bluuebunny/crossref_metadata_2025_split huggingface dataset:
The Associations Between Residents' Behavior and the Thomas-Kilmann Conflict MODE Instrument
Authors: Ogunyemi Dotun , Fong Susie , Elmore Geoff , Korwin Devra , Azziz Ricardo 
Published: March 2010

Abstract

Objective
To assess if the Thomas-Kilmann Conflict MODE Instrument predicts residents’ performance.

Study Design
Nineteen residents were assessed on the Thomas-Kilmann conflict modes of competing, collaborating, compromising, accommodating, and avoiding. Residents were classified as contributors (n  =  6) if they had administrative duties or as concerning (n  =  6) if they were on remediation for academic performance and/or professionalism. Data were compared to faculty evaluations on the Accreditation Council for Graduate Medical Education (ACGME) competencies. P value of &lt; .05 was considered significant.

Results
Contributors had significantly higher competing scores (58% versus 17%; P  =  .01), with lower accommodating (50% versus 81%; P 5 .01) and avoiding (32% versus 84%; P  =  .01) scores; while concerning residents had significantly lower collaborating scores (10% versus 31%; P  =  .01), with higher avoiding (90% versus 57%; P  =  .006) and accommodating (86% versus 65%; P  =  .03) scores.
There were significant positive correlations between residents’ collaborating scores with faculty ACGME competency evaluations of medical knowledge, communication skills, problem-based learning, system-based practice, and professionalism. There were also positive significant correlations between compromising scores and faculty evaluations of problem-based learning and professionalism with negative significant correlations between avoiding scores and faculty evaluations of problem-based learning, communication skills and professionalism.

Conclusions
Residents who successfully execute administrative duties are likely to have a Thomas-Kilmann profile high in collaborating and competing but low in avoiding and accommodating. Residents who have problems adjusting are likely to have the opposite profile. The profile seems to predict faculty evaluation on the ACGME competencies.
An Assessment Tool for Aseptic Technique in Resident Physicians: A Journey Towards Validation in the Real World of Limited Supervision
Authors: Lypson Monica L. , Hamstra Stanley J. , Ross Paula T. , Gruppen Larry D. , Colletti Lisa M. 
Published: March 2010

Abstract

Purpose
The purpose of this study was to describe the validation process for assessing an instrument to assess residents' aseptic technique skills.

Methods
The validation study entailed comparisons of the performance of aseptic technique procedures between postgraduate year–1 (PGY-1) surgical residents and PGY-2/3 surgical residents. We also compared the performance of PGY-1 surgical residents from 2 different academic years for the same procedures. Finally, we compared the performance of novices (medical students) and experts (operating room nurses) in an effort to determine validity.

Results
Our initial analysis found no significant difference between the performance of PGY-1 (mean score, 75.8) and PGY-2/3 (mean score, 75.6) surgical residents for aseptic technique (t(55)  =  0.84, P  =  0.404). Further investigation of validity was obtained to determine whether the no difference results reflected a lack of reliability or validity or a true equivalence between the 2 cohorts. The comparison of novices and experts produced the following findings. For reliability, the internal consistency of the checklist for each of the 2 raters was 0.87 and 0.71 (Cronbach α), interrater reliability was 0.74, with P &lt; 0.001 (intraclass correlation coefficient) for the global scale. (Internal consistency was done within instrument, ie, between items not between raters.) For validity, operating room nurses outperformed students on the global scale (t14  =  7.47, P &lt; 0.0001 and t(14)  =  10.66, P &lt; 0.0001 for the 2 raters, respectively) and on several checklist items. The effect size values for raters were large (Cohen d  =  3.0 and 4.4), providing validity evidence for the ability of this assessment to detect difference in performance on this task.

