bluuebunny/crossref_metadata_2025_split huggingface dataset:
Continuity Clinic Model and Diabetic Outcomes in Internal Medicine Residencies: Findings of the Educational Innovations Project Ambulatory Collaborative
Authors: Francis Maureen D. , Julian Katherine A. , Wininger David A. , Drake Sean , Bollman KeriLyn , Nabors Christopher , Pereira Anne , Rosenblum Michael , Zelenski Amy B. , Sweet David , Thomas Kris , Varney Andrew , Warm Eric , Francis Mark L. 
Published: December 2015

ABSTRACT

Background
Efforts to improve diabetes care in residency programs are ongoing and in the midst of continuity clinic redesign at many institutions. While there appears to be a link between resident continuity and improvement in glycemic control for diabetic patients, it is uncertain whether clinic structure affects quality measures and patient outcomes.

Methods
This multi-institutional, cross-sectional study included 12 internal medicine programs. Three outcomes (glycemic control, blood pressure control, and achievement of target low-density lipoprotein [LDL]) and 2 process measures (A1C and LDL measurement) were reported for diabetic patients. Traditional, block, and combination clinic models were compared using analysis of covariance (ANCOVA). Analysis was adjusted for continuity, utilization, workload, and panel size.

Results
No significant differences were found in glycemic control across clinic models (P = .06). The percentage of diabetic patients with LDL &lt; 100 mg/dL was 60% in block, compared to 54.9% and 55% in traditional and combination models (P = .006). The percentage of diabetic patients with blood pressure &lt; 130/80 mmHg was 48.4% in block, compared to 36.7% and 36.9% in other models (P &lt; .001). The percentage of diabetic patients with HbA1C measured was 92.1% in block compared to 75.2% and 82.1% in other models (P &lt; .001). Also, the percentage of diabetic patients with LDL measured was significantly different across all groups, with 91.2% in traditional, 70.4% in combination, and 83.3% in block model programs (P &lt; .001).

Conclusions
While high scores on diabetic quality measures are achievable in any clinic model, the block model design was associated with better performance.
Outcomes of a Novel Training Program for Physician-Scientists: Integrating Graduate Degree Training With Specialty Fellowship
Authors: Wong Mitchell D. , Guerrero Lourdes , Sallam Tamer , Frank Joy S. , Fogelman Alan M. , Demer Linda L. 
Published: December 2015

ABSTRACT

Background
Although physician-scientists generally contribute to the scientific enterprise by providing a breadth of knowledge complementary to that of other scientists, it is a challenge to recruit, train, and retain physicians in a research career pathway.

Objective
To assess the outcomes of a novel program that combines graduate coursework and research training with subspecialty fellowship.

Methods
A retrospective analysis was conducted of career outcomes for 123 physicians who graduated from the program during its first 20 years (1993–2013). Using curricula vitae, direct contact, and online confirmation, data were compiled on physicians' subsequent activities and careers as of 2013. Study outcomes included employment in academic and nonacademic research, academic clinical or private practice positions, and research grant funding.

Results
More than 80% of graduates were actively conducting research in academic, institutional, or industrial careers. The majority of graduates (71%) had academic appointments; a few (20%) were in private practice. Fifty percent had received career development awards, and 19% had received investigator-initiated National Institutes of Health (NIH) R01 or equivalent grants. Individuals who obtained a PhD during subspecialty training were significantly more likely to have major grant funding (NIH R series or equivalent) than those who obtained a Master of Science in Clinical Research. Trainees who obtained a PhD in a health services or health policy field were significantly more likely to have research appointments than those in basic science.

Conclusions
Incorporation of graduate degree research, at the level of specialty or subspecialty clinical training, is a promising approach to training and retaining physician-scientists.
Automation Improves Schedule Quality and Increases Scheduling Efficiency for Residents
Authors: Perelstein Elizabeth , Rose Ariella , Hong Young-Chae , Cohn Amy , Long Micah T. 
Published: December 2015

ABSTRACT

Background
Medical resident scheduling is difficult due to multiple rules, competing educational goals, and ever-evolving graduate medical education requirements. Despite this, schedules are typically created manually, consuming hours of work, producing schedules of varying quality, and yielding negative consequences for resident morale and learning.

Objective
To determine whether computerized decision support can improve the construction of residency schedules, saving time and improving schedule quality.

