Italo-Swiss "Chalk and blackboard interactive 2-day workshop"-participants feedback

Ten "chalk and blackboard interactive workshops" have taken place between 2011 and 2015 in Southern Switzerland or Italy. Students, residents and expert pediatricians meet during 2 days and discuss 10-15 cases. Pediatricians promote reasoning, provide supporting information and correct statements. Emphasis is placed on history taking and examination, and on all participants being involved in a stimulating atmosphere. Thirty-seven participants were asked, ≥3 months after workshop-completion, to evaluate the workshop and a recent teaching session. Thirty answered and scored the workshop as excellent (N = 24) or above average (N = 6). The scores assigned to the workshop were higher (P < 0.001) than those assigned to the lecture-based teaching.

Timing of extreme drought modifies reproductive output in semi-natural grassland

Questions Do extreme dry spells in late summer or in spring affect abundance and species composition of the reproductive shoots and the seed rain in the next annual crop? Are drought effects on reproductive shoots related to the rooting depths of species? Location Species-rich semi-natural grassland at Negrentino, Switzerland. Methods In plots under automated rain-out shelters, rainwater was added to simulate normal conditions and compare them with two experimentally effected long dry spells, in late summer (2004) and in the following spring (2005). For 28 plots, numbers of reproductive shoots per species were counted in 1-m2 areas and seed rain was estimated using nine sticky traps of 102 cm2 after dry spells. Results The two extreme dry spells in late summer and spring were similar in length and their probability of recurrence. They independently reduced the subsequent reproductive output of the community, while their seasonal timing modified its species composition. Compared to drought in spring, drought in late summer reduced soil moisture more and reduced the number of reproductive shoots of more species. The negative effects of summer drought decreased with species’ rooting depth. The shallow-rooted graminoids showed a consistent susceptibility to summer drought, while legumes and other forbs showed more varied responses to both droughts. Spring drought strongly reduced density (–53%) and species richness (–43%) of the community seed rain, while summer drought had only a marginally significant impact on seed density of graminoids (–44%). Reductions in seed number per shoot vs reproductive shoot density distinguished the impacts of drought with respect to its seasonal timing. Conclusion The essentially negative impact of drought in different seasons on reproductive output suggests that more frequent dry spells could contribute to local plant diversity loss by aggravating seed deficiency in species-rich grassland.

Entwicklung eines deutschsprachigen Fragebogens zur Durchführung von Multisource-Feedback in der ärztlichen Weiterbildung

