Current-carrying states in superconductor/insulator and superconductor/semiconductor superlattices in the mesoscopic regime

We discuss some of the basic theoretical aspects of current-carrying states in superconducting superlattices with tunnel barriers in the mesoscopic regime, when the superconducting layer thickness is small compared to the BCS coherence length but large compared to the atomic scale. We establish the necessary conditions for the observation of the classical Josephson effect (with sinusoidal current-phase dependence) and derive self-consistent analytical expressions for the critical Josephson current. These expressions are proportional to an additional small factor and have unusual temperature dependence as compared with the single-junction case. For certain parameter values, the superconducting gap exhibits an exponential decrease due to pair-breaking effect of the supercurrent. The supercurrent can completely destroy the superconductivity of the system above a certain characteristic temperature (lower than the transition temperature of individual layers). In this paper, we also study the effect of intrabarrier exchange interactions. We show that this effect is strongly enhanced compared with the single- junction case and can manifest itself in an exponential decrease of the critical temperature.Comment: 13 pages, ReVTeX, no figure

Physicians\u27 Perceptions of Quality of Care, Professional Autonomy, and Job Satisfaction in Canada, Norway, and the United States

Background We lack national and cross-national studies of physicians’ perceptions of quality of patient care, professional autonomy, and job satisfaction to inform clinicians and policymakers. This study aims to compare such perceptions in Canada, the United States (U.S.), and Norway. Methods We analyzed data from large, nationwide, representative samples of physicians in Canada (n = 3,213), the U.S. (n = 6,628), and Norway (n = 657), examining demographics, job satisfaction, and professional autonomy. Results Among U.S. physicians, 79% strongly agreed/agreed they could provide high quality patient care vs. only 46% of Canadian and 59% of Norwegian physicians. U.S. physicians also perceived more clinical autonomy and time with their patients, with differences remaining significant even after controlling for age, gender, and clinical hours. Women reported less adequate time, clinical freedom, and ability to provide high-quality care. Country differences were the strongest predictors for the professional autonomy variables. In all three countries, physicians’ perceptions of quality of care, clinical freedom, and time with patients influenced their overall job satisfaction. Fewer U.S. physicians reported their overall job satisfaction to be at-least-somewhat satisfied than did Norwegian and Canadian physicians. Conclusions U.S. physicians perceived higher quality of patient care and greater professional autonomy, but somewhat lower job satisfaction than their colleagues in Norway and Canada. Differences in health care system financing and delivery might help explain this difference; Canada and Norway have more publicly-financed, not-for-profit health care delivery systems, vs. a more-privately-financed and profit-driven system in the U.S. None of these three highly-resourced countries, however, seem to have achieved an ideal health care system from the perspective of their physicians

Hvordan kan sykepleier kommunisere hensiktsmessig med sykehjemsbeboere med alvorlig demens?

Problemstilling: Hvordan kan sykepleier kommunisere hensiktsmessig med sykehjemsbeboere med alvorlig demens? Metode: Litterær oppgave som tar utgangspunkt i eksisterende forskning og relevant litteratur. Funn: Hovedfunnene fra forskningsartiklene er basert på viktigheten av god relasjon mellom sykepleier og personer med demens, ulike kommunikasjonstilnærminger som verbal og nonverbal kommunikasjon, validering og sang og musikk. Betydningen av personsentret omsorg og opplæring i bruken av ulike kommunikasjonsteknikker. Drøfting: Drøftingen tar utgangspunkt i disse hovedpunktene: betydningen av god relasjon mellom sykepleier og personer med demens, bruk av ulike kommunikasjonstilnærminger, betydningen av personsentrert tilnærming og opplæring i bruken av ulike kommunikasjonsteknikker. Konklusjon: Det å kommunisere med personer med alvorlig demens for sykepleieren er en utfordring, men det er ikke umulig. Når sykepleieren etablerer en god relasjon med personen, bruker ulike kommunikasjonstekniker, får opplæring i bruken av ulike kommunikasjonsteknikker, og anvender en personsentret tilnærming i samhandling med personen, kan det bidra til at sykepleieren kan kommunisere hensiktsmessig med personer med alvorlig demens

Counselling for burnout in Norwegian doctors: one year cohort study

Objective To investigate levels and predictors of change in dimensions of burnout after an intervention for stressed doctors

Self-development groups reduce medical school stress: a controlled intervention study

