The Effect of interruptions on prospective memory in the emergency department

Using the activation goal memory framework, this study categorized 256 separate emergency department interruptions in a large research hospital setting. Prior to and following their shift, twelve physicians completed a semi-structured qualitative survey about their experiences with, and perceptions of, interruptions at work. During their shift, these physicians were shadowed and the interruptions they experienced were documented. Frequencies of four types of interruptions were tallied: Direct reminders, indirect reminders, memory lapses and no reported memory change. Memory events were a significant proportion of interruptions (47%). Direct reminders comprised the largest majority, followed by memory lapses, indirect reminders and combination memory events. Both prior to and following their shifts, physicians overestimated both the harmfulness of interruptions to themselves and the helpfulness of interruptions to the interrupter. Physicians perceived the majority of interruptions they experienced as justified

Three Essays in Econometrics

This thesis consists of three self-contained essays in econometrics and statistics. It discusses methodological topics in semi- and nonparametric statistics as well as empirical questions in financial econometrics. My methodological contributions cover regression and times series prediction techniques, which are designed to deal with complex and high-dimensional data. The proposed statistical concepts are particularly useful for the analysis of risk in modern financial markets, which is of major importance for example in risk management, automated trading and for regulatory authorities. The empirical contribution of this thesis is an analysis of the role and dynamics of price and liquidity risk of equity and debt securities in developed capital markets. The applications in the first two chapters deal with risk on stock markets, while the third chapter deals with risk on bond markets

Vocal Pegagogy and Applications for Conductors not Trained in Singing

Musicians who are given the opportunity to conduct a choir may not always be trained singers themselves. In particular, keyboard players who are not trained as vocalists often elect to pursue careers that include choral conducting. There is no single resource designed specifically for choral conductors (or any conductor whose primary instrument is not their singing voice) who may not have received private voice lessons for an extended period in their musical training. There are many resources for advanced choral techniques, warm-ups, vocal pedagogy for those who already have experience as choral conductors, choral singers and vocal soloists. This document provides basic discussions and applications that address the fundamentals of vocal pedagogy and how those fundamentals could be applied within basic choral warm-ups and rehearsal techniques, all designed for conductors who do not have training in applied voice or in choral music education. The heart of this document focuses on basic Vocal Pedagogy, equipping the inexperienced vocalist with anatomical knowledge of the voice and the mechanics of vocal production. Inexperienced and untrained singers, along with other musicians who are seeking ways to teach vocal technique to choirs will benefit from this overview, as it will provide a single and concise resource to answer questions concerning foundational issues of vocal pedagogy, and their application within a choral rehearsal. My sources include a compilation of books, articles, and videos published in the latter half of the twentieth century, weighted more toward materials published within the last ten years. I analyze, highlight and compare current leading Vocal and Choral Pedagogy texts by Barbara Conable, Meribeth Bunch, Cynthia Vaughn, Leon Thurman, Graham Welch, Roger Love, Frauke Haasemann and other authors citing, in my opinion, the most important information needed by inexperienced vocalists who find themselves teaching and/or conducting in a choral setting. I then share my own experiences, offer applications and exercises and reflect and/or comment on the information cited. I hope this makes the terminology less technical and more user-friendly to the "vocal layperson," or inexperienced vocalist, allowing for quicker understanding and application of the content

Barriers to managing childhood mental health problems: a systematic review of primary care practitioner's perceptions

Background: Mental health problems are common and typically have an early onset. Effective treatments for mental health problems in childhood and adolescence are available yet only a minority of affected children access them. This is of serious concern, considering the far-reaching and long-term negative consequences of such problems. Primary care is usually the first port of call for concerned parents so it is important to understand how primary care practitioners (PCPs) manage childhood mental health problems and the barriers they face. Aim: To ascertain PCP’s perceptions of barriers preventing effective management of childhood mental health problems Design: A systematic review of qualitative and quantitative literature Method: A database search of peer-reviewed articles using PsycInfo, MEDLINE, EMBASE and Web of Science, until October 2014, was conducted. Additional studies were identified through hand-searching and forward-citation searches. Studies needed to have at least one search term in four categories: (i) primary care, (ii) childhood/adolescence, (iii) mental health and (iv) barriers. Results: A total of 4151 articles were found, of which 43 were included (30 quantitative and 13 qualitative). The majority of the barriers related to identification, management and/or referral. Considerable barriers included a lack of providers and resources, extensive waiting lists and financial restrictions. Conclusion: The identification of a broad range of significant barriers highlights the need to strengthen the ability to deal with these common difficulties in primary care. There is a particular need for tools and training to aid accurate identification and management, and for more efficient access to specialist services

