Communication skills Assessed at OSCE are not Affected by Participation in the Adolescent Healthy Sexuality Program

Purpose: We proposed that first year medical students who voluntarily participated in the Healthy Sexuality adolescent program would perform better than their peers on an adolescent counseling station at the year-end OSCE (Objective Structured Clinical Examination). In addition we compared medical students’ communication skills at the time of the program as assessed by self, peers and participating adolescents. Methods: Nineteen first year medical students voluntarily participated in the ongoing Healthy Sexuality program. Adolescent participants, medical student peer participants and medical students assessed communication components on a 7-point Likert scale at the end of the program. At the year-end OSCE, all first year medical students at the University of Western Ontario were assessed at an adolescent counseling station by a standardized patient (SP) and a physician examiner. Statistical analysis examined differences between the two groups. Results: Students who participated in the Healthy Sexuality program did not perform better than their colleagues on the year-end OSCE. A statistically significant correlation between physician examiner and SP evaluations was found (r = 0.62). Adolescent participants communication skills assessments in the Healthy Sexuality Program demonstrated no significant correlation with medical student assessments (self or peer). Conclusions:Voluntary intervention with adolescents did not result in improved communication skills at the structured year-end examination. Further investigation will be directed towards delineating differences between SP and physician examiner assessment

Accuracy of adults’ recall of childhood social class: findings from the Aberdeen children of the 1950s study

<b>Background</b>: Although adult reported childhood socioeconomic position has been related to health outcomes in many studies, little is known about the validity of such distantly recalled information. This study evaluated the validity of adults’ reports of childhood paternal social class. <b>Methods</b>: Data are drawn from the Aberdeen children of the 1950s study, a cohort of 12 150 people born in Aberdeen (Scotland) who took part in a school based survey in 1962. In this survey, two indices of early life socioeconomic position were collected: occupational social class at birth (abstracted from maternity records) and occupational social class in childhood (reported during the 1962 survey by the study participants). Between 2000 and 2003, a questionnaire was mailed to traced middle aged cohort members in which inquiries were made about their fathers’ occupation when they were aged 12 years. The level of agreement between these reports and prospectively collected data on occupational social class was assessed. <b>Results</b>: In total, 7183 (63.7%) persons responded to the mid-life questionnaire. Agreement was moderate between social class of father recalled in adulthood and that measured in early life ( statistics were 0.47 for social class measured at birth, and 0.56 for social class reported by the child). The relation of occupational social class to birth weight and childhood intelligence was in the expected directions, although weaker for adults’ reports in comparison with prospectively gathered data. <b>Conclusions</b>: In studies of adult disease aetiology, associations between childhood social class based on adult recall of parental occupation and health outcomes are likely to underestimate real effects

Effect of Ground Motion Characteristics on the Seismic Response of Torsionally Coupled Elastic Systems

This study presents a systematic investigation of the effects of ground motion characteristics, especially its multi-directional character, on the response of torsionally coupled elastic structural systems. The ground motion model is probabilistic and is founded on the assumption of the existence of ground motion principal directions. The structural systems considered are single-story and multi-story elastic shear beam models with stiffness eccentricity.National Science Foundation Grants ENV 77-07190 and PFR 80-0258

Spare capacity modelling and its applications in survivable iP-over-optical networks

As the interest in IP-over-optical networks are becoming the preferred core network architecture, survivability has emerged as a major concern for network service providers; a result of the potentially huge traffic volumes that will be supported by optical infrastructure. Therefore, implementing recovery strategies is critical. In addition to the traditional recovery schemes based around protection and restoration mechanisms, pre-allocated restoration represents a potential candidate to effect and maintain network resilience under failure conditions. Preallocated restoration technique is particularly interesting because it provides a trade-off in terms of recovery performance and resources between protection and restoration schemes. In this paper, the pre-allocated restoration performance is investigated under single and dual-link failures considering a distributed GMPLSbased IP/WDM mesh network. Two load-based spare capacity optimisation methods are proposed in this paper; Local Spare Capacity Optimisation (LSCO) and Global Spare Capacity Optimisation (GSCO)

Emigration and the age profile of retirement among immigrants

This paper analyzes the relationship between immigrants’ retirement status and the prevalence of return migration from the host country to their country of origin. We develop a simple theoretical model to illustrate that under reasonable conditions the probability of return migration is maximized at retirement. Reduced-form models of retirement status which control for the rate of return migration are then estimated using unique data on emigration rates matched to individual-level data for Australia. We find that immigrants, particularly immigrant women, are more likely to be retired than are native-born men and women with the same demographic, human capital, and family characteristics. Moreover, within the immigrant population, there is a negative relationship between the propensity to be retired and the return migration rate of one’s fellow countrymen, particularly amongst men. This link is strongest for those individuals who are at (or near) retirement age and among those with the highest cost of return migration. These results suggest that the fiscal pressures associated with aging immigrant populations vary substantially across origin countries

Does the UK Local Finance Improvement Trust (Lift)Initiative Improve Risk Management in Public-Private Procurement?

