Adolescent Medicine: Attitudes and Skills of Pediatric and Medical Residents

PEDIATRICS ◽  
1984 ◽  
Vol 74 (2) ◽  
pp. 191-197 ◽  
Author(s):  
Gail B. Slap
Keyword(s):  
Learning Disabilities ◽  
Medical Residents ◽  
Adolescent Medicine ◽  
Delayed Puberty ◽  
Pediatric Residents ◽  
Level 3 ◽  
The Mean ◽  
Level 1 ◽  
Resident Group

Adolescents receive care from different specialists whose training may affect the quality of care. To measure possible effects, all 80 level 1 and level 3 pediatric and medical residents at one institution completed a questionnaire that asked if they planned to care for adolescents and determined their attitudes and skills for 30 relevant tasks. The mean age chosen for transfer of care from a pediatrician to an internist was 18.7 years by the pediatric residents and 16.6 years by the medical residents (P = .00001). Skill in obtaining histories; staging puberty; screening for scoliosis; performing pelvic examinations; diagnosing delayed puberty, psychiatric disorders, or learning disabilities; immunizing; and treating knee and hip pain more often were thought to be important by pediatric residents (88% to 100%) than by medical residents (40% to 75%) (P < .02). More than 70% of PL-3 but fewer than 50% of ML-3 residents rated themselves skilled for these tasks (P < .05). Fewer than 60% of each resident group rated themselves skilled in contraception. Both groups rated themselves underskilled in adolescent history-taking; counseling; evaluation of psychopathology; and treatment of dysmenorrhea and hypertension. In both groups, the decision to care for an adolescent was negatively influenced by the presence of a psychosocial disorder. In conclusion, both pediatric and medical residents plan to care for adolescents, and both recognize deficiencies in their training. Pediatric residents, however, are more confident of their skills in adolescent care than are medical residents.

scholarly journals Literature Review on Fingerprint Level 1 and Level 2 Features Enhancement to Improve Quality of Image

2017 ◽  
pp. 8-19 ◽  
Author(s):  
Krishna Prasad K. ◽  
P. S. Aithal
Keyword(s):  
Recognition System ◽  
Fingerprint Recognition ◽  
Human Beings ◽  
Global Features ◽  
Basic Premise ◽  
Level 3 ◽  
Level 1 ◽  
The One ◽  
Level 2

Biometrics is the one most popular property in human distinguishing proof based on physical or behavioral features. The different physiological characteristics are Fingerprint, DNA, Face, hand, retina, ear features, and odor, where as behavioral characteristics or features are typing rhythm, gait, gesture, and voice with the basic premise that all are unique and all human beings are identified by these intrinsic traits. In the physiological traits, Fingerprint is most commonly utilized the biometric feature in diverse fields for identification and verification purpose. Fingerprint features can be separated into three noteworthy classifications in view of the granularity at which they are removed as level 1, level 2, and level 3 features. Level 1 feature contains macro details, which are easily extractable and include orientation filed, ridge frequency filed and pattern configuration. Only these global features or Level 1 features are not sufficient to uniquely identify or recognize, but if these features are used along with level 2 or level 3 features, that can make the fingerprint recognition system more robust and secure. Level1 features are used for image enhancement and orientation purpose. In this paper, we made a survey of existing literature on Level 1 features and try to analyze other researcher's contribution to this field.

scholarly journals Increased Knowledge about Floral Preservatives Influences Consumers’ Perception of the Quality and Value of a Floral Arrangement Purchase

2013 ◽  
Vol 23 (2) ◽  
pp. 142-148
Author(s):  
Morgan M. Jenkins ◽  
Kimberly A. Williams ◽  
Laura A. Brannon
Keyword(s):  
Generation Y ◽  
Purchase Intention ◽  
Intent To Purchase ◽  
Intention To Purchase ◽  
Level 3 ◽  
Perception Of Quality ◽  
Level 1 ◽  
Four Levels ◽  
Level 2

