bluuebunny/crossref_metadata_2025 huggingface dataset:
A Comparative Study on the Different Ethyl Alcohol Disinfection Methods on Dental Casts
Authors: Mendoza Diane Sumagpang , Palad Catherine Jill Dequito , Likot Mae Louise Romero , Rodrigo Jason Anthony Bernabe , Gatchalian Deborah Cynthia Teodoro
Published: December 2019

Student clinicians are expected to encounter microorganisms during the process of thepatients’ treatment that can cause various diseases. In the Dentistry’s Prosthodontics clinicmanual, dental students should perform disinfection but no specific method wasrecommended. This study utilized the True experimental research design to evaluate theeffectiveness of two ethyl alcohol disinfection methods (spray and immersion) in thereduction of the bacterial colony count on dental casts and when running tap water is used torinse the dental casts. Informed consent from the 34 participants was first secured from eachof them. They were purposively selected based on their age and if they were partiallyedentulous with at least ten teeth present in each arch. Sixty eight dental casts were producedafter the impression taking of both their maxillary and mandibular arches, 34 of which werefor the experimental group and 34 were for the control group. The Streaking Plate Techniquewas used in determining the bacterial colony count on each dental cast before and after thedisinfection. The results were analyzed statistically using one-way ANOVA. Results revealedthat both the immersion and spray methods in which 70% ethyl alcohol was used as adisinfectant, were found to be independently effective as compared with tap water rinsingonly in reducing the bacterial colony count of each dental cast. However, when the two ethylalcohol disinfection techniques were compared to each other, results showed that there wereno significant statistical differences between them when the ability to reduce the bacterialcolony count on dental casts was observed. From the conclusions, it is recommended that theDentistry students consider using either the immersion or spray method with 70% ethylalcohol as a disinfectant on dental casts. Further studies may also be done to test differentkinds of alcohols with various concentrations.
Challenges in clinical performance of dentistry clinicians: towards strengthening areas of outcomes or competencies
Authors: Laguna Arvin Bullon
Published: December 2019

The study investigated the phenomenon of challenges and difficulties in the clinicalperformance of students in a university, accounting for the frequency of weaknesses and errorsof clinician students during clinical training as observed by the faculty in terms of theirknowledge, practical skills and attitudes. All eighteen faculty clinical consultants who weresupervising the 7 Clinical Departments in the College of Dentistry in a university were invitedto participate in the study, wherein questionnaires were given in two stages to identify andrecall the frequency of occurrence of errors or weaknesses in the clinical performance ofstudent clinicians in the 3rd and 4th year proper levels of the Dentistry Program. The sevenClinical Departments included the Restorative Dentistry Department, Oral DiagnosisDepartment, Periodontics Department, Oral Surgery Department, Endodontics Department,Prosthodontics Department, and the Pediatric Dentistry Department. The findings revealedseveral errors or weaknesses in clinical performance of students and some of these weaknesseswere seen by the clinical consultants to be frequently performed. Some of these are critical inthe proper training of future dentists and thus interventions in the target outcomes in the clinicaltraining program, as well as target outcomes and competencies in the area of pre-clinicaltraining, were recommended to be addressed.
The Influence of General Management Practices on Employees’ Satisfaction of an Employment Agency in Alabang, Philippines
Authors: PUSPITA MEGA , Lian Cing San
Published: December 2019

Managing a company is a complex activity, and effective managers face many challenges from within and outside the organization. Management helps company to achieve its goals effectively and efficiently through planning, organizing, leading, and controlling. Employee satisfaction is also important to the success of any business. Many managers believe it is important because they think satisfied employees will do better work. The aim of the study was to evaluate and analyze the general management practices of an employment agency in Alabang, Philippines and determine their relationship to employee satisfaction. Quantitative research method was used in this study. One hundred and ten employees of an employment agency participated in the survey. Questionnaires were distributed using closedended questions. Random sampling technique was used in this study. Descriptive statistics andcorrelation analysis were used for the data analysis. The general management practices of the company were good and the level of the employee satisfaction was very high. A strong positive relationship was found between general management practices and employee satisfaction. There was no significant difference in the level of employee satisfaction when the respondents’ profile in term of age, gender, and length of work were considered. For further research, other factors that may influence employee satisfaction may be considered utilizing a larger population size.
Exploring the Effect of Professional Skills and Personality Traits to Job Performance of Employees in Automotive Corporation, Laguna, Philippines
Authors: Thang Piang Lian , Thein Saw Dennis , Duodu Enoch Asuah
Published: December 2019