Conclusion
The validation study showed that the instrument exhibited reliability and evidence for validity, making it useful for the assesment of aseptic technique skills in different specialties. Programs may want to consider using a validated instrument to check competence given that appropriate use of sterile technique frequently occurs in the context of unsupervised activities. Further work is needed to enhance resident skills in the area of aspectic technique because of limited improvement despite additional clinical experience.
How Residents View Their Clinical Supervision: A Reanalysis of Classic National Survey Data
Authors: Baldwin De Witt C. , Daugherty Steven R. , Ryan Patrick M. 
Published: March 2010

Abstract

Background
Concerns over patient safety have made adequacy of clinical supervision an important component of care in teaching settings. Yet, few studies have examined residents' perceptions about the quality and adequacy of their supervision. We reanalyzed data from a survey conducted in 1999 to explore residents' perspectives on their supervision.

Methods
A national, multispecialty survey was distributed in 1999 to a 14.5% random sample of postgraduate year 2 (PGY-2) and PGY-3 residents. The response rate was 64.4%. Residents (n  =  3604) were queried about how often they had cared for patients “without adequate supervision” during their preceding year of training.

Results
Of responding residents, 21% (n  =  737) reported having seen patients without adequate supervision at least once a week, with 4.5% saying this occurred almost daily. Differences were found across specialties, with 45% of residents in ophthalmology, 46% in neurology, and 44% in neurosurgery stating that they had experienced inadequate supervision at least once a week throughout the year, compared with 1.5% of residents in pathology and 3% in dermatology. Inadequate supervision was found to be inversely correlated with residents' positive ratings of their learning, time with attendings, and overall residency experience (P &lt; .001 for all), and positively correlated with negative features of training, including medical errors, sleep deprivation, stress, conflict with other medical personnel, falsifying patient records, and working while impaired (P &lt; .001).

Conclusions
In residents' self-report, inadequate clinical supervision correlates with other reported negative aspects of training. Collectively, this may detrimentally affect resident learning and patient safety.
A Strategy to Reduce Interruptions at Hospital Morning Report
Authors: Wieland Mark L. , Loertscher Laura L. , Nelson Darlene R. , Szostek Jason H. , Ficalora Robert D. 
Published: March 2010

Abstract

Background
The learning atmosphere of hospital morning report is frequently interrupted by nonurgent beeper pages to participating residents.

Intervention
During 176 consecutive internal medicine morning reports, 1 of the 4 chief residents at a single academic medical center collected and answered house staff pages during the 30-minute conference.

Results
A total of 884 pages were answered during this period. Of these, 743 could wait until after the end of morning report, resulting in more than 4 interruptions averted per session. Over half of the pages were from nursing personnel. There was no significant decrease in the total number of pages or nurse pages during the observation period.

Discussion
In summary, our simple system of holding intern pages resulted in a dramatic reduction in interruptions during hospital morning report.
Disparity Between Resident and Attending Physician Perceptions of Intraoperative Supervision and Education
Authors: Levinson Kimberly L. , Barlin Joyce N. , Altman Kristiina , Satin Andrew J. 
Published: March 2010

Abstract

Background
As part of an ongoing evaluation of our residency program, a needs assessment was performed to assess resident and attending perspectives on current methods of surgical skills training in the operating room.

Methods
Participants included obstetrics-gynecology residents and faculty at a university program. Two surveys were developed and validated. Results were analyzed with 2-sample t tests, comparing Likert scores. Findings were significant if the difference between means was &gt;1.

Results
Thirty of 31 residents and 40 of 60 attending physicians responded to the survey. Residents and attending physicians agreed that the surgical skills training program needs improvement (difference in mean, −0.39; confidence interval [CI]: −0.98 to 0.20). The areas of most disagreement were regarding feedback on surgical skills and instrument handling (difference in mean, 2.53; CI: 1.81–3.26, and difference in mean, 2.24; CI: 1.44–3.05).

