~3800 patients) were used to characterize patients by gender, age, major disease category (both acute and chronic, e.g., Cardio Acute, Cardio Chronic, etc., for a total of 44 disease categories), and number of disease categories. Imbalance across resident panels was characterized by the standard deviation for disease category, patient panel size, and annual visit frequency. To balance case-mix in resident panels, patient reassignment algorithms were proposed. First, patients were sorted by complexity; then patients were allocated sequentially to the panel with the least overall complexity. Patient reassignment across resident panels was considered under 3 scenarios: 1) within preceptor, 2) within a group of preceptors, and 3) across the entire practice annually. were compared with case-mix (pre-July 2012) and post-July 2012. Results. All 3 reassignment algorithms produced significant reductions in standard deviation of either number of disease categories or diagnoses across residents when compared with baseline (pre-July 2012) and actual July 2012 reassignment. Reassignment across the clinic and group provided the best and second best scenarios, respectively, although both came at the cost of initially reduced patient-preceptor continuity. Systematically reallocating patient panels in teaching clinics potentially can improve the consistency and breadth of the educational experience. The method in principle can be extended to any target of health care system reform where there is patient or clinician turnover.

  13. Mobile technology in radiology resident education.

    PubMed

    Korbage, Aiham C; Bedi, Harprit S

    2012-06-01

    The authors hypothesized that ownership of a mobile electronic device would result in more time spent learning radiology. Current trends in radiology residents' studying habits, their use of electronic and printed radiology learning resources, and how much of the funds allotted to them are being used toward printed vs electronic education tools were assessed in this study. A survey study was conducted among radiology residents across the United States from June 13 to July 5, 2011. Program directors listed in the Association of Program Directors in Radiology e-mail list server received an e-mail asking for residents to participate in an online survey. The questionnaire consisted of 12 questions and assessed the type of institution, the levels of training of the respondents, and book funds allocated to residents. It also assessed the residents' study habits, access to portable devices, and use of printed and electronic radiology resources. Radiology residents are adopters of new technologies, with 74% owning smart phones and 37% owning tablet devices. Respondents spend nearly an equal amount of time learning radiology from printed textbooks as they do from electronic resources. Eighty-one percent of respondents believe that they would spend more time learning radiology if provided with tablet devices. There is considerable use of online and electronic resources and mobile devices among the current generation of radiology residents. Benefits, such as more study time, may be obtained by radiology programs that incorporate tablet devices into the education of their residents. Copyright © 2012 American College of Radiology. Published by Elsevier Inc. All rights reserved.

  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. Advanced laparoscopic fellowship and general surgery residency can coexist without detracting from surgical resident operative experience.

    PubMed

    Kothari, Shanu N; Cogbill, Thomas H; O'Heron, Colette T; Mathiason, Michelle A

    2008-01-01

    Concern has been voiced that general surgery residents who train at institutions that also offer advanced laparoscopic fellowships may receive inadequate advanced laparoscopic operative experience. The purpose of our study was to compare the operative experience of general surgery residents who graduated from our institution before initiation of an advanced laparoscopic fellowship with the experience of those who graduated after the fellowship began. Operative case logs of surgery residents who graduated from 2000 through 2007 and of advanced laparoscopic fellows from 2004 through 2007 were reviewed. Surgery resident experience with basic and nonbariatric advanced laparoscopic cases during the 4 years before the fellowship was compared with the experience during the 4 years after the fellowship began. Residents who graduated before 2004 performed a mean of 140.5 +/- 19.4 basic and 77.0 +/- 17.8 advanced laparoscopic cases during their 5-year residency, compared with 193.3 +/- 34.5 basic (p = 0.003) and 113.3 +/- 23.5 advanced cases (p = 0.005) performed by those who graduated in 2004 or later. The number of nonbariatric advanced laparoscopic cases performed by each graduating surgical resident during the chief year ranged from 26 to 47 cases from 2000 to 2003 and from 36 to 69 cases from 2004 to 2007. Fellows reported from 40 to 85 nonbariatric advanced laparoscopic cases annually. General surgery residents did not experience a reduction in the total number of basic and nonbariatric advanced laparoscopic cases with the addition of an advanced laparoscopic fellowship, nor did they perform fewer cases during the chief year. As the result of a cooperative venture between the surgery residency and fellowship directors as well as an expansion of the total number of laparoscopic cases performed at our institution because of changes in clinical practice, surgery residents reported an increase in the number of laparoscopic cases while a successful fellowship was

  17. Ka Band Channelized Receiver

    DTIC Science & Technology

    2015-09-01

    Communications allocations reside in this band of the spectrum. This report defines a first-order system analysis of constructing an analog radio ......art in digital signal processing hardware and software algorithms. RF commercial-off-the-shelf (COTS) parts are selected in order to develop a system

  18. Resident-to-Resident Aggression in Long-Term Care Facilities: An Understudied Problem

    PubMed Central

    Rosen, Tony; Pillemer, Karl; Lachs, Mark

    2009-01-01

    Resident-to-resident aggression (RRA) between long-term care residents includes negative and aggressive physical, sexual, or verbal interactions that in a community setting would likely be construed as unwelcome and have high potential to cause physical or psychological distress in the recipient. Although this problem potentially has high incidence and prevalence and serious consequences for aggressors and victims, it has received little direct attention from researchers to date. This article reviews the limited available literature on this topic as well as relevant research from related areas including: resident violence toward nursing home staff, aggressive behaviors by elderly persons, and community elder abuse. We present hypothesized risk factors for aggressor, victim, and nursing home environment, including issues surrounding cognitive impairment. We discuss methodological challenges to studying RRA and offer suggestions for future research. Finally, we describe the importance of designing effective interventions, despite the lack currently available, and suggest potential areas of future research. PMID:19750126

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

    PubMed

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

    2015-11-01

    The University of Maryland Department of Epidemiology and Public Health collaborated with the Center for Integrative Medicine at the same institution to develop and implement a unique integrative medicine curriculum within a preventive medicine residency program. Between October 2012 and July 2014, Center for Integrative Medicine faculty provided preventive medicine residents and faculty, and occasionally other Department of Epidemiology and Public Health faculty, with comprehensive exposure to the field of integrative medicine, including topics such as mind-body medicine, nutrition and nutritional supplements, Traditional Chinese Medicine, massage, biofield therapies, manual medicine, stress management, creative arts, and the use of integrative medicine in the inpatient setting. Preventive medicine residents, under the supervision of Department of Epidemiology and Public Health faculty, led integrative medicine-themed journal clubs. Resident assessments included a case-based knowledge evaluation, the Integrative Medicine Attitudes Questionnaire, and a qualitative evaluation of the program. Residents received more than 60 hours of integrative medicine instruction, including didactic sessions, experiential workshops, and wellness retreats in addition to clinical experiences and individual wellness mentoring. Residents rated the program positively and recommended that integrative medicine be included in preventive medicine residency curricula. The inclusion of a wellness-focused didactic, experiential, and skill-based integrative medicine program within a preventive medicine residency was feasible and well received by all six preventive medicine residents. Copyright © 2015 American Journal of Preventive Medicine. Published by Elsevier Inc. All rights reserved.

  20. 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.

  1. Surgical resident learning styles: faculty and resident accuracy at identification of preferences and impact on ABSITE scores.

    PubMed

    Kim, Roger H; Gilbert, Timothy; Ristig, Kyle; Chu, Quyen D

    2013-09-01

    As a consequence of surgical resident duty hour restrictions, there is a need for faculty to utilize novel teaching methods to convey information in a more efficient manner. The current paradigm of surgical training, which has not changed significantly since the time of Halsted, assumes that all residents assimilate information in a similar fashion. However, recent data has shown that learners have preferences for the ways in which they receive and process information. The VARK model categorizes learners as visual (V), aural (A), read/write (R), and kinesthetic (K). The VARK learning style preferences of surgical residents have not been previously evaluated. In this study, the preferred learning styles of general surgery residents were determined, along with faculty and resident perception of resident learning styles. In addition, we hypothesized that American Board of Surgery In-Training Exam (ABSITE) scores are associated with preference for a read/write (R) learning style. The Fleming VARK learning styles inventory was administered to all general surgery residents at a university hospital-based program. Responses on the inventory were scored to determine the preferred learning style for each resident. Faculty members were surveyed to determine their accuracy in identifying the preferred learning style of each resident. All residents were also surveyed to determine their accuracy in identifying their peers' VARK preferences. Resident ABSITE scores were examined for association with preferred learning styles. Twenty-nine residents completed the inventory. Most (18 of 29, 62%) had a multimodal preference, although more than a third (11 of 29, 38%) demonstrated a single-modality preference. Seventy-six percent of all residents (22 of 29) had some degree of kinesthetic (K) learning, while under 50% (14 of 29) were aural (A) learners. Although not significant, dominant (R) learners had the highest mean ABSITE scores. Faculty identified residents' learning styles

  2. 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.

  3. Data-fusion receiver

    SciTech Connect

    Gabelmann, Jeffrey M.; Kattner, J. Stephen; Houston, Robert A.

    2006-12-19

    This invention is an ultra-low frequency electromagnetic telemetry receiver which fuses multiple input receive sources to synthesize a decodable message packet from a noise corrupted telemetry message string. Each block of telemetry data to be sent to the surface receiver from a borehole tool is digitally encoded into a data packet prior to transmission. The data packet is modulated onto the ULF EM carrier wave and transmitted from the borehole to the surface and then are simultaneously detected by multiple receive sensors disbursed within the rig environment. The receive sensors include, but are not limited to, electric field and magnetic field sensors. The spacing of the surface receive elements is such that noise generators are unequally coupled to each receive element due to proximity and/or noise generator type (i.e. electric or magnetic field generators). The receiver utilizes a suite of decision metrics to reconstruct the original, non noise-corrupted data packet from the observation matrix via the estimation of individual data frames. The receiver will continue this estimation process until: 1) the message validates, or 2) a preset "confidence threshold" is reached whereby frames within the observation matrix are no longer "trusted".

  4. Hybrid receiver study

    NASA Technical Reports Server (NTRS)

    Stone, M. S.; Mcadam, P. L.; Saunders, O. W.

    1977-01-01

    The results are presented of a 4 month study to design a hybrid analog/digital receiver for outer planet mission probe communication links. The scope of this study includes functional design of the receiver; comparisons between analog and digital processing; hardware tradeoffs for key components including frequency generators, A/D converters, and digital processors; development and simulation of the processing algorithms for acquisition, tracking, and demodulation; and detailed design of the receiver in order to determine its size, weight, power, reliability, and radiation hardness. In addition, an evaluation was made of the receiver's capabilities to perform accurate measurement of signal strength and frequency for radio science missions.

  5. The Efficacy of Residents as Teachers in an Ophthalmology Module.

    PubMed

    Ryg, Peter A; Hafler, Janet P; Forster, Susan H

    2016-01-01

    Resident physicians have reported spending upward of 25% of their time teaching fellow residents and medical students. Until relatively recently, there have not been formal requirements in residency programs to learn teaching skills. The first goal of this study was to develop a novel residents-as-teachers training program to educate Ophthalmology residents on facilitating group learning and emphasizing critical-thinking skills. The second goal was to educate residents on how to teach clinical reasoning skills. We designed a longitudinal residents-as-teachers program that consisted of a 2-hour workshop, voluntary observation of their teaching in the small group, and student feedback on their teaching. The focus of the workshop was to educate the residents on how to facilitate critical thinking and clinical reasoning in a small group format. Voluntary video recording of residents' teaching was offered, and feedback on their teaching was provided. Yale University School of Medicine, Department of Ophthalmology and Visual Science. In total, ten second-year medical student groups consisting of approximately 7 to 11 students in each group were organized in this course and each group had one teacher: 4 senior Ophthalmology residents and 6 community faculty. This study found that the resident teachers who completed the residents-as-teachers program were equally as effective as community faculty teachers in building medical students' comprehension of ophthalmic principles during small group seminars according to the students' evaluation of teaching performance. We also found that all of the medical students' responses were overwhelmingly positive toward having residents as teachers. The medical students particularly noted residents' preparedness and effectiveness in facilitating a discussion during the small group seminars. Our novel program was effective at teaching residents how to teach critical-thinking skills and the resident teachers were well received by medical

  6. Residents' experiences of abuse, discrimination and sexual harassment during residency training. McMaster University Residency Training Programs.

    PubMed

    Cook, D J; Liutkus, J F; Risdon, C L; Griffith, L E; Guyatt, G H; Walter, S D

    1996-06-01

    To assess the prevalence of psychological abuse, physical assault, and discrimination on the basis of gender and sexual orientation, and to examine the prevalence and impact of sexual harassment in residency training programs. Self-administered questionnaire. McMaster University, Hamilton, Ont. Residents in seven residency training programs during the academic year from July 1993 to June 1994. Of 225 residents 186 (82.7%) returned a completed questionnaire, and 50% of the respondents were women. Prevalence of psychological abuse, physical assault and discrimination on the basis of gender and sexual orientation experienced by residents during medical training, prevalence and residents' perceived frequency of sexual harassment. Psychological abuse was reported by 50% of the residents. Some of the respondents reported physical assault, mostly by patients and their family members (14.7% reported assaults by male patients and family members, 9.8% reported assaults by female patients and family members), 5.4% of the female respondents reported assault by male supervising physicians. Discrimination on the basis of gender was reported to be common and was experienced significantly more often by female residents than by male residents (p < 0.01). Ten respondents, all female, reported having experienced discrimination on the basis of their sexual orientation. Most of the respondents experienced sexual harassment, especially in the form of sexist jokes, flirtation and unwanted compliments on their dress or figure. On average, 40% of the respondents, especially women (p < 0.01), reported experiencing offensive body language and receiving sexist teaching material and unwanted compliments on their dress. Significantly more female respondents than male respondents stated that they had reported events of sexual harassment to someone (p < 0.001). The most frequent emotional reactions to sexual harassment were embarassment (reported by 24.0%), anger (by 23.4%) and frustration (20

  7. Methylnaltrexone in the treatment of opioid-induced constipation in cancer patients receiving palliative care: willingness-to-pay and cost-benefit analysis.

    PubMed

    Iskedjian, Michael; Iyer, Shrividya; Librach, S Lawrence; Wang, Mike; Farah, Bechara; Berbari, Jade

    2011-01-01

    When laxative regimens have failed, methylnaltrexone may be indicated for the relief of opioid-induced constipation (OIC) in patients with advanced illness receiving palliative care. A cost-benefit analysis (CBA), based on a willingness-to-pay (WTP) approach, was performed to determine if methylnaltrexone should be added to the formulary list of drugs being reimbursed by third-party payers in Canada for the treatment of cancer patients in palliative care suffering from OIC. The WTP study had two components: a decision board explaining treatment options (Component A) and a questionnaire to measure individual WTP using a bidding game approach (Component B). Component A had two options: Option 1 (laxatives only) and Option 2 (laxatives+methylnaltrexone injection). Only participants choosing Option 2 were invited to complete Component B. The results of the WTP survey were then incorporated into a CBA. Within a hypothetical cohort, additional monthly premiums that individuals were willing to pay for methylnaltrexone were compared with the monthly costs to the insurer for providing methylnaltrexone to all patients who would potentially be using it. Four hundred one Canadians, of age 18 years and older, were surveyed and yielded a WTP in additional monthly insurance premiums of Canadian dollar (CAD) $8.65 (95% confidence interval: CAD$6.17-CAD$11.13). The CBA resulted in additional CAD$89,307 with a cost of CAD$139,840 and benefits of CAD$229,147. A set of 10,000 Monte Carlo simulations resulted in average CBA savings of CAD$145,011 with a 99.86% probability of dominance. The present CBA provides pharmacoeconomic evidence for the adoption of methylnaltrexone for treating OIC in terminally ill cancer patients. Copyright © 2011 U.S. Cancer Pain Relief Committee. Published by Elsevier Inc. All rights reserved.

  8. Resident procedure and resuscitation tracking using a palm computer

    PubMed

    Rosenthal; Wolford

    2000-10-01

    Resident procedure and resuscitation tracking is an onerous task required for residency accreditation and for future hospital privilege applications by the resident. To date, most tracking systems have been somewhat cumbersome and prone to data loss (forms not being filled out, recorded, etc.). Our residency program uses a palm computer database tracking system utilizing Palm III (3Com) hardware and a custom written data collection form utilizing an inexpensive, commercially available software package (Pendragon Forms (version 2), Pendragon Software Corporation, Libertyville, IL). Every resident receives a Palm III on entry into the residency. Residents enter basic demographic data and record procedures and resuscitations into the Palm III after each encounter. Generally, each patient logged requires approximately one minute for data entry. On a frequent basis, the resident's Palm is 'HotSync-ed' and the recorded data transferred to the program's central computer. Resident data are easily manipulated and reports are generated using a common, relational database program (Access97, Microsoft Corporation, Redmond, WA). We have found this system to be relatively inexpensive, to improve data capture, to reduce demands on secretarial time, and to allow improved tracking of resident procedure and resuscitation experiences.

  9. Forensic Pathology Education in Pathology Residency

    PubMed Central

    Ross, Wayne K.; Domen, Ronald E.

    2017-01-01

    Forensic pathology is a fundamental part of anatomic pathology training during pathology residency. However, the lack of information on forensic teaching suggests the highly variable nature of forensic education. A survey of pathology residency program directors was performed to determine key aspects of their respective forensic rotations and curriculum. A total of 38.3% of programs from across the country responded, and the survey results show 5.6% don’t require a forensic pathology rotation. In those that do, most forensic pathology rotations are 4 weeks long, are done at a medical examiner’s office, and require set prerequisites. A total of 21.1% of responding programs have residents who are not receiving documented evaluations for this rotation. While 39.6% of programs have a defined forensics curriculum, as many as 15% do not. Furthermore, nearly 43% of programs place no limit on counting forensic autopsies when applying for pathology board examinations. Our survey confirmed the inconsistent nature of forensic pathology training in resident education. Additionally, our curriculum was reorganized to create a more robust educational experience. A pre- and post-forensic lecture quiz and Resident In-Service Examination scores were analyzed to determine our curriculum’s impact and effectiveness. Analysis of our pre- and post-lecture quiz showed an improved overall average as well as an increase in Resident In-Service Examination scores, indicating improved general forensic pathology knowledge. Using this knowledge, along with changes in our curriculum, we generated a number of recommendations for improving forensic pathology education in pathology residency. PMID:28913415

  10. Gout treatment: survey of Brazilian rheumatology residents.

    PubMed

    Amorim, Rodrigo Balbino Chaves; Vargas-Santos, Ana Beatriz; Pereira, Leticia Rocha; Coutinho, Evandro Silva Freire; da Rocha Castelar-Pinheiro, Geraldo

    2017-05-01

    To assess the current practices in gout management among Brazilian rheumatology residents. We performed a cross-sectional online survey among all the rheumatology residents and those rheumatologists who had just completed their training (post-residency (PR)) regarding their approach to gout management. Results were compared with the 2012 American College of Rheumatology (ACR) gout guidelines and with the responses of a previous survey with a representative sample of practicing Brazilian rheumatologists (RHE). We received 224 responses (83%) from 271 subjects. Among all respondents, the first-choice treatment for gout flares was the combination of a nonsteroidal anti-inflammatory drug + colchicine for otherwise healthy patients. A target serum urate <6 mg/dL for patients without tophi was reported by >75%. Less than 70% reported starting allopurinol at low doses (≤100 mg/day) for patients with normal renal function and <50% reported maintaining urate-lowering therapy indefinitely for patients without tophi. Among residents and PR, the residency stage was the main predictor of concordance with the ACR guidelines, with PR achieving the greatest rates. Reported practices were commonly concordant with the 2012 ACR gout guidelines, especially among PR. However, some important aspects of gout management need improvement. These results will guide the development of a physician education program to improve the management of gout patients in Brazil.

  11. Right to Receive.

    ERIC Educational Resources Information Center

    Oborn, Richard

    The concept of a United States citizen's right to receive information is acquiring increased judicial recognition. This report traces the evolution of that right from its philosophical basis in the United States Consitution, through its interpretation by the Supreme Court, up to the current concern that the public receive certain economic…

  12. Flight termination receiver catalog

    NASA Astrophysics Data System (ADS)

    1993-02-01

    This catalog provides reference information on ultra-high frequency flight termination receivers used at various U.S. missile ranges and test facilities. It is not intended to be a comprehensive review of all available flight termination receivers. Inclusion in this catalog does not constitute approval or endorsement for use at any government installation. Information in this catalog was extracted from manufacturers' specifications.

  13. Pennsylvania SBIRT Medical and Residency Training: Developing, Implementing, and Evaluating an Evidenced-Based Program

    ERIC Educational Resources Information Center

    Pringle, Janice L.; Melczak, Michael; Johnjulio, William; Campopiano, Melinda; Gordon, Adam J.; Costlow, Monica

    2012-01-01

    Medical residents do not receive adequate training in screening, brief intervention, and referral to treatment (SBIRT) for alcohol and other drug use disorders. The federally funded Pennsylvania SBIRT Medical and Residency Training program (SMaRT) is an evidence-based curriculum with goals of training residents in SBIRT knowledge and skills and…

  14. Pennsylvania SBIRT Medical and Residency Training: Developing, Implementing, and Evaluating an Evidenced-Based Program

    ERIC Educational Resources Information Center

    Pringle, Janice L.; Melczak, Michael; Johnjulio, William; Campopiano, Melinda; Gordon, Adam J.; Costlow, Monica

    2012-01-01

    Medical residents do not receive adequate training in screening, brief intervention, and referral to treatment (SBIRT) for alcohol and other drug use disorders. The federally funded Pennsylvania SBIRT Medical and Residency Training program (SMaRT) is an evidence-based curriculum with goals of training residents in SBIRT knowledge and skills and…

  15. Supervising incoming first-year residents: faculty expectations versus residents' experiences.

    PubMed

    Touchie, Claire; De Champlain, André; Pugh, Debra; Downing, Steven; Bordage, Georges

    2014-09-01

    First-year residents begin clinical practice in settings in which attending staff and senior residents are available to supervise their work. There is an expectation that, while being supervised and as they become more experienced, residents will gradually take on more responsibilities and function independently. This study was conducted to define 'entrustable professional activities' (EPAs) and determine the extent of agreement between the level of supervision expected by clinical supervisors (CSs) and the level of supervision reported by first-year residents. Using a nominal group technique, subject matter experts (SMEs) from multiple specialties defined EPAs for incoming residents; these represented a set of activities to be performed independently by residents by the end of the first year of residency, regardless of specialty. We then surveyed CSs and first-year residents from one institution in order to compare the levels of supervision expected and received during the day and night for each EPA. The SMEs defined 10 EPAs (e.g. completing admission orders, obtaining informed consent) that were ratified by a national panel. A total of 113 CSs and 48 residents completed the survey. Clinical supervisors had the same expectations regardless of time of day. For three EPAs (managing i.v. fluids, obtaining informed consent, obtaining advanced directives) the level of supervision reported by first-year residents was lower than that expected by CSs (p < 0.001) regardless of time of day (i.e. day or night). For four more EPAs (initiating the management of a critically ill patient, handing over the care of a patient to colleagues, writing a discharge prescription, coordinating a patient discharge) differences applied only to night-time work (p ≤ 0.001). First-year residents reported performing EPAs with less supervision than expected by CSs, especially during the night. Using EPAs to guide the content of the undergraduate curriculum and during examinations could

  16. 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…

  17. 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)

  18. 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)

  19. 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…

  20. 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.…

  1. 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.…

  2. 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)

  3. Flight termination receiver catalog

    NASA Astrophysics Data System (ADS)

    1984-07-01

    This catalog provides reference information on ultrahigh-frequency flight termination receivers used at various U.S. missile ranges and test facilities. It is not intended to be a comprehensive review of all available flight termination receivers, and inclusion of hardware in this catalog does not constitute approval or endorsement for use at any government installation. Use of a specific receiver at a missile range or test facility requires the approval of the Commander of that installation. Approval for use of a particular receiver on a given missile at one installation does not constitute automatic approval for use of the same receiver on other missiles at the same installation or on the same missile at other installations. The information in this catalog has been extracted from manufacturers' specifications. It is provided as reference material only and is not intended as an endorsement of any model.

  4. Florida manatee now resident in the Bahamas

    USGS Publications Warehouse

    Reid, James P.

    2000-01-01

    In January 2000, both the Bahamas National Trust and the Save the Manatee Club received reports of a manatee at Bullocks Harbor, Great Harbour Cay, Bahamas. Under permit with the Bahamas’ Department of Fisheries, I visited Great Harbour Cay from 25 to 27 February 2000 to make a field assessment of the manatee, interview local residents, and provide management recommendations. Detailed below are findings from this trip and a review of this individual’s interesting history.

  5. 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

  6. CALUTRON RECEIVER STRUCTURE

    DOEpatents

    Roush, J.L.

    1959-09-01

    A receiver is described for collecting isotopes in a calutron The receiver has several compartments, formed by a sertes of parallel metal plates and an open front. Each plate has flanges which space it from the other plates and a flexible extension pressing against a common supporting red to maintain the plate in assembled relation when all but the last rod is removed. The plates may be removed individualy from the front of the receiver, cleaned ard replaced without disturbing the alignment of the other plates.

  7. 30-micron heterodyne receiver

    NASA Technical Reports Server (NTRS)

    Kostiuk, Theodor; Spears, David L.

    1987-01-01

    Advantages and constraints of remote measurements using heterodyne spectroscopy near 30 microns are discussed. The state of the art of wideband HgCdTe photomixers and PbSnSe diode-laser local oscillators being developed for FIR heterodyne receivers is described. The first compact 30-micron heterodyne radiometer was built, and initial results at 28-microns show about 2-percent mixer efficiency for a 500-MHz-bandwidth receiver. Factors limiting receiver performance are discussed, along with the projected sensitivity of new interdigitated-electrode HgCdTe photoconductor mixers being developed for operation up to 200 microns.

  8. Has diversity increased in orthopaedic residency programs since 1995?

    PubMed

    Daniels, Eldra W; French, Keisha; Murphy, Laurie A; Grant, Richard E

    2012-08-01

    Diversity among health professionals is believed to be an important step toward improving patient communication and addressing health disparities. Orthopaedic surgery traditionally has been overly represented by Caucasian males, and it remains one of the least racially and gender-diversified surgical subspecialties. As the US population becomes increasingly diverse, a concomitant increase in ethnic diversity and gender diversity is needed to ensure that all Americans receive high-quality, culturally competent health care. We asked whether (1) representation of female orthopaedic residents and clinical faculty and (2) representation of ethnic minority orthopaedic residents, clinical faculty, and basic science faculty increased during the past 15 years since our original study. A questionnaire, created on SurveyMonkey®, was distributed by email to the coordinators of all 152 orthopaedic residency training programs in the United States. Eighty (53%) responses were received. The percentage of female orthopaedic surgery residents and female clinical faculty has nearly doubled since 1995. The percentages of African American, Asian/Pacific Islander, and Hispanic orthopaedic residents, and of clinical faculty have increased. Orthopaedic basic science research faculty is 83% male and is comprised primarily of Caucasians (62%) and Asian/Pacific Islanders (24%). Despite the increase in diversity in the orthopaedic workforce during the past 15 years, ethnic and gender disparities persist among orthopaedic residency programs regarding residents, clinical faculty, and basic research faculty. To increase diversity in orthopaedic residency programs, an emphasis on recruiting ethnic and gender minority candidates needs to become a priority in the orthopaedic academic community.

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

    PubMed

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

    2011-01-01

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

  10. Coleadership Among Chief Residents: Exploration of Experiences Across Specialties

    PubMed Central

    Pettit, Jeffrey E.

    2015-01-01

    Background Many departments have multiple chief residents. How these coleaders relate to each other could affect their performance, the residency program, and the department. Objective This article reports on how co-chiefs work together during the chief year, and what may allow them to be more effective coleaders. Methods A phenomenological research design was used to investigate experiences of outgoing chief residents from 13 specialties at the University of Iowa Hospitals and Clinics over a 2-year period from 2012 through 2013. Thematic analysis of semistructured interviews was conducted to investigate commonalities and recommendations. Results Face-to-face interviews with 19 chief residents from 13 different specialties identified experiences that helped co-chiefs work effectively with each other in orienting new co-chiefs, setting goals and expectations, making decisions, managing interpersonal conflict, leadership styles, communicating, working with program directors, and providing evaluations and feedback. Although the interviewed chief residents received guidance on how to be an effective chief resident, none had been given advice on how to effectively work with a co-chief, and 26% (5 of 19) of the respondents reported having an ineffective working relationship with their co-chief. Conclusions Chief residents often colead in carrying out their multiple functions. To successfully function in a multichief environment, chief residents may benefit from a formal co-orientation in which they discuss goals and expectations, agree on a decision-making process, understand each other's leadership style, and receive feedback on their efficacy as leaders. PMID:26221435

  11. Useful but Different: Resident Physician Perceptions of Interprofessional Feedback.

    PubMed

    Vesel, Travis P; O'Brien, Bridget C; Henry, Duncan M; van Schaik, Sandrijn M

    2016-01-01

    Phenomenon: Based on recently formulated interprofessional core competencies, physicians are expected to incorporate feedback from other healthcare professionals. Based on social identity theory, physicians likely differentiate between feedback from members of their own profession and others. The current study examined residents' experiences with, and perceptions of, interprofessional feedback. In 2013, Anesthesia, Obstetrics-Gynecology, Pediatrics, and Psychiatry residents completed a survey including questions about frequency of feedback from different professionals and its perceived value (5-point scale). The authors performed an analysis of variance to examine interactions between residency program and profession of feedback provider. They conducted follow-up interviews with a subset of residents to explore reasons for residents' survey ratings. Fifty-two percent (131/254) of residents completed the survey, and 15 participated in interviews. Eighty percent of residents reported receiving written feedback from physicians, 26% from nurses, and less than 10% from other professions. There was a significant interaction between residency program and feedback provider profession, F(21, 847) = 3.82, p < .001, and a significant main effect of feedback provider profession, F(7, 847) = 73.7, p < .001. On post hoc analyses, residents from all programs valued feedback from attending physicians higher than feedback from others, and anesthesia residents rated feedback from other professionals significantly lower than other residents. Ten major themes arose from qualitative data analysis, which revealed an overall positive attitude toward interprofessional feedback and clarified reasons behind residents' perceptions and identified barriers. Insights: Residents in our study reported limited exposure to interprofessional feedback and valued such feedback less than intraprofessional feedback. However, our data suggest opportunities exist for effective utilization of

  12. Education research: neurology training reassessed. The 2011 American Academy of Neurology Resident Survey results.

    PubMed

    Johnson, Nicholas E; Maas, Matthew B; Coleman, Mary; Jozefowicz, Ralph; Engstrom, John

    2012-10-23

    To assess the strengths and weaknesses of neurology resident education using survey methodology. A 27-question survey was sent to all neurology residents completing residency training in the United States in 2011. Of eligible respondents, 49.8% of residents returned the survey. Most residents believed previously instituted duty hour restrictions had a positive impact on resident quality of life without impacting patient care. Most residents rated their faculty and clinical didactics favorably. However, many residents reported suboptimal preparation in basic neuroscience and practice management issues. Most residents (71%) noted that the Residency In-service Training Examination (RITE) assisted in self-study. A minority of residents (14%) reported that the RITE scores were used for reasons other than self-study. The vast majority (86%) of residents will enter fellowship training following residency and were satisfied with the fellowship offers they received. Graduating residents had largely favorable neurology training experiences. Several common deficiencies include education in basic neuroscience and clinical practice management. Importantly, prior changes to duty hours did not negatively affect the resident perception of neurology residency training.