Methods
The Optimized Residency Scheduling Assistant was designed by a team from the University of Michigan Department of Industrial and Operations Engineering. It was implemented in the C.S. Mott Children's Hospital Pediatric Emergency Department in the 2012–2013 academic year. The 4 metrics of schedule quality that were compared between the 2010–2011 and 2012–2013 academic years were the incidence of challenging shift transitions, the incidence of shifts following continuity clinics, the total shift inequity, and the night shift inequity.

Results
All scheduling rules were successfully incorporated. Average schedule creation time fell from 22 to 28 hours to 4 to 6 hours per month, and 3 of 4 metrics of schedule quality significantly improved. For the implementation year, the incidence of challenging shift transitions decreased from 83 to 14 (P &lt; .01); the incidence of postclinic shifts decreased from 72 to 32 (P &lt; .01); and the SD of night shifts dropped by 55.6% (P &lt; .01).

Conclusions
This automated shift scheduling system improves the current manual scheduling process, reducing time spent and improving schedule quality. Embracing such automated tools can benefit residency programs with shift-based scheduling needs.
National Trends in Carpal Tunnel Release and Hand Fracture Procedures Performed During Orthopaedic Residency: An Analysis of ACGME Case Logs
Authors: Hinds Richard M. , Gottschalk Michael B. , Capo John T. 
Published: December 2015

ABSTRACT

Background
Mastery in performing carpal tunnel release (CTR) and hand fracture procedures is an essential component of orthopaedic residency training.

Objective
To assess orthopaedic resident case log data for temporal trends in CTR and hand fracture cases and to determine the degree of variability in case volume among residents.

Methods
Accreditation Council for Graduate Medical Education orthopaedic surgery resident case logs were reviewed for graduation years 2007 through 2014. Annual data regarding the mean number of CTR and hand fracture/dislocation procedures were recorded, as well as the median number of procedures reported by the top and bottom 10% of residents (by case volume). Temporal trends were assessed using linear regression modeling.

Results
There was no change in the mean number of CTRs performed per resident. Over the 8-year period, the top 10% of residents performed a significantly greater number of CTRs than the bottom 10% (62.1 versus 9.3, P &lt; .001). Similarly, no change was noted in the mean number of total hand fracture/dislocation cases performed, with the top 10% of residents performing significantly more hand fracture cases than the bottom 10% (47.1 versus 9.3, P &lt; .001).

Conclusions
Our results indicate no change in CTR and hand fracture caseload for orthopaedic residents. However, as resident experience performing both procedures varies significantly, this variability likely has important educational implications.
A Strategic Approach to Implementation of Medical Mentorship Programs
Authors: Caruso Thomas J. , Steinberg Diane H. , Piro Nancy , Walker Kimberly , Blankenburg Rebecca , Rassbach Caroline , Marquez Juan L. , Katznelson Laurence , Dohn Ann 
Published: December 2015

ABSTRACTBackgroundMentors influence medical trainees' experiences through career enhancement and psychosocial support, yet some trainees never receive benefits from involved mentors.ObjectiveOur goals were to examine the effectiveness of 2 interventions aimed at increasing the number of mentors in training programs, and to assess group differences in mentor effectiveness, the relationship between trainees' satisfaction with their programs given the presence of mentors, and the relationship between the number of trainees with mentors and postgraduate year (PGY).MethodsIn group 1, a physician adviser funded by the graduate medical education department implemented mentorships in 6 residency programs, while group 2 involved a training program with funded physician mentoring time. The remaining 89 training programs served as controls. Chi-square tests were used to determine differences.ResultsSurvey responses from group 1, group 2, and controls were 47 of 84 (56%), 34 of 78 (44%), and 471 of 981 (48%, P = .38), respectively. The percentages of trainees reporting a mentor in group 1, group 2, and the control group were 89%, 97%, and 79%, respectively (P = .01). There were no differences in mentor effectiveness between groups. Mentored trainees were more likely to be satisfied with their programs (P = .01) and to report that faculty supported their professional aspirations (P = .001). Across all programs, fewer first-year trainees (59%) identified a mentor compared to PGY-2 through PGY-8 trainees (84%, P &lt; .001).ConclusionsA supported mentorship program is an effective way to create an educational environment that maximizes trainees' perceptions of mentorship and satisfaction with their training programs.
Ethnicity, Indigeneity and Indigenous Rights: The ‘Orang Asli’ Experience
Authors: Subramaniam Yogeswaran 
Published: December 2015