Fragestellung/Einleitung: Multisource-Feedback (MSF) ist ein anerkanntes Instrument zur Überprüfung und Verbesserung der ärztlichen Tätigkeit [1]. Es beinhaltet Feedback, das von MitarbeiterInnen verschiedener Tätigkeitsbereiche und verschiedener Hierarchiestufen gegeben wird. Das Feedback wird anonym mithilfe eines Fragebogens gegeben, der verschiedene Kriterien der ärztlichen Kompetenz beschreibt. Das Feedback wird anschlieβend für die zu beurteilenden ÄrztInnen in einem Gespräch von einer/m SupervisorIn zusammengefasst. Bislang existiert kein deutschsprachiger Fragebogen für Multisource-Feedback für die ärztliche Tätigkeit. Unsere Zielsetzung war es daher, einen deutschsprachigen Fragebogen zu erstellen und diesen bzgl. relevanter Validitätskriterien zu untersuchen. Methoden: Zur Erstellung des Fragebogens sammelten wir die beste verfügbare Evidenz der entsprechenden Literatur. Wir wählten einen validierten englischen Fragebogen, der bereits in der Weiterbildung in Groβbritannien angewendet wird [2] und den wichtigsten Kriterien entspricht. Dieser wurde übersetzt und in einigen Bereichen erweitert, um ihn sprachlichen Gegebenheiten und lokalen Bedürfnissen anzupassen. Bezüglich der Validität wurden zwei Kriterien untersucht: Inhaltsvalidität (content validity evidence) und Antwortprozesse (response process validity evidence). Um die Inhaltsvalidität zu untersuchen, wurde in einer Expertenrunde diskutiert, ob der übersetzte Fragebogen die erwarteten Kompetenzen widerspiegelt. Im Anschluss wurden die Antwortprozesse mithilfe eines sog. „think-alouds“ mit ÄrztInnen in Weiterbildung und ihren AusbilderInnen untersucht. Ergebnisse: Der resultierende Fragebogen umfasst 20 Fragen. Davon sind 15 Items den Bereichen „Klinische Fähigkeiten“, „Umgang mit Patienten“, „Umgang mit Kollegen“ und „Arbeitsweise“ zuzuordnen. Diese Fragen werden auf einer fünfstufigen Likert-Skala beantwortet. Zusätzlich bietet jede Frage die Möglichkeit, einen Freitext zu besonderen Stärken und Schwächen der KandidatInnen aufzuführen. Weiterhin gibt es fünf globale Fragen zu Stärken und Verbesserungsmöglichkeiten, äuβeren Einflüssen, den Arbeitsbedingungen und nach Zweifeln an der Gesundheit oder Integrität des Arztes/ der Ärztin. In der Expertenrunde wurde der Fragebogen als für den deutschsprachigen Raum ohne Einschränkungen anwendbar eingeschätzt. Die Analyse der Antwortprozesse führte zu kleineren sprachlichen Anpassungen und bestätigt, dass der Fragebogen verständlich und eindeutig zu beantworten ist und das gewählte Konstrukt der ärztlichen Tätigkeit vollständig umschreibt. Diskussion/Schlussfolgerung: Wir entwickelten einen deutschsprachigen Fragebogen zur Durchführung von Multisource-Feedback in der ärztlichen Weiterbildung. Wir fanden Hinweise für die Validität dieses Fragebogens bzgl. des Inhalts und der Antwortprozesse. Zusätzliche Untersuchungen zur Validität wie z.B. die durch den Fragebogen entstehenden Auswirkungen (consequences) sind vorgesehen. Dieser Fragebogen könnte zum breiteren Einsatz von MSF in der ärztlichen Weiterbildung auch im deutschsprachigen Raum beitragen. This is an Open Access article distributed under the terms of the Creative Commons Attribution License. You are free: to Share - to copy, distribute and transmit the work, provided the original author and source are credited. See license information at http://creativecommons.org/licenses/by-nc-nd/3.0/.

Improving residency training with the help of multisource feedback: Generation of a model of influencing factors

Background: Feedback is considered to be one of the most important drivers of learning. One form of structured feedback used in medical settings is multisource feedback (MSF). This feedback technique provides the opportunity to gain a differentiated view on a doctor’s performance from several perspectives using a questionnaire and a facilitating conversation, in which learning goals are formulated. While many studies have been conducted on the validity, reliability and feasibility of the instrument, little is known about the impact of factors that might influence the effects of MSF on clinical performance. Summary of Work: To study under which circumstances MSF is most effective, we performed a literature review on Google Scholar with focus on MSF and feedback in general. Main key-words were: MSF, multi-source-feedback, multi source feedback, and feedback each combined with influencing/ hindering/ facilitating factors, effective, effectiveness, doctors-intraining, and surgery. Summary of Results: Based on the literature, we developed a preliminary model of facilitating factors. This model includes five main factors influencing MSF: questionnaire, doctor-in-training, group of raters, facilitating supervisor, and facilitating conversation. Discussion and Conclusions: Especially the following points that might influence MSF have not yet been sufficiently studied: facilitating conversation with the supervisor, individual aspects of doctors-in-training, and the causal relations between influencing factors. Overall there are only very few studies focusing on the impact of MSF on actual and long-term performance. We developed a preliminary model of hindering and facilitating factors on MSF. Further studies are needed to better understand under which circumstances MSF is most effective. Take-home messages: The preliminary model might help to guide further studies on how to implement MSF to use it at its full potential.

