Helping medical students to acquire a deeper understanding of truth-telling.

PROBLEM: Truth-telling is an important component of respect for patients' self-determination, but in the context of breaking bad news, it is also a distressing and difficult task. INTERVENTION: We investigated the long-term influence of a simulated patient-based teaching intervention, integrating learning objectives in communication skills and ethics into students' attitudes and concerns regarding truth-telling. We followed two cohorts of medical students from the preclinical third year to their clinical rotations (fifth year). Open-ended responses were analysed to explore medical students' reported difficulties in breaking bad news. CONTEXT: This intervention was implemented during the last preclinical year of a problem-based medical curriculum, in collaboration between the doctor-patient communication and ethics programs. OUTCOME: Over time, concerns such as empathy and truthfulness shifted from a personal to a relational focus. Whereas 'truthfulness' was a concern for the content of the message, 'truth-telling' included concerns on how information was communicated and how realistically it was received. Truth-telling required empathy, adaptation to the patient, and appropriate management of emotions, both for the patient's welfare and for a realistic understanding of the situation. LESSONS LEARNED: Our study confirms that an intervention confronting students with a realistic situation succeeds in making them more aware of the real issues of truth-telling. Medical students deepened their reflection over time, acquiring a deeper understanding of the relational dimension of values such as truth-telling, and honing their view of empathy.

Broadside Reporting the Fenian Invasion, June 3 1866

The collection consists of 6 broadsides reporting the events of the Fenian invasion of Canada on June 2 and 3, 1866. Three of the broadsides are titled Leader Extra, two are titled Globe Extra, and the last is titled News Extra. This one is titled "Globe Extra!" and headings include "Colonel Peacock's Force", "Col. Lowry Joins Col. Peacock with Reinforcements", "Colonel Dennis' Skirmish", "Colonel Booker's Skirmish!", "Fenian Movements at Ogdensburg", "Tereatened Raid at St. Albans", "Preparations at Cornwall!", "Latest! Bad News! The Fenians Escaped! The Whole Horde Fled Across the River."

L’annonce d’un décès au service des urgences : une étude qualitative

Nous cherchions à explorer les compétences que les intervenants du service des urgences (SU), des médecins et des infirmières travaillant en équipe dans des rôles complémentaires, ont développées dans la divulgation d‘un décès, pour éclairer l‘apprentissage de cette compétence de « Communicateur ». Nous avons utilisé des entrevues semi-dirigées et un échantillonnage non probabiliste de 8 intervenants. Nous avons analysé les entrevues à l‘aide de méthodes qualitatives reconnues. Le nombre total de présences de nos intervenants à une divulgation est estimé supérieur à 2000. Notre analyse a démontré qu‘ils utilisent une structure de divulgation uniforme. Néanmoins, ils repoussaient l‘utilisation d‘un protocole, parce que jugé trop rigide. La flexibilité et l‘empathie se sont révélées des qualités essentielles pour les intervenants. Nous représentons la visite de la famille comme un épisode de désorganisation/dysfonction qui se résorbe partiellement durant le séjour au SU. Nous proposons un modèle pédagogique qui est basé sur nos résultats.

Análisis de la Política Exterior Rusa en materia energética, comercial y militar hacia la República de Moldavia (Período 2000-2010)

Rusia sufrió grandes cambios tras la desintegración de la URSS en 1991. No obstante, con la llegada de Vladimir Putin al poder, los intereses geoestratégicos de Rusia sobre el espacio postsoviético revivieron con nuevo ímpetu debido a una mayor cantidad de recursos a disposición del Estado. La República de Moldavia es un claro ejemplo del resurgir de la política exterior rusa hacia el espacio postsoviético, siendo incluso, una región clave en la lucha de la Federación Rusa por recuperar su zona de influencia.

Estilos de liderazgo y su relación con los niveles de optimismo de los colaboradores, en entornos culturales de países suramericanos

Los estudios del liderazgo dentro de un contexto empresarial se han desarrollado para alcanzar la perdurabilidad empresarial, generar bienestar, lograr el éxito esperado, valorar el capital humano, los talentos y los recursos existentes, etc. Sin embargo, aún existen muchos aspectos que se deben analizar. Uno de ellos es entender los conceptos del optimismo, del tipo de liderazgo y las diferencias culturales de diversos países. Por otro lado, no hay evidencia precisa de la repercusión que tiene el tipo de liderazgo en los seguidores según la cultura presente, que permita comprender las relaciones existentes entre estas variables. Este texto que se presenta se basa en una revisión conceptual de los diferentes tipos de liderazgo; transaccional y transformacional, de la psicología positiva, del capital psicológico y del optimismo. Así mismo, presenta los diferentes estudios que se han realizado acerca de la relación que existe entre el liderazgo y el optimismo generado en los empleados para lograr mayores y mejores resultados, y una relación del liderazgo en diferentes culturas con poca distancia cultural frente a Colombia.

Autoregressive conditional kurtosis

This article proposes a new model for autoregressive conditional heteroscedasticity and kurtosis. Via a time-varying degrees of freedom parameter, the conditional variance and conditional kurtosis are permitted to evolve separately. The model uses only the standard Student’s t-density and consequently can be estimated simply using maximum likelihood. The method is applied to a set of four daily financial asset return series comprising U.S. and U.K. stocks and bonds, and significant evidence in favor of the presence of autoregressive conditional kurtosis is observed. Various extensions to the basic model are proposed, and we show that the response of kurtosis to good and bad news is not significantly asymmetric.