Conclusions
A significant proportion of surgical skills training during residency occurs as on-the-job training, and operating room time provides a key learning opportunity. This report demonstrates that there is a noteworthy difference in the perception of attending physicians and residents about the quality of teaching and feedback that is currently occurring in the operating room. The difference in perspectives among residents and attending physicians reported in this survey suggests a need for improved communication and systematic feedback in order to capitalize on operating room time as a critical surgical skills training arena.
Primary Production in Flowing Waters1
Authors: ODUM HOWARD T. 
Published: March 2010

Respiration, photosynthetic production, and diffusion interact to produce the daily curve of oxygen change in a segment of flowing water. Conversely, the observed curves of oxygen in streams can be used to calculate the component rates of production, respiration, and diffusion. New production values obtained with these analyses of oxygen curves from various sources, as well as a few previously existing estimates of primary production, indicate a generally higher rate of production in flowing waters than in other types of aquatic environments.The ratio of total primary production to total community respiration is used to classify communities quantitatively according to their predominantly heterotrophic or autotrophic characteristics. Longitudinal succession within a stream tends to modify the ratio towards unity from higher values for autotrophic and from lower values for heterotrophic communities. The behavior of this ratio is described for the annual cycle in a stream, for the sequence of pollution recovery, and for diverse types of communities.
The Accumulation and Exchange of Strontium by Marine Planktonic Algae1
Authors: RICE T. R. 
Published: March 2010

The radioactivity taken up by each of twelve species of algae, grown in a mixture of radioactive strontium and yttrium, was separated into that due to each isotope. This was accomplished by following the decay curve of the activity in the algae. The uptake of radioactive strontium and yttrium was followed at frequent intervals in Carteria cells grown in medium containing these two isotopes. The removal of yttrium from the medium by Carteria was shown to be due to adsorption on the surface, whereas strontium was taken into the cells.It was found that Carteria could not divide in the absence of calcium in the medium. Neither could strontium be substituted for calcium in the metabolism of Carteria cells. When other factors were kept constant, the amount of strontium removed by the cells was dependent upon the strontium concentration in the medium.With the radioisotopic dilution technique, the number of times strontium is concentrated by Carteria and Nitzschia over the amount occurring in sea water was determined. It was demonstrated that the division rate, the age of the culture, and the hydrogen ion concentration all influenced the number of times strontium was concentrated in Carteria cells.Exchange experiments showed that radioactive strontium was not lost from Carteria cells unless the medium contained a chelating compound. Some loss of radioactive strontium from Carteria cells occurred when the cells were filter‐washed with several different types of solutions.
Benthic Productivity as Influenced by Fish Predation*
Authors: HAYNE DON W. , BALL ROBERT C. 
Published: March 2010

Sampling of benthic organisms was carried out in two similar, one‐acre ponds in southern Michigan throughout the open water period of 1951. The bottom fauna in each pond was sampled by means of 20 Ekman dredge collections each week. This sampling scheme was found capable of detecting a difference between two populations when the ratio of their magnitudes is 1.9.Fish were present in one of the ponds in the first half of the summer. These were then transferred from this pond to the second pond in early July. Rates of growth of the fish and the bottom organisms were estimated and the production calculated at both trophic levels. The apparent rate of change of bottom fauna biomass was assumed to reflect a basic rate of increase varying inversely with the biomass level, minus the rate of fish predation.Calculated production of 811 pounds of fish‐food and 181 pounds of fish are shown to be of reasonable order as compared with other studies, with the fish‐food probably underestimated. A factor not included in the calculations was the effect of emergence of aquatic insects.The average production of bottom fauna fish‐food during a growing season amounted to about 17 times the standing crop, when fish were present. In the absence of fish, the apparent production rate of fish food decreased and finally stopped at a higher level of standing crop. In the presence of fish, the standing crop of fish food was depressed and the rate of production increased.
Factors Influencing the Choice of Substratum in Cumella vulgaris Hart (Crustacea, Cumacea)1
Authors: WIESER WOLFGANG 
Published: March 2010

