The holistic phase model of early adult crisis

The objective of the current study was to explore the structural, temporal and experiential manifestations of crisis episodes in early adulthood, using a holistic-systemic theoretical framework. Based on an analysis of 50 interviews with individuals about a crisis episode between the ages of 25 and 35, a holistic model was developed. The model comprises four phases: (1) Locked-in, (2) Separation/Time-out, (3) Exploration and (4) Rebuilding, which in turn have characteristic features at four levels—person-in-environment, identity, motivation and affect-cognition. A crisis starts out with a commitment at work or home that has been made but is no longer desired, and this is followed by an emotionally volatile period of change as that commitment is terminated. The positive trajectory of crisis involves movement through an exploratory period towards active rebuilding of a new commitment, but ‘fast-forward’ and ‘relapse’ loops can interrupt Phases 3 and 4 and make a positive resolution of the episode less likely. The model shows conceptual links with life stage theories of emerging adulthood and early adulthood, and it extends current understandings of the transitional developmental challenges that young adults encounter

Not lost in translation: Managerial career narratives and the construction of protean identities

How can managers remain in charge of their own careers based on personal values and motivations, rather than surrendering to the vulnerabilities of modern day corporate bureaucracies? This question represents a core issue for managers whose careers have been significantly affected by changing business environments, new organizational forms and the related changes of work organization in modern day corporations. Managers can no longer rely on the traditional linear models of organizational careers. It is increasingly demanded that they be more flexible and direct their own careers, which is captured in new career concepts, such as the ‘protean career’. Drawing on narrative identity theory, this study sets out to investigate how managers construct a protean identity and how specific narrative practices support individuals in shaping, implementing and defending this identity. The life stories of 29 individuals, all of whom have experienced significant career changes, are analysed. Based on these stories, four core narrative building blocks at the heart of protean identity construction and related narrative practices are identified, including (i) the discovery of conflicting expectations, (ii) the exploration of one’s own values and capabilities, (iii) the commitment to one’s own path and (iv) defending that path

Plasmonically Enhanced Reflectance of Heat Radiation from Low-Bandgap Semiconductor Microinclusions

Increased reflectance from the inclusion of highly scattering particles at low volume fractions in an insulating dielectric offers a promising way to reduce radiative thermal losses at high temperatures. Here, we investigate plasmonic resonance driven enhanced scattering from microinclusions of low-bandgap semiconductors (InP, Si, Ge, PbS, InAs and Te) in an insulating composite to tailor its infrared reflectance for minimizing thermal losses from radiative transfer. To this end, we compute the spectral properties of the microcomposites using Monte Carlo modeling and compare them with results from Fresnel equations. The role of particle size-dependent Mie scattering and absorption efficiencies, and, scattering anisotropy are studied to identify the optimal microinclusion size and material parameters for maximizing the reflectance of the thermal radiation. For composites with Si and Ge microinclusions we obtain reflectance efficiencies of 57 - 65% for the incident blackbody radiation from sources at temperatures in the range 400 - 1600 {\deg}C. Furthermore, we observe a broadbanding of the reflectance spectra from the plasmonic resonances due to charge carriers generated from defect states within the semiconductor bandgap. Our results thus open up the possibility of developing efficient high-temperature thermal insulators through use of the low-bandgap semiconductor microinclusions in insulating dielectrics.Comment: Main article (8 Figures and 2 Tables) + Supporting Information (8 Figures

Physicians' communication skills with patients and legal liability in decided medical malpractice litigation cases in Japan

<p>Abstract</p> <p>Background</p> <p>In medical malpractice litigations in recent years in Japan, it is notable that the growing number of medical litigation cases includes the issue of a doctor's explanation to the patient as a pivotal point. The objective of this study was to identify factors of physicians' communication skills with patients, as related to their legal liability, and differences in doctors' communication skills with patients by the type of medical facility.</p> <p>Methods</p> <p>Decisions of medical malpractice litigation cases between 1988 and 2005 in Japan, the pivotal issue of which was a physician's explanation, were analyzed in the study. The content of each decision was summarized using the study variables (information about the patient, doctor, manner of the doctor's explanation, and subsequent litigation), and a database comprising the content of each decision (<it>N </it>= 100) was constructed. In order to evaluate an association between doctors' communication skills with patients and the outcome of the litigation, the analysis was performed based on the outcome of litigation or the type of medical facility.</p> <p>Results</p> <p>The ratio of acknowledged physician liability by court decision was lower in cases in which the doctor's explanation occurred before treatment or surgery (<it>p </it>= 0.013). The ratio of acknowledged physician liability by court decision was higher in cases of elective or non-urgent treatment (<it>p </it>= 0.046). The ratio of acknowledged physician liability by court decision was higher in clinics than in hospital groups (<it>p </it>= 0.036).</p> <p>Conclusion</p> <p>These findings are beneficial for the prevention of medical disputes and improvement of patient-physician communication.</p

