Female residents experiencing medical errors in general internal medicine: a qualitative study.

BACKGROUND: Doctors, especially doctors-in-training such as residents, make errors. They have to face the consequences even though today's approach to errors emphasizes systemic factors. Doctors' individual characteristics play a role in how medical errors are experienced and dealt with. The role of gender has previously been examined in a few quantitative studies that have yielded conflicting results. In the present study, we sought to qualitatively explore the experience of female residents with respect to medical errors. In particular, we explored the coping mechanisms displayed after an error. This study took place in the internal medicine department of a Swiss university hospital. METHODS: Within a phenomenological framework, semi-structured interviews were conducted with eight female residents in general internal medicine. All interviews were audiotaped, fully transcribed, and thereafter analyzed. RESULTS: Seven main themes emerged from the interviews: (1) A perception that there is an insufficient culture of safety and error; (2) The perceived main causes of errors, which included fatigue, work overload, inadequate level of competences in relation to assigned tasks, and dysfunctional communication; (3) Negative feelings in response to errors, which included different forms of psychological distress; (4) Variable attitudes of the hierarchy toward residents involved in an error; (5) Talking about the error, as the core coping mechanism; (6) Defensive and constructive attitudes toward one's own errors; and (7) Gender-specific experiences in relation to errors. Such experiences consisted in (a) perceptions that male residents were more confident and therefore less affected by errors than their female counterparts and (b) perceptions that sexist attitudes among male supervisors can occur and worsen an already painful experience. CONCLUSIONS: This study offers an in-depth account of how female residents specifically experience and cope with medical errors. Our interviews with female residents convey the sense that gender possibly influences the experience with errors, including the kind of coping mechanisms displayed. However, we acknowledge that the lack of a direct comparison between female and male participants represents a limitation while aiming to explore the role of gender.

Le nombre de reines chez les fourmis et sa conséquence sur l'organisations sociale

Nearly half of all ant species form polygyne societies (cohabitation of more than a single egg-laying queen). These queens are generally smaller and store fewer fat reserves than queens from monogyne colonies. Most queens in polygyne colonies (70-100 pour 100) are inseminated, although this proportion varies among species, and even among populations of the same species. They exhibit mutual tolerance and they all contribute to the reproductive effort of the colony. Nevertheless, their individual fecundity is considerably reduced compared with that of queens from monogyne colonies. This reduction in fecundity seems to be due to some form of mutual inhibition, in some cases the secretion by each female of a substance suppressing egg production in other queens has been implicated. In a few species, queens are organized into a hierarchy such that certain queens lay more eggs than others or even monopolize egg-laying (functional monogyny). Polygyny is linked to a particular life history. It rarely results from the association of several foundresses (primary polygyny). Usually, it is due to the adoption of young queens by an established nest just after a nuptial flight. This secondary polygyny means that the dispersal of the species is limited and is achieved by the budding of a mother nest. Thus colony founding is dependent; with workers accompanying young queens in establishing new colonies. Observation of closely related species exhibiting different social organizations, some monogyne and others polygyne, shows a possible link between queen number and ecological conditions: polygyne forms are more frequent in unstable habitats susceptible to rapid change, such as that caused by human activity. The existence of polygyne societies is an intriguing evolutionary mystery. Research into the origin and maintenance of polygyny focuses on patterns of speciation in relation to queen number and the different theories put forth for the evolution of eusociality, mainly kin selection and mutualism.

Male dominance linked to size and age, but not to 'good genes' in brown trout (Salmo trutta).

BACKGROUND: Males that are successful in intra-sexual competition are often assumed to be of superior quality. In the mating system of most salmonid species, intensive dominance fights are common and the winners monopolise most mates and sire most offspring. We drew a random sample of mature male brown trout (Salmo trutta) from two wild populations and determined their dominance hierarchy or traits linked to dominance. The fish were then stripped and their sperm was used for in vitro fertilisations in two full-factorial breeding designs. We recorded embryo viability until hatching in both experiments, and juvenile survival during 20 months after release into a natural streamlet in the second experiment. Since offspring of brown trout get only genes from their fathers, we used offspring survival as a quality measure to test (i) whether males differ in their genetic quality, and if so, (ii) whether dominance or traits linked to dominance reveal 'good genes'. RESULTS: We found significant additive genetic variance on embryo survival, i.e. males differed in their genetic quality. Older, heavier and larger males were more successful in intra-sexual selection. However, neither dominance nor dominance indicators like body length, weight or age were significantly linked to genetic quality measured as embryo or juvenile survival. CONCLUSION: We found no evidence that females can improve their offspring's genetic viability by mating with large and dominant males. If there still were advantages of mating with dominant males, they may be linked to non-genetic benefits or to genetic advantages that are context dependent and therefore possibly not revealed under our experimental conditions - even if we found significant additive genetic variation for embryo viability under such conditions.

