Needs Assessment in Postgraduate Medical Education:A Review

Although the concept of needs assessment in continuing medical education is well accepted, there is limited information on needs assessment in postgraduate medical education. We discuss the learning needs of postgraduate trainees and review the various methods of needs assessment such as: questionnaire surveys, interviews, focus groups, chart audits, chart-stimulated recall, standardized patients, and environmental scans in the context of post graduate medical education

Difference on perception of evaluation criteria between Division I and Iii head basketball coaches and athletic directors

The purpose of this study was to compare the differences in perceptions of evaluation criteria between athletic directors and head basketball coaches at National Collegiate Athletic Association Division I and III institutions in the western region of the United States. The objective of this study was to answer the question, is there a difference in perceptions of evaluation criteria by athletic directors and Division I and III basketball coaches? The researcher modified a 39 item questionnaire developed by Overton (1997) into a 21 item survey. The survey was sent to athletic directors and head men\u27s and women\u27s basketball coaches at a total of 114 universities and colleges in the western region: (a) fifty-four from Division I, and (b) sixty from Division III. Responses from the returned surveys were entered into a SPSS program (version 14.0) and analyzed utilizing a MANOVA for evaluation. Comparisons between athletic directors and coaches were conducted

A reexamination of the separable verb in selected Anglo-Saxon prose works

The systems of compounding verbs in Old English and German are analogous, but not every grammarian is agreed that Old English possessed a system of separable compound verbs. One authority, Joseph Wright, dismisses any need for discussing separable compounds in Old English on the grounds that they were merely juxtapositions of independent words, but others have shown that Old English did indeed possess such a system, notably T.P. Harrison, George Curme, and Murat Roberts. -- Three types of compound verbs can be distinguished in Old English: two groups which are inseparable and one which is separable. One of the inseparable groups is comprised of verbs or verb stems to which have been prefixed prepositions or decayed prepositions (a-, ge-, on-, mis-, etc.); the second inseparable type is formed with certain verbs to which nouns or adjectives have been added (nealæcan, efensorgian, etc.). The separable verb, so-called, is one which is used with an adverb or prepositional adverb (the term given to particles which function both as prepositions or as adverbs), but whose components are not always written together as one word. The adverbial particle may be found following the verb, for example, as in eode ōa in. -- This thesis re-examines the separable verb in Old English on a broader basis than some of the earlier studies. A considerable sampling of English prose has been made, much of it not translations of foreign sources, and the selections range from King Alfred’s Orosius through Wulfstan, Ælfric, and the late prose of the Peterborough Chronicle. -- Because stress in prose, whether spoken or read aloud, is difficult to ascertain, especially with the rather scanty legacy of Old English works, this linguistic aspect has been left to one side except for a brief mention of how it might have influenced the separation of verb and particles. Most authorities are agreed that the separable compound verb took the stress on the particle; the inseparable verb, on the verb base or stem. Separation or lack of it also affected the meaning of the verb as will be seen. -- In addition to the difficulty of determining stress in Old English prose, another problem met with is ambiguous or dubious syntax. Frequent examples of word order in which an objective pronoun is followed by a prepositional form and then a verb, allow two-fold interpretations. One can interpret the sequence as that of a prepositional phrase with the preposition placed after its object, or one may regard the structure as that of a compound verb with the pronoun object in the particular case required by usage. The ambiguity can sometimes be resolved by comparison to clear-cut illustrations in other areas of Old English; sometimes, analogous patterns and syntax in Old High German point to a compound verb; frequently, however, no definitive analysis can be made. -- Generally, compound verbs are formed with adverbs of place. This was the rule in Old High German and still is in present-day German; examination of representative texts in Old English prose shows a similar tendency for adverbs of place to form verbal combinations. Not every adverb of place formed a compound or combination, however, and adverbs in -an proved to be the least productive of such types. -- Unlike Modern English, Old English combinations of adverbial particle and verb tended to remain literal in meaning, but the frequency with which verb and particle occurred together points to real combinations or sense-units. -- Many of the prepositional adverbs are traditionally considered to form only inseparable compounds, but several instances were observed of both separable and inseparable usage for the same combination of verb and particle. -- Ofslean, for example, was used in both ways: separated, it means 'strike off, 'cut off; as an inseparable verb, 'kill'. Though not prefixed with a prepositional adverb, the Verb forōfaran also showed the same differentiation between a literal meaning when the verb and particle were separate and a figurative meaning when inseparable. According to the evidence of the corpus, the system in Old English was not as regular as it is in present-day German, but the basis of the principle of separation or lack of separation with consequent differences in literal and figurative meanings can clearly be seen. -- The following conclusions can be drawn: based on the frequency of occurrence and spread of usage among authors and by virtue of noun compounds composed of parallel verb-adverb combinations, adverbial particles often formed sense-units with the verb in close enough syntactical relationship to be considered true compounds or verb-adverb combinations. Prepositional adverbs formed obvious compounds, for the most part, but a large number of ambiguous cases must remain unresolved in classification either as prepositional constructions or as compound verbs. However, on the basis of comparison with Old High German, compound verbs in Old English may be more numerous than some grammarians have hitherto considered