Handling linkage disequilibrium in qualitative trait linkage analysis using dense SNPs: a two-step strategy

<p>Abstract</p> <p>Background</p> <p>In affected sibling pair linkage analysis, the presence of linkage disequilibrium (LD) has been shown to lead to overestimation of the number of alleles shared identity-by-descent (IBD) among sibling pairs when parents are ungenotyped. This inflation results in spurious evidence for linkage even when the markers and the disease locus are not linked. In our study, we first theoretically evaluate how inflation in IBD probabilities leads to overestimation of a nonparametric linkage (NPL) statistic under the assumption of linkage equilibrium. Next, we propose a two-step processing strategy in order to systematically evaluate approaches to handle LD. Based on the observed inflation of expected logarithm of the odds ratio (LOD) from our theoretical exploration, we implemented our proposed two-step processing strategy. Step 1 involves three techniques to filter a dense set of markers. In step 2, we use the selected subset of markers from step 1 and apply four different methods of handling LD among dense markers: 1) marker thinning (MT); 2) recursive elimination; 3) SNPLINK; and 4) LD modeling approach in MERLIN. We evaluate relative performance of each method through simulation.</p> <p>Results</p> <p>We observed LOD score inflation only when the parents were ungenotyped. For a given number of markers, all approaches evaluated for each type of LD threshold performed similarly; however, RE approach was the only one that eliminated the LOD score bias. Our simulation results indicate a reduction of approximately 75% to complete elimination of the LOD score inflation while maintaining the information content (IC) when setting a tolerable squared correlation coefficient LD threshold (r²) above 0.3 for or 2 SNPs per cM using MT.</p> <p>Conclusion</p> <p>We have established a theoretical basis of how inflated IBD information among dense markers overestimates a NPL statistic. The two-step processing strategy serves as a useful framework to systematically evaluate relative performance of different methods to handle LD.</p

Medical school faculty discontent: prevalence and predictors of intent to leave academic careers

<p>Abstract</p> <p>Background</p> <p>Medical school faculty are less enthusiastic about their academic careers than ever before. In this study, we measured the prevalence and determinants of intent to leave academic medicine.</p> <p>Methods</p> <p>A 75-question survey was administered to faculty at a School of Medicine. Questions addressed quality of life, faculty responsibilities, support for teaching, clinical work and scholarship, mentoring and participation in governance.</p> <p>Results</p> <p>Of 1,408 eligible faculty members, 532 (38%) participated. Among respondents, 224 (40%; CI95: 0.35, 0.44) reported that their careers were not progressing satisfactorily; 236 (42%; CI95: 0.38, 0.46) were "seriously considering leaving academic medicine in the next five years." Members of clinical departments (OR = 1.71; CI95: 1.01, 2.91) were more likely to consider leaving; members of inter-disciplinary centers were less likely (OR = 0.68; CI95: 0.47, 0.98). The predictors of "serious intent to leave" included: Difficulties balancing work and family (OR = 3.52; CI95: 2.34, 5.30); inability to comment on performance of institutional leaders (OR = 3.08; CI95: 2.07, 4.72); absence of faculty development programs (OR = 3.03; CI95: 2.00, 4.60); lack of recognition of clinical work (OR = 2.73; CI95: 1.60, 4.68) and teaching (OR = 2.47; CI95: 1.59, 3.83) in promotion evaluations; absence of "academic community" (OR = 2.67; CI95: 1.86, 3.83); and failure of chairs to evaluate academic progress regularly (OR = 2.60; CI95: 1.80, 3.74).</p> <p>Conclusion</p> <p>Faculty are a medical school's key resource, but 42 percent are seriously considering leaving. Medical schools should refocus faculty retention efforts on professional development programs, regular performance feedback, balancing career and family, tangible recognition of teaching and clinical service and meaningful faculty participation in institutional governance.</p

Physicians' explanatory behaviours and legal liability in decided medical malpractice litigation cases in Japan

