Graduating 4th year radiology residents' perception of optimal imaging modalities for neoplasm and trauma: a pilot study from four U.S. universities

OBJECTIVE: Our purpose was to assess 4th year radiology residents' perception of the optimal imaging modality to investigate neoplasm and trauma. MATERIALS AND METHODS: Twenty-seven 4th year radiology residents from four residency programs were surveyed. They were asked about the best imaging modality to evaluate the brain and spine, lungs, abdomen, and the musculoskeletal system. Imaging modalities available were MRI, CT, ultrasound, PET, and X-ray. All findings were compared to the ACR appropriateness criteria. RESULTS: MRI was chosen as the best imaging modality to evaluate brain, spine, abdominal, and musculoskeletal neoplasm in 96.3%, 100%, 70.4%, and 63% of residents, respectively. CT was chosen by 88.9% to evaluate neoplasm of the lung. Optimal imaging modality to evaluate trauma was CT for brain injuries (100%), spine (92.6%), lung (96.3%), abdomen (92.6%), and major musculoskeletal trauma (74.1%); MRI was chosen for sports injury (96.3%). There was agreement with ACR appropriateness criteria. CONCLUSION: Residents' perception of the best imaging modalities for neoplasm and trauma concurred with the appropriateness criteria by the ACR.

New technologies and nursing: use and perception of primary healthcare nurses about electronic health record in Catalonia, Spain

This study was aimed to analyze and assess the use and perception of electronic health records (EHRs) by nurses. The study sample included 113 nurses from different shifts of primary health facilities in Catalonia, Spain, devoted to adult as well as pediatric outpatients using EHRs throughout the year 2010. A majority of the sample (87.5%) were women and 12.5% were men. The average age was 44.27 years and the average time working in primary healthcare was 47.15 months. A majority (80.4%) received specific training on the use of the EHR and 19.6% did not. The use of the application required side technical support (mean: 3.42) and it is considered necessary to learn more about the performance of the application (mean: 3.50). The relationship between the average ratings that nurses have about the EHR and age shows that there is no statistically significant linear relationship (r = - 0.002, p-value = 0.984). As to how long they have used the EHRs, there are significant differences (r= -0.304, p-value = 0.00), so the more time the nurse takes using the EHR, the greater degree of satisfaction is shown. In addition, there are significant differences between nurses" perceptions regarding the EHR and gender (t = - 0.421, p-value = 0.675). Nurses assessed as positive the contribution of the EHRs in their nursing care day work (average score: 2.55/5). Considering that the usability of the EHR device is assessed as satisfactory, the results of the perception of nurses show that we must also take into account the training and emphasize the need for a side technical support in the implementation process of the EHR. Doing so, the positive perception that nurses have in regard to information and communication technology in general and with respect to the EHR in particular may be increased.

New technologies and nursing: use and perception of primary healthcare nurses about electronic health record in Catalonia, Spain

This study was aimed to analyze and assess the use and perception of electronic health records (EHRs) by nurses. The study sample included 113 nurses from different shifts of primary health facilities in Catalonia, Spain, devoted to adult as well as pediatric outpatients using EHRs throughout the year 2010. A majority of the sample (87.5%) were women and 12.5% were men. The average age was 44.27 years and the average time working in primary healthcare was 47.15 months. A majority (80.4%) received specific training on the use of the EHR and 19.6% did not. The use of the application required side technical support (mean: 3.42) and it is considered necessary to learn more about the performance of the application (mean: 3.50). The relationship between the average ratings that nurses have about the EHR and age shows that there is no statistically significant linear relationship (r = - 0.002, p-value = 0.984). As to how long they have used the EHRs, there are significant differences (r= -0.304, p-value = 0.00), so the more time the nurse takes using the EHR, the greater degree of satisfaction is shown. In addition, there are significant differences between nurses" perceptions regarding the EHR and gender (t = - 0.421, p-value = 0.675). Nurses assessed as positive the contribution of the EHRs in their nursing care day work (average score: 2.55/5). Considering that the usability of the EHR device is assessed as satisfactory, the results of the perception of nurses show that we must also take into account the training and emphasize the need for a side technical support in the implementation process of the EHR. Doing so, the positive perception that nurses have in regard to information and communication technology in general and with respect to the EHR in particular may be increased.