  13. 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.

  14. 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.

  15. Pennsylvania SBIRT Medical and Residency Training: developing, implementing, and evaluating an evidenced-based program.

    PubMed

    Pringle, Janice L; Melczak, Michael; Johnjulio, William; Campopiano, Melinda; Gordon, Adam J; Costlow, Monica

    2012-01-01

    Medical residents do not receive adequate training in screening, brief intervention, and referral to treatment (SBIRT) for alcohol and other drug use disorders. The federally funded Pennsylvania SBIRT Medical and Residency Training program (SMaRT) is an evidence-based curriculum with goals of training residents in SBIRT knowledge and skills and disseminating the curriculum throughout the medical residency programs. The SMaRT program collaborates with 4 hospital systems and 7 residency sites, with a target of 1147 residents to be trained. This brief report describes the design of the SMaRT program curriculum, implementation across settings and programs, and its evaluation methods.

  16. Ultrasonic pulser-receiver

    DOEpatents

    Taylor, Steven C.

    2006-09-12

    Ultrasonic pulser-receiver circuitry, for use with an ultrasonic transducer, the circuitry comprising a circuit board; ultrasonic pulser circuitry supported by the circuit board and configured to be coupled to an ultrasonic transducer and to cause the ultrasonic transducer to emit an ultrasonic output pulse; receiver circuitry supported by the circuit board, coupled to the pulser circuitry, including protection circuitry configured to protect against the ultrasonic pulse and including amplifier circuitry configured to amplify an echo, received back by the transducer, of the output pulse; and a connector configured to couple the ultrasonic transducer directly to the circuit board, to the pulser circuitry and receiver circuitry, wherein impedance mismatches that would result if the transducer was coupled to the circuit board via a cable can be avoided.

  17. Cryogenic microwave channelized receiver

    SciTech Connect

    Rauscher, C.; Pond, J.M.; Tait, G.B.

    1996-07-01

    The channelized receiver being presented demonstrates the use of high temperature superconductor technology in a microwave system setting where superconductor, microwave-monolithic-integrated-circuit, and hybrid-integrated-circuit components are united in one package and cooled to liquid-nitrogen temperatures. The receiver consists of a superconducting X-band four-channel demultiplexer with 100-MHz-wide channels, four commercial monolithically integrated mixers, and four custom-designed hybrid-circuit detectors containing heterostructure ramp diodes. The composite receiver unit has been integrated into the payload of the second-phase NRL high temperature superconductor space experiment (HTSSE-II). Prior to payload assembly, the response characteristics of the receiver were measured as functions of frequency, temperature, and drive levels. The article describes the circuitry, discusses the key issues related to design and implementation, and summarizes the experimental results.

  18. Ceramic Solar Receiver

    NASA Technical Reports Server (NTRS)

    Robertson, C., Jr.

    1984-01-01

    Solar receiver uses ceramic honeycomb matrix to absorb heat from Sun and transfer it to working fluid at temperatures of 1,095 degrees and 1,650 degrees C. Drives gas turbine engine or provides heat for industrial processes.

  19. Solar energy receiver

    DOEpatents

    Schwartz, Jacob

    1978-01-01

    An improved long-life design for solar energy receivers provides for greatly reduced thermally induced stress and permits the utilization of less expensive heat exchanger materials while maintaining receiver efficiencies in excess of 85% without undue expenditure of energy to circulate the working fluid. In one embodiment, the flow index for the receiver is first set as close as practical to a value such that the Graetz number yields the optimal heat transfer coefficient per unit of pumping energy, in this case, 6. The convective index for the receiver is then set as closely as practical to two times the flow index so as to obtain optimal efficiency per unit mass of material.

  20. [Assessment of a residency training program in endocrinology and nutrition: results of a resident survey].

    PubMed

    Gutiérrez-Alcántara, Carmen; Moreno-Fernández, Jesús; Palomares-Ortega, Rafael; García-Manzanares, Alvaro; Benito-López, Pedro

    2011-12-01

    In 2006, a new training program was approved for resident physicians in endocrinology and nutrition (EN). A survey was conducted to EN residents to assess their training, their depth of knowledge, and compliance with the new program, as well as potential changes in training, and the results obtained were compared to those from previous surveys. A survey previously conducted in 2000 and 2005 was used for this study. The survey included demographic factors, questions about the different rotations, scientific and practical training, assessment of their training departments and other aspects. Results of the current survey were compared to those of the 2005 survey. The survey was completed by 40 residents. Mandatory rotations are mainly fulfilled, except for neurology. Some rotations removed from the program, such as radiology and nuclear medicine, still are frequently performed and popular among residents, who would include them back into the program. There was a low compliance with practical training in the endocrinology area. Forty percent of residents were not aware of the new program, but 60% thought that it was fulfilled. A total of 82.5% of residents thought that their departments fulfilled the training objectives. Few differences were found in rotations as compared to the data collected in 2005 despite changes in the training program, and there was still a lack of practical training. By contrast, rating of training received from departments and senior physicians was improved as compared to prior surveys. Copyright © 2011 SEEN. Published by Elsevier Espana. All rights reserved.

  1. Receiver Gain Modulation Circuit

    NASA Technical Reports Server (NTRS)

    Jones, Hollis; Racette, Paul; Walker, David; Gu, Dazhen

    2011-01-01

    A receiver gain modulation circuit (RGMC) was developed that modulates the power gain of the output of a radiometer receiver with a test signal. As the radiometer receiver switches between calibration noise references, the test signal is mixed with the calibrated noise and thus produces an ensemble set of measurements from which ensemble statistical analysis can be used to extract statistical information about the test signal. The RGMC is an enabling technology of the ensemble detector. As a key component for achieving ensemble detection and analysis, the RGMC has broad aeronautical and space applications. The RGMC can be used to test and develop new calibration algorithms, for example, to detect gain anomalies, and/or correct for slow drifts that affect climate-quality measurements over an accelerated time scale. A generalized approach to analyzing radiometer system designs yields a mathematical treatment of noise reference measurements in calibration algorithms. By treating the measurements from the different noise references as ensemble samples of the receiver state, i.e. receiver gain, a quantitative description of the non-stationary properties of the underlying receiver fluctuations can be derived. Excellent agreement has been obtained between model calculations and radiometric measurements. The mathematical formulation is equivalent to modulating the gain of a stable receiver with an externally generated signal and is the basis for ensemble detection and analysis (EDA). The concept of generating ensemble data sets using an ensemble detector is similar to the ensemble data sets generated as part of ensemble empirical mode decomposition (EEMD) with exception of a key distinguishing factor. EEMD adds noise to the signal under study whereas EDA mixes the signal with calibrated noise. It is mixing with calibrated noise that permits the measurement of temporal-functional variability of uncertainty in the underlying process. The RGMC permits the evaluation of EDA by

  2. Advanced Solar Receivers

    NASA Technical Reports Server (NTRS)

    Owen, W. A.

    1984-01-01

    Low thermal efficiencies in solar receivers are discussed in terms of system design. It is recommended that careful attention be given to the overall thermal systems design, especially to conductive losses about the window and areas of relatively thin insulation. If the cavity design is carefully managed to insure a small, minimally reradiating aperture, the goal of a very high efficiency cavity receiver is a realistic one.

  3. OCD RADIO ALERT RECEIVERS.

    DTIC Science & Technology

    for methods of operating a radioalert system were established in conjunction with OCD representatives. Four types of operation were selected. Three...models each of these four receiver types were fabricated and tested. The total of 12 laboratory models were delivered to OCD . Test equipment...suitable for demonstrating the two most promising receiver types was also assembled, and delivered to OCD . A preliminary analysis of the cost of mass

  4. Project Echo: Receiving System

    NASA Technical Reports Server (NTRS)

    Ohm, E. A.

    1961-01-01

    A tracking horn-reflector antenna, a maser preamplifier (and standby parametric preamplifier), and a special FM demodulator were combined to form a low-noise receiving system which made possible the establishment of a high-quality voice circuit via the Echo I passive satellite. This paper describes the 2390-Mc receiving system located at the Bell Telephone Laboratories facility in Holmdel, New Jersey.

  5. Are All Competencies Equal in the Eyes of Residents? A Multicenter Study of Emergency Medicine Residents' Interest in Feedback.

    PubMed

    Bentley, Suzanne; Hu, Kevin; Messman, Anne; Moadel, Tiffany; Khandelwal, Sorabh; Streich, Heather; Noelker, Joan

    2017-01-01

    Feedback, particularly real-time feedback, is critical to resident education. The emergency medicine (EM) milestones were developed in 2012 to enhance resident assessment, and many programs use them to provide focused resident feedback. The purpose of this study was to evaluate EM residents' level of interest in receiving real-time feedback on each of the 23 competencies/sub-competencies. This was a multicenter cross-sectional study of EM residents. We surveyed participants on their level of interest in receiving real-time on-shift feedback on each of the 23 competencies/sub-competencies. Anonymous paper or computerized surveys were distributed to residents at three four-year training programs and three three-year training programs with a total of 223 resident respondents. Residents rated their level of interest in each milestone on a six-point Likert-type response scale. We calculated average level of interest for each of the 23 sub-competencies, for all 223 respondents and separately by postgraduate year (PGY) levels of training. One-way analyses of variance were performed to determine if there were differences in ratings by level of training. The overall survey response rate across all institutions was 82%. Emergency stabilization had the highest mean rating (5.47/6), while technology had the lowest rating (3.24/6). However, we observed no differences between levels of training on any of the 23 competencies/sub-competencies. Residents seem to ascribe much more value in receiving feedback on domains involving high-risk, challenging procedural skills as compared to low-risk technical and communication skills. Further studies are necessary to determine whether residents' perceived importance of competencies/sub-competencies needs to be considered when developing an assessment or feedback program based on these 23 EM competencies/sub-competencies.

  6. 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.

  7. 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.

  8. 75 FR 62186 - Proposed Information Collection (Residency Verification Report-Veterans and Survivors) Activity...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-10-07

    ... at the full-dollar rate continues to meet the United States residency requirements. DATES: Written... receiving service-connected compensation benefits and survivors receiving service connected death benefits at the full-dollar rate, actually resides in the United States as United States citizens or as...

  9. General Surgery Resident Satisfaction on Cardiothoracic Rotations.

    PubMed

    Lussiez, Alisha; Bevins, Jack; Plaska, Andrew; Rosin, Vadim; Reddy, Rishindra M

    2016-01-01

    General surgery residents' exposure to cardiothoracic (CT) surgery rotations has decreased, which may affect resident satisfaction. We surveyed general surgery graduates to assess the relationships among rotation satisfaction, CT disease exposure, rotation length, mentorship, and mistreatment. A survey assessing CT curriculum, exposure, mentorship, and satisfaction was forwarded to general surgery graduates from 17 residency programs. A Wilcoxon rank-sum test was used to assess statistical significance of ordinal level data. Statistical significance was defined as p < 0.05. This study was conducted at the University of Michigan Health System in Ann Arbor, MI, a tertiary care center. The survey was sent to approximately 1300 graduates of general surgery residency programs who graduated between the years of 1999 to 2014. A total of 94 responses were completed and received. Receiving adequate exposure to CT procedures and disease management was significantly associated with higher satisfaction ratings for all procedures, particularly thoracotomy incisions (p < 0.001), empyemas and pleural effusions (p < 0.001), and lung cancer care (p < 0.001). The absence of mistreatment and good/very good mentorship were both positively associated with higher reported satisfaction (p = 0.018 and p < 0.001, respectively). Increased length of time on CT rotation was neither associated with improved levels of satisfaction nor with an improvement in the quality of mentorship. Rotation satisfaction is positively associated with procedure exposure, better mentorship, and the absence of mistreatment. Longer rotation length was not associated with satisfaction. Shorter rotations are not detrimental to training if they have focused clinical exposure and invested mentors to maximize resident satisfaction. These specific markers of rotation quality are useful in curricular design. Copyright © 2015 Association of Program Directors in Surgery. Published by Elsevier Inc. All rights reserved.

  10. 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".

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

    PubMed

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

    2015-11-01

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

  12. Musculoskeletal education in physical medicine and rehabilitation residency programs.

    PubMed

    Smith, Jay; Krabak, Brian J; Malanga, Gerard A; Moutvic, Margaret A

    2004-10-01

    To characterize current musculoskeletal (MSK) education experiences in physical medicine and rehabilitation residency programs and to identify perceived barriers to providing more extensive MSK education experiences. In addition, to establish utilization patterns for the PASSOR Physical Examination Core Competencies List. Between March and November 2003, all 81 physical medicine and rehabilitation residency program directors were asked to complete an MSK education survey developed by the authors. A total of 69 of 81 program directors (86%) responded after multiple contacts. The most frequently utilized MSK education formats were MSK lecture series, MSK departmental conferences, and physical examination workshops. Potential barriers to expanded MSK education included money, time, and staff number. Given unlimited resources, most residency programs would greatly increase utilization of visiting lecturers, CD-ROMs/DVDs, objective structured clinical examinations, and physical examination videos. Of the 30 program directors who recalled receiving the Core Competencies List, only 40% (12 of 30) have formally integrated the list into their residency training. Barriers to implementation included logistical challenges and lack of direction regarding implementation. Residency program directors indicate a strong interest in expanding resident MSK education through the use of CD-ROMs/DVDs, physical examination videos, objective structured clinical examinations, and visiting lecturer programs. CD-ROMs/DVDs and videos represent particularly attractive educational formats for supplementing resident MSK education due to the advantages of central production, nominal costs, widespread distribution, multimedia capabilities, and accessibility. These educational formats should be considered for targeted educational initiatives to enhance resident MSK education, regardless of residency program size or resources.

  13. Evaluation of a clinical skills orientation program for residents.

    PubMed

    Nielsen, Peter E; Holland, Robert H B; Foglia, Lisa M

    2003-09-01

    Our purpose was to implement and evaluate an orientation program for residents, focusing on outpatient clinical skills. Eleven of 12 residents participated in a clinical skills orientation program immediately preceding the academic year. The skill stations included evaluation of abnormal uterine bleeding, intrauterine device insertion, basic infertility evaluation, endometrial and vulvar biopsies, pelvic organ prolapse quantification examination, hysterosalpingography and office hysteroscopy, ultrasound scanning, labor and delivery triage, and clinic administrative responsibilities. Before test, after test, and anonymous resident evaluations were used to evaluate the program. First-year residents demonstrated a statistically significant increase in posttest scores compared to pretest scores (42.5% vs 71.3%, P=.003). Only first-year resident posttest scores for the labor and delivery triage and basic infertility evaluation stations demonstrated statistically significant increases over pretest scores (14.3% vs 46.4%, P=.009; and 41.7% vs 83.3%, P=.049, respectively). Sixty-four percent of the residents rated the program as "very helpful." Most residents felt that the program was well organized and that the facilities were conducive to learning; all of the participants recommended an annual clinical orientation program. A clinical skills orientation program was well received and strongly desired by residents. First-year residents appeared to benefit the most from this orientation.

  14. 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

  15. 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

  16. 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.

  17. Resident perceptions of the educational value of night float rotations.

    PubMed

    Luks, Andrew M; Smith, C Scott; Robins, Lynne; Wipf, Joyce E

    2010-07-01

    Night float rotations are being increasingly used in the era of resident physician work-hour regulations, but their impact on resident education is not clear. Our objective was to clarify resident perceptions of the educational aspects of night float rotations. An anonymous survey of internal medicine residents at a university-based residency program was completed. Responses were received from 116 of 163 surveyed residents (71%). Residents attended less residents' report (0.10 +/- .43 vs. 2.70 + 0.93 sessions/week, p< .001) and fewer grand rounds sessions (0.14 +/- 0.25 vs. 0.43 +/- 0.28 sessions/week, p< .001) and spent less time reading, (2.63 +/- 2.0 vs. 3.33 +/- 1.6 hr/week, p< .001) interacting with attending physicians (0.57 +/- 1.1 vs. 2.97 +/- 1.5 hr/week, p< .001) and sleeping at home (6.3 +/- 1.2 vs. 7.10 +/- 0.9 hr/day, p< .001) on night float rotations than on non-night float rotations. Residents had strongly negative opinions about the educational value of night float, sleep cycle adjustment issues, and impact on their personal lives, which correlated with resident evaluations from the regular program evaluation process. In free responses, residents commented that they liked the autonomy and opportunity to improve triage skills on these rotations and confirmed their negative opinions about the sleep-wake cycle and interference with personal lives. Internal medicine residents at a university-based program have negative opinions regarding the educational value of night float rotations. Further work is necessary to determine whether problems exist across programs and specialties.

  18. Highly directional acoustic receivers

    NASA Astrophysics Data System (ADS)

    Cray, Benjamin A.; Evora, Victor M.; Nuttall, Albert H.

    2003-03-01

    The theoretical directivity of a single combined acoustic receiver, a device that can measure many quantities of an acoustic field at a collocated point, is presented here. The formulation is developed using a Taylor series expansion of acoustic pressure about the origin of a Cartesian coordinate system. For example, the quantities measured by a second-order combined receiver, denoted a dyadic sensor, are acoustic pressure, the three orthogonal components of acoustic particle velocity, and the nine spatial gradients of the velocity vector. The power series expansion, which can be of any order, is cast into an expression that defines the directivity of a single receiving element. It is shown that a single highly directional dyadic sensor can have a directivity index of up to 9.5 dB. However, there is a price to pay with highly directive sensors; these sensors can be significantly more sensitive to nonacoustic noise sources.

  19. Central solar energy receiver

    DOEpatents

    Drost, M. Kevin

    1983-01-01

    An improved tower-mounted central solar energy receiver for heating air drawn through the receiver by an induced draft fan. A number of vertically oriented, energy absorbing, fin-shaped slats are radially arranged in a number of concentric cylindrical arrays on top of the tower coaxially surrounding a pipe having air holes through which the fan draws air which is heated by the slats which receive the solar radiation from a heliostat field. A number of vertically oriented and wedge-shaped columns are radially arranged in a number of concentric cylindrical clusters surrounding the slat arrays. The columns have two mirror-reflecting sides to reflect radiation into the slat arrays and one energy absorbing side to reduce reradiation and reflection from the slat arrays.

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

    PubMed

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

    2015-03-01

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

  1. Graduating Pediatric Resident Reports on Procedural Training and Preparation.

    PubMed

    Schumacher, Daniel J; Frintner, Mary Pat; Cull, William

    2017-08-04

    Determine pediatric resident training and preparation for 14 ACGME-required procedures. National, random sample of 1000 graduating pediatric residents in 2015. For each of the ACGME-required procedures, residents were asked if they received training, successfully completed the procedure at least once, were comfortable performing the procedure unsupervised, and desired more training. To examine relationships among these 4 measures of training, we conducted logistic regression models and receiver operating characteristics (ROC) curves. Chi-square examined whether desiring more training varied by program size and career goal. Response rate was 55% (550/1000). More than half of residents received training in each procedure (56.4-99.3% across procedures) and had successfully completed them at least once (59.8-99.6%). However, 91.3% desired more training in at least one procedure, and 30.0% would like more training in over half of the procedures (8 or more). Relationships were found between the four training measures, with some relationships stronger than others. Residents with primary care goals were more likely than those with subspecialty or hospital practice goals to desire more training in abscess incision and drainage and temporary splinting of fractures, p<.05. Residents in large programs were more likely than those in smaller programs to desire more training in bladder catheterization, peripheral intravenous catheter placement, and venipuncture, p<.05. While pediatric residents are overall well-prepared to perform ACGME-required procedures, exceptions exist. Considering the role of program size and resident career goal may help when optimizing and individualizing resident procedural training and preparation. Copyright © 2017. Published by Elsevier Inc.

  2. Gynecology resident laparoscopy training: present and future.

    PubMed

    Shore, Eliane M; Lefebvre, Guylaine G; Grantcharov, Teodor P

    2015-03-01

    Simulator education is essential to surgical training and it should be a requirement at all training programs across North America. Yet, in a survey of North American obstetrics and gynecology program directors (response rate 52%), we found that while 73% (n = 98) of programs teach laparoscopic skills, only 59% (n = 81) were satisfied with their curriculum. Most programs lacked standard setting in the form of theoretical examinations (94%, n = 127) or skills assessments (91%, n = 123) prior to residents performing surgery on patients in the operating room. Most programs (97%, n = 131) were interested in standardizing laparoscopy education by implementing a common curriculum. We present 3 core recommendations to ensure that gynecologists across North America are receiving adequate training in gynecologic laparoscopic surgery as residents: (1) uniform simulator education should be implemented at all training programs across North American residency programs; (2) a standardized curriculum should be developed using evidence-based techniques; and (3) standardized assessments should take place prior to operating room performance and specialty certification. Future collaborative research initiatives should focus on establishing the content of a standardized laparoscopy curriculum for gynecology residents utilizing a consensus method approach.

  3. Training of hysteroscopic skills in residency program: the Dutch experience.

    PubMed

    Janse, Juliënne A; Driessen, Sara R C; Veersema, Sebastiaan; Broekmans, Frank J M; Jansen, Frank W; Schreuder, Henk W R

    2015-01-01

    To evaluate whether hysteroscopy training in the Dutch gynecological residency program is judged as sufficient in daily practice, by assessment of the opinion on hysteroscopy training and current performance of hysteroscopic procedures. In addition, the extent of progress in comparison with that of the residency program of a decade ago is reviewed. Survey (Canadian Task Force Classification III). Postgraduate years 5 and 6 residents in obstetrics and gynecology and gynecologists who finished residency within 2008 to 2013 in the Netherlands. Subjects received an online survey regarding performance and training of hysteroscopy, self-perceived competence, and hysteroscopic skills acquirement. Response rate was 65% of the residents and 73% of the gynecologists. Most residents felt adequately prepared for basic hysteroscopic procedures (86.7%), but significantly less share this opinion for advanced procedures (64.5%) (p < 0.01). In comparison with their peers in 2003, the current residents demonstrated a 10% higher appreciation of the training curriculum. However, their self-perceived competence did not increase, except for diagnostic hysteroscopy. Regarding daily practice, not only do more gynecologists perform advanced procedures nowadays but also their competence level received higher scores in comparison with gynecologists in 2003. Lack of simulation training was indicated to be the most important factor during residency that could be enhanced for optimal acquirement of hysteroscopic skills. Implementation of hysteroscopic procedures taught during residency training in the Netherlands has improved since 2003 and is judged as sufficient for basic procedures. The skills of surgical educators have progressed toward a level in which gynecologists feel competent to teach and supervise advanced hysteroscopic procedures. Even though the residency preparation for hysteroscopy is more highly appreciated than a decade ago, this study indicated that simulation training might

  4. 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

  5. [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.

  6. Hanson receives Macelwane Medal

    NASA Astrophysics Data System (ADS)

    Ravishankara, A. R.; Hanson, David R.

    At the 1996 Spring Meeting in Baltimore, Maryland, David R. Hanson received the 1996 James B. Macelwane Medal, which recognizes significant contributions to the geophysical sciences by a young scientist of outstanding ability. The medal citation and Hanson's response are given here.

  7. Zero-power receiver

    SciTech Connect

    Brocato, Robert W.

    2016-10-04

    An unpowered signal receiver and a method for signal reception detects and responds to very weak signals using pyroelectric devices as impedance transformers and/or demodulators. In some embodiments, surface acoustic wave devices (SAW) are also used. Illustrative embodiments include satellite and long distance terrestrial communications applications.

  8. Submillimeter wave heterodyne receiver

    NASA Technical Reports Server (NTRS)

    Chattopadhyay, Goutam (Inventor); Manohara, Harish (Inventor); Siegel, Peter H. (Inventor); Ward, John (Inventor)

    2011-01-01

    In an embodiment, a submillimeter wave heterodyne receiver includes a finline ortho-mode transducer comprising thin tapered metallic fins deposited on a thin dielectric substrate to separate a vertically polarized electromagnetic mode from a horizontally polarized electromagnetic mode. Other embodiments are described and claimed.

  9. Received Pronunciation and "Realphonetik."

    ERIC Educational Resources Information Center

    Shibles, Warren

    1995-01-01

    This article argues that British Received Pronunciation (RP) is inconsistently defined, arbitrary, and anachronistic, and that it should be replaced as an instructional concept by British Pronunciation (BP), which would be based on an actual and adequate descriptive phonetics, called here "Realphonetik." Contains 77 references. (MDM)

  10. Help Seeking and Receiving.

    ERIC Educational Resources Information Center

    Nadler, Arie

    Although social psychology has always had an interest in helping behavior, only recently has the full complexity of helping relations begun to be researched. Help seeking and receiving in the educational setting raise many issues regarding the use and effectiveness of the help itself. Central to all helping relations is the seeking/receiving…

  11. Olympus beacon receiver

    NASA Technical Reports Server (NTRS)

    Ostergaard, Jens

    1988-01-01

    A medium-size Beacon Receiving System for reception and processing of the B1 (20 GHz) and B2 (30 GHz) beacons from Olympus has been developed. Integration of B1 and B2 receiving equipment into one system using one antenna and a common computer for control and data processing provides the advantages of a compact configuration and synchronization of the two receiver chains. Range for co-polar signal attenuation meaurement is about 30 dB for both beacons, increasing to 40 dB for B2 if the receivers are synchronized to B1. The accuracy is better than 0.5 dB. Cross-polarization discriminations of the order of 10 to 30 dB may be determined with an accuracy of 1 to 2 dB. A number of radiometers for complementary measurements of atmospheric attenuation of 13 to 30 GHz has also been constructed. A small multi-frequency system for operation around 22 GHz and 31 GHz is presently under development.

  12. Simplified OMEGA receivers

    NASA Technical Reports Server (NTRS)

    Burhans, R. W.

    1974-01-01

    The details are presented of methods for providing OMEGA navigational information including the receiver problem at the antenna and informational display and housekeeping systems based on some 4 bit data processing concepts. Topics discussed include the problem of limiters, zero crossing detectors, signal envelopes, internal timing circuits, phase counters, lane position displays, signal integrators, and software mapping problems.

  13. Procedural skills training. Canadian family practice residency programs.

    PubMed Central

    van der Goes, T.; Grzybowski, S. C.; Thommasen, H.

    1999-01-01

    OBJECTIVE: To survey Canadian family practice residency programs to discover which procedural skills residents are expected to learn. DESIGN: Cross-sectional eight-item questionnaire. SETTING AND PARTICIPANTS: The survey was sent to all 92 program directors and site or unit directors of family practice residency programs across Canada. MAIN OUTCOME MEASURES: Information on procedural skills lists was solicited. We sought date of creation, date of most recent revision, and who was involved in creating the list. A copy of the most recent list available was requested. RESULTS: We received 65 responses, for a 71% return rate. Surveys were received from all provinces and from all Canadian universities offering family practice residency programs. We received 24 unique lists of procedural skills: the shortest listed only 10 procedural skills; the longest, 75 skills; and the average, 36 skills. Only five procedural skills were found on more than 80% of the lists; 30 skills were listed on half or more of the lists. CONCLUSIONS: Canadian family practice residency programs have widely varying expectations of procedural skills for their residents. This survey is a first step in examining the whole issue of procedural skills training in Canadian family medicine programs. PMID:10889860

  14. Physical Medicine and Rehabilitation Resident Use of iPad Mini Mobile Devices.

    PubMed

    Niehaus, William; Boimbo, Sandra; Akuthota, Venu

    2015-05-01

    Previous research on the use of tablet devices in residency programs has been undertaken in radiology and medicine or with standard-sized tablet devices. With new, smaller tablet devices, there is an opportunity to assess their effect on resident behavior. This prospective study attempts to evaluate resident behavior after receiving a smaller tablet device. To evaluate whether smaller tablet computers facilitate residents' daily tasks. Prospective study that administered surveys to evaluate tablet computer use. Residency program. Thirteen physical medicine and rehabilitation residents. Residents were provided 16-GB iPad Minis and surveyed with Redcap to collect usage information at baseline, 3, and 6 months. Survey analysis was conducted using SAS (SAS, Cary, NC) for descriptive analysis. To evaluate multiple areas of resident education, the following tasks were selected: accessing e-mail, logging duty hours, logging procedures, researching clinical information, accessing medical journals, reviewing didactic presentations, and completing evaluations. Then, measurements were taken of: (1) residents' response to how tablet computers made it easier to access the aforementioned tasks; and (2) residents' response to how tablet computers affected the frequency they performed the aforementioned tasks. After being provided tablet computers, our physical medicine and rehabilitation residents reported significantly greater access to e-mail, medical journals, and didactic material. Also, receiving tablet computers was reported to increase the frequency that residents accessed e-mail, researched clinical information, accessed medical journals, reviewed didactic presentations, and completed evaluations. After receiving a tablet computer, residents reported an increase in the use of calendar programs, note-taking programs, PDF readers, online storage programs, and file organization programs. These physical medicine and rehabilitation residents reported tablet computers

  15. A digital beacon receiver

    NASA Technical Reports Server (NTRS)

    Ransome, Peter D.

