Physician Communication Skills: Results of a Survey of General/Family Practitioners in Newfoundland

Purpose: To describe the attitudes related to communication skills, confidence in using commnication skills, and use of communication skills during the physician-patient encounter among a population-based sample of family physicians. Procedures: A mailed survey, distributed to all family physicians and general practitioners currently practicing in Newfoundland. The questionnaire was designed to collect data in five general areas participant demographics, physician confidence in using specific communication strategies, perceived adequacy of time spent by physicians with their patients, physician use of specific communication strategies with the adult patients they saw in the prior week, and physician use of specific communication strategies during the closing minutes of the encounters they had with adult patients in the prior week. Main Findings: A total of 160 completed surveys was received from practicing family physicians/general practitioners in Newfoundland, yielding an adjusted response rate of 43.1%. Most of the respondents (83.8%) indicated their communication skills are as important as technical skills in terms of achieving positive patient outcomes. Between one-third and one-half of the respondents, depending on the educational level queried, rated their communications skills training as being inadequate. Fewer than 20% of the respondents rated the communications skills training they received as being excellent. Physicians indicated a need to improve their use of 8 of 13 specific communication strategies during patient encounters, and reported using few communication strategies during the closing minutes of the encounter. Interactions that occurred during a typical encounter tended to focus on biomedical versus psychosocial issues. Conclusions: Family physicians/general practitioners recognize a need to improve their commnications skills. Well-designed communications skills training programs should be implemented at multi-levels of physician training in order to improve patient satisfaction with their encounters with family/general practitioners, and to increase the likelihood of positive patient outcomes

Bioprocesses

The application of remote sensing techniques to the study of eutrophication in natural waters and the location and characterization of fronts is considered. The specific problem to be studied is examined along with the feasibility and capabability of remote sensing techniques for each application

Dust storms on Mars: Considerations and simulations

Aeolian processes are important in modifying the surface of Mars at present, and appear to have been significant in the geological past. Aeolian activity includes local and global dust storms, the formation of erosional features such as yardangs and depositional features such as sand dunes, and the erosion of rock and soil. As a means of understanding aeolian processes on Mars, an investigation is in progress that includes laboratory simulations, field studies of earth analogs, and interpretation of spacecraft data. This report describes the Martian Surface Wind Tunnel, an experimental facility established at NASA-Ames Research Center, and presents some results of the general investigation. Experiments dealing with wind speeds and other conditions required for the initiation of particle movement on Mars are described and considerations are given to the resulting effectiveness of aeolian erosion

System for determining position of normal shock in supersonic flow

Light from a plurality of light emitting diodes is transmitted through optical cables (12) to a lens system. The lenses (56, 58) expand and collimate the light and project it in a sheet (16) across the supersonic inlet of an aircraft power plant perpendicular to incoming airflow. A normal shock bends a portion of the sheet of light (16). A linear array of a multiplicity of optical fiber ends collects discrete samples of light. The samples are processed and compared to a predetermined profile to determine the shock location

Electronic health information and long term conditions

This article discusses the increasing availability of health-related information, and the impact that this can have for people with long-term conditions’ expectations of healthcare providers. The article suggests a framework for decision making about the role that healthcare staff should play in the information searching, retrieval, and synthesis activities which people with long-term conditions engage in. The framework is based on a series of decisions related to: perceptions of ownership of long-term conditions; whether intermediatory or apomediatory approaches to information management are deemed to be most appropriate; and, as a result of these considerations, what, if any, place healthcare staff should take in the process of patients searching or and interpreting information about long-term health needs. These decisions will enable healthcare providers to plan services based on clear decision pathways, and to clarify to all concerned what are deemed to be reasonable expectations of health service provision

Avalanche Dynamics in Wet Granular Materials

We have studied the dynamics of avalanching wet granular media in a rotating drum apparatus. Quantitative measurements of the flow velocity and the granular flux during avalanches allow us to characterize novel avalanche types unique to wet media. We also explore the details of viscoplastic flow (observed at the highest liquid contents) in which there are lasting contacts during flow, leading to coherence across the entire sample. This coherence leads to a velocity independent flow depth at high rotation rates and novel robust pattern formation in the granular surface.Comment: 5 pages, 3 figures in color, REVTeX4, for smaller pdfs see http://angel.elte.hu/~tegzes/condmat.htm