Listening to parents: The role of symptom perception in pediatric palliative home care.

OBJECTIVE: This study analyzes symptom perception by parents and healthcare professionals and the quality of symptom management in a pediatric palliative home care setting and identifies which factors contribute to a high quality of palliative and end-of-life care for children. METHODS: In this retrospective, cross-sectional study, parents were surveyed at the earliest three months after their child's death. All children were cared for by a specialized home pediatric palliative care team that provides a 24/7 medical on-call service. Questionnaires assessed symptom prevalence and intensity during the child's last month of life as perceived by parents, symptom perception, and treatment by medical staff. The responses were correlated with essential palliative care outcome measures (e.g., satisfaction with the care provided, quality-of-life of affected children and parents, and peacefulness of the dying phase). RESULTS: Thirty-eight parent dyads participated (return rate 84%; 35% oncological disorders). According to parental report, dyspnea (61%) and pain (58%) were the dominant symptoms with an overall high symptom load (83%). Pain, agitation, and seizures could be treated more successfully than other symptoms. Successful symptom perception was achieved in most cases and predicted the quality of symptom treatment (R 2, 0.612). Concordant assessment of symptom severity between parents and healthcare professionals (HCPs) improved the satisfaction with the care provided (p = 0.037) as well as the parental quality-of-life (p = 0.041). Even in cases with unsuccessful symptom control, parents were very satisfied with the SHPPC team's care (median 10; numeric rating scale 0-10) and rated the child's death as highly peaceful (median 9). Significance of the results: The quality and the concordance of symptom perception between parents and HCPs essentially influence parental quality-of-life as well as parental satisfaction and constitute a predictive factor for the quality of symptom treatment and palliative care.

Perception du timing pubertaire et comportements à risque chez des adolescents suisses