    1988-01-01

    A digital satellite beacon receiver is described which provides measurement information down to a carrier/noise density ratio approximately 15 dB below that required by a conventional (phase locked loop) design. When the beacon signal fades, accuracy degrades gracefully, and is restored immediately (without hysteresis) on signal recovery, even if the signal has faded into the noise. Benefits of the digital processing approach used include the minimization of operator adjustments, stability of the phase measuring circuits with time, repeatability between units, and compatibility with equipment not specifically designed for propagation measuring. The receiver has been developed for the European Olympus satellite which has continuous wave (CW) beacons at 12.5 and 29.7 GHz, and a switched polarization beacon at 19.8 GHz approximately, but the system can be reconfigured for CW and polarization-switched beacons at other frequencies.

  16. Survey of emergency medicine resident debt status and financial planning preparedness.

    PubMed

    Glaspy, Jeffrey N; Ma, O John; Steele, Mark T; Hall, Jacqueline

    2005-01-01

    Most resident physicians accrue significant financial debt throughout their medical and graduate medical education. The objective of this study was to analyze emergency medicine resident debt status, financial planning actions, and educational experiences for financial planning and debt management. A 22-item questionnaire was sent to all 123 Accreditation Council on Graduate Medical Education-accredited emergency medicine residency programs in July 2001. Two follow-up mailings were made to increase the response rate. The survey addressed four areas of resident debt and financial planning: 1) accrued debt, 2) moonlighting activity, 3) financial planning/debt management education, and 4) financial planning actions. Descriptive statistics were used to analyze the data. Survey responses were obtained from 67.4% (1,707/2,532) of emergency medicine residents in 89 of 123 (72.4%) residency programs. Nearly one half (768/1,707) of respondents have accrued more than 100,000 dollars of debt. Fifty-eight percent (990/1,707) of all residents reported that moonlighting would be necessary to meet their financial needs, and more than 33% (640/1,707) presently moonlight to supplement their income. Nearly one half (832/1,707) of residents actively invested money, of which online trading was the most common method (23.3%). Most residents reported that they received no debt management education during residency (82.1%) or medical school (63.7%). Furthermore, 79.1% (1,351/1,707) of residents reported that they received no financial planning lectures during residency, although 84.2% (1,438/1,707) reported that debt management and financial planning education should be available during residency. Most emergency medicine residency programs do not provide their residents with financial planning education. Most residents have accrued significant debt and believe that more financial planning and debt management education is needed during residency.

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

    PubMed Central

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

    2014-01-01

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

  18. Multichannel homodyne receiver

    DOEpatents

    Landt, J.A.

    1981-01-19

    A homodyne radar transmitter/receiver device which produces a single combined output which contains modulated backscatter information for all phase conditions of both modulated and unmodulated backscatter signals is described. The device utilizes taps along coaxial transmission lines, strip transmission line, and waveguides which are spaced by 1/8 wavelength or 1/6 wavelength, etc. This greatly reduces costs by eliminating separate transmission and reception antennas and an expensive arrangement of power splitters and mixers utilized in the prior art.

  19. Multichannel homodyne receiver

    DOEpatents

    Landt, Jeremy A.

    1982-01-01

    A homodyne radar transmitter/receiver device which produces a single combined output which contains modulated backscatter information for all phase conditions of both modulated and unmodulated backscatter signals. The device utilizes taps along coaxial transmission lines, strip transmission line, and waveguides which are spaced by 1/8 wavelength or 1/6 wavelength, etc. This greatly reduces costs by eliminating separate transmission and reception antennas and an expensive arrangement of power splitters and mixers utilized in the prior art.

  20. An advanced teaching certificate program for postgraduate year 2 residents.

    PubMed

    Medina, Melissa S; Herring, Holly R

    2011-12-01

    The rationale, structure, and elements of a teaching certificate program for second-year pharmacy residents are described. Evidence suggests that postgraduate year 2 (PGY2) pharmacy residents generally have limited options for the continued development of their teaching skills after the completion of a postgraduate year 1 (PGY1) teaching certificate program. To expand those options, the University of Oklahoma College of Pharmacy developed a program (implemented during the 2005-06 residency year and formalized during the 2010-11 residency year) of advanced teaching-skills development that allows PGY2 residents to build on the foundational skills acquired in its PGY1 teaching certificate program; the new program also has been adapted to meet the needs of incoming PGY2 residents who earned PGY1-level teaching certificates at other institutions. The teaching certificate program comprises eight modules of instruction in advanced topic areas (e.g., course coordination, grading, active learning, teaching with technology) designed to prepare PGY2 residents for future faculty and preceptor positions. Among other required and optional activities, residents in the PGY2 certificate program receive hands-on instruction in course-coordination duties through a shadowing experience, serve as preceptors to fourth-year pharmacy students under the guidance of the residency director, and redeliver refined versions of lectures originally presented as PGY1 residents. A teaching certificate program specifically designed for PGY2 residents has allowed participants to continue to develop and refine their teaching skills through learning activities beyond those provided in the PGY1 program.

  1. A needs assessment of surgical residents as teachers

    PubMed Central

    Rotenberg, Brian W.; Woodhouse, Rosamund A.; Gilbart, Michael; Hutchison, Carolyn R.

    2000-01-01

    Objective To determine the needs of surgical residents as teachers of clinical clerks. Design A needs assessment survey. Setting Department of Surgery, University of Toronto. Participants Clinical clerks and surgical residents and staff surgeons. Methods Three stakeholder groups were defined: staff surgeons, surgical residents and clinical clerks. Focus-group sessions using the nominal group technique identified key issues from the perspectives of clerks and residents. Resulting information was used to develop needs assessment surveys, which were administered to 170 clinical clerks and 190 surgical residents. Faculty viewpoints were assessed with semi-structured interviews. Triangulation of these 3 data sources provided a balanced approach to identifying the needs of surgical residents as teachers. Results Response rates were 64% for clinical clerks and 66% for surgical residents. Five staff surgeons were interviewed. Consensus was noted among the stakeholder groups regarding the importance of staff surgeon role modelling and feedback, resident attitude, time management, knowledge of clerks’ formal learning objectives, and appropriate times and locations for teaching. Discrepancies included a significant difference in opinion regarding the residents’ capacity to address clerks’ individual learning needs and to foster good team relationships. Residents indicated that they did not receive regular feedback regarding their teaching and that staff did not place an emphasis on their teaching role. Conclusions This study has, from a multi-source perspective, assessed the needs of surgical residents as teachers. These needs include enhancing residents’ education regarding how and what to teach medical students on a surgical rotation, and a need for staff surgeons to increase feedback to residents regarding their teaching. PMID:10948691

  2. The Themis solar receiver

    NASA Astrophysics Data System (ADS)

    Gravrand, J. M.; Pouget-Abadie, X.

    The theoretical modeling, materials, and design of the central receiver heat exchanger on the tower of the Themis solar power plant are presented. The receiver was conceived based on the incident solar flux at different times of the day and year and the efficiency of transferring the heat to molten salts. The square aperture admits energy at a peak rate of 3.402 MWth at some points, with heat transfer to the power loop resulting in a maximum efficiency of 25 percent. Optimization studies indicated a receiver inclined 30 deg from the horizontal to face the heliostat field, and the flux incident on the walls was mapped. Tubes filled with the salts at 250 C form the walls behind radiator fins and elevate the salt to temperatures up to a limit of 490 C. Measures taken to allow for the expansion of the cavity walls and to mount the heat exchange tubes for easy replacement are described, along with the instrumentation to measure performance, flux, and detect malfunctions due to perturbations in the fluid flow or failure of any of the components.

  3. 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.

  4. 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

  5. Finding Value in Surgical Didactics: Longitudinal Resident Feedback From Case-Based and Traditional Lectures in an Orthopaedic Residency.

    PubMed

    Barnwell, Jonathan C; Halvorson, Jason J; Teasdall, Robert D; Carroll, Eben A

    To evaluate orthopedic resident perceptions of a didactic curriculum presented in traditional and case-based formats. Prospective cohort study using anonymous web-based survey after each conference evaluating resident perceptions of faculty participation, didactic delivery, content, and overall conference value. Conferences were structured as primarily case-based or traditional lecture. Logistic analysis was performed to determine factors predictive of rating a conference as valuable time spent. Orthopedic residency training program at single institution over an academic year. Orthopedic residents in postgraduate training year 1 to 5 attending mandatory didactic conference. Cased-based conferences received higher Likert ratings on residents' perception of faculty participation, instructor delivery, and improvement in topic understanding when compared to traditional lecture-based conferences (p < 0.0001 for each factor). Residents also were more likely to rate case-based conferences as valuable time spent (p < 0.0001). In our logistic model, factors associated with a negative likelihood of rating a conference as valuable were lecture format (odds ratio [OR] = 0.155, 95% CI: 0.115-0.208), PGY-2 level presenter (OR = 0.288, 95% CI: 0.169-0.490), and PGY-3 level presenter (OR = 0.433, 95% CI: 0.269-0.696). Timing in the year, surgical subspeciality, and conference identity were not significant predictors of conference value rating. Longitudinal resident feedback demonstrates highly favorable resident perceptions toward case-based formats in didactic sessions. Junior levels residents are not perceived as effective as senior residents and faculty in presenting material in either format. These methods allow for a dynamic approach to identifying strengths and weaknesses in a resident curriculum as a well as a means for more focused and real-time improvements. Copyright © 2016 Association of Program Directors in Surgery. Published by Elsevier Inc. All rights reserved.

  6. A psychopharmacology course for psychiatry residents utilizing active-learning and residents-as-teachers to develop life-long learning skills.

    PubMed

    Muzyk, Andrew J; White, Crystal D; Kinghorn, Warren A; Thrall, Grace C

    2013-09-01

    The authors describe the implementation and evaluation of a 1-year psychopharmacology course using residents-as-teachers and active-learning exercises intended to improve understanding of current psychopharmacology and its evidence base, and skills for life-long learning. Weekly classes were devoted to psychotropic medications, treating specific disorders, and use of psychotropics in special patient populations. Each class was divided into three sections: a pharmacology review, a literature review and a faculty-led discussion of clinical questions. Each class included residents as teachers, an audience response system and questions for self-assessment. Resident and faculty presenters evaluated the course weekly and all residents were given a year-end evaluation Resident and faculty evaluations indicated an overall positive response. The residents reported improved perception of knowledge and engagement with this interactive format. The course was well received, demonstrating the viability and value of residents taking a more active role in their own learning.

  7. 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.

  8. LANL receiver system development

    SciTech Connect

    Laubscher, B.; Cooke, B.; Cafferty, M.; Olivas, N.

    1997-08-01

    The CALIOPE receiver system development at LANL is the story of two technologies. The first of these technologies consists of off-the-shelf mercury-cadmium-telluride (MCT) detectors and amplifiers. The vendor for this system is Kolmar Technologies. This system was fielded in the Tan Trailer I (TTI) in 1995 and will be referred to in this paper as GEN I. The second system consists of a MCT detector procured from Santa Barbara Research Center (SBRC) and an amplifier designed and built by LANL. This system was fielded in the Tan Trailer II (TTII) system at the NTS tests in 1996 and will be referred to as GEN II. The LANL CALIOPE experimental plan for 1996 was to improve the lidar system by progressing to a higher rep rate laser to perform many shots in a much shorter period of time. In keeping with this plan, the receiver team set a goal of developing a detector system that was background limited for the projected 100 nanosecond (ns) laser pulse. A set of detailed simulations of the DIAL lidar experiment was performed. From these runs, parameters such as optimal detector size, field of view of the receiver system, nominal laser return power, etc. were extracted. With this information, detector physics and amplifier electronic models were developed to obtain the required specifications for each of these components. These derived specs indicated that a substantial improvement over commercially available, off-the-shelf, amplifier and detector technologies would be needed to obtain the goals. To determine if the original GEN I detector was usable, the authors performed tests on a 100 micron square detector at cryogenic temperatures. The results of this test and others convinced them that an advanced detector was required. Eventually, a suitable detector was identified and a number of these single element detectors were procured from SBRC. These single element detectors were witness for the detector arrays built for another DOE project.

  9. Custom accounts receivable modeling.

    PubMed

    Veazie, J

    1994-04-01

    In hospital and clinic management, accounts are valued as units and handled equally--a $20 account receives the same minimum number of statements as a $20,000 account. Quite often, the sheer number of accounts a hospital or clinic has to handle forces executives to manage accounts by default and failure--accounts mature on an aging track and, if left unpaid by patients, eventually are sent to collections personnel. Of the bad-debt accounts placed with collections agencies, many are misclassified as charity or hardship cases, while others could be collected by hospital or clinic staff with a limited amount of additional effort.

  10. Ultra-wideband receiver

    DOEpatents

    McEwan, Thomas E.

    1996-01-01

    An ultra-wideband (UWB) receiver utilizes a strobed input line with a sampler connected to an amplifier. In a differential configuration, .+-.UWB inputs are connected to separate antennas or to two halves of a dipole antenna. The two input lines include samplers which are commonly strobed by a gating pulse with a very low duty cycle. In a single ended configuration, only a single strobed input line and sampler is utilized. The samplers integrate, or average, up to 10,000 pulses to achieve high sensitivity and good rejection of uncorrelated signals.

  11. Ultra-wideband receiver

    DOEpatents

    McEwan, Thomas E.

    1994-01-01

    An ultra-wideband (UWB) receiver utilizes a strobed input line with a sampler connected to an amplifier. In a differential configuration, .+-.UWB inputs are connected to separate antennas or to two halves of a dipole antenna. The two input lines include samplers which are commonly strobed by a gating pulse with a very low duty cycle. In a single ended configuration, only a single strobed input line and sampler is utilized. The samplers integrate, or average, up to 10,000 pulses to achieve high sensitivity and good rejection of uncorrelated signals.

  12. Ultra-wideband receiver

    DOEpatents

    McEwan, T.E.

    1996-06-04

    An ultra-wideband (UWB) receiver utilizes a strobed input line with a sampler connected to an amplifier. In a differential configuration, {+-}UWB inputs are connected to separate antennas or to two halves of a dipole antenna. The two input lines include samplers which are commonly strobed by a gating pulse with a very low duty cycle. In a single ended configuration, only a single strobed input line and sampler is utilized. The samplers integrate, or average, up to 10,000 pulses to achieve high sensitivity and good rejection of uncorrelated signals. 21 figs.

  13. Ultra-wideband receiver

    DOEpatents

    McEwan, T.E.

    1994-09-06

    An ultra-wideband (UWB) receiver utilizes a strobed input line with a sampler connected to an amplifier. In a differential configuration, [+-] UWB inputs are connected to separate antennas or to two halves of a dipole antenna. The two input lines include samplers which are commonly strobed by a gating pulse with a very low duty cycle. In a single ended configuration, only a single strobed input line and sampler is utilized. The samplers integrate, or average, up to 10,000 pulses to achieve high sensitivity and good rejection of uncorrelated signals. 16 figs.

  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. Weather Data Receiver

    NASA Technical Reports Server (NTRS)

    1982-01-01

    Northern Video Graphics, Inc. developed a low-cost satellite receiving system for users such as independent meteorologists, agribusiness firms, small airports or flying clubs, marine vessels and small TV stations. Called Video Fax, it is designed for use with certain satellites; the GOES (Geostationary Operational Environmental Satellite) spacecraft operated by the National Oceanic and Atmospheric Administration, the European Space Agency's Meteosat and Japan's Geostationary Meteorological Satellite. By dictum of the World Meteorological Organization, signals from satellites are available to anyone without cost so the Video Fax user can acquire signals directly from the satellite and cut out the middle man, enabling savings. Unit sells for about one-fifth the cost of the equipment used by TV stations. It consists of a two-meter antenna; a receiver; a microprocessor-controlled display computer; and a video monitor. Computer stores data from the satellites and converts it to an image which is displayed on the monitor. Weather map can be preserved as signal data on tape, or it can be stored in a video cassette as a permanent image.

  16. Programs and Services Received by Older Persons with Mental Retardation.

    ERIC Educational Resources Information Center

    Lakin, K. Charlie; And Others

    1991-01-01

    A national sample of 370 older persons with mental retardation in 235 facilities (foster care, small group homes, large private facilities, and state-operated facilities) was surveyed. Information is presented on resident characteristics, day program participation, services received, and differences in programs and services by facility type. The…

  17. Results of a Multisite Survey of U.S. Psychiatry Residents on Education in Professionalism and Ethics

    ERIC Educational Resources Information Center

    Jain, Shaili; Dunn, Laura B.; Warner, Christopher H.; Roberts, Laura Weiss

    2011-01-01

    Objective: The authors assess the perspectives of psychiatry residents about the goals of receiving education in professionalism and ethics, how topics should be taught, and on what ethical principles the curriculum should be based. Method: A written survey was sent to psychiatry residents (N = 249) at seven U.S. residency programs in Spring 2005.…

  18. Perceptions of U.S. Medical Residents Regarding Amount and Usefulness of Sexual Health Instruction in Preparation for Clinical Practice

    ERIC Educational Resources Information Center

    Criniti, Shannon; Crane, Betsy; Woodland, Mark B.; Montgomery, Owen C.; Urdaneta Hartmann, Sandra

    2016-01-01

    Despite patient demand for sexual health discussions with their physicians, sexuality instruction in residency is often lacking. This exploratory quantitative study assessed the amount and usefulness of sexuality instruction received by a sample of medical residents, as well as the residents' self-perceived readiness regarding addressing sexuality…

  19. Results of a Multisite Survey of U.S. Psychiatry Residents on Education in Professionalism and Ethics

    ERIC Educational Resources Information Center

    Jain, Shaili; Dunn, Laura B.; Warner, Christopher H.; Roberts, Laura Weiss

    2011-01-01

    Objective: The authors assess the perspectives of psychiatry residents about the goals of receiving education in professionalism and ethics, how topics should be taught, and on what ethical principles the curriculum should be based. Method: A written survey was sent to psychiatry residents (N = 249) at seven U.S. residency programs in Spring 2005.…

  20. Perceptions of U.S. Medical Residents Regarding Amount and Usefulness of Sexual Health Instruction in Preparation for Clinical Practice

    ERIC Educational Resources Information Center

    Criniti, Shannon; Crane, Betsy; Woodland, Mark B.; Montgomery, Owen C.; Urdaneta Hartmann, Sandra

    2016-01-01

    Despite patient demand for sexual health discussions with their physicians, sexuality instruction in residency is often lacking. This exploratory quantitative study assessed the amount and usefulness of sexuality instruction received by a sample of medical residents, as well as the residents' self-perceived readiness regarding addressing sexuality…

  1. International Health Experiences in Family Medicine Residency Training.

    PubMed

    Porter, Maribeth; Mims, Lisa; Garven, Chad; Gavin, Jennifer; Carek, Peter; Diaz, Vanessa

    2016-02-01

    International health experiences (IHEs) have been associated with improved clinical skills, altruistic attitudes, cross-cultural sensitivity, and exposure to community medicine for residents and medical students. Although an increasing number of family medicine residencies offer IHEs, there are currently no standardized competencies or guidelines for developing IHEs. The aim of this study was to examine the content of IHEs in order to provide an overview of the current landscape of global health training in family medicine residency programs. Residency programs self-identifying as offering IHEs on the American Medical Association's (AMA) FREIDA Online website were emailed an electronic survey with questions regarding IHE characteristics, resident selection criteria, faculty support, motivations for participation, challenges to implementation, and funding. Of the 153 programs that responded, 84% still offered IHEs. Most IHEs are 3--4 weeks (71.1%) and are funded by the resident (74.2%). Faculty from the resident's department or institution generally provide supervision (76.6%) and have undergone some type of specialized training in global health (65.6%). Being in good academic standing was the most important eligibility criteria for residents participating in an IHE (86.7%), and funding was reported as the most challenging aspect (62.5%) of offering IHEs. IHEs are increasing in number and receiving more funding, but the experiences are variable among residency programs. While most program directors believe residents participate in IHEs to gain exposure with underserved populations, only a small percentage (5.5%) include a commitment to community service as part of a requirement for participation in an IHE.

  2. Increasing Patient Safety Event Reporting in an Emergency Medicine Residency.

    PubMed

    Steen, Sven; Jaeger, Cassie; Price, Lindsay; Griffen, David

    2017-01-01

    Patient safety event reporting is an important component for fostering a culture of safety. Our tertiary care hospital utilizes a computerized patient safety event reporting system that has been historically underutilized by residents and faculty, despite encouragement of its use. The objective of this quality project was to increase patient safety event reporting within our Emergency Medicine residency program. Knowledge of event reporting was evaluated with a survey. Eighteen residents and five faculty participated in a formal educational session on event reporting followed by feedback every two months on events reported and actions taken. The educational session included description of which events to report and the logistics of accessing the reporting system. Participants received a survey after the educational intervention to assess resident familiarity and comfort with using the system. The total number of events reported was obtained before and after the educational session. After the educational session, residents reported being more confident in knowing what to report as a patient safety event, knowing how to report events, how to access the reporting tool, and how to enter a patient safety event. In the 14 months preceding the educational session, an average of 0.4 events were reported per month from the residency. In the nine months following the educational session, an average of 3.7 events were reported per month by the residency. In addition, the reported events resulted in meaningful actions taken by the hospital to improve patient safety, which were shared with the residents. Improvement efforts including an educational session, feedback to the residency of events reported, and communication of improvements resulting from reported events successfully increased the frequency of safety event reporting in an Emergency Medicine residency.

  3. Menopause education: needs assessment of American obstetrics and gynecology residents.

    PubMed

    Christianson, Mindy S; Ducie, Jennifer A; Altman, Kristiina; Khafagy, Ayatallah M; Shen, Wen

    2013-11-01

    This study aims to understand the current teaching of menopause medicine in American obstetrics and gynecology residency programs. A Web-based survey was e-mailed to all American obstetrics and gynecology residency directors, with a request that they forward it to their residents. Of 258 residency program directors contacted, 79 (30.6%) confirmed forwarding the survey. In all, 1,799 people received the survey, with 510 completions, for a response rate of 28.3%. Most residents reported that they had limited knowledge and needed to learn more about these aspects of menopause medicine: pathophysiology of menopause symptoms (67.1%), hormone therapy (68.1%), nonhormone therapy (79.0%), bone health (66.1%), cardiovascular disease (71.7%), and metabolic syndrome (69.5%). Among fourth-year residents who will be entering clinical practice soon, a large proportion also reported a need to learn more in these areas: pathophysiology of menopause symptoms (45.9%), hormone therapy (54.2%), nonhormone therapy (69.4%), bone health (54.2%), cardiovascular disease (64.3%), and metabolic syndrome (63.8%). When asked to rate the most preferred modalities for learning about menopause, the top choice was supervised clinics (53.2%), followed by case presentations (22.2%), formal lectures (21.3%), small groups (14.7%), Web-based learning (7.8%), and independent reading (5.2%). Only 20.8% of residents reported that their program had a formal menopause medicine learning curriculum, and 16.3% had a defined menopause clinic as part of their residency. It seems that some American residency programs do not fulfill the educational goals of their residents in menopause medicine. A curriculum would be beneficial for increasing knowledge and clinical experience on menopause issues.

  4. Adverse Childhood Experiences: Survey of Resident Practice, Knowledge, and Attitude.

    PubMed

    Tink, Wendy; Tink, Jessica C; Turin, Tanvir C; Kelly, Martina

    2017-01-01

    Adverse childhood experiences (ACEs) affect 20%-50% of adults and are associated with considerable adult chronic disease, unhealthy behavior, and early mortality. Physicians seldom identify this history although identification can improve health. Low screening rates are attributed to poor physician knowledge of ACEs and barriers to screening, including a lack of confidence to screen and insufficient training. Female physicians and physicians with personal ACE histories report more confidence to screen and fewer time barriers. Our aims were to identify resident screening practices, ACE knowledge, attitudes, and personal ACE histories and to determine preferred ways to learn more, if required. Family medicine residents were surveyed, using a previously published survey. Items included ACE screening practices, ACE knowledge, attitudes, and personal ACE histories. The response rate was 97% (112/115), and 58% were female. Two percent of residents screened females and males at the first visit, thereafter residents screened women (6.3%) more than men (0.9%). One third of residents identified the correct prevalence of ACE in women and one tenth male prevalence. Unhealthy behaviors or physical chronic disease were not associated with ACE histories. Sixty-five percent of residents were not confident to screen. Twenty-nine percent of residents reported a trauma history. Eighty percent believed it was their role to screen. Formal medical training to screen was received by 45.5%; only five residents recalled training during residency. Resident ACE screening rates were extremely low. Physician educational initiatives are recommended to increase confidence to screen and actual screening prior to graduation.

  5. Exposure to and Attitudes Regarding Transgender Education Among Urology Residents.

    PubMed

    Dy, Geolani W; Osbun, Nathan C; Morrison, Shane D; Grant, David W; Merguerian, Paul A

    2016-10-01

    Transgender individuals are underserved within the health care system but might increasingly seek urologic care as insurers expand coverage for medical and surgical gender transition. To evaluate urology residents' exposure to transgender patient care and their perceived importance of transgender surgical education. Urology residents from a representative sample of U.S. training programs were asked to complete a cross-sectional survey from January through March 2016. Respondents were queried regarding demographics, transgender curricular exposure (didactic vs clinical), and perceived importance of training opportunities in transgender patient care. In total, 289 urology residents completed the survey (72% response rate). Fifty-four percent of residents reported exposure to transgender patient care, with more residents from Western (74%) and North Central (72%) sections reporting exposure (P ≤ .01). Exposure occurred more frequently through direct patient interaction rather than through didactic education (psychiatric, 23% vs 7%, P < .001; medical, 17% vs 6%, P < .001; surgical, 33% vs 11%, P < .001). Female residents placed greater importance on gender-confirming surgical training than did their male colleagues (91% vs 70%, P < .001). Compared with Western section residents (88%), those from South Central (60%, P = .002), Southeastern (63%, P = .002), and Mid-Atlantic (63%, P = .003) sections less frequently viewed transgender-related surgical training as important. Most residents (77%) stated transgender-related surgical training should be offered in fellowships. Urology resident exposure to transgender patient care is regionally dependent. Perceived importance of gender-confirming surgical training varies by sex and geography. A gap exists between the direct transgender patient care urology residencies provide and the didactic transgender education they receive. Copyright © 2016 International Society for Sexual Medicine. Published by Elsevier Inc. All

  6. Exit Survey of Senior Residents: Cost Conscious but Uninformed

    PubMed Central

    Long, Theodore; Silvestri, Mark T.; Dashevsky, Meir; Halim, Andrea; Fogerty, Robert L.

    2016-01-01

    Background Cost awareness, to ensure physician stewardship of limited resources, is increasingly recognized as an important skill for physicians. The Accreditation Council for Graduate Medical Education has made cost awareness part of systems-based practice, a core competency of resident education. However, little is known about resident cost awareness. Objective We sought to assess senior resident self-perceived cost awareness and cost knowledge. Methods In March 2014, we conducted a cross-sectional survey of all emergency medicine, internal medicine, obstetrics and gynecology, orthopaedic surgery pediatrics, and medicine-pediatrics residents in their final year at Yale–New Haven Hospital. The survey examined attitudes toward health care costs and residents' estimates of order prices. We considered resident price estimates to be accurate if they were between 50% and 200% of the Connecticut-specific Medicare price. Results We sent the survey to 84 residents and received 47 completed surveys (56% response rate). Although more than 95% (45 of 47) felt that containing costs is the responsibility of every clinician, and 49% (23 of 47) agreed that cost influenced their decision when ordering, only 4% (2 of 47) agreed that they knew the cost of tests being ordered. No residents accurately estimated the price of a complete blood count with differential, and only 2.1% (1 of 47) were accurate for a basic metabolic panel. The overall accuracy of all resident responses was 25%. Conclusions In our study, many trainees exit residency with self-identified deficiencies in knowledge about costs. The findings show the need for educational approaches to improve cost awareness among trainees. PMID:27168897

  7. Digital Receiver Phase Meter

    NASA Technical Reports Server (NTRS)

    Marcin, Martin; Abramovici, Alexander

    2008-01-01

    The software of a commercially available digital radio receiver has been modified to make the receiver function as a two-channel low-noise phase meter. This phase meter is a prototype in the continuing development of a phase meter for a system in which radiofrequency (RF) signals in the two channels would be outputs of a spaceborne heterodyne laser interferometer for detecting gravitational waves. The frequencies of the signals could include a common Doppler-shift component of as much as 15 MHz. The phase meter is required to measure the relative phases of the signals in the two channels at a sampling rate of 10 Hz at a root power spectral density <5 microcycle/(Hz)1/2 and to be capable of determining the power spectral density of the phase difference over the frequency range from 1 mHz to 1 Hz. Such a phase meter could also be used on Earth to perform similar measurements in laser metrology of moving bodies. To illustrate part of the principle of operation of the phase meter, the figure includes a simplified block diagram of a basic singlechannel digital receiver. The input RF signal is first fed to the input terminal of an analog-to-digital converter (ADC). To prevent aliasing errors in the ADC, the sampling rate must be at least twice the input signal frequency. The sampling rate of the ADC is governed by a sampling clock, which also drives a digital local oscillator (DLO), which is a direct digital frequency synthesizer. The DLO produces samples of sine and cosine signals at a programmed tuning frequency. The sine and cosine samples are mixed with (that is, multiplied by) the samples from the ADC, then low-pass filtered to obtain in-phase (I) and quadrature (Q) signal components. A digital signal processor (DSP) computes the ratio between the Q and I components, computes the phase of the RF signal (relative to that of the DLO signal) as the arctangent of this ratio, and then averages successive such phase values over a time interval specified by the user.

  8. Simulation-based education with mastery learning improves residents' lumbar puncture skills

    PubMed Central

    Cohen, Elaine R.; Caprio, Timothy; McGaghie, William C.; Simuni, Tanya; Wayne, Diane B.