In today’s global environment there is a competition on performances of organizations. Business organizations are seeking highly skilled professionals to be employed to achieve high performance and productivity over their competitors. This research is to determine the effects of personality traits, and professional skills on employee performance in an Automotive Corporation in the Philippines. The study is a quantitative research, and a descriptive correlation. Self-Constructed survey questionnaires were distributed to 97 employees of Automotive Corporation using convenience sampling. The statistical tools used for analyzing the results from the SPSS 22, was Pearson correlation to analyze the relationship and standard deviation and the mean for the descriptive study, and t-test and ANOVA were used to analyze the difference, and in terms of predictions, linear regression was used. The study shows that the relationship between Professional Skills has a positive significant relationship with employee performance but there is no significant relationship between personality traits and employee performance, though openness was dominant with the highest mean. The study also revealed that professional skills, personality traits, and employee performance are high. Considering the sex, males had higher employee performance than females. Further results revealed that only professional skills predicted employee performance. The result of the study implies that business owners need employees that can get the job done because employee performance is critical to the overall success of the company. The study recommends that industries should bear in mind that Professional Skills, and Personality Traits of workers isessential to the success of business organizations.
The Mediating Effect of Intellectual Capital on the Quality of Higher Education and Capital Wellness
Authors: Kyamuhangire Daniel M , Carpizo Ruben Tangonan , Borromeo Robert A , Narbarte Reuel E , Lopez Glenda Joy B , Mergal Vicky C
Published: December 2019

This study aimed to determine the mediating effect of intellectual capital on the quality of higher education and financial wellness. It is a quantitative research that made use of descriptive-correlation design with 403 respondent institutions from public and private HEIs in the East Africa Community. Data were analyzed using descriptivE AND INFERENTIAL STATISTICS. Results showed that quality of higher education and intellectual capital was perceived to be high; the level of financial wellness was good, and intellectual capital partially mediated the relationship of quality higher education and financial wellness. The direct effect of quality higher education on financial wellness is 0.613 at p-value 0.05 and its indirect effect, which is the mediation effect of intellectual capital, is 0.266 (0.378 * 0.703). The total effect of quality higher education on financial wellness when mediated by intellectual capital is 0.879 (0.613+0.266). Higher Education Institutions need to create a system that will ensure the regular assessment of the quality of education that they offer and their intellectual capital to increase capital wellness.
Compact 2G HTS power cable: new cold tests results
Authors: Vysotsky Vitaly , Fetisov Sergey , Zubko Vasily , Zanegin Sergey , Nosov Alexander
Published: December 2019

New results of tests of the smallest HTS 2G power cable model.
Presented at EUCAS - 2019, Glasgow, UK, September 2019
Review of Distribution Network Phase Unbalance: Scale, Causes, Consequences, Solutions, and Future Research Direction
Authors: Ma Kang , Fang Lurui , Kong Wangwei
Published: December 2019

Phase unbalance is
widespread in the distribution networks in the UK, continental Europe, US,
China, and other countries. First, this paper reviews the mass scale of phase unbalance
and its causes and consequences. Three challenges arise from phase rebalancing:
the scalability, data scarcity, and adaptability (towards changing unbalance
over time) challenges. Solutions to address the challenges are: 1) using
retrofit-able, maintenance-free, automatic solutions to overcome the
scalability challenge; 2) using data analytics to overcome the data-scarcity
challenge; and 3) using phase balancers or other online phase rebalancing
solutions to overcome the adaptability challenge. This paper categorizes existing
phase rebalancing solutions into three classes: 1) load/lateral re-phasing; 2)
using phase balancers; 3) controlling energy storage, electric vehicles,
distributed generation, and micro-grids for phase rebalancing. Their advantages
and limitations are analyzed and ways to overcome the limitations are
recommended. Finally, this paper suggests future research topics: 1) long-term
forecast of phase unbalance; 2) whole-system analysis of the unbalance-induced
costs; 3) phase unbalance diagnosis for data-scarce LV networks; 4)
techno-commercial solutions to exploit the flexibility from large three-phase
customers for phase balancing; 5) the optimal placement of phase balancers; 6)
the transition from single-phase customers to three-phase customers.
Review of Distribution Network Phase Imbalance: Scale, Consequences, Solutions, and Future Research Direction
Authors: Ma Kang , Fang Lurui , Kong Wangwei
Published: December 2019

Phase imbalance is
widespread in the distribution networks in the UK, continental Europe, US,
China, and other countries. First, this paper reviews the mass scale of phase
imbalance and its consequences. Three challenges arise from phase rebalancing:
the scalability, data scarcity, and adaptability (towards changing imbalance
over time) challenges. Solutions to address the challenges are: 1) using
retrofit-able, maintenance-free, automatic solutions to overcome the
scalability challenge; 2) using data analytics to overcome the data-scarcity
challenge; and 3) using phase balancers or other online phase rebalancing
solutions to overcome the adaptability challenge. This paper categorizes existing
phase rebalancing solutions into three classes: 1) load/lateral re-phasing; 2)
using phase balancers; 3) controlling energy storage, electric vehicles,
distributed generation, and micro-grids for phase rebalancing. Their advantages
and limitations are analyzed and ways to overcome the limitations are
recommended. Finally, this paper suggests future research topics.
Negligence, Inadvertence, and Moral Responsibility
Authors: Mosqueda Alejandro
Published: December 2019