Dried sand which is put back into water is rejected at first by Cumella vulgaris. However, attractiveness of the dried sand increases with the time of immersion in water, the regaining of attractiveness proceeding more slowly in sand that had been dried in an oven at 55°C than in sand dried at room temperature.In nature C. vulgaris prefers substrata with a median grain diameter of less than 160µ, and in the intertidal zone established populations occur predominantly below the 5 ft. level.In sand predominantly finer than 150µ and in mud C. vulgaris feeds as a “deposit‐feeder”, while in sand predominantly coarser than 150µ. it feeds as an “epistrate‐feeder”, that is, by scraping food off the surface of individual grains. If fractions finer than 150µ are thoroughly sieved, C. vulgaris cannot employ the latter feeding habit because the sand grains are too small for efficient individual handling by the mouth parts. On the other hand, deposit‐feeding cannot be employed either, since the fine organic debris which in this instance serves as the source of food, has been removed by the process of sieving. Consequently, the attractiveness of the material is lowered markedly. However, if a sieving method is used in which the fractions finer than 150µ retain their content of organic debris, the material also retains its attractiveness. Sand grains coarser than 0.5 mm are too large to be handled in an efficient manner by the mouth parts of C. vulnaris.The degree of attractiveness to C. vulgaris of a certain substratum must depend on the amount and the kind of food available. The food content seems to be one of the most powerful stimuli to which sand‐inhabiting animals react in choosing substratum.
Phosphorus Release from Bog Lake Muds1
Authors: ZICKER E. L. , BERGER K. C. , HASLER A. D. 
Published: March 2010

The paper reports the results of some laboratory investigations concerning the mud‐water phosphorus relationship of some Northern Wisconsin and Upper Michigan bog lake muds as influenced by lime, acid, and mechanical agitation.Calcium carbonate added to the water phase of mud‐water systems reduced the amount of soluble phosphorus from 8.0 to 0.8 parts per billion. The lime formed a thin crust at the mud‐water interface, while the original pH of the bottom material prevailed at a depth of one‐fourth inch below the mud surface. Agitation of the mud cores by stirring resulted in complete lime penetration throughout a three‐inch core.Experimental apparatus in which it is possible to obtain a 12°C temperature differential for stratifying water is described.Radioactive ordinary superphosphate fertilizer was placed at various depths below the mud surface, and the percentage as well as the amount of phosphorus released to the water was indicated to be very small with virtually no phosphorus released from depths greater than one‐fourth inch below the mud surface. Agitation by stirring of the muds resulted in approximately twice the concentrations of soluble phosphorus in the water phase of the agitated systems as compared to the undisturbed systems. The most effective means of releasing fertilizer phosphorus placed one‐fourth inch below the mud surface was found to be the acidification of previously limed mud‐water systems.The mechanism of phosphorus suppression by the addition of calcium compounds to mud water systems is suggested to be adsorption of phosphate ions onto the surface of the calcium particles in a similar manner as that described by Boischot et al.
Primary Production Measurements in Eleven Florida Springs and a Marine Turtle‐Grass Community1
Authors: ODUM HOWARD T. 
Published: March 2010

During July and August, 1955, primary production measurements were made in eleven Florida spring communities and a marine turtle‐grass community in the Florida Keys by means of the diurnal curve method. Diurnal measurements of oxygen and carbon dioxide made at a station downstream from the main springs were used in estimating gross primary production and community photosynthetic quotients. These curves show in detail the course of production hour by hour under various conditions in whole natural communities.The primary production values obtained ranged from 0.7 g oxygen/m2/day in a small, heavily shaded, anaerobic spring on a rainy day to 64 g oxygen/m2/day on a sunny day in an aerobic spring where the plant beds trailed at the water surface. A comparison of the chemostatic properties in the springs studied suggests that oxygen, phosphate, nitrate, and carbon‐dioxide levels are relatively unimportant in determining the magnitude of primary production in these spring communities. Light as influenced by cloud cover, trees, and water depth is the main controlling factor. Approximate efficiencies found were 0.5 to 10% (mean 4%) of the visible light energy reaching plant level. Downstream increases in planktonic chlorophyll and oxygen suggested a steady state in 7 km of longitudinal succession in Rainbow Springs River. Net production of benthic algae of 1.5 g/m2/day was estimated in Orange Springs from the rate of bubble release into funnels placed on the bottom.
On the Occurrence of Free Sugars in Lake Sediment Extracts
Authors: WHITTAKER J. R. , VALLENTYNE J. R. 
Published: March 2010