Il faut distinguer timing pubertaire objectif (TPO ; comparaison du timing pubertaire réel d'un sujet avec celui d'un groupe de référence) et timing pubertaire subjectif (TPS ; perception subjective par le sujet de son timing pubertaire par rapport à celui de ses pairs). Chez l'adolescente, la ménarche est couramment utilisée comme marqueur du TPO. La littérature s'intéressant aux variations physiologiques (normales) du timing pubertaire montre qu'un TPO précoce est corrélé chez les adolescentes avec de nombreux problèmes de santé (p.ex. dépression, abus de substances, comportements à risques, niveau d'études inférieur). Un TPO tardif chez l'adolescente serait quant à lui associé à une meilleure réussite scolaire. Les diverses hypothèses expliquant ces corrélations sont brièvement décrites dans notre travail. Certaines hypothèses impliquent des facteurs objectifs tels les changements du corps à la puberté, alors que d'autres privilégient des facteurs plus subjectifs, dans le registre de la perception de soi. A ce jour, la littérature ne s'est que très peu intéressée au TPS en soi. Une adolescente percevant son timing pubertaire comme précoce est-elle à risque même si sa puberté survient objectivement au même âge que la majorité de ses pairs ? L'objectif de ce travail est de rechercher d'éventuelles corrélations entre TPS et adoption de comportements à risque chez des adolescentes rapportant un TPO dans la moyenne. Nos données proviennent de l'enquête SMASH 2002, une étude par questionnaire auto-administré conduite parmi un échantillon de 7548 adolescentes et adolescents suisses âgés de 16-20 ans. Des 3658 adolescentes de l'échantillon initial, nous ne sélectionnons que les 1003 d'entre elles qui ont répondu à la question sur le TPS et qui ont rapporté un âge à la ménarche de 13 ans, soit la moyenne et la médiane de l'âge à la ménarche rapporté par les 3658 adolescentes de l'échantillon initial. Ces 1003 adolescentes sélectionnées sont considérées comme ayant un TPO dans la moyenne. Ces 1003 adolescentes sont séparées en 3 groupes en fonction de leur TPS (précoce/correspondant à la moyenne/tardif). A l'aide d'analyses bivariées et logistiques, nous comparons ces 3 groupes en termes d'adoption de comportements à risque dans le champ de la sexualité (précocité des rapports sexuels) et dans celui de la consommation de substances (tabac, cannabis, drogues dures). Nos résultats montrent principalement qu'une perception de précocité pubertaire est associée avec une précocité des premiers rapports sexuels et de l'usage de drogues dures. A l'inverse, les adolescentes percevant leur puberté comme tardive rapportent moins fréquemment des rapports sexuels avant 16 ans que les adolescentes percevant leur puberté comme dans la moyenne. Les implications cliniques sont les suivantes : face à une adolescente percevant sa puberté comme étant ou ayant été précoce, le praticien devrait investiguer l'existence de comportements à risque même si la puberté survient ou est survenue à un âge similaire à ce qui est retrouvé chez la majorité des pairs. En effet, notre étude suggère que même si cette adolescente se trompe en percevant sa puberté comme précoce, la probabilité de comportements à risque est augmentée dans le champ de la sexualité et de la consommation de substances. Nos résultats suggèrent aussi que l'association retrouvée dans la littérature entre précocité objective de la puberté et comportements à risque chez les adolescentes n'est pas uniquement médiée par les changements corporels pubertaires mais qu'un facteur psychologique tel que la perception subjective est également impliqué.

Individual Perception of Organizational Values

The objective of this master’s thesis was to examine how corporate values come true among the white-collar employees in the case organization. It was also studied if values were perceived similarly in the different departments. Impact of organizational position and education on value orientation was tested through hypotheses based on earlier values research. There are only few value scales available for measuring organizational values. The empirical study results indicate that personnel’s perception of organizational values can be measured statistically. When defining the scale it is utmost important to link the questions and claims close to the employees’ daily working environment. In this study, Work ethic appeared as the strongest organizational value reflecting respondents’ commitment to their duties. Related to corporate values, Performance was perceived as the strongest value and Emphasis on people the weakest. Value consensus between the departments varied. According to the previous research organizational position and educational level has an impact on value perceptions. In this study, employees in superior position or with higher education perceived organizational values to come true better than subordinates or employees with lower education. Empirical data (N=229) was collected by a web-based survey questionnaire among white-collar employees in the case organization in April 2008. Statistical analyses were performed by SPSS programme.

Identidad, percepción de vitalidad etnolingüística y comunicación intergrupal en Cataluña: An identity and ethnolinguistic perception vitality study in Catalonia

Catalan has drawn considerable attention given its impressive institutional support and increased usage since the restoration of the Generalitat of Catalonia. We report a study on 112 Catalan-speaking students who were administered the"subjective vitality questionnaire". Results show (and these are compared with reports 20 years ago) that it continues to gain momentum and status, even with the International stature of Spanish. The theoretical and pragmatic significance of these findings are discussed in terms of vitality"s role in shaping Language choices (Catalan vs. Castilian) in everyday communication as well as the societal level in forging Language policies for communicating in Catalan in business, political, educational, and media arenas