This paper is an assessment of the conclusion that negligent agents are not morally responsible for the damages they cause, reached by Matt King in “The Problem with Negligence” (2009). King’s argument involves two difficult issues that are often disregarded in discussions about moral responsibility. One is that it is not clear why we usually attribute responsibility in cases of negligence but not in cases of inadvertence even though both phenomena are characterized by the absence of conscious mental elements. The other is that any explanation of the responsibility attributed in cases of negligence and in paradigmatic cases should shed light on the features that both cases share. I will review these issues involved in King’s argument in order to avoid his conclusion and to clarify some important matters of our attribution of responsibility in cases of negligence and in cases of inadvertence.
Hechos, eventos y la referencia
Authors: Polakof Ana Clara
Published: December 2019

En este artículo, proponemos que es posible analizar la referencia a hechos y eventos a partir de un análisis lingüístico. Para esto, proveemos, en primer lugar, una caracterización ontológica de hechos y eventos basada en una ontología platonista, que contiene entidades concretas y abstractas y se encuentra jerarquizada en niveles, y en segundo lugar, un análisis de la referencia a hechos y eventos que parte de un análisis gramatical de las descripciones definidas que pueden ser relacionadas a dichas entidades. Finalmente, determinamos si es posible referir a los hechos y a los eventos o no.
ТЕОРЕТИЧЕСКИЕ ОСНОВЫ СТРУКТУРИЗАЦИИ ЭКОНОМИЧЕСКОГО ПРОСТРАНСТВА
Authors: Т.А. Бородина , Г.Г. Бояджан
Published: December 2019

В статье рассмотрены теоретические подходы к трактовке таких категорий, как «экономическое пространство», «структура экономического пространства», «структурирование экономического пространства». Методологической основой исследования является диалектический метод, предусматривающий изучение данной категории в развитии, взаимосвязи и взаимозависимости. Вместе с тем использовались общенаучные и специфические методы исследования. Авторами на основании монографических исследований обобщены с точки зрения эволюции человеческого общества территориальный, ресурсный, процессный, информационный и институциональный подходы, исследованы заложенные в них основополагающие принципы. Полученные результаты позволяют сделать вывод, что в основе трактовок экономического пространства при любом подходе заложен экономический интерес участников, основанный на потребностях людей, как первичных, характеризующих физиологические и экзистенциальные потребности, так и вторичных, обуславливаемых социумом, территориальными и социально-культурными особенностями. Предложено выделять понятия макроструктуры и микроструктуры социально-экономического пространства, так как экономика региона должна обладать неким минимальным уровнем сложности и разнообразия. С экономической точки зрения усиление какой-то одной, наиболее эффективной отрасли хозяйства в тех или иных районах является положительным моментом. Тем не менее, это не должно происходить за счет упрощения экономической структуры, отказа от малых по вкладу в общую валовую добавленную стоимость производств. При этом структурированность пространства с социально-экономической точки зрения должна учитывать как факторы окружающей среды, так и административно-правовые, экономические и социально-культурные условия той или иной территории, что позволяет комплексно применять рассмотренные теоретические подходы.
Transitioning towards senior medical resident: identification of the required competencies using consensus methodology
Authors: Khalife Roy , Gonsalves Carol , Code Catherine , Halman Samantha
Published: December 2019

Background: Residency programs are facing significant restructuring through the “Competence by Design” (CBD) framework proposed by the Royal College of Physicians and Surgeons of Canada (RCPSC). Our goal was to establish the competencies to be acquired during the transition to a senior role within Internal Medicine (IM) training.     Methods: Using a modified Delphi technique, practicing IM physicians and recent graduates were polled to develop consensus on the required competencies to effectively transition from junior to senior medical resident. Participants rated each competency on a three-point Likert scale. Each competency was linked to an Entrustable Professional Activity (EPA) identified by the RCPSC IM Specialty Committee.Results: A total of eighteen participants took part in item generation (16% response rate) and nineteen in the initial ranking with seventeen completing all three iterations (89% completion rate). Eighty-three competencies were identified during questionnaire development. A final list of seventy-seven competencies reached consensus after three rounds. Most competencies matched to core of discipline EPAs.Conclusion: This consensus-based list of competencies will help create a framework and tools for the assessment of junior residents as they prepare to transition to the role of senior in the new CBD curricula for IM trainees at our institution.
“They don’t have the history and the stature:” examining perceptions of Caribbean offshore medical schools held by Canadian medical education stakeholders
Authors: Morgan Jeffrey , Crooks Valorie , Snyder Jeremy , Pickering John
Published: December 2019