This research examines whether knowledge about floral preservatives increases consumers’ perception of quality, purchase intention, and price of a floral arrangement. A survey was administered to 222 participants at two locations in Manhattan, KS. Seventy-three percent of respondents fell within Generation Y (18 to 30 years old). The survey instrument presented four levels of presentation of a floral arrangement that were associated with increasing knowledge about the use of floral preservatives on consumers’ perceptions about the quality and price of that arrangement, as follows: Level 1 showed a photo of a floral arrangement without preservatives; Level 2 showed the same photo of a floral arrangement with a small, unlabeled packet of preservatives; Level 3 showed the same photo of a floral arrangement with a large, clearly labeled packet of preservatives; and Level 4 showed the same photos as Level 3 but was presented after a 191-word message describing the three functions of floral preservatives. Participants of the survey rated the quality of a floral arrangement higher from Level 2 (presence of floral preservatives not explicit) to Level 3 (presence of floral preservatives explicit) and from Level 3 to Level 4 (after reading a message about floral preservatives’ function and effectiveness). Their intent to purchase the floral arrangement generally increased with each level of presentation. Females indicated intention to purchase flowers more frequently than males. Participants increased the price that they were willing to pay for the floral arrangement at each level of presentation, starting at $25.46 at Level 1 (no floral preservatives use indicated) to $29.19 at Level 4. Participants were more knowledgeable about the benefits of floral preservatives and believed that floral preservatives increased the value of floral arrangements after reading a message describing their function and effectiveness more so than before reading a message. The younger the respondent, the more willing they were to pay more for floral arrangements with floral preservatives. As consumers become more aware of the use of floral preservatives and more knowledgeable about how and why they are effective, they attribute higher quality to floral arrangements with preservatives, they are willing to pay more for arrangements with preservatives, and their purchase intention frequency increases. Florists should always use preservatives in their processing and construction of fresh floral arrangements, consider providing a message about the function and effectiveness of floral preservatives to their customers, and then market their use of these materials.

scholarly journals MATHEMATICAL LITERACY’S VOCATIONAL STUDENTS BASED ON LOGICAL AND NUMERICAL REASONING

2017 ◽  
Vol 6 (2) ◽  
pp. 95
Author(s):  
Lathifatun Ni'mah ◽  
Iwan Junaedi ◽  
Scolastika Mariani
Keyword(s):  
Research Result ◽  
Logical Reasoning ◽  
Mathematical Literacy ◽  
Numerical Reasoning ◽  
Low Level ◽  
Medium Level ◽  
Level 3 ◽  
Level 1 ◽  
Research Type

The research aims is (1) to obtain learning quality of CTL model to students mathematical literacy, (2) to obtain mathematical literacy description based on logical reasoning, (3) to obtain mathematical literacy description based on numerical reasoning and (4) to obtain mathematical literacy description based on logical and numerical reasoning. The research type is descriptive study. The subject is XI AK SMK NU Lasem were taken 6 students high, medium and low logical reasoning, 6 students high, medium, and low numerical reasoning, 6 students high, medium, and low logical and numerical reasoning, 2 students high logical and medium numerical reasoning, 2 students medium logical and high numerical reasoning. The research result is (1) CTL models learning quality for mathematical literacy is good, (2) student mathematical literacy based on high logical reasoning level 4 and 5, medium level 3, low level 1 and 2, (3) student mathematical literacy based on high numerical reasoning level 5, medium level 4, low level 2 and 3, (4) student mathematical literacy based on high logical and numerical reasoning level 5, medium level 3 and 4, high logical and medium numerical reasoning or medium logical and high numerical reasoning level 4 and 5, low level 1 and 2.

scholarly journals Penerapan Metode Taguchi Dalam Optimasi Parameter Pada Proses Electrical Discharge Machining (EDM)

