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.

Separation of free amino acids in human plasma by capillary electrophoresis with laser induced fluorescence: potential for emergency diagnosis of inborn errors of metabolism.

Free amino acids (AAs) in human plasma are derivatized with 3-(4-carboxybenzoyl)quinoline-2-carboxaldehyde (CBQCA) and analyzed by capillary electrophoresis (CE) with laser induced fluorescence (LIF) detection. The labeling procedure is significantly improved over results reported previously. Derivatization can be completed in 40 min, with concentrations as low as 4 x 10(-8) M successfully labeled in favourable cases. Twenty-nine AAs (including 2 internal standards) are identified and can be reproducibly separated in 70 min. Migration time RSD values for 23 of these AAs were calculated and found in the range from 0.5 to 4%. The rapid derivatization procedure and the resolution obtained in the separation are sufficient for a semi-quantitative, emergency diagnosis of several inborn errors of metabolism (IEM). Amino acid profiles for both normal donor plasma samples and plasma samples of patients suffering from phenylketonuria, tyrosinemia, maple syrup urinary disease, hyperornithinemia, and citrullinemia are studied.

Organizational configurations of strategic choices and strategic management accounting

This is the first study to adopt a configurational paradigm in an investigation of strategic management accounting (SMA) adoption. The study examines the alignment and effectiveness of strategic choice and strategic management accounting (SMA) system design configurations. Six configurations were derived empirically by deploying a cluster analysis of data collected from a sample of 193 large Slovenian companies. The first four clusters appear to provide some support for the central configurational proposition that higher levels of vertical and horizontal configurational alignments are associated with higher levels of performance. Evidence that contradicts the theory is also apparent, however, as the remaining two clusters exhibit high degrees of SMA vertical and horizontal alignment, but low performance levels. A particular contribution of the paper concerns its demonstration of the way that the configurational paradigm can be operationalised to examine management accounting phenomena and the nature of management accounting insights that can derive from applying the approach.

The Analysis of Accounting Multipliers: The NAMEA Approach in the Case of Catalonia

The aim of this paper is the analysis of the Catalan economy (2001) with the use of a National Accounting Matrix with environmental accounts (NAMEA) for the Catalan economy with 2001 data. We will focus on the analysis of the emission multipliers and we will also analyse the impact of a 10% reduction in greenhouse emissions on emission multipliers. This emission-reduction percentage would bring the Catalan economy into compliance with the maximum emissions level allowed by the Kyoto Protocol. We consider three possible scenarios that would allow this goal to be met. First, we will simulate a 10% reduction in regional emissions and a 5% drop in the endogenous income of the multipliers' model (production, factorial and private income). Second, we will simulate a 10% reduction in emissions and a 10% increase in endogenous income. Finally, we will simulate a 10% reduction in emissions and a 5% increase in endogenous income. Additionally, we will analyse the decomposition of the emission multipliers into own effects, open effects and circular effects to capture the different channels of the emission generation process. Keywords: NAMEA, emission multipliers, Kyoto Protocol.

Accounting conservatism and firm investment efficiency

Conservatism, through the timelier recognition of losses in the income statement, is expected to increase firm investment efficiency through three main channels: (1) by decreasing the adverse effect of information asymmetries between outside equity holders and managers, facilitating the monitoring of managerial investment decisions; (2) by increasing managerial incentives to abandon poorly performing projects earlier and to undertake fewer negative net present-value investments; and (3) by facilitating the access to external financing at lower cost. Using a large US sample for the period 1990-2007 we find a negative association between conservatism and measures of over- and under- investment, and a positive association between conservatism and future profitability. This is consistent with firms reporting more conservative numbers investing more efficiently and in more profitable projects. Our results add to a growing stream of literature suggesting that eliminating conservatism from accounting regulatory frameworks may lead to undesirable economic consequences.

Monitorització de rendiment i accounting de centres de computació grid

El Port d'Informació Científica és un centre de Computació Grid de referència que dona suport a comunitats científiques, com el LHC (CERN). Al PIC, trobem una gran varietat de tecnologies que proporcionen serveis al centre. Des de l'arquitectura i elements de la xarxa, fins a recursos informàtics de computació, sistemes d'emmagatzematge a disc i cinta magnètica, bases de dades (ORACLE/PostgreSQL). El projecte consisteix en el disseny i implementació d'una base de dades col·lectora de tota la informació rellevant dels diferents sistemes del centre, i un portal web on mostrar tots els valors i gràfiques, tot basat en programari lliure.

Linear Aggregation In The Social Accounting Matrix Framework

In economic literature, information deficiencies and computational complexities have traditionally been solved through the aggregation of agents and institutions. In inputoutput modelling, researchers have been interested in the aggregation problem since the beginning of 1950s. Extending the conventional input-output aggregation approach to the social accounting matrix (SAM) models may help to identify the effects caused by the information problems and data deficiencies that usually appear in the SAM framework. This paper develops the theory of aggregation and applies it to the social accounting matrix model of multipliers. First, we define the concept of linear aggregation in a SAM database context. Second, we define the aggregated partitioned matrices of multipliers which are characteristic of the SAM approach. Third, we extend the analysis to other related concepts, such as aggregation bias and consistency in aggregation. Finally, we provide an illustrative example that shows the effects of aggregating a social accounting matrix model.

Errors sintàctics del gènere gramatical durant la cirurgia de gliomes cerebrals

Les bases neurals del processament sintàctic del gènere no han estat gairebé estudiades. En aquest estudi hem utilitzat el mapeig cerebral, durant la cirurgia de gliomes cerebrals per a estudiar les estructures cortico-subcorticals implicades en el processament del gènere i determinar si aquestes són comunes a altres àrees de la producció del llenguatge. Amb l’estimulació cerebral directa hem observat alteracions sintàctiques del gènere, al estimular la circumvolució frontal inferior, la part posterior circumvolució temporal mitja, i en el nucli caudat. També hem pogut observar, una doble dissociació entre el gènere gramatical i la producció de la paraula, corroborant les teories d’un model independent en la producció del llenguatge.

Accounting for Big City Growth in Low Paid Occupations: Immigration and/or Service Class Consumption

Growth of 'global cities' in the 1980s was supposed to have involved an occupational polarisation, including growth of low paid service jobs. Though held to be untrue for European cities, at the time, some such growth did emerge in London a decade later than first reported for New York. The question is whether there was simply a delay before London conformed to the global city model, or whether another distinct cause was at work in both cases. This paper proposes that the critical factor in both cases was actually an upsurge of immigration from poor countries providing an elastic supply of cheap labour. This hypothesis and its counterpart based on growth in elite jobs are tested econometrically for the British case with regional data spanning 1975-2008, finding some support for both effects, but with immigration from poor countries as the crucial influence in late 1990s London. Keywords: regional labour markets; wages; employment; international migration; consumer demand JEL Codes: J21, J23, F22, R12

Study of certain accounting issues related to the HSE (Considine Report)

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