<em>Orang Asli, the Indigenous minority of Peninsular Malaysia, continue to face formidable challenges in realizing their rights as distinct Indigenous peoples despite being ascribed a measure of constitutional and statutory protection. With reference the 2007 United Nations Declaration on the Rights of Indigenous People and various international definitions of ‘Indigenous peoples’, this paper examines the impact of the term ‘Orang Asli’ on the Orang Asli struggle for the recognition of their rights as Indigenous Peoples. The term ‘Orang Asli’, an officially-constructed term to describe heterogeneous groups of people considered to be ‘aboriginal’, has since gained acceptance by the people categorized as such and has been used to advocate their rights as Indigenous peoples with relative success. However, the term carries legal implications which continue to place Orang Asli ethnicity and identity under the protection and equally, the control of the state. The extensive legal powers possessed by the state are arguably inconsistent of international norms on Indigenos rights and can additionally function as a tool to deny Orang Asli their attendant rights as Indigenous peoples. More importantly, the continued existence of these powers potentially functions to reinforce existing domestic challenges that Orang Asli face in finding their rightful place as distinct Indigenous peoples in the light of: (1) competing notions of Indigeneity vis-à-vis ethnic Malays; (2) historical discrimination against Orang Asli that continues to persist; and (3) Indigenous rights being construed as a possible hindrance to national economic prosperity. A possible starting point for the reconciliation of these matters may be to legally clarify the term ‘Orang Asli’ in a manner that sustains and respects the Orang Asli community as distinct Indigenous peoples while not threatening the existing special constitutional position afforded to ethnic Malays.</em>
Save the Reef! Civic Crowdfunding and Public Interest Environmental Litigation
Authors: Hamman Evan 
Published: December 2015

<h2><em><span>This article looks at the emerging area of civic crowdfunding, a subset of crowdfunding, as a means of financing public interest environmental litigation. The literature surrounding civic crowdfunding and third party litigation funding is currently underdeveloped. The link between those areas and public interest environmental litigation takes a further step into the unknown. As a case study, the Sea Dumping Case presents exciting opportunities for civil society and access to justice, but further research is needed before any firm conclusions can be drawn.</span></em></h2>
Les liens entre le jugement de l’enseignant sur les biais d’autoévaluation de compétence de l’élève et la qualité de leur relation
Authors: Lévesque-Guillemette Rebecca , Bouffard Thérèse , Vezeau Carole 
Published: December 2015

Cette étude a deux objectifs : 1) examiner le jugement porté par les enseignants sur le caractère utile ou nuisible des biais d’autoévaluation de compétence de leurs élèves et 2) vérifier si ce jugement était lié à la qualité de la relation rapportée par eux et leurs élèves. 49 enseignants de 6e année du primaire et leurs 277 élèves (128 filles) ont répondu à un questionnaire en classe. Les résultats indiquent qu’une majorité d’enseignants considère préférable qu’un élève surévalue ses capacités plutôt que l’inverse. Ils montrent aussi que les élèves sous-évaluant leurs capacités rapportent une relation plus chaleureuse avec leur enseignant lorsque celui-ci croit qu’une telle sous-évaluation est positive. La qualité de la relation rapportée par les enseignants de ces mêmes élèves est aussi meilleure que celle qu’ils disent entretenir avec les autres élèves. Ces résultats suggèrent l’importance de poursuivre l’examen des croyances des enseignants sur les biais d’autoévaluation de compétence des élèves.
Sous quelles conditions les représentations graphiques externes peuvent-elles favoriser l’apprentissage des enfants d’âge préscolaire ?
Authors: Matalliotaki Eirini , Boilevin Jean-Marie 
Published: December 2015

