bluuebunny/crossref_metadata_2025_split huggingface dataset:
Trout Fishing and Red Herring: The Meaning of Going Wild in Percival Everett’sDamned If I Do
Authors: Dumas Frédéric 
Published: July 2013

Abstract:The article explores the complex notion of wildness that characterizes the twelve stories of Percival Everett’s Damned If I Do and examines the palindromic nature of meaning that sheds light on the coherence of the collection. Everett’s stories belong to a literary tradition, dating back to the nineteenth century, that celebrates life in an almost Edenic Western landscape. The violence, the humour, and the flights of creative fancy that characterize Damned If I Do point to an understanding of the wilderness that informs both the diegetic world and the textual nature of that world.
The Real and the Unreal, or the Endogenous and the Exogenous: The Case of Walk Me to the Distance and Wounded
Authors: Julien Claude 
Published: July 2013

Abstract: The article brings together two novels that were published twenty years apart: Percival Everett’s Walk Me to the Distance and Wounded. Although, of course, the two stories are marked by the different social concerns of their different periods, there is a clear thematic continuity that links them. Beyond each story’s particular journey, each is haunted by violence under several guises. No story speaks its author’s words or mind-set directly. Art is no didactic exercise. The article suggests, nevertheless, that fiction is a confrontation between endogenous forces (the author’s own stand) and various exogenous forces, ways, and attitudes the author declines to share.
Nuclear magnetic resonance study of sea-water freezing mechanisms: 1. Temperature dependence of relative brine content in sea ice
Authors: Mel’nichenko N.A. , Slobodyuk A.B. 
Published: July 2013

AbstractThe results of measuring relative brine content (Qlm) in the liquid phase of frozen sea water at temperatures between −2°C and −43°C with variable rate and direction of temperature change are presented. Various pulsed and steady-state nuclear magnetic resonance (NMR) methods are used and the results are compared with data in the literature. Temperature dependences of Qlm in sea water with dry NaCl added are given. Quasi-hysteresis corresponding to the crystallization range of certain seawater salts, mainly NaCl, which partially precipitates as the crystalline hydrate NaCl·2H2O at temperatures below −23°C, is detected in the temperature dependence of Qlm. The reasons why Qlm values, under various experimental conditions, differ from data in the literature are explained. Brine salinity (S) is calculated from the relative intensity of NMR signals of Ql, and agrees well with previously published data over a wide temperature range. It is shown that determining Qlm from base measurements of Ql in ice does not require information about brine salinity. Empirical equations for calculating brine content at different sea-water temperatures and salinity are given.
Nuclear magnetic resonance study of sea-water freezing mechanisms: 2. Temperature dependence of relaxation time of protons in sea-ice brine
Authors: Mel’nichenko N.A. 
Published: July 2013

AbstractResults of determinations of proton magnetic relaxation time (T1) in the liquid phase of frozen sea water at temperatures between −2°C and −38°C, with variable rate and direction of temperature change, are presented. Temperature hysteresis corresponding to the crystallization range of certain sea-water salts, mainly NaCl which partially precipitates as the crystalline hydrate NaCl.°2H2O at temperatures below −23°C, is detected in the temperature dependence of T1, as in the analogous dependence of brine content. It is shown that formation of crystalline hydrates in brine is preceded by complete solvation of ions at −5 to −6°C. The main causes of hysteresis in temperature dependence of T1 and the extension of loop limits compared with the analogous loop for liquid brine content are indicated. Additional potentialities of using the nuclear magnetic resonance method for investigating sea-ice properties are presented.
Treatment of Enterococcal Peritonitis with Intraperitoneal Daptomycin in a Vancomycin-Allergic Patient and a review of the literature
Authors: Gilmore James F. , Kim Miae , LaSalvia Mary T. , Mahoney Monica V. Golik 
Published: July 2013