    2012-01-01

    Objective: To evaluate the effect of simulation-based mastery learning (SBML) on internal medicine residents' lumbar puncture (LP) skills, assess neurology residents' acquired LP skills from traditional clinical education, and compare the results of SBML to traditional clinical education. Methods: This study was a pretest-posttest design with a comparison group. Fifty-eight postgraduate year (PGY) 1 internal medicine residents received an SBML intervention in LP. Residents completed a baseline skill assessment (pretest) using a 21-item LP checklist. After a 3-hour session featuring deliberate practice and feedback, residents completed a posttest and were expected to meet or exceed a minimum passing score (MPS) set by an expert panel. Simulator-trained residents' pretest and posttest scores were compared to assess the impact of the intervention. Thirty-six PGY2, 3, and 4 neurology residents from 3 medical centers completed the same simulated LP assessment without SBML. SBML posttest scores were compared to neurology residents' baseline scores. Results: PGY1 internal medicine residents improved from a mean of 46.3% to 95.7% after SBML (p < 0.001) and all met the MPS at final posttest. The performance of traditionally trained neurology residents was significantly lower than simulator-trained residents (mean 65.4%, p < 0.001) and only 6% met the MPS. Conclusions: Residents who completed SBML showed significant improvement in LP procedural skills. Few neurology residents were competent to perform a simulated LP despite clinical experience with the procedure. PMID:22675080

  9. 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

  10. 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

  11. Solar thermal energy receiver

    NASA Technical Reports Server (NTRS)

    Baker, Karl W. (Inventor); Dustin, Miles O. (Inventor)

    1992-01-01

    A plurality of heat pipes in a shell receive concentrated solar energy and transfer the energy to a heat activated system. To provide for even distribution of the energy despite uneven impingement of solar energy on the heat pipes, absence of solar energy at times, or failure of one or more of the heat pipes, energy storage means are disposed on the heat pipes which extend through a heat pipe thermal coupling means into the heat activated device. To enhance energy transfer to the heat activated device, the heat pipe coupling cavity means may be provided with extensions into the device. For use with a Stirling engine having passages for working gas, heat transfer members may be positioned to contact the gas and the heat pipes. The shell may be divided into sections by transverse walls. To prevent cavity working fluid from collecting in the extensions, a porous body is positioned in the cavity.

  12. THE ETHICAL EDUCATION OF OPHTHALMOLOGY RESIDENTS: AN EXPERIMENT

    PubMed Central

    Packer, Samuel

    2005-01-01

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

  13. Experiential Leadership Training for Pediatric Chief Residents: Impact on Individuals and Organizations

    PubMed Central

    Doughty, Robert A.; Williams, Patricia D.; Brigham, Timothy P.; Seashore, Charles

    2010-01-01

    Background The past decade has seen a proliferation of leadership training programs for physicians that teach skills outside the graduate medical education curriculum. Objective To determine the perceived value and impact of an experiential leadership training program for pediatric chief residents on the chief residents and on their programs and institutions. Methods The authors conducted a retrospective study. Surveys were sent to chief residents who completed the Chief Resident Training Program (CRTP) between 1988 and 2003 and to their program directors and department chairs asking about the value of the program, its impact on leadership capabilities, as well as the effect of chief resident training on programs and institutions. Results Ninety-four percent of the chief residents and 94% of program directors and department chairs reported that the CRTP was “very” or “somewhat” relevant, and 92% of the chief residents indicated CRTP had a positive impact on their year as chief resident; and 75% responded it had a positive impact beyond residency. Areas of greatest positive impact included awareness of personality characteristics, ability to manage conflict, giving and receiving feedback, and relationships with others. Fifty-six percent of chief residents reported having held a formal leadership position since chief residency, yet only 28% reported having received additional leadership training. Conclusion The study demonstrates a perceived positive impact on CRTP participants and their programs and institutions in the short and long term. PMID:21975638

  14. Validity and Reliability of a Tool to Assess Quality Improvement Knowledge and Skills in Pediatrics Residents.

    PubMed

    Doupnik, Stephanie K; Ziniel, Sonja I; Glissmeyer, Eric W; Moses, James M

    2017-02-01

    Residency programs are expected to educate residents in quality improvement (QI). Effective assessments are needed to ensure residents gain QI knowledge and skills. Limitations of current tools include poor interrater reliability and requirement for scorer training. To provide evidence for the validity of the Assessment of Quality Improvement Knowledge and Skills (AQIKS), which is a new tool that provides a summative assessment of pediatrics residents' ability to recall QI concepts and apply them to a clinical scenario. We conducted a quasi-experimental study to measure the AQIKS performance in 2 groups of pediatrics residents: postgraduate year (PGY) 2 residents who participated in a 1-year longitudinal QI curriculum, and a concurrent control group of PGY-1 residents who received no formal QI training. The curriculum included 20 hours of didactics and participation in a resident-led QI project. Three faculty members with clinical QI experience, who were not involved in the curriculum and received no additional training, scored the AQIKS. Complete data were obtained for 30 of 37 residents (81%) in the intervention group, and 36 of 40 residents (90%) in the control group. After completing a QI curriculum, the intervention group's mean score was 40% higher than at baseline (P < .001), while the control group showed no improvement (P = .29). Interrater reliability was substantial (κ = 0.74). The AQIKS detects an increase in QI knowledge and skills among pediatrics residents who participated in a QI curriculum, with better interrater reliability than currently available assessment tools.

  15. Resident satisfaction and its components in residential aged care.

    PubMed

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

    2002-04-01

    The purpose of this study was to assess the direction and magnitude of the effects among the components of resident satisfaction in residential aged care and to examine if the relationships among satisfaction components vary according to facility type (i.e., nursing home and hostel). Briefly, a hostel is a low-care facility in which residents are more independent and receive personal but not nursing care. A cross-sectional survey design was adopted to collect the required information, and a stratified random sampling approach was used to select facilities. Structural equation modeling was used to examine relationships among satisfaction components in a sample of 394 nursing home and 752 hostel residents. The results indicate that satisfaction with staff care has a moderate and positive effect on all other aspects of resident satisfaction. The relationships among satisfaction components are different for nursing home and hostel residents. The findings lead to an improved understanding of the interrelationship among resident satisfaction components, which has important implications for improving quality outcomes (e.g., resident satisfaction) through appropriate intervention (e.g., enhancing staff care).

  16. Supervision and responses of psychiatry residents to adverse patient events.

    PubMed

    Deringer, Emily; Caligor, Eve

    2014-12-01

    Throughout training, psychiatry residents may experience adverse patient outcomes. The purpose of this study was to explore whether residents' perceptions of the quality of their supervision impacts their emotional reactions to adverse events. All psychiatry residents from a training program at an academic medical center who were in their PGY2-4 years, as well as those in their first year out of training, were recruited to participate. Those who self-identified as having experienced an adverse event participated in a semi-structured interview. For the purpose of the study, "adverse event" was defined as follows: patient suicide, patient homicide or homicide attempt outside the hospital, patient violence inside the hospital, life-threatening reaction to psychotropic medication, and physical assault of a resident by a patient. In this sample, 22 of the 64 residents (34 %) reported experiencing an adverse event. Of these, 21/22 (95 %) participated in the interview. Two residents reported experiencing two adverse events; the total number of adverse events analyzed was 23. For 21/23 (91 %) of these events, respondents felt that the quality of the supervision they received impacted their emotional reactions to the event. The supervisory relationship appears to play a significant role in how residents experience, and potentially learn from, adverse events; this has practical implications for educators and leaders.

  17. 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…

  18. 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)

  19. 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)

  20. 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

  1. 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…

  2. 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)

  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. 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.

  5. 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…

  6. 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.

  7. 26 CFR 25.2702-5 - Personal residence trusts.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... governing instrument must provide that the right of the term holder to receive the annuity amount begins on... right to use the condominium during L's lifetime. The trust is a qualified personal residence trust... enclosures for confinement of farm animals. W transfers the farm to an irrevocable trust, retaining the use...

  8. Resident Assistant Mattering: Do Placement and Community Size Matter?

    ERIC Educational Resources Information Center

    Stoner, James C.; Zhang, Yi

    2017-01-01

    A sense of mattering among college students has been found to have positive outcomes, including lower levels of anxiety and depression as well as increased self-esteem, wellness, happiness, and job satisfaction. However, the feeling of mattering among Resident Assistants (RAs) has received little attention in literature. This quantitative study…

  9. Nursing Home Consultation: Difficult Residents and Frustrated Staff.

    ERIC Educational Resources Information Center

    Block, Christopher; And Others

    1987-01-01

    Night shift nursing home aides who received in-service training in behavior therapy designed and implemented intervention programs for two of their most difficult residents. Describes programs and their outcomes. Discusses use of staff members as agents of behavior change. (Author/NB)

  10. Use of Pets in Therapy with Elderly Nursing Home Residents.

    ERIC Educational Resources Information Center

    Sutton, Diana M.

    In order to test the effectiveness of the use of pets with the elderly in a nursing home setting, three concurrent studies were conducted. The 29 residents participating in the experiment were selected by nursing home personnel as meeting the criteria of being depressed and withdrawn, and receiving no regular (weekly) visitors. Study I compared…

  11. Obstetric-gynecology resident education regarding barrier and over-the-counter contraceptives: a national study.

    PubMed

    Miklavcic, Amie Y; Isaacs, Christine R

    2012-11-01

    The study was conducted to assess obstetrics-gynecology resident knowledge about barrier and over-the-counter (OTC) contraceptives and identify strengths and weaknesses in resident education. We developed a survey for distribution among 50 randomly selected U.S. obstetrics-gynecology residency programs. Of 202 respondents, only 57% and 36% of residents reported adequate knowledge to counsel patients regarding latex vs. nonlatex condom use, respectively. Ninety-six percent knew spermicides were nonprotective against sexually transmitted diseases (STDs); however, there was limited knowledge about delivery options. Only 17% had ever fit or prescribed a diaphragm, and 30% reported knowledge in performing a fitting. Greater than 80% of residents stated they received no formal didactics addressing the use of condoms, spermicides, or diaphragms. Limited experience regarding Cycle Beads and natural family planning was expressed. Obstetrics-gynecology residents receive little formal training about barrier and OTC contraceptive options and seek more education because of their awareness of inadequate knowledge.

  12. How we implemented a resident-led medical simulation curriculum in a large internal medicine residency program.

    PubMed

    Mathai, Susan K; Miloslavsky, Eli M; Contreras-Valdes, Fernando M; Milosh-Zinkus, Tanya; Hayden, Emily M; Gordon, James A; Currier, Paul F

    2014-04-01

    Mannequin-based simulation in graduate medical education has gained widespread acceptance. Its use in non-procedural training within internal medicine (IM) remains scant, possibly due to the logistical barriers to implementation of simulation curricula in large residency programs. We report the Massachusetts General Hospital Department of Medicine's scale-up of a voluntary pilot program to a mandatory longitudinal simulation curriculum in a large IM residency program (n = 54). We utilized an eight-case curriculum implemented over the first four months of the academic year. An intensive care unit curriculum was piloted in the spring. In order to administer a comprehensive curriculum in a large residency program where faculty resources are limited, thirty second-year and third-year residents served as session facilitators and two senior residents served as chairpersons of the program. Post-session anonymous survey revealed high learner satisfaction scores for the mandatory program, similar to those of the voluntary pilot program. Most interns believed the sessions should continue to be mandatory. Utilizing residents as volunteer facilitators and program leaders allowed the implementation of a well-received mandatory simulation program in a large IM residency program and facilitated program sustainability.

  13. ADMX Receiver and Analysis

    NASA Astrophysics Data System (ADS)

    Malagon, Ana; ADMX Collaboration

    2016-03-01

    ADMX looks for the excess radiation deposited into a cavity from the conversion of a dark matter axion into a microwave photon. The sensitivity of the experiment increases by reducing the background thermal noise and minimizing the electronic noise of the readout system. The axion masses that the experiment can detect are determined by the resonant frequency of the cavity mode of interest, which is tuned using a two rod configuration. One can also increase the search rate by measuring the output from two cavity modes at once, which requires two separate readout schemes. I will discuss the ADMX dual-channel receiver which has been upgraded to have near quantum-limited sensitivity on both channels, and describe how the correct modes are verified, using simulations, in the presence of dense electromagnetic structure. I conclude by describing upgrades to the ADMX analysis which allow for real-time exclusion limits. Supported by DOE Grants DE-FG02-97ER41029, DE-FG02-96ER40956, DE- AC52-07NA27344, DE-AC03-76SF00098, and the Livermore LDRD program.

  14. Twelve tips for preparing residents as teachers.

    PubMed

    Mann, Karen V; Sutton, Evelyn; Frank, Blye

    2007-05-01

    Residents are frequently identified by medical students as their most frequent and memorable teachers; residents also teach their peers, junior and senior colleagues, other health professionals, and their patients. Many will teach in their future practice. Developing the skills to become a teacher is an important part of postgraduate education, and warrants a systematic, planned approach that may include many complementary learning opportunities. Our purpose is to describe one such approach: a 4-week elective experience in medical education offered to postgraduate learners. The paper describes the background and goals for the elective, and the various steps in planning, implementing, and evaluating such a course, drawing on the literature and mining our own experience for examples. Specifically, we address the following: needs assessment; the determination and selection of content, sequence, and teaching and learning methods; the experiential learning opportunities offered; and the emphasis on the participants' developing self-awareness of themselves as teachers, and as part of a community of teachers. The program implementation, program evaluation, and response to feedback received are described. A 4-week elective experience in medical education was positively received by participants.

  15. 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.

  16. 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

  17. Wilmingtons West End Neighborhood House receives $192,000 EPA brownfields training grant

    EPA Pesticide Factsheets

    PHILADELPHIA (June 10, 2015) -- The U.S. Environmental Protection Agency today announced that West End Neighborhood House in Wilmington will receive a $192,300 Environmental Workforce Development and Job Training Grant to help train low-income resid

  18. 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.

  19. Learning styles of orthodontic residents.

    PubMed

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

    2009-03-01

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

  20. The calibration of Doppler receivers

    NASA Astrophysics Data System (ADS)

    Jaks, W.

    A study to determine the relative positions of the antennas of two simultaneously operating Doppler receivers and the systematic corrections needed for a given type of receiver is presented. The types of receivers included in the study are listed and results showing the differences between the geocentric coordinates of the antenna phase centers of the receivers are given. It is found that, for DOG receivers, each antenna phase center must be determined separately.

  1. The use of error analysis to assess resident performance.

    PubMed

    D'Angelo, Anne-Lise D; Law, Katherine E; Cohen, Elaine R; Greenberg, Jacob A; Kwan, Calvin; Greenberg, Caprice; Wiegmann, Douglas A; Pugh, Carla M

    2015-11-01

    The aim of this study was to assess validity of a human factors error assessment method for evaluating resident performance during a simulated operative procedure. Seven postgraduate year 4-5 residents had 30 minutes to complete a simulated laparoscopic ventral hernia (LVH) repair on day 1 of a national, advanced laparoscopic course. Faculty provided immediate feedback on operative errors and residents participated in a final product analysis of their repairs. Residents then received didactic and hands-on training regarding several advanced laparoscopic procedures during a lecture session and animate lab. On day 2, residents performed a nonequivalent LVH repair using a simulator. Three investigators reviewed and coded videos of the repairs using previously developed human error classification systems. Residents committed 121 total errors on day 1 compared with 146 on day 2. One of 7 residents successfully completed the LVH repair on day 1 compared with all 7 residents on day 2 (P = .001). The majority of errors (85%) committed on day 2 were technical and occurred during the last 2 steps of the procedure. There were significant differences in error type (P ≤ .001) and level (P = .019) from day 1 to day 2. The proportion of omission errors decreased from day 1 (33%) to day 2 (14%). In addition, there were more technical and commission errors on day 2. The error assessment tool was successful in categorizing performance errors, supporting known-groups validity evidence. Evaluating resident performance through error classification has great potential in facilitating our understanding of operative readiness. Copyright © 2015 Elsevier Inc. All rights reserved.

  2. Leadership training in a family medicine residency program

    PubMed Central

    Gallagher, Erin; Moore, Ainsley; Schabort, Inge

    2017-01-01

    Abstract Objective To assess the current status of leadership training as perceived by family medicine residents to inform the development of a formal leadership curriculum. Design Cross-sectional quantitative survey. Setting Department of Family Medicine at McMaster University in Hamilton, Ont, in December 2013. Participants A total of 152 first- and second-year family medicine residents. Main outcome measures Family medicine residents’ attitudes toward leadership, perceived level of training in various leadership domains, and identified opportunities for leadership training. Results Overall, 80% (152 of 190) of residents completed the survey. On a Likert scale (1 = strongly disagree, 4 = neutral, 7 = strongly agree), residents rated the importance of physician leadership in the clinical setting as high (6.23 of 7), whereas agreement with the statement “I am a leader” received the lowest rating (5.28 of 7). At least 50% of residents desired more training in the leadership domains of personal mastery, mentorship and coaching, conflict resolution, teaching, effective teamwork, administration, ideals of a healthy workplace, coalitions, and system transformation. At least 50% of residents identified behavioural sciences seminars, a lecture and workshop series, and a retreat as opportunities to expand leadership training. Conclusion The concept of family physicians as leaders resonated highly with residents. Residents desired more personal and system-level leadership training. They also identified ways that leadership training could be expanded in the current curriculum and developed in other areas. The information gained from this survey might facilitate leadership development among residents through application of its results in a formal leadership curriculum. PMID:28292816

  3. The Use of Error Analysis to Assess Resident Performance

    PubMed Central

    D’Angelo, Anne-Lise D.; Law, Katherine E.; Cohen, Elaine R.; Greenberg, Jacob A.; Kwan, Calvin; Greenberg, Caprice; Wiegmann, Douglas A.; Pugh, Carla M.

    2015-01-01

    Background The aim of this study is to assess validity of a human factors error assessment method for evaluating resident performance during a simulated operative procedure. Methods Seven PGY4-5 residents had 30 minutes to complete a simulated laparoscopic ventral hernia (LVH) repair on Day 1 of a national, advanced laparoscopic course. Faculty provided immediate feedback on operative errors and residents participated in a final product analysis of their repairs. Residents then received didactic and hands-on training regarding several advanced laparoscopic procedures during a lecture session and animate lab. On Day 2, residents performed a nonequivalent LVH repair using a simulator. Three investigators reviewed and coded videos of the repairs using previously developed human error classification systems. Results Residents committed 121 total errors on Day 1 compared to 146 on Day 2. One of seven residents successfully completed the LVH repair on Day 1 compared to all seven residents on Day 2 (p=.001). The majority of errors (85%) committed on Day 2 were technical and occurred during the last two steps of the procedure. There were significant differences in error type (p=<.001) and level (p=.019) from Day 1 to Day 2. The proportion of omission errors decreased from Day 1 (33%) to Day 2 (14%). In addition, there were more technical and commission errors on Day 2. Conclusion The error assessment tool was successful in categorizing performance errors, supporting known-groups validity evidence. Evaluating resident performance through error classification has great potential in facilitating our understanding of operative readiness. PMID:26003910

  4. Understanding Residents' Environmental Knowledge in a Metropolitan City of Hong Kong, China

    ERIC Educational Resources Information Center

    Cheung, Lewis T. O.; Fok, Lincoln; Tsang, Eric P. K.; Fang, Wei; Tsang, H. Y.

    2015-01-01

    This study aimed to understand the environmental knowledge (EK) of the residents of Hong Kong. A territory-wide survey was administered to investigate the subjective and objective EK of the respondents as well as their means of receiving information about the environment. The results indicated that Hong Kong's residents have a comparatively low…

  5. 28 CFR 115.378 - Interventions and disciplinary sanctions for residents.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... process shall consider whether a resident's mental disabilities or mental illness contributed to his or... isolation shall receive daily visits from a medical or mental health care clinician. Residents shall also... determines that the activity is not coerced. Medical and Mental Care ...

  6. 28 CFR 115.378 - Interventions and disciplinary sanctions for residents.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... process shall consider whether a resident's mental disabilities or mental illness contributed to his or... isolation shall receive daily visits from a medical or mental health care clinician. Residents shall also... determines that the activity is not coerced. Medical and Mental Care ...

  7. 28 CFR 115.378 - Interventions and disciplinary sanctions for residents.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... process shall consider whether a resident's mental disabilities or mental illness contributed to his or... isolation shall receive daily visits from a medical or mental health care clinician. Residents shall also... determines that the activity is not coerced. Medical and Mental Care ...

  8. Understanding Residents' Environmental Knowledge in a Metropolitan City of Hong Kong, China

    ERIC Educational Resources Information Center

    Cheung, Lewis T. O.; Fok, Lincoln; Tsang, Eric P. K.; Fang, Wei; Tsang, H. Y.

    2015-01-01

    This study aimed to understand the environmental knowledge (EK) of the residents of Hong Kong. A territory-wide survey was administered to investigate the subjective and objective EK of the respondents as well as their means of receiving information about the environment. The results indicated that Hong Kong's residents have a comparatively low…

  9. Assisting Cognitively Impaired Nursing Home Residents with Bathing: Effects of Two Bathing Interventions on Caregiving

    ERIC Educational Resources Information Center

    Hoeffer, Beverly; Talerico, Karen Amann; Rasin, Joyce; Mitchell, C. Madeline; Stewart, Babara J.; McKenzie, Darlene; Barrick, Ann Louise; Rader, Joanne; Sloane, Philip D.

    2006-01-01

    Purpose: When cognitively impaired nursing home residents exhibit agitated and aggressive behaviors during bathing, nursing home caregivers are in a unique position to improve residents' experience. This report addresses whether certified nursing assistants (CNAs) who received training in a person-centered approach with showering and with the…

  10. Personal Health Care of Residents: Preferences for Care outside of the Training Institution

    ERIC Educational Resources Information Center

    Dunn, Laura B.; Moutier, Christine; Hammond, Katherine A. Green; Lehrmann, Jon; Roberts, Laura Weiss

    2008-01-01

    Objective: The personal health care issues of residents are important but have received minimal study. Available evidence suggests that residents experience difficulties obtaining care, partly related to both the demands of medical training and concerns about confidentiality and privacy. Methods: A self-report survey was distributed in 2000-2001…

  11. Personal Health Care of Residents: Preferences for Care outside of the Training Institution

    ERIC Educational Resources Information Center

    Dunn, Laura B.; Moutier, Christine; Hammond, Katherine A. Green; Lehrmann, Jon; Roberts, Laura Weiss

    2008-01-01

    Objective: The personal health care issues of residents are important but have received minimal study. Available evidence suggests that residents experience difficulties obtaining care, partly related to both the demands of medical training and concerns about confidentiality and privacy. Methods: A self-report survey was distributed in 2000-2001…

  12. Effect of History of Psychological Counseling on Selection of Applicants for Residencies.

    ERIC Educational Resources Information Center

    Oppenheimer, Kim; And Others

    1987-01-01

    A study of the extent to which a residency applicant's history of having received psychological counseling for stress-related problems influences residency program directors' perceptions of such an applicant found differing practices and attitudes in different specializations and toward males and females. (MSE)

  13. Survey of Advanced Education in Prosthodontics Directors and Residents on Practices in Esthetic Dentistry.

    PubMed

    Sheets, James L; Yuan, Judy Chia-Chun; Sukotjo, Cortino; Wee, Alvin G

    2016-10-01

    The aim of this study was to determine the difference between the intended education by advanced education in prosthodontics (AEP) program directors and the perceived education received by AEP residents with respect to concepts of esthetic dentistry. Residents' confidence levels and current practices were also determined based on program level, with first- and second-year residents combined into "junior residents" and third- and fourth-year residents combined into "senior residents." Surveys were distributed to all U.S. and Canadian AEP program directors (N=52) in 2014 and residents (N=393) in 2015. The seven questions asked of directors and 20 asked of residents assessed resident training. The response rate for directors was 59.6% and for residents was 27.3%. Statistically significant results were found between the responding program directors' perceived education on esthetic principles and the responding residents' perceived education. The senior-level residents were more confident in each of the categories than residents at the junior level, although the difference was only significant for selecting porcelain systems to match inherent translucency, transfer of information to the laboratory, and surface staining or characterization. There was a difference between the program directors' intended teaching and the residents' perceptions with regards to bleaching, shade matching, selection of porcelain systems, transfer of information to the laboratory, and surface staining or characterization. The residents' confidence levels were higher at the senior level than those at the junior level in selecting porcelain systems, transfer of information to the laboratory, and staining/characterization. Faculty members in advanced prosthodontics programs may be able to use these findings to improve their residents' education in these areas.

  14. Investigating the Scope of Resident Patient Care Handoffs within Neurosurgery

    PubMed Central

    Babu, Maya A.; Nahed, Brian V.; Heary, Robert F.

    2012-01-01

    Introduction Handoffs are defined as verbal and written communications during patient care transitions. With the passage of recent ACMGE work hour rules further limiting the hours interns can spend in the hospital, many fear that more handoffs will occur, putting patient safety at risk. The issue of handoffs has not been studied in the neurosurgical literature. Methods A validated, 20-question online-survey was sent to neurosurgical residents in all 98 accredited U.S. neurosurgery programs. Survey results were analyzed using tabulations. Results 449 surveys were completed yielding a 56% response rate. 63% of neurosurgical residents surveyed had not received formal instruction in what constitutes an effective handoff; 24% believe there is high to moderate variability among their co-residents in terms of the quality of the handoff provided; 55% experience three or more interruptions during handoffs on average. 90% of neurosurgical residents surveyed say that handoff most often occurs in a quiet, private area and 56% report a high level of comfort for knowing the potential acute, critical issues affecting a patient when receiving a handoff. Conclusions There needs to be more focused education devoted to learning effective patient-care handoffs in neurosurgical training programs. Increasingly, handing off a patient adequately and safely is becoming a required skill of residency. PMID:22848615

  15. Research funding and mentoring in family medicine residencies.

    PubMed

    Young, Richard A; DeHaven, Mark J; Passmore, Cindy; Baumer, Joane G; Smith, Karen V

    2007-06-01

    This study's purpose was to measure the current status of research funding and mentoring in family medicine residencies and to ascertain what resources are needed to increase residencies' research output. This was a cross-sectional survey of family medicine residency program directors in the United States. We measured grant funding sources, availability of mentors, the likelihood programs could qualify for National Institutes of Health (NIH) K awards, barriers to research, and how these factors varied by program type. The response rate was 66% (298/453). Medical school-based programs were much more likely to report that their family medicine faculty wrote funded research grants than were community-based medical school affiliated programs (76% versus 32%). The majority of both program types reported that research mentors were available (85% versus 60%). Very few programs of either type were likely to meet the minimum requirements for NIH K01, K08, or K23 awards (29% for medical school programs versus 3% for community programs). The most commonly reported specific resources needed to increase research output were time, money, and more faculty (range 86% to 92% between program types). The majority of family medicine residencies did not receive grant funding for research, reported that time and money were the most significant barriers to research, but were ineligible to receive support from NIH K awards. More realistic funding mechanisms are needed to support residency-based research faculty.

  16. Cardiothoracic surgery resident education: update on resident recruitment and job placement.

    PubMed

    Salazar, Jorge D; Ermis, Peter; Laudito, Antonio; Lee, Richard; Wheatley, Grayson H; Paul, Sean; Calhoon, John

    2006-09-01

    Applications to cardiothoracic surgery training programs have steadily declined. The application cycle for 2004 marked the first time the number of applicants was lower than the positions offered. This survey reflects on this trend in applications and the perspectives of current and graduating residents. In June 2004, the Thoracic Surgery Residents Association, in conjunction with CTSNet, surveyed residents completing accredited cardiothoracic training or additional subspecialization. Participation was anonymous and voluntary. Of the 140 graduates, 88 responded. Most were male (92%) and married (72%). Their average age was 35.7 years, and 56% had children. The mean educational debt was less than $50,000. Of the 88 respondents, 69 (78%) had plans to seek jobs whereas 15 (17%) sought additional training. Among job-seeking residents, 12% received no offers. Also, 59% of graduates initially sought a position in academics and 41% in private practice. Nearly one quarter (23%) reported that they would not choose a career in cardiothoracic surgery again, and more than half (52%) would not strongly recommend cardiothoracic surgery to potential trainees. Almost all (90%) of the graduates believed that the number of cardiothoracic training spots should be decreased, and 92% believed that a reduction in training positions should be achieved by closing marginal training programs. Additionally, 91% believed reimbursement for cardiothoracic surgery was inadequate, and 88% thought low reimbursement resulted in restricted patient access and decreased quality of care. Cardiothoracic training programs are having difficulty in both applicant recruitment and in suitable job placement. This frustration in the job search coupled with reimbursement and lifestyle issues most likely contributes to the general dissatisfaction conveyed by the graduates. If these trends continue, the field will be faced with a crisis of unfilled residency programs and unemployed graduates.

  17. 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.

  18. 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.

  19. 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)

  20. 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)

  1. 38 CFR 51.70 - Resident rights.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

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

  2. 38 CFR 51.70 - Resident rights.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

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

  3. Perspective of ophthalmology residents in the United States about residency programs and competency in relation to the International Council of Ophthalmology guidelines.

    PubMed

    Abdelfattah, Nizar Saleh; Radwan, Ahmed E; Sadda, Srinivas R

    2016-09-01

    To evaluate the perspective of ophthalmology residents in the US about their residency programs and compare the competency of residency programs to international competency levels set by the International Council of Ophthalmology (ICO). A cross-sectional web-based survey extracted from the ICO published competency standards was sent to program directors of ophthalmology residency programs in the US to forward it to current PGY-3, 4 residents, and residency graduates from 2011 to 2014. Eighty-seven responses were received, comprising 61 residents and 26 graduates. Most respondents were highly satisfied with their programs (93.6%). Clinic-based training was rated satisfactorily. Insufficient exposure to low-vision rehabilitation (38.5%), refraction and contact lenses prescription (38.5%), and vitreo-retinal surgeries (38.5%) was reported. Respondents were satisfied with their overall surgical experiences, with the vast majority (>83%) rating case volume, complexity, and variety as satisfactory or better. A significant group stated they had insufficient exposure to extra-capsular cataract extraction (26.3%), refractive surgery (19.7%), and orbital surgery (64.5%). All graduates surveyed passed their Ophthalmic Knowledge Assessment Program (OKAP) examinations, and 72% felt their residency programs adequately prepared them for the examinations. All respondents reported insufficient training in certain nonclinical areas, such as practice management, staffing, and administration skills. Ophthalmology residents in the US express high levels of satisfaction with their residency training programs. While most programs adequately address most ICO core objectives, certain curriculum modifications should be considered.

