Burnout and psychiatric morbidity in new medical graduates

OBJECTIVE: To determine the prevalence of psychiatric morbidity and burnout in final-year medical students, and changes in these measures during the intern year. DESIGN: Prospective longitudinal cohort study over 18 months, with assessment of psychiatric morbidity and burnout on six occasions. PARTICIPANTS: All 117 students in the first graduating cohort of the University of Sydney Graduate Medical Program were invited to participate in the study; 110 consented. OUTCOME MEASURES: Psychiatric morbidity assessed with the 28-item General Health Questionnaire and burnout assessed with the Maslach Burnout Inventory. RESULTS: The point prevalence of participants meeting criteria for psychiatric morbidity and burnout rose steadily throughout the study period. CONCLUSIONS: Internship remains a stressful time for medical graduates, despite initiatives to better support them during this period. The implications for the doctors themselves and for the communities they serve warrant further attention, including programs specifically aimed at reducing the rate of psychological morbidity and burnout during internship.NHMR

Learning management systems: one size fits all?

Learning management systems such as WebCT and Blackboard are rapidly becoming the principal systems behind institutions' moves to technology-based learning settings. In settings where lecturers have had no or limited exposure to ICT as a teaching tool, LMSs pave the way for quick introduction and eventual adoption of technology-based teaching practices. Many lecturers quickly progress and grow in the field. But there are those who argue that the use of LMS tend to be counter-productive and that in their current forms, they cannot be used effectively as a learning tool. Critics argue that they support only traditional forms of teaching and encourage poor learning designs in their implementation. This panel will explore LMSs as they exist today and will explore whether they are the solution to a pressing problem or in fact problems within themselves

Dependability of Aggregated Objects, a pervasive integrity checking architecture

International audienceRFID-enabled security solutions are becoming ubiquitous; for example in access control and tracking applications. Well known solutions typically use one tag per physical object architecture to track or control, and a central database of these objects. This architecture often requires a communication infrastructure between RFID readers and the database information system. Aggregated objects is a different approach presented in this paper, where a group of physical objects use a set of RFID tags to implement a self-contained security solution. This distributed approach offers original advantages, in particular autonomous operation without an infrastructure support, and enhanced security

The role of federal libraries and federal librarians in research data services (RDS): An exploratory study

This study explores the roles federal (government) libraries and librarians play in scientific (international) knowledge development within federal agencies and in the larger scientific enterprise. In particular, this research looks at libraries’ and librarians’ facilitation of scientific inquiry through the application of research data services (RDS). Currently, librarians’ research and data consultation activities with administrators and researchers typically involve creating citations and finding datasets; less frequently, librarians are engaged in data management planning and other RDS activities. However, federal libraries and librarians have been identified as key stakeholders in collaborative science generally and specifically in scientific data cyberinfrastructures, such as the NSF-funded DataONE Project. “DataONE (Data Observation Network for Earth) enables science through cyberinfrastructure development for data storage, preservation, use, and reuse and by building a ommunity of data literate researchers and information practitioners” (see dataone.org)

Changes in Data Sharing and Data Reuse Practices and Perceptions among Scientists Worldwide

The incorporation of data sharing into the research lifecycle is an important part of modern scholarly debate. In this study, the DataONE Usability and Assessment working group addresses two primary goals: To examine the current state of data sharing and reuse perceptions and practices among research scientists as they compare to the 2009/2010 baseline study, and to examine differences in practices and perceptions across age groups, geographic regions, and subject disciplines. We distributed surveys to a multinational sample of scientific researchers at two different time periods (October 2009 to July 2010 and October 2013 to March 2014) to observe current states of data sharing and to see what, if any, changes have occurred in the past 3–4 years. We also looked at differences across age, geographic, and discipline-based groups as they currently exist in the 2013/2014 survey. Results point to increased acceptance of and willingness to engage in data sharing, as well as an increase in actual data sharing behaviors. However, there is also increased perceived risk associated with data sharing, and specific barriers to data sharing persist. There are also differences across age groups, with younger respondents feeling more favorably toward data sharing and reuse, yet making less of their data available than older respondents. Geographic differences exist as well, which can in part be understood in terms of collectivist and individualist cultural differences. An examination of subject disciplines shows that the constraints and enablers of data sharing and reuse manifest differently across disciplines. Implications of these findings include the continued need to build infrastructure that promotes data sharing while recognizing the needs of different research communities. Moving into the future, organizations such as DataONE will continue to assess, monitor, educate, and provide the infrastructure necessary to support such complex grand science challenges

Research Data Services in Academic Libraries: Data Intensive Roles for the Future?