Exploring women's academic careers in cross-national perspective: lessons for equal epportunity eolicies

Purpose - In recent years, several countries and/or higher education institutions have adopted equal opportunity policies to promote women's access to the upper levels of the academic career structure. The purpose of this paper is to argue that there is no universal solution to the glass ceiling that women face within academia. Insofar as the feminisation process evolves according to a variety of models, according to national and occupational context, the solutions adopted in one context may prove to be ineffective elsewhere. Design/methodology/approach - Analysis of the different models of occupational feminisation is based on a secondary analysis of the sociological literature on the subject, combined with recent data on women's access to academic positions in France and Germany. Findings - Although there are similarities in the structure of the academic labour market across countries and in the rate of feminisation of the most prestigious academic positions, the precise mechanisms through which women gain access to an academic career vary significantly from one national context to another. This cross-national variation would tend to suggest that there will also be variation when it comes to defining the most effective policy measures for increasing women's access to the upper echelons of the academic hierarchy. Indeed, different models of gender equality in academia may lead to very different results with regard to existing gender relations. Originality/value - The paper uses the available sociological literature on the feminisation process to examine how different measures adopted to promote women's access to the highest echelons of the academic career structure may have different effects on the reproduction and/or transformation of the dominant sex/gender system.

Learning-induced plasticity in human audition: Objects, time, and space.

The human auditory system is comprised of specialized but interacting anatomic and functional pathways encoding object, spatial, and temporal information. We review how learning-induced plasticity manifests along these pathways and to what extent there are common mechanisms subserving such plasticity. A first series of experiments establishes a temporal hierarchy along which sounds of objects are discriminated along basic to fine-grained categorical boundaries and learned representations. A widespread network of temporal and (pre)frontal brain regions contributes to object discrimination via recursive processing. Learning-induced plasticity typically manifested as repetition suppression within a common set of brain regions. A second series considered how the temporal sequence of sound sources is represented. We show that lateralized responsiveness during the initial encoding phase of pairs of auditory spatial stimuli is critical for their accurate ordered perception. Finally, we consider how spatial representations are formed and modified through training-induced learning. A population-based model of spatial processing is supported wherein temporal and parietal structures interact in the encoding of relative and absolute spatial information over the initial ∼300ms post-stimulus onset. Collectively, these data provide insights into the functional organization of human audition and open directions for new developments in targeted diagnostic and neurorehabilitation strategies.

Positionnement par satellites (GPS) et accélérométrie : nouvelles applications dans le domaine du sport

Grâce à des développements technologiques récents, tels que le système de positionnement par satellites GPS (Global Positioning System) en mode différentie on est maintenant capable de mesurer avec une grande précision non seulement le profil de vitesse de déplacement d'un sujet sur la terre mais aussi sa trajectoire en faisant totalement abstraction de la chronométrie classique. De plus, des capteurs accélérométriques miniaturisés permettent d'obtenir un complément d'information biomécanique utile (fréquence et longueur du pas, signature accélérométrique individuelle). Dans cet artide, un exemple d'application de ces deux techniques à des sports tels que le ski alpin (descente ou Super G) et le sprint est présenté. La combinaison de plusieurs mesures physiologiques, cinétiques et biomécaniques permettra de mieux comprendre les facteurs endogènes et exogènes qui jouent un rôle dans l'amélioration des performances de l'homme.