  4. A medical resident post-discharge phone call study.

    PubMed

    Weisman, David S; Bashir, Lubna; Mehta, Anand; Bhatia, Leena; Levine, Stuart M; Mete, Mihriye; Padmore, Jamie S

    2012-04-01

    Several studies have identified the post-discharge period as a time of vulnerability for patients, and an opportunity exists to improve patient care. Adverse drug events are the most common events leading to complications during the post-discharge period. Recent studies have shown that using a scripted medication reconciliation process improves the quality of patient care. Does a phone call from a medical resident within 72 hours after hospital discharge improve patient satisfaction and quality of care? Does this exercise result in improved attitudes and competence for practice-based learning, and improvement and system-based practice of participating residents? This was a prospective randomized study comparing 1 group of patients that received a medication reconciliation phone call from a medical resident within 72 hours after discharge with a control group that did not receive a call. Adult patients aged ≥ 18 years on a medical resident service for ≥ 2 days and being discharged to home were invited to participate. The primary endpoint of the study was patient satisfaction. Secondary endpoints included readmission rates, emergency department visits, follow-up with the primary care provider, and resident attitudes and competence. The primary and secondary endpoints did not reach statistical significance. However, a medication reconciliation error occurred in 48% of patients, and 93% of residents agreed that the phone call was beneficial to patient care. Although patient satisfaction was not improved from this exercise, a follow-up call to patients after hospital discharge can identify otherwise missed medication reconciliation errors. Medical residents found the phone call to be worthwhile and gained valuable insight into their own discharge practices as demonstrated by self-reflection and intended change in discharge practices.

  5. 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

  6. Beneficial "halo effects" of surgical resident performance feedback.

    PubMed

    Lau, Brandyn D; Streiff, Michael B; Hobson, Deborah B; Kraus, Peggy S; Shaffer, Dauryne L; Popoola, Victor O; Farrow, Norma E; Efron, David T; Haut, Elliott R

    2016-09-01

    Venous thromboembolism (VTE) prevention is one of the most frequent measures of quality in hospital settings. In 2013, we began providing individualized feedback to general surgery residents about their VTE prophylaxis prescribing habits for general surgical patients. The purpose of this study was to investigate the indirect, or "halo effects" of providing individualized performance feedback to residents regarding prescription of appropriate VTE prophylaxis. This retrospective cohort study compared appropriate VTE prophylaxis prescription for all patients admitted to the adult trauma service from July 1, 2012 to May 31, 2015 at The Johns Hopkins Hospital, an academic hospital and Level 1 trauma center in Baltimore, Maryland. On October 1, 2013, we began providing monthly performance feedback to general surgery residents regarding their VTE prophylaxis prescribing habits for general surgery patients. Data were not provided about their prescription practice for trauma patients, or to any other prescribers within the hospital. During the study period, 931 adult trauma patients were admitted to the adult trauma service. After providing individualized feedback about general surgery patients, general surgery residents' prescribing practice for writing appropriate VTE prophylaxis orders for adult trauma patients significantly improved (93.9% versus 78.1%, P < 0.001). Prescription practice significantly improved among all other prescribers although they did not receive any specific individualized feedback, (84.9% versus 75.1%, P = 0.025); however, practice was significantly better among general surgery residents versus other providers (93.9% versus 84.9%, P = 0.003). There is a beneficial "halo effect" for patients treated by residents receiving individualized feedback about practice habits. Individualized feedback regarding practice habits for one patient type has both a direct and indirect effect on the quality of care patients receive and should be implemented for

  7. Considerations for Future IGS Receivers

    NASA Astrophysics Data System (ADS)

    Humphreys, T. E.; Young, L. E.; Pany, T.

    2008-12-01

    Future International GNSS Service (IGS) receivers are considered against the backdrop of GNSS signal modernization and the IGS's goal of further improving the accuracy of its products. The purpose of this paper is to provide the IGS ---and any other group that uses geodetic-quality GNSS receivers---with a guide to making decisions about GNSS receivers. Modernized GNSS signals are analyzed with a view toward IGS applications. A schedule for minimum IGS receiver requirements is proposed. Features of idealized conceptual receivers are discussed. The prospects for standard commercial receivers and for software-defined GNSS receivers are examined. Recommendations are given for how the IGS should proceed in order to maximally benefit from the transformation in GNSS that will occur over the next decade. There are two reasons why it makes sense for the IGS to study GNSS receivers that will be integrated into its network in the coming years. First, the new GNSS signals that will come on line over the next decade will render current IGS receivers obsolete, so it is prudent to examine receiver options going forward. Second, the push to improve the accuracy of IGS products beyond current limits demands greater accuracy in the models used to describe receiver measurements. As a result, the IGS must demand from vendors more transparency into receiver firmware or adoption of user-specified algorithms. This paper considers future IGS receivers from four different points of view. Section 2 looks at modernized GNSS signals and their benefits for the IGS. Section 3 surveys the range of expected receiver capability. Section 4 considers current and future commercial geodetic-quality receivers. Section 5 considers software GNSS receivers as an alternative to less reconfigurable traditional receivers. Section 6 lays out the authors' recommendations to the IGS.

  8. The effect of monthly resident reflection on achieving rotation goals.

    PubMed

    Toy, Eugene C; Harms, Konrad P; Morris, Robert K; Simmons, Jeané R; Kaplan, Alan L; Ownby, Allison R

    2009-01-01

    Reflection is a learning tool increasingly being used in medical education. It has not been well studied as a method of communicating resident rotation goals and objectives. The purpose was to study the effect of monthly resident reflection on achieving curriculum goals. During the first half of the 2005-06 academic year, obstetrics/gynecology residents at a community hospital received curriculum goals in a traditional written manner. During the second 6 months, the same trainees underwent 1-hr monthly structured reflection sessions on the rotation goals and objectives. Sixteen residents were studied. Compared to control, residents reported the rotation goals as better defined during reflection months. More trainees rated reflection as more valuable than the didactic time it replaced. All 16 residents documented more cumulative procedures in the Accreditation Council for Graduate Medical Education operative log Web site during reflection months for each of the three major categories; there was a mean increased number of procedures logged in Obstetrics (23.1 +/- 14.0, p < .001), Gynecology (18.3 +/- 10.9, p < .001), and Primary Care (21.1 +/- 23.5, p = .003). Overall, there was a mean of 62.6 +/- 32.1 (p < .001) more procedures entered during the reflection period, which translated to an 18% increase. Structured monthly reflection may lead to a higher success of achieving rotation goals.

  9. Endophthalmitis after resident-performed intravitreal bevacizumab injection.

    PubMed

    Falavarjani, Khalil Ghasemi; Aghamirsalim, Mohammadreza; Modarres, Mehdi; Hadavandkhani, Ali; Hashemi, Masih; Parvaresh, Mohammad Mehdi; Naseripour, Masood; Samiy, Nasrollah

    2015-02-01

    To evaluate the rate of acute endophthalmitis after resident-performed intravitreal bevacizumab (IVB) injections and to compare the results with those performed by attending retina surgeons. Retrospective comparative case series. Eight thousand thirty-seven patients treated with intravitreal injection of bevacizumab. A retrospective chart review of the resident-performed IVB injections at Rassoul Akram Hospital and attending-performed IVB injections at a private eye clinic between 2011 and 2014 was undertaken. Cases of clinical endophthalmitis were identified. During the study interval, the overall incidence rate of postinjection endophthalmitis was 0.01% (1/8037). Antibiotic eye drops were prescribed after IVB injection for 2771 eyes (34.5%). The single case of acute endophthalmitis occurred after a resident-performed injection, and vitreous culture showed growth of Staphylococcus epidermidis. The incidence rate of acute endophthalmitis after resident-performed IVB injection was 0.02% (1/4921). No statistically significant difference was found in the rates of endophthalmitis between resident-performed and attending-performed injections (p = 1). Also, the difference in the rates of endophthalmitis between those receiving postinjection antibiotics and those who did not was not statistically significant (p = 0.3). The risk for endophthalmitis after resident-performed IVB injection is low and similar to that of the supervising surgeons performing the procedure. Copyright © 2015 Canadian Ophthalmological Society. Published by Elsevier Inc. All rights reserved.

  10. Postmarital residence and biological variation at Pueblo Bonito.

    PubMed

    Schillaci, Michael A; Stojanowski, Christopher M

    2003-01-01

    Although the social organization of many of the present-day pueblos of the American Southwest is well-described in the anthropological literature, many aspects of prehistoric Puebloan social organization have received limited attention since initial investigations of postmarital residence in the 1960s and 1970s. This paper examines postmarital residence at the Chaco Canyon great house of Pueblo Bonito, using biological data. Our findings are inconsistent with the previously well-accepted hypothesis that the Pueblo II and Pueblo III occupants of the San Juan Basin conformed to a socially prescribed pattern of matrilocal residence with matrilineal descent. Univariate variance differences for nine craniometric variables indicate a pattern of increased female variability consistent with patrilocal/bilocal residence. The results of multivariate determinant ratio analyses are in agreement with the univariate results, suggesting the possibility of a patrilocal or bilocal residence preference at Pueblo Bonito. These findings are inconsistent with the notion that the female-based system of matrilocal residence with matrilineal descent observed among the present-day Western Pueblos was the ancestral Anasazi condition.

  11. Tablet Computing in Clinical Training of Pediatric Residents.

    PubMed

    Howard, David J; Coovert, Sally A; Coovert, Michael D; Nelson, Robert M

    2015-07-01

    Medical residents receive both medical education and clinical skills training. New technologies and pedagogies are being developed to address each of these phases. Our research focuses on the efficacy of an iPad(®) (Apple, Cupertino, CA) for clinical skills training. For a period of 3 years, the University of South Florida provided incoming pediatric residents (n=94) with an iPad. At the end of the 3-year program, we surveyed the residents, measuring perceptions and satisfaction of iPad use in clinical training. Sixty percent of the residents responded to the survey. Ninety-three percent reported at least some iPad usage per day on clinical activities. We classified 13 facets of clinical training into three conceptual areas and provided figures detailing iPad use for each facet relative to other facets in the same cluster. The obtaining, management, and display of information are primary uses of iPad applications in clinical training. Finally, we provide information relative to perceived obstacles in clinical training, with weight of the device being the most frequently cited. The role of graduate medical education is changing with the introduction of new technologies. These technologies can differentially impact the various aspects of residency education and training. Residents reported using an iPad extensively in their clinical training. We argue that in addition to impacting traditional educational strategies, iPads can successfully facilitate aspects of clinical training in medical education.

  12. Missed opportunities: a descriptive assessment of teaching and attitudes regarding communication skills in a surgical residency.

    PubMed

    Hutul, Olivia A; Carpenter, Robert O; Tarpley, John L; Lomis, Kimberly D

    2006-01-01

    The Accreditation Council for Graduate Medical Education (ACGME) requires that "residents must be able to demonstrate interpersonal and communication skills that result in effective information exchange and teaming with patients, their patients' families, and professional associates." The authors sought to assess current methods of teaching and attitudes regarding communication skills in their surgical residency. After obtaining Institutional Review Board (IRB) exemption, voluntary anonymous surveys were completed by a sample of convenience at the Vanderbilt University Medical Center: surgical residents at Grand Rounds and attending surgeons in a faculty meeting. Data were evaluated from 49 respondents (33 of 75 total surgical residents, 16 representative attending surgeons). One hundred percent of respondents rated the importance of communication to the successful care of patients as "4" or "5" of 5. Direct attending observation of residents communicating with patients/families was confirmed by residents and faculty. Residents reported varying levels of comfort with different types of conversations. Residents were "comfortable" or "very comfortable" as follows: obtaining informed consent, 91%; reporting operative findings, 64%; delivering bad news, 61%; conducting a family conference, 40%; discussing do not resuscitate (DNR) orders, 36%; and discussing transition to comfort care, 24%. Resident receptiveness to communication skills education varied with proposed venues: 84% favored teaching in the course of routine clinical care, 52% via online resources, and 46% in workshops. Residents were asked how frequently they received feedback specific to their communication skills during the past 6 months: Most residents reported 0 (39%) or 1 (21%) feedback episode. Only 30% of resident respondents reported receiving feedback that they perceived helpful. Attending surgeons reported that they did provide residents feedback specific to their communication skills. When asked

  13. Real-time software receiver

    NASA Technical Reports Server (NTRS)

    Ledvina, Brent M. (Inventor); Psiaki, Mark L. (Inventor); Powell, Steven P. (Inventor); Kintner, Jr., Paul M. (Inventor)

    2006-01-01

    A real-time software receiver that executes on a general purpose processor. The software receiver includes data acquisition and correlator modules that perform, in place of hardware correlation, baseband mixing and PRN code correlation using bit-wise parallelism.

  14. Real-time software receiver

    NASA Technical Reports Server (NTRS)

    Ledvina, Brent M. (Inventor); Psiaki, Mark L. (Inventor); Powell, Steven P. (Inventor); Kintner, Jr., Paul M. (Inventor)

    2007-01-01

    A real-time software receiver that executes on a general purpose processor. The software receiver includes data acquisition and correlator modules that perform, in place of hardware correlation, baseband mixing and PRN code correlation using bit-wise parallelism.

  15. 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...

  16. High-temperature ceramic receivers

    SciTech Connect

    Jarvinen, P. O.

    1980-01-01

    An advanced ceramic dome cavity receiver is discussed which heats pressurized gas to temperatures above 1800/sup 0/F (1000/sup 0/C) for use in solar Brayton power systems of the dispersed receiver/dish or central receiver type. Optical, heat transfer, structural, and ceramic material design aspects of the receiver are reported and the development and experimental demonstration of a high-temperature seal between the pressurized gas and the high-temperature silicon carbide dome material is described.

  17. High temperature solar thermal receiver

    NASA Technical Reports Server (NTRS)

    1979-01-01

    A design concept for a high temperature solar thermal receiver to operate at 3 atmospheres pressure and 2500 F outlet was developed. The performance and complexity of windowed matrix, tube-header, and extended surface receivers were evaluated. The windowed matrix receiver proved to offer substantial cost and performance benefits. An efficient and cost effective hardware design was evaluated for a receiver which can be readily interfaced to fuel and chemical processes or to heat engines for power generation.

  18. 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

  19. Family physicians’ attitudes toward education in research skills during residency

    PubMed Central

    Leahy, Natalie; Sheps, Jordana; Tracy, C. Shawn; Nie, Jason X.; Moineddin, Rahim; Upshur, Ross E.G.

    2008-01-01

    OBJECTIVE To determine the attitudes of practising Canadian family physicians toward education in research skills during residency, to identify what determines these attitudes, and to investigate the effect of education in research skills on future research activity. DESIGN Mailed survey. SETTING Primary care. PARTICIPANTS Stratified random sample of 247 practising physicians who were members of the College of Family Physicians of Canada. MAIN OUTCOME MEASURES Physicians’ attitudes toward education in research skills during residency, their perceptions of the value of research in primary care, and their current involvement in research activities. RESULTS Overall response rate was 56%. Nearly all respondents agreed that critical appraisal skills are essential to the practice of modern family medicine. Most agreed that it is very important that the evidence base for primary care medicine be developed by family physicians, yet only one-third agreed that research skills ought to receive more emphasis during residency training, and fewer than one-quarter agreed that practising family physicians should have strong research skills. Fewer than half the respondents agreed that a core goal of family medicine residency training should be to promote and develop an active interest in research. While three-quarters agreed that research projects during residency can be formative learning experiences, only about 40% indicated that research projects should be required, and only about 20% considered their own resident research projects to have been highly influential learning experiences. Respondents whose residency programs had research in the curriculum were significantly more likely to have found their research projects to be highly influential learning experiences (P <.05), and those who had successfully completed research projects were less likely to believe that they lacked the necessary skills and expertise to conduct their own research studies. Those who had successfully

  20. Benchmarks of support in internal medicine residency training programs.

    PubMed

    Wolfsthal, Susan D; Beasley, Brent W; Kopelman, Richard; Stickley, William; Gabryel, Timothy; Kahn, Marc J

    2002-01-01

    To identify benchmarks of financial and staff support in internal medicine residency training programs and their correlation with indicators of quality. A survey instrument to determine characteristics of support of residency training programs was mailed to each member program of the Association of Program Directors of Internal Medicine. Results were correlated with the three-year running average of the pass rates on the American Board of Internal Medicine certifying examination using bivariate and multivariate analyses. Of 394 surveys, 287 (73%) were completed: 74% of respondents were program directors and 20% were both chair and program director. The mean duration as program director was 7.5 years (median = 5), but it was significantly lower for women than for men (4.9 versus 8.1; p =.001). Respondents spent 62% of their time in educational and administrative duties, 30% in clinical activities, 5% in research, and 2% in other activities. Most chief residents were PGY4s, with 72% receiving compensation additional to base salary. On average, there was one associate program director for every 33 residents, one chief resident for every 27 residents, and one staff person for every 21 residents. Most programs provided trainees with incremental educational stipends, meals while oncall, travel and meeting expenses, and parking. Support from pharmaceutical companies was used for meals, books, and meeting expenses. Almost all programs provided meals for applicants, with 15% providing travel allowances and 37% providing lodging. The programs' board pass rates significantly correlated with the numbers of faculty fulltime equivalents (FTEs), the numbers of resident FTEs per office staff FTEs, and the numbers of categorical and preliminary applications received and ranked by the programs in 1998 and 1999. Regression analyses demonstrated three independent predictors of the programs' board pass rates: number of faculty (a positive predictor), percentage of clinical work

  1. Hands-on Physics Education of Residents in Diagnostic Radiology.

    PubMed

    Zhang, Jie; Hardy, Peter A; DiSantis, David J; Oates, M Elizabeth

    2017-06-01

    The American Board of Radiology Core Examination integrates assessment of physics knowledge into its overall testing of clinical radiology, with an emphasis on understanding image quality and artifacts, radiation dose, and patient safety for each modality or subspecialty organ system. Accordingly, achieving a holistic approach to physics education of radiology residents is a huge challenge. The traditional teaching of radiological physics-simply through didactic lectures-was not designed for such a holistic approach. Admittedly, time constraints and clinical demands can make incorporation of physics teaching into clinical practice problematic. We created and implemented a week-long, intensive physics rotation for fledgling radiology residents and evaluated its effectiveness. The dedicated physics rotation is held for 1 week during the first month of radiology residency. It comprises three components: introductory lectures, hands-on practical clinical physics operations, and observation of clinical image production. A brief introduction of the physics pertinent to each modality is given at the beginning of each session. Hands-on experimental demonstrations are emphasized, receiving the greatest allotment of time. The residents perform experiments such as measuring radiation dose, studying the relationship between patient dose and clinical practice (eg, fluoroscopy technique), investigating the influence of acquisition parameters (kV, mAs) on radiographs, and evaluating image quality using computed tomography, magnetic resonance imaging, ultrasound, and gamma camera/single-photon emission computed tomography/positron emission tomography phantoms. Quantitative assessment of the effectiveness of the rotation is based on an examination that tests the residents' grasp of basic medical physics concepts along with written course evaluations provided by each resident. The pre- and post-rotation tests show that after the physics rotation, the average correct score of 25

  2. Attending and resident satisfaction with feedback in the emergency department.

    PubMed

    Yarris, Lalena M; Linden, Judith A; Gene Hern, H; Lefebvre, Cedric; Nestler, David M; Fu, Rongwei; Choo, Esther; LaMantia, Joseph; Brunett, Patrick

    2009-12-01

    Effective feedback is critical to medical education. Little is known about emergency medicine (EM) attending and resident physician perceptions of feedback. The focus of this study was to examine perceptions of the educational feedback that attending physicians give to residents in the clinical environment of the emergency department (ED). The authors compared attending and resident satisfaction with real-time feedback and hypothesized that the two groups would report different overall satisfaction with the feedback they currently give and receive in the ED. This observational study surveyed attending and resident physicians at 17 EM residency programs through web-based surveys. The primary outcome was overall satisfaction with feedback in the ED, ranked on a 10-point scale. Additional survey items addressed specific aspects of feedback. Responses were compared using a linear generalized estimating equation (GEE) model for overall satisfaction, a logistic GEE model for dichotomized responses, and an ordinal logistic GEE model for ordinal responses. Three hundred seventy-three of 525 (71%) attending physicians and 356 of 596 (60%) residents completed the survey. Attending physicians were more satisfied with overall feedback (mean score 5.97 vs. 5.29, p < 0.001) and with timeliness of feedback (odds ratio [OR] = 1.56, 95% confidence interval [CI] = 1.23 to 2.00; p < 0.001) than residents. Attending physicians were also more likely to rate the quality of feedback as very good or excellent for positive feedback, constructive feedback, feedback on procedures, documentation, management of ED flow, and evidence-based decision-making. Attending physicians reported time constraints as the top obstacle to giving feedback and were more likely than residents to report that feedback is usually attending initiated (OR = 7.09, 95% CI = 3.53 to 14.31; p < 0.001). Attending physician satisfaction with the quality, timeliness, and frequency of feedback given is higher than resident

  3. Predictors of final specialty choice by internal medicine residents.

    PubMed

    Diehl, Andrew K; Kumar, Vineeta; Gateley, Ann; Appleby, Jane L; O'Keefe, Mary E

    2006-10-01

    Sociodemographic factors and personality attributes predict career decisions in medical students. Determinants of internal medicine residents' specialty choices have received little attention. To identify factors that predict the clinical practice of residents following their training. Prospective cohort study. Two hundred and four categorical residents from 2 university-based residency programs. Sociodemographic and personality inventories performed during residency, and actual careers 4 to 9 years later. International medical school graduates (IMGs) were less likely to practice general medicine than U.S. graduates (33.3% vs 70.6%, P < .001). Residents with higher loan indebtedness more often became generalists (P = .001). A corresponding trend favoring general internal medicine was observed among those who perceived General Internists to have lower potential incomes (69.0% vs 53.3%, P = .08). There was a trend for generalists to have lower scores on scales measuring authoritarianism, negative orientation to psychological problems, and Machiavellianism (0.05 < P < .10). In a logistic regression, graduation from a U.S. medical school (odds ratio [OR] 3.02; 95% confidence interval [CI], 1.00 to 9.10, P = .049) and perception of low future income (OR 1.65; 95% CI, 1.06 to 2.56, P = .03) predicted entry into general medicine, with trends apparent for higher debt (P = .05) and greater comfort caring for patients with psychological problems (P = .07). Recruitment of IMGs may not increase the supply of General Internists. Prospects of lower income, even in the face of large debt, may not discourage residents from becoming generalists. If increasing generalist manpower is a goal, residencies should consider weighing applicants' personal attributes during the selection process.

  4. Predictors of Final Specialty Choice by Internal Medicine Residents

    PubMed Central

    Diehl, Andrew K; Kumar, Vineeta; Gateley, Ann; Appleby, Jane L; O'Keefe, Mary E

    2006-01-01

    BACKGROUND Sociodemographic factors and personality attributes predict career decisions in medical students. Determinants of internal medicine residents' specialty choices have received little attention. OBJECTIVE To identify factors that predict the clinical practice of residents following their training. DESIGN Prospective cohort study. PARTICIPANTS Two hundred and four categorical residents from 2 university-based residency programs. MEASUREMENTS Sociodemographic and personality inventories performed during residency, and actual careers 4 to 9 years later. RESULTS International medical school graduates (IMGs) were less likely to practice general medicine than U.S. graduates (33.3% vs 70.6%, P<.001). Residents with higher loan indebtedness more often became generalists (P = .001). A corresponding trend favoring general internal medicine was observed among those who perceived General Internists to have lower potential incomes (69.0% vs 53.3%, P = .08). There was a trend for generalists to have lower scores on scales measuring authoritarianism, negative orientation to psychological problems, and Machiavellianism (0.05residents from becoming generalists. If increasing generalist manpower is a goal, residencies should consider weighing applicants' personal attributes during the selection process. PMID:16836624

  5. Pediatric residency education: is sports medicine getting its fair share?

    PubMed

    Demorest, Rebecca A; Bernhardt, David T; Best, Thomas M; Landry, Gregory L

    2005-01-01

    Sports are the leading injury-related cause for pediatric primary care visits. Pediatric residency education guidelines suggest incorporating sports medicine (SM) education into curricula; however, research is lacking regarding effective teaching methods. To assess reported US pediatric residency SM curricula, teaching methods, and resident evaluation of SM education. Chief residents (CRs) and third-year residents (PL3s) from 100 randomly selected US Accreditation Council for Graduate Medical Education-accredited residency programs, stratified by size and geographic location, received surveys regarding programs' SM curriculum and teaching methods and individuals' methods for learning SM. Response rates were 63% and 39% for CRs and PL3s, respectively. According to CRs, 34% of programs had no one in charge of their SM curriculum. Lecture (77%) was the primary method used for teaching SM. Hands-on teaching (37%) was used less frequently. CRs stated that 29% of programs did not include musculoskeletal examination teaching in their curriculums; 24% did not include formal teaching of concussion management, and 29% did not include reasons for medical disqualification. PL3s rated teaching of joint examinations and the preparticipation physical as the most poorly taught components of the physical examination. PL3s rated hands-on teaching and patient experience as the best methods for improving SM education. CRs reported that only 36% of programs have discussed incorporating more SM into their curriculum. SM education is deficient in US pediatric residency programs. Standardized curricula should be developed with a focus on hands-on training as a means for teaching SM to pediatric residents.

  6. Minority Underrepresentation in Academia: Factors Impacting Careers of Surgery Residents.

    PubMed

    Julien, Jamii St; Lang, Ryan; Brown, Tony N; Aldrich, Melinda C; Deppen, Steven A; Wu, Huiyun; Feurer, Irene D; Tarpley, Margaret; Hill, George; Tarpley, John; Beauchamp, R Daniel; Grogan, Eric L

    2014-12-01

    Underrepresentation of minorities within academic surgery is an ever present problem with a profound impact on healthcare. The factors influencing surgery residents to pursue an academic career have yet to be formally investigated. We sought to elucidate these factors, with a focus on minority status. A web-based questionnaire was sent to all administered to all ACGME-accredited general surgery programs in the United States. The main outcome was the decision to pursue a fully academic versus non-academic career. Multivariable logistic regression was used to identify characteristics impacting career choice. Of the 3,726 residents who received the survey, a total of 1,217 residents completed it - a response rate of 33%. Forty-seven percent planned to pursue non-academic careers, 35% academic careers, and 18% were undecided. There was no association between underrepresented minority status and academic career choice (Odds Ratio = 1.0, 95% Confidence Interval 0.6 - 1.6). Among all residents, research during training (OR=4.0, 95% CI 2.7-5.9), mentorship (OR=2.1, 95% CI 1.6-2.9), and attending a residency program requiring research (OR=2.3, 95% CI 1.5-3.4) were factors associated with choosing an academic career. When the analysis was performed among only senior residents (i.e., 4(th) and 5(th) year residents), a debt burden >$150,000 was associated with choosing a non-academic career (OR=0.4, 95% CI 0.1-0.9). Underrepresented minority status is not associated with career choice. Intentional recruitment of minorities into research-oriented training programs, increased mentorship and research support among current minority residents, and improved financial options for minorities may increase the number choosing an academic surgical career.

  7. Profiles of nursing home residents with multiple sclerosis using the minimum data set.

    PubMed

    Buchanan, R J; Wang, S; Huang, C; Graber, D

    2001-06-01

    This paper profiles nursing home residents with multiple sclerosis (MS) at the time of admission, including sociodemographic characteristics, health status measures, and treatments received. Admission assessments from the Minimum Data Set are used to create these profiles of residents with MS. There are 9,013 admission assessments in the MDS for residents with MS between June 22, 1998 and January 17, 2000 analyzed for this study. Residents with MS are distinctly younger at admission than most nursing home residents, averaging 57.98 years of age. Recently admitted residents with MS are more physically dependent than other nursing home residents and tend to have limited range of motion and loss of voluntary movement About one in three newly admitted residents with MS had some degree of impaired cognitive function. Over one third of residents with MS were depressed at admission, yet only 11.7% of recently admitted residents with MS were evaluated by a licensed mental health specialist This prompts concem about the psychosocial well-being of MS residents in nursing homes.

  8. Integrating an evidence-based medicine rotation into an internal medicine residency program.

    PubMed

    Akl, Elie A; Izuchukwu, Ifeoma S; El-Dika, Samer; Fritsche, Lutz; Kunz, Regina; Schünemann, Holger J

    2004-09-01

    To measure the impact of a resident focused evidence-based medicine (EBM) educational intervention on EBM knowledge of residents and students, to assess its feasibility, and to evaluate residents' attitudes regarding this rotation. In 2002, based on the EBM user and EBM practitioner model, the authors designed the EBM elective rotation and conducted a controlled trial of its implementation in the internal medicine residency program in three teaching hospitals affiliated with the University at Buffalo, New York. The intervention group (one hospital, 17 medical students and residents) received a multifaceted intervention. In the control group (two hospitals, 23 medical students and residents), there was no curriculum change. The effectiveness in a pre- and post-test was assessed using the English version of the Berlin Questionnaire. A survey of all internal medicine residents (n = 119) was conducted to evaluate their attitudes toward the EBM elective rotation. In the intervention group, knowledge improved slightly, but not significantly (.71 on a scale ranging from 0-15 on the Berlin questionnaire, p =.3). The mean score in the control group decreased significantly (1.65, p =.005). The difference in change scores between the two groups was significant even after adjustment for covariates (2.52, p =.006). Residents (response rate 83%) had positive attitudes regarding the rotation. An EBM elective rotation was successfully integrated into a residency program. This multifaceted educational approach with an "on-the-ward" EBM resident, may improve the EBM knowledge and skills of targeted students and residents.

