2,533 research outputs found

    Emotional Dissonance and the Information Technology Professional: A Methodological Replication Study

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    This study is a methodological replication of Emotional Dissonance and the Information Technology Professional by Rutner, Hardgrave, and McKnight (2008). Though we adopted the original study\u27s hypotheses and research methodology, we add to that research by investigating generational differences, increasing the sample size, and including respondents from multiple firms and industries. In this replication, we were able to 1) establish continued support for the direct impact of emotional dissonance on work exhaustion, 2) increase the explanatory power, and 3) provide broader generalizability through sampling subjects from multiple firms. We discuss both the practical and theoretical implications of these findings

    Report: Telepaediatrics in Rural and Remote Australia and Canada

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    Rural and remote communities in Australia and Canada experience barriers to accessing healthcare services (1). These barriers are especially pronounced when attempting to access more specialized health care services, such as paediatric (2–4). Both countries have implemented programs that aim to bridge the gap between rural communities and specialized healthcare. One such service is telepaediatrics. Telepaediatrics, as part of telehealth, refers to any paediatric health-related service, network, or medical tool that transmits voice, data, images and information through telecommunication programs as part of providing health services (5–7). Telehealth services are ideal because they remove the need to relocate the rural patient to urban specialist sites (5–7). In a WHO survey (2010), 60% of member countries had telehealth services in place but only 30% of these programs were implemented as part of routin

    Facilitation of Task Performance and Removal of the Effects of Sleep Deprivation by an Ampakine (CX717) in Nonhuman Primates

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    The deleterious effects of prolonged sleep deprivation on behavior and cognition are a concern in modern society. Persons at risk for impaired performance and health-related issues resulting from prolonged sleep loss would benefit from agents capable of reducing these detrimental effects at the time they are sleep deprived. Agents capable of improving cognition by enhancing brain activity under normal circumstances may also have the potential to reduce the harmful or unwanted effects of sleep deprivation. The significant prevalence of excitatory α-amino-3-hydroxy-5-methyl-4-isoxazolepropionic acid (AMPA) glutamatergic receptors in the brain provides a basis for implementing a class of drugs that could act to alter or remove the effects of sleep deprivation. The ampakine CX717 (Cortex Pharmaceuticals), a positive allosteric modulator of AMPA receptors, was tested for its ability to enhance performance of a cognitive, delayed match-to-sample task under normal circumstances in well-trained monkeys, as well as alleviate the detrimental effects of 30–36 h of sleep deprivation. CX717 produced a dose-dependent enhancement of task performance under normal alert testing conditions. Concomitant measures of regional cerebral metabolic rates for glucose (CMR(glc)) during the task, utilizing positron emission tomography, revealed increased activity in prefrontal cortex, dorsal striatum, and medial temporal lobe (including hippocampus) that was significantly enhanced over normal alert conditions following administration of CX717. A single night of sleep deprivation produced severe impairments in performance in the same monkeys, accompanied by significant alterations in task-related CMR(glc) in these same brain regions. However, CX717 administered to sleep-deprived monkeys produced a striking removal of the behavioral impairment and returned performance to above-normal levels even though animals were sleep deprived. Consistent with this recovery, CMR(glc) in all but one brain region affected by sleep deprivation was also returned to the normal alert pattern by the drug. The ampakine CX717, in addition to enhancing cognitive performance under normal alert conditions, also proved effective in alleviating impairment of performance due to sleep deprivation. Therefore, the ability to activate specific brain regions under normal alert conditions and alter the deleterious effects of sleep deprivation on activity in those same regions indicate a potential role for ampakines in sustaining performance under these types of adverse conditions

    Monitoring the assembly-disassembly-organisation-reassembly process of germanosilicate UTL through in situ pair distribution function analysis

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    The authors would like to thank: The EPSRC (grants: EP/K025112/1; EP/K005499/1; EP/K503162/1) for funding opportunities and beam line I15 at the Diamond Light Source. Phoebe Allan is acknowledged for her help and knowledge of PDF refinement. M.M. and R.E.M. would like to acknowledge OP VVV "Excellent Research Teams", project No. CZ.02.1.01/0.0/0.0/15_003/0000417 - CUCAM.A study into the disassembly and organisation steps of the ADOR process has been undertaken through in situ Pair Distribution Function (PDF) analysis. Three aqueous systems (water, 6 M HCl and 12 M HCl) were introduced to a parent zeolite germanosilicate UTL in a cell. Hydrolysis could be clearly seen when UTL was exposed to water over a period of 8 hr, forming the disorded layered material, IPC-1P. In hydrochloric acid, the hydrolysis step is too quick to observe and a Ge-Cl containing species could be seen. In 6 M HCl, the rearrangement of the interlayer region began after an induction period of 8 hr, with the process still occuring after 15 hr. In 12 M HCl, the rearrangement appears to have come to an end after only 6 hr.PostprintPeer reviewe

