24 research outputs found

    Development and evaluation of a cultural competency training curriculum

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    BACKGROUND: Increasing the cultural competence of physicians and other health care providers has been suggested as one mechanism for reducing health disparities by improving the quality of care across racial/ethnic groups. While cultural competency training for physicians is increasingly promoted, relatively few studies evaluating the impact of training have been published. METHODS: We recruited 53 primary care physicians at 4 diverse practice sites and enrolled 429 of their patients with diabetes and/or hypertension. Patients completed a baseline survey which included a measure of physician culturally competent behaviors. Cultural competency training was then provided to physicians at 2 of the sites. At all 4 sites, physicians received feedback in the form of their aggregated cultural competency scores compared to the aggregated scores from other physicians in the practice. The primary outcome at 6 months was change in the Patient-Reported Physician Cultural Competence (PRPCC) score; secondary outcomes were changes in patient trust, satisfaction, weight, systolic blood pressure, and glycosylated hemoglobin. Multiple analysis of variance was used to control for differences patient characteristics and baseline levels of the outcome measure between groups. RESULTS: Patients had a mean of 2.8 + 2.2 visits to the study physician during the study period. Changes in all outcomes were similar in the "Training + Feedback" group compared to the "Feedback Only" group (PRPCC: 3.7 vs.1.8; trust: -0.7 vs. -0.2 ; satisfaction: 1.9 vs. 2.5; weight: -2.5 lbs vs. -0.7 lbs; systolic blood pressure: 1.7 mm Hg vs. 0.1 mm Hg; glycosylated hemoglobin 0.02% vs. 0.07%; p = NS for all). CONCLUSION: The lack of measurable impact of physician training on patient-reported and disease-specific outcomes in the current has several possible explanations, including the relatively limited nature of the intervention. We hope that the current study will help provide a basis for future studies, using more intensive interventions with different provider groups

    First 100 T Non-Destructive Magnet Outer Coil Set First 100 T Non-Destructive Magnet Outer Coil Set

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    Abstract-The controlled power outer coil set of the first 100 T non-destructive (100 T ND) magnet is described. This magnet will be installed as part of the user facility research equipment at the National High Magnetic Field laboratory (NHMFL) Pulsed Field Facility at Los Alamos National Laboratory. The 100 T ND controlled power outer coil set consists of seven nested, mechanically independent externally reinforced coils. These coils, in combination, will produce a 47 T platform field in a 225-mm diameter bore. Using inertial energy storage a synchronous motor/generator provides ac power to a set of seven ac-dc converters rated at 64 MW/80 MVA each. These converters energize three independent coil circuits to create 170 MJ of field energy in the outer coil set at the platform field of 47 T. Each coil consists of a multi-layer winding of high strength conductor supported by an external high strength stainless steel shell. Coils with the highest magnetic loads will utilize a reinforcing shell fabricated from highly cold worked 301 stainless steel strip. The autofrettage conditioning method will be used to pre-stress the coils and thereby limit conductor and reinforcement strains to the elastic range. The purpose of pre-stressing the coils is to attain a design life of 10,000 full field pulses. The operation and conditioning of the coil set will be described along with special features of its design, magnetic and structural analyses and construction. Index Terms-high field, pulsed magnet, 100 tesl
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