Background Intraperitoneal (IP) administration of antibiotics is a mainstay of therapy in the treatment of peritoneal dialysis–related peritonitis. The therapeutic options against gram-positive organisms in patients intolerant to vancomycin are limited. Methods This case report and review of the literature used a search of PubMed with the terms “daptomycin,” “intraperitoneal,” and “peritoneal” for 2004 through 7 February 2013 to find relevant publications. Results In addition to our patient, we identified 6 case reports of IP daptomycin for the treatment of peritonitis. Our patient was treated with a 14-day course of IP daptomycin, with resolution of signs and symptoms of peritonitis. She presented again 7 weeks later with signs and symptoms of peritonitis and was treated with a repeat course of IP daptomycin. Among the 6 patients reported in the literature, 4 received loading doses of daptomycin. Daptomycin 20 mg per liter of dialysate was administered in 4 patients, and the other 2 patients received higher doses based on body weight (milligrams per kilogram). Treatment duration averaged 10 or 14 days. In all 6 cases, clinical cure was reported. Conclusions Although limited to case reports, the available literature suggests that IP daptomycin is a viable alternative for peritoneal dialysis–related peritonitis. However, routine use of this agent must be cautioned, because further prospective studies are required.
L'intégration professionnelle des travailleurs âgés : le cas d'Électricité Réseau Distribution France
Authors: Guérin Serge , Urasadettan Jennifer , Saint-Germes Ève 
Published: July 2013

L’ensemble des pays occidentaux fait face à la problématique du maintien en emploi des travailleurs âgés de plus de 50 ans. Dans ce contexte, de nombreuses dispositions légales ont été instituées pour reculer l’âge de la retraite et pour pousser les entreprises à améliorer le taux d’activité des salariés âgés. Quelles sont les incidences de la loi française sur la gestion et l’intégration des travailleurs âgés dans les entreprises françaises ? Après avoir rappelé les obligations légales en matière de négociation d’Accords et plans d’actions seniors (APAS) depuis 2010, cet article décrit de quelle manière une grande société française, Électricité Réseau Distribution France (ERDF), a réalisé un diagnostic et fait évoluer ses pratiques afin d’améliorer l’intégration des salariés âgés de plus de 50 ans. Pour relever ce défi, l’entreprise doit aller au-delà de la loi et repenser la relation avec tous ses salariés.
Experiential Leadership Training for Pediatric Chief Residents: Impact on Individuals and Organizations
Authors: Doughty Robert A. , Williams Patricia D. , Brigham Timothy P. , Seashore Charles 
Published: July 2013

AbstractBackgroundThe past decade has seen a proliferation of leadership training programs for physicians that teach skills outside the graduate medical education curriculum.ObjectiveTo 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.MethodsThe 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.ResultsNinety-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.ConclusionThe study demonstrates a perceived positive impact on CRTP participants and their programs and institutions in the short and long term.
Organized Continuity Panel Reassignment
Authors: Bennett Kevin , Baxley Elizabeth , Carter Charles , Stanek Michele 
Published: July 2013

Abstract

Background
Structured continuity clinical experience is required in all primary care residency programs. There is a paucity of data on whether continuity patient panels are routinely used, what the ideal panel composition is, how panels are managed within residency programs across the country, and the outcomes related to this training requirement.

Methods
We designed an organized continuity panel reassignment process with the goal of producing balanced resident panels, that is, panels with similar numbers of patients by race/ethnicity, sex, and age group, as well as comparable numbers of patients with diabetes and those with high health care use. This project focused on postgraduate year-1 (PGY-1) panels to use balanced panels for redesign and focus of their initial training experiences on practice-based learning and patient care continuity.

Results
Findings suggest improved parity in patient care experiences through more evenly distributed panels. Furthermore, the focus on panel review and case management enhanced the curriculum for PGY-1 residents, whose clinical experiences and diabetes clinical quality indicators compared more favorably to residents in earlier classes.

Conclusions
Balanced continuity panels provide an enhanced substrate for building clinical curricula. Preliminary data suggest that this process helped contribute to improved quality indicators for patients with diabetes.
Use of a Policy Debate to Teach Residents About Health Care Reform
Authors: Nguyen Vu Q. C , Hirsch Mark A 
Published: July 2013

Abstract

Background
Resident education involves didactics and pedagogic strategies using a variety of tools and technologies in order to improve critical thinking skills. Debating is used in educational settings to improve critical thinking skills, but there have been no reports of its use in residency education. The present paper describes the use of debate to teach resident physicians about health care reform.

Objective
We aimed to describe the method of using a debate in graduate medical education.

Methods
Second-year through fourth-year physical medicine and rehabilitation residents participated in a moderated policy debate in which they deliberated whether the United States has one of the “best health care system(s) in the world.” Following the debate, the participants completed an unvalidated open-ended questionnaire about health care reform.

Results
Although residents expressed initial concerns about participating in a public debate on health care reform, all faculty and residents expressed that the debate was robust, animated, and enjoyed by all. Components of holding a successful debate on health care reform were noted to be: (1) getting “buy-in” from the resident physicians; (2) preparing the debate; and (3) follow-up.

