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Survey Evaluating Sleep Education Catalyzed Change in Residency Training  [PDF]
Demetra S. Stamm, Sandra Taylor, Uyen Thao Nguyen, Kimberly Hardin
International Journal of Clinical Medicine (IJCM) , 2015, DOI: 10.4236/ijcm.2015.67058
Background: Despite the high prevalence and negative effects of sleep disorders, sleep issues often remain unexplored during medical encounters. Research has shown that primary care physicians regard their knowledge as inadequate. Objective: We investigated residents’ perceived adequacy of sleep education and level of competency in diagnosing and treating sleep disorders. Methods: A questionnaire via Survey Monkey was administered to senior residents in University of California, Davis (UCD) from family medicine, internal medicine, neurology, and psychiatry to assess perception of their knowledge and training of sleep disorders. Likert scale ratings were used, from 1 (not adequate/competent) to 5 (extremely adequate/competent). Non-parametric statistical methods were used to evaluate differences in survey responses among specialties and assess the correlation between survey responses. Results: Only 33 residents responded with a 29.5% response rate. Neurology residents routinely rotate with a sleep medicine attending and subsequently reported the highest self-competency, adequacy of training, hours of didactics received and frequency of asking patients about sleep. All other residents reported receiving insufficient sleep medicine education. The combined mean score was 1.5 across the specialties regarding adequacy of sleep education in their respective medical schools with 31.3% reporting no sleep medicine training. Conclusions: This study demonstrated that there is a perceived deficit in most residents’ training and competency regarding sleep disorders. These results prompted 2 of the 4 residency programs to change their educational structure with electives in clinical sleep medicine. We believe that this paper illuminates potential need for increasing sleep medicine education throughout various levels of training. Nationwide educational research is needed to promote ACGME to incorporate the fundamentals of sleep medicine into core curriculum. Current Knowledge/Study Rationale: There are no studies, to our knowledge, directly measuring residents’ perceived adequacy of sleep medicine education provided and their perceived level of competency in diagnosing and treating sleep disorders. The aim of this study was to evaluate both the amount of time and quality of sleep education provided to residents as insufficient knowledge in addressing sleep problems may reflect gaps in educational
Back to basics
Susan Hardin
Genome Biology , 2002, DOI: 10.1186/gb-2002-3-8-reports4026
Abstract: This year's Association of Biomolecular Resource Facilities (ABRF) meeting, entitled "Biomolecular Technologies: Tools for Discovery in Proteomics and Genomics", emphasized the protein and DNA technologies that inspired the formation of the ABRF. Meeting abstracts and some presentation slides or posters are available through the ABRF website http://www.abrf.org webcite. Some presentations are also submitted for publication in the ABRF journal, Journal of Biomolecular Techniques.The plenary sessions emphasized the importance of technology development on scientific discovery, which is especially true for genomics and proteomics. Richard Wilson (Washington University School of Medicine, St. Louis, USA) summarized the development of techniques for physical mapping of the genome and discussed the importance of automating procedures for generating genome sequence information. He commented that the human genome sequence will be finished to coincide with the 50th anniversary of the discovery of the structure of DNA by Watson and Crick, in April 2003. He described his lab's collaboration with the lab of Eric Green (National Human Genome Research Institute, National Institutes of Health, Bethesda, USA) to analyze human chromosome 7, focusing on the Pendrin gene and the effect of its mutation on ear development. The gene is associated with 5-10% of cases of human hereditary deafness and also with enlargement of the thyroid (goiter) and encodes an anion transporter that, when mutated, is believed to damage (rupture) delicate ear structures. Pendrin knockout mice are deaf and a large portion of the progeny have an unusual phenotype of running in circles. Wilson also described his work on some large, highly repetitive (and therefore challenging) sequences on the human Y chromosome that may have biological significance for male fertility and sperm production.Raymond Deshaies (Howard Hughes Medical Institute and California Institute of Technology, Pasadena, USA) described the use o
Macromolecular technologies: applications and improvements
Susan Hardin
Genome Biology , 2001, DOI: 10.1186/gb-2001-2-5-reports4012
