دیدگاه کارورزان، دستیاران و اعضای هیأت علمی بخش زنان در خصوص عوامل مؤثر بر شکل‌گیری اخلاق حرفه‌ای در بالین

مقدمه: آموزش اخلاق حرفه­ای بخش مهمی از برنامه­های فراگیران پزشکی است و حرفه ای‌گری (پروفیشنالیسم) از شایستگی­های محوری دوره پزشکی محسوب می­شود. شناسایی عوامل مؤثر بر فراگیری حرفه ای‌گری در بخش زنان و زایمان که از چالش­های اخلاقی خاص خود برخوردار است، می­تواند به کارآمدی برنامه­های آموزشی کمک کند. مطالعه حاضر با هدف تبیین دیدگاه و تجربیات اساتید و فراگیران پزشکی در بخش زنان و زایمان در خصوص عوامل مؤثر بر شکل‌گیری اخلاق حرفه­ای در بالین انجام شد. روش‌کار: در این مطالعه کیفی (1392)، 10 نفر از اساتید زنان و زایمان و 30 نفر از دستیاران تخصصی و کارورزان بخش زنان و زایمان مرکز آموزشی درمانی شهید صیاد شیرازی مشارکت نمودند. برای جمع‌آوری داده‌ها از روش مصاحبه­های انفرادی نیمه‌ساختار تا رسیدن به اشباع داده­ها استفاده شد. مصاحبه­ها خط به خط، دست‌نویس و مطابق رویکرد "تحلیل محتوای مرسوم" کدگذاری و طبقه‌بندی شدند. یافته‌ها: از تحلیل داده­ها چهار مضمون اصلی"ماهیت انسانی کار، شخصیت و منش فردی، داشتن الگو و مدل و عوامل آموزشی اجتماعی" استخراج شد که تبیین کننده عوامل مؤثر بر شکل‌گیری اخلاق حرفه­ای در بخش زنان و زایمان از دیدگاه اساتید و دانشجویان و دستیاران پزشکی بود. نتیجه‌گیری: الگو بودن اساتید و برنامه­های آموزشی بالینی در بخش زنان و زایمان، از مهم‌ترین عوامل مؤثر بر شکل‌گیری اخلاق حرفه­ای است، لذا به نظر می­رسد با مداخلات آموزشی مناسب روی این دو مؤلفه مهم بتوان به ارتقاء آموزش اخلاق حرفه­ای در بالین کمک کرد. کلیدواژه ها آموزش اخلاق؛ اخلاق حرفه‌ای؛ برنامه­های دستیاری؛ حرفه‌ ای گری؛ زنان و زایمان؛ کارورز پزشکی عنوان مقاله [English

Bubble Rise Dynamics in Complex Fluids

Formation of gas bubbles in complex fluids and their subsequent rise due to buoyancy is a very important fundamental phenomenon both in nature and industry. Bubble size and bubble velocity are critical parameters which govern the interfacial transport phenomena and play an important role in gas-solid contact. These characteristics affect the operating parameters as well as the design of equipment in industrial applications. Non-Newtonian, Shear-thickening fluids have been studied extensively due to their immense potential for commercial use in shock absorbing and force damping applications, such as liquid body armor, sports and personal protection. Furthermore, a better understanding of shear-thickening fluid is pertinent to industrial processing for enhancing flow, preventing the breakage or clogging of mixing equipment, and preventing clogging in narrow orifices. Despite their significance, many aspects of the flow of these non-Newtonian fluids remain poorly understood. In the first part of this dissertation, we study the dynamics of rising bubbles in three dimensional fluidized beds using computational fluid dynamics-discrete element method (CFD-DEM) to shed light on the physics underpinning phenomena uncovered previously using magnetic resonance imaging (MRI). We were able to understand the underlying mechanism behind the anomalous collapse of a bubble in side-by-side injection as well as an alternating asynchronous pinch-off pattern due to jet interaction in a fluidized bed by looking into the gas streamlines and the drag force on the particles. In the second part of this dissertation, we study dynamics of rising bubbles in Newtonian fluids and non-Newtonian cornstarch-water suspensions experimentally using optical imaging. We were able to identify that Capillary number (Ca) is a key dimensionless parameter governing the regimes of interacting jets in water. We also observed a periodic coalescence of bubbles at the same points in space in cornstarch-water suspensions and attributed this behavior to leading bubbles entering a shear thickening regime. Further, we identified the key dimensionless parameters for wobbling behavior of single bubbles in cornstarch suspensions to be Bond (Bo), and Reynolds (Re) number, regardless of the bubble being in a Newtonian or a shear-thinning regime. We believe our findings can be applied in industry to optimize the mass transport and liquid mixing for a range of applications

First passage time moments of asymmetric L\'evy flights

We investigate the first-passage dynamics of symmetric and asymmetric L\'evy flights in a semi-infinite and bounded intervals. By solving the space-fractional diffusion equation, we analyse the fractional-order moments of the first-passage time probability density function for different values of the index of stability and the skewness parameter. A comparison with results using the Langevin approach to L\'evy flights is presented. For the semi-infinite domain, in certain special cases analytic results are derived explicitly, and in bounded intervals a general analytical expression for the mean first-passage time of L\'evy flights with arbitrary skewness is presented. These results are complemented with extensive numerical analyses.Comment: 47 pages, 13 figures, IOP LaTe

