Introduction de carnets d’apprentissage expérientiel portant sur la responsabilité sociale à l’externat au doctorat de premier cycle en médecine

Implication Statement Medical schools have a responsibility to ensure students meet and advocate for the needs of the community. However, addressing the social determinants of health is not always emphasized in clinical learning objectives. Learning logs are useful tools that can engage students to reflect on clinical encounters and direct students in their learning to target the development of highlighted skills. Despite their efficacy, the use of learning logs in medical education is largely applied towards biomedical knowledge and procedural skills. Thus, students may lack competence to address the psychosocial challenges involved in comprehensive medical care. Social accountability experiential logs were developed for third year medical students at the University of Ottawa to address and intervene on the social determinants of health. Students completed quality improvement surveys and results demonstrated this initiative to be beneficial to their learning and contributed to greater clinical confidence. Experiential logs in clinical training can be adapted across other medical schools and tailored to fit the needs and priorities of each institution’s local communities.Énoncé des implications de la recherche Les facultés de médecine ont la responsabilité de s’assurer que les étudiants répondent aux besoins de la collectivité et militent pour leur satisfaction. Or, les objectifs d’apprentissage clinique ne sont pas toujours axés sur les déterminants sociaux de la santé. L’utilité des carnets d’apprentissage est d’inciter les étudiants à réfléchir sur les rencontres cliniques et de les orienter dans leur apprentissage vers le développement des compétences ciblées. Malgré leur efficacité, les carnets d’apprentissage sont surtout appliqués aux connaissances biomédicales et aux compétences procédurales. Par conséquent, les étudiants pourraient ne pas disposer des compétences nécessaires pour relever les enjeux psychosociaux, qui sont à considérer aux fins d’une prise en charge médicale globale. Des carnets d’apprentissage expérientiel portant sur la responsabilité sociale ont été élaborés pour les étudiants en médecine de troisième année de l’Université d’Ottawa afin d’aborder et d’intervenir sur les déterminants sociaux de la santé. Les étudiants ont participé à des sondages sur l’amélioration de la qualité et les résultats de ceux-ci ont montré que cette initiative était bénéfique pour leur apprentissage et qu’elle contribuait à améliorer leur confiance en eux en tant que cliniciens. Les carnets expérientiels en formation clinique peuvent être adaptés par les diverses facultés de médecine pour qu’ils correspondent aux besoins et aux priorités des collectivités locales qu’elles desservent

Geometrical dependence of low frequency noise in superconducting flux qubits

A general method for directly measuring the low-frequency flux noise (below 10 Hz) in compound Josephson junction superconducting flux qubits has been used to study a series of 85 devices of varying design. The variation in flux noise across sets of qubits with identical designs was observed to be small. However, the levels of flux noise systematically varied between qubit designs with strong dependence upon qubit wiring length and wiring width. Furthermore, qubits fabricated above a superconducting ground plane yielded lower noise than qubits without such a layer. These results support the hypothesis that localized magnetic impurities in the vicinity of the qubit wiring are a key source of low frequency flux noise in superconducting devices.Comment: 5 pages, 5 figure

Security proof of a three-state quantum key distribution protocol without rotational symmetry

Standard security proofs of quantum key distribution (QKD) protocols often rely on symmetry arguments. In this paper, we prove the security of a three-state protocol that does not possess rotational symmetry. The three-state QKD protocol we consider involves three qubit states, where the first two states, |0_z> and |1_z>, can contribute to key generation and the third state, |+>=(|0_z>+|1_z>)/\sqrt{2}, is for channel estimation. This protocol has been proposed and implemented experimentally in some frequency-based QKD systems where the three states can be prepared easily. Thus, by founding on the security of this three-state protocol, we prove that these QKD schemes are, in fact, unconditionally secure against any attacks allowed by quantum mechanics. The main task in our proof is to upper bound the phase error rate of the qubits given the bit error rates observed. Unconditional security can then be proved not only for the ideal case of a single-photon source and perfect detectors, but also for the realistic case of a phase-randomized weak coherent light source and imperfect threshold detectors. Our result on the phase error rate upper bound is independent of the loss in the channel. Also, we compare the three-state protocol with the BB84 protocol. For the single-photon source case, our result proves that the BB84 protocol strictly tolerates a higher quantum bit error rate than the three-state protocol; while for the coherent-source case, the BB84 protocol achieves a higher key generation rate and secure distance than the three-state protocol when a decoy-state method is used.Comment: 10 pages, 3 figures, 2 column