Background: Caribbean offshore medical schools are for-profit, private institutions that provide undergraduate medical education to primarily international students, including from the United States or Canada. Despite the growing role that offshore medical schools play in training Canadian physicians, little is known about how these institutions are perceived by those in professional and decision-making positions where graduates intend to practice.Methods: The authors interviewed 13 Canadian medical education stakeholders whose professional positions entail addressing the medical education system or physician workforce. Participants were employed in academic, governmental, and non-governmental organizations in leadership roles.Results: Thematic analysis revealed three cross-cutting perceptions of offshore medical schools: (a) they are at the bottom of an international hierarchy of medical schools; (b) they are heterogeneous in quality of education and student body; and (c) they have a unique business model, characterized by profit-generating and serving international students.Conclusion: Consistent growth of the offshore medical school industry in the Caribbean may result in adverse reputational harms for well-established offshore or regional medical schools. Both comparative (e.g., USMLE pass rate) and intuitive factors (e.g., professional familiarity) informed participants’ perceptions. Participants believed that core principles of social accountability in medical education are incompatible with the offshore medical school model.
Does testing enhance learning in continuing medical education?
Authors: McConnell Meghan , Hou Chenchen , Panju Mohamed , Panju Akbar , Azzam Khalid
Published: December 2019

Background: There has been growing interest in using theory-driven research to develop and evaluate continuing medical education (CME) activities. Within health professions education, testing has been shown to promote learning in a variety of different contexts, an effect referred to as test-enhanced learning (TEL). However, the extent to which TEL generalizes to CME remains unclear. The purpose of this study was to investigate whether physicians who received two intervening tests following a CME event would experience a TEL effect relative to physicians who received additional study material to review without testing. Methods: Forty-nine physicians were recruited during a local CME activity. Physicians were randomized to either a) the test group (n=26), where participants completed two 20 multiple-choice question (MCQ) quizzes related to the lecture content or b) the study group (n=23), where participants studied the same information without testing. Testing and studying occurred independently during the CME activity, and then four weeks later online. At eight weeks, participants completed a final 20-item MCQ online test. A between-subjects t-test was used to compare performance on the final test as a function of the initial educational activity (test group vs. study group).Results: Performance on the final MCQ test was equivalent for both test (Mean (SD): 75% (9.9)) and study-only (77% (7.3)) conditions (t(47) = 0.94, p=0.35). Conclusion: The null findings in the present study are contrary to previous findings demonstrating TEL among novice learner populations. The lack of TEL highlights several programmatic considerations that should be factored in before implementing TEL as a part of CME.
Reducing physician voiding cystourethrogram ordering in children with first febrile urinary tract infection: evaluation of a purposefully sequenced educational intervention
Authors: Banks Anke , Samuel Susan , Johnson David , Hecker Kent , McLaughlin Kevin
Published: December 2019

Background: Physicians often fail to implement clinical practice guidelines. Our aim was to evaluate whether a purposefully sequenced, multifaceted educational intervention would increase physician adherence to a guideline for voiding cystourethrogram (VCUG) use following first urinary tract infection (UTI) in young children.  Methods: Using a single centre, pretest-posttest design, we compared the proportion of guideline adherent VCUG orders and the VCUG ordering rate before and after three educational interventions (interactive lecture, clinical pathway, faxed reminder) selected and sequenced according to the PRECEDE (Predisposing, Reinforcing and Enabling Constructs in Educational Diagnosis and Evaluation) health promotion model.Results: One hundred and nine physicians ordered 219 VCUGs for 219 children. Following the interventions, there was an increase in the monthly proportion of adherent VCUGs ordered by pediatricians (analysis of variance (ANOVA) F(2,29) = 3.38, p = .048) and non-pediatricians (ANOVA F(2,28) = 14.71, p < .001). Also, pediatricians decreased their monthly VCUG ordering rate (linear trend incidence rate ratio 0.74, 95% confidence interval (CI) [0.54, 0.99]). Pediatricians were more likely to adhere with the guideline than were non-pediatricians (odds ratio 2.91, 95% CI [1.5, 5.5]).Conclusion: Exposure to purposefully sequenced educational interventions based on the PRECEDE model was associated with increased adherence to guideline recommendations.
Duoethnography as a dialogic and collaborative form of curriculum inquiry for resident professionalism and self-care education
Authors: Docherty-Skippen Susan , Beattie Karen
Published: December 2019

Medical residency is an important time in the development of physician professionalism, as residents’ identities and medical responsibilities shift from student-learners to practitioner-leaders. During this transition time, many residents struggle with stress due to the unique pressures of their post-graduate training. This, in turn, can potentially hinder successful professional identity development. In response, the Royal College of Physicians and Surgeons of Canada (RCPSC) has incorporated physician health into its CanMEDS professional competency framework.Although this framework identifies enabling self-care professional competencies (e.g., capacity for self-regulation and resilience for sustainable practice), it does not specify the types of educational strategies best suited to teach and assess these competencies. To support the prevention and rehabilitation of resident health issues, residency training programs are faced with the complex challenge of developing socially accountable curricula that successfully foster self-care competencies. Duoethnography, a dialogic and collaborative form of curriculum inquiry, is presented as a pedagogical model for resident professionalism and self-care education. Merits of duoethnography centers on its: 1) capability to foster self-reflexive and transformative learning; 2) versatility to accommodate learner diversity; and 3) adaptability for use in different social, situational, and ethical contexts.
Are we failing to “build on the scientific basis of medicine?”
Authors: Coderre Sylvain , Ripstein Ira , Veale Pamela , Mclaughlin Kevin
Published: December 2019