  9. The flipped classroom: a modality for mixed asynchronous and synchronous learning in a residency program.

    PubMed

    Young, Timothy P; Bailey, Caleb J; Guptill, Mindi; Thorp, Andrea W; Thomas, Tamara L

    2014-11-01

    A "flipped classroom" educational model exchanges the traditional format of a classroom lecture and homework problem set. We piloted two flipped classroom sessions in our emergency medicine (EM) residency didactic schedule. We aimed to learn about resident and faculty impressions of the sessions, in order to develop them as a regular component of our residency curriculum. We evaluated residents' impression of the asynchronous video component and synchronous classroom component using four Likert items. We used open-ended questions to inquire about resident and faculty impressions of the advantages and disadvantages of the format. For the Likert items evaluating the video lectures, 33/35 residents (94%, 95% CI 80%-99%) responded that the video lecture added to their knowledge about the topic, and 33/35 residents felt that watching the video was a valuable use of their time. For items evaluating the flipped classroom format, 36/38 residents (95%, 95% CI 82%-99%) preferred the format to a traditional lecture on the topic, and 38/38 residents (100%, 95% CI 89%-100%) felt that the small group session was effective in helping them learn about the topic. Most residents preferred to see the format monthly in our curriculum and chose an ideal group size of 5.5 (first session) and 7 (second session). Residents cited the interactivity of the sessions and access to experts as advantages of the format. Faculty felt the ability to assess residents' understanding of concepts and provide feedback were advantages. Our flipped classroom model was positively received by EM residents. Residents preferred a small group size and favored frequent use of the format in our curriculum. The flipped classroom represents one modality that programs may use to incorporate a mixture of asynchronous and interactive synchronous learning and provide additional opportunities to evaluate residents.

  10. The Effect of Gender on Resident Autonomy in the Operating room.

    PubMed

    Meyerson, Shari L; Sternbach, Joel M; Zwischenberger, Joseph B; Bender, Edward M

    2017-06-29

    Discrimination against women training in medicine and surgery has been subjectively described for decades. This study objectively documents gender differences in the degree of autonomy given to thoracic surgery trainees in the operating room. Thoracic surgery residents and faculty underwent frame of reference training on the use of the 4-point Zwisch scale to measure operative autonomy. Residents and faculty then submitted evaluations of their perception of autonomy granted for individual operations as well as operative difficulty on a real-time basis using the "Zwisch Me!!" mobile application. Differences in autonomy given to male and female residents were elucidated using chi-square analysis and ordered logistic regression. Seven academic medical centers with thoracic surgery training programs. Volunteer thoracic surgery residents in both integrated and traditional training pathways and their affiliated cardiothoracic faculty. Residents (n = 33, female 18%) submitted a total of 596 evaluations to faculty (n = 48, female 12%). Faculty gave less autonomy to female residents with only 56 of 184 evaluations (30.3%) showing meaningful autonomy (passive help or supervision only) compared to 107 of 292 evaluations (36.7%) at those levels for male residents (p = 0.02). Resident perceptions of autonomy showed even more pronounced differences with female residents receiving only 38 of 197 evaluations (19.3%) with meaningful autonomy compared to 133 of 399 evaluations (33.3%) for male residents (p < 0.001). Potential influencing factors explored included attending gender and specialty, case type and difficulty, and resident level of training. In multivariate analysis, only case difficultly, resident gender, and level of training were significantly related to autonomy granted to residents. Evaluations of operative autonomy reveal a significant bias against female residents. Faculty education is needed to encourage allowing female residents more operative autonomy. Copyright

  11. Two perspectives on the educational and administrative roles of the pediatric chief resident.

    PubMed

    Dabrow, Sharon M; Harris, Elizabeth J; Maldonado, Luis A; Gereige, Rani S

    2011-03-01

    To investigate pediatric chief residents' responsibilities and determine how chief residents and program directors view the scope of the chief resident's role. We distributed a 20-item survey to program directors and chief residents at all US pediatric residency programs. Questions pertained to activities performed and the level of importance of administrative, clinical, and educational activities. The survey also investigated motivating factors to become chief resident, future career plans, and level of job satisfaction. We received responses from 127 program directors and 101 chief residents. Of the chief residents, 98% (99/101) felt administrative tasks were very/somewhat important, followed by education, service, and research. Significantly more program directors than chief residents felt chiefs' overall workload was well balanced. Program directors gave higher ratings than chief residents on chief's ability to develop clinical skills (79% [95/121] versus 61% [61/100]) and manage stress and burnout (86% [104/121] versus 72% [72/100]). Future career plans for chief residents in decreasing order included fellowship, outpatient practice, academic practice, and working as a hospitalist. The most significant problems reported by the chief residents were lack of administrative support and lack of time spent in educational/clinical activities. The chief resident role is primarily administrative, but program directors and chiefs feel teaching and clinical responsibilities also are important. Although the 2 groups agreed in many areas, program directors underestimated the administrative demands placed on the chief residents, and our findings suggest the chief resident role may be more fulfilling if the balance was shifted somewhat toward teaching and clinical responsibilities.

  12. 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.

  13. 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.

  14. Sample medication dispensing in a residency practice.

    PubMed

    Morelli, D; Koenigsberg, M R

    1992-01-01

    The distribution of sample medications to physicians by pharmaceutical manufacturers has been regulated by Congress and extensively critiqued in the medical literature. Manufacturers distributed 2.4 billion samples in 1988, yet there are no published reports on the clinical use of sample medications. A 4-week descriptive study was conducted that catalogued the contents of a sample medication collection in a family practice residency model office, calculated the value of the sample collection (average wholesale price [AWP]), and monitored dispensing of medication samples. The collection initially contained 5546 samples with an AWP of $19,273. A total of 1012 samples worth $4154 was withdrawn from the collection during the study period. Patients received 548 of the sample packages in 105 dispensements ($2583), physicians or their families received 169 samples in 44 dispensements ($603), others received 26 samples in 6 dispensements ($152), and the destination of 269 samples ($816) was unknown. When a prescription was written at the time that a sample was dispensed, it was almost always for the same brand-name medication. Although a majority of medications dispensed were given to patients, approximately one third of the value of the medications withdrawn either went to physicians and their families or had an unknown destination. The high association of sample dispensing and simultaneous prescribing of the same brand-name drug supports the contention that sampling influences physician-prescribing habits. Further research should define how the availability of free sample medications affects physician-prescribing practices.

  15. Performance testing of lidar receivers

    NASA Technical Reports Server (NTRS)

    Shams, M. Y.

    1986-01-01

    In addition to the considerations about the different types of noise sources, dynamic range, and linearity of a lidar receiver, one requires information about the pulse shape retaining capabilities of the receiver. For this purpose, relatively precise information about the height resolution as well as the recovery time of the receiver, due both to large transients and to fast changes in the received signal, is required. As more and more analog receivers using fast analog to digital converters and transient recorders will be used in the future lidar systems, methods to test these devices are essential. The method proposed for this purpose is shown. Tests were carried out using LCW-10, LT-20, and FTVR-2 as optical parts of the optical pulse generator circuits. A commercial optical receiver, LNOR, and a transient recorder, VK 220-4, were parts of the receiver system.

  16. Bragg-cell receiver study

    NASA Technical Reports Server (NTRS)

    Wilson, Lonnie A.

    1987-01-01

    Bragg-cell receivers are employed in specialized Electronic Warfare (EW) applications for the measurement of frequency. Bragg-cell receiver characteristics are fully characterized for simple RF emitter signals. This receiver is early in its development cycle when compared to the IFM receiver. Functional mathematical models are derived and presented in this report for the Bragg-cell receiver. Theoretical analysis is presented and digital computer signal processing results are presented for the Bragg-cell receiver. Probability density function analysis are performed for output frequency. Probability density function distributions are observed to depart from assumed distributions for wideband and complex RF signals. This analysis is significant for high resolution and fine grain EW Bragg-cell receiver systems.

  17. Residence location and likelihood of kidney transplantation

    PubMed Central

    Tonelli, Marcello; Klarenbach, Scott; Manns, Braden; Culleton, Bruce; Hemmelgarn, Brenda; Bertazzon, Stefania; Wiebe, Natasha; Gill, John S.

    2006-01-01

    Background In a universal, public health care system, access to kidney transplantation should not be influenced by residence location. We determined the likelihood of kidney transplantation from deceased donors among Canadian dialysis patients living in 7 geographic regions. Within each region we also determined whether distance from the closest transplant centre was associated with the likelihood of transplantation. Methods A random sample of 7034 subjects initiating dialysis in Canada between 1996 and 2000 was studied. We used Cox proportional hazards models to examine the relation between residence location and the likelihood of kidney transplantation from deceased donors over a median period of 2.4 years. Results There were significant differences in the likelihood of kidney transplantation from deceased donors and predicted waiting times between the different geographic regions. For example, the adjusted relative likelihood of transplantation in Alberta was 3.74 (95% confidence interval [CI] 2.95–4.76) compared with the likelihood in Ontario (p < 0.001). These differences persisted after further adjustment for differences in the rate of deceased organ donation. Within regions, patients who resided 50.1–150 km, 150.1–300 km and more than 300 km from the closest transplant centre had a similar adjusted likelihood of receiving a kidney transplant as those who lived less than 50 km away. Interpretation The adjusted likelihood of undergoing a kidney transplant from a deceased donor varied substantially between geographic regions in Canada. In contrast, the likelihood of transplantation within regions was not affected by distance from the closest transplant centre. PMID:16940265

  18. 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.

  19. General surgery residents' perception of robot-assisted procedures during surgical training.

    PubMed

    Farivar, Behzad S; Flannagan, Molly; Leitman, I Michael

    2015-01-01

    With the continued expansion of robotically assisted procedures, general surgery residents continue to receive more exposure to this new technology as part of their training. There are currently no guidelines or standardized training requirements for robot-assisted procedures during general surgical residency. The aim of this study was to assess the effect of this new technology on general surgery training from the residents' perspective. An anonymous, national, web-based survey was conducted on residents enrolled in general surgery training in 2013. The survey was sent to 240 Accreditation Council for Graduate Medical Education-approved general surgery training programs. Overall, 64% of the responding residents were men and had an average age of 29 years. Half of the responses were from postgraduate year 1 (PGY1) and PGY2 residents, and the remainder was from the PGY3 level and above. Overall, 50% of the responses were from university training programs, 32% from university-affiliated programs, and 18% from community-based programs. More than 96% of residents noted the availability of the surgical robot system at their training institution. Overall, 63% of residents indicated that they had participated in robotic surgical cases. Most responded that they had assisted in 10 or fewer robotic cases with the most frequent activities being assisting with robotic trocar placement and docking and undocking the robot. Only 18% reported experience with operating the robotic console. More senior residents (PGY3 and above) were involved in robotic cases compared with junior residents (78% vs 48%, p < 0.001). Overall, 60% of residents indicated that they received no prior education or training before their first robotic case. Approximately 64% of residents reported that formal training in robotic surgery was important in residency training and 46% of residents indicated that robotic-assisted cases interfered with resident learning. Only 11% felt that robotic-assisted cases

  20. Are there enough jobs in cardiothoracic surgery? The thoracic surgery residents association job placement survey for finishing residents.

    PubMed

    Salazar, Jorge D; Lee, Richard; Wheatley, Grayson H; Doty, John R

    2004-11-01

    Applications to cardiothoracic surgery training programs have declined. Anecdotal evidence suggests limited job availability for residents completing cardiothoracic training, which may contribute to this decline. This survey sought to document the experience of current, graduating residents. In June 2003, the Thoracic Surgery Residents Association surveyed residents completing accredited cardiothoracic training or additional subspecialization, utilizing a web-based survey hosted by CTSNet. Resident participation was voluntary and anonymous. Of the estimated 140 graduates, 89 responded. The majority were male (91.0%, n = 81), married (80.0%, n = 71), and had children (61.0%, n = 54). Average age was 36.2 years old, and mean educational debt was less than 50K dollars. Of the 89 respondents, 77 initially sought jobs and 12 sought additional training. For residents seeking jobs, 19.5% (n = 15) received no offers and 13 of these ultimately pursued additional training. Acquired jobs were in private (53.0%, n = 34) or academic practice (47.0%, n = 30), with 73.4% (n = 47) involving general thoracic surgery. Most would again choose cardiothoracic surgery as a career (75.5%, n = 67), and 62.0% (n = 55) would again submit the same match list. However, 87.0% (n = 77) believed that the number of trainees should be decreased, 81.0% (n = 72) believed that reimbursement for cardiothoracic surgery is inadequate, and 77.5% (n = 69) believed that excessively low reimbursement will result in restricted access or decreased quality for patients. Most cardiothoracic residents were successful in finding employment after training. A substantial percentage, however, pursued additional training due to lack of job opportunities. Although most finishing residents were satisfied with training and career choice, significant concerns exist regarding job opportunities and compensation. These conditions may lead to difficulty in recruitment to the specialty.

  1. 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.

  2. Non-resident Fathers’ Social Networks: The Relationship between Social Support and Father Involvement

    PubMed Central

    Castillo, Jason T.; Sarver, Christian M.

    2011-01-01

    Literature and research examining non-resident fathers’ involvement with their chidren has focused primarily on the fathers’ relationship with their child’s mother. Receiving limited attention in the literature has been the inclusion of examining non-resident fathers’ social support networks, the function of these social networks—perceived and received social support, and how these social support networks affect non-resident fathers’ involvement with their children. Using data from Wave One of the Fragile Families and Child Well-being Study, this study examined the social support networks non-resident fathers (n = 895) utilized in their involvement with their children. Results of the regression analyses indicate that non-resident fathers’ relationship with their child’s mother and perceived social support from their social networks contributed positively to their involvement with their children. Policy and practice implications are discussed. PMID:23288998

  3. Teaching pediatric laboratory medicine to pathology residents.

    PubMed

    Pysher, Theodore J; Bach, Philip R; Geaghan, Sharon M; Hamilton, Marilyn S; Laposata, Michael; Lockitch, Gillian; Brugnara, Carlo; Coffin, Cheryl M; Pasquali, Marzia; Rinaldo, Piero; Roberts, William L; Rutledge, Joe C; Ashwood, Edward R; Blaylock, Robert C; Campos, Joseph M; Goldsmith, Barbara; Jones, Patricia M; Lim, Megan; Meikle, A Wayne; Perkins, Sherrie L; Perry, Deborah A; Petti, Cathy A; Rogers, Beverly B; Steele, Paul E; Weiss, Ronald L; Woods, Gail

    2006-07-01

    Laboratory data are essential to the medical care of fetuses, infants, children, and adolescents. However, the performance and interpretation of laboratory tests on specimens from these patients, which may constitute a significant component of the workload in general hospitals and integrated health care systems as well as specialized perinatal or pediatric centers, present unique challenges to the clinical pathologist and the laboratory. Therefore, pathology residents should receive training in pediatric laboratory medicine. Children's Health Improvement through Laboratory Diagnostics, a group of pathologists and laboratory scientists with interest and expertise in pediatric laboratory medicine, convened a task force to develop a list of curriculum topics, key resources, and training experiences in pediatric laboratory medicine for trainees in anatomic and clinical pathology or straight clinical pathology residency programs and in pediatric pathology fellowship programs. Based on the experiences of 11 training programs, we have compiled a comprehensive list of pediatric topics in the areas of clinical chemistry, endocrinology, hematology, urinalysis, coagulation medicine, transfusion medicine, immunology, microbiology and virology, biochemical genetics, cytogenetics and molecular diagnostics, point of care testing, and laboratory management. This report also includes recommendations for training experiences and a list of key texts and other resources in pediatric laboratory medicine. Clinical pathologists should be trained to meet the laboratory medicine needs of pediatric patients and to assist the clinicians caring for these patients with the selection and interpretation of laboratory studies. This review helps program directors tailor their curricula to more effectively provide this training.

  4. Providing rapid feedback to residents on their teaching skills: an educational strategy for contemporary trainees.

    PubMed

    Katz-Sidlow, Rachel J; Baer, Tamar G; Gershel, Jeffrey C

    2016-03-20

    The objective of this study was to assess the attitudes of contemporary residents toward receiving rapid feedback on their teaching skills from their medical student learners. Participants consisted of 20 residents in their second post-graduate training year. These residents facilitated 44 teaching sessions with medical students within our Resident-as-Teacher program. Structured, written feedback from students was returned to the resident within 3 days following each session. Residents completed a short survey about the utility of the feedback, whether they would make a change to future teaching sessions based on the feedback, and what specifically they might change. The survey utilized a 4-point scale ("Not helpful/likely=1" to "Very helpful/likely=4"), and allowed for one free-text response. Free-text responses were hand-coded and underwent qualitative analysis to identify themes. There were 182 student feedback encounters resulting from 44 teaching sessions. The survey response rate was 73% (32/44). Ninety-four percent of residents rated the rapid feedback as "very helpful," and 91% would "very likely" make a change to subsequent sessions based on student feedback. Residents' proposed changes included modifications to session content and/or their personal teaching style. Residents found that rapid feedback received from medical student learners was highly valuable to them in their roles as teachers. A rapid feedback strategy may facilitate an optimal educational environment for contemporary trainees.

  5. High temperature helical tubular receiver for concentrating solar power system

    NASA Astrophysics Data System (ADS)

    Hossain, Nazmul

    In the field of conventional cleaner power generation technology, concentrating solar power systems have introduced remarkable opportunity. In a solar power tower, solar energy concentrated by the heliostats at a single point produces very high temperature. Falling solid particles or heat transfer fluid passing through that high temperature region absorbs heat to generate electricity. Increasing the residence time will result in more heat gain and increase efficiency. A novel design of solar receiver for both fluid and solid particle is approached in this paper which can increase residence time resulting in higher temperature gain in one cycle compared to conventional receivers. The helical tubular solar receiver placed at the focused sunlight region meets the higher outlet temperature and efficiency. A vertical tubular receiver is modeled and analyzed for single phase flow with molten salt as heat transfer fluid and alloy625 as heat transfer material. The result is compared to a journal paper of similar numerical and experimental setup for validating our modeling. New types of helical tubular solar receivers are modeled and analyzed with heat transfer fluid turbulent flow in single phase, and granular particle and air plug flow in multiphase to observe the temperature rise in one cyclic operation. The Discrete Ordinate radiation model is used for numerical analysis with simulation software Ansys Fluent 15.0. The Eulerian granular multiphase model is used for multiphase flow. Applying the same modeling parameters and boundary conditions, the results of vertical and helical receivers are compared. With a helical receiver, higher temperature gain of heat transfer fluid is achieved in one cycle for both single phase and multiphase flow compared to the vertical receiver. Performance is also observed by varying dimension of helical receiver.

  6. Improving year-end transfers of care in academic ambulatory clinics: a survey of pediatric resident physician perceptions.

    PubMed

    Lerner, Carlos F; Hamilton, Leslie J; Klitzner, Thomas S

    2012-01-01

    In resident primary care continuity clinics, at the end of each academic year, continuity of care is disrupted when patients cared for by the graduating class are redistributed to other residents. Yet, despite the recent focus on the transfers of care between resident physicians in inpatient settings, there has been minimal attention given to patient care transfers in academic ambulatory clinics. We sought to elicit the views of pediatric residents regarding year-end patient handoffs in a pediatric resident continuity clinic. Residents assigned to a continuity clinic of a large pediatric residency program completed a questionnaire regarding year-end transfers of care. Thirty-one questionnaires were completed out of a total 45 eligible residents (69% response). Eighty seven percent of residents strongly or somewhat agreed that it would be useful to receive a written sign-out for patients with complex medical or social issues, but only 35% felt it would be useful for patients with no significant issues. Residents more frequently reported having access to adequate information regarding their new patients' medical summary (53%) and care plan (47%) than patients' functional abilities (30%), social history (17%), or use of community resources (17%). When rating the importance of receiving adequate sign-out in each those domains, residents gave most importance to the medical summary (87% of residents indicating very or somewhat important) and plan of care (84%). Residents gave less importance to receiving sign-out regarding their patients' functional abilities (71%) social history (58%), and community resources (58%). Residents indicated that lack of access to adequate patient information resulted in additional work (80%), delays or omissions in needed care (56%), and disruptions in continuity of care (58%). In a single-site study, residents perceive that they lack adequate information during year-end patient transfers, resulting in potential negative consequences for

  7. Improving year-end transfers of care in academic ambulatory clinics: a survey of pediatric resident physician perceptions

    PubMed Central

    Lerner, Carlos F.; Hamilton, Leslie J.; Klitzner, Thomas S.

    2012-01-01

    Background In resident primary care continuity clinics, at the end of each academic year, continuity of care is disrupted when patients cared for by the graduating class are redistributed to other residents. Yet, despite the recent focus on the transfers of care between resident physicians in inpatient settings, there has been minimal attention given to patient care transfers in academic ambulatory clinics. We sought to elicit the views of pediatric residents regarding year-end patient handoffs in a pediatric resident continuity clinic. Methods Residents assigned to a continuity clinic of a large pediatric residency program completed a questionnaire regarding year-end transfers of care. Results Thirty-one questionnaires were completed out of a total 45 eligible residents (69% response). Eighty seven percent of residents strongly or somewhat agreed that it would be useful to receive a written sign-out for patients with complex medical or social issues, but only 35% felt it would be useful for patients with no significant issues. Residents more frequently reported having access to adequate information regarding their new patients’ medical summary (53%) and care plan (47%) than patients’ functional abilities (30%), social history (17%), or use of community resources (17%). When rating the importance of receiving adequate sign-out in each those domains, residents gave most importance to the medical summary (87% of residents indicating very or somewhat important) and plan of care (84%). Residents gave less importance to receiving sign-out regarding their patients’ functional abilities (71%) social history (58%), and community resources (58%). Residents indicated that lack of access to adequate patient information resulted in additional work (80%), delays or omissions in needed care (56%), and disruptions in continuity of care (58%). Conclusions In a single-site study, residents perceive that they lack adequate information during year-end patient transfers

  8. [Knowledge of breastfeeding management among residents in pediatrics].

    PubMed

    Temboury Molina, M C

    2003-03-01

    The staff of maternity wards and clinics for maternal and child health should receive appropriate basic and in-service training on the health benefits of breastfeeding and on lactation management. Pediatricians should not only be knowledgeable about the health, nutritional and physiological aspects of appropriate feeding, they should also be familiar with the mechanics of breastfeeding, its various psychosocial influences, possible difficulties and how to overcome them. To evaluate knowledge of breastfeeding among pediatrics residents throughout Spain, a survey was conducted. A total of 250 questionnaires were collected. Significant differences were observed among provinces. In most areas, residents' training was insufficient. To achieve an appropriate level of knowledge among pediatrics residents in a subject as important to mother and child health as breastfeeding, courses should be given and repeated at regular intervals. Professional associations should be actively involved in promoting appropriate training for health professionals.

  9. 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...

  10. 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...

  11. 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...

  12. 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.…

  13. 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.…

  14. 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.…

  15. 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)

  16. 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...

  17. 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...

  18. 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...

  19. 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

  20. 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.

  1. 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.

  2. 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…

  3. 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)

  4. Teaching residents practice-management knowledge and skills: an in vivo experience.

    PubMed

    Williams, Laurel Lyn

    2009-01-01

    This article explores the relevant data regarding teaching psychiatric residents practice management knowledge and skills. This article also introduces a unique program for teaching practice management to residents. A literature search was conducted through PubMed and Academic Psychiatry. Additionally residents involved in the training program for practice management were given an anonymous survey to complete. There were no randomized, controlled trials in the academic psychiatric field concerning the topic of practice management. The responses to the resident survey (n=10) indicated a modest improvement in residents' perception of receiving adequate training and exposure to practice management knowledge and skills. The available research suggests that many residents and faculty believe that practice management knowledge and skills are still not adequately addressed. The Baylor Clinic practice management program may be one possible solution for integrating the teaching of practice management knowledge and skills. More research on this topic is needed.

  5. 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.

  6. Optical Receivers With Rough Reflectors

    NASA Technical Reports Server (NTRS)

    Vilnrotter, Victor A.

    1989-01-01

    Receiver for optical communications uses rough reflector instead of diffraction-limited reflector customarily thought necessary for such systems. Rough reflector collects and focuses optical signal. Other receiver components include narrow-passband optical filter to reject out-of-band background radiation, spatial filter to limit receiver field of view, optical-detector array (typically two concentric detectors), and postdetection processor to reconstruct transmitted message.

  7. Frequency Diverse Array Receiver Architectures

    DTIC Science & Technology

    2015-06-29

    Frequency Diverse Array Receiver Architectures A thesis submitted in partial fulfillment of the requirements for the degree of Master of Science in...VISION BY AaronM. Jones ENTITLED Frequency Diverse Array Receiver Architectures BE ACCEPTED IN PARTIAL FULFILLMENT OF THE REQUIREMENTS FOR THE DEGREE OF...M.S.Egr, Department of Electrical Engineering and Computer Science, Wright State University, 2011. Frequency Diverse Array Receiver Architectures

  8. Long-term Outcomes of Performing a Postdoctoral Research Fellowship During General Surgery Residency

    PubMed Central

    Robertson, Charles M.; Klingensmith, Mary E.; Coopersmith, Craig M.

    2007-01-01

    Objective: To determine whether dedicated research time during surgical residency leads to funding following postgraduate training. Summary Background Data: Unlike other medical specialties, a significant number of general surgery residents spend 1 to 3 years in dedicated laboratory research during their training. The impact this has on obtaining peer reviewed research funding after residency is unknown. Methods: Survey of all graduates of an academic general surgery resident program from 1990 to 2005 (n = 105). Results: Seventy-five (71%) of survey recipients responded, of which 66 performed protected research during residency. Fifty-one currently perform research (mean effort, 26%; range, 2%–75%). Twenty-three respondents who performed research during residency (35%) subsequently received independent faculty funding. Thirteen respondents (20%) obtained NIH grants following residency training. The number of papers authored during resident research was associated with obtaining subsequent faculty grant support (9.3 vs. 5.2, P = 0.02). Faculty funding was associated with obtaining independent research support during residency (42% vs. 17%, P = 0.04). NIH-funded respondents spent more combined years in research before and during residency (3.7 vs. 2.8, P = 0.02). Academic surgeons rated research fellowships more relevant to their current job than private practitioners (4.3 vs. 3.4 by Likert scale, P < 0.05). Both groups considered research a worthwhile use of their time during residency (4.5 vs. 4.1, P = not significant). Conclusions: A large number of surgical trainees who perform a research fellowship in the middle of residency subsequently become funded investigators in this single-center survey. The likelihood of obtaining funding after residency is related to productivity and obtaining grant support during residency as well as cumulative years of research prior to obtaining a faculty position. PMID:17414597

  9. The Variation of Statin Use Among Nursing Home Residents and Physicians: A Cross-Sectional Analysis.

    PubMed

    Campitelli, Michael A; Maxwell, Colleen J; Giannakeas, Vasily; Bell, Chaim M; Daneman, Nick; Jeffs, Lianne; Morris, Andrew M; Austin, Peter C; Hogan, David B; Ko, Dennis T; Lapane, Kate L; Maclagan, Laura C; Seitz, Dallas P; Bronskill, Susan E

    2017-08-09

    To examine the variability of statin use among nursing home residents and prescribing physicians, and to assess statin use by resident frailty. Population-based, cross-sectional analysis. All nursing home facilities (N = 631) in Ontario, Canada between April 1, 2013 and March 31, 2014. All adults aged 66 years and older who received a full clinical assessment while residing in a nursing home facility and their assigned, most responsible, physician. Statin use on date of clinical assessment. Resident- and physician-level characteristics ascertained through clinical assessment and health administrative data. Resident frailty was derived using a previously validated index. Among 76,226 nursing home residents assigned to 1,919 physicians, 25,648 (33.6%) were statin users. There were 13,331 (30.1%) statin users among the 44,290 residents categorized as frail. In an adjusted mixed-effects logistic regression model, frail residents (adjusted odds ratio = 0.62, 95% confidence interval 0.58-0.65) were significantly less likely to be statin users compared with non-frail residents. After adjustment for resident characteristics, the intraclass correlation coefficient indicated that between-physician variability accounted for 9.1% of the residual unexplained variation in statin use (P < .001). Among the 894 physicians assigned 20 or more residents, funnel plots confirmed there were more low-outlying (17.4%) and high-outlying (12.0%) prescribers of statins than expected by chance. Physicians who were high-outlying prescribers had higher historical rates of statin prescribing. Statin prescribing was substantial within nursing homes, even among frail residents. After controlling for resident characteristics, the likelihood of statin prescribing varied significantly across physicians. Further studies are required to evaluate the risks and benefits of statin use, and discontinuation, among nursing home residents to better inform clinical practice in this setting. © 2017, Copyright

  10. Long-term outcomes of performing a postdoctoral research fellowship during general surgery residency.

    PubMed

    Robertson, Charles M; Klingensmith, Mary E; Coopersmith, Craig M

    2007-04-01

    To determine whether dedicated research time during surgical residency leads to funding following postgraduate training. Unlike other medical specialties, a significant number of general surgery residents spend 1 to 3 years in dedicated laboratory research during their training. The impact this has on obtaining peer reviewed research funding after residency is unknown. Survey of all graduates of an academic general surgery resident program from 1990 to 2005 (n = 105). Seventy-five (71%) of survey recipients responded, of which 66 performed protected research during residency. Fifty-one currently perform research (mean effort, 26%; range, 2%-75%). Twenty-three respondents who performed research during residency (35%) subsequently received independent faculty funding. Thirteen respondents (20%) obtained NIH grants following residency training. The number of papers authored during resident research was associated with obtaining subsequent faculty grant support (9.3 vs. 5.2, P = 0.02). Faculty funding was associated with obtaining independent research support during residency (42% vs. 17%, P = 0.04). NIH-funded respondents spent more combined years in research before and during residency (3.7 vs. 2.8, P = 0.02). Academic surgeons rated research fellowships more relevant to their current job than private practitioners (4.3 vs. 3.4 by Likert scale, P < 0.05). Both groups considered research a worthwhile use of their time during residency (4.5 vs. 4.1, P = not significant). A large number of surgical trainees who perform a research fellowship in the middle of residency subsequently become funded investigators in this single-center survey. The likelihood of obtaining funding after residency is related to productivity and obtaining grant support during residency as well as cumulative years of research prior to obtaining a faculty position.

  11. Low cost omega navigation receiver

    NASA Technical Reports Server (NTRS)

    Lilley, R. W.

    1974-01-01

    The development of a low cost Omega navigation receiver is discussed. Emphasis is placed on the completion and testing of a modular, multipurpose Omega receiver which utilizes a digital memory-aided, phase-locked loop to provide phase measurement data to a variety of applications interfaces. The functional units contained in the prototype device are described. The receiver is capable of receiving and storing phase measurements for up to eight Omega signals and computes two switch-selectable lines of position, displaying this navigation data in chart-recorded form.