The unstable CO2 feedback cycle on ocean planets

Ocean planets are volatile-rich planets, not present in our Solar system, which are thought to be dominated by deep, global oceans. This results in the formation of high-pressure water ice, separating the planetary crust from the liquid ocean and, thus, also from the atmosphere. Therefore, instead of a carbonate-silicate cycle like on the Earth, the atmospheric carbon dioxide concentration is governed by the capability of the ocean to dissolve carbon dioxide (CO2). In our study, we focus on the CO2 cycle between the atmosphere and the ocean which determines the atmospheric CO2 content. The atmospheric amount of CO2 is a fundamental quantity for assessing the potential habitability of the planet's surface because of its strong greenhouse effect, which determines the planetary surface temperature to a large degree. In contrast to the stabilizing carbonate-silicate cycle regulating the long-term CO2 inventory of the Earth atmosphere, we find that the CO2 cycle feedback on ocean planets is negative and has strong destabilizing effects on the planetary climate. By using a chemistry model for oceanic CO2 dissolution and an atmospheric model for exoplanets, we show that the CO2 feedback cycle can severely limit the extension of the habitable zone for ocean planets.

The Great Moderation and the Relationship between Output Growth and Its Volatility

This study examines the effect of the Great Moderation on the relationship between U.S. output growth and its volatility over the period 1947 to 2006. First, we consider the possible effects of structural change in the volatility process. In so doing, we employ GARCH-M and ARCH-M specifications of the process describing output growth rate and its volatility with and without a one-time structural break in volatility. Second, our data analyses and empirical results suggest no significant relationship between the output growth rate and its volatility, favoring the traditional wisdom of dichotomy in macroeconomics. Moreover, the evidence shows that the time-varying variance falls sharply or even disappears once we incorporate a one-time structural break in the unconditional variance of output starting 1982 or 1984. That is, the integrated GARCH effect proves spurious. Finally, a joint test of a trend change and a one-time shift in the volatility process finds that the one-time shift dominates.

Measuring Scale Efficiency from the Translog Multi-Input, Multi-Output Distance Function

Ray (1998) developed measures of input- and output-oriented scale efficiency that can be directly computed from an estimated Translog frontier production function. This note extends the earlier results from Ray (1998) to the multiple-output multiple input case.

Endogenous Financing and the Long Run Impact of Money Growth on Output and Prices

Most monetary models make use of the quantity theory of money along with a Phillips curve. This implies a strong correlation between money growth and output in the short run (with little or no correlation between money and prices) and a strong long run correlation between money growth and inflation and inflation (with little or no correlation between money growth and output). The empirical evidence between money and inflation is very robust, but the long run money/output relationship is ambiguous at best. This paper attempts to explain this by looking at the impact of money growth on firm financing.

Comparing Input- and Output-Oriented Measures of Technical Efficiency to Determine Local Returns to Scale in DEA Models

This paper shows how one can infer the nature of local returns to scale at the input- or output-oriented efficient projection of a technically inefficient input-output bundle, when the input- and output-oriented measures of efficiency differ.

The Relationship between Large Fiscal Adjustments and Short-Term Output Growth Under Alternative Fiscal Policy Regimes

A small, but growing, body of literature searches for evidence of non-Keynesian effects of fiscal contractions. That is, some evidence exists that large fiscal contractions stimulate short-run economic activity. Our paper continues this research effort by systematically examining the effects, if any, of unusual fiscal events - either non-Keynesian results within a Keynesian model or Keynesian results within a neoclassical model -- on short-run economic activity. We examine this issue within three separate models -- a St. Louis equation, a Hall-type consumption equation, and a growth accounting equation. Our empirical findings are mixed, and do not provide strong systematic support for the view that unusually large fiscal contractions/expansions reverse the effects of normal fiscal events. Moreover, we find only limited evidence that trigger points are empirically important.

Measuring Potential Output and Output Gap and Macroeconomic Policy: The Case of Kenya

Measuring the level of an economy.s potential output and output gap are essential in identifying a sustainable non-inflationary growth and assessing appropriate macroeconomic policies. The estimation of potential output helps to determine the pace of sustainable growth while output gap estimates provide a key benchmark against which to assess inflationary or disinflationary pressures suggesting when to tighten or ease monetary policies. These measures also help to provide a gauge in the determining the structural fiscal position of the government. This paper attempts to measure Kenya.s potential output and output gap using alternative statistical techniques and structural methods. Estimation of potential output and output gap using these techniques shows varied results. The estimated potential output growth using different methods gave a range of .2.9 to 2.4 percent for 2000 and a range of .0.8 to 4.6 for 2001. Although various methods produce varied results, they however provided a broad consensus on the over-all trend and performance of the Kenyan economy. This study found that firstly, potential output growth is declining over the recent time and secondly, the Kenyan economy is contracting in the recent years.