In this article, we question if and why the Canadian national medical education organizations have failed to introduce or promote changes that compel or encourage Canadian medical schools to heed the recommendation from the Future of Medical Education in Canada report to "build on the scientific basis of medicine." We end by offering suggestions on how these organizations could help Canadian medical schools build in the scientific basis of medicine.
Feasibility and effectiveness of an online mindfulness meditation program for medical students
Authors: Danilewitz Marlon , Koszycki Diana , Maclean Heather , Sanchez-Campos Millaray , Gonsalves Carol , Archibald Douglas , Bradwejn Jacques
Published: December 2019

Background: The need to incorporate tools to promote medical student wellness in medical education is underscored by the concerning rates of psychological distress among them. The objective of this prospective cohort study was to obtain preliminary data on the feasibility and effectiveness of an online mindfulness intervention for medical student wellness.Methods: A convenience sample of 52 medical students consented to participate in this study. Feasibility was assessed by ease of recruitment, number of modules completed, satisfaction with the program, and adherence to a regular meditation practice. Participants completed the Maslach Burnout Inventory, the Jefferson Scale of Empathy-medical student version, the Five Face of Mindfulness Questionnaire-short form, and the Self Compassion Scale-short form pre and post intervention.Results: The convenience sample was recruited within a two-month period. Forty-five participants completed at least one of seven modules. Descriptive statistics (mean±standard deviation) revealed that the mean number of modules completed was 4.85±2.7. Mean satisfaction with the modules was 7.07±1.1 out of 10. Adherence to a regular formal meditation practice was poor; the average amount of formal meditation practice per module was 34.14±27.44 minutes. Self-compassion and the “observe and describe” facets of mindfulness practice significantly statistically increased from baseline, but no such change was observed for levels of burnout and empathy.Conclusion: The present study indicates that an online mindfulness meditation program may be of interest to medical students. The results did not provide any evidence that the program was effective but we believe further research and development is warranted.
An interprofessional urban health elective focused on the social determinants of health
Authors: Pinto Andrew , To Matthew , Rucchetto Anne , Sharma Malika , Rouleau Katherine
Published: December 2019

Background: More than half of the world’s population now lives in cities. Health professionals should understand how social factors and processes in urban spaces determine individual and population health. We report on lessons from an interprofessional urban health elective developed to focus on the social determinants of health (SDOH).                Methods: An interprofessional committee developed an urban health elective based in downtown Toronto. Course objectives included promoting collaboration to address SDOH, identifying barriers to care, accessing community-based resources, and learning to advocate at individual- and community-levels.Results: Seventeen students from eight disciplines participated during the 2011-2012 academic year. Sessions were co-facilitated with community partners and community members identified as experts based on their personal experience. Topics included housing, income and food security, Indigenous communities in urban spaces, and advocacy. Students collaborated on self-directed projects, which ranged from literature reviews to policy briefs for government. Students particularly valued learning about community agencies and hearing from people with lived experience.Conclusion: The specific health challenges faced in urban settings can benefit from an interprofessional approach informed by the experiences and needs of patient communities. This elective was innovative in engaging students in interprofessional learning on how health and social agencies collaborate to tackle social determinants in urban spaces.
Abductor digiti minimi
Authors: Turski Daniel
Published: December 2019

Medicine largely relies upon flexible, nimble, and agile thinking while working through complex differentials. Consequently, I like letting my mind roam while learning so as to enhance my mental flexibility. And this was one of the many images that popped into my mind while learning the musculoskeletal system. I’m also a visual learner.
The effects of previous educational training on physical activity counselling and exercise prescription practices among physicians across Nova Scotia: a cross-sectional study
Authors: O'Brien Myles , Shields Chris , Crowell Sandra , Theou Olga , McGrath Patrick , Fowles Jonathon
Published: December 2019