Gestión de recursos en nodos multi-core de memoria compartida

La gestión de recursos en los procesadores multi-core ha ganado importancia con la evolución de las aplicaciones y arquitecturas. Pero esta gestión es muy compleja. Por ejemplo, una misma aplicación paralela ejecutada múltiples veces con los mismos datos de entrada, en un único nodo multi-core, puede tener tiempos de ejecución muy variables. Hay múltiples factores hardware y software que afectan al rendimiento. La forma en que los recursos hardware (cómputo y memoria) se asignan a los procesos o threads, posiblemente de varias aplicaciones que compiten entre sí, es fundamental para determinar este rendimiento. La diferencia entre hacer la asignación de recursos sin conocer la verdadera necesidad de la aplicación, frente a asignación con una meta específica es cada vez mayor. La mejor manera de realizar esta asignación és automáticamente, con una mínima intervención del programador. Es importante destacar, que la forma en que la aplicación se ejecuta en una arquitectura no necesariamente es la más adecuada, y esta situación puede mejorarse a través de la gestión adecuada de los recursos disponibles. Una apropiada gestión de recursos puede ofrecer ventajas tanto al desarrollador de las aplicaciones, como al entorno informático donde ésta se ejecuta, permitiendo un mayor número de aplicaciones en ejecución con la misma cantidad de recursos. Así mismo, esta gestión de recursos no requeriría introducir cambios a la aplicación, o a su estrategia operativa. A fin de proponer políticas para la gestión de los recursos, se analizó el comportamiento de aplicaciones intensivas de cómputo e intensivas de memoria. Este análisis se llevó a cabo a través del estudio de los parámetros de ubicación entre los cores, la necesidad de usar la memoria compartida, el tamaño de la carga de entrada, la distribución de los datos dentro del procesador y la granularidad de trabajo. Nuestro objetivo es identificar cómo estos parámetros influyen en la eficiencia de la ejecución, identificar cuellos de botella y proponer posibles mejoras. Otra propuesta es adaptar las estrategias ya utilizadas por el Scheduler con el fin de obtener mejores resultados.

Social rules govern vocal competition in the barn owl

To resolve the share of limited resources, animals often compete through exchange of signals about their relative motivation to compete. When two competitors are similarly motivated, the resolution of conflicts may be achieved in the course of an interactive process. In barn owls, Tyto alba, in which siblings vocally compete during the prolonged absence of parents over access to the next delivered food item, we investigated what governs the decision to leave or enter a contest, and at which level. Siblings alternated periods during which one of the two individuals vocalized more than the other. Individuals followed turn-taking rules to interrupt each other and momentarily dominate the vocal competition. These social rules were weakly sensitive to hunger level and age hierarchy. Hence, the investment in a conflict is determined not only by need and resource-holding potential, but also by social interactions. The use of turn-taking rules governing individual vocal investment has rarely been shown in a competitive context. We hypothesized that these rules would allow individuals to remain alert to one another's motivation while maintaining the cost of vocalizing at the lowest level.

Modelo de red de interconexión basado en enlace

La computación de altas prestaciones es una área de la informática que evoluciona rápidamente, en la que actualmente aparecen nuevos computadores que llegan a los petaflops. Al principio del trabajo, se estudian los distintos tipos de redes de interconexión y los modelos de red que se utilizan para medir su latencia. El objetivo de este trabajo, es el diseño, implementación y simulación de un modelo de red de interconexión basado en enlace, que tiene en cuenta la información de topología y enrutamiento de la red de interconexión. Teniendo en cuenta que los modelos son una abstracción del sistema, en éste trabajo se hace la verificación y validación del modelo, para asegurar que éste se aproxima a lo planteado en el diseño y también que se parece al sistema que se quiere modelar.

Signaling in Dynamic Contests: Some Impossibility Results

General signaling results in dynamic Tullock contests have been missing for long. The reason is the tractability of the problems. In this paper, an uninformed contestant with valuation vx competes against an informed opponent with valuation, either high vh or low vl. We show that; (i) When the hierarchy of valuations is vh ≥ vx ≥ vl, there is no pooling. Sandbagging is too costly for the high type. (ii) When the order of valuations is vx ≥ vh ≥ vl, there is no separation if vh and vl are close. Sandbagging is cheap due to the proximity of valuations. However, if vh and vx are close, there is no pooling. First period cost of pooling is high. (iii) For valuations satisfying vh ≥ vl ≥ vx, there is no separation if vh and vl are close. Bluffing in the first period is cheap for the low valuation type. Conversely, if vx and vl are close there is no pooling. Bluffing in the first stage is too costly. JEL: C72, C73, D44, D82. KEYWORDS: Signaling, Dynamic Contests, Non-existence, Sandbag Pooling, Bluff Pooling, Separating

Acknowledgment and psychiatric symptoms in police officers in Switzerland

The way supervisors acknowledge specific contribution and efforts of their employees has an impact on occupational health and wellbeing. Acknowledgement is a protective factor when it is sufficiently provided. We carried out a study about occupational health in police officers with special emphasis on acknowledgment and reward. A questionnaire was sent to 1000 police officers and inspectors working for a cantonal administration in Switzerland. In total, 695 participants answered the questionnaire. We used the TST questionnaire (French version of the Langner's questionnaire on psychiatric symptoms) to identify cases characterized by potential mental health problems. Multiple choice items (5 modalities ranging from "not at all" to "tremendously") were used to measure acknowledgment. The score for psychiatric symptoms was high (TST score >or= 9) for 86 police officers and inspectors for whom health might be at risk. Compared with police officers having low or medium scores for psychiatric symptoms (TST score < 9), police officers with high TST scores were more likely to report the lack of support and attention from the supervisors (odds ratio [OR] 3.2, 95% confidence interval [CI] 2.0 to 5.1) and the lack of acknowledgment by the hierarchy (OR 3.0, 95% CI 1.9 to 4.8). They were also more likely to mention that judicial authorities have a low consideration for police officers (OR 2.7, 95% CI 1.7 to 4.3) and that the public in general have a low appreciation of police officers (OR 1.8, 95% CI 1.2 to 2.9). Preserving mental health in occupations characterized by high emotional demand is challenging. Our results show that acknowledgment and mental health are associated. Further research should address a potential causal relation of acknowledgment on mental health in police officers and inspectors.