Principles And Practices Fostering Inclusive Excellence: Lessons From The Howard Hughes Medical Institute’s Capstone Institutions

Best-practices pedagogy in science, technology, engineering, and mathematics (STEM) aims for inclusive excellence that fosters student persistence. This paper describes principles of inclusivity across 11 primarily undergraduate institutions designated as Capstone Awardees in Howard Hughes Medical Institute’s (HHMI) 2012 competition. The Capstones represent a range of institutional missions, student profiles, and geographical locations. Each successfully directed activities toward persistence of STEM students, especially those from traditionally underrepresented groups, through a set of common elements: mentoring programs to build community; research experiences to strengthen scientific skill/identity; attention to quantitative skills; and outreach/bridge programs to broaden the student pool. This paper grounds these program elements in learning theory, emphasizing their essential principles with examples of how they were implemented within institutional contexts. We also describe common assessment approaches that in many cases informed programming and created traction for stakeholder buy-in. The lessons learned from our shared experiences in pursuit of inclusive excellence, including the resources housed on our companion website, can inform others’ efforts to increase access to and persistence in STEM in higher education

Multiple prior concussions are associated with symptoms in high school athletes

Objectives: The purpose of this study was to evaluate the association of prior concussion on baseline computerized neurocognitive testing in a large cohort of high school athletes. Methods: This is a retrospective cohort study of student athletes from 49 Maine High Schools in 2010 who underwent baseline computerized neurocognitive evaluation with Immediate Post-Concussion Assessment and Cognitive Testing (ImPACT®). As part of the ImPACT®, subjects reported a prior history of concussion as well as demographic information and a symptom questionnaire. We used linear regression to evaluate the association of prior concussion with baseline: (1) ImPACT® composite scores; and (2) symptom scores. Results: Six thousand seventy-five subjects were included in the study, of whom 57% were boys. The majority of student athletes (85.3%) reported no prior history of concussion while 4.6% reported having sustained two or more prior concussions. On simple linear regression, increasing number of concussions was related to worse performance in verbal memory (P = 0.039) and greater symptoms scores (P < 0.001). On multivariate modeling, only the association with baseline symptoms remained (P < 0.001). Other factors associated with baseline symptom reporting in the multivariate model included mental health history, headache/migraine history, gender, developmental and/or learning problems, and number of prior concussions. Interpretation In this large-scale, retrospective survey study, history of multiple prior concussions was associated with higher symptom burden but not baseline computerized neurocognitive testing. The association between baseline symptom reporting and clinical and demographic factors was greater than the association with a history of multiple concussions

The dynamics of a family’s gut microbiota reveal variations on a theme

Abstract Background It is clear that the structure and function of the human microbiota has significant impact on maintenance of health and yet the factors that give rise to an adult microbiota are poorly understood. A combination of genetics, diet, environment, and life history are all thought to impact the development of the gut microbiome. Here we study a chronosequence of the gut microbiota found in eight individuals from a family consisting of two parents and six children ranging in age from two months to ten years old. Results Using 16S rRNA gene and metagenomic shotgun sequence data, it was possible to distinguish the family from a cohort of normal individuals living in the same geographic region and to differentiate each family member. Interestingly, there was a significant core membership to the family members’ microbiota where the abundance of this core accounted for the differences between individuals. It was clear that the introduction of solids represents a significant transition in the development of a mature microbiota. This transition was associated with increased diversity, decreased stability, and the colonization of significant abundances of Bacteroidetes and Clostridiales. Although the children and mother shared essentially the identical diet and environment, the children’s microbiotas were not significantly more similar to their mother than they were to their father. Conclusions This analysis underscores the complex interactions that give rise to a personalized microbiota and suggests the value of studying families as a surrogate for longitudinal studies.http://deepblue.lib.umich.edu/bitstream/2027.42/109502/1/40168_2014_Article_54.pd