43,747 research outputs found
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Factors Affecting Demand for Plug-in Charging Infrastructure: An Analysis of Plug-in Electric Vehicle Commuters
The public sector and the private sector, which includes automakers and charging network companies, are increasingly investing in building charging infrastructure to encourage the adoption and use of plug-in electric vehicles (PEVs) and to ensure that current facilities are not congested. However, building infrastructure is costly and, as with road congestion, when there is significant uptake of PEVs, we may not be able to âbuild out of congestion.â We modelled the choice of charging location that more than 3000 PEV drivers make when given the options of home, work, and public locations. Our study focused on understanding the importance of factors driving demand such as: the cost of charging, driver characteristics, access to charging infrastructure, and vehicle characteristics. We found that differences in the cost of charging play an important role in the demand for charging location. PEV drivers tend to substitute workplace charging for home charging when they pay a higher electricity rate at home, more so when the former is free. Additionally, socio-demographic factors like dwelling type and gender, as well as vehicle technology factors like electric range, influence the choice of charging location
Medical Studentsâ First Male Urogenital Examination: Investigating the Effects of Instruction and Gender on Anxiety
Objectives: To investigate the effect that standardized instruction of the male urogenital examination had on the anxiety levels of students and to determine what influence, if any, the gender of the student had on this experience.
Methods: One hundred thirty six second year medical students were asked to report their level of anxiety before and after participation in a small group teaching session on the male urogenital examination. We gathered both qualitative and quantitative information to better understand studentsâ anxiety surrounding this instruction.
Results: Students had significantly lower state-anxiety scores following the instruction than before (F(1, 76)=102.353, p=.000, eta2=.574) and female students were more likely to have greater state-anxiety than male students (F=6.952, p=.010, eta2=.084). Ninety-nine percent of students reported that the teaching associates successfully reduced their anxiety. This decrease was attributed predominantly to the personal qualities of the teaching associates and to the format of the instruction.
Conclusions: This study provides both quantitative and qualitative evidence that the use of male teaching associates to provide standardized instruction on the urogenital exam is effective at reducing studentsâ anxiety, particularly with regard to female students. Added standardized instruction may lead to increased confidence, skill, and future compliance with intimate physical exam screening practices
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Supercharged? Electricity Demand and the Electrification of Transportation in California
The rapid electrification of the transportation fleet in California raises important questions about the reliability, cost, and environmental implications for the electric grid. A crucial first element to understanding these implications is an accurate picture of the extent and timing of residential electricity use devoted to EVs. Although California is now home to over 650,000 electric vehicles (EVs), less than 5% of these vehicles are charged at home using a meter dedicated to EV use. This means that state policy has had to rely upon very incomplete data on residential charging use. This report summarizes the first phase of a project combining household electricity data and information on the adoption of electric vehicles over the span of four years. We propose a series of approaches for measuring the effects of EV adoption on electricity load in California. First, we measure load from the small subset of households that do have an EV-dedicated meter. Second, we estimate how consumption changes when households go from a standard residential electricity tariff to an EV-specific tariff. Finally, we suggest an approach for estimating the effect of EV ownership on electricity consumption in the average EV-owning household. We implement this approach using aggregated data, but future work should use household-level data to more effectively distinguish signal from noise in this analysis. Preliminary results show that households on EV-dedicated meters are using 0.35 kWh per hour from Pacific Gas and Electric (PGE); 0.38 kWh per hour from Southern California Edison; and 0.28 kWh per hour from San Diego Gas and Electric on EV charging. Households switching to EV rates without dedicated meters are using less electricity for EV charging: 0.30 kWh per hour in PGE. Our household approach applied to aggregated data is too noisy to be informative. These estimates should be viewed as evidence that more focused analysis with more detailed data would be of high value and likely necessary to produce rigorous analysis of the role EVs are playing in residential electricity consumption
Pilot and Feasibility Test of an Implementation Intention Intervention to Improve Fruit and Vegetable Intake Among Women with Low Socioeconomic Status
