Impact of Generalist Physician Initiatives on Residency Selection

Objective:To compare the residency selection choices of students who experienced courses resulting from generalist physician initiatives to choices made by students prior to the implementation of those courses and to describe the characteristics of students selecting primary care residencies. Background:In the fall of 1994 a first year Community Continuity Experience course was initiated and in the summer of 1995 a third year Multidisciplinary Ambulatory Clerkship was begun at the University of Texas Medical Branch in Galveston. These courses were inserted into the curriculum to enhance and promote primary care education. Design/Methods:We examined the residency selections of cohorts of graduating medical students before (1992-1996) and after (1997-1999) the implementation of the primary care courses. Survey information on career preferences at matriculation and in the fourth year of medical school were available for students graduating after the programs began. We compared the career preferences and characteristics of those students who selected a primary care residency to those who did not. Results:Prior to the implementation of the programs, 45%(425/950) of students graduating selected primary care residencies compared to 45% (210/465) of students participating in the programs (p=0.88). At matriculation, 45% of students had listed a primary care discipline as their first career choice. Among the students who had indicated this degree of primary care interest 61% ended up matching in a primary care discipline. At year 4, 31% of students indicated a primary care discipline as their first career choice and 92% of these students matched to a primary care residency. By univariate analysis, minority students (53%) were more likely to select a primary care residency than non-minority students (40%); students in the two lowest grade point average quartiles (55% and 50%) selected primary care residencies compared to 37% and 38% of students in the top 2 quartiles; and students who stated that income potential had little or no impact on their choice were more likely to select a primary care residency (48%) than those who said income potential was important (37%). Conclusions:We observed no significant trend towards higher proportions of graduating students selecting primary care discipline residencies as a result of implementing courses that emphasized primary care. Those students expressing an interest in a primary care discipline at their entrance into medical school were more likely to select a primary care residency. A more significant impact on graduating students interested in primary care may be made through the medical student selection process than by altering the curriculum

Mineral Occurrence Database suggestions for revision and update 2005

The Mineral Occurrence Database contains over 12000 entries from all parts of Great Britain. It includes mineral occurrences associated with old mines and trials, unexploited more recent discoveries and panned stream sediment concentrates (mainly gold grains). It was developed in Oracle, using an Access interface with the user, in the mid 1990s. The database structure has been unaltered for many years. It now requires a thorough re-examination of all the entries to check their validity as well as a re-examination of the relationships between tables as some of the links have become corrupted and new data entry is either difficult or impossible. The database has an important role in the future with the increasing interest in mine waste and environmental contamination, as well as to assist any commercial mineral exploration companies if necessary. However, this can only be realised if the database is current, accurate and comprehensive in both coverage and content. The database has many problems and these are detailed in this report together with possible solutions. In addition, a number of suggestions are made for the update of the database, with estimates for the time required

Allometry and growth of eight tree taxa in United Kingdom woodlands.

This work is licensed under a Creative Commons Attribution 4.0 International License. The images or other third party material in this article are included in the article’s Creative Commons license, unless indicated otherwise in the credit line; if the material is not included under the Creative Commons license, users will need to obtain permission from the license holder to reproduce the material. To view a copy of this license, visit http://creativecommons.org/licenses/by/4.0As part of a project to develop predictive ecosystem models of United Kingdom woodlands we have collated data from two United Kingdom woodlands - Wytham Woods and Alice Holt. Here we present data from 582 individual trees of eight taxa in the form of summary variables relating to the allometric relationships between trunk diameter, height, crown height, crown radius and trunk radial growth rate to the tree's light environment and diameter at breast height. In addition the raw data files containing the variables from which the summary data were obtained. Large sample sizes with longitudinal data spanning 22 years make these datasets useful for future studies concerned with the way trees change in size and shape over their life-span

Comparison of Best Management Practice Adoption Between Virginia\u27s Chesapeake Bay Basin and Southern Rivers Watersheds

Producers in two regions of Virginia (Chesapeake Bay basin and Southern Rivers region) were surveyed to compare farming practices and agricultural best management practice (BMP) adoption. Objectives were to assess farming operations and determine the extent of cost-share and non-cost-share BMP implementation and gain insight into the impact of selected socioeconomic factors on the BMP adoption. Although farming characteristics and producer attitudes toward pollution and water quality were similar, BMP implementation differed between the two regions. Differences in BMP implementation may be due to a more focused, longer-term NPS pollution control educational effort in the Bay basin

Theoretical Analysis of the Stress Induced B-Z Transition in Superhelical DNA

We present a method to calculate the propensities of regions within a DNA molecule to transition from B-form to Z-form under negative superhelical stresses. We use statistical mechanics to analyze the competition that occurs among all susceptible Z-forming regions at thermodynamic equilibrium in a superhelically stressed DNA of specified sequence. This method, which we call SIBZ, is similar to the SIDD algorithm that was previously developed to analyze superhelical duplex destabilization. A state of the system is determined by assigning to each base pair either the B- or the Z-conformation, accounting for the dinucleotide repeat unit of Z-DNA. The free energy of a state is comprised of the nucleation energy, the sequence-dependent B-Z transition energy, and the energy associated with the residual superhelicity remaining after the change of twist due to transition. Using this information, SIBZ calculates the equilibrium B-Z transition probability of each base pair in the sequence. This can be done at any physiologically reasonable level of negative superhelicity. We use SIBZ to analyze a variety of representative genomic DNA sequences. We show that the dominant Z-DNA forming regions in a sequence can compete in highly complex ways as the superhelicity level changes. Despite having no tunable parameters, the predictions of SIBZ agree precisely with experimental results, both for the onset of transition in plasmids containing introduced Z-forming sequences and for the locations of Z-forming regions in genomic sequences. We calculate the transition profiles of 5 kb regions taken from each of 12,841 mouse genes and centered on the transcription start site (TSS). We find a substantial increase in the frequency of Z-forming regions immediately upstream from the TSS. The approach developed here has the potential to illuminate the occurrence of Z-form regions in vivo, and the possible roles this transition may play in biological processes