Scheduling in virtual infrastructure

For the execution of the scientific applications, different methods have been proposed to dynamically provide execution environments for such applications that hide the complexity of underlying distributed and heterogeneous infrastructures. Recently virtualization has emerged as a promising technology to provide such environments. Virtualization is a technology that abstracts away the details of physical hardware and provides virtualized resources for high-level scientific applications. Virtualization offers a cost-effective and flexible way to use and manage computing resources. Such an abstraction is appealing in Grid computing and Cloud computing for better matching jobs (applications) to computational resources. This work applies the virtualization concept to the Condor dynamic resource management system by using Condor Virtual Universe to harvest the existing virtual computing resources to their maximum utility. It allows existing computing resources to be dynamically provisioned at run-time by users based on application requirements instead of statically at design-time thereby lay the basis for efficient use of the available resources, thus providing way for the efficient use of the available resources.

Dormant and self-renewing hematopoietic stem cells and their niches.

In the mouse, over the last 20 years, a set of cell-surface markers and activities have been identified, enabling the isolation of bone marrow (BM) populations highly enriched in hematopoietic stem cells (HSCs). These HSCs have the ability to generate multiple lineages and are capable of long-term self-renewal activity such that they are able to reconstitute and maintain a functional hematopoietic system after transplantation into lethally irradiated recipients. Using single-cell reconstitution assays, various marker combinations can be used to achieve a functional HSC purity of almost 50%. Here we have used the differential expression of six of these markers (Sca1, c-Kit, CD135, CD48, CD150, and CD34) on lineage-depleted BM to refine cell hierarchies within the HSC population. At the top of the hierarchy, we propose a dormant HSC population (Lin(-)Sca1(+)c-Kit(+) CD48(-)CD150(+)CD34(-)) that gives rise to an active self-renewing CD34(+) HSC population. HSC dormancy, as well as the balance between self-renewal and differentiation activity, is at least, in part, controlled by the stem cell niches individual HSCs are attached to. Here we review the current knowledge about HSC niches and propose that dormant HSCs are located in niches at the endosteum, whereas activated HSCs are in close contact to sinusoids of the BM microvasculature.

Factores de rendimiento asociados a SPMD

Actualmente existen muchas aplicaciones paralelas/distribuidas en las cuales SPMD es el paradigma más usado. Obtener un buen rendimiento en una aplicación paralela de este tipo es uno de los principales desafíos dada la gran cantidad de aplicaciones existentes. Este objetivo no es fácil de resolver ya que existe una gran variedad de configuraciones de hardware, y también la naturaleza de los problemas pueden ser variados así como la forma de implementarlos. En consecuencia, si no se considera adecuadamente la combinación "software/hardware" pueden aparecer problemas inherentes a una aplicación iterativa sin una jerarquía de control definida de acuerdo a este paradigma. En SPMD todos los procesos ejecutan el mismo código pero computan una sección diferente de los datos de entrada. Una solución a un posible problema del rendimiento es proponer una estrategia de balance de carga para homogeneizar el cómputo entre los diferentes procesos. En este trabajo analizamos el benchmark CG con cargas heterogéneas con la finalidad de detectar los posibles problemas de rendimiento en una aplicación real. Un factor que determina el rendimiento en esta aplicación es la cantidad de elementos nonzero contenida en la sección de matriz asignada a cada proceso. Determinamos que es posible definir una estrategia de balance de carga que puede ser implementada de forma dinámica y demostramos experimentalmente que el rendimiento de la aplicación puede mejorarse de forma significativa con dicha estrategia.