A semi‐quantitative method is described for the determination of free sugars in lake sediments. The method involves extraction with 70% ethanol, deionization with ion exchange resins, and separation and estimation of the sugars on paper chromatograms. The following sugars were detected in extracts of sediments from three Ontario lakes: maltose, sucrose, glucose, fructose, galactose, arabinose, ribose, xylose, and two unknowns. Total amounts of free sugar ranged from traces up to 2.9 g/kg of sediment ignitable matter. Maltose and glucose were usually the dominant sugars. Analyses of two surface cores of mud revealed decreasing concentrations of free sugars from the mud surface down to a depth of 50 cm. The sedimentary sugars are quantitatively held by the mud particles, and are lacking in the pore water of the mud. Lake mud sorbs small amounts of sugars from dilute aqueous solution, but the problem of sorption requires more detailed investigation before its importance can be assessed. Analysis showed that tendipedid larvae were not the source of the mud sugars, and theoretical arguments were presented to show that neither were the living bacteria in the sediment.Three samples of seston contained 2.3, 3.9, and 42.4 g of total sugar per kg dry weight respectively, with glucose and maltose present in the greatest amounts. The concentration of free sugars in seston decreased by over 90% during aerobic decomposition in the laboratory. Seston is considered to be the main source of the sedimentary sugars, both by directly contributing free sugars to the mud as well as by producing starch‐like polysaccharides which can be hydrolysed in situ to produce free sugars.The results of a culture experiment with lake mud showed complete disappearance of sedimentary sugars after 24 days of anaerobic culture in the presence of Bacto‐Yeast‐N‐base. Without the addition of Bacto‐Yeast‐N‐base, more sugar was found after 24 days than was initially present, both in aerobic and anaerobic cultures. Some factor in the Bacto‐Yeast‐N‐base enhanced the disappearance of sugars from mud.
Substrates as a Factor in Shrimp Distribution1
Authors: WILLIAMS AUSTIN B. 
Published: March 2010

Three species of Western Atlantic penaeid shrimps—Penaeus setiferus, P. aztecus, and P. duorarum—were allowed a free choice among five types of substrates in partitioned experimental troughs. The substrates used were beach sand, shell‐sand, muddy sand, sandy mud, and loose peat. Each species was tested separately, and each experiment was replicated once. Results of the experiments showed that distribution of the shrimps on the different substrates was not random. In each experiment departures from the expected distribution were statistically significant. P. duorarum occurred most often on shell‐sand. P. aztecus and P. setiferus were found most frequently on the softer, muddier substrates—loose peat, sandy mud, and muddy sand.Food content in the bottom materials may have been a confounding factor, but the results indicate attraction to substrate aside from the possible attraction to food.Water volume, or pore space, and the compaction of bottom materials, may influence the degree of burrowing.
The Salton Sea. Physical and Chemical Characteristics1
Authors: CARPELAN LARS H. 
Published: March 2010

The Salton Sea of California lying below sea level in a desert basin, serves as a sump for irrigation water diverted from the Colorado River. The present Sea reached its maximum size and highest surface elevation at the time of its formation in 1907. Due to evaporation at the rate of six feet per year the surface elevation fell from ‒195 feet to its minimum of ‒240 feet in 1948, the surface area decreased from about 500 square miles to about 320, and the salt content (salinity) increased from 3.6‰ to about 40‰. Since 1948 increased “wastage” of water into the Sea has raised the surface to ‒235 feet (1956) and diluted the waters to a salinity of about 33‰. Although the total salinity is approximately the same as that of the oceans the waters of the Sea contain a different proportion of ions, and the pH is slightly higher.The annual range of water temperature is from 10° to 36°C. In spring the surface may become as much as 5° warmer than the bottom, but since the maximum depth of the Sea is about 12 meters, mixing by winds rapidly removes differences between surface and bottom; during most of the year (August to May) there is less than 1°C difference between surface and bottom. Concentrations of dissolved oxygen ranged up to 11.8 mg/L at the surface and 9.3 mg/L at the bottom during winter. During calm periods in summer, however, the water at depths below 8–9 meters became anoxic for periods as long as 1–3 days; the surface waters, too, became depleted of oxygen, but for only an hour or so at about dawn. Concentrations of sulfide as high as 85 µg‐at./L, and of ammonia as high as 50 µg‐at./L were found during the anoxic periods in summer.