Fruit and vegetable intake (FVI), a modifiable risk factor for chronic diseases, is lower in low socioeconomic status (SES) populations. Implementation intentions (a specific type of planning that extends the Theory of Planned Behavior) has been studied to improve FVI, but not exclusively with low SES groups. Using mixed methods, we evaluated the feasibility, acceptability, and preliminary efficacy of an implementation intention intervention (versus a general plan) to increase FVI in women with low SES. For the pilot randomized controlled trial, demographics, body mass index, attitude, perceived behavioral control, goal intention strength, and FVI were measured at baseline and FVI again 1-month following the intervention. Feasibility data were collected for recruitment, randomization, retention, and assessment procedures and compared to predetermined targets. Semi-structured interview data was analyzed for emergent themes regarding acceptability of the trial. Preliminary efficacy of the intervention to improve FVI was analyzed descriptively. Feasibility targets were met for randomization (100% vs. â„80% target), retention (93.5% vs. â„70% target) and the assessment metrics missing data points (2% vs. â€10% target) and days from intervention to follow up (mean=69.2, sd=42.6 vs.days). Targets for recruitment were not met with the exception of participants giving informed consent (100% vs. â„70% target). Participants described the intervention as enjoyable and reported behavioral constructs outside of those measured as important to improve FVI. Limited efficacy analysis suggested that both groups increased their FVI (experimental: +0.17 servings per day, 95% CI: -0.85, 1.20; control: +0.50 servings per day, 95% CI: -0.56, 1.58). Further research which examines interventions based upon behavior change models to improve dietary health behaviors in marginalized groups is needed
A Call for the Structured Physicist Report
Introduction:
The field of diagnostic radiology continues to struggle with the clinical adoption of the structured interpretive report, with many radiologists preferring a semistructured, free-text dictation style to a more rigid, highly structured approach that some professional leaders have promoted [1]. Although structured reporting compliance in the radiologist community has been difficult to achieve, diagnostic radiologists have been thinking about and discussing this important issue for many years; it is also a part of the ACRâs Imaging 3.0_ campaign [2]. In the breast imaging community, the well-established BI-RADS_ recommendations produce a very structured report, with a discussion of interpretive findings culminating in a numeric BI-RADS score ranging from 0 to 6 [3]. Unlike some interpretive radiology reports, which can be ambiguous in terms of the next course of action, the BI-RADS scale is not only a diagnostic scale but also prescriptive of what the necessary follow-up should be
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Zero-Emission Medium- and Heavy-duty Truck Technology, Markets, and Policy Assessments for California
This report assesses zero emissions medium- and heavy-duty vehicle technologies, their associated costs, projected market share, and possible policy mandates and incentives to support their adoption. Cost comparisons indicate that battery-electric transit buses and city delivery trucks are the most economically attractive of the zero-emission vehicles (ZEVs) based on their break-even mileage being a small fraction of the expected total mileage. These ZEVs using fuel cells are also attractive for a hydrogen cost of $5/kg. The most economically unattractive vehicle types for ZEV adoption are long-haul trucks and inter-city buses. Developing mandates for buses and trucks will be more difficult than for passenger cars for several reasons, including the large differences in the size and cost of the vehicles and the ways they are used in commercial, profit-oriented fleets. The best approach will be to develop separate mandates for classes of vehicles that have similar sizes, cost characteristics, use patterns, and ownership/business models. These mandates should be coupled to incentives that vary by vehicle type/class and by year or accumulated sales volume, to account for the effects of expected price reductions with time
Physician Communication Skills: Results of a Survey of General/Family Practitioners in Newfoundland
Purpose: To describe the attitudes related to communication skills, confidence in using commnication skills, and use of communication skills during the physician-patient encounter among a population-based sample of family physicians.
Procedures: A mailed survey, distributed to all family physicians and general practitioners currently practicing in Newfoundland. The questionnaire was designed to collect data in five general areas participant demographics, physician confidence in using specific communication strategies, perceived adequacy of time spent by physicians with their patients, physician use of specific communication strategies with the adult patients they saw in the prior week, and physician use of specific communication strategies during the closing minutes of the encounters they had with adult patients in the prior week.
Main Findings: A total of 160 completed surveys was received from practicing family physicians/general practitioners in Newfoundland, yielding an adjusted response rate of 43.1%. Most of the respondents (83.8%) indicated their communication skills are as important as technical skills in terms of achieving positive patient outcomes. Between one-third and one-half of the respondents, depending on the educational level queried, rated their communications skills training as being inadequate. Fewer than 20% of the respondents rated the communications skills training they received as being excellent. Physicians indicated a need to improve their use of 8 of 13 specific communication strategies during patient encounters, and reported using few communication strategies during the closing minutes of the encounter. Interactions that occurred during a typical encounter tended to focus on biomedical versus psychosocial issues.