Conclusion
The debate facilitated the study of a large, complex topic like health care reform. It created an active learning process. It encouraged learners to keenly attend to an opposing perspective while enthusiastically defending their position. We conclude that the use of debates as a teaching tool in resident education is valuable and should be explored further.
Residents' Attitudes and Behaviors Regarding Care for Underserved Patients: A Multi-Institutional Survey
Authors: Wieland Mark L , Beckman Thomas J , Cha Stephen S , Beebe Timothy J , McDonald Furman S ,   for the Underserved Care Curriculum Collaborative
Published: July 2013

Abstract

Background
Resident physicians often encounter underprivileged patients before other providers, yet little is known about residents' attitudes and behaviors regarding these patients.

Objective
To measure US resident physician attitudes regarding topics relevant to medically underserved patients, their behaviors (volunteerism) with underserved patients, and the association between attitudes and behaviors.

Methods
In 2007 and 2008, 956 surveys on resident attitudes and behaviors about underserved patients were distributed to 18 residency programs in the United States. Survey content was based on existing literature and an expert needs assessment. The attitude assessment had 15 items with 3-point scales (range 0–1). The behavior assessment evaluated volunteering for underserved patients in the past, present, and future.

Results
A total of 498 surveys (response rate  =  52%) were completed. Attitudes regarding underserved patients were generally positive and more favorable for women than men (overall attitude score 0.83 versus 0.74; P  =  &lt; .001). Rates of volunteering for underserved patients were high in medical school (N  =  375, 76%) and anticipated future practice (N  =  409, 84%), yet low during residency (N  =  95, 19%). Respondents who volunteered regularly had more favorable attitudes than those who did not volunteer (overall average attitude score of 0.81 versus 0.73; P  =  &lt;.001). Relationships between hours volunteered per-week and favorable attitudes about topics related to the underserved were significant across all 15 items in medical school and anticipated future practice (P value range of .035 to &lt;.0001).

Conclusions
This survey revealed that US residents' attitudes towards topics regarding medically underserved populations are generally favorable. Rates of volunteerism for underserved patients were higher in medical school than during residency, and resident's anticipated rates of volunteerism in future practice volunteerism were approximately the same as rates of volunteerism in medical school. Resident attitudes are strongly correlated with volunteerism.
Development, Testing, and Implementation of the ACGME Clinical Learning Environment Review (CLER) Program
Authors: Weiss Kevin B. , Wagner Robin , Nasca Thomas J. 
Published: July 2013

Abstract
Since the release of the Institute of Medicine's report on resident hours and patient safety, there have been calls for enhanced institutional oversight of duty hour limits and of efforts to enhance the quality and safety of care in teaching hospitals. The ACGME has established the Clinical Learning Environment Review (CLER) program as a key component of the Next Accreditation System with the aim to promote safety and quality of care by focusing on 6 areas important to the safety and quality of care in teaching hospitals and the care residents will provide in a lifetime of practice after completion of training. The 6 areas encompass engagement of residents in patient safety, quality improvement and care transitions, promoting appropriate resident supervision, duty hour oversight and fatigue management, and enhancing professionalism.
Over the coming 18 months the ACGME will develop, test, and fully implement this new program by conducting visits to the nearly 400 clinical sites of sponsoring institutions with two or more specialty or subspecialty programs. These site visits will provide an understanding of how the learning environment for the 116 000 current residents and fellows addresses the 6 areas important to safety and quality of care, and will generate baseline data on the status of these activities in accredited institutions. We expect that over time the CLER program will serve as a new source of formative feedback for teaching institutions, and generate national data that will guide performance improvement for United States graduate medical education.
To Play or Not To Play: Leveraging Video in Medical Education
Authors: Hurtubise Larry , Martin Bryan , Gilliland Anne , Mahan John 
Published: July 2013

AbstractWhile video is a powerful teaching and learning tool because it can influence knowledge, skills, and attitude formation effectively and reach learners with various learning and communication styles, there are pedagogical, technical, and copyright considerations. Instructors must know sources of appropriate videos, select effective video segments, apply various strategies for incorporating video triggers into the overall educational process, refine the message, overcome technological obstacles, and comply with copyright laws. One might ask, “Is using video triggers to improve your teaching worth it?” “Yes!” Numerous studies demonstrate that using video in many medical education settings supports and enhances learning and offers a bigger advantage in contrast with traditional methods.
Educational Milestone Development in the First 7 Specialties to Enter the Next Accreditation System
Authors: Swing Susan R. , Beeson Michael S. , Carraccio Carol , Coburn Michael , Iobst William , Selden Nathan R. , Stern Peter J. , Vydareny Kay 
Published: July 2013

Abstract

Background
The Accreditation Council for Graduate Medical Education (ACGME) Outcome Project introduced 6 general competencies relevant to medical practice but fell short of its goal to create a robust assessment system that would allow program accreditation based on outcomes. In response, the ACGME, the specialty boards, and other stakeholders collaborated to develop educational milestones, observable steps in residents' professional development that describe progress from entry to graduation and beyond.