Objectives: The primary objectives of this study are to gauge the various levels of Research Data Service academic libraries provide based on demographic factors, gauging RDS growth since 2011, and what obstacles may prevent expansion or growth of services. Methods: Survey of academic institutions through stratified random sample of ACRL library directors across the U.S. and Canada. Frequencies and chi-square analysis were applied, with some responses grouped into broader categories for analysis. Results: Minimal to no change for what services were offered between survey years, and interviews with library directors were conducted to help explain this lack of change. Conclusion: Further analysis is forthcoming for a librarians study to help explain possible discrepancies in organizational objectives and librarian sentiments of RDS

Impact of Preoperative Chemotherapy Features on Patient Outcomes after Hepatectomy for Initially Unresectable Colorectal Cancer Liver Metastases: A LiverMetSurvey Analysis

Liver metastases; Liver resection; Preoperative chemotherapyMetástasis hepáticas; Resección hepática; Quimioterapia preoperatoriaMetàstasis hepàtiques; Resecció hepàtica; Quimioteràpia preoperatòriaBackground: Prognostic factors have been extensively reported after resection of colorectal liver metastases (CLM); however, specific analyses of the impact of preoperative systemic anticancer therapy (PO-SACT) features on outcomes is lacking. Methods: For this real-world evidence study, we used prospectively collected data within the international surgical LiverMetSurvey database from all patients with initially-irresectable CLM. The main outcome was Overall Survival (OS) after surgery. Disease-free (DFS) and hepatic-specific relapse-free survival (HS-RFS) were secondary outcomes. PO-SACT features included duration (cumulative number of cycles), choice of the cytotoxic backbone (oxaliplatin- or irinotecan-based), fluoropyrimidine (infusional or oral) and addition or not of targeted monoclonal antibodies (anti-EGFR or anti-VEGF). Results: A total of 2793 patients in the database had received PO-SACT for initially irresectable diseases. Short (<7 or <13 cycles in 1st or 2nd line) PO-SACT duration was independently associated with longer OS (HR: 0.85 p = 0.046), DFS (HR: 0.81; p = 0.016) and HS-RFS (HR: 0.80; p = 0.05). All other PO-SACT features yielded basically comparable results. Conclusions: In this international cohort, provided that PO-SACT allowed conversion to resectability in initially irresectable CLM, surgery performed as soon as technically feasible resulted in the best outcomes. When resection was achieved, our findings indicate that the choice of PO-SACT regimen had a marginal if any, impact on outcomes

Multisite Phosphorylation Modulates the T Cell Receptor ζ-Chain Potency but not the Switchlike Response

AbstractMultisite phosphorylation is ubiquitous in cellular signaling and is thought to provide signaling proteins with additional regulatory mechanisms. Indeed, mathematical models have revealed a large number of mechanisms by which multisite phosphorylation can produce switchlike responses. The T cell antigen receptor (TCR) is a multisubunit receptor on the surface of T cells that is a prototypical multisite substrate as it contains 20 sites that are distributed on 10 conserved immunoreceptor tyrosine-based activation motifs (ITAMs). The TCR ζ-chain is a homodimer subunit that contains six ITAMs (12 sites) and exhibits a number of properties that are predicted to be sufficient for a switchlike response. We have used cellular reconstitution to systematically study multisite phosphorylation of the TCR ζ-chain. We find that multisite phosphorylation proceeds by a nonsequential random mechanism, and find no evidence that multiple ITAMs modulate a switchlike response but do find that they alter receptor potency and maximum phosphorylation. Modulation of receptor potency can be explained by a reduction in molecular entropy of the disordered ζ-chain upon phosphorylation. We further find that the tyrosine kinase ZAP-70 increases receptor potency but does not modulate the switchlike response. In contrast to other multisite proteins, where phosphorylations act in strong concert to modulate protein function, we suggest that the multiple ITAMs on the TCR function mainly to amplify subsequent signaling

DEEP RESERVOIR TEMPERATURES OF LOW-ENTHALPY GEOTHERMAL SYSTEMS IN TUNISIA: NEW CONSTRAINTS FROM CHEMISTRY OF THERMAL WATERS

Tunisia is characterized by hot and warm groundwaters (temperature up to 75 °C) which represent the surface manifestation of geothermal systems hosted in carbonate-evaporite rock sequences. The T-conditions of Tunisia deep thermal reservoirs are here evaluated for the first time at the regional scale. The results here shown clearly highlight the limitations inherent in the application of common geothermometric methods in the estimation of equilibrium temperatures in sedimentary environments. The modeling approach proposed by Chiodini et alii (1995), which makes use of the ratios between dissolved HCO3, SO4 and F, provides the most reliable results, and allows us to derive equilibrium temperatures up to 200 °C for the Tunisian thermal reservoirs. Very high equilibrium pCO2 (100 bar) values are also estimated, likely indicative of the confined aquifer conditions