Measured and Calculated Dynamic Response of Rock-Fill Dam

The U.S. Army Corps of Engineers recently completed a seismic stability assessment of the Ririe Darn and Reservoir Project located near Idaho Falls, Idaho. Ririe Darn is an earth- and rockfill darn with a central impervious core constructed between 1966 and 1975 in a narrow canyon of Willow Creek. A geologic and seismologic study indicated that the controlling maximum credible earthquake (MCE} is a Magnitude 7.5 earthquake at a distance of 8 km from the darn. The seismic stability analysis included a dynamic response analysis of the darn using two-dimensional finite element procedures. Empirical relations derived from the observed response and analyses of other darns in narrow canyons were used to develop adjustment factors to correct natural frequencies, dynamic shear stresses, and peak accelerations for three-dimensional (3-D} effects. The October 28, 1983 Mt. Borah Earthquake triggered five strong-motion instruments installed at the crest, left abutment, downstream toe, and outlet tower of Ririe Darn. The epicentral distance to the darn was 179 km. The peak horizontal accelerations recorded at the crest and at the abutment were 0.05 g and 0.02 g, respectively. The accelerogram recorded by the instrument station at the abutment was used to calculate the dynamic response of the darn during the earthquake. From this analysis, the finite element model and the soil parameters were calibrated to best represent the 3-D dynamic response of the darn. After consideration of 3-D effects, the calculated response of the darn using soil properties derived from in-situ and laboratory measurements was in good agreement with the measured response during the 1983 Mt. Borah earthquake. These results indicate that when properly applied, currently available methods to determine soil properties for the dynamic response analysis of embankment darns including in-situ measurements, can provide properties in good agreement with those back-calculated from the observed response of darns

The measurement of the winds near the ocean surface with a radiometer-scatterometer on Skylab

The author has identified the following significant results. There were a total of twenty-six passes in the ZLV mode that yielded useful data. Six were in the in-track noncontiguous mode; all others were in the cross-track noncontiguous mode. The wind speed and direction, as effectively determined in a neutral atmosphere at 19.5 m above the sea surface, were found for each cell scanned by S193. It is shown how the passive microwave measurements were used both to compute the attenuation of the radar beam and to determine those cells where the backscatter measurement was suspect. Given the direction of the wind from some independent source, with the typical accuracy of measurement by available meteorological methods, a backscatter measurement at a nadir angle of 50, 43, or 32 deg can be used to compute the speed of the wind averaged over the illuminated area

Instability and `Sausage-String' Appearance in Blood Vessels during High Blood Pressure

A new Rayleigh-type instability is proposed to explain the `sausage-string' pattern of alternating constrictions and dilatations formed in blood vessels under influence of a vasoconstricting agent. Our theory involves the nonlinear elasticity characteristics of the vessel wall, and provides predictions for the conditions under which the cylindrical form of a blood vessel becomes unstable.Comment: 4 pages, 4 figures submitted to Physical Review Letter

Seek, and ye shall find: Accessing the global epidemiological literature in different languages.

The thematic series Beyond English: Accessing the global epidemiological literature in Emerging Themes in Epidemiology highlights the wealth of epidemiological and public health literature in the major languages of the world, and the bibliographic databases through which they can be searched and accessed. This editorial suggests that all systematic reviews in epidemiology and public health should include literature published in the major languages of the world and that the use of regional and non-English bibliographic databases should become routine.Published versio

On the Consistency of Hedge Fund Indexes across Providers

Based on the style analysis pioneered in [Sharpe, W.F. (1992). Asset Allocation: Management Style and Performance Measurement, Journal of Portfolio Management, 7-19.] I define a procedure to examine the consistency of hedge fund indexes across providers. The results of my investigation suggest that the competing indexes of the different providers are homogeneous. However, I also find two cases for which one provider differently allocates the funds between styles compared to its peers

Influence of FK 506 (tacrolimus) on circulating CD4 ⁺ t cells expressing cd25 and cd45ra antigens in 19 patients with chronic progressive multiple sclerosis participating in an open label drug safety trial

We have taken the opportunity of a clinical trial of the potential efficacy and safety of FK 506 (tacrolimus) in chronic progressive multiple sclerosis (MS) to examine the influence of this potent new immunosuppressant on circulating T-lymphocytes in an otherwise healthy non-transplant population. Peripheral blood levels of subsets of CD4+ T lymphocytes expressing the activation molecule interleukin-2 receptor (p55 α chain; CD25) or the CD45RA isoform were determined sequentially in 19 patients that were treated continuously with oral FK 506 (starting dose 0.15 mg/kg/day) for 12 months. No significant change in the proportion of circulating CD25 + CD4+ cells was observed over the study period in which the mean trough plasma FK 506 level rose from 0.3 ±0.2 to 0.5 ±0.4 ng/ml. There was also no significant effect of FK 506 on the percentage of CD45RA + CD4 + cells in the peripheral blood at 12 months compared with pretreatment values. Analysis of a subgroup of 7 patients, who showed a sustained reduction in CD25 + CD4+ cells and a reciprocal increase in CD45RA* CD4 * cells for at least 6 months after start of treatment, did not reveal any difference in disability at one year compared with the treatment group as a whole. The side effects of FK 506 were mild and the overall degree of disability estimated by the mean Kurtzke expanded disability status scale (EDSS) score or the ambulation index did not deteriorate significantly in the 19 patients studied over the 12 months of FK 506 administration. © 1994 Informa UK Ltd All rights reserved: reproduction in whole or part not permitted