Role of Selected Spectral Attributes in the Perception of Synthetic Vowels

This thesis is an experimental study regarding the identification and discrimination of vowels, studied using synthetic stimuli. The acoustic attributes of synthetic stimuli vary, which raises the question of how different spectral attributes are linked to the behaviour of the subjects. The spectral attributes used are formants and spectral moments (centre of gravity, standard deviation, skewness and kurtosis). Two types of experiments are used, related to the identification and discrimination of the stimuli, respectively. The discrimination is studied by using both the attentive procedures that require a response from the subject, and the preattentive procedures that require no response. Together, the studies offer information about the identification and discrimination of synthetic vowels in 15 different languages. Furthermore, this thesis discusses the role of various spectral attributes in the speech perception processes. The thesis is divided into three studies. The first is based only on attentive methods, whereas the other two concentrate on the relationship between identification and discrimination experiments. The neurophysiological methods (EEG recordings) reveal the role of attention in processing, and are used in discrimination experiments, while the results reveal differences in perceptual processes based on the language, attention and experimental procedure.

Risk perception and stages of smoking acquisition = Percepción de riesgo y etapas de iniciación en el consumo de tabaco

The purpose of this descriptive survey was to investigate the risk perceptions of smoking in a sample of 1,510 Spanish adolescents(49.1% males; mean age = 14.03; SD = 1.28). In addition, the present research categorised adolescents into one of the fourstages of smoking acquisition, as described by the Transtheoretical Model of Change (TMC): Precontemplation (notthinking about trying smoking in the next 6 months), Contemplation (thinking about trying smoking in the next 6 months), Preparation (thinking about starting smoking in the next 30 days) and Action (smokers), by gender and age. The results showed that age and risk perceptions are important variables in the progression through the stages of change towards regular tobacco consumption (Action stage). These results clearly demonstrate the importance of starting antismoking campaigns at an early age to prevent smoking acquisition or the thought of starting in the near future. These findings also highlight the need to continuously remind adolescents about the negative consequences of smoking

Brain Dopamine and Serotonin Receptors in the Perception of Pain. Positron Emission Tomography Studies in Healthy Subjects

The role of dopamine and serotonin in spinal pain regulation is well established. However, little is known concerning the role of brain dopamine and serotonin in the perception of pain in humans. The aim of this study was to assess the potential role of brain dopamine and serotonin in determining experimental pain sensitivity in humans using positron emission tomography (PET) and psychophysical methods. A total of 39 healthy subjects participated in the study, and PET imaging was performed to assess brain dopamine D2/D3 and serotonin 5-HT_1A receptor availability. In a separate session, sensitivity to pain and touch was assessed with traditional psychophysical methods, allowing the evaluation of potential associations between D2/D3 and 5-HT_1A binding and psychophysical responses. The subjects’ responses were also analyzed according to Signal Detection Theory, which enables separate assessment of the subject’s discriminative capacity (sensory factor) and response criterion (non-sensory factor). The study found that the D2/D3 receptor binding in the right putamen was inversely correlated with pain threshold and response criterion. 5-HT_1A binding in cingulate cortex, inferior temporal gyrus and medial prefrontal cortex was inversely correlated with discriminative capacity for touch. Additionally, the response criterion for pain and intensity rating of suprathreshold pain were inversely correlated with 5-HT_1A binding in multiple brain areas. The results suggest that brain D2/D3 receptors and 5-HT_1A receptors modulate sensitivity to pain and that the pain modulatory effects may, at least partly, be attributed to influences on the response criterion. 5-HT_1A receptors are also involved in the regulation of touch by having an effect on discriminative capacity.

Un estudio transversal sobre la percepción de la vitalidad etnolingüística en jóvenes y adultos de Catalunya = A cross-sectional study on ethnolinguistic vitality perception in young and adulthood people from Catalonia

