3,505 research outputs found

    Use of Simulation to Solve a Queueing Problem

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    Person-centered decision-making and socio-cultural contexts influencing cesarean deliveries: a national analysis.

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    The cesarean delivery rate has increased and accounts for a third of pregnancies in the U.S., especially among marginalized women. This study applied a newly developed conceptual model to identify potential areas of influence that could reduce rates of cesarean deliveries. The Giving Voice to Mothers - United States data was used for analyses to predict covariates associated with having a cesarean delivery vs. spontaneous vaginal delivery (n=1,876). Significant covariates were determined and included the following: having a prior cesarean delivery (OR: 14.11, 95% CI: 7.99 - 24.90); more than one child (OR: 0.21, 95% CI: 0.13 - 0.35); elevated pregnancy risk (OR: 2.22 - 4.90, 95% CI: 2.22 - 4.90); doctor as perinatal care provider (OR: 2.25, 95% CI: 1.40 - 3.61); and receiving disrespectful perinatal care (OR: 2.16, 95% CI: 1.13 - 4.12). Significant covariates associated with race/ethnicity with white women as the reference group included the following: Asian women had higher odds of having a prior cesarean delivery (OR: 2.59, 95% CI: 1.31 - 5.12) and doctor as their perinatal care provider (OR: 2.31, 95% CI: 1.22 - 4.35); Black women had higher odds of having one or more child (OR: 2.15, 95% CI: 1.11 - 4.14); and Hispanic (OR: 1.89, 95% CI: 1.04 - 3.45) and Indigenous (OR: 3.17, 95% CI: 1.34 - 7.48) women had higher odds of receiving disrespectful perinatal care. Cesarean delivery rates could reduce by intervening at individual and interpersonal levels of influence that incorporate fewer medical interventions and improved patient-provider interactions

    Curated Collections for Educators: Eight Key Papers about Feedback in Medical Education

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    Feedback is an essential part of learning, growth, and academic success. Junior faculty members are often unfamiliar with the grounding literature that defines feedback. Many times they receive little education on providing and receiving feedback, resulting in unhelpful "feedback" for both learners and program leadership alike. This article aims to summarize eight key papers on feedback, to outline relevant information for emerging clinician educators, and identify ways to use these resources for the faculty development. In order to generate a list of key papers that describes the importance and significance of feedback, the authors conducted a consensus-building process to identify the top papers. In August and September, 2018, the 2018-2019 Academic Life in Emergency Medicine (ALiEM) Faculty Incubator program discussed the topic of feedback in medical education. A number of papers on the topic was highlighted. This list of papers was further augmented using the suggestions and expertise of guest experts who are leaders in the field of medical education and feedback. The authors also used social media to conduct an open call on Twitter for important papers regarding feedback (utilizing #meded, #Feedback hashtags). Via this process, a list of 88 key papers was identified on the topic of feedback in medical education. After compiling these papers, the authorship group engaged in a modified Delphi approach to build consensus on the top eight papers on feedback. These papers were deemed essential by the authors and have been summarized with respect to their relevance to junior faculty members and to faculty developers. In this manuscript, we present eight key papers addressing feedback in medical education with discussions and applications for junior faculty members and faculty developers. This list of articles that can serve to help junior clinician educators grow in their ability to give effective feedback and also serve as resources upon which senior faculty can design the faculty development sessions

    Cumulant expansion for phonon contributions to the electron spectral function

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    We describe an approach for calculations of phonon contributions to the electron spectral function, including both quasiparticle properties and satellites. The method is based on a cumulant expansion for the retarded one-electron Green's function and a many-pole model for the electron self-energy. The electron-phonon couplings are calculated from the Eliashberg functions, and the phonon density of states is obtained from a Lanczos representation of the phonon Green's function. Our calculations incorporate ab initio dynamical matrices and electron-phonon couplings from the density functional theory code ABINIT. Illustrative results are presented for several elemental metals and for Einstein and Debye models with a range of coupling constants. These are compared with experiment and other theoretical models. Estimates of corrections to Migdal's theorem are obtained by comparing with leading order contributions to the self-energy, and are found to be significant only for large electron-phonon couplings at low temperatures

    Modulation and lack of cross-talk between signal transducer and activator of transcription 5 and suppressor of cytokine signaling-3 in insulin and growth hormone signaling in 3T3-L1 adipocytes

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    Objective: To examine the role of signal transducer and activator of transcription (STAT) 5 and suppressor of cytokine signaling (SOCS)-3 in the cross-talk between growth hormone and insulin (INS) signaling in fat cells. Research Methods and Procedures: Fully differentiated 3T3-L1 adipocytes were exposed to INS, growth hormone (GH), or both of these growth factors, and the activation of STAT5 proteins and mitogen-activated protein kinase was examined using phospho-specific antibodies. The induction of SOCS-3 mRNA was assessed by Northern blot analysis. INS-stimulated glucose transport was also measured. Results: We observed that GH, not INS, induced STAT5 activation in adipocytes in a manner that was independent of extracellular signal-regulated kinase (ERK) activation or new protein synthesis. GH strongly induced SOCS-3 mRNA expression, whereas INS had a much less potent effect on SOCS-3 mRNA expression. Because SOCS-3 has been implicated in the attenuation of GH and INS signaling, we examined the cross-talk between these signaling pathways. GH pretreatment of adipocytes inhibited GH signaling. Similarly, INS pretreatment inhibited INS signaling. However, INS did not block the GH-induced activation of STAT5, and GH did not block the INS induction of ERK activity or of increased glucose uptake. We observed that neither new protein synthesis nor activation of ERKs 1 and 2 were required for the inhibition of GH signaling. Discussion: These results demonstrate that blocking the induction of the SOCS-3 protein has no effect on the attenuation of GH signaling and support recent studies suggesting that SOCS proteins have additional functions. In addition, these studies demonstrate that GH-induced SOCS-3 expression is insufficient to inhibit INS-induced glucose uptake in adipocytes. Copyright © 2006 NAASO
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