59 research outputs found

    The Central Kiloparsec of Starbursts and Active Galactic Nuclei: The La Palma Connection

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    Original article can be found at :--http://www.journals.uchicago.edu/--Copyright The Astronomical Society of the PacificPeer reviewe

    Teorías Feministas de la Tecnología:. Evolución y principales debates.

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    Las teorías feministas de la tecnología se constituyen como la expresión teórica de una serie de diversos y controvertidos movimientos sociales y políticos, filosofías y prácticas que tienen como común denominador la oposición y la voluntad de superar el sexismo y el androcentrismo en la relación género y tecnología. A partir de los años 70 se desarrollan las teorías feministas a través de los debates generados a partir de los diversos feminismos y las distintas innovaciones tecnológicas que se suceden en el tiempo. En este artículo se presenta una revisión de los feminismos y postfeminismos de la tecnología desde sus inicios para, sobretodo, enfatizar sus puntos de encuentro y visibilizar algunas corrientes feministas poco abordas

    Functional Neuroimaging Correlates of Burnout among Internal Medicine Residents and Faculty Members

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    Contains fulltext : 125473.pdf (publisher's version ) (Open Access)Burnout is prevalent in residency training and practice and is linked to medical error and suboptimal patient care. However, little is known about how burnout affects clinical reasoning, which is essential to safe and effective care. The aim of this study was to examine how burnout modulates brain activity during clinical reasoning in physicians. Using functional Magnetic Resonance Imaging (fMRI), brain activity was assessed in internal medicine residents (n = 10) and board-certified internists (faculty, n = 17) from the Uniformed Services University (USUHS) while they answered and reflected upon United States Medical Licensing Examination and American Board of Internal Medicine multiple-choice questions. Participants also completed a validated two-item burnout scale, which includes an item assessing emotional exhaustion and an item assessing depersonalization. Whole brain covariate analysis was used to examine blood-oxygen-level-dependent (BOLD) signal during answering and reflecting upon clinical problems with respect to burnout scores. Higher depersonalization scores were associated with less BOLD signal in the right dorsolateral prefrontal cortex and middle frontal gyrus during reflecting on clinical problems and less BOLD signal in the bilateral precuneus while answering clinical problems in residents. Higher emotional exhaustion scores were associated with more right posterior cingulate cortex and middle frontal gyrus BOLD signal in residents. Examination of faculty revealed no significant influence of burnout on brain activity. Residents appear to be more susceptible to burnout effects on clinical reasoning, which may indicate that residents may need both cognitive and emotional support to improve quality of life and to optimize performance and learning. These results inform our understanding of mental stress, cognitive control as well as cognitive load theory

    Does the think-aloud protocol reflect thinking? Exploring functional neuroimaging differences with thinking (answering multiple choice questions) versus thinking aloud

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    Item does not contain fulltextBackground: Whether the think-aloud protocol is a valid measure of thinking remains uncertain. Therefore, we used functional magnetic resonance imaging (fMRI) to investigate potential functional neuroanatomic differences between thinking (answering multiple-choice questions in real time) versus thinking aloud (on review of items). Methods: Board-certified internal medicine physicians underwent formal think-aloud training. Next, they answered validated multiple-choice questions in an fMRI scanner while both answering (thinking) and thinking aloud about the questions, and we compared fMRI images obtained during both periods. Results: Seventeen physicians (15 men and 2 women) participated in the study. Mean physician age was 39.5 + 7 (range: 32-51 years). The mean number of correct responses was 18.5/32 questions (range: 15-25). Statistically significant differences were found between answering (thinking) and thinking aloud in the following regions: motor cortex, bilateral prefrontal cortex, bilateral cerebellum, and the basal ganglia (p < 0.01). Discussion: We identified significant differences between answering and thinking aloud within the motor cortex, prefrontal cortex, cerebellum, and basal ganglia. These differences were by degree (more focal activation in these areas with thinking aloud as opposed to answering). Prefrontal cortex and cerebellum activity was attributable to working memory. Basal ganglia activity was attributed to the reward of answering a question. The identified neuroimaging differences between answering and thinking aloud were expected based on existing theory and research in other fields. These findings add evidence to the notion that the think-aloud protocol is a reasonable measure of thinking

    A pilot study exploring the relationship between internists' self-reported sleepiness, performance on multiple-choice exam items and prefrontal cortex activity

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    Item does not contain fulltextBACKGROUND: Studies of resident fatigue and performance have shown mixed results. However, research has not examined daytime sleepiness and performance among attending physicians. The purpose of this study was to explore the relationship between sleep, performance and prefrontal cortex (PFC) activity. We hypothesized that sleepiness scores would negatively correlate with multiple-choice question (MCQ) performance and would also correlate with PFC activity. METHODS: Board-certified physicians completed an Epworth Sleepiness Scale (ESS) and then answered MCQs from licensing examinations while in a functional Magnetic Resonance Imaging (fMRI) scanner. RESULTS: Seventeen board-certified internists completed the study. The mean number of correct responses was 18.5/32. The correlation between the ESS and MCQ score was -0.30, and higher ESS scores were negatively associated with statistically significant changes in medial PFC (mPFC) activity. CONCLUSIONS: Attending physicians who reported higher sleepiness scores performed worse on licensing exam questions. Notably, our cohort had normal to mild sleepiness scores. Moreover, higher sleepiness scores were negatively associated with changes in mPFC activity on fMRI, which is consistent with emerging work implicating the PFC in fatigue-related cognitive impairment. Our findings have implications regarding the impact of sleep on physician performance during examinations and potentially on their care of patients

    Relationship of neuroimaging to typical sleep times during a clinical reasoning task: a pilot study

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    Item does not contain fulltextBACKGROUND: Sleep deprivation and fatigue have been associated with medical errors, clinical performance decrements, and reduced quality of life for both practicing physicians and medical students. Greater understanding of the impact of sleep quantity on clinical reasoning could improve patient care. The purpose of our pilot study was to examine relationships between clinical reasoning (assessed by functional magnetic resonance imaging) and sleep time (measured in different ways by actigraphy) while answering multiple-choice questions (MCQs) from licensing agencies. METHODS: Residents and faculty were administered a clinical reasoning exercise (MCQs from licensing bodies) during functional magnetic resonance imaging. Usual sleep patterns were sampled with actigraphy. Covariate analysis was used to examine the relationship between sleep duration (mean sleep, minimum sleep, maximum sleep) and brain activity during clinical reasoning (solving MCQs from licensing bodies). RESULTS: The mean sleep time over the duration of monitoring for the group was 7.19 hours (SD 0.66) with a range of 6.1 to 8.1 hours (internal medicine faculty 7.1 hours, SD 0.41; internal medicine residents 7.27 hours, SD 0.92). There was a negative relationship between activation in the prefrontal cortex and minimum sleep time while reflecting on MCQs. CONCLUSION: Our findings provide evidence that the quantity of sleep can modulate brain activity while completing a clinically meaningful task that should be confirmed in larger studies. Our findings suggest that the construct of sleepiness may be more complex than appreciated by many and that the most important of these sleep measures in terms of outcomes remains to be determined
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