Maps as risk mitigation tools. Adaptation of the Swiss hazard assessment and mapping methodology to a Moroccan site: Beni Mellal

Dans le contexte climatique actuel, les régions méditerranéennes connaissent une intensification des phénomènes hydrométéorologiques extrêmes. Au Maroc, le risque lié aux inondations est devenu problématique, les communautés étant vulnérables aux événements extrêmes. En effet, le développement économique et urbain rapide et mal maîtrisé augmente l'exposition aux phénomènes extrêmes. La Direction du Développement et de la Coopération suisse (DDC) s'implique activement dans la réduction des risques naturels au Maroc. La cartographie des dangers et son intégration dans l'aménagement du territoire représentent une méthode efficace afin de réduire la vulnérabilité spatiale. Ainsi, la DDC a mandaté ce projet d'adaptation de la méthode suisse de cartographie des dangers à un cas d'étude marocain (la ville de Beni Mellal, région de Tadla-Azilal, Maroc). La méthode suisse a été adaptée aux contraintes spécifiques du terrain (environnement semi-aride, morphologie de piémont) et au contexte de transfert de connaissances (caractéristiques socio-économiques et pratiques). Une carte des phénomènes d'inondations a été produite. Elle contient les témoins morphologiques et les éléments anthropiques pertinents pour le développement et l'aggravation des inondations. La modélisation de la relation pluie-débit pour des événements de référence, et le routage des hydrogrammes de crue ainsi obtenus ont permis d'estimer quantitativement l'aléa inondation. Des données obtenues sur le terrain (estimations de débit, extension de crues connues) ont permis de vérifier les résultats des modèles. Des cartes d'intensité et de probabilité ont été obtenues. Enfin, une carte indicative du danger d'inondation a été produite sur la base de la matrice suisse du danger qui croise l'intensité et la probabilité d'occurrence d'un événement pour obtenir des degrés de danger assignables au territoire étudié. En vue de l'implémentation des cartes de danger dans les documents de l'aménagement du territoire, nous nous intéressons au fonctionnement actuel de la gestion institutionnelle du risque à Beni Mellal, en étudiant le degré d'intégration de la gestion et la manière dont les connaissances sur les risques influencent le processus de gestion. L'analyse montre que la gestion est marquée par une logique de gestion hiérarchique et la priorité des mesures de protection par rapport aux mesures passives d'aménagement du territoire. Les connaissances sur le risque restent sectorielles, souvent déconnectées. L'innovation dans le domaine de la gestion du risque résulte de collaborations horizontales entre les acteurs ou avec des sources de connaissances externes (par exemple les universités). Des recommandations méthodologiques et institutionnelles issues de cette étude ont été adressées aux gestionnaires en vue de l'implémentation des cartes de danger. Plus que des outils de réduction du risque, les cartes de danger aident à transmettre des connaissances vers le public et contribuent ainsi à établir une culture du risque. - Severe rainfall events are thought to be occurring more frequently in semi-arid areas. In Morocco, flood hazard has become an important topic, notably as rapid economic development and high urbanization rates have increased the exposure of people and assets in hazard-prone areas. The Swiss Agency for Development and Cooperation (SADC) is active in natural hazard mitigation in Morocco. As hazard mapping for urban planning is thought to be a sound tool for vulnerability reduction, the SADC has financed a project aimed at adapting the Swiss approach for hazard assessment and mapping to the case of Morocco. In a knowledge transfer context, the Swiss method was adapted to the semi-arid environment, the specific piedmont morphology and to socio-economic constraints particular to the study site. Following the Swiss guidelines, a hydro-geomorphological map was established, containing all geomorphic elements related to known past floods. Next, rainfall / runoff modeling for reference events and hydraulic routing of the obtained hydrographs were carried out in order to assess hazard quantitatively. Field-collected discharge estimations and flood extent for known floods were used to verify the model results. Flood hazard intensity and probability maps were obtained. Finally, an indicative danger map as defined within the Swiss hazard assessment terminology was calculated using the Swiss hazard matrix that convolves flood intensity with its recurrence probability in order to assign flood danger degrees to the concerned territory. Danger maps become effective, as risk mitigation tools, when implemented in urban planning. We focus on how local authorities are involved in the risk management process and how knowledge about risk impacts the management. An institutional vulnerability "map" was established based on individual interviews held with the main institutional actors in flood management. Results show that flood hazard management is defined by uneven actions and relationships, it is based on top-down decision-making patterns, and focus is maintained on active mitigation measures. The institutional actors embody sectorial, often disconnected risk knowledge pools, whose relationships are dictated by the institutional hierarchy. Results show that innovation in the risk management process emerges when actors collaborate despite the established hierarchy or when they open to outer knowledge pools (e.g. the academia). Several methodological and institutional recommendations were addressed to risk management stakeholders in view of potential map implementation to planning. Hazard assessment and mapping is essential to an integrated risk management approach: more than a mitigation tool, danger maps represent tools that allow communicating on hazards and establishing a risk culture.