The Unlit Path Behind the House by Margo Wheaton

Review of Margo Wheaton\u27s The Unlit Path Behind the House

Hazardous to your health: a novel approach to facilitating resident error reporting

BACKGROUND: Medical errors are frequently encountered by trainees but there is currently no standard curriculum for educating residents about medical errors. Morning report is a case-based peer-facilitated conference in which residents learn concepts in general internal medicine. We used our standard Chief Resident facilitated morning report to enhance resident learning about medical errors. PURPOSE: Evaluate house staff experiences with medical errors and to facilitate resident discussion, understating and reporting of medical errors using a morning report format. DESCRIPTION: Our Quality Chief Resident designed and led a 50-minute morning report by selecting 3 cases of medical errors that had occurred recently on the teaching service: (1) a missed diagnosis that did not result in harm, (2) a delay in initiation of antibiotic therapy due to prolonged administrative approvals, and (3) discovery of a previously unrecognized error by a colleague when the patient was transferred to another service. For each instance, relevant clinical aspects of the case were presented, followed by resident-lead small group discussions about the seriousness of the error, reporting obligations, patient disclosure, and provider emotions. A more formal discussion was then led by the Quality Chief and an attending hospitalist that included the following principles of patient safety and just culture: differentiating adverse events from medical error; harm and near miss; reporting obligations; ethics of disclosure; and the concept of second victim. 17/19 residents and 4/5 faculty attendees completed a voluntary anonymous survey at the end of the session. 88% of residents reported being involved in patient care when an error had occurred and 50% involved in an error with serious patient harm. 75% of residents had experienced emotional distress and 71% reported feelings of guilt related to patient errors. Only 47% reported any previous education about medical errors. Respondents self-reported confidence in reporting errors rose from 31% before the session to 77% reported after the conference. 88% of respondents found the session useful or very useful, and 93% recommended continuing these sessions in the future. CONCLUSIONS: Residents commonly encounter patient care errors which frequently result in feelings of emotional distress and guilt. A peer-led case-based morning report improved resident confidence in error reporting and was felt to be useful to surveyed attendees.\u2

Hip MR Arthrography for Acetabular Labral Tears

Peer Reviewedhttps://deepblue.lib.umich.edu/bitstream/2027.42/145325/1/cpmia2602.pd

Abnormalities of the Osseous Structures of the Hip and Peri‐Articular Soft Tissues

This unit presents a basic protocol for detection and assessment of a large number of disorders arising in the bones of the hip or the surrounding soft tissues, including osteonecrosis, transient osteopenia, fractures, soft tissue injuries, and tumors. All of these disorders can be readily assessed without the use of a contrast agent. The evaluation of intra‐articular structures, in particular the acetabular labrum, however, is probably best accomplished with the use of the direct injection of a Gd‐chelate contrast agent into the hip joint. The protocol is presented for a 1.5‐Tesla system for evaluation of disease in the region of the hip. Modifications for low‐field (0.23 to 0.3 T) systems are also discussed.Peer Reviewedhttps://deepblue.lib.umich.edu/bitstream/2027.42/145311/1/cpmia2601.pd

Environmental Policy Update 2012: Development Strategies and Environmental Policy in East Africa

The seven chapters that comprise this report explore ways to integrate sustainability goals and objectives into Ethiopia's current development strategies

On the persistence of strategic sophistication

We examine whether the “Level-k” model of strategic behavior generates reliable cross-game predictions at the individual level. We find no correlation in subjects' estimated levels of reasoning across two families of games. Furthermore, estimating a higher level for Ann than Bob in one family of games does not predict their ranking in the other. Direct tests of strategic reasoning generally do not predict estimated levels. Within families of games, we find that levels are fairly consistent within one family, but not the other. Our results suggest that the use of Level-k reasoning varies by game, making prediction difficult

Design, development and validation of a model of problem solving for Egyptian Science classes

Educators and policymakers envision the future of education in Egypt as enabling learners to acquire scientific inquiry and problem-solving skills. In this article, we describe the validation of a model for problem solving and the design of instruments for evaluating new teaching methods in Egyptian science classes. The instruments were based on an established model for problem solving and were designed to assess seventh grade students’ problem solving, experimental strategy knowledge, achievement and motivation towards science. The test for assessing students’ knowledge has been developed based on the topic, density and buoyancy which will be taught in seventh grade in a later intervention study. The instruments were partly self-developed and partly adapted from newly performed studies on strategy knowledge and problem solving in Germany. All instruments were translated into Arabic; the translation process and quality control are described. In order to determine the quality of the instruments, 44 students in Egypt completed the questionnaires and tests. The study’s aim to develop and validate the instruments did require an ad hoc and typical sample which was drawn from an accessible population. Accordingly, the characteristics of the sample are described. Data were analysed according to the classical test theory, but to underpin the results, the instruments were additionally analysed using the even stronger Rasch model. The findings demonstrated the reliability of the items and aspects of validity. In addition, this study showed how test items can be successfully developed and adapted in an international study and applied in a different language

The Formation of the Bicoid Morphogen Gradient Requires Protein Movement from Anteriorly Localized mRNA

New quantitative data show that the Bicoid morphogen gradient is generated from a dynamic localized source and that protein gradient formation requires protein movement along the anterior-posterior axis