A Feasible and Efficacious Mobile-Phone Based Lifestyle Intervention for Filipino Americans with Type 2 Diabetes: Randomized Controlled Trial

BackgroundFilipino Americans have a high prevalence of obesity, type 2 diabetes (T2D), and cardiovascular disease compared with other Asian American subgroups and non-Hispanic whites. Mobile health (mHealth) weight loss interventions can reduce chronic disease risks, but these are untested in Filipino Americans with T2D.ObjectiveThe objective of this study was to assess feasibility and potential efficacy of a pilot, randomized controlled trial (RCT) of a culturally adapted mHealth weight loss lifestyle intervention (Pilipino Americans Go4Health [PilAm Go4Health]) for overweight Filipino Americans with T2D.MethodsThis was a 2-arm pilot RCT of the 3-month PilAm Go4Health intervention (phase 1) with an active waitlist control and 3-month follow-up (phase 2). The waitlist control received the PilAm Go4Health in phase 2, whereas the intervention group transitioned to the 3-month follow-up. PilAm Go4Health incorporated a Fitbit accelerometer, mobile app with diary for health behavior tracking (steps, food/calories, and weight), and social media (Facebook) for virtual social support, including 7 in-person monthly meetings. Filipino American adults ≥18 years with T2D were recruited from Northern California. Feasibility was measured by rates of recruitment, engagement, and retention. Multilevel regression analyses assessed within and between group differences for the secondary outcome of percent weight change and other outcomes of weight (kg), body mass index (BMI), waist circumference, fasting plasma glucose, HbA1c, and steps.ResultsA total of 45 Filipino American adults were enrolled and randomized. Mean age was 58 (SD 10) years, 62% (28/45) were women, and mean BMI was 30.1 (SD 4.6). Participant retention and study completion were 100%, with both the intervention and waitlist group achieving near-perfect attendance at all 7 intervention office visits. Groups receiving the PilAm Go4Health in phase 1 (intervention group) and phase 2 (waitlist group) had significantly greater weight loss, -2.6% (-3.9 to -1.4) and -3.3% (-1.8 to -4.8), respectively, compared with the nonintervention group, resulting in a moderate to small effect sizes (d=0.53 and 0.37, respectively). In phase 1, 18% (4/22) of the intervention group achieved a 5% weight loss, whereas 82% (18/22) maintained or lost 2% to 5% of their weight and continued to maintain this weight loss in the 3-month follow-up. Other health outcomes, including waist circumference, BMI, and step counts, improved when each arm received the PilAm Go4Health, but the fasting glucose and HbA1c outcomes were mixed.ConclusionsThe PilAm Go4Health was feasible and demonstrated potential efficacy in reducing diabetes risks in overweight Filipino Americans with T2D. This study supports the use of mHealth and other promising intervention strategies to reduce obesity and diabetes risks in Filipino Americans. Further testing in a full-scale RCT is warranted. These findings may support intervention translation to reduce diabetes risks in other at-risk diverse populations.Trial registrationClinicaltrials.gov NCT02290184; https://clinicaltrials.gov/ct2/show/NCT02290184 (Archived by WebCite at http://www.webcitation.org/6vDfrvIPp)

L\'evy noise-driven escape from arctan potential wells

The escape from a potential well is an archetypal problem in the study of stochastic dynamical systems, representing real-world situations from chemical reactions to leaving an established home range in movement ecology. Concurrently, L{\'e}vy noise is a well-established approach to model systems characterized by statistical outliers and diverging higher-order moments, ranging from gene expression control to the movement patterns of animals and humans. Here, we study the problem of L\'evy noise-driven escape from an almost rectangular, arctan potential well restricted by two absorbing boundaries. We unveil analogies of the observed transient dynamics to the general properties of stationary states of L{\'e}vy processes in single-well potentials. The first escape dynamics is shown to exhibit exponential tails. We examine the dependence of the escape on the shape parameters, steepness and height, of the arctan potential. Finally, we explore in detail the behavior of the probability densities of the first-escape time and the last-hitting point.Comment: 12 page

First-passage properties of asymmetric Lévy flights

Lévy flights are paradigmatic generalised random walk processes, in which the independent stationary increments—the 'jump lengths'—are drawn from an -stable jump length distribution with long-tailed, power-law asymptote. As a result, the variance of Lévy flights diverges and the trajectory is characterised by occasional extremely long jumps. Such long jumps significantly decrease the probability to revisit previous points of visitation, rendering Lévy flights efficient search processes in one and two dimensions. To further quantify their precise property as random search strategies we here study the first-passage time properties of Lévy flights in one-dimensional semi-infinite and bounded domains for symmetric and asymmetric jump length distributions. To obtain the full probability density function of first-passage times for these cases we employ two complementary methods. One approach is based on the space-fractional diffusion equation for the probability density function, from which the survival probability is obtained for different values of the stable index and the skewness (asymmetry) parameter . The other approach is based on the stochastic Langevin equation with -stable driving noise. Both methods have their advantages and disadvantages for explicit calculations and numerical evaluation, and the complementary approach involving both methods will be profitable for concrete applications. We also make use of the Skorokhod theorem for processes with independent increments and demonstrate that the numerical results are in good agreement with the analytical expressions for the probability density function of the first-passage times

Correction: A Feasible and Efficacious Mobile-Phone Based Lifestyle Intervention for Filipino Americans with Type 2 Diabetes: Randomized Controlled Trial.

[This corrects the article DOI: 10.2196/diabetes.8156.]