<p>Abstract</p> <p>Background</p> <p>High stress levels and mental health problems are common among medical students and there is a lack of studies on group interventions that aim to reduce such distress during medical school.</p> <p>Methods</p> <p>A full class of students (n = 129) participated in group sessions during their third year of medical school in Bergen, Norway. The subsequent third-year class (n = 152) acted as control group, in order to create a quasi-experimental design. Two types of group intervention sessions were offered to the first class. One option was self-development groups led by trained group psychotherapists. Alternatively, students could choose discussion groups that focused on themes of special relevance to doctors, led by experienced general practitioners. The intervention comprised of 12 weekly group sessions each lasting 90 minutes. Data were gathered before the intervention (T1), and three months post intervention (T2). Distress was measured using the Perceived Medical School Stress (PMSS) and Symptom Check List-5 (SCL-5) assessments.</p> <p>Results</p> <p>The intervention group showed a significant reduction in PMSS over the observation period. The subsequent year control group stayed on the same PMSS levels over the similar period. The intervention was a significant predictor of PMSS reduction in a multiple regression analysis adjusted for age and sex, β = -1.93 (-3.47 to -0.38), P = 0.02. When we analysed the effects of self-development and discussion groups with the control group as reference, self-development group was the only significant predictor of PMSS reduction, β = -2.18 (-4.03 to -0.33), P = 0.02. There was no interaction with gender in our analysis. This implicates no significant difference between men and women concerning the effect of the self-development group. There was no reduction in general mental distress (SCL-5) over this period.</p> <p>Conclusion</p> <p>A three-month follow-up showed that the intervention had a positive effect on perceived medical school stress among the students, and further analyses showed this was due to participation in self-development groups.</p

Life satisfaction and resilience in medical school – a six-year longitudinal, nationwide and comparative study

BACKGROUND: This study examined the relationship between life satisfaction among medical students and a basic model of personality, stress and coping. Previous studies have shown relatively high levels of distress, such as symptoms of depression and suicidal thoughts in medical undergraduates. However despite the increased focus on positive psychological health and well-being during the past decades, only a few studies have focused on life satisfaction and coping in medical students. This is the first longitudinal study which has identified predictors of sustained high levels of life satisfaction among medical students. METHODS: This longitudinal, nationwide questionnaire study examined the course of life satisfaction during medical school, compared the level of satisfaction of medical students with that of other university students, and identified resilience factors. T-tests were used to compare means of life satisfaction between and within the population groups. K-means cluster analyses were applied to identify subgroups among the medical students. Analysis of Variance (ANOVA) and logistic regression analyses were used to compare the subgroups. RESULTS: Life satisfaction decreased during medical school. Medical students were as satisfied as other students in the first year of study, but reported less satisfaction in their graduation year. Medical students who sustained high levels of life satisfaction perceived medical school as interfering less with their social and personal life, and were less likely to use emotion focused coping, such as wishful thinking, than their peers. CONCLUSION: Medical schools should encourage students to spend adequate time on their social and personal lives and emphasise the importance of health-promoting coping strategies

Hverdagslivet til foreldre som har barn med utviklingsmessige funksjonshemninger

Published version of an article in the journal: Vård i Norden. Also available from the publisher at: http://www.artikel.nu/Bob/GetBob.aspx?bobID=3544Purpose: The purpose of this study was to describe and illuminate the daily life of parents who have children with developmental disabilities. Background: Up to the 1980’s most children with disabilities were institutionalized. Today these children live with their families supported by public health care services and the family’s social network. Parents experience extreme strain due to unpredictability, sleep deprivation, multiple hospitalizations and demanding caregiving procedures. Method: Semi structured interviews of four couples of parents with children from age one to six years with developmental disabilities were conducted. The interviews were taped and transcribed verbatim. Data were analyzed using Systematic Text Condensation. Findings: Four main themes were identified, “different and unpredictable daily life”, “always in a state of preparedness”, “living right now” and “challenging encounters with health professionals“. Despite parents’ challenging daily life they emphasized their positive view of caring for a child with disabilities. Conclusion: To manage their daily life parents needed to be acknowledged as valuable collaborators and experts on their child’s condition. They expressed a need for information adjusted to their child’s illness trajectory. Training family, especially grandparents, to be confident performers of caring procedures may relieve parents’ caring load. Despite a challenging daily life the parents expressed a positive and healthful attitude. To improve parents’ coping it is crucial that health professionals support the parents’ health promoting strategies as well as their need for care. Further studies on grandparents’ contribution is needed, as well as parents’ experiences of early transfer to the child’s habilitation services

A three-year cohort study of the relationships between coping, job stress and burnout after a counselling intervention for help-seeking physicians