  12. Internet Training for Nurse Aides to Prevent Resident Aggression

    PubMed Central

    Blair Irvine, A.; Bourgeois, Michelle; Billow, Molly; Seeley, John R.

    2007-01-01

    Objectives Evaluate Internet training to help Nurse Aides decrease resident aggression. Design Randomized treatment and control design; pre-post assessment. Setting The study was conducted entirely on the Internet. Participants Nurse Aides; N=62 Intervention Internet based interactive training using video modeling and mastery learning instructional design. Measurements Video situations testing and assessment of psycho-social constructs associated with behavior change; follow-up interviews with a sample of treatment participants. Results MANCOVA analysis showed positive results (p=.001) for knowledge, attitudes, self efficacy, and behavioral intention, with large effect sizes; it was well received by the users. Conclusions Interactive training is an effective approach to shaping appropriate staff reactions to aggressive resident behaviors. The training can effectively be delivered on the Internet. In this research, it was both valued and well received by study participants. PMID:17931576

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

    PubMed

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

    2016-09-01

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

  14. Training module to teach ultrasound-guided breast biopsy skills to residents improves accuracy.

    PubMed

    Hassard, Mary K; McCurdy, Lauren I; Williams, Jackie C A; Downey, Donal B

    2003-06-01

    To evaluate the effectiveness of a training module in teaching residents the skills necessary to perform accurate and safe ultrasound-guided breast biopsies (USGBB). Twelve residents with no USGBB experience, but variable ultrasound (US) experience, were randomly assigned to 2 groups; 1 group participated in a training module, and the other received no training. Each resident then attempted 30 core biopsies of "lesions" implanted in breast phantoms. Successful biopsies extracted some "lesion" material. "Chest wall" hits were also counted. The trained residents had significantly fewer "chest wall" hits than the untrained group (p < 0.002), but there was no significant difference in the number of successful biopsies (73% v. 43%, p = 0.09). The subgroup of residents who were USGBB trained but inexperienced in US (n = 4) achieved more successful biopsies (p < 0.05) and fewer "chest wall" hits (p < 0.01) than their matched untrained cohort (n = 3). The trained US-experienced subgroup (n = 2) had fewer "chest wall" hits than the matched untrained subgroup (n = 3; p < 0.05) but similar biopsy success rates. Untrained US-experienced residents (n = 3) had more successful biopsies than untrained US-inexperienced residents (n = 3; p < 0.001) and similar "chest wall" hits. Residents with training perform USGBBs more safely, and training significantly improves accuracy of USGBB in residents with no US experience. US experience improves biopsy success rates but does not affect safety levels of residents with no USGBB training.

  15. Family Medicine Residency Program Directors Attitudes and Knowledge of Family Medicine CAM Competencies

    PubMed Central

    Gardiner, Paula; Filippelli, Amanda C.; Lebensohn, Patricia; Bonakdar, Robert

    2013-01-01

    Context Little is known about the incorporation of integrative medicine (IM) and complementary and alternative medicine (CAM) into family medicine residency programs. Objective The Society for Teachers of Family Medicine (STFM) approved a set of CAM/IM competencies for family medicine residencies. We hope to evaluate with an online survey tool, whether residency programs are implementing such competencies into their curriculum. We also hope to assess the knowledge and attitudes of Residency Directors (RDs) on the CAM/IM competencies. Design A survey was distributed by the CAFM (Council of Academic Family Medicine) Educational Research Alliance to RDs via email. The survey was distributed to 431 RDs. Of those who received it, 212 responded for a response rate of 49.1%. Questions assessed the knowledge and attitudes of CAM/IM competencies and incorporation of CAM/IM into residency curriculum. Results Forty-five percent of RDs were aware of the competencies. In term of RD attitudes, 58% reported that CAM/IM is an important component of residents' curriculum yet, 60% report not having specific learning objectives for CAM/IM in their residency curriculum. Among all programs, barriers to CAM/IM implementation included: time in residents' schedules (77%); faculty training (75%); access to CAM experts (43%); lack of reimbursement (43%), and financial resources (29%). Conclusions While many RDs are aware of the STFM CAM/IM competencies and acknowledge their role in residence education, there are many barriers preventing residencies to implementing the STFM CAM/IM competencies. PMID:24021471

  16. Resident physicians as human information systems: sources yet seekers

    PubMed Central

    Bass, Ellen J; DeVoge, Justin Michael; Waggoner-Fountain, Linda A; Borowitz, Stephen M

    2013-01-01

    Objective To characterize question types that residents received on overnight shifts and what information sources were used to answer them. Materials and Methods Across 30 overnight shifts, questions asked of on-call senior residents, question askers’ roles, and residents’ responses were documented. External sources were noted. Results 158 of 397 questions (39.8%) related to the plan of care, 53 (13.4%) to medical knowledge, 48 (12.1%) to taskwork knowledge, and 44 (11.1%) to the current condition of patients. For 351 (88.4%) questions residents provided specific, direct answers or visited the patient. For 16 of these, residents modeled or completed the task. For 216 questions, residents used previous knowledge or their own clinical judgment. Residents solicited external information sources for 118 questions and only a single source for 77 (65.3%) of them. For the 118, most questions concerned either the plan of care or the patient's current condition and were asked by interns and nurses (those with direct patient care responsibilities). Discussion Resident physicians serve as an information system and they often specifically answer the question using previous knowledge or their own clinical judgment, suggesting that askers are contacting an appropriately knowledgeable person. However, they do need to access patient information such as the plan of care. They also serve an educator role and answer many knowledge-related questions. Conclusions As synchronous verbal communications continue to be important pathways for information flow, informaticians need to consider the relationship between such communications and workflow in the development of healthcare support tools. PMID:23268485

  17. Getting by: underuse of interpreters by resident physicians.

    PubMed

    Diamond, Lisa C; Schenker, Yael; Curry, Leslie; Bradley, Elizabeth H; Fernandez, Alicia

    2009-02-01

    Language barriers complicate physician-patient communication and adversely affect healthcare quality. Research suggests that physicians underuse interpreters despite evidence of benefits and even when services are readily available. The reasons underlying the underuse of interpreters are poorly understood. To understand the decision-making process of resident physicians when communicating with patients with limited English proficiency (LEP). Qualitative study using in-depth interviews. Internal medicine resident physicians (n = 20) from two urban teaching hospitals with excellent interpreter services. An interview guide was used to explore decision making about interpreter use. Four recurrent themes emerged: 1) Resident physicians recognized that they underused professional interpreters, and described this phenomenon as "getting by;" 2) Resident physicians made decisions about interpreter use by weighing the perceived value of communication in clinical decision making against their own time constraints; 3) The decision to call an interpreter could be preempted by the convenience of using family members or the resident physician's use of his/her own second language skills; 4) Resident physicians normalized the underuse of professional interpreters, despite recognition that patients with LEP are not receiving equal care. Although previous research has identified time constraints and lack of availability of interpreters as reasons for their underuse, our data suggest that the reasons are far more complex. Residents at the study institutions with interpreters readily available found it easier to "get by" without an interpreter, despite misgivings about negative implications for quality of care. Findings suggest that increasing interpreter use will require interventions targeted at both individual physicians and the practice environment.

  18. Getting By: Underuse of Interpreters by Resident Physicians

    PubMed Central

    Schenker, Yael; Curry, Leslie; Bradley, Elizabeth H.; Fernandez, Alicia

    2008-01-01

    Background Language barriers complicate physician–patient communication and adversely affect healthcare quality. Research suggests that physicians underuse interpreters despite evidence of benefits and even when services are readily available. The reasons underlying the underuse of interpreters are poorly understood. Objective To understand the decision-making process of resident physicians when communicating with patients with limited English proficiency (LEP). Design Qualitative study using in-depth interviews. Participants Internal medicine resident physicians ( = 20) from two urban teaching hospitals with excellent interpreter services. Approach An interview guide was used to explore decision making about interpreter use. Results Four recurrent themes emerged: 1) Resident physicians recognized that they underused professional interpreters, and described this phenomenon as “getting by;” 2) Resident physicians made decisions about interpreter use by weighing the perceived value of communication in clinical decision making against their own time constraints; 3) The decision to call an interpreter could be preempted by the convenience of using family members or the resident physician’s use of his/her own second language skills; 4) Resident physicians normalized the underuse of professional interpreters, despite recognition that patients with LEP are not receiving equal care. Conclusions Although previous research has identified time constraints and lack of availability of interpreters as reasons for their underuse, our data suggest that the reasons are far more complex. Residents at the study institutions with interpreters readily available found it easier to “get by” without an interpreter, despite misgivings about negative implications for quality of care. Findings suggest that increasing interpreter use will require interventions targeted at both individual physicians and the practice environment. PMID:19089503

  19. Team-based learning in a pathology residency training program.

    PubMed

    Brandler, Tamar C; Laser, Jordan; Williamson, Alex K; Louie, James; Esposito, Michael J

    2014-07-01

    Team-based learning (TBL) has been integrated into undergraduate and medical education curricula in many institutions. However, TBL has not been widely introduced into postgraduate medical education. Our study aimed to measure the effect of TBL on promoting learning and teamwork in the setting of pathology residency training. Four TBL sessions were held and individual and group readiness assurance tests (IRAT/GRATs) were performed; scores were compared using Wilcoxon matched-pairs signed rank tests. Residents completed 18-item validated team performance surveys measuring the quality of team interactions on a scale of 0 (none of the time) to 6 (all of the time). Mean and standard deviation were calculated for each item. Scores on the IRAT vs GRAT were significantly different (P < .05). The team performance survey received mean scores ranging from 5.3 ± 1.1 to 6.0 ± 0.0. The use of TBL promotes teamwork and learning in a pathology residency program. Residents scored higher on the readiness assurance tests when working in teams, demonstrating the effectiveness of team learning and achievement. In addition, the Accreditation Council for Graduate Medical Education competencies of professionalism and interpersonal and communication skills were further enhanced by incorporating TBL into pathology residency training. Copyright© by the American Society for Clinical Pathology.

  20. Practical training for postgraduate year 1 surgery residents.

    PubMed

    Marshall, R L; Gorman, P J; Verne, D; Culina-Gula, S; Murray, W B; Haluck, R S; Krummel, T M

    2000-03-01

    Surgical interns accept significant patient care responsibilities with minimal orientation. We have developed a multifaceted training program for incoming surgical interns in which learning in a simulated environment plays a key role. The purpose of this study was to evaluate resident perceptions of simulated clinical calls as an educational modality and to measure the effect on self-ratings of confidence. A multidisciplinary team compiled 15 clinical scenarios. Simulated nurse-to-resident clinical call sessions were held on 3 separate days. Daily course evaluation surveys and identical precourse and postcourse confidence surveys were completed. The resident confidence measure increased significantly postcourse (6.73 versus 8.35, P <0.03). The evaluation survey score averaged 4.35 out of 5. Simulated clinical call sessions were well received and resulted in a significant increase in resident confidence levels. Based on this modality's apparent efficacy and ease of implementation, we offer it as a useful educational tool for incoming postgraduate year-1 surgical residents.

  1. 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…

  2. 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)

  3. 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.

  4. 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)

  5. 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)

  6. 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…

  7. 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,…

  8. Receiver System Analysis and Optimization

    DTIC Science & Technology

    2013-01-01

    True Top-Down Design Methodology .................................. 5 Figure 4. Generic 16- QAM direct-conversion receiver...ADC 16- QAM decoder Figure 4. Generic 16- QAM direct-conversion receiver Complex digitally generated signals defy traditional spreadsheet...Intercept Point Three QAM Quadrature Amplitude Modulation SNR Signal-to-Noise Ratio USAF USR VCO United States Air Force Upsampling Ratio Voltage Controlled Oscillator

  9. 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.

  10. UWB delay and multiply receiver

    DOEpatents

    Dallum, Gregory E.; Pratt, Garth C.; Haugen, Peter C.; Romero, Carlos E.

    2013-09-10

    An ultra-wideband (UWB) delay and multiply receiver is formed of a receive antenna; a variable gain attenuator connected to the receive antenna; a signal splitter connected to the variable gain attenuator; a multiplier having one input connected to an undelayed signal from the signal splitter and another input connected to a delayed signal from the signal splitter, the delay between the splitter signals being equal to the spacing between pulses from a transmitter whose pulses are being received by the receive antenna; a peak detection circuit connected to the output of the multiplier and connected to the variable gain attenuator to control the variable gain attenuator to maintain a constant amplitude output from the multiplier; and a digital output circuit connected to the output of the multiplier.

  11. Repaying in Kind: Examination of the Reciprocity Effect in Faculty and Resident Evaluations.

    PubMed

    Gardner, Aimee K; Scott, Daniel J

    Although the reciprocity hypothesis (that trainees have a tendency to modify evaluations based on the grades they receive from instructors) has been documented in other fields, very little work has examined this phenomenon in the surgical residency environment. The purpose of this study was to investigate the extent to which lenient-grading faculty receive higher evaluations from surgery residents. Evaluation data from 2 consecutive academic years were collected retrospectively at a large university-based General Surgery residency program. Monthly faculty evaluations of residents (15 items) and resident evaluations of faculty (8 items; 1 = never demonstrates, 10 = always demonstrates) were included. Correlation and regression analyses were conducted with SPSS version 22 (IBM; Chicago, IL). A total of 2274 faculty assessments and 1480 resident assessments were included in this study, representing 2 years of evaluations for 32 core faculty members responsible for completing all resident evaluations and 68 PGY1-5 general surgery residents. Faculty (63% men, 13.5 ± 9.8 years out of training) represented 5 different divisions (general surgery, surgical oncology, transplant, trauma critical care, and vascular) within the general surgery department. Faculty received an average of 71.1 ± 33.9 evaluations from residents over the course of 2 years. The average rating of faculty teaching by residents was 9.5 ± 0.4. Residents received an average of 21.8 ± 0.5 evaluations with average ratings of 4.2 ± 0.4. Correlation analyses indicated a positive relationship between the average rating received from residents and the number of years since faculty completed training (r = 0.44, p = 0.01). Additionally, a significant relationship emerged between ratings received from residents and ratings given to residents (r = 0.40, p = 0.04). Regression analyses indicated that when both variables (years since training, ratings given to residents) were included in the model, only ratings

  12. 22 CFR 19.5-3 - Residence of spouse during service at unhealthful post.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... receive post differential and does receive or request extra service credit, the participant shall report... of the spouse during the assignment, a new joint Form OF-140 shall be filed to report the change. (b.../her spouse or former spouse concerning residency at an unhealthful post, or the submission of a...

  13. 22 CFR 19.5-3 - Residence of spouse during service at unhealthful post.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... receive post differential and does receive or request extra service credit, the participant shall report... of the spouse during the assignment, a new joint Form OF-140 shall be filed to report the change. (b.../her spouse or former spouse concerning residency at an unhealthful post, or the submission of a...

  14. The Extended Effects of the Life Review in Nursing Home Residents.

    ERIC Educational Resources Information Center

    Haight, Barbara K.; Michel, Yvonne; Hendrix, Shirley

    2000-01-01

    Fifty-two nursing home residents received either a life review or a friendly visit and took part in repeated testings to determine lasting effects of the life review. Results showed a trend toward continued and by year three significant improvement over time in those who received the life review on measures of depression, life satisfaction, and…

  15. Prevalence of Psychoactive Drug Use among North Dakota Group Home Residents.

    ERIC Educational Resources Information Center

    Burd, Larry; And Others

    1991-01-01

    A survey of 809 persons with mental retardation residing in community settings in North Dakota found that 37 percent were using psychoactive medications. Excluding anticonvulsant medications, only 18 percent were receiving psychoactive medications. A total of 37 percent of the individuals receiving medications other than anticonvulsants did not…

  16. The Extended Effects of the Life Review in Nursing Home Residents.

    ERIC Educational Resources Information Center

    Haight, Barbara K.; Michel, Yvonne; Hendrix, Shirley

    2000-01-01

    Fifty-two nursing home residents received either a life review or a friendly visit and took part in repeated testings to determine lasting effects of the life review. Results showed a trend toward continued and by year three significant improvement over time in those who received the life review on measures of depression, life satisfaction, and…

  17. Prevalence of Psychoactive Drug Use among North Dakota Group Home Residents.

    ERIC Educational Resources Information Center

    Burd, Larry; And Others

    1991-01-01

    A survey of 809 persons with mental retardation residing in community settings in North Dakota found that 37 percent were using psychoactive medications. Excluding anticonvulsant medications, only 18 percent were receiving psychoactive medications. A total of 37 percent of the individuals receiving medications other than anticonvulsants did not…

  18. Expectations of iPad use in an internal medicine residency program: is it worth the "hype"?

    PubMed

    Luo, Nancy; Chapman, Christopher G; Patel, Bhakti K; Woodruff, James N; Arora, Vineet M

    2013-05-08

    While early reports highlight the benefits of tablet computing in hospitals, introducing any new technology can result in inflated expectations. The aim of the study is to compare anticipated expectations of Apple iPad use and perceptions after deployment among residents. 115 internal medicine residents received Apple iPads in October 2010. Residents completed matched surveys on anticipated usage and perceptions after distribution 1 month prior and 4 months after deployment. In total, 99% (114/115) of residents responded. Prior to deployment, most residents believed that the iPad would improve patient care and efficiency on the wards; however, fewer residents "strongly agreed" after deployment (34% vs 15% for patient care, P<.001; 41% vs 24% for efficiency, P=.005). Residents with higher expectations were more likely to report using the iPad for placing orders post call and during admission (71% vs 44% post call, P=.01, and 16% vs 0% admission, P=.04). Previous Apple iOS product owners were also more likely to use the iPad in key areas. Overall, 84% of residents thought the iPad was a good investment for the residency program, and over half of residents (58%) reported that patients commented on the iPad in a positive way. While the use of tablets such as the iPad by residents is generally well received, high initial expectations highlight the danger of implementing new technologies. Education on the realistic expectations of iPad benefits may be warranted.

  19. 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.

  20. Customizable Digital Receivers for Radar

    NASA Technical Reports Server (NTRS)

    Moller, Delwyn; Heavey, Brandon; Sadowy, Gregory

    2008-01-01

    Compact, highly customizable digital receivers are being developed for the system described in 'Radar Interferometer for Topographic Mapping of Glaciers and Ice Sheets' (NPO-43962), NASA Tech Briefs, Vol. 31, No. 7 (August 2007), page 72. The receivers are required to operate in unison, sampling radar returns received by the antenna elements in a digital beam-forming (DBF) mode. The design of these receivers could also be adapted to commercial radar systems. At the time of reporting the information for this article, there were no commercially available digital receivers capable of satisfying all of the operational requirements and compact enough to be mounted directly on the antenna elements. A provided figure depicts the overall system of which the digital receivers are parts. Each digital receiver includes an analog-to-digital converter (ADC), a demultiplexer (DMUX), and a field-programmable gate array (FPGA). The ADC effects 10-bit band-pass sampling of input signals having frequencies up to 3.5 GHz. The input samples are demultiplexed at a user-selectable rate of 1:2 or 1:4, then buffered in part of the FPGA that functions as a first-in/first-out (FIFO) memory. Another part of the FPGA serves as a controller for the ADC, DMUX, and FIFO memory and as an interface between (1) the rest of the receiver and (2) a front-panel data port (FPDP) bus, which is an industry-standard parallel data bus that has a high data-rate capability and multichannel configuration suitable for DBF. Still other parts of the FPGA in each receiver perform signal-processing functions. The digital receivers can be configured to operate in a stand-alone mode, or in a multichannel mode as needed for DBF. The customizability of the receiver makes it applicable to a broad range of system architectures. The capability for operation of receivers in either a stand-alone or a DBF mode enables the use of the receivers in an unprecedentedly wide variety of radar systems.

  1. The impact of re-engineering a multi-institutional residency program on resident perceptions of the individual institutions.

    PubMed

    Dobkin, Eric; Fassler, Steven; Horowitz, Sheryl; Kirton, Orlando; Civetta, Joseph

    2002-01-01

    We report on the development of a survey tool used to assess resident perceptions of support and educational quality among multiple institutions in an integrated surgical residency, as well as its use in measuring the impact of re-engineering on that program. The University of Connecticut Integrated General Surgical Residency (UCIGSR) is a multisite program that was placed on probation by the Residency Review Committee in Surgery (RRC) in November 1998. This led to a re-evaluation and a re-engineering of the program. In order to better assess the residents' evaluation of the program, we serially examined their attitudes with a survey of 65 questions. A 4-point grading scale (1 = Poor, 4 = Excellent) was used, and each resident was required to complete a survey beginning shortly after RRC probation was announced and at 6-month intervals. Seven global questions in the survey, directed at residency program support and educational quality, were asked for each of the 4 individual adult hospitals, for a total of 28 questions. Statistical analysis of the data was performed using the Jonckhere-Terpstra and the Mann-Whitney U tests. The results demonstrated significant improvement for all 7 questions in all 4 hospitals between November 1998 (S1) and November 1999 (S3). Average scores for all 7 questions, Hospital Support (HS), Departmental Support (DS), Hospital Teaching (HT), Outpatient Teaching (OTC), Operating Room Teaching (ORT), Grand Rounds (GR), and Morbidity and Mortality Conferences (MM), improved in every hospital by 16-28%. In S1, 1 out of 28 questions received an average score greater than or equal to 3, whereas on the most recent survey, 17 of 28 scored greater than or equal to 3 and 78.5% of the questions demonstrated statistically significant improvement (p < 0.05). Three of the 4 hospitals now have a combined overall average score greater than or equal to 3 for all 7 questions. Areas of strength in each hospital had the least amount of improvement yet

  2. Patterns and predictions of resident misbehavior--a 10-year retrospective look.

    PubMed

    Resnick, Andrew S; Mullen, James L; Kaiser, Larry R; Morris, Jon B

    2006-01-01

    Surgical educators are charged with ensuring that their trainees conduct themselves in a professional manner. The authors retrospectively reviewed a 10-year experience of incident reports on surgical housestaff to determine patterns and predictors of behavior. A retrospective review of all letters, e-mails, and incident reports was conducted for general surgery residents from 1995 to 2005. Descriptive variables were selected for binary categorization (not mutually exclusive): poor professional conduct, protocol violation, administrative deficiency, verbal mistreatment, physical boundary issues, mistreatment of superiors, and deficient medical student interaction. Resident status was defined as current, graduate, and attrition. Of 110 residents [90 [82%] categorical, 23 [21%] undesignated preliminary (3 overlapped both groups); 87 [79%] male, 23 [21%] female] who trained at the University of Pennsylvania during this period, 66 complaints were generated about 29 individuals. Overall, 50 of the 66 complaints (76%) were directed toward men and the remaining 16 (24%) toward women; 24% of all men and 35% of all women received 1 or more complaints. A total of 76% of complaints concerned categorical residents and 24% undesignated preliminary residents. And 26% of all categorical residents and 26% of all preliminary residents received at least 1 complaint. The most common complaints concerned professional conduct (83%), protocol violation (33%), verbal mistreatment (23%), deficiencies of administrative duties (8%), violations of physical boundaries (5%), deficient medical student interaction (5%), and mistreatment of attendings by residents (3%). Recipients of verbal mistreatment included staff nurses (27%), radiology technicians (13%), medical students (13%), environmental services employees (7%), security guards (7%), patients (7%), surgery attendings (7%), anesthesia attendings (7%), internal medicine chief residents (7%), and pharmacists (7%). A total of 31% of the

  3. Intrauterine device knowledge and practices: a national survey of obstetrics and gynecology residents.

    PubMed

    Tang, Jennifer; Maurer, Rie; Bartz, Deborah

    2013-09-01

    The primary objective of this study was to assess the current intrauterine device (IUD) knowledge and counseling practices of US obstetrics and gynecology chief residents. The secondary objective was to evaluate the current IUD experience of obstetrics and gynecology residents. A Web-based survey about IUD knowledge and practices was sent to US obstetrics and gynecology residents in January 2010. An analysis of responses by postgraduate year was completed using descriptive statistics. We received 699 surveys (36%) from a pool of 1922 residents in 96 different residency programs. A total of 654 respondents (94%) had placed an IUD during residency and 88% had received formal teaching about IUDs during residency. Only 53% of respondents knew that the copper IUD could be used for emergency contraception. Less than 65% of respondents would routinely recommend the IUD to adolescents or immediately after first trimester abortion. Many US obstetrics and gynecology residents lack knowledge about IUD benefits and do not counsel all eligible women to use IUDs. We should continue to evaluate our training and educational programs to ensure that women's health providers do not act as a barrier to IUD use.

  4. Clinical teaching performance improvement of faculty in residency training: A prospective cohort study.

    PubMed

    Van Der Leeuw, Renée M; Boerebach, Benjamin C M; Lombarts, Kiki M J M H; Heineman, Maas Jan; Arah, Onyebuchi A

    2016-05-01

    The purpose of this study is to investigate how aspects of a teaching performance evaluation system may affect faculty's teaching performance improvement as perceived by residents over time. Prospective multicenter cohort study conducted in The Netherlands between 1 September 2008 and 1 February 2013. Nine hundred and one residents and 1068 faculty of 65 teaching programs in 16 hospitals were invited to annually (self-) evaluate teaching performance using the validated, specialty-specific System for Evaluation of Teaching Qualities (SETQ). We used multivariable adjusted generalized estimating equations to analyze the effects of (i) residents' numerical feedback, (ii) narrative feedback, and (iii) faculty's participation in self-evaluation on residents' perception of faculty's teaching performance improvement. The average response rate over three years was 69% for faculty and 81% for residents. Higher numerical feedback scores were associated with residents rating faculty as having improved their teaching performance one year following the first measurement (regression coefficient, b: 0.077; 95% CI: 0.002-0.151; p = 0.045), but not after the second wave of receiving feedback and evaluating improvement. Receiving more suggestions for improvement was associated with improved teaching performance in subsequent years. Evaluation systems on clinical teaching performance appear helpful in enhancing teaching performance in residency training programs. High performing teachers also appear to improve in the perception of the residents.

  5. Cosmetic surgery training in Canadian plastic surgery residencies: are we training competent surgeons?

    PubMed

    Chivers, Quinton J; Ahmad, Jamil; Lista, Frank; Warren, Richard J; Arkoubi, Amr Y; Mahabir, Raman C; Murray, Kenneth A; Islur, Avinash

    2013-01-01

    With the demand for cosmetic surgery continuing to rise, it is necessary to reevaluate the current state of cosmetic surgery training during plastic surgery residency. An evaluation of cosmetic surgery training in US plastic surgery residency programs in 2006 identified several areas for improvement, resulting in changes to both the duration and content of training. The authors assess the current state of cosmetic surgery training in Canadian plastic surgery residency programs. A paper survey of all graduating Canadian plastic surgery residents eligible to complete the 2009 Royal College of Physicians and Surgeons of Canada fellowship examinations was performed (N = 29). The survey was conducted primarily at the Canadian Plastic Surgery Review Course in February 2009, with surveys collected from absent residents by e-mail within 1 month after the course. The survey covered 2 broad areas: (1) specifics regarding resident cosmetic surgery training and (2) confidence and satisfaction associated with this experience. Of the 29 residents surveyed, 28 responded (96%). The majority of Canadian plastic surgery residency programs (75%) have a designated cosmetic surgery rotation, but 90% of respondents felt it has become increasingly difficult to gain exposure to cosmetic procedures as most are performed at private surgery centers. Elective rotations at cosmetic surgery practices and resident cosmetic clinics were considered the most beneficial for cosmetic surgery education. Residents considered cosmetic surgery procedures of the face (such as rhinoplasty and facelift) more challenging, but they had more confidence with breast and body contouring procedures. Canadian plastic surgery residency programs need to ensure that residents continue to receive comprehensive exposure to both surgical and nonsurgical cosmetic procedures to ensure our specialty's continued leadership in this evolving and highly competitive field. A multidimensional approach utilizing a variety of

  6. Resident Experiences With Implementation of the I-PASS Handoff Bundle.

    PubMed

    Coffey, Maitreya; Thomson, Kelly; Li, Shelly-Anne; Bismilla, Zia; Starmer, Amy J; O'Toole, Jennifer K; Blankenburg, Rebecca L; Rosenbluth, Glenn; Cole, F Sessions; Yu, Clifton E; Hepps, Jennifer H; Sectish, Theodore C; Spector, Nancy D; Srivastava, Rajendu; Allen, April D; Mahant, Sanjay; Landrigan, Christopher P

    2017-06-01

    The I-PASS Handoff Study found that introduction of a handoff bundle (handoff and teamwork training for residents, a mnemonic, a handoff tool, a faculty development program, and a sustainability campaign) at 9 pediatrics residency programs was associated with improved communication and patient safety. This parallel qualitative study aimed to understand resident experiences with I-PASS and to inform future implementation and sustainability strategies. Resident experiences with I-PASS were explored in focus groups (N = 50 residents) at 8 hospitals throughout 2012-2013. A content analysis of transcripts was conducted following the principles of grounded theory. Residents generally accepted I-PASS as an ideal format for handoffs, and valued learning a structured approach. Across all sites, residents reported full adherence to I-PASS when observed, but selective adherence in usual practice. Residents adhered more closely when patients were complex, teams were unfamiliar, and during evening handoff. Residents reported using elements of the I-PASS mnemonic variably, with Illness Severity and Action Items most consistently used, but Synthesis by Receiver least used, except when observed. Most residents were receptive to the electronic handoff tool, but perceptions about usability varied across sites. Experiences with observation and feedback were mixed. Concern about efficiency commonly influenced attitudes about I-PASS. Residents generally supported I-PASS implementation, but adherence was influenced by patient type, context, and individual and team factors. Our findings could inform future implementation, particularly around the areas of resident engagement in change, sensitivity to resident level, perceived efficiency, and faculty observation.

  7. Behavioral Characteristics of Agitated Nursing Home Residents With Dementia at the End of Life

    PubMed Central

    Allen, Rebecca S.; Burgio, Louis D.; Fisher, Susan E.; Hardin, J. Michael; Shuster, John L.