2019 ◽  
Vol 12 (1) ◽  
pp. 7-12
Author(s):  
Farizi Rachman Rachman ◽  
Tri Andi Setiawan ◽  
Bayu Wiro Karuniawan ◽  
Risma Aris Maya
Keyword(s):  
Taguchi Method ◽  
Manufacturing Industry ◽  
Electrical Discharge Machining ◽  
Machining Process ◽  
Level 3 ◽  
Level 1 ◽  
Electrical Conductors ◽  
Off Time ◽  
Conventional Machining

EDM is a non-conventional machining process with feeding material carried out by electric spark (spark) through a gap between the electrode and the workpiece containing liquid in the electric. The usefulness of the liquid is as a medium for rinsing the remnants of erosion material, electrodes and workpieces as electrical conductors. In the manufacturing industry, EDM is widely used for the manufacture of products that demand the quality of surface roughness resulting from smooth cutting and high precision. The Taguchi method is one method in experimental design that can be used to control product quality. This study considers 3 parameters, namely gap voltage, on time, and off time on the SKD-11 material as one of the 13 mm thick dies / dies. This study uses the Taguchi method to obtain optimal parameters with smaller criteria better. Based on the table above the highest voltage parameter gap at level 1 which is 30 volts, the parameters at the most agreed time at level 3 are 120 μs and the most difficult off time parameter to be reached at level 1 is 20 μs to roughness.   EDM adalah suatu proses permesinan yang bersifat non konvensional dengan pemakanan material benda kerja yang dilakukan oleh loncatan bunga api listrik (spark) melalui celah antara elektroda dan benda kerja yang berisi cairan di elektrik. Kegunaan cairan tersebut adalah sebagai medium untuk flushing sisa-sisa partikel material hasil erosi,pendinginan elektroda dan benda kerja serta sebagai konduktor listrik. Dalam industri manufaktur, EDM banyak digunakan untuk pembuatan produk-produk yang menuntut kualitas kekasaran permukaan hasil pemotongan yang halus dan kepresisian yang tinggi. Metode Taguchi merupakan salah satu metode dalam desain eksperimen yang dapat digunakan untuk mengendalikan kualitas produk. Penelitian ini mempertimbangkan 3 parameter yaitu gap voltage, on time, dan off time pada pengerjaan material SKD-11 sebagai salah satu bahan pembuatan cetakan/dies dengan tebal 13 mm. Penelitian ini menggunakan metode Taguchi untuk mendapatkan parameter yang optimum dengan kriteria smaller is better. Berdasarkan tabel diatas parameter gap voltage paling berpengaruh pada level 1 yaitu 30 volt, parameter on time paling berpengaruh pada level 3 yaitu 120 µs dan parameter off time paling berpengaruh pada level 1 yaitu 20 µs terhadap kekasaran.    

Vendor-Recommended Protocol Is Not Adequate To Verify Analyzer Performance After Probe Replacement

2020 ◽  
Vol 154 (Supplement_1) ◽  
pp. S91-S92
Author(s):  
S Fathima ◽  
A F Gallegos ◽  
V Kumar
Keyword(s):  
Quality Control ◽  
Alanine Aminotransferase ◽  
Critical Error ◽  
Level 3 ◽  
Allowable Error ◽  
The Mean ◽  
Level 1 ◽  
Assay Precision ◽  
Acceptability Criterion ◽  
Acceptability Criteria