Field-in-field breast planning for a jawless, double-stack MLC LINAC using flattening-filter-free beams

BACKGROUND: This study intends to develop an efficient field-in-field (FiF) planning technique with the Eclipse treatment planning system (TPS) to determine the feasibility of using the Halcyon treatment delivery system for 3D treatment of breast cancer. METHODS: Ten treatment plans were prepared on the Halcyon treatment planning system and compared to the same patients\u27 clinically delivered TrueBeam plans which used flattened 6 MV and 10 MV beams. Patients selected for this study were treated via simple, tangential breast irradiation and did not receive radiotherapy of the supraclavicular or internal mammary lymph nodes. Planning target volumes (PTV) volumes ranged from 519 cc to 1211 cc with a mean target volume of 877 cc. Several planning techniques involving collimator, gantry rotation, and number of FiF segments were investigated as well as the use of the dynamically flattened beam (DFB) - a predefined MLC pattern that is designed to provide a flattened beam profile at 10 cm depth on a standard water phantom. For comparison, the clinically delivered TrueBeam plans remained unaltered except for normalization of the target coverage to more readily compare the two treatment delivery techniques. RESULTS: Using the physician defined PTV, normalized such that 98% of the volume was covered by 95% of the prescribed dose, the Halcyon plans were deemed clinically acceptable and comparable to the TrueBeam plans by the radiation oncologist. Resulting average global maximum doses in the test patients were identical between the TrueBeam and Halcyon plans (108% of Rx) and a mean PTV dose of 102.5% vs 101.6%, respectively. CONCLUSIONS: From this study a practical and efficient planning method for delivering 3D conformal breast radiotherapy using the Halcyon linear accelerator has been developed. When normalized to the clinically desired coverage, hot spots were maintained to acceptable levels and overall plan quality was comparable to plans delivered on conventional C-arm LINACs

Planning and delivery of intensity modulated bolus electron conformal therapy

PURPOSE: Bolus electron conformal therapy (BECT) is a clinically useful, well-documented, and available technology. The addition of intensity modulation (IM) to BECT reduces volumes of high dose and dose spread in the planning target volume (PTV). This paper demonstrates new techniques for a process that should be suitable for planning and delivering IM-BECT using passive radiotherapy intensity modulation for electrons (PRIME) devices. METHODS: The IM-BECT planning and delivery process is an addition to the BECT process that includes intensity modulator design, fabrication, and quality assurance. The intensity modulator (PRIME device) is a hexagonal matrix of small island blocks (tungsten pins of varying diameter) placed inside the patient beam-defining collimator (cutout). Its design process determines a desirable intensity-modulated electron beam during the planning process, then determines the island block configuration to deliver that intensity distribution (segmentation). The intensity modulator is fabricated and quality assurance performed at the factory (.decimal, LLC, Sanford, FL). Clinical quality assurance consists of measuring a fluence distribution in a plane perpendicular to the beam in a water or water-equivalent phantom. This IM-BECT process is described and demonstrated for two sites, postmastectomy chest wall and temple. Dose plans, intensity distributions, fabricated intensity modulators, and quality assurance results are presented. RESULTS: IM-BECT plans showed improved D CONCLUSION: These results demonstrated the feasibility of translating IM-BECT to the clinic using the techniques presented for treatment planning, intensity modulator design and fabrication, and quality assurance processes

Posture and Locomotion Coupling: A Target for Rehabilitation Interventions in Persons with Parkinson's Disease

Disorders of posture, balance, and gait are debilitating motor manifestations of advancing Parkinson's disease requiring rehabilitation intervention. These problems often reflect difficulties with coupling or sequencing posture and locomotion during complex whole body movements linked with falls. Considerable progress has been made with demonstrating the effectiveness of exercise interventions for individuals with Parkinson's disease. However, gaps remain in the evidence base for specific interventions and the optimal content of exercise interventions. Using a conceptual theoretical framework and experimental findings, this perspective and review advances the viewpoint that rehabilitation interventions focused on separate or isolated components of posture, balance, or gait may limit the effectiveness of current clinical practices. It is argued that treatment effectiveness may be improved by directly targeting posture and locomotion coupling problems as causal factors contributing to balance and gait dysfunction. This approach may help advance current clinical practice and improve outcomes in rehabilitation for persons with Parkinson's disease

Bostonia: The Boston University Alumni Magazine. Volume 32

Founded in 1900, Bostonia magazine is Boston University's main alumni publication, which covers alumni and student life, as well as university activities, events, and programs