El estudio utiliza un diseño transversal en el campo de la percepción de la vitalidad etnolingüística. Es el primero que compara la percepción de la vitalidad etnolingüística, así como los factores asociados, entre adultos jóvenes y adultos, en relación con los grupos castellanohablantes y catalanohablantes de la Comunidad Autónoma de Cataluña. Para ello, se aplicó el 'Cuestionario de vitalidad etnolingüística subjetiva' (CVS) a una muestra de 527 participantes, 268 jóvenes y 259 adultos, de los cuales se seleccionó una submuestra de individuos que tenían el catalán como lengua materna y se identificaban como catalanes (n=301). En ambas muestras se aduce una tendencia a descriminar favorablemente la vitalidad percibida por el grupo catalán, aspecto que se acentúa significativa en el grupo de jóvenes estudiados en relación al grupo de edad de los adultos. Se discuten los resultados según las repercusiones teóricas y pragmáticas de los estudios realizados en el ámbito de la comunicación intergrupal

Contextualizing entrepreneurial intentions : a multiple case study on entrepreneurial cognition and perception

Avhandlingen behandlar entreprenöriella intentioner och individens uppfattningar om entreprenörskap. Om vi vill främja entreprenörskap så räcker det inte att vi förstår vilken nytta samhället kan ha av entreprenörer (arbetsplatser, mera skatteinkomster osv.). Vi måste förstå varför entreprenörskap är intressant och attraktiv ur individens synvinkel. Just den frågan har varit central inom kognitiv entreprenörskapsforskning de senaste 10 åren har vår förståelse för entreprenörer ökat betydligt tack vare den forskningen. Problemet med existerande forskning är att uppfattad genomförbarhet och uppfattad attraktivitet, dvs. de attityder som sägs leda till entreprenöriella intentioner, beskriver enbart vilken attityd individen generellt har till entreprenörskap. Enligt tidigare forskningsresultat så är det skillnad på generella attityder till en handling och attityder till att genomföra just den handlingen. Vill vi veta om individen kan tänka sig starta och driva ett företag så måste vi alltså studera individens attityd till att utföra just den specifika handlingen. Enligt avhandlingens forskningsresultat så kan vi lära oss mera om attityder till entreprenörskap genom att studera också motivation och mål. På så sätt kan vi förstå varför en del väljer att bli entreprenörer medan andra väljer att låta bli, även om de utåt sett har samma möjligheter att bli entreprenörer.

Lifelong learning travels : single actors´ perception and talk of lifelong learning in a specific organizational context

I mars 2003 certifierades en finländsk advokatbyrå av den Europeiska kommissionen som den bästa i Europa inom specialkategorin livslångt lärande. Advokatbyrån var överraskad över utnämningen emedan de inte aktivt och/eller medvetet implementerat eller utövat en livslångt lärandestrategi i sin verksamhet bland sin personal. Byrån deltog i en tävling om bästa arbetsplats i Europa ("Best workplaces in Europe 2003") utan att vara medveten om den Europeiska kommissionens special- kategorier. Emedan advokatbyrån inte medvetet implementerat en livslångt lärandestrategi bland sin personal formar aktörerna, vars uppfattning och prat denna avhandling handlar om, sina föreställningar och sitt prat om livslångt lärande efter utnämningen. Översättningsprocessen av en idé utlöses sålunda i denna studie av en extern händelse. I sin avhandling beskriver Annica Isacsson hur och varför en idé (livslångt lärande) föds (på nytt) på en institutionell nivå, hur idén reser och förändras i en process av översättning, hur idén landar i två organisationer samt hur idén om livslångt lärande uppfattas och beskrivs av lokala aktörer i två olika organisationer. Fokus i studien ligger sålunda på enskilda aktörers uppfattning om ett kontroversiellt koncept i en lokal kontext. Teoretiskt möts och sammanlänkas teori om livslångt lärande, sociokulturella teorier om lärande och teorier om organisatoriskt lärande. Isacssons avhandling visar på hur livslångt lärande inte enbart, i en organisatorisk kontext, handlar om individuell kompetensutveckling utan också om organisatoriskt lärande i vilken lärande av andra organisationsmedlemmar och organisationer ingår. Studien visar vidare på hur enskilda aktörers prat påverkas av det institutionella fältet och av den tidsanda inom vilken diskursen livslångt lärande föds, rör sig och ingår.