Consequences of insecurity in emergency telephone consultations: an experimental study in medical students.

QUESTION UNDER STUDY Handling emergency telephone consultations (ETCs) is a challenging and very important task for doctors. The aims of the study were to document insecurity in medical students during ETCs and to identify the reasons for that insecurity. We hypothesised that insecurity is associated with advising more urgent action (e.g. advice to call for an ambulance) in ETCs. METHODS We used ETCs with simulated patients (SPs), with each student randomly allocated two of four possible cases. After the training, 137 students reported on any insecurity that they had in the various ETC phases. We analysed the reasons for insecurity using descriptive statistics. The association between the students' advice that urgent action was needed and their insecurity was analysed with Spearman rank correlation. RESULTS Overall, 95% of the students felt insecure in at least one phase of their ETC. History taking was the phase in which students felt most insecure (63.1%), followed by the phase of analysing the information given by the patient (44.9%). Perceived insecurity was associated with more urgent advice in one case scenario (abdominal pain; correlation r = 0.46; p <0.01). The other two cases (child with fever; chest pain) also had a positive, but not statistically significant, correlation trend (p <0.12; p <0.08). CONCLUSIONS Insecurity is highly prevalent among medical students in their ETC decision-making. ETC training in medical schools, with a focus on structured history taking and formulating discriminating questions, might help decrease insecurity in ETCs. Medical education should also teach management of insecurity.

Lepton Flavor Violation in the Standard Model with general Dimension-Six Operators

We study lepton flavor observables in the Standard Model (SM) extended with all dimension-6 operators which are invariant under the SM gauge group. We calculate the complete one-loop predictions to the radiative lepton decays μ → eγ, τ → μγ and τ → eγ as well as to the closely related anomalous magnetic moments and electric dipole moments of charged leptons, taking into account all dimension-6 operators which can generate lepton flavor violation. Also the 3-body flavor violating charged lepton decays τ ± → μ ± μ + μ −, τ ± → e ± e + e −, τ ± → e ± μ + μ −, τ ± → μ ± e + e −, τ ± → e ∓ μ ± μ ±, τ ± → μ ∓ e ± e ± and μ ± → e ± e + e − and the Z 0 decays Z 0 → ℓ+iℓ−j are considered, taking into account all tree-level contributions.

Reliability of operational data from pig herds and performance ratings by veterinarians and pig farmers collected during telephone interviews for the evaluation of a PCV2 piglet vaccination

BackgroundThe aim of the present study was to evaluate the feasibility of using a telephone survey in gaining an understanding of the possible herd and management factors influencing the performance (i.e. safety and efficacy) of a vaccine against porcine circovirus type 2 (PCV2) in a large number of herds and to estimate customers¿ satisfaction.ResultsDatasets from 227 pig herds that currently applied or have applied a PCV2 vaccine were analysed. Since 1-, 2- and 3-site production systems were surveyed, the herds were allocated in one of two subsets, where only applicable variables out of 180 were analysed. Group 1 was comprised of herds with sows, suckling pigs and nursery pigs, whereas herds in Group 2 in all cases kept fattening pigs. Overall 14 variables evaluating the subjective satisfaction with one particular PCV2 vaccine were comingled to an abstract dependent variable for further models, which was characterized by a binary outcome from a cluster analysis: good/excellent satisfaction (green cluster) and moderate satisfaction (red cluster). The other 166 variables comprised information about diagnostics, vaccination, housing, management, were considered as independent variables. In Group 1, herds using the vaccine due to recognised PCV2 related health problems (wasting, mortality or porcine dermatitis and nephropathy syndrome) had a 2.4-fold increased chance (1/OR) of belonging to the green cluster. In the final model for Group 1, the diagnosis of diseases other than PCV2, the reason for vaccine administration being other than PCV2-associated diseases and using a single injection of iron had significant influence on allocating into the green cluster (P¿<¿0.05). In Group 2, only unchanged time or delay of time of vaccination influenced the satisfaction (P¿<¿0.05).ConclusionThe methodology and statistical approach used in this study were feasible to scientifically assess ¿satisfaction¿, and to determine factors influencing farmers¿ and vets¿ opinion about the safety and efficacy of a new vaccine.

Eigenvalue estimates for non-selfadjoint Dirac operators on the real line

We show that the non-embedded eigenvalues of the Dirac operator on the real line with complex mass and non-Hermitian potential V lie in the disjoint union of two disks, provided that the L1-norm of V is bounded from above by the speed of light times the reduced Planck constant. The result is sharp; moreover, the analogous sharp result for the Schrödinger operator, originally proved by Abramov, Aslanyan and Davies, emerges in the nonrelativistic limit. For massless Dirac operators, the condition on V implies the absence of non-real eigenvalues. Our results are further generalized to potentials with slower decay at infinity. As an application, we determine bounds on resonances and embedded eigenvalues of Dirac operators with Hermitian dilation-analytic potentials.

On the similarity of Sturm-Liouville operators with non-Hermitian boundary conditions to self-adjoint and normal operators

We consider one-dimensional Schrödinger-type operators in a bounded interval with non-self-adjoint Robin-type boundary conditions. It is well known that such operators are generically conjugate to normal operators via a similarity transformation. Motivated by recent interests in quasi-Hermitian Hamiltonians in quantum mechanics, we study properties of the transformations and similar operators in detail. In the case of parity and time reversal boundary conditions, we establish closed integral-type formulae for the similarity transformations, derive a non-local self-adjoint operator similar to the Schrödinger operator and also find the associated “charge conjugation” operator, which plays the role of fundamental symmetry in a Krein-space reformulation of the problem.

[Emergency telephone cosultations].

Telephone consultations are part of GP's daily routine. The patients appreciate the quick and uncomplicated access to consultations via phone and therefore the demand for telephone consultations is increasing steadily. Nevertheless, telephone consultations pose a challenge to healthcare professionals. Safety is improved by adhering to recommendations. The required skills are learnable.

Root system of singular perturbations of the harmonic oscillator type operators

We analyze perturbations of the harmonic oscillator type operators in a Hilbert space H, i.e. of the self-adjoint operator with simple positive eigenvalues μ k satisfying μ k+1 − μ k ≥ Δ > 0. Perturbations are considered in the sense of quadratic forms. Under a local subordination assumption, the eigenvalues of the perturbed operator become eventually simple and the root system contains a Riesz basis.

Sexual harassment over the telephone: Occupational risk at call centers

The phenomenon of sexually harassing telephone calls in the workplace has been studied only marginally. In the present study 106 employees working in call centres in Germany answered a questionnaire regarding their experiences of sexual harassment over the telephone. The following data are presented: description of the phenomenon, i.e. prevalence and characteristics, stress reactions of the victims, behavioural reactions and coping strategies, consequences and anticipated consequences; prediction of the stress reactions by characteristics of the situation; and employees' recommendations for coping with sexually harassing calls. It was found that the female employees were more often sexually harassed over the telephone at work than their male colleagues. Three out of four female employees had experienced sexually harassing telephone calls; in the majority of cases the harassers were men. Characteristic patterns of harassment included groaning, sexual insults, silence, and threats of sexual violence. Some 16% of the harassed female employees described these experiences as extremely stressful. If the harassment contained threats of sexual violence and groaning, the perceived physical response was stronger. Being subjected to sexual harassment over the telephone both at home and at work was a more severe stress than having the experience only in the workplace. In conclusion, employees' recommendations for coping with the occurrence of sexually harassing calls are described.