Objectives
We summarize the development of the milestones, focusing on 7 specialties, moving to the next accreditation system in July 2013, and offer evidence of their validity.

Methods
Specialty workgroups with broad representation used a 5-level developmental framework and incorporated information from literature reviews, specialty curricula, dialogue with constituents, and pilot testing.

Results
The workgroups produced richly diverse sets of milestones that reflect the community's consideration of attributes of competence relevant to practice in the given specialty. Both their development process and the milestones themselves establish a validity argument, when contemporary views of validity for complex performance assessment are used.

Conclusions
Initial evidence for validity emerges from the development processes and the resulting milestones. Further advancing a validity argument will require research on the use of milestone data in resident assessment and program accreditation.
Subtest Scores From the In-Training Examination: An Evaluation Tool for an Obstetric-Anesthesia Rotation
Authors: Gaiser Robert 
Published: July 2013

Abstract

Objective
To evaluate resident performance in the obstetric-anesthesia rotation using resident portfolios and their In-Training Examination scores, which are provided by the American Board of Anesthesiology/American Society of Anesthesiologists.

Methods
We reviewed academic portfolios for second- and third-year anesthesiology residents at a single institution from 2006–2008 to examine United States Medical Licensing Exam Step 1 and 2 scores, grade for obstetrics-gynecology in medical school, and performance on the In-Training Examination. Faculty evaluation of medical knowledge and correlations for the various scores were obtained.

Results
We examined scores for 43 residents. The subtest score for obstetric anesthesia increased after completing a rotation in obstetric anesthesia, 26.1 ± 10.3 versus 36.3 ± 10.6 (P  =  .02). The subtest score correlated with United States Medical Licensing Exam Step 2, r  =  0.46 (P  =  .027) but not with United States Medical Licensing Exam Step 1 or with the grade obtained in medical school. There was no correlation between faculty evaluations of medical knowledge and resident subtest scores in obstetric anesthesia.

Conclusions
Subtest scores in obstetric anesthesia are valid and provide a tool for the assessment of the educational program of a rotation. Knowledge as assessed by a faculty member is different from the knowledge assessed on a written examination. Both methods can help provide a more complete assessment of the resident and the rotation.
Residents as Role Models: The Effect of the Obstetrics and Gynecology Clerkship on Medical Students' Career Interest
Authors: Chang Judy C. , Odrobina Michele R. , McIntyre-Seltman Kathleen 
Published: July 2013

Abstract

Background
Medical students' choice of residency specialty is based in part on their clerkship experience. Postclerkship interest in a particular specialty is associated with the students' choice to pursue a career in that field. But, many medical students have a poor perception of their obstetrics and gynecology clerkships.

Objective
To determine whether fourth-year medical students' perceptions of teaching quality and quantity and amount of experiential learning during the obstetrics-gynecology clerkship helped determine their interest in obstetrics-gynecology as a career choice.

Methods
We distributed an anonymous, self-administered survey to all third-year medical students rotating through their required obstetrics and gynecology clerkship from November 2006 to May 2007. We performed bivariate analysis and used χ2 analysis to explore factors associated with general interest in obstetrics and gynecology and interest in pursuing obstetrics and gynecology as a career.

Results
Eighty-one students (N  =  91, 89% response rate) participated. Postclerkship career interest in obstetrics and gynecology was associated with perceptions that the residents behaved professionally (P &lt; .0001) and that the students were treated as part of a team (P  =  .008). Having clear expectations on labor and delivery procedures (P  =  .014) was associated with postclerkship career interest. Specific hands-on experiences were not statistically associated with postclerkship career interest. However, performing more speculum examinations in the operating room trended toward having some influence (P  =  .068). Although more women than men were interested in obstetrics and gynecology as a career both before (P  =  .027) and after (P  =  .014) the clerkship, men were more likely to increase their level of career interest during the clerkship (P  =  .024).

Conclusions
Clerkship factors associated with greater postclerkship interest include higher satisfaction with resident professional behavior and students' sense of inclusion in the clinical team. Obstetrics and gynecology programs need to emphasize to residents their role as educators and professional role models for medical students.