Digital Story Telling: Clemantine’s Life described through my lenses

Clementine was born and brought up in an upper middle-class family in Rwanda. She was contented with her small world which revolved around her family and friends. Her perfect life began falling into pieces when she had to run away with her sister leaving behind everything she held dear. The Rwandan genocide had taken everything from her and the life that followed was filled with torments, challenges and pain. Throughout my article I have tried to jot down Clementine’s life through the lenses of my thoughts and linking them with pictures

What Predicts Individuals’ Disidentification? The Joint Effect of Fearful Attachment and Social and Economic Exchanges

Integrating attachment and exchange theories, we examined the joint effect of fearful attachment and two types of exchange behavior (social and economic exchange) on individuals’ disidentification from the organizations. Results indicated that fearfully attached individuals reported more disidentification when they engaged in both low social exchanges and high economic exchanges with their organizations. From a practical standpoint, reducing individuals’ disidentification can be accomplished by organizations, leaders, or coworkers who need to emphasize their social exchanges and deemphasize their economic exchanges with the focal individual

Employee Alignment: A Process for Understanding Individual Changeability

Despite the fact that employee alignment with an initiative is often considered a critical process of organizational change, few studies have examined processes where organizations change the individual to bring about alignment. This research aims to fill this gap by examining how employees change following the introduction of a new change initiative. Specifically, I investigate how employee knowledge of (1) a change objective (i.e., line of sight objectives) and (2) how to best affect the objective (i.e., line of sight actions) changes following the introduction of a change initiative. To better understand potential attributes that may affect the trajectory of the line of sight constructs, I take a social cognitive approach to suggest five potential moderators (i.e., locus of control, interaction quality, valence, learning goal orientation, self-efficacy) based on the five core concepts of social cognitive theory (i.e., agency, observational learning, valued outcomes, goals, self-efficacy). Additionally, I propose a potential trajectory for behavioral alignment, based on a theory of change momentum; and, I examine the potential moderating effects of learning on the behavioral alignment trajectory. I also examine a potential pathway in which line of sight actions mediate the relationship between line of sight objectives and behavioral alignment with the same five social cognitive facets as proposed moderators. In a sample of 189 fast food employees, partial support is found for the alignment model. Line of sight objectives influences both line of sight actions and behavioral alignment. Line of sight actions also predicted performance. When looking at the trajectories, the time period encompassing the intervention saw significant gains in line of sight objectives, but not line of sight actions. The change in line of sight objectives and line of sight actions also predicted the change in behavioral alignment. Implications and future directions for research are discussed

Wound Botulism in Injection Drug Users: Time to Antitoxin Correlates with Intensive Care Unit Length of Stay

Objectives: We sought to identify factors associated with need for mechanical ventilation (MV), length of intensive care unit (ICU) stay, length of hospital stay, and poor outcome in injection drug users (IDUs) with wound botulism (WB).Methods: This is a retrospective review of WB patients admitted between 1991-2005. IDUs were included if they had symptoms of WB and diagnostic confirmation. Primary outcome variables were the need for MV, length of ICU stay, length of hospital stay, hospital-related complications, and death.Results: Twenty-nine patients met inclusion criteria. Twenty-two (76%) admitted to heroin use only and seven (24%) admitted to heroin and methamphetamine use. Chief complaints on initial presentation included visual changes, 13 (45%); weakness, nine (31%); and difficulty swallowing, seven (24%). Skin wounds were documented in 22 (76%). Twenty-one (72%) patients underwent mechanical ventilation (MV). Antitoxin (AT) was administered to 26 (90%) patients but only two received antitoxin in the emergency department (ED). The time from ED presentation to AT administration was associated with increased length of ICU stay (Regression coefficient = 2.5; 95% CI 0.45, 4.5). The time from ED presentation to wound drainage was also associated with increased length of ICU stay (Regression coefficient = 13.7; 95% CI = 2.3, 25.2). There was no relationship between time to antibiotic administration and length of ICU stay.Conclusion: MV and prolonged ICU stays are common in patients identified with WB. Early AT administration and wound drainage are recommended as these measures may decrease ICU length of stay.[West J Emerg Med. 2009;10(4):251-256.

Teaching Musculoskeletal Physical Diagnosis Using A Web-based Tutorial and Pathophysiology-Focused Cases