Does active management add any value?

The question as to whether active management adds any value above that of the funds investment policy is one of continual interest to investors. In order to investigate this issue in the UK real estate market we examine a number of related questions. First, how much return variability is explained by investment policy? Second, how similar are the policies across funds? Third, how much of a fund’s return is determined by investment policy? Finally, how was this added value achieved? Using data for 19 real estate funds we find that investment policy explains less than half of the variability in returns over time, nothing of the variation across funds and that more than 100% of a level of return is attributed to investment policy. The results also show UK real estate fund focus exclusively on trying to pick winners to add value and that in pursuit of active return fund mangers incur high tracking error risk, consequently, successful active management is very difficult to achieve. In addition, the results are dependent on the benchmark used to represent the investment policy of the fund. Nonetheless, active management can indeed add value to a real estate funds performance. This is the good news. The bad news is adding value is much more difficult to achieve than is generally accepted.

The effect of asymmetries on optimal hedge ratios

There is widespread evidence that the volatility of stock returns displays an asymmetric response to good and bad news. This article considers the impact of asymmetry on time-varying hedges for financial futures. An asymmetric model that allows forecasts of cash and futures return volatility to respond differently to positive and negative return innovations gives superior in-sample hedging performance. However, the simpler symmetric model is not inferior in a hold-out sample. A method for evaluating the models in a modern risk-management framework is presented, highlighting the importance of allowing optimal hedge ratios to be both time-varying and asymmetric.

O impacto das notícias no mercado financeiro brasileiro

As informações publicadas na mídia ajudam os investidores no processo decisório e consequentemente influenciam no mercado financeiro. O objetivo do presente trabalho é explorar o efeito da publicação de notícias no mercado financeiro. Para isso, o trabalho aborda variáveis de quantidade de notícias e o efeito semântico de cada uma delas, bem como sua relação com os índices de retorno, volatilidade e volume negociado do Ibovespa. As hipóteses da pesquisa são de que a quantidade de conteúdo publicado e o sentimento da informação podem ser preditores válidos para o nível de volatilidade, retorno e volume. Contudo, isso não implica que esses dados ajudam a prever o futuro, mas sim o presente. Os resultados encontrados evidenciam que a quantidade e conteúdo semântico das notícias não têm efeito significativo sobre o retorno, mas os aumentos da quantidade de notícias e da quantidade de notícias negativas sugerem o aumento da volatilidade e do volume negociado do Ibovespa. Além disso, o efeito das notícias é maior na volatilidade de acordo com o estado econômico, ou seja, o impacto de más notícias na expectativa dos investidores é maior em bons tempos que em maus tempos. Este trabalho também apresenta novas evidências para o efeito de acordo com o dia da semana. Isto é, a quantidade de notícias publicadas de sexta-feira a domingo está relacionada com a volatilidade e o volume negociado do Ibovespa.

Managerial turnover and leverage under a takeover threat

How do shareholders perceive managers who lever up under a takeover threat? Increasing leverage conveys good news if it reflects management's ability to enhance value. It conveys bad news, though, if inefficient managers are more pressured to lever up. This paper demonstrates that negative (positive) updating prevails when takeover costs are small (large). Managers who leve r up to end a takeover threat thus may commit to an increase in the firm's value and yet increase their chances of being replaced by their shareholders. The model predicts that intraindustry leverage is less dispersed when takeover costs are low.

O processo de comunicação médico/família/criança: a percepção de mães de crianças portadoras de doenças crônicas graves

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

Comunicado más notícias: protocolo paciente

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

A experiência materna com seu recém-nascido em fototerapia

Pós-graduação em Enfermagem - FMB

CASNR Fall Faculty Meeting

I am so pleased to have this opportunity to speak with you today. There is something about the beginning of a semester that always strikes me as hopeful and exciting, and it is a treat to share in hopeful times just as we have shared in the very difficult economic times the Institute, the university, and our state have experienced in the past two years. We have dealt with budget crises and made some tremendously difficult decisions that are felt personally, as well as professionally. We know it often seems that "bad news" grabs the headlines, yet a tremendous number of good things have happened in the past year, as well, thanks to the talent, enthusiasm, and the professionalism of our faculty, staff, and students.

Low-Income Developing Countries and WTO Litigation: Why Wake Up the Sleeping Dog?

The World Trade Organization (WTO) is one of the most judicialized dispute settlement systems in international politics. While a general appreciation has developed that the system has worked quite well, research has not paid sufficient attention to the weakest actors in the system. This paper addresses the puzzle of missing cases of least-developed countries initiating WTO disputes settlement procedures. It challenges the existing literature on developing countries in WTO dispute settlement which predominantly focuses on legal capacity and economic interests. The paper provides an argument that the small universe of ‘actionable cases’, the option of free riding and the assessment of the perceived opportunity costs related to other foreign policy priorities better explain the absence of cases. In addition (and somewhat counterintuitively), we argue that the absence of cases is not necessarily bad news and shows how the weakest actors can use the dispute settlement system in a ‘lighter version’ or in indirect ways. The argument is empirically assessed by conducting a case study on four West African cotton-producing countries (C4) and their involvement in dispute settlement.