    Anatomy and Three-Dimensional Reconstructions of the Brain of the White Whale (Delphinapterus leucas) From Magnetic Resonance Images

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    Magnetic resonance imaging offers a means of observing the internal structure of the brain where traditional procedures of embedding, sectioning, staining, mounting, and microscopic examination of thousands of sections are not practical. Furthermore, internal structures can be analyzed in their precise quantitative spatial interrelationships, which is difficult to accomplish after the spatial distortions often accompanying histological processing. For these reasons, magnetic resonance imaging makes specimens that were traditionally difficult to analyze, more accessible. In the present study, images of the brain of a white whale (Beluga) Delphinapterus leucas were scanned in the coronal plane at 119 antero-posterior levels. Fromthese scans, a computer-generated three-dimensional model was constructed using the programs VoxelViewand VoxelMath (Vital Images, Inc.). This model, wherein details of internal and external morphology are represented in three-dimensional space, was then resectioned in orthogonal planes to produce corresponding series of “virtual” sections in the horizontal and sagittal planes. Sections in all three planes display the sizes and positions of such structures as the corpus callosum, internal capsule, cerebral peduncles, cerebral ventricles, certain thalamic nuclear groups, caudate nucleus, ventral striatum, pontine nuclei, cerebellar cortex and white matter, and all cerebral cortical sulci and gyri

    Gait measurement in chronic mild traumatic brain injury: A model approach

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    INTRODUCTION: Mild traumatic brain injury (mTBI) can impact gait, with deficits linked to underlying neural disturbances in cognitive, motor and sensory systems. Gait is complex as it is comprised of multiple characteristics that are sensitive to underlying neural deficits. However, there is currently no clear framework to guide selection of gait characteristics in mTBI. This study developed a model of gait in chronic mTBI and replicated this in a separate group of controls, to provide a comprehensive and structured methodology on which to base gait assessment and analysis. METHODS: Fifty-two people with chronic mTBI and 59 controls completed a controlled laboratory gait assessment; walking for two minutes back and forth over a 13 m distance while wearing five wirelessly synchronized inertial sensors. Thirteen gait characteristics derived from the inertial sensors were selected for entry into the principle component analysis based on previous literature, robustness and novelty. Principle component analysis was then used to derive domains (components) of gait. RESULTS: Four gait domains were derived for our chronic mTBI group (variability, rhythm, pace and turning) and this was replicated in a separate control cohort. Domains totaled 80.8% and 77.4% of variance in gait for chronic mTBI and controls, respectively. Gait characteristic loading was unambiguous for all features, with the exception of gait speed in controls that loaded on pace and rhythm domains. CONCLUSION: This study contributes a four component model of gait in chronic mTBI and controls that can be used to comprehensively assess and analyze gait and underlying mechanisms involved in impairment, or examine the influence of interventions

    Highly Porous Hydrogen-Bond Networks from a Triptycene-Based Catechol

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    Solvate crystals of 9,10-dimethyl-2,3,6,7,14,15-hexa(hydroxy)-triptycene (1) form a variety of 3D hydrogen-bonded topologies, including bcu, acs, bsn and an apparently new 7-connected net. Several of these networks contain 1D or 2D arrays of solvent-filled channels, amounting to up to 60% solvent-accessible void space

    Whole-body MRI compared with standard pathways for staging metastatic disease in lung and colorectal cancer: the Streamline diagnostic accuracy studies.

