Relationships between scores on the Jefferson Scale of physician empathy, patient perceptions of physician empathy, and humanistic approaches to patient care: a validity study.

BACKGROUND: Empathy is the backbone of a positive physician-patient relationship. Physician empathy and the patient\u27s awareness of the physician\u27s empathic concern can lead to a more positive clinical outcome. MATERIAL/METHODS: The Jefferson Scale of Physician Empathy (JSPE) was completed by 36 physicians in the Family Medicine residency program at Thomas Jefferson University Hospital, and 90 patients evaluated these physicians by completing the Jefferson Scale of Patient Perceptions of Physician Empathy (JSPPPE), and a survey about physicians\u27 humanistic approaches to patient care. RESULTS: A statistically significant correlation was found between scores of the JSPE and JSPPPE (r=0.48, p CONCLUSIONS: These findings provide further support for the validity of the JSPE. Implications for the assessments of empathy in the physician-patient relationship as related to clinical outcomes are discussed

A hazard model of the probability of medical school dropout in the United Kingdom

From individual level longitudinal data for two entire cohorts of medical students in UK universities, we use multilevel models to analyse the probability that an individual student will drop out of medical school. We find that academic preparedness—both in terms of previous subjects studied and levels of attainment therein—is the major influence on withdrawal by medical students. Additionally, males and more mature students are more likely to withdraw than females or younger students respectively. We find evidence that the factors influencing the decision to transfer course differ from those affecting the decision to drop out for other reasons

Dredging in the Spratly Islands: gaining land but losing reefs

Coral reefs on remote islands and atolls are less exposed to direct human stressors but are becoming increasingly vulnerable because of their development for geopolitical and military purposes. Here we document dredging and filling activities by countries in the South China Sea, where building new islands and channels on atolls is leading to considerable losses of, and perhaps irreversible damages to, unique coral reef ecosystems. Preventing similar damage across other reefs in the region necessitates the urgent development of cooperative management of disputed territories in the South China Sea. We suggest using the Antarctic Treaty as a positive precedent for such international cooperation

Quasi-local first law of black-hole dynamics

A property well known as the first law of black hole is a relation among infinitesimal variations of parameters of stationary black holes. We consider a dynamical version of the first law, which may be called the first law of black hole dynamics. The first law of black hole dynamics is derived without assuming any symmetry or any asymptotic conditions. In the derivation, a definition of dynamical surface gravity is proposed. In spherical symmetry it reduces to that defined recently by one of the authors (SAH).Comment: Latex, 8 pages; version to appear in Class. Quantum Gra

Survival of microencapsulated probiotic Lactobacillus paracasei LBC-1e during manufacture of Mozzarellacheese and simulated gastric digestion

An erythromycin-resistant strain of probiotic Lactobacillus paracasei ssp. paracasei LBC-1 (LBC-1e) was added to part-skim Mozzarella cheese in alginate-microencapsulated or free form at a level of 108 and 107 cfu/g, respectively. Survival of LBC-1e and total lactic acid bacteria (LAB) was investigated through the pasta filata process of cheese making (in which the cheese curd was heated to 55°C and stretched in 70°C-hot brine), followed by storage at 4°C for 6 wk and simulated gastric and intestinal digestion. This included incubation in 0.1 M and 0.01 M HCl, 0.9 M H3PO4, and a simulated intestinal juice consisting of pancreatin and bile salts in a pH 7.4 phosphate buffer. Some reductions were observed in both free and encapsulated LBC-1e during heating and stretching, with encapsulated LBC-1e surviving slightly better. Changes in total LAB losses during heating and stretching did not reach statistical significance. During storage, a decrease was observed in total LAB, but no statistically significant decrease was observed in LBC-1e. Survival during gastric digestion in HCl was dependent on the extent of neutralization of HCl by the cheese, with more survival in the weaker acid, in which pH increased to 4.4 after cheese addition. The alginate microcapsules did not provide any protection against the HCl. It is interesting that survival of the encapsulated LBC-1e was greater during incubation in H3PO4 than in the HCl gastric juices. Proper selection of simulated gastric digestion media is important for predicting the delivery of probiotic bacteria into the human intestinal tract. Neither free nor encapsulated LBC-1e was affected by incubation in the pancreatin-bile solution. Based on the level of probiotic bacteria in cheese needed to provide a health benefit and its survival during simulated gastric digestion, as determined in this study, it should theoretically be possible to lower the amount that needs to be ingested in cheese by up to a factor of 103 compared with other fermented dairy foods or when consumed as supplements

The analysis of a generic air-to-air missile simulation model

A generic missile model was developed to evaluate the benefits of using a dynamic missile fly-out simulation system versus a static missile launch envelope system for air-to-air combat simulation. This paper examines the performance of a launch envelope model and a missile fly-out model. The launch envelope model bases its probability of killing the target aircraft on the target aircraft's position at the launch time of the weapon. The benefits gained from a launch envelope model are the simplicity of implementation and the minimal computational overhead required. A missile fly-out model takes into account the physical characteristics of the missile as it simulates the guidance, propulsion, and movement of the missile. The missile's probability of kill is based on the missile miss distance (or the minimum distance between the missile and the target aircraft). The problems associated with this method of modeling are a larger computational overhead, the additional complexity required to determine the missile miss distance, and the additional complexity of determining the reason(s) the missile missed the target. This paper evaluates the two methods and compares the results of running each method on a comprehensive set of test conditions

Fixing Detroit: how far, how fast, how fuel efficient

The Automotive Industry Crisis of 2009 is the worst the industry has ever experienced. This paper helps resolve the debate on how much and fast it should change and how it should it respond to demands for increased fuel efficiency. Looking at the actions of successful corporate turnarounds, the lessons are very clear: implement broad, deep, fast change, replace the management team, and transform the culture. We modeled the impacts of different fuel economy standards on profitability and sales, using the most accepted estimates of all the key parameters, and conducted an extensive sensitivity analysis on the key parameters. The impact of higher fuel economy standards on industry profits is very clear: increasing fuel economy 30% to 50% (35 MPG to 40.5 MPG) would increase the Detroit 3’s gross profits by roughly $3 billion per year, and increase sales by the equivalent of two large assembly plants. The sensitivity analysis showed our findings are very robust. The overall risk and reward profile is very positive, with only a small chance of losing and a very large probability of gain.Energy Foundationhttp://deepblue.lib.umich.edu/bitstream/2027.42/63024/1/102298.pd

Metabolic differences in colon mucosal cells

The colonic expression of cytochromes P450 from the CYP1A, CYP3A and CYP4B subfamilies has been characterized in rabbit and human tissues using RNA blotting, immunoblotting, immunohistochemistry and hybridization histochemistry. These studies demonstrate negligible expression of the CYP1A subfamily in either rabbit or human colon. The CYP3A6 gene is expressed in rabbit colon although at markedly reduced levels relative to liver and small intestine. Whilst at least two CYP3A genes are expressed at the mRNA level in human colon tissue from some individuals, no expression was demonstrated in others. Where expression was observed, this expression was continuous throughout the length of the colon. In rabbits, CYP4B1 represents a major colon P450 enzyme, expressed at levels in colon comparable to liver and small intestine. In contrast, the human CYP4B1 gene is expressed at low levels in some individuals. These studies highlight individual differences in the expression of cytochrome P450 enzymes of importance in procarcinogen metabolism