Niveau de connaissance, de confiance et d'acceptation des patients en ce qui concerne le rôle des résidents dans une clinique universitaire de médecine familiale

Background: Although participation of patients is essential for completing the training of medical residents, little is known about the relationships among patients’ level of knowledge about the role and responsibilities of medical residents, their confidence in residents’ abilities, and their acceptance toward receiving care from residents. The study sought to clarify if and how these three patient-resident relationship components are interrelated. Methods: This is a cross-sectional study using a self-administered questionnaire distributed in 2016 to a convenience sample of adult patients (≥ 18 years old) visiting a family medicine teaching clinic. Proportions and chi-square statistics were used to describe and compare groups, respectively. Results: Of the 471 patients who answered the questionnaire, only 28% were found to be knowledgeable about the role of family medicine residents. Between 54% and 83% of patients reported being highly confident in the ability of residents to perform five routine tasks. Of the patients surveyed, 69% agreed to see a resident during their next appointments. Patients with a high level of confidence in residents’ abilities were more likely to agree to see a resident during future appointments (p <0.0001). There was no significant association between level of knowledge and either confidence or acceptance. Conclusions: Although the majority of patients had poor knowledge about the role of residents, this was not related to their acceptance of being cared for by residents. A higher level of confidence in residents’ ability to perform certain tasks was associated with greater acceptance toward seeing a resident during future appointments.Contexte : Tandis que la participation des patients est essentielle pour la formation de résidents en médecine, on en sait peu sur le rapport entre le niveau de connaissance qu'ont les patients du rôle et des responsabilités des résidents, leur confiance dans les compétences des résidents et leur acceptation de recevoir des soins de leur part. La présente étude visait à clarifier si et de quelle manière ces trois composantes du rapport patient-résident sont interreliées. Méthodes : Il s'agit d'une étude transversale réalisée au moyen d'un questionnaire auto-administré distribué en 2016 à un échantillon de convenance de patients adultes (≥ 18 ans) ayant fréquenté une clinique universitaire de médecine familiale. La proportion et le test du khi carré ont été utilisés respectivement pour décrire et pour comparer les groupes. Résultats : Parmi les 471 patients qui ont répondu au questionnaire, à peine 28 % connaissaient bien le rôle des résidents en médecine familiale. Entre 54 % et 83 % des patients ont déclaré avoir une grande confiance dans la capacité des résidents à effectuer cinq tâches de routine. Parmi les patients interrogés, 69 % ont accepté de voir un résident lors de leurs prochains rendez-vous. Les patients ayant un niveau de confiance élevé dans les capacités des résidents étaient plus susceptibles d'accepter de voir un résident lors de leurs prochains rendez-vous (p <0,0001). Il n'y avait pas d'association significative entre le niveau de connaissance des patients et leur confiance dans les résidents ou leur acceptation d'être traités par ces derniers. Conclusions : Bien que la majorité des patients aient une mauvaise connaissance du rôle des résidents, celle-ci n'a pas d'incidence sur leur acceptation d'être soignés par de résidents. Un niveau de confiance plus élevé dans la capacité des résidents à effectuer certaines tâches était associé à une plus grande acceptation de voir un résident à l'avenir

Orbits for the Impatient: A Bayesian Rejection Sampling Method for Quickly Fitting the Orbits of Long-Period Exoplanets

We describe a Bayesian rejection sampling algorithm designed to efficiently compute posterior distributions of orbital elements for data covering short fractions of long-period exoplanet orbits. Our implementation of this method, Orbits for the Impatient (OFTI), converges up to several orders of magnitude faster than two implementations of MCMC in this regime. We illustrate the efficiency of our approach by showing that OFTI calculates accurate posteriors for all existing astrometry of the exoplanet 51 Eri b up to 100 times faster than a Metropolis-Hastings MCMC. We demonstrate the accuracy of OFTI by comparing our results for several orbiting systems with those of various MCMC implementations, finding the output posteriors to be identical within shot noise. We also describe how our algorithm was used to successfully predict the location of 51 Eri b six months in the future based on less than three months of astrometry. Finally, we apply OFTI to ten long-period exoplanets and brown dwarfs, all but one of which have been monitored over less than 3% of their orbits, producing fits to their orbits from astrometric records in the literature.Comment: 32 pages, 28 figures, Accepted to A

Gemini Planet Imager Observational Calibrations VI: Photometric and Spectroscopic Calibration for the Integral Field Spectrograph

The Gemini Planet Imager (GPI) is a new facility instrument for the Gemini Observatory designed to provide direct detection and characterization of planets and debris disks around stars in the solar neighborhood. In addition to its extreme adaptive optics and corona graphic systems which give access to high angular resolution and high-contrast imaging capabilities, GPI contains an integral field spectrograph providing low resolution spectroscopy across five bands between 0.95 and 2.5 $\mu$m. This paper describes the sequence of processing steps required for the spectro-photometric calibration of GPI science data, and the necessary calibration files. Based on calibration observations of the white dwarf HD 8049B we estimate that the systematic error in spectra extracted from GPI observations is less than 5%. The flux ratio of the occulted star and fiducial satellite spots within coronagraphic GPI observations, required to estimate the magnitude difference between a target and any resolved companions, was measured in the $H$-band to be $\Delta m = 9.23\pm0.06$ in laboratory measurements and $\Delta m = 9.39\pm 0.11$ using on-sky observations. Laboratory measurements for the $Y$, $J$, $K1$ and $K2$ filters are also presented. The total throughput of GPI, Gemini South and the atmosphere of the Earth was also measured in each photometric passband, with a typical throughput in $H$-band of 18% in the non-coronagraphic mode, with some variation observed over the six-month period for which observations were available. We also report ongoing development and improvement of the data cube extraction algorithm.Comment: 15 pages, 6 figures. Proceedings of the SPIE, 9147-30