Conclusions: Family physicians/general practitioners recognize a need to improve their commnications skills. Well-designed communications skills training programs should be implemented at multi-levels of physician training in order to improve patient satisfaction with their encounters with family/general practitioners, and to increase the likelihood of positive patient outcomes
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Learning to Collaborate: Lessons Learned from Governance Processes Addressing the Impacts of Sea Level Rise on Transportation Corridors Across California
This study was designed to identify lessons learned from experiences of multi-stakeholder collaboration in governance processes focused on adaptation to sea level rise for specific transportation corridors/assets across different areas of California. Four transportation assets in California were selected as case studies: State Route 37 in the Bay Area; the Cardiff Beach Living Shorelines Project and the LOSSAN railroad at Del Mar in San Diego County; and the Port of Long Beach in Los Angeles County. The study methods included attendance of policy meetings; document analysis; and interviews of staff at (local, regional, and state) government bodies, transportation agencies, climate collaboratives, etc. The study identified three major governance challenges shared among these cases: (1) stakeholder involvement or collaboration with âunusualâ partners; (2) jurisdictional fragmentation; and (3) lack of funding. The lessons learned to address these challenges were: (a) include a wide range of stakeholders early on in the project; (b) identify an intermediary or facilitator with relevant knowledge and social capital with the stakeholders; (c) establish a forum for negotiations and information exchange; (d) draft a memorandum of understanding with the rules of collaboration; (e) appoint a project manager to tie all the project parts and stakeholders together and sustain engagement; (f) structure the collaboration in tiers from technical/operational to executive/political; (g) explore options to make any given project a multi-benefit project; (h) advocate for a multi-year stream of funding rather than a lump sum; (i) leverage collaboration for funding and highlight, to potential funders, the collaborative element as a means to increase the efficiency of their investment. Issues to consider when deriving lessons from other jurisdictions were: differences in capacity, or available resources and staff; the numbers of actors involved; pre-existing positive collaborative relationships between the actors; exposure of transportation assets to sea-level rise; existing vulnerabilities of the corridor/asset; and the economic relevance of the corridor/asset
COMPARISON OF EMOTIONAL RESPONSES IN MONKEYS WITH RHINAL CORTEX OR AMYGDALA LESIONS
Four emotionally arousing stimuli were used to probe the behavior of monkeys with bilateral ablations of the entorhinal and perirhinal cortex. The animalsâ behavioral changes were then contrasted with those observed earlier (Meunier et al., 1999) in monkeys with either neurotoxic or aspiration lesions of the neighboring amygdala. Rhinal cortex ablations yielded several subtle behavioral changes, but none of them resembled any of the disorders typically seen after amygdalectomies. The changes produced by rhinal damage took mainly the form of heightened defensiveness, and attenuated submission and approach responses, that is, just the opposite of some of the most distinctive symptoms following amygdala damage. These findings raise the possibility that the rhinal cortex and amygdala have distinct, interactive, functions in normal behavioral adaptation to affective stimuli
Baseline data of a longitudinal assessment of a Bachelor of Science in Health Science (BSHS) Program based on the core competencies for Interprofessional Collaborative Practice (IPCP)
Background:
IPCP has been identified as essential to provide quality healthcare: so, IPE is being integrated to professional programs. While IPE is being researched in professional programs, not much is known about IPE at the pre-professional level.
Purpose:
Stocktonâs BSHS program was built based upon the Core Competencies for IPCP. The current study assessed the following IPE-related constructs: Health Science Reasoning, Ethical Decision Making for Health, Attitude Towards Health Care Teams, and Readiness for IP Learning.
Description:
A cohort of students was recruited during the introductory course to the program. The following measures were administered at baseline: Health Science Reasoning Test (HSRT), Ethical Decision Making (EDM) Measure for Health Science, The Attitudes Toward Health Care Teams Scale (ATHCTS), Readiness for Interprofessional Learning (RIPLS) and demographic questions.
Results:
A cohort (N = 483) of students was recruited; N = 464 participated of the baseline. Results of main measures are: HSRT (M = 17.2, SD = 4.7), EDM (M = 2.18, SD = 0.20), ATHCTS (M = 4.1, SD = 0.47), RIPLS (M = 3.68, SD = 0.91). Results for subscales and demographic data will be included in the presentation.
Conclusions:
Results from EDM, ATHCTS and RIPLS suggest undergraduate pre-professional studentsâ Ethicality is at expected levels, they have positive attitudes toward healthcare teams and are prepared to receive IPE. However, the sample performed significantly below the expected level of critical thinking.
Relevance:
This suggests that students in an undergraduate health science program can receive interprofessional education, at least at the attitudinal and awareness level. IPE at this level can effectively foster positive attitudes towards working interprofessionally
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