3,481 research outputs found

    Assessing Professionalism: A theoretical framework for defining clinical rotation assessment criteria

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    Although widely accepted as an important graduate competence, professionalism is a challenging outcome to define and assess. Clinical rotations provide an excellent opportunity to develop student professionalism through the use of experiential learning and effective feedback, but without appropriate theoretical frameworks, clinical teachers may find it difficult to identify appropriate learning outcomes. The adage “I know it when I see it” is unhelpful in providing feedback and guidance for student improvement, and criteria that are more specifically defined would help students direct their own development. This study sought first to identify how clinical faculty in one institution currently assess professionalism, using retrospective analysis of material obtained in undergraduate teaching and faculty development sessions. Subsequently, a faculty workshop was held in which a round-table type discussion sought to develop these ideas and identify how professionalism assessment could be improved. The output of this session was a theoretical framework for teaching and assessing professionalism, providing example assessment criteria and ideas for clinical teaching. This includes categories such as client and colleague interaction, respect and trust, recognition of limitations, and understanding of different professional identities. Each category includes detailed descriptions of the knowledge, skills, and behaviors expected of students in these areas. The criteria were determined by engaging faculty in the development of the framework, and therefore they should represent a focused development of criteria already used to assess professionalism, and not a novel and unfamiliar set of assessment guidelines. The faculty-led nature of this framework is expected to facilitate implementation in clinical teaching

    Gravitational collapse in an expanding background and the role of substructure II: Excess power at small scales and its effect of collapse of structures at larger scales

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    We study the interplay of clumping at small scales with the collapse and relaxation of perturbations at larger scales using N-Body simulations. We quantify the effect of collapsed haloes on perturbations at larger scales using two point correlation function, moments of counts in cells and mass function. The purpose of the study is twofold and the primary aim is to quantify the role played by collapsed low mass haloes in the evolution of perturbations at large scales, this is in view of the strong effect seen when the large scale perturbation is highly symmetric. Another reason for this study is to ask whether features or a cutoff in the initial power spectrum can be detected using measures of clustering at scales that are already non-linear. The final aim is to understand the effect of ignoring perturbations at scales smaller than the resolution of N-Body simulations. We find that these effects are ignorable if the scale of non-linearity is larger than the average inter-particle separation in simulations. Features in in the initial power spectrum can be detected easily if the scale of these features is in the linear regime, detecting such features becomes difficult as the relevant scales become non-linear. We find no effect of features in initial power spectra at small scales on the evolved power spectra at large scales. We may conclude that in general, the effect on evolution of perturbations at large scales of clumping on small scales is very small and may be ignored in most situations.Comment: Accepted for publication in MNRA

    Kinetic power of quasars and statistical excess of MOJAVE superluminal motions

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    The MOJAVE survey contains 101 quasars with a total of 354 observed radio components that are different from the radio cores, among which 95% move with apparent projected superluminal velocities with respect to the core, and 45% have projected velocities larger than 10c (with a maximum velocity 60c). Doppler boosting effects are analyzed to determine the statistics of the superluminal motions. We integrate over all possible values of the Lorentz factor the values of the kinetic energy corresponding to each component. The calculation of the mass in the ejection is carried out by assuming the minimum energy state. This kinetic energy is multiplied by the frequency at which the portions of the jet fluid identified as "blobs" are produced. Hence, we estimate the average total power released by the quasars in the form of kinetic energy in the long term on pc-scales. RESULTS. A selection effect in which both the core and the blobs of the quasar are affected by huge Doppler-boosting enhancement increases the probability of finding a jet ejected within 10 degrees of the line of sight >~40 times above what one would expect for a random distribution of ejection, which explains the ratios of the very high projected velocities given above. The average total kinetic power of each MOJAVE quasar should be very high to obtain this distribution: ~7E47 erg/s. This amount is much higher than previous estimates of kinetic power on kpc-scales based on the analysis of cavities in X-ray gas or radio lobes in samples of objects of much lower radio luminosity but similar black hole masses. The kinetic power is a significant portion of the Eddington luminosity, on the order of the bolometric luminosity, and proportional on average to square root of the radio luminosity, although this correlation might be induced by Malmquist-like bias.Comment: Published in A&A; v2: minor changes to fit the published versio

    Are there biological differences between screen-detected and interval colorectal cancers in the English Bowel Cancer Screening Programme?

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    Background: We measured biomarkers of tumour growth and vascularity in interval and screen-detected colorectal cancers (CRCs) in the English Bowel Cancer Screening Programme in order to determine whether rapid tumour growth might contribute to interval CRC (a CRC diagnosed between a negative guaiac stool test and the next scheduled screening episode). Methods: Formalin-fixed, paraffin-embedded sections from 71 CRCs (screen-detected 43, interval 28) underwent immunohistochemistry for CD31 and Ki-67, in order to measure the microvessel density (MVD) and proliferation index (PI), respectively, as well as microsatellite instability (MSI) testing. Results: Interval CRCs were larger (P=0.02) and were more likely to exhibit venous invasion (P=0.005) than screen-detected tumours. There was no significant difference in MVD or PI between interval and screen-detected CRCs. More interval CRCs displayed MSI-high (14%) compared with screen-detected tumours (5%). A significantly (P=0.005) higher proportion (51%) of screen-detected CRC resection specimens contained at least one polyp compared with interval CRC (18%) resections. Conclusions: We found no evidence of biological differences between interval and screen-detected CRCs, consistent with the low sensitivity of guaiac stool testing as the main driver of interval CRC. The contribution of synchronous adenomas to occult blood loss for screening requires further investigation