Background: Physicians (MDs) report difficulty including physical activity (PA) and exercise (PAE) as part of routine care. MDs who report previous educational training in PAE may prescribe exercise more frequently. We evaluated the effects of previous training on perceptions and practices of PA counselling and exercise prescriptions among MDs in Nova Scotia.Methods: MDs (n=174) across Nova Scotia completed an online self-reflection survey regarding their current PAE practices. MDs who reported previous training (n=41) were compared to those who reported no training (n=133). Results: Trained-MDs were 22% more confident performing PA counselling than untrained-MDs (p<0.005). In patient appointments, trained-MDs included PAE more often (51% vs 39%; p=0.03) but trained-MDs and untrained-MDs had similar rates of exercise prescriptions (12%; p>0.05). The most impactful barriers (on a scale of 1 to 4) were lack of time (2.5) and perceived patient interest (2.4), which were unaffected by previous training (p>0.05).Conclusion: Previous training was associated with a higher confidence to include PAE discussions with patients by MDs in Nova Scotia, but had minimal influence on their many barriers that prevent exercise prescription. Although some training supports MDs inclusion of PAE into their practice, there is a need for greater, more intensive educational training to assist MDs in prescribing exercise.
Learners’ experiences of an enhanced surgical skills training program for family physicians
Authors: Kornelsen Jude , Geller Brian , Janke Fred , Iglesias Stuart
Published: December 2019

Background: Family Physicians with Enhanced Surgical Skills (FPESS) have sustained rural operative care, including local access to caesarean section, in many communities across rural Canada and internationally. The contemporary role of FPESS within the health system, however, has not been without challenges. The 12-month Prince Albert Enhanced Surgical Skills (ESS) program intakes two learners a year and is one of only two accredited programs in Canada offering a scope of surgical practice beyond operative delivery.Methods: This paper highlights the results of an evaluation of graduates’ experiences of training and the post-training environment. Graduates were practicing in Western and Northern Canada after completing the ESS training program, specifically in British Columbia, Alberta, Manitoba, and the Northwest Territories.Results: Findings suggest the overall success of the program in meeting learners’ needs. There was a close match between the training curriculum and post-training practice. Conclusion: The findings from the post training experience suggest that sustainability of ESS is linked to 1) creating pathways to privileges between the ESS community and the Health Authorities, 2) building functional and trusting relationships with surgical specialists, and 3) creating a web of accessible effective rurally appropriate surgical Continuing Professional Development (CDP). Ongoing CPD is identified as essential in increasing the comfort of FPESS.
The roles of attachment and resilience in perceived stress in medical students
Authors: Thompson Galilee , Wrath Andrew , Trinder Krista , Adams G. Camelia
Published: December 2019

Background: Medical students are susceptible to high levels of psychological stress, while being equipped with lower levels of resilience, especially females. Adult attachment is a known risk factor for a broad range of mental health difficulties and poor coping. The purpose of this study is to examine relationship attachment style, perceived stress, and resilience in medical students.Methods: Data was collected via an online survey using self-report measures from University of Saskatchewan undergraduate medical students (n = 188). Attachment was assessed with the Relationship Questionnaire and Experiences in Close Relationships Scale. Resilience and stress were assessed with the Connor-Davidson Resilience Scale and Perceived Stress Scale, respectively.Results: Approximately half of our sample endorsed secure attachment style (49.4%). Females reported significantly more attachment insecurity, higher attachment anxiety, higher perceived stress, and lower resilience compared to males, as expected. As predicted, attachment anxiety and avoidance were predictors of perceived stress. Mediation analyses supported the hypothesis that resilience acted as a partial mediator between attachment insecurity and perceived stress.Conclusion: These findings suggest attachment plays a role in perceived stress in medical students. In addition, the role of resiliency in protecting against this effect highlights potential areas for intervention to improve medical student well-being and provides a foundation for longitudinal follow-up.
Sustainability of physical exam skills in a resident-led curriculum in a large internal medicine program with competency based medical education
Authors: Thiwanka Wijeratne Don , Srivastava Siddhartha , Chan Barry , Hopman Wilma , Thomson Benjamin
Published: December 2019

Background: Competency Based Medical Education (CBME) designates physical examination competency as an Entrustable Professional Activity (EPA). Considerable concern persists regarding the increased time burden CBME may place on educators. We developed a novel physical examination curriculum that shifted the burden of physical examination case preparation and performance assessment from faculty to residents. Our first objective was to determine if participation led to sustainable improvements in physical examination skills. The second objective was to determine if resident peer assessment was comparable to faculty assessment.    Methods: We selected physical exam case topics based on the Objectives of Training in the Specialty of Internal Medicine as prescribed by the Royal College of Physicians and Surgeons of Canada. Internal Medicine residents compiled evidence-based physical exam checklists that faculty reviewed before distribution to all learners. Physical exam practice sessions with whole-group demonstration followed by small-group practice sessions were performed weekly. We evaluated this pilot curriculum with a formative OSCE, during which a resident peer and a faculty member simultaneously observed and assessed examinee performance by .Results: Participation in the novel curriculum practice sessions improved OSCE performance (faculty score mean 78.96 vs. 62.50, p<0.05). Peer assessment overestimated faculty scores (76.2 vs. 65.7, p<0.001), but peer and faculty assessments were highly correlated (R2 = 0.73 (95% CI 0.50-0.87).Conclusion: This novel physical examination curriculum leads to sustainable improvement of physical examination skills. Peer assessment correlated well with the gold standard faculty assessment. This resident-led physical examination curriculum enhanced physical examination skills in a CBME environment, with minimal time commitment from faculty members.
Trajectories of physicians in Manitoba, Canada: the influence of contact points of rural-focused professional learning
Authors: Murray John , Penner Charles , Heide Wayne , Piasta Dawn , Klassen Don
Published: December 2019