Inflation Targeting and Output Growth: Evidence from Aggregate European Data

This paper evaluates inflation targeting and assesses its merits by comparing alternative targets in a macroeconomic model. We use European aggregate data to evaluate the performance of alternative policy rules under alternative inflation targets in terms of output losses. We employ two major alternative policy rules, forward-looking and spontaneous adjustment, and three alternative inflation targets, zero percent, two percent, and four percent inflation rates. The simulation findings suggest that forward-looking rules contributed to macroeconomic stability and increase monetary policy credibility. The superiority of a positive inflation target, in terms of output losses, emerges for the aggregate data. The same methodology, when applied to individual countries, however, suggests that country-specific flexible inflation targeting can improve employment prospects in Europe.

Cross-Country Evidence on Output Growth Volatility: Nonstationary Variance and GARCH Models

This paper revisits the issue of conditional volatility in real GDP growth rates for Canada, Japan, the United Kingdom, and the United States. Previous studies find high persistence in the volatility. This paper shows that this finding largely reflects a nonstationary variance. Output growth in the four countries became noticeably less volatile over the past few decades. In this paper, we employ the modified ICSS algorithm to detect structural change in the unconditional variance of output growth. One structural break exists in each of the four countries. We then use generalized autoregressive conditional heteroskedasticity (GARCH) specifications modeling output growth and its volatility with and without the break in volatility. The evidence shows that the time-varying variance falls sharply in Canada, Japan, and the U.K. and disappears in the U.S., excess kurtosis vanishes in Canada, Japan, and the U.S. and drops substantially in the U.K., once we incorporate the break in the variance equation of output for the four countries. That is, the integrated GARCH (IGARCH) effect proves spurious and the GARCH model demonstrates misspecification, if researchers neglect a nonstationary unconditional variance.

Motivational interviewing and feedback for college drinkers: Handling missing values with complete case analysis and multiple imputation

Objective: In this secondary data analysis, three statistical methodologies were implemented to handle cases with missing data in a motivational interviewing and feedback study. The aim was to evaluate the impact that these methodologies have on the data analysis. ^ Methods: We first evaluated whether the assumption of missing completely at random held for this study. We then proceeded to conduct a secondary data analysis using a mixed linear model to handle missing data with three methodologies (a) complete case analysis, (b) multiple imputation with explicit model containing outcome variables, time, and the interaction of time and treatment, and (c) multiple imputation with explicit model containing outcome variables, time, the interaction of time and treatment, and additional covariates (e.g., age, gender, smoke, years in school, marital status, housing, race/ethnicity, and if participants play on athletic team). Several comparisons were conducted including the following ones: 1) the motivation interviewing with feedback group (MIF) vs. the assessment only group (AO), the motivation interviewing group (MIO) vs. AO, and the intervention of the feedback only group (FBO) vs. AO, 2) MIF vs. FBO, and 3) MIF vs. MIO.^ Results: We first evaluated the patterns of missingness in this study, which indicated that about 13% of participants showed monotone missing patterns, and about 3.5% showed non-monotone missing patterns. Then we evaluated the assumption of missing completely at random by Little's missing completely at random (MCAR) test, in which the Chi-Square test statistic was 167.8 with 125 degrees of freedom, and its associated p-value was p=0.006, which indicated that the data could not be assumed to be missing completely at random. After that, we compared if the three different strategies reached the same results. For the comparison between MIF and AO as well as the comparison between MIF and FBO, only the multiple imputation with additional covariates by uncongenial and congenial models reached different results. For the comparison between MIF and MIO, all the methodologies for handling missing values obtained different results. ^ Discussions: The study indicated that, first, missingness was crucial in this study. Second, to understand the assumptions of the model was important since we could not identify if the data were missing at random or missing not at random. Therefore, future researches should focus on exploring more sensitivity analyses under missing not at random assumption.^