Cet article théorique vise à déterminer à quelles conditions l’utilisation des représentations graphiques externes facilite l’apprentissage chez les jeunes enfants, afin de proposer un modèle théorique de conception de tâches cognitivement efficaces pour l’apprentissage. Nous avons repéré trois notions que nous considérons comme essentielles dans le processus d’apprentissage de et à travers la fonction symbolique des représentations graphiques : la décontextualisation, la métacognition et le statut de représentation des représentations graphiques. La synthèse théorique de ces notions, illustrée par des exemples empiriques sur des tâches en mathématiques avec des dessins, conduit à la conception d’un modèle théorique de préparation de tâches qui devrait faciliter l’apprentissage à travers les représentations symboliques. Ce modèle pourrait être applicable dans le domaine des sciences ou sur des données textuelles pour produire des inférences. L’objectif à long terme est de faciliter l’accès des enfants à la conception et à la compréhension des représentations symboliques plus tard dans leur scolarité.
La relation entre les connaissances et les attitudes concernant la diversité sexuelle chez les futurs enseignants au Québec
Authors: Franco Morales Freddy , Venet Michèle , Correa Molina Enrique 
Published: December 2015

Cette étude s’intéresse aux attitudes du futur personnel enseignant envers les personnes homosexuelles et bisexuelles, en lien avec ses connaissances sur la diversité des rôles et des comportements sexuels ainsi que sur les réalités des jeunes homosexuels et bisexuels des deux sexes. L’échantillon, composé de 82 étudiantes et étudiants québécois du Baccalauréat en enseignement secondaire, a été invité à remplir un questionnaire comportant deux échelles de 51 et 14 items afin d’évaluer respectivement leurs connaissances et leurs attitudes. Les résultats des analyses descriptives indiquent que le futur personnel enseignant a peu de connaissances sur les trois aspects évalués, et qu’il manifeste des attitudes plus ou moins positives envers les personnes homosexuelles et bisexuelles. De plus, les résultats des analyses corrélationnelles montrent qu’il existe une relation positive entre les connaissances sur les rôles et comportements sexuels et les attitudes de l’échantillon. Enfin, l’étude identifie des pistes relatives à la formation du personnel enseignant.
The Politics of the Senate Reform Reference: Fidelity, Frustration, and Federal Unilateralism
Authors: Dodek Adam 
Published: December 2015

References are the most political of cases, almost always involving high profile public policy issues. Frequently, references are brought to obtain rulings on the relationship between the federal government and the provinces. Less frequently, references involve questions of interbranch relations, that is, between two or more of the executive, legislative, and judicial branches of government. The Senate Reform Reference was one of the rare cases that featured each of these three elements. This article analyzes the Senate Reform Reference on several political levels. First, it situates the reference in terms of megaconstitutional politics, the long-held Canadian practice of attempting to resolve constitutional issues through formal and often high-profile negotiations between the federal and provincial governments. Such interactions have been anathema to the Harper government which has preferred unilateral political action to negotiated political agreement. The article then examines interparty politics or the relationship between the Harper government and the opposition parties during the period of minority government (2006–2011). This is the period during which one would have expected the government to bring a reference because of its inability to obtain support from the other parties in the House of Commons and the Senate for its proposed legislation on the Senate. However, it did not. This leads to an examination of the third issue: intra-party politics or the politics within the governing party, the Conservative Party of Canada. Finally, the article discusses legal politics and how the government of Québec essentially forced the federal government’s hand by bringing its own reference to the Québec Court of Appeal. The overarching framework of interbranch politics—the relationship between the executive, legislative and judicial branches of government—is examined throughout the article.
Le fédéralisme comme principe matriciel dans l’interprétation de la procédure de modification constitutionnelle
Authors: Mathieu Catherine , Taillon Patrick 
Published: December 2015

Rendus à quelques semaines d’intervalle, le Renvoi relatif à la réforme du Sénat de même que le Renvoi relatif à la Loi sur la Cour suprême, art. 5 et 6 posent des limites importantes à l’action unilatérale d’Ottawa en matière de réforme des institutions, et ce, au nom d’un principe fondamental jouant un rôle matriciel dans l’interprétation de la procédure de modification constitutionnelle : le fédéralisme. À l’occasion de ces deux avis, la Cour a non seulement précisé le champ d’application des procédures multilatérales de modification de la partie V de la Loi constitutionnelle de 1982, mais elle a aussi tiré les conséquences qui s’imposent du principe fédéral. D’abord, sur le plan institutionnel, ce dernier principe constitue, non seulement une limite à l’action unilatérale d’Ottawa, mais aussi un facteur structurant l’ordonnancement juridique et un fondement à l’action de la Cour suprême du Canada. Puis, sur le plan du contenu du principe fédéral, la Cour suprême développe, à l’occasion des deux avis de 2014 relatifs à la procédure de modification, une réflexion plus formelle sur les dimensions consociatives du fédéralisme canadien dans le cadre desquelles la spécificité nationale du Québec et les arrangements spéciaux négociés en conséquence sont protégés, du moins partiellement, par la procédure de modification adoptée en 1982 sans l’accord du Québec. De ce fait, le principe fédéral s’impose comme un principe matriciel qui conditionne l’interprétation de la procédure de modification constitutionnelle et qui favorise le fédéralisme consociatif.
De la structure constitutionnelle dans le Renvoi relatif au Sénat : vers une gestalt constitutionnelle?
Authors: Karazivan Noura 
Published: December 2015