Background: The Manitoba Office of Rural and Northern Health (ORNH) provided a multi-year series of elective opportunities for undergraduate medical students to support rural/remote medical practice. The purpose of this study was to examine the career trajectories of Manitoba physicians in eight matched cohorts over the period 2004-2007 between: 1) those who experienced a required rural clinical block rotation only during their undergraduate medicine training in Manitoba (Med 1 and Med 3), and; 2) those who engaged in and completed additional elective programs referred to here as “contact points”.                Methods: The study utilized a retrospective/longitudinal matched cohort design which included the common factor of a mandated rural clinical one-week rotation and the differentiating factors of experiences in elective programming offered by the ORNH (contact points).Results: Of the 344 Manitoba-trained physicians whose location of current practice could be determined, 74 are presently in rural/remote communities and 270 in urban settings. Those physicians who are now in rural/remote practice were significantly more likely (p ≤ 0.05) to have continued contact with ORNH in addition to the mandatory rural rotation alone. For practitioners now located in rural/remote settings, a mean of 0.903 contact points per learner with ORNH programs is observed. For those now in urban practice the mean number of contact points per learner was 0.233.Conclusion: We conclude that there is an association between rural-focused contact points and rural and remote practice in Manitoba. Targeted professional learning where physician recruitment and retention remains a continuing challenge is discussed.
Becoming a dentist: faculty perceptions of student experiences with threshold concepts in a Canadian dental program
Authors: Green Jacqueline , Rasmussen Kari
Published: December 2019

Background: In each discipline, there are moments where students “get stuck” in their education and/or training and are often unable to move forward. These moments may be caused by threshold concepts as they represent a portal that students must cross in order to become successful in their chosen profession. This study investigated the threshold concepts from the instructors’ perspective that students must navigate as they transform from learners to dentists within a dental program.               Methods: Two focus groups with faculty members within the School of Dentistry, University of Alberta were completed in the fall of 2017. Focus groups explored the faculty’s perception of the students’ transition from learner to dentist, difficult moments in the program, and the students’ ability to navigate the program successfully.Results: A qualitative phenomenographic analysis of the faculty focus group transcripts identified four potential threshold concepts within the dental program: 1) dealing with the whole patient, 2) accountability, 3) that you may not know everything, and 4) problem solving and adapting during practice.Conclusion: This study demonstrates that there are concepts within a dental program that faculty believe students must navigate in order to transition from learner to dentist. These concepts may inform curriculum design as well as other disciplines in the health sciences.
Towards a shared mental model of progressive competence in postgraduate medical education
Authors: Prost Eric
Published: December 2019

Many professions have hierarchies and a promotion structure. Postgraduate medicine has a tradition of promoting residents based on time spent in a certain specialty. The military, too, may promote its personnel based on factors other than just merit. Both professions have been criticized for divorcing competence from promotion. While Competency-Based Medical Education (CBME) partly solves this problem in medicine, many models of CBME, including the Canadian one, retain distinct stages of training. We urgently need a shared mental model of what a learner in each stage looks like. Some models have been proposed but fall short.
A settler physician perspective on Indigenous health, truth, and reconciliation
Authors: Jaworsky Denise
Published: December 2019

This brief report presents one settler physician’s perspectives on our responsibility to engage in reconciliation and decolonize our healthcare institutions. It draws from existing literature to identify key actions for reconciliation in health care. These include i) engaging Indigenous peoples as leaders and equal partners in developing health interventions, ii) increasing our awareness and education around the colonial history and settler presence in Canada, including our role in the ongoing oppression of Indigenous peoples, iii) providing services in ways that recognize and mitigate colonial determinants of health, and iii) practicing cultural safety at an individual level and advocating for it at a structural level. These actions can be realized through educational interventions and ongoing reflexivity among medical trainees and practicing physicians.
In her own time
Authors: Jung Flora
Published: December 2019

As I look back on my first year as a medical student, I am dazed by the whirlwind of emotions and experiences I met within this short time. One recurring theme emerged from my first experiences in clinic. Younger and healthier patients are often asked to be our bedside teachers to facilitate our learning, but consequently, I found it uncannily natural to see myself in them. Each patient and their tale of tenacity, misery, sanguinity, and bravery would leave me lost in thought for days to follow. What if that were me?
Geometrische und spektrale Erfassung von Bestandeseigenschaften zur Phänotypisierung von Zuckerrüben und Weizen
Authors: Bohnenkamp David , Paulus Stefan , Mahlein Anne-Katrin
Published: December 2019