<p>Abstract</p> <p>Background</p> <p>Knowledge about important factors in reduction of burnout is needed, but there is a dearth of burnout intervention program studies and their effects among physicians. The present three-year follow-up study aimed to investigate the roles of coping strategies, job stress and personality traits in burnout reduction after a counselling intervention for distressed physicians.</p> <p>Methods</p> <p>227 physicians who attended a counselling intervention for burnout at the Resource Centre Villa Sana, Norway in 2003-2005, were followed with self-report assessments at baseline, one-year, and three-year follow-up. Main outcome measures were emotional exhaustion (one dimension of burnout), job stress, coping strategies and neuroticism. Changes in these measures were analyzed with repeated measures ANOVA. Temporal relationships between changes were examined using structural modelling with cross-lagged and synchronous panel models.</p> <p>Results</p> <p>184 physicians (81%, 83 men, 101 women) completed the three-year follow-up assessment. Significantly reduced levels of emotional exhaustion, job stress, and emotion-focused coping strategies from baseline to one year after the intervention, were maintained at three-year follow-up.</p> <p>Panel modelling indicated that changes in emotion-focused coping (z = 4.05, p < 0.001) and job stress (z = 3.16, p < 0.01) preceded changes in emotional exhaustion from baseline to three-year follow-up. A similar pattern was found from baseline to one-year follow-up.</p> <p>Conclusion</p> <p>A sequential relationship indicated that reduction in emotion-focused coping and in job stress preceded reduction in emotional exhaustion. As a consequence, coping strategies and job stress could be important foci in intervention programs that aim to reduce or prevent burnout in help-seeking physicians.</p

Does a self-referral counselling program reach doctors in need of help? A comparison with the general Norwegian doctor workforce

BACKGROUND: Doctors have a relatively high degree of emotional distress, but seek help to a lesser degree and at a later stage than other academic groups. This can be deleterious for themselves and for their patients. Prevention programs have therefore been developed but it is unclear to what extent they reach doctors in need of help. This study describes doctors who participated in a self-referrral, easily accessible, stress relieving, counselling program in Norway, and compares them with a nationwide sample of Norwegian doctors. METHODS: Two hundred and twenty seven (94%) of the doctors, 117 women and 110 men, who came to the resort centre Villa Sana, Modum, Norway, between August 2003 and July 2005, agreed to participate in the study. Socio-demographic data, reasons for and ways of help-seeking, sick-leave, symptoms of depression and anxiety, job stress and burnout were assessed by self-reporting questionnaires. RESULTS: Forty-nine percent of the Sana doctors were emotionally exhausted (Maslach) compared with 25% of all Norwegian doctors. However, they did not differ on empathy and working capacity, the other two dimensions in Maslach's burnout inventory. Seventy-three percent of the Sana doctors could be in need of treatment for depression or anxiety based on their symptom distress scores, compared with 14% of men and 18% of women doctors in Norway. Twenty-one percent of the Sana doctors had a history of suicidal thoughts, including how to commit the act, as compared to 10% of Norwegian doctors in general. CONCLUSION: Sana doctors displayed a higher degree of emotional exhaustion, symptoms of depression and anxiety as well as job related stress, compared with all Norwegian doctors. This may indicate that the program at Villa Sana to a large extent reaches doctors in need of help. The counselling intervention can help doctors to evaluate their professional and private situation, and, when necessary, enhance motivation for seeking adequate treatment

Does Personality Moderate the Effects of Mindfulness Training for Medical and Psychology Students?

The majority of mindfulness research to date has reported only on the group-level effects of interventions. Therefore, there is a need to better understand who is most likely to benefit from mindfulness interventions. This study reports on moderation analyses from a two-centre randomised controlled trial of mindfulness-based stress reduction (MBSR) among 288 medical and psychology students. The study investigated whether baseline personality factors (neuroticism, conscientiousness and extroversion) and baseline mindfulness moderated effects on mental distress, study stress and subjective well-being measured after the intervention. An increased effect of the intervention on mental distress and subjective well-being was found in students with higher scores on neuroticism. Students with higher scores on conscientiousness showed an increased effect of mindfulness training on study stress. The training protected students against an increase in mental distress and study stress and a decrease in subjective well-being that was seen in the control group. Baseline mindfulness and extroversion did not moderate the effects of the intervention on the outcomes. The majority of the 288 medical and psychology students in the study sample were female. Female participants scored significantly higher on neuroticism and conscientiousness, and they may therefore be an important target group for mindfulness interventions among students