ObjectiveTo assess the effectiveness of an experimental curriculum on teaching first-year medical students the musculoskeletal exam as compared to a traditional curriculum.BackgroundMusculoskeletal complaints are common in the primary care setting. Practitioners are often deficient in examination skills and knowledge regarding musculoskeletal diseases. There is a lack of uniformity regarding how to teach the musculoskeletal examination among sub-specialists. We propose a novel web-based approach to teaching the musculoskeletal exam that is enhanced by peer practice with pathophysiology-focused cases. We sought to assess the effectiveness of an innovative musculoskeletal curriculum on the knowledge and skills of first-year medical students related to musculoskeletal physical diagnosis as compared to a traditional curriculum. The secondary purpose of this study was to assess satisfaction of students and preceptors exposed to this teaching method.MethodsThis quasi-experimental study was conducted at a single LCME-accredited medical school and included a convenience sample from 2 consecutive classes of medical students during the musculoskeletal portion of their physical diagnosis class. We conducted a needs assessment of the traditional curriculum used to teach musculoskeletal examination. The needs assessment informed the development of an experimental curriculum. One class (control group) received the traditional curriculum while the second class (experimental group) received the experimental curriculum, consisting of a web-based musculoskeletal tutorial, pathophysiology-focused cases, and facilitator preparation. We used multiple-choice questions and musculoskeletal OSCE scores to assess differences between knowledge and skills in the 2 groups.ResultsThe sample consisted of 140 students in each medical school class. There were no statistically significant differences between the 2 groups. One hundred seven students from the control group and 120 students from the experimental group took the multiple-choice examination. The average score was 66% (95% CI= 59.7-72.3) for the control group and 66% (95% CI = 60.5-71.5) for the experimental group. There was no difference between the median musculoskeletal OSCE scores between the 2 groups. The experimental group was satisfied with the new teaching method and gained the additional benefit of a persistent resource.ConclusionsThis web-based experimental curriculum was as effective as the traditional curriculum for teaching the musculoskeletal exam. Additionally, users were satisfied with the web-based training and benefited from a persistent resource

Sex Differences in Neurological Emergencies Presenting to Multiple Urban Level 1 Trauma Centers

Previous studies have suggested that there are sex differences in the treatment and outcome of neurological emergencies; however, research identifying the role these sex differences play in the management of neurological emergencies is lacking. More knowledge of the way sex factors into the pathophysiology of neurological emergencies will be helpful in improving outcomes for these patients. The aim of this cross-sectional study was to assess the prevalence and management of neurological emergencies while evaluating sex differences in the diagnosis and treatment of these emergencies. We analyzed a cohort of 530 adult patients from four level 1 trauma centers over a period of 4 weeks who had a chief complaint of a neurological emergency, including seizures, cerebrovascular events, headache disorders, traumatic brain injuries, and central nervous system infections. Among patients with neurological emergencies, a significantly lower proportion of female patients underwent neurosurgery and were admitted to the intensive care unit compared to male patients, but there were no significant differences between sexes in the time of symptom onset, type of hospital transportation, amount of neuroimaging performed, admission rates, hospital length of stay, and disposition from the emergency department. Although female patients were more likely to have a chief complaint of headache compared to traumatic injuries in male patients, this was not statistically significant. A significantly higher proportion of female patients had health insurance coverage than male patients

Fuel Savings and Emission Reductions from Next-Generation Mobile Air Conditioning Technology in India: Preprint

This paper quantifies the mobile air-conditioning fuel consumption of the typical Indian vehicle, exploring potential fuel savings and emissions reductions these systems for the next generation of vehicles

Drugs that lower the seizure threshold

Drugs with potential to lower the seizure threshold are numerous and diverse. Whether they contribute to clinically overt seizures depends on the dosage in which they are taken, the time-course of their effects and the susceptibility of the patient. Crucially, however, their contribution to seizure risk is potentially modifiable

Work-related pesticide poisoning among farmers in two villages of Southern China: a cross-sectional survey

<p>Abstract</p> <p>Background</p> <p>Pesticide poisoning is an important health problem among Chinese farm workers, but there is a paucity of pesticide poisoning data from China. Using the WHO standard case definition of a possible acute pesticide poisoning, we investigated the prevalence and risk factors of acute work-related pesticide poisoning among farmers in Southern China.</p> <p>Methods</p> <p>A stratified sample of 910 pesticide applicators from two villages in southern China participated in face-to-face interviews. Respondents who self-reported having two or more of a list of sixty-six symptoms within 24 hours after pesticide application were categorized as having suffered acute pesticide poisoning. The association between the composite behavioral risk score and pesticide poisoning were assessed in a multivariate logistic model.</p> <p>Results</p> <p>A total of 80 (8.8%) pesticide applicators reported an acute work-related pesticide poisoning. The most frequent symptoms among applicators were dermal (11.6%) and nervous system (10.7%) symptoms. Poisoning was more common among women, farmers in poor areas, and applicators without safety training (all p < 0.001). After controlling for gender, age, education, geographic area and the behavioral risk score, farmers without safety training had an adjusted odds ratio of 3.22 (95% CI: 1.86-5.60). The likelihood of acute pesticide poisoning was also significantly associated with number of exposure risk behaviors. A significant "dose-response" relationship between composite behavioral risk scores calculated from 9 pesticides exposure risk behaviors and the log odds of pesticide poisoning prevalence was seen among these Chinese farmers (R²= 0.9246).</p> <p>Conclusions</p> <p>This study found that 8.8% of Chinese pesticide applicators suffered acute pesticide poisoning and suggests that pesticide safety training, safe application methods, and precautionary behavioral measures could be effective in reducing the risk of pesticide poisoning.</p