    Nonlinear Effects in the Cosmic Microwave Background

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    Major advances in the observation and theory of cosmic microwave background anisotropies have opened up a new era in cosmology. This has encouraged the hope that the fundamental parameters of cosmology will be determined to high accuracy in the near future. However, this optimism should not obscure the ongoing need for theoretical developments that go beyond the highly successful but simplified standard model. Such developments include improvements in observational modelling (e.g. foregrounds, non-Gaussian features), extensions and alternatives to the simplest inflationary paradigm (e.g. non-adiabatic effects, defects), and investigation of nonlinear effects. In addition to well known nonlinear effects such as the Rees-Sciama and Ostriker-Vishniac effects, further nonlinear effects have recently been identified. These include a Rees-Sciama-type tensor effect, time-delay effects of scalar and tensor lensing, nonlinear Thomson scattering effects and a nonlinear shear effect. Some of the nonlinear effects and their potential implications are discussed.Comment: Invited contribution to Relativistic Cosmology Symposium (celebrating the 60th year of GFR Ellis); to appear Gen. Rel. Gra

    The Local Group as a test of cosmological models

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    The dynamics of the Local Group and its environment provide a unique challenge to cosmological models. The velocity field within 5h-1 Mpc of the Local Group (LG) is extremely ``cold''. The deviation from a pure Hubble flow, characterized by the observed radial peculiar velocity dispersion, is measured to be about 60km/s. We compare the local velocity field with similarly defined regions extracted from N-body simulations of Universes dominated by cold dark matter (CDM). This test is able to strongly discriminate between models that have different mean mass densities. We find that neither the Omega=1 (SCDM) nor Omega=0.3 (OCDM) cold dark matter models can produce a single candidate Local Group that is embedded in a region with such small peculiar velocities. For these models, we measure velocity dispersions between 500-700km/s and 150-300km/s respectively, more than twice the observed value. Although both CDM models fail to produce environments similar to those of our Local Group on a scale of a few Mpc, they can give rise to many binary systems that have similar orbital properties as the Milky Way--Andromeda system. The local, gravitationally induced bias of halos in the CDM ``Local Group'' environment, if defined within a sphere of 10 Mpc around each Local Group is about 1.5, independent of Omega. No biasing scheme could reconcile the measured velocity dispersions around Local Groups with the observed one. Identification of binary systems using a halo finder (named Skid (http://www-hpcc.astro.washington.edu/tools/DENMAX for a public version)) based on local density maxima instead of a simple linking algorithm, gives a much more complete sample. We show that a standard ``friend of friends'' algorithm would miss 40% of the LG candidates present in the simulations.Comment: Latex file (19 pages) + 13 figures. Submitted to New Astronomy. Two MPEG movies were not included. Also available (this time with the movies) at http://www-hpcc.astro.washington.edu/faculty/fabio/index.htm

    Accretion Disks Around Black Holes: Twenty Five Years Later

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    We study the progress of the theory of accretion disks around black holes in last twenty five years and explain why advective disks are the best bet in explaining varied stationary and non-stationary observations from black hole candidates. We show also that the recently proposed advection dominated flows are incorrect.Comment: 30 Latex pages including figures. Kluwer Style files included. Appearing in `Observational Evidence for Black Holes in the Universe', ed. Sandip K. Chakrabarti, Kluwer Academic Publishers (DORDRECHT: Holland

    Effects of acute fatigue on the volitional and magnetically-evoked electromechanical delay of the knee flexors in males and females

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    Neuromuscular performance capabilities, including those measured by evoked responses, may be adversely affected by fatigue; however, the capability of the neuromuscular system to initiate muscle force rapidly under these circumstances is yet to be established. Sex-differences in the acute responses of neuromuscular performance to exercise stress may be linked to evidence that females are much more vulnerable to ACL injury than males. Optimal functioning of the knee flexors is paramount to the dynamic stabilisation of the knee joint, therefore the aim of this investigation was to examine the effects of acute maximal intensity fatiguing exercise on the voluntary and magnetically-evoked electromechanical delay in the knee flexors of males and females. Knee flexor volitional and magnetically-evoked neuromuscular performance was assessed in seven male and nine females prior to and immediately after: (i) an intervention condition comprising a fatigue trial of 30-seconds maximal static exercise of the knee flexors, (ii) a control condition consisting of no exercise. The results showed that the fatigue intervention was associated with a substantive reduction in volitional peak force (PFV) that was greater in males compared to females (15.0%, 10.2%, respectively, p < 0.01) and impairment to volitional electromechanical delay (EMDV) in females exclusively (19.3%, p < 0.05). Similar improvements in magnetically-evoked electromechanical delay in males and females following fatigue (21%, p < 0.001), however, may suggest a vital facilitatory mechanism to overcome the effects of impaired voluntary capabilities, and a faster neuromuscular response that can be deployed during critical times to protect the joint system
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