Pulsation period variations in the RRc Lyrae star KIC 5520878

Learned et. al. proposed that a sufficiently advanced extra-terrestrial civilization may tickle Cepheid and RR Lyrae variable stars with a neutrino beam at the right time, thus causing them to trigger early and jogging the otherwise very regular phase of their expansion and contraction. This would turn these stars into beacons to transmit information throughout the galaxy and beyond. The idea is to search for signs of phase modulation (in the regime of short pulse duration) and patterns, which could be indicative of intentional, omnidirectional signaling. We have performed such a search among variable stars using photometric data from the Kepler space telescope. In the RRc Lyrae star KIC 5520878, we have found two such regimes of long and short pulse durations. The sequence of period lengths, expressed as time series data, is strongly auto correlated, with correlation coefficients of prime numbers being significantly higher ($p=99.8$\%). Our analysis of this candidate star shows that the prime number oddity originates from two simultaneous pulsation periods and is likely of natural origin. Simple physical models elucidate the frequency content and asymmetries of the KIC 5520878 light curve. Despite this SETI null result, we encourage testing other archival and future time-series photometry for signs of modulated stars. This can be done as a by-product to the standard analysis, and even partly automated.Comment: Accepted for publication in ApJ. 49 pages, 16 figure

The effect of the addition of SiCp on the mechanical behaviour of silane treated epoxy and polyester composites reinforced with unidirectional carbon fiber fabric.

The prime material for performance intensive applications is carbon fiber reinforced polymer composites (CFRPC). Researchers have improved the properties of CFRPC by creating a stronger interface between the constituents either by treating the fiber surface with alkalis, oxidization agents or gases. However, there is a possibility of fiber damage during treatment. In this investigation two different matrices viz., epoxy and polyester were modified by incorporating (3-Aminopropyl)trimethoxysilane coupling agent and silicon carbide particulate filler (SiCp). The effect of matrix modification on the mechanical behaviour of CFRPC is investigated in terms of tensile, flexural and impact properties. It was observed that CFRPC with modified matrices had better properties due to improved adhesion between the constituents. In particular, carbon fiber reinforced 10 wt. % SiCp filled silane treated polyester matrix composite had better mechanical properties. The results have been supplemented with morphological investigation

A stitch in time: Efficient computation of genomic DNA melting bubbles

Background: It is of biological interest to make genome-wide predictions of the locations of DNA melting bubbles using statistical mechanics models. Computationally, this poses the challenge that a generic search through all combinations of bubble starts and ends is quadratic. Results: An efficient algorithm is described, which shows that the time complexity of the task is O(NlogN) rather than quadratic. The algorithm exploits that bubble lengths may be limited, but without a prior assumption of a maximal bubble length. No approximations, such as windowing, have been introduced to reduce the time complexity. More than just finding the bubbles, the algorithm produces a stitch profile, which is a probabilistic graphical model of bubbles and helical regions. The algorithm applies a probability peak finding method based on a hierarchical analysis of the energy barriers in the Poland-Scheraga model. Conclusions: Exact and fast computation of genomic stitch profiles is thus feasible. Sequences of several megabases have been computed, only limited by computer memory. Possible applications are the genome-wide comparisons of bubbles with promotors, TSS, viral integration sites, and other melting-related regions.Comment: 16 pages, 10 figure

The Clinical Reasoning Assessment Tool for Learning from Standardized Patient Experiences: A Pilot Study

Purpose: Clinical reasoning (CR) is the ability to integrate the knowledge of diagnoses with the use of supporting theories to create effective, client-centered interventions. One means of teaching CR to rehabilitation students is using standardized patient (SP) experiences. The relationship between faculty and student CR ratings after SP experiences has not been researched. The purpose of the study was to determine if there would be correlations between physical therapy (PT) and occupational therapy (OT) student and faculty ratings of CR skills after an SP experience. Method: The Clinical Reasoning Assessment Tool (CRAT) was used by students to self-reflect on their CR performance after an SP experience and compared to their respective faculty ratings. The CRAT includes three subsections: content knowledge, procedural knowledge, and conceptual reasoning, each with a visual analog scale. Correlations between students’ self-assessment of CR and faculty reviews were analyzed using Spearman’s rho correlations. Results: Seventeen PT and seventeen OT students participated. Spearman’s rho correlation coefficients for the PT students and their faculty were: content knowledge (r=.180; p=.488), procedural knowledge (r=.697; p=.002), and conceptual reasoning (r=.258; p=.317). Spearman’s rho correlation coefficients for the OT students and their faculty were: content knowledge (r=.103; p=.693), procedural knowledge (r=.676; p=.003), and conceptual reasoning (r=.505; p=.039). Conclusions: Neither PT nor OT student ratings was a statistically significant correlation in content knowledge ratings in relation to respective faculty ratings. Both PT and OT student procedural knowledge rating correlations with faculty were strong and statistically significant. PT student and faculty ratings were not significantly correlated in conceptual reasoning compared to faculty; however, OT students and faculty ratings were strong, had positive correlations, and were statistically significant. Further research is needed to assess students’ CR development longitudinally across curricula