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    BACKGROUND: Whole-body magnetic resonance imaging is advocated as an alternative to standard pathways for staging cancer. OBJECTIVES: The objectives were to compare diagnostic accuracy, efficiency, patient acceptability, observer variability and cost-effectiveness of whole-body magnetic resonance imaging and standard pathways in staging newly diagnosed non-small-cell lung cancer (Streamline L) and colorectal cancer (Streamline C). DESIGN: The design was a prospective multicentre cohort study. SETTING: The setting was 16 NHS hospitals. PARTICIPANTS: Consecutive patients aged ≥ 18 years with histologically proven or suspected colorectal (Streamline C) or non-small-cell lung cancer (Streamline L). INTERVENTIONS: Whole-body magnetic resonance imaging. Standard staging investigations (e.g. computed tomography and positron emission tomography-computed tomography). REFERENCE STANDARD: Consensus panel decision using 12-month follow-up data. MAIN OUTCOME MEASURES: The primary outcome was per-patient sensitivity difference between whole-body magnetic resonance imaging and standard staging pathways for metastasis. Secondary outcomes included differences in specificity, the nature of the first major treatment decision, time and number of tests to complete staging, patient experience and cost-effectiveness. RESULTS: Streamline C - 299 participants were included. Per-patient sensitivity for metastatic disease was 67% (95% confidence interval 56% to 78%) and 63% (95% confidence interval 51% to 74%) for whole-body magnetic resonance imaging and standard pathways, respectively, a difference in sensitivity of 4% (95% confidence interval -5% to 13%; p = 0.51). Specificity was 95% (95% confidence interval 92% to 97%) and 93% (95% confidence interval 90% to 96%) respectively, a difference of 2% (95% confidence interval -2% to 6%). Pathway treatment decisions agreed with the multidisciplinary team treatment decision in 96% and 95% of cases, respectively, a difference of 1% (95% confidence interval -2% to 4%). Time for staging was 8 days (95% confidence interval 6 to 9 days) and 13 days (95% confidence interval 11 to 15 days) for whole-body magnetic resonance imaging and standard pathways, respectively, a difference of 5 days (95% confidence interval 3 to 7 days). The whole-body magnetic resonance imaging pathway was cheaper than the standard staging pathway: £216 (95% confidence interval £211 to £221) versus £285 (95% confidence interval £260 to £310). Streamline L - 187 participants were included. Per-patient sensitivity for metastatic disease was 50% (95% confidence interval 37% to 63%) and 54% (95% confidence interval 41% to 67%) for whole-body magnetic resonance imaging and standard pathways, respectively, a difference in sensitivity of 4% (95% confidence interval -7% to 15%; p = 0.73). Specificity was 93% (95% confidence interval 88% to 96%) and 95% (95% confidence interval 91% to 98%), respectively, a difference of 2% (95% confidence interval -2% to 7%). Pathway treatment decisions agreed with the multidisciplinary team treatment decision in 98% and 99% of cases, respectively, a difference of 1% (95% confidence interval -2% to 4%). Time for staging was 13 days (95% confidence interval 12 to 14 days) and 19 days (95% confidence interval 17 to 21 days) for whole-body magnetic resonance imaging and standard pathways, respectively, a difference of 6 days (95% confidence interval 4 to 8 days). The whole-body magnetic resonance imaging pathway was cheaper than the standard staging pathway: £317 (95% confidence interval £273 to £361) versus £620 (95% confidence interval £574 to £666). Participants generally found whole-body magnetic resonance imaging more burdensome than standard imaging but most participants preferred the whole-body magnetic resonance imaging staging pathway if it reduced time to staging and/or number of tests. LIMITATIONS: Whole-body magnetic resonance imaging was interpreted by practitioners blinded to other clinical data, which may not fully reflect how it is used in clinical practice. CONCLUSIONS: In colorectal and non-small-cell lung cancer, the whole-body magnetic resonance imaging staging pathway has similar accuracy to standard staging pathways, is generally preferred by patients, improves staging efficiency and has lower staging costs. Future work should address the utility of whole-body magnetic resonance imaging for treatment response assessment. TRIAL REGISTRATION: Current Controlled Trials ISRCTN43958015 and ISRCTN50436483. FUNDING: This project was funded by the NIHR Health Technology Assessment programme and will be published in full in Health Technology Assessment; Vol. 23, No. 66. See the NIHR Journals Library website for further project information

    A systematic review of strategies to recruit and retain primary care doctors

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    Background There is a workforce crisis in primary care. Previous research has looked at the reasons underlying recruitment and retention problems, but little research has looked at what works to improve recruitment and retention. The aim of this systematic review is to evaluate interventions and strategies used to recruit and retain primary care doctors internationally. Methods A systematic review was undertaken. MEDLINE, EMBASE, CENTRAL and grey literature were searched from inception to January 2015.Articles assessing interventions aimed at recruiting or retaining doctors in high income countries, applicable to primary care doctors were included. No restrictions on language or year of publication. The first author screened all titles and abstracts and a second author screened 20%. Data extraction was carried out by one author and checked by a second. Meta-analysis was not possible due to heterogeneity. Results 51 studies assessing 42 interventions were retrieved. Interventions were categorised into thirteen groups: financial incentives (n=11), recruiting rural students (n=6), international recruitment (n=4), rural or primary care focused undergraduate placements (n=3), rural or underserved postgraduate training (n=3), well-being or peer support initiatives (n=3), marketing (n=2), mixed interventions (n=5), support for professional development or research (n=5), retainer schemes (n=4), re-entry schemes (n=1), specialised recruiters or case managers (n=2) and delayed partnerships (n=2). Studies were of low methodological quality with no RCTs and only 15 studies with a comparison group. Weak evidence supported the use of postgraduate placements in underserved areas, undergraduate rural placements and recruiting students to medical school from rural areas. There was mixed evidence about financial incentives. A marketing campaign was associated with lower recruitment. Conclusions This is the first systematic review of interventions to improve recruitment and retention of primary care doctors. Although the evidence base for recruiting and care doctors is weak and more high quality research is needed, this review found evidence to support undergraduate and postgraduate placements in underserved areas, and selective recruitment of medical students. Other initiatives covered may have potential to improve recruitment and retention of primary care practitioners, but their effectiveness has not been established
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