Radial Velocity Measurements of HR 8799 b and c with Medium Resolution Spectroscopy

High-contrast medium resolution spectroscopy has been used to detect molecules such as water and carbon monoxide in the atmospheres of gas giant exoplanets. In this work, we show how it can be used to derive radial velocity (RV) measurements of directly imaged exoplanets. Improving upon the traditional cross-correlation technique, we develop a new likelihood based on joint forward modeling of the planetary signal and the starlight background (i.e., speckles). After marginalizing over the starlight model, we infer the barycentric RV of HR 8799 b and c in 2010 yielding −9.2 ± 0.5 km s⁻¹ and −11.6 ± 0.5 km s⁻¹, respectively. These RV measurements help to constrain the 3D orientation of the orbit of the planet by resolving the degeneracy in the longitude of an ascending node. Assuming coplanar orbits for HR 8799 b and c, but not including d and e, we estimate Ω = 89°⁺²⁷₋₁₇ and i = 20°.8^(4.5)_(-3.7)

Deep exploration of the planets HR 8799 b, c, and d with moderate-resolution spectroscopy

Funding: J.-B.R. acknowledges support from the David and Ellen Lee Prize Postdoctoral Fellowship. The research was supported by grants from NSF, including AST-1411868 (J.-B.R., B.M.) and 1614492 (T.S.B.). Material presented in this work is supported by the National Aeronautics and Space Administration under Grants/Contracts/Agreements No. NNX17AB63G (Q.M.K., T.S.B., and K.K.W.) issued through the Astrophysics Division of the Science Mission Directorate and NNX15AD95G (J.-B.R., R.J.D.R.).The four directly imaged planets orbiting the star HR 8799 are an ideal laboratory to probe atmospheric physics and formation models. We present more than a decade's worth of Keck/OSIRIS observations of these planets, which represent the most detailed look at their atmospheres to date by its resolution and signal-to-noise ratio. We present the first direct detection of HR 8799 d, the second-closest known planet to the star, at moderate spectral resolution with Keck/OSIRIS (K band; R ≈ 4000). Additionally, we uniformly analyze new and archival OSIRIS data (H and K band) of HR 8799 b, c, and d. First, we show detections of water (H2O) and carbon monoxide (CO) in the three planets and discuss the ambiguous case of methane (CH4) in the atmosphere of HR 8799 b. Then, we report radial-velocity (RV) measurements for each of the three planets. The RV measurement of HR 8799 d is consistent with predictions made assuming coplanarity and orbital stability of the HR 8799 planetary system. Finally, we perform a uniform atmospheric analysis on the OSIRIS data, published photometric points, and low-resolution spectra. We do not infer any significant deviation from the stellar value of the carbon-to-oxygen ratio (C/O) of the three planets, which therefore does not yet yield definitive information about the location or method of formation. However, constraining the C/O for all the HR 8799 planets is a milestone for any multiplanet system, and particularly important for large, widely separated gas giants with uncertain formation processes.Publisher PDFPeer reviewe

Bringing "The Moth" to Light: A Planet-Sculpting Scenario for the HD 61005 Debris Disk

The HD 61005 debris disk ("The Moth") stands out from the growing collection of spatially resolved circumstellar disks by virtue of its unusual swept-back morphology, brightness asymmetries, and dust ring offset. Despite several suggestions for the physical mechanisms creating these features, no definitive answer has been found. In this work, we demonstrate the plausibility of a scenario in which the disk material is shaped dynamically by an eccentric, inclined planet. We present new Keck NIRC2 scattered-light angular differential imaging of the disk at 1.2-2.3 microns that further constrains its outer morphology (projected separations of 27-135 AU). We also present complementary Gemini Planet Imager 1.6 micron total intensity and polarized light detections that probe down to projected separations less than 10 AU. To test our planet-sculpting hypothesis, we employed secular perturbation theory to construct parent body and dust distributions that informed scattered-light models. We found that this method produced models with morphological and photometric features similar to those seen in the data, supporting the premise of a planet-perturbed disk. Briefly, our results indicate a disk parent body population with a semimajor axis of 40-52 AU and an interior planet with an eccentricity of at least 0.2. Many permutations of planet mass and semimajor axis are allowed, ranging from an Earth mass at 35 AU to a Jupiter mass at 5 AU.Comment: Accepted to AJ; added Figure 5 and minor text edit

GPI 2.0: Upgrades to the IFS including new spectral modes

The Gemini Planet Imager (GPI) is a high-contrast imaging instrument designed to directly image and characterize exoplanets. GPI is currently undergoing several upgrades to improve performance. In this paper, we discuss the upgrades to the GPI IFS. This primarily focuses on the design and performance improvements of new prisms and filters. This includes an improved high-resolution prism which will provide more evenly dispersed spectra across y, J, H and K-bands. Additionally, we discuss the design and implementation of a new low-resolution mode and prism which allow for imaging of all four bands (y, J, H and K-bands) simultaneously at R=10. We explore the possibility of using a multiband filter which would block the light between the four spectral bands. We discuss possible performance improvements from the multiband filter, if implemented. Finally we explore the possibility of making small changes to the optical design to improve the IFS's performance near the edge of the field of view.Comment: 8 pages, 5 figures, Proc. of SPIE Paper No. 11447-41