Abstract Introduction/Objective To verify performance after probe replacement on Siemens ADVIA® 1800 analyzer, the vendor recommends running 2 levels of quality control (QC) for each analyte; however, this approach provides only a snapshot of analyzer performance. Additional experiments were conducted to determine if the vendor-recommended protocol adequately verifies analyzer performance. Methods Serum from 20 random patients was mixed, centrifuged at 1000 g for 10 min, and supernatant prepared (PPS). Intra-assay precision was assessed by analyzing 20 replicates of 2 levels of QC, and PPS for the following indicator assays (total allowable error [TEa] in parentheses): alanine aminotransferase (20%), calcium (6%), creatinine (15%), immunoglobulin G (25%), and sodium (5 mEq/L). Inter-assay precision over past 30 days was calculated from the values (90 – 114) of 2 levels of QC. Violation of 13s QC rule is most commonly used for detecting critical error (error > TEa). We used TEa/4 and TEa/3 as the acceptability criteria for intra- and inter-assay precision. Inter-assay precision was also compared to the precision claim by the vendor. Bias between the mean of QC values from intra- and inter- assay precision was calculated and TEa/4 used as the acceptability criterion. Results Intra-assay precision for both levels of QC for all analytes was acceptable. Intra-assay precision (5.48%) for only alanine aminotransferase in the PPS was unacceptable, indicating that patient matrix may impact precision for certain analytes. Inter-assay precision (2.24%) for level 1 QC for calcium was unacceptable. For all analytes, inter- assay precision compared to vendor’s claim was found to be significantly higher (32% - 405%). The bias was unacceptable for level 3 QC for sodium (-2.11). Conclusion Increased imprecision and/or bias may be observed if either probe replacement or alignment was not appropriate; or the verification protocol was not adequate. This study demonstrates the need to conduct experiments beyond vendor-recommended protocol to ensure production of clinically acceptable results.

scholarly journals Correlation Between Quality of Evidence and Number of Citations in Top 50 Cited Articles on Elbow Medial Ulnar Collateral Ligament Surgery

2018 ◽  
Vol 6 (4) ◽  
pp. 232596711876821 ◽  
Author(s):  
Robert A. Jack ◽  
Kyle R. Sochacki ◽  
Hannah A. Morehouse ◽  
Patrick C. McCulloch ◽  
David M. Lintner ◽  
...  
Keyword(s):  
Methodological Quality ◽  
Ulnar Collateral Ligament ◽  
The United States ◽  
Publication Date ◽  
Collateral Ligament ◽  
Level Of Evidence ◽  
The Mean ◽  
Level 1 ◽  
Number Of Citations

Background: Several studies have analyzed the most cited articles in shoulder, elbow, pediatrics, and foot and ankle surgery. However, no study has analyzed the quality of the most cited articles in elbow medial ulnar collateral ligament (UCL) surgery. Purpose: To (1) identify the top 50 most cited articles related to UCL surgery, (2) determine whether there was a correlation between the top cited articles and level of evidence, and (3) determine whether there was a correlation between study methodological quality and the top cited articles. Study Design: Systematic review. Methods: Web of Science and Scopus online databases were searched to identify the top 50 cited articles in UCL surgery. Level of evidence, number of times cited, year of publication, name of journal, country of origin, and study type were recorded for each study. Study methodological quality was analyzed for each article with the Modified Coleman Methodology Score (MCMS) and the Methodological Index for Non-randomized Studies (MINORS). Correlation coefficients were calculated. Results: The 50 most cited articles were published between 1981 and 2015. The number of citations per article ranged from 20 to 301 (mean ± SD, 71 ± 62 citations). Most articles (92%) were from the United States and were level 3 (16%), level 4 (58%), or unclassified (16%) evidence. There were no articles of level 1 evidence quality. The mean MCMS and MINORS scores were 28.1 ± 13.4 (range, 3-52) and 9.2 ± 3.6 (range, 2-19), respectively. There was no significant correlation between the mean number of citations and level of evidence or quality ( rs = –0.01, P = .917), MCMS ( rs = 0.09, P = .571), or MINORS ( rs = –0.26, P = .089). Conclusion: The top 50 cited articles in UCL surgery constitute a low level of evidence and low methodological quality, including no level 1 articles. There was no significant correlation between the mean number of citations and level of evidence or study methodological quality. However, weak correlations were observed for later publication date and improved level of evidence and methodological quality.

scholarly journals Evaluation of acceptability of the use of internal and external condoms in couples: a cross-over study

2020 ◽  
Vol 9 (9) ◽  
pp. e846997942
Author(s):  
Tatiana Moreira Afonso ◽  
Taciana Silveira Passos ◽  
Marcos Antonio Almeida-Santos
Keyword(s):  
Repeated Measures ◽  
Analogue Scale ◽  
Ease Of Use ◽  
Wave Type ◽  
Four Dimensions ◽  
Level 3 ◽  
The Mean ◽  
Level 1 ◽  
Level 2 ◽  
Better Than