En matière d’interprétation constitutionnelle canadienne, l’analyse structurelle est traditionnellement entendue comme un procédé qui consiste à déduire des principes implicites à partir des structures gouvernementales. Cependant, on assiste depuis peu au développement d’une analyse structurelle orientée vers les institutions faisant partie de la structure constitutionnelle canadienne, sur l’identification de leurs rôles au sein de cette dernière, et sur la détermination des caractéristiques essentielles à leur bon fonctionnement. Cet article vise principalement à explorer cette seconde dimension, que l’auteure nomme la dimension relationnelle et fonctionnelle de l’analyse structurelle. Après avoir fait ressortir les liens que l’analyse structurelle entretient avec l’herméneutique juridique, l’auteure retrace les divers usages de la notion de structure constitutionnelle dans la jurisprudence de la Cour suprême précédant le Renvoi relatif au Sénat. L’auteure avance que c’est ce cadre d’analyse qui a été appliqué dans le Renvoi relatif au Sénat lorsque la Cour s’est penchée sur la question des élections consultatives des sénateurs. L’auteure formule ensuite trois observations critiques qui aspirent à susciter un débat plus large sur la légitimité du recours à ce type d’analyse. Ainsi, le choix du rôle de chambre de réflexion du Sénat, au détriment de celui de chambre fédérale, fera l’objet d’une première observation critique. Ensuite, la question du rôle des principes implicites au sein même de l’analyse structurelle sera examinée. Finalement, l’auteure abordera la question de l’interprétation progressiste du rôle fondamental d’une institution. Malgré ces observations, l’auteure conclut qu’en consacrant la dimension relationnelle et fonctionnelle de l’analyse structurelle, le Renvoi relatif au Sénat marque un tournant vers le développement d’une gestalt constitutionnelle. Il invite ainsi à identifier les diverses parties de la structure constitutionnelle canadienne, à cerner leurs rôles fondamentaux au sein de cette dernière, et à envisager de manière dynamique ce qui constitue le « tout » à partir duquel les parties se conçoivent. Comme la psychologie de la gestalt, le Renvoi relatif au Sénat fait de l’intégrité une valeur suprême en immunisant le « tout » contre les actions qui nuiraient au bon fonctionnement de ses parties, dans le respect de l’intégrité constitutionnelle canadienne.
Les libellules (Odonata) de Gatineau, Québec, d’hier à aujourd’hui
Authors: Piché Caroline , Hutchinson Raymond 
Published: December 2015

Gatineau, 4eville en importance au Québec, se situe au sud-ouest de la province, en bordure de la rivière des Outaouais. On y trouve au moins 87 espèces de libellules. Un inventaire fait en 2013 et 2014 a permis de documenter la constance, l’abondance relative et les indices de reproduction pour 82 d’entre elles. La comparaison des résultats avec l’odonatofaune historique (1886-1935) a révélé qu’au moins 90 % des espèces s’étaient maintenues depuis le tournant du 20esiècle. Huit espèces spécialistes, associées aux ruisseaux, aux rivières ou aux milieux humides temporaires pourraient cependant avoir décliné ou disparu. En revanche, au moins 7 espèces généralistes, pionnières et associées aux eaux stagnantes, toutes de la famille des Libellulidae à l’exception d’une Coenagrionide, y sont en expansion. Ces changements de l’odonatofaune pourraient être attribuables à l’étalement urbain. Les libellules, indicatrices de changements environnementaux, peuvent être facilement observées et surveillées dans le cadre de projets de science citoyenne.