<p>Abstract</p> <p>Background</p> <p>A physician's duty to provide an adequate explanation to the patient is derived from the doctrine of informed consent and the physician's duty of disclosure. However, findings are extremely limited with respect to physicians' specific explanatory behaviours and what might be regarded as a breach of the physicians' duty to explain in an actual medical setting. This study sought to identify physicians' explanatory behaviours that may be related to the physicians' legal liability.</p> <p>Methods</p> <p>We analysed legal decisions of medical malpractice cases between 1990 and 2009 in which the pivotal issue was the physician's duty to explain (366 cases). To identify factors related to the breach of the physician's duty to explain, an analysis was undertaken based on acknowledged breaches with regard to the physician's duty to explain to the patient according to court decisions. Additionally, to identify predictors of physicians' behaviours in breach of the duty to explain, logistic regression analysis was performed.</p> <p>Results</p> <p>When the physician's explanation was given before treatment or surgery (<it>p </it>= 0.006), when it was relevant or specific (<it>p </it>= 0.000), and when the patient's consent was obtained (<it>p </it>= 0.002), the explanation was less likely to be deemed inadequate or a breach of the physician's duty to explain. Patient factors related to physicians' legally problematic explanations were patient age and gender. One physician factor was related to legally problematic physician explanations, namely the number of physicians involved in the patient's treatment.</p> <p>Conclusion</p> <p>These findings may be useful in improving physician-patient communication in the medical setting.</p

Entrepreneurs’ age, institutions, and social value creation goals: a multi-country study

This study explores the relationship between an entrepreneur's age and his/her social value creation goals. Building on the lifespan developmental psychology literature and institutional theory, we hypothesize a U-shaped relationship between entrepreneurs’ age and their choice to create social value through their ventures, such that younger and older entrepreneurs create more social value with their businesses while middle age entrepreneurs are relatively more economically and less socially oriented with their ventures. We further hypothesize that the quality of a country’s formal institutions in terms of economic, social, and political freedom steepen the U-shaped relationship between entrepreneurs’ age and their choice to pursue social value creation as supportive institutional environments allow entrepreneurs to follow their age-based preferences. We confirm our predictions using multilevel mixed-effects linear regressions on a sample of over 15,000 entrepreneurs (aged between 18 and 64 years) in 45 countries from Global Entrepreneurship Monitor data. The findings are robust to several alternative specifications. Based on our findings, we discuss implications for theory and practice, and we propose future research directions

Network Centrality of Metro Systems

Whilst being hailed as the remedy to the world’s ills, cities will need to adapt in the 21st century. In particular, the role of public transport is likely to increase significantly, and new methods and technics to better plan transit systems are in dire need. This paper examines one fundamental aspect of transit: network centrality. By applying the notion of betweenness centrality to 28 worldwide metro systems, the main goal of this paper is to study the emergence of global trends in the evolution of centrality with network size and examine several individual systems in more detail. Betweenness was notably found to consistently become more evenly distributed with size (i.e. no “winner takes all”) unlike other complex network properties. Two distinct regimes were also observed that are representative of their structure. Moreover, the share of betweenness was found to decrease in a power law with size (with exponent 1 for the average node), but the share of most central nodes decreases much slower than least central nodes (0.87 vs. 2.48). Finally the betweenness of individual stations in several systems were examined, which can be useful to locate stations where passengers can be redistributed to relieve pressure from overcrowded stations. Overall, this study offers significant insights that can help planners in their task to design the systems of tomorrow, and similar undertakings can easily be imagined to other urban infrastructure systems (e.g., electricity grid, water/wastewater system, etc.) to develop more sustainable cities

Benefits of Stimulus Congruency for Multisensory Facilitation of Visual Learning

Background. Studies of perceptual learning have largely focused on unisensory stimuli. However, multisensory interactions are ubiquitous in perception, even at early processing stages, and thus can potentially play a role in learning. Here, we examine the effect of auditory-visual congruency on visual learning. Methodology/Principle Findings. Subjects were trained over five days on a visual motion coherence detection task with either congruent audiovisual, or incongruent audiovisual stimuli. Comparing performance on visual-only trials, we find that training with congruent audiovisual stimuli produces significantly better learning than training with incongruent audiovisual stimuli or with only visual stimuli. Conclusions/ Significance. This advantage from stimulus congruency during training suggests that the benefits of multisensory training may result from audiovisual interactions at a perceptual rather than cognitive level