Objective: To evaluate the acceptability (comfort, ease of use, lubrication, and pleasure) of internal and external condom use in stable couples. Metodology: This randomized cross-over trial included 54 couples (108 adult individuals). Participants were asked to evaluate acceptability measures of both types of condoms using the Visual Analogue Scale.  We developed a three-level hierarchical model [level 1= three repeated measures (wave, type of condom); level 2= individual (gender, age); level 3= couple (sequence of presentation of female versus external condom)]. Results: The "ease of use" dimension represented the biggest difference between the types of condoms for men (Hedges 'g = 0.96; p <0.0001) and women (Hedges' g = 1.62; p <0.0001). Regardless of gender, external condoms performed better (1.61; 95% HPD = 1.41 – 1.81). Men gave lower scores in general (-0.62; 95% HPD = -1.16 − -0.10). Conclusion: The external condom scored better than the internal condom for women and their male partners. The scores tended to improve with the repetitive use of the condom. There is no evidence of the influence of the age of the individuals or the randomly selected sequence of use of condoms with regards to the mean score of the four dimensions.

Anwendung des 10-Gruppenklassifikationssystems nach Robson für den Vergleich eines Perinatalzentrums Level 1 mit einem Level-3-Zentrum

2020 ◽  
Author(s):  
C Pulvermacher ◽  
P van de Vondel ◽  
L Gerzen ◽  
U Gembruch ◽  
W Merz
Keyword(s):  
Level 3 ◽  
Level 1

PENINGKATAN KUALITAS HIDUP MELALUI LOGOTERAPI PADA KLIEN YANG MENJALANI HEMODIALISIS

2019 ◽  
Vol 11 (1) ◽  
pp. 9-18
Author(s):  
Abdul Wakhid ◽  
Ana Puji Astuti ◽  
Maya Kurnia Dewi
Keyword(s):  
Quality Of Life ◽  
Renal Failure ◽  
Test Group ◽  
Sampling Technique ◽  
T Test ◽  
P Value ◽  
Number Of Patients ◽  
Post Test ◽  
The Mean

Logoterapi merupakan terapi untuk menemukan makna positif dibalik sebuah kejadian yang tidak diharapkan. Logoterapi dilaksanakan secara individu maupun berkelompok dalam bentuk konseling dan berorientasi pada pencarian makna hidup individu. Tujuan logoterapi meningkatkan makna pengalaman hidup individu yang diarahkan kepada pengambilan keputusan yang bertanggung jawab. Penelitian ini dilakukan dengan menggunakan rancangan pre-experiment dengan metode pre and post test group, artinya pengumpulan data dilakukan terhadap responden untuk membandingkan kualitas hidup sebelum dan sesudah dilakukan intervensi. Teknik pengambilan sampel dilakukan dengan metode total sampling yaitu pengambilan seluruh sampel dengan tetap memperhatikan kriteria yang telah ditetapkan. Jumlah pasien yang menjalani hemodialisis di RSUD Ungaran sebanyak 21 orang dan di RSUD Ambarawa sebanyak 25 pasien. Analisis data dilakukan dengan menggunakan uji t test dependent. Hasil penelitian didapatkan bahwa dari 46 responden didapatkan rata-rata skor kualitas hidup pasien yang mejalani hemodialisis sebesar 60.22 dengan skor terrendah 55 dan skor tertinggi 69. Bahwa dari 46 responden didapatkan rata-rata skor kualitas hidup pasien yang mejalani hemodialisis sebesar 88.72 dengan skor terrendah 79 dan skor tertinggi 103. Hasil uji statistik dengan uji t test dependent diketahui ada pengaruh logoterapi terhadap kemampuan memaknai hidup pada klien yang menjalani hemodialisis di RSUD Kabupaten Semarang (p value: 0,0001). Saran perlunya peningkatan kemampuan perawat dalam memberikan layanan kesehatan termasuk pemberian atau pemanduan penemuan makna hidup bagi pasien hemodialysis, agar selain dengan hemodialysis, ada faktor internal dari pasien yang dapat dijadikan sebagai motivasi untuk sembuh dari penyakit.   Kata Kunci: Logoterapi, kualitas hidup   IMPROVE THE QUALITY OF LIFE OF PATIENTS WITH RENAL FAILURE WHO UNDERWENT HEMODIALYSIS   ABSTRACT Logotherapy is a therapy to discover the positive meaning behind an unexpected event. Logotherapy is carried out individually or in groups in the form of counseling and oriented to the search for the meaning of individual life. This study aims to improve the quality of life of patients with renal failure who underwent hemodialysis. This research was conducted by using pre-experiment with pre-post test study. The sampling technique was done by the convenience sampling. The number of patients undergoing hemodialysis as many as 46 respondents. Data analysis was done by using test t test dependent. The result showed that from 46 respondents got the mean of quality of life of patients who had hemodialysis 60.22 with lowest score 55 and highest score 69. Whereas from 46 respondents got the mean score of life quality of patients who had hemodialysis 88.72 with score the lowest score 79 and the highest score 103. The result of statistical test with t test dependent is known there is influence of logoterapi to the ability of meaningful life on client who undergo hemodialysis at Semarang Regency hospitals (p value: 0.0001). Advice on the need to improve the nurse's ability to provide health services, including the provision or guidance of the discovery of the meaning of life for hemodialysis patients, in addition to hemodialysis, there are internal factors of the patient that can be used as a motivation to recover from illness.   Keywords: Logotherapy, quality of life, kidney failure.  