Monitoring von Pflanzen mit nicht-destruktiver Sensorik ist ein etabliertes Werkzeug bei der Begutachtung und Beschreibung pflanzlicher Entwicklung und Leistungsfähigkeit. Diese Methoden werden im Labor- und Gewächshaus auf Organ-, Pflanzen-, und Kleinbestandebene eingesetzt. Hochdurchsatzverfahren sind ebenfalls etabliert. Die Übertragung dieser Techniken auf die Feldebene ermöglicht die Validierung von Resultaten aus kontrollierten Bedingungen und eine Integration in Prozesse des Anbaumanagements. Dazu müssen die Sensoren auf mobilen Trägerplattformen angebracht werden. Hierbei kommen neben manuell verschiebbaren Stativen auch radgestützte Versuchsträger (Roboter, Geräteträger und Traktoren) oder luftgestützte Plattformen (Drohnen, Hubschrauber, Flugzeuge, Satelliten) jeweils bemannt oder unbemannt zum Einsatz. Je nach Trägerplattform variiert der Messaufbau, der Abstand zwischen Sensor und Pflanze, der Durchsatz und somit die Auflösung bzw. die Möglichkeit, Details zu erkennen.

Im folgenden Text werden Versuche mit drei unterschiedlichen experimentellen Trägerplattformen – (i) stativgebunden, (ii) auf einer mobilen Verfahreinheit mit Linearachse (Phytobike) und (iii) Drohne – dargestellt, um pflanzliche Parameter auf verschiedenen Skalenebenen im Feld zu untersuchen. Mit einer Drohne wurde in Zuckerrüben der Bedeckungsgrad quantifiziert, während mit Stativmessungen eine Unterscheidung zwischen gesunden und mit Cercospora beticola inokulierten Parzellen dargestellt wurde. Der geringste Abstand zwischen Pflanze und Sensor wird mit dem System Phytobike erreicht. Damit konnten auf Weizenblättern Gelbrostsymptome detektiert und quantifiziert werden.
Legionella in factory water systems – a regulated future
Authors: Bergwall Christer
Published: December 2019

Legionella are pathogenic fresh water bacteria in natural and manmade water systems with a unique water-to-air transmission route. The water temperature is an important factor influencing the colonisation of water systems. Potential critical areas are cooling water, wet scrubbers, sanitary water systems, and aerobic part of wastewater treatment plants. The most recent legislation in Europe, 42nd German Federal Immission Control Act, regulates the technical and organizational requirements for the operators of evaporative cooling, cooling towers, and wet scrubber systems. The regulation specifies two test and one action limit for Legionella and the required measures when exceeding each limit. The reference method, ISO 11731:2017, has disadvantages e.g. analysis time of 7–10d and interfering non-Legionella bacteria that can give false negative results. Alternative methods includes quantitative PCR and fluorescence in situ hybridisation (FISH). Both methods are suitable for in-house evaluation of Legionella. The operation of Legionella positive system is a challenge mainly due to significant resistance to biocides when the bacteria are associated with biofilms. Preventative and corrective actions with focus on cooling water systems are summarised.
Knockdown of CD-74 in the Proliferative and Apoptotic Activity of Breast Cancer Cells
Authors: Al Ssadh Hussain , Al Abdulmonem Waleed , Rasheed Zafar , Madar Inamul Hasan , Alhoderi Jamila , Eldeen Samah K Nasr , Alradhwan Ali , Alasmael Noura , Alkhamiss Abdullah , Fernández Nelson
Published: December 2019

BACKGROUND: The cluster of differentiation (CD) 74 is known for its immunological functions and its elevated level was reported in various cancer cells.
AIM: The aim of the present study was to investigate the expression and potential roles of CD74 in the proliferative and apoptotic activity of breast cancer.
METHODS: Expression of CD74, macrophage migration inhibitory factor (MIF) and CD44 was assayed in CAMA-1 and MDA-MB-231 cell lines using flow cytometry. CD74 was knocked down using CD74 siRNA-transfection in CAMA-1, and MDA-MB-231 cells and proliferation and apoptosis were determined in the transfected breast cancer cells.
RESULTS: The data showed that CD74, MIF and CD44 were expressed in breast cancer cell lines and were associated with cell proliferation and apoptosis. Correlation analysis revealed that CD74 was positively correlated and colocalised with MIF on the cell-surface of CAMA-1 and MDA-MB-231. The knockdown of CD74 significantly reduced CAMA-1 and MDA-MB-231 cell proliferation and increased the level of apoptotic cells.
CONCLUSION: We concluded that the interactions of CD74 with MIF and CD74 with CD44 could be a potential tumour marker for breast cancer cells. Moreover, the level of co-expression of MIF and CD74 or CD44 could be a surrogate marker for the efficacy of anti-angiogenic drugs, particularly in breast cancer tumours. In short, the study revealed the potential roles of CD74 in the proliferation and apoptosis of breast cancer which may serve as a potential therapeutic target for breast cancer.