The UK government introduced the Private Finance Initiative (PFI) and, latterly, the Local Improvement Finance Trust (LIFT) in an attempt to improve public service provision. As a variant of PFI, LIFT seeks to create a framework for the effective provision of primary care facilities. Like conventional PFI procurement, LIFT projects involve long-term contracts, complex multi-party interactions and thus create various risks to public sector clients. This paper investigates the advantages and disadvantages of LIFT with a focus on how this approach facilitates or impedes risk management from the public sector client perspective. Our paper concludes that LIFT has a potential for creating additional problems, including the further reduction of public sector control, conflicts of interest, the inappropriate use of enabling funds, and higher than market rental costs affecting the uptake of space in the buildings by local health care providers. However, there is also evidence that LIFT has facilitated new investment and that Primary Care Trusts (PCTs) have themselves started addressing some of the weaknesses of this procurement format through the bundling of projects and other forms of regional co-operation

Mesoscale subduction at the Almeria-Oran front. Part 1: ageostrophic flow

This paper presents a detailed diagnostic analysis of hydrographic and current meter data from three, rapidly repeated, fine-scale surveys of the Almeria-Oran front. Instability of the frontal boundary, between surface waters of Atlantic and Mediterranean origin, is shown to provide a mechanism for significant heat transfer from the surface layers to the deep ocean in winter. The data were collected during the second observational phase of the EU funded OMEGA project on RRS Discovery cruise 224 during December 1996. High resolution hydrographic measurements using the towed undulating CTD vehicle, SeaSoar,. traced the subduction of Mediterranean Surface Water across the Almeria-Oran front. This subduction is shown to result from a significant baroclinic component to the instability of the frontal jet. The Q-vector formulation of the omega equation is combined with a scale analysis to quantitatively diagnose vertical transport resulting from mesoscale ageostrophic circulation. The analyses are presented and discussed in the presence of satellite and airborne remotely sensed data; which provide the basis for a thorough and novel approach to the determination of observational error

Hypothesis: ‘Vasocrine’ signalling from perivascular fat - a mechanism linking insulin resistance and vascular disease

Adipose tissue expresses cytokines which inhibit insulin signalling pathways in liver and muscle. Obesity also results in impairment of endothelium-dependent vasodilatation to insulin. We propose a vasoregulatory role for local deposits of fat around the origin of arterioles supplying skeletal muscle. Isolated first order arterioles from rat cremaster muscle are under dual regulation by insulin, which activates both endothelin-1 mediated vasoconstriction and nitric oxide mediated vasodilatation. In obese rat arterioles, insulin-stimulated nitric oxide synthesis is impaired, resulting in unopposed vasoconstriction. We propose this to be the consequence of production of the adipocytokine tumour necrosis factor-α from the cuff of fat seen surrounding the origin of the arteriole in obese rats – a depot to which we ascribe a specialist vasoregulatory role. We suggest that this cytokine accesses the nutritive vascular tree to inhibit insulin-mediated capillary recruitment – a mechanism we term ‘vasocrine’ signalling. We also suggest a homology between this vasoactive periarteriolar fat and both periarterial and visceral fat, which may explain relationships between visceral fat, insulin resistance and vascular disease

First evidence for molecular interfaces between outflows and ambient clouds in high-mass star-forming regions?

We present new observations of the Cep A East region of massive star formation and describe an extended and dynamically distinct feature not previously recognized. This feature is present in emission from H2CS, OCS, CH3OH, and HDO at −5.5 km s−1 but is not traced by the conventional tracers of star-forming regions, H2S, SO2, SO, and CS. The feature is extended up to at least 0.1 pc. We show that the feature is neither a hot core nor a shocked outflow. However, the chemistry of the feature is consistent with predictions from a model of an eroding interface between a fast wind and a dense core; mixing between the two media occurs in the interface on a timescale of 10–50 yr. If these observations are confirmed by detailed maps and by detections in species also predicted to be abundant (e.g., HCO+, H2CO, and NH3), this feature would be the first detection of such an interface in regions of massive star formation. An important implication of the model is that a significant reservoir of sulfur in grain mantles is required to be in the form of OCS

Universal persistence exponents in an extremally driven system

The local persistence R(t), defined as the proportion of the system still in its initial state at time t, is measured for the Bak--Sneppen model. For 1 and 2 dimensions, it is found that the decay of R(t) depends on one of two classes of initial configuration. For a subcritical initial state, R(t)\sim t^{-\theta}, where the persistence exponent \theta can be expressed in terms of a known universal exponent. Hence \theta is universal. Conversely, starting from a supercritical state, R(t) decays by the anomalous form 1-R(t)\sim t^{\tau_{\rm ALL}} until a finite time t_{0}, where \tau_{\rm ALL} is also a known exponent. Finally, for the high dimensional model R(t) decays exponentially with a non--universal decay constant.Comment: 4 pages, 6 figures. To appear in Phys. Rev.