Quality of ram spermatozoa separated with modified swim up method

2018 ◽  
Vol 33 (2) ◽  
pp. 62-70 ◽  
Author(s):  
A Hossain ◽  
MM Islam ◽  
F Naznin ◽  
RN Ferdousi ◽  
FY Bari ◽  
...  
Keyword(s):  
Semen Quality ◽  
Membrane Integrity ◽  
Quality Parameters ◽  
Fluid Medium ◽  
Normal Morphology ◽  
The Mean ◽  
Mass Activity ◽  
Fresh Semen ◽  
Artificial Vagina

Semen was collected from four rams, using artificial vagina and viability%, motility% and plasma membrane integrity% were measured. Fresh ejaculates (n = 32) were separated by modified swim-up separation using modified human tubal fluid medium. Four fractions of supernatant were collected at 15-minute intervals. The mean volume, mass activity, concentration, motility%, viability%, normal morphology and membrane integrity% (HOST +ve) of fresh semen were 1.0 ± 0.14, 4.1 ± 0.1 × 109 spermatozoa/ml, 85.0 ± 1.3, 89.4 ± 1.0, 85.5 ± 0.7, 84.7 ± 0.5 respectively. There was no significant (P>0.05) difference in fresh semen quality parameters between rams. The motility%, viability% and HOST +ve % of first, second, third and fourth fractions were 53.4 ± 0.5, 68.2 ± 0.3, 74.8 ± 0.3 and 65.5 ± 0.4; 55.5 ± 0.4, 66.2 ± 0.4, 74.5 ± 0.3 and 73.6 ± 0.3 and 66.7 ± 0.5, 66.8 ± 0.5, 65.2 ± 0.4 and 74.7 ± 0.5 respectively. The motility%, viability% and membrane integrity% of separated semen samples differed significantly (P<0.05) between four fractions. The mean motility% and viability% were significantly higher (P<0.05) in third fraction (74.8 ± 0.3%), whereas the mean HOST +ve% was significantly higher (P<0.05) in fourth fraction (74.7 ± 0.5). All quality parameters of separated spermatozoa were significantly (P<0.05) lower than that of fresh semen. The pregnancy rates were higher with fresh semen (71%) in comparison to that of separated sample (57%).Bangl. vet. 2016. Vol. 33, No. 2, 62-70

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