Transition of pediatric liver transplant recipients to adult care: Patient and parent perspectives

Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/87036/1/j.1399-3046.2011.01499.x.pd

Assessment of transition readiness skills and adherence in pediatric liver transplant recipients

Fredericks EM, Dore-Stites D, Well A, Magee JC, Freed GL, Shieck V, Lopez MJ. Assessment of transition readiness skills and adherence in pediatric liver transplant recipients. Pediatr Transplantation 2010: 14:944–953. © 2010 John Wiley & Sons A/S.To examine transition readiness, adherence, and health outcomes in pediatric liver transplant recipients using a clinically administered screening measure. Seventy-one pediatric liver transplant recipients (11–20 yr) and 58 parents completed a clinic-based TRS measuring perceived and demonstrated self-management skills, AoR for health-related tasks, regimen knowledge, and psychosocial adjustment. Adherence was measured using s.d. of immunosuppressants, proportion of immunosuppressant blood levels out of target range, and clinic attendance. Health outcomes included liver test panels, biopsies, rejection episodes, and hospitalizations. Results indicate that all domains of transition readiness, with the exception of demonstrated skills, and non-adherence were positively correlated with age. Proportion of immunosuppressant blood levels below target range was positively correlated with self-management skills and increased responsibility for medication tasks. Parent regimen knowledge was associated with clinic attendance. Health outcomes were significantly related to medication non-adherence, but not to transition readiness domains. Medication adherence is considered to be a key factor in the transition from pediatric to adult-centered transplant care. Non-adherence is associated with an increased risk for medical complications and is potentially modifiable. Interventions to promote self-management skills and adherence should be an essential component of transition planning.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/79176/1/j.1399-3046.2010.01349.x.pd

Ena/VASP proteins have an anti-capping independent function in filopodia formation

Author Posting. © American Society for Cell Biology, 2007. This article is posted here by permission of American Society for Cell Biology for personal use, not for redistribution. The definitive version was published in Molecular Biology of the Cell 18 (2007): 2579-2591, doi:10.1091/mbc.E06-11-0990.Filopodia have been implicated in a number of diverse cellular processes including growth-cone path finding, wound healing, and metastasis. The Ena/VASP family of proteins has emerged as key to filopodia formation but the exact mechanism for how they function has yet to be fully elucidated. Using cell spreading as a model system in combination with small interfering RNA depletion of Capping Protein, we determined that Ena/VASP proteins have a role beyond anticapping activity in filopodia formation. Analysis of mutant Ena/VASP proteins demonstrated that the entire EVH2 domain was the minimal domain required for filopodia formation. Fluorescent recovery after photobleaching data indicate that Ena/VASP proteins rapidly exchange at the leading edge of lamellipodia, whereas virtually no exchange occurred at filopodial tips. Mutation of the G-actin–binding motif (GAB) partially compromised stabilization of Ena/VASP at filopodia tips. These observations led us to propose a model where the EVH2 domain of Ena/VASP induces and maintains clustering of the barbed ends of actin filaments, which putatively corresponds to a transition from lamellipodial to filopodial localization. Furthermore, the EVH1 domain, together with the GAB motif in the EVH2 domain, helps to maintain Ena/VASP at the growing barbed ends.This work was supported in part by National Institutes of Health Grants GM7542201 to D.A.A., GM58801 to F.B.G., and GM62431 to G.G.B. and by Cell Migration Consortium Grants GM64346 to D.A.A and G.G.B