    2009-01-01

    Purpose The purpose of this study was to examine group differences in verbal agitation, verbal interaction, bed restraint, pain, analgesic and neuroleptic medication use, and medical comorbidity among agitated nursing home residents who died during a 6-month clinical trial compared with residents of the same gender and similar initial cognitive status who did not die during the trial. Design and Methods We conducted a two-group secondary data analysis of prospective observational data from 10 nursing homes in Birmingham, Alabama. By means of chart review, resident assessments, surveys of certified nursing assistants, and direct observation of residents' daily behaviors and environment, 32 residents (87.34 ± 7.29 years) with a Mini-Mental State Examination (MMSE) score = 4.31 (±5.54) who died were compared with 32 residents (84 ± 6.96 years) with a mean MMSE score = 4.28 (±5.49) who did not die during the clinical trial. Results Residents who died displayed more verbal agitation, less time in verbal interaction with staff, and almost twice as much time restrained in bed during observation time in comparison with residents who did not die during the clinical trial. However, groups did not differ significantly in severity of comorbid illness, functional status, number of painful diagnoses, certified nursing assistants' reports of residents' pain, or opioid or nonopioid analgesic prescription or dosage. Surviving residents were more likely to receive neuroleptic medication than residents who died. Implications Results suggest that agitated nursing home residents may exhibit a heightened level of verbal agitation, decreased verbal interaction with staff, and increased bed restraint up to 3 months prior to death. Prospective observational studies are needed to identify markers for imminent mortality among nursing home residents. PMID:16199401

  8. The Flipped Classroom: A Modality for Mixed Asynchronous and Synchronous Learning in a Residency Program

    PubMed Central

    Young, Timothy P.; Bailey, Caleb J.; Guptill, Mindi; Thorp, Andrea W.; Thomas, Tamara L.

    2014-01-01

    Introduction A “flipped classroom” educational model exchanges the traditional format of a classroom lecture and homework problem set. We piloted two flipped classroom sessions in our emergency medicine (EM) residency didactic schedule. We aimed to learn about resident and faculty impressions of the sessions, in order to develop them as a regular component of our residency curriculum. Methods We evaluated residents’ impression of the asynchronous video component and synchronous classroom component using four Likert items. We used open-ended questions to inquire about resident and faculty impressions of the advantages and disadvantages of the format. Results For the Likert items evaluating the video lectures, 33/35 residents (94%, 95% CI 80%–99%) responded that the video lecture added to their knowledge about the topic, and 33/35 residents felt that watching the video was a valuable use of their time. For items evaluating the flipped classroom format, 36/38 residents (95%, 95% CI 82%–99%) preferred the format to a traditional lecture on the topic, and 38/38 residents (100%, 95% CI 89%–100%) felt that the small group session was effective in helping them learn about the topic. Most residents preferred to see the format monthly in our curriculum and chose an ideal group size of 5.5 (first session) and 7 (second session). Residents cited the interactivity of the sessions and access to experts as advantages of the format. Faculty felt the ability to assess residents’ understanding of concepts and provide feedback were advantages. Conclusion Our flipped classroom model was positively received by EM residents. Residents preferred a small group size and favored frequent use of the format in our curriculum. The flipped classroom represents one modality that programs may use to incorporate a mixture of asynchronous and interactive synchronous learning and provide additional opportunities to evaluate residents. PMID:25493157

  9. An NNSS satellite timing receiver

    NASA Technical Reports Server (NTRS)

    Jain, C. L.; Kumar, K.; Andharia, H. I.; Singh, M.; Dsouza, V.; Goel, V. K.; Sisodia, A. K.

    1982-01-01

    The U.S. Navy Navigation Satellite System, NNSS, offers a unique worldwide facility for precise time synchronization. Space Applications Centre (SAC) developed a simple timing receiver. Using this timing receiver first the internal time consistency of NNSS was studied and then its performance to synchronize time was compared with that of National Time Standard. The methodology of data analysis, results, and various sources of error which affect the time transfer accuracy were studied and described. The main source of error was found to be the receiver delay which varies with signal strength. It is possible to apply that this delay correction empirically provided signal strength is recorded.

  10. Elderly Support and Intergenerational Transfer in Zimbabwe: An Analysis by Gender, Marital Status, and Place of Residence.

    ERIC Educational Resources Information Center

    Adamchak, Donald J.; And Others

    1991-01-01

    Surveyed elderly persons (n=150) in Zimbabwe to determine elderly support and intergenerational transfer by gender, marital status, and place of residence. Found respondents received considerable support from their children, because 45 percent received cash support and 61 percent received noncash support in the prior year. (ABL)

  11. Perceptions, attitudes, and satisfaction concerning resident participation in health care among dermatology outpatients.

    PubMed

    AlGhamdi, Khalid M; Almohanna, Hind M; Alkeraye, Salim S; Alsaif, Fahad M; Alrasheed, Saleh K

    2014-01-01

    A limited number of published studies have discussed patient attitudes toward resident physicians' participation in dermatology clinics. A literature search failed to identify any such study in the Middle East. The aim of this study was to explore patient perceptions and attitudes toward resident participation in dermatology outpatient clinics. A self-administered questionnaire focused on patient attitudes toward dermatology resident participation was distributed randomly to all adult outpatients attending dermatology clinics at a university hospital in Saudi Arabia between July and September 2010. The questionnaire was returned by 742 of 900 patients, for an 82% response rate. The mean patient age was 30.58 ± 11.67 years. Forty-two percent (311 of 742) of the respondents were male. The major reason for visiting the hospital was a medical dermatology consultation (80.4%). Only 35% of the patients self-reported an accurate understanding of the "resident" designation. In total, 86.4% of patients were satisfied with the residents' behavior. Furthermore, 98.4% of the patients were satisfied with the medical care provided by the residents. The patients agreed with resident participation in their health care. The majority of the patients expressed their willingness to provide a medical history and receive counseling from residents (87.6% and 86.3%, respectively). There was no gender-associated effect on the understanding of the resident position or the decision to receive a physical examination by a resident. Dermatology outpatients are satisfied and have positive perceptions and attitudes toward resident participation in the dermatology clinic.

  12. The effect of simulation training on PALS skills among family medicine residents.

    PubMed

    Gerard, James M; Thomas, Scott M; Germino, Kevin W; Street, Megan H; Burch, Wesley; Scalzo, Anthony J

    2011-06-01

    The Accreditation Council for Graduate Medical Education requires that family medicine residents receive structured skills training on pediatric advanced life support (PALS) and should learn procedures for medical emergencies in patients of all ages. Traditional methods of training family medicine residents in PALS is challenging given their limited clinical exposure to critically ill patients. The primary objective of this study was to assess the effect of a 2-hour PALS training session utilizing high-fidelity mannequins on residents' psychomotor skills performances. Between February and June 2009, residents from two urban family medicine residency programs received training on four PALS procedures (bag-mask ventilation, tracheal intubation, intraosseous line placement, and cardiac rhythm assessment/defibrillation) at a university simulation center. Residents completed questionnaires to provide data on previous resuscitation training and experience. We collected self-confidence data and video recordings of residents performing the procedures before and after training. To assess retention at 6 months, we collected self-confidence data and video recordings of PGY-1 and PGY-2 residents performing the procedures. A blinded reviewer scored the video recordings. Forty-seven residents completed the study. The majority of residents (53.2%) had never performed any of the procedures on a real patient. Immediately following skills training, mean overall performance improved from 39.5% (± 11.5%) to 76.5% (± 10.4%), difference 37.0% (95% CI, 33.5%--40.6%). Bag-mask ventilation and intraosseous insertion skills remained above baseline at 6-month follow-up. Simulation training is beneficial for teaching PALS procedures to family medicine residents.

  13. Stevenson received the Whipple award

    NASA Astrophysics Data System (ADS)

    Shoemaker, Eugene M.; Stevenson, David J.

    1996-02-01

    David J. Stevenson received the Whipple Award at the 1994 Spring Meeting in Baltimore. The award is given for outstanding scientific contributions to the field of planetology. The citation and Stevenson's response are given here.

  14. Coe Receives 2007 Gilbert Award

    NASA Astrophysics Data System (ADS)

    Bogue, Scott W.; Coe, Robert S.

    2008-05-01

    Robert S. Coe received the 2007 William Gilbert Award at the 2007 AGU Fall Meeting in San Francisco, Calif. The award recognizes outstanding and unselfish work in magnetism of Earth materials and of the Earth and planets.

  15. Direct Absorption Receiver flow experiments

    NASA Astrophysics Data System (ADS)

    Chavez, J. M.; Tyner, C. E.; Couch, W. A.

    1987-09-01

    In a solar central receiver system Direct Absorption Receiver (DAR), the heat absorbing fluid (a blackened molten nitrate salt) flows in a thin film down a vertical panel (rather than through tubes as in conventional receiver designs) and absorbs the concentrated solar flux directly. To better understand flow phenomena in this type of receiver, we are conducting flow tests using water (because its flow properties are similar to molten salt) and a 3 MWt solar-heated DAR panel research experiment using salt. In this paper we discuss the results of the water flow testing, including manifold development, film stability, wave phenomena, and wind and natural convection effects on flow. In addition, we describe the design of the panel research experiment and planned testing.

  16. 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.

  17. [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.

  18. 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

  19. 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

  20. Involvement of Visit Companions in Internal Medicine Resident Ambulatory Clinic Visits: Perspectives of Patients, Companions, and Internal Medicine Residents

    PubMed Central

    Colburn, Jessica L; Christmas, Colleen

    2013-01-01

    The purpose of this study is to understand the role and perspectives of visit companions during medical visits with resident physicians. Surveys were administered in person to patients and visit companions, if present, attending a medical resident continuity clinic. Residents were asked to complete an online survey on their experiences with visit companions. The average age of patients without companions was 55 years. The most common reason these patients did not bring a visit companion was that they did not feel it would be helpful. In the past, 52% of these patients had brought a companion, reporting that they had previously done so for support and company, to ask the physician questions, and for help remembering the physician's instructions. The average age of patients with companions was 50 years, while the average age of their companions was 40 years. Nine were family members and 10 were non-relatives, of which 7 were spouses. Nearly all companions (84.2%) accompanied the patient to the exam room, and about half (47.4%) accompanied the patient to every clinic visit. Nearly all companions (84.2%) reported satisfaction with the clinic visit. The most frequently reported roles during visits were asking the physician questions and helping to remember the physician's instructions. Twenty-seven residents have responded to the online survey to date (55% response rate), and 74% reported feeling comfortable working with companions during clinic visits, 96% had not received any formal training in working with visit companions, and 70% reported interest in additional training. The most desired type of training was clinic mentorship and group sessions with caregivers. Residents reported involving companions during clinic visits by asking them for additional information and providing instructions to assist the patient after the visit. When asked to rank aspects of the clinic visit they believed were most important to companions, residents reported that receiving

  1. 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.

  2. 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.

  3. 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.

  4. 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.

  5. Streak camera receiver definition study

    NASA Technical Reports Server (NTRS)

    Johnson, C. B.; Hunkler, L. T., Sr.; Letzring, S. A.; Jaanimagi, P.

    1990-01-01

    Detailed streak camera definition studies were made as a first step toward full flight qualification of a dual channel picosecond resolution streak camera receiver for the Geoscience Laser Altimeter and Ranging System (GLRS). The streak camera receiver requirements are discussed as they pertain specifically to the GLRS system, and estimates of the characteristics of the streak camera are given, based upon existing and near-term technological capabilities. Important problem areas are highlighted, and possible corresponding solutions are discussed.

  6. Emergency Department Visits by Nursing Home Residents in the United States

    PubMed Central

    Wang, Henry E.; Shah, Manish N.; Allman, Richard M.; Kilgore, Meredith

    2012-01-01

    BACKGROUND/OBJECTIVES The Emergency Department (ED) is an important source of health care for nursing home residents. The objective of this study was to characterize ED use by nursing home residents in the United States (US). DESIGN Analysis of the National Hospital Ambulatory Medical Care Survey SETTING US Emergency Departments, 2005-2008 PARTICIPANTS Individuals visiting US EDs, stratified by nursing home and non-nursing home residents. INTERVENTIONS None MEASUREMENTS We identified all ED visits by nursing home residents. We contrasted the demographic and clinical characteristics between nursing home residents and non-nursing home residents. We also compared ED resource utilization, length of stay and outcomes. RESULTS During 2005-2008, nursing home residents accounted for 9,104,735 of 475,077,828 US ED visits (1.9%; 95% CI: 1.8-2.1%). The annualized number of ED visits by nursing home residents was 2,276,184. Most nursing home residents were elderly (mean 76.7 years, 95% CI: 75.8-77.5), female (63.3%), and non-Hispanic White (74.8%). Compared with non-nursing home residents, nursing home residents were more likely have been discharged from the hospital in the prior seven days (adjusted OR 1.4, 95% CI: 1.1-1.9). Nursing home residents were more likely to present with fever (adjusted OR 1.9; 95% CI: 1.5-2.4) or hypotension (systolic blood pressure ≤90 mm Hg, OR 1.8; 95% CI: 1.5-2.2). Nursing home patients were more likely to receive diagnostic test, imaging and procedures in the ED. Almost half of nursing home residents visiting the ED were admitted to the hospital. Compared with non-nursing home residents, nursing home residents were more likely to be admitted to the hospital (adjusted OR 1.8; 95% CI 1.6-2.1) and to die (adjusted OR 2.3; 95% CI 1.6-3.3). CONCLUSIONS Nursing home residents account for over 2.2 million ED visits annually in the US. Compared with other ED patients, nursing home residents have higher medical acuity and complexity. These

  7. Solar dynamic heat receiver technology

    NASA Technical Reports Server (NTRS)

    Sedgwick, Leigh M.

    1991-01-01

    A full-size, solar dynamic heat receiver was designed to meet the requirements specified for electrical power modules on the U.S. Space Station, Freedom. The heat receiver supplies thermal energy to power a heat engine in a closed Brayton cycle using a mixture of helium-xenon gas as the working fluid. The electrical power output of the engine, 25 kW, requires a 100 kW thermal input throughout a 90 minute orbit, including when the spacecraft is eclipsed for up to 36 minutes from the sun. The heat receiver employs an integral thermal energy storage system utilizing the latent heat available through the phase change of a high-temperature salt mixture. A near eutectic mixture of lithium fluoride and calcium difluoride is used as the phase change material. The salt is contained within a felt metal matrix which enhances heat transfer and controls the salt void distribution during solidification. Fabrication of the receiver is complete and it was delivered to NASA for verification testing in a simulated low-Earth-orbit environment. This document reviews the receiver design and describes its fabrication history. The major elements required to operate the receiver during testing are also described.

  8. [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.

  9. Methotrexate safety improvement in nursing home residents.

    PubMed

    Zarowitz, Barbara J; Erwin, W Gary; Ferris, Mindy; Losben, Nancy; Proud, Terri

    2012-01-01

    Improve the safety of methotrexate use in nursing home residents by reducing methotrexate errors. Concurrent cohort analysis. Long term care facilities. Residents who received methotrexate from January 1, 2007, to December 31, 2009. A 3-pronged approach involving modification to dispensing systems and practices, mandatory staff training, and measurement was implemented in June 2008 and monitored through December 2009. Software programming to the pharmacy operating systems occurred forcing a mandatory second clinical review of all methotrexate orders during the pharmacist verification process, before dispensing. Pharmacists were required to call and clarify orders that failed to fulfill prespecified safety criteria before approving the prescription for dispensing. All pharmacists were required to complete a brief, concise, focused, mandatory training program that emphasized the proper use, adverse effects, boxed warnings, appropriate dosing schedules, and new dispensing requirements for methotrexate. On a daily basis, methotrexate orders from the previous day were summarized and forwarded to a Clinical Intervention Center for analysis and measurement. Prescriptions that triggered preestablished safety concerns were triaged back to their respective pharmacies for verification or modification. The results of the Methotrexate Safety Program were measured by tracking the number of prescriptions filled, number of patients treated, number of sentinel events, and number of safety variances identified. All assigned pharmacists (n = 2293) completed the mandatory training between June and December 2008. In 2009, a total of 369 new employees completed the training. The prescriptions per year and patients treated per year remained comparable, whereas the number of sentinel events decreased from 3 in 2007 and 4 in 2008 to 0 following program implementation. The most prevalent variance was daily dosing of methotrexate when weekly was intended. The measurement process detected and

  10. Instruction in teaching and teaching opportunities for residents in US dermatology programs: Results of a national survey.

    PubMed

    Burgin, Susan; Homayounfar, Gelareh; Newman, Lori R; Sullivan, Amy

    2017-04-01

    Dermatology residents routinely teach junior co-residents and medical students. Despite the importance of teaching skills for a successful academic career, no formal teaching instruction programs for dermatology residents have been described to our knowledge, and the extent of teaching opportunities for dermatology residents is unknown. We sought to describe the range of teaching opportunities and instruction available to dermatology residents and to assess the need for additional teaching training from the perspective of dermatology residency program directors nationwide. A questionnaire was administered to 113 US dermatology residency program directors or their designees. Descriptive statistics were used to analyze questionnaire item responses. The response rate was 55% (62/113). All program directors reported that their residents teach; 59% (33/56) reported offering trainees teaching instruction; 11% (7/62) of programs offered a short-term series of formal sessions on teaching; and 7% (4/62) offered ongoing, longitudinal training. Most program directors (74%, 40/54) believed that their residents would benefit from more teaching instruction. Response rate and responder bias are potential limitations. Dermatology residents teach in a broad range of settings, over half receive some teaching instruction, and most dermatology residency program directors perceive a need for additional training for residents as teachers. Copyright © 2016 American Academy of Dermatology, Inc. Published by Elsevier Inc. All rights reserved.

  11. An Objective Structured Clinical Examination to Improve Formative Assessment for Senior Pediatrics Residents

    PubMed Central

    Mangold, Karen A.; Jeffers, Justin M.; Burns, Rebekah A.; Trainor, Jennifer L.; Unti, Sharon M.; Eppich, Walter; Adler, Mark D.

    2015-01-01

    Background Residency programs are developing new methods to assess resident competence and to improve the quality of formative assessment and feedback to trainees. Simulation is a valuable tool for giving formative feedback to residents. Objective To develop an objective structured clinical examination (OSCE) to improve formative assessment of senior pediatrics residents. Methods We developed a multistation examination using various simulation formats to assess the skills of senior pediatrics residents in communication and acute resuscitation. We measured several logistical factors (staffing and program costs) to determine the feasibility of such a program. Results Thirty-one residents participated in the assessment program over a 3-month period. Residents received formative feedback comparing their performance to both a standard task checklist and to peers' performance. The program required 16 faculty members per session, and had a cost of $624 per resident. Conclusions A concentrated assessment program using simulation can be a valuable tool to assess residents' skills in communication and acute resuscitation and provide directed formative feedback. However, such a program requires considerable financial and staffing resources. PMID:26457159

  12. Assessment of leadership training needs of internal medicine residents at the Massachusetts General Hospital.

    PubMed

    Fraser, Traci N; Blumenthal, Daniel M; Bernard, Kenneth; Iyasere, Christiana

    2015-07-01

    Internal medicine (IM) physicians, including residents, assume both formal and informal leadership roles that significantly impact clinical and organizational outcomes. However, most internists lack formal leadership training. In 2013 and 2014, we surveyed all rising second-year IM residents at a large northeastern academic medical center about their need for, and preferences regarding, leadership training. Fifty-five of 113 residents (49%) completed the survey. Forty-four residents (80% of respondents) reported a need for additional formal leadership training. A self-reported need for leadership training was not associated with respondents' gender or previous leadership training and experience. Commonly cited leadership skill needs included "leading a team" (98% of residents), "confronting problem employees" (93%), "coaching and developing others" (93%), and "resolving interpersonal conflict" (84%). Respondents preferred to learn about leadership using multiple teaching modalities. Fifty residents (91%) preferred to have a physician teach them about leadership, while 19 (35%) wanted instruction from a hospital manager. IM residents may not receive adequate leadership development education during pregraduate and postgraduate training. IM residents may be more likely to benefit from leadership training interventions that are physician-led, multimodal, and occur during the second year of residency. These findings can help inform the design of effective leadership development programs for physician trainees.

  13. Results of the 2015 Survey of the American Alliance of Academic Chief Residents in Radiology.

    PubMed

    Hammer, Mark M; Shetty, Anup S; Cizman, Ziga; McWilliams, Sebastian R; Holt, Daniel K; Gould, Jennifer E; Evens, Ronald G

    2015-10-01

    The American Alliance of Academic Chief Residents in Radiology conducts an annual survey of chief residents in Diagnostic Radiology programs in North America. The survey serves as a resource for observing trends and disseminating ideas among radiology training programs. An online survey was distributed to chief residents at 181 residency programs, with questions on a broad range of topics including resident benefits, program and call structure, American Board of Radiology Core exam preparation, fellowships, and the job market. A total of 193 individual responses were received from 120 programs, for a response rate of 66%. The responses were compared to data from prior years' surveys, principally from 2012 to 2014. Programs are shifting resident benefits spending toward Core exam preparation resources and away from lead aprons. In addition, 24-hour attending coverage continues to spread among programs, and the fraction of programs providing face-to-face postcall readouts continues to decline. Finally, although resident perception of the job market is now improving, residents feel that the job market continues to discourage medical students from entering radiology, a fact borne out by the 2015 match results. How the upcoming change to a direct interventional radiology residency will affect medical student interest is as yet uncertain. Copyright © 2015 AUR. Published by Elsevier Inc. All rights reserved.

  14. Integration of QR codes into an anesthesia information management system for resident case log management.

    PubMed

    Avidan, Alexander; Weissman, Charles; Levin, Phillip D

    2015-04-01

    Quick response (QR) codes containing anesthesia syllabus data were introduced into an anesthesia information management system. The code was generated automatically at the conclusion of each case and available for resident case logging using a smartphone or tablet. The goal of this study was to evaluate the use and usability/user-friendliness of such system. Resident case logging practices were assessed prior to introducing the QR codes. QR code use and satisfactions amongst residents was reassessed at three and six months. Before QR code introduction only 12/23 (52.2%) residents maintained a case log. Most of the remaining residents (9/23, 39.1%) expected to receive a case list from the anesthesia information management system database at the end of their residency. At three months and six months 17/26 (65.4%) and 15/25 (60.0%) residents, respectively, were using the QR codes. Satisfaction was rated as very good or good. QR codes for residents' case logging with smartphones or tablets were successfully introduced in an anesthesia information management system and used by most residents. QR codes can be successfully implemented into medical practice to support data transfer. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

  15. A web based Foundations of Radiological Physics for diagnostic radiology residents.

    PubMed

    Blackmon, Kevin N; Huda, Walter; Lewis, Madelene C; Tipnis, Sameer; Mah, Eugene; Frey, Donald G

    2013-03-01

    RATIONALE AND OBJECTS: We describe a new web-based physics course for radiology residents preparing for the Exam of the Future (EOF). A course was developed with a total of 12 web-based modules. Six modules were focused on "imaging" and six on "radiation." A module was subdivided into nine short "nuggets." Traditional lectures were replaced by modules using prerecorded lectures (Tegrity) to a secure website (WebCT). Each module was accompanied by three quizzes, each consisting of ten questions designed to reinforce covered materials. All online modules were accompanied by a noon conference that employed an Audience Response System (Turning Point). Seventeen first-year residents over 2 consecutive years beginning in July 2010 took this new course, and participated in an anonymous online follow-up survey (Survey Monkey). The recorded 12 modules had an overall average duration of 72 ± 19 minutes. Ten of 17 residents expressed a preference of 15 minutes for nugget duration. Highest personal assessment scores of each resident's understanding were obtained in human radiation risks and radiation protection. Residents considered supplemental noon conferences to be important for learning radiological physics. Satisfaction level was largely positive, with five residents highly satisfied, nine residents somewhat satisfied, two residents neutral, and only one resident somewhat dissatisfied. Our Foundations of Radiological Physics course was well received and served as the springboard for mastering x-ray-based imaging modalities of radiography, mammography, fluoroscopy, interventional radiology, and computed tomography. Copyright © 2013 AUR. Published by Elsevier Inc. All rights reserved.

  16. Pneumonia care and the nursing home: a qualitative descriptive study of resident and family member perspectives

    PubMed Central

    Chan Carusone, Soo; Loeb, Mark; Lohfeld, Lynne

    2006-01-01

    Background Nursing home residents are frequently sent to hospital for diagnostic tests or to receive acute health care services. These transfers are both costly and for some, associated with increased risks. Although improved technology allows long-term care facilities to deliver more complex health care on site, if this is to become a trend then residents and family members must see the value of such care. This qualitative study examined resident and family member perspectives on in situ care for pneumonia. Methods A qualitative descriptive study design was used. Participants were residents and family members of residents treated for pneumonia drawn from a larger randomized controlled trial of a clinical pathway to manage nursing home-acquired pneumonia on-site. A total of 14 in-depth interviews were conducted. Interview data were analyzed using the editing style, described by Miller and Crabtree, to identify key themes. Results Both residents and family members preferred that pneumonia be treated in the nursing home, where possible. They both felt that caring and attention are key aspects of care which are more easily accessible in the nursing home setting. However, residents felt that staff or doctors should make the decision whether to hospitalize them, whereas family members wanted to be consulted or involved in the decision-making process. Conclusion These findings suggest that interventions to reduce hospitalization of nursing home residents with pneumonia are consistent with resident and family member preferences. PMID:16430782

  17. Implementation of a Chronic Illness Model for Diabetes Care in a Family Medicine Residency Program

    PubMed Central

    Beresford, Robin

    2010-01-01

    ABSTRACT INTRODUCTION While the Chronic Care Model (CCM) has been shown to improve the care of patients with chronic illnesses, primary care physicians have been unprepared in its use, and residencies have encountered challenges in introducing it into the academic environment. AIM Our residency program has implemented a diabetes management program modeled on the CCM to evaluate its impact on health outcomes of diabetic patients and educational outcomes of residents. SETTING University-affiliated, community-based family medicine residency program. PROGRAM DESCRIPTION Six residents, two faculty clinicians, and clinic staff formed a diabetes management team. We redesigned the outpatient experience for diabetic patients by incorporating elements of the CCM: multidisciplinary team care through planned and group visits; creation of a diabetes registry; use of guidelines-based flow sheets; and incorporation of self-management goal-setting. Residents received extensive instruction in diabetes management, quality improvement, and patient self-management. PROGRAM EVALUATION We achieved overall improvement in all metabolic and process measures for patients, with the percentage achieving HbA1c, LDL, and BP goals simultaneously increasing from 5.7% to 17.1%. Educational outcomes for residents, as measured by compliance with review of provider performance reports and self-management goal-setting with patients, also significantly improved. DISCUSSION Through a learning collaborative experience, residency programs can successfully incorporate chronic care training for residents while addressing gaps in care for patients with diabetes. PMID:20737237

  18. Agitation in nursing home residents: the role of gender and social context.

    PubMed

    Burgio, L D; Butler, F R; Roth, D L; Hardin, J M; Hsu, C C; Ung, K

    2000-12-01

    We investigated the relationship among gender of resident, staff social interaction, and agitation in 46 (31 male and 15 female) nursing home residents with clinically significant agitation. Direct observations were conducted of resident behaviors and environmental contextual events using a computer-assisted, real-time observational system. The system recorded frequency, duration, and temporal sequencing of events. Results show that female residents displayed almost three times the amount of agitation as male residents (35% vs. 13% of total observation time, respectively), although men in the study were more likely to receive psychoactive drugs for their agitation. Staff spent similar amounts of time verbally interacting and touching male and female residents. Sequential analyses were conducted to examine the likelihood of staff verbal and touch interactions both preceding and following resident agitation using Bakeman and Quera's (1995) SDIS-GSEQ program. Results suggest that staff touch and verbal interaction elicit agitation in a significant proportion of residents. Once agitation occurs, staff were likely to respond by interacting verbally, but not physically, with the resident.

  19. Teaching across the continuum: variations in rankings and valued teaching components between surgery residents and medical students.

    PubMed

    Sandhu, Gurjit; Robinson, Adina B; Magas, Christopher P; Purkiss, Joel A; Reddy, Rishindra M

    2016-11-01

    Surgical faculty teach medical students and residents within the same environment; however, each group may require different teaching methods. The aim of this study was to identify teaching components valued by these sets of learners. Teaching evaluations for 43 surgical faculty members who received yearly evaluations from students and residents were analyzed. Highest and lowest ranked educators in medical student evaluations were traced to corresponding rankings in resident evaluations. Thematic analysis was conducted on written comments. Educators rated the highest in the medical student group were spread out among the residents' rankings, with several educators being rated the lowest. Similar patterns were observed in reverse for faculty rated highly by residents. Residents and medical students value faculty teaching using different criteria, with residents more focused on operative autonomy and medical students focused on approachability. Using one group to define best teaching methods is insufficient as learners value different optimal attributes. Copyright © 2016 Elsevier Inc. All rights reserved.

  20. 38 CFR 51.110 - Resident assessment.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ...) PER DIEM FOR NURSING HOME CARE OF VETERANS IN STATE HOMES Standards § 51.110 Resident assessment. The...) Review of assessments. The nursing facility management must examine each resident no less than once every...

  1. 38 CFR 51.110 - Resident assessment.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ...) PER DIEM FOR NURSING HOME CARE OF VETERANS IN STATE HOMES Standards § 51.110 Resident assessment. The...) Review of assessments. The nursing facility management must examine each resident no less than once every...

  2. 38 CFR 51.110 - Resident assessment.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ...) PER DIEM FOR NURSING HOME CARE OF VETERANS IN STATE HOMES Standards § 51.110 Resident assessment. The...) Review of assessments. The nursing facility management must examine each resident no less than once every...

  3. 38 CFR 51.110 - Resident assessment.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ...) PER DIEM FOR NURSING HOME CARE OF VETERANS IN STATE HOMES Standards § 51.110 Resident assessment. The...) Review of assessments. The nursing facility management must examine each resident no less than once every...

  4. 38 CFR 51.110 - Resident assessment.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ...) PER DIEM FOR NURSING HOME CARE OF VETERANS IN STATE HOMES Standards § 51.110 Resident assessment. The...) Review of assessments. The nursing facility management must examine each resident no less than once every...

  5. 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)

  6. 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'