Abstract: Approximately 1,000 scientists arrived in San Diego for the annual ABRF meeting, which was entitled "The new biology: technologies for resolving macromolecular communications". An online version of the meeting abstracts will be available through the ABRF journal, the Journal of Biomolecular Techniques [http://www.abrf.org/JBT/JBTindex.html webcite], and more details can be found at the ABRF website [http://www.abrf.org webcite]. This meeting was, as in previous years, a great place to learn about both new technologies and recently developed modifications that improve existing research methods. A regular meeting highlight is the recognition of an outstanding contributor to technology development. This year, Csaba Horvath (Yale University, New Haven, USA) was recognized for his contributions to the evolution of modern chromatography.The plenary talks provided an appropriate backdrop to illustrate how basic science drives the discovery and development of the many research methods and technologies that were discussed in detail during the smaller concurrent sessions. Ronald Evans (Salk Institute, La Jolla, USA) presented the intricacies of nuclear hormone receptor action and illustrated potential effects that can result from drug-drug interactions. He described an interesting adaptation mechanism that enables the body to increase resistance to an introduced chemical, and outlined how this 'xenobiotic response' facilitates detoxification and clearance of the chemical from the body. This response can be triggered by substances present in non-prescription compounds (such as St John's Wort) and, once activated, removes a variety of substances from the body. Examples of drugs that can be eliminated from the body by the xenobiotic response include the active ingredient in birth control pills (thus providing a scientific explanation for many 'miracle' babies), and protease inhibitors, which are used to treat HIV.Roger Brent (Molecular Sciences Institute, Berkeley, USA) discusse
La tragedia de los comunes
Garrett Hardin
Polis : Revista de la Universidad Bolivariana , 2005,
Teach them to Fly: Strategies for Encouraging Active Online Learning
The Turkish Online Journal of Distance Education , 2004,
Abstract: Teach them to Fly: Strategies for Encouraging Active Online Learning Karen HARDIN Cameron University Lawton, OK, USA PROBLEM One of the hot topics in education in the past 10 years has been the shift of the role of the educator. Whereas, he has traditionally been the owner and deliverer of the knowledge (Sage on the stage), now his role is shifting to a guide and facilitator (guide by the side). The purpose is to give the students ownership in their own learning process. As technology becomes more sophisticated, automation is replacing students problem solving skills, critical thinking and sometimes patience. On one of my evaluations in a 1999 online course, a student criticized that, she s not doing the teaching, I m doing the learning. Of course in my desire to encourage active learning, I took the response as a compliment, but the student meant it as a criticism. I began pondering the reluctance of students to take control of the learning process. I ve noticed this lack of problem solving, critical thinking and patience with young adults in the workplace. For example, I often visit Sam s, a warehouse store owned by Wal-Mart. When I check out, I pay with a check. The computerized register will print the check for me, so I allow the cashier to do that. I often ask him or her to add $15 to the total to give me cash back. It s amazing how long it takes these young adults to add $15 to the total because of their reliance on computers. In another situation, when I was in an outlet shoe store in Texas, I purchased a pair of sandals. After I checked out, I noticed a sign that promoted, buy one, get a second for one cent. Of course, I wanted to take advantage of this opportunity, so I told the cashier that I wanted to find another pair of shoes. She replied, It s too late, your transaction is complete. I wouldn t know what to do. I said, It s simple, I owe you one cent. She said, I don t know how to make the computer fix it. After attempting many explanations of how she could return the shoes I bought, and re-process, I walked out of the store with one pair of shoes. The student lacked problem solving skills because of her reliance on the computer. Online courses can tend to make students more dependent on the computer for problem solving. STUDENTS COMMENTS After several semesters of working with students in the online environment, I posted this discussion: All of you have taken courses and done well (for me it was History) and then 2-3 years later, you can't remember what you learned. That was probably because the learning process for that course w
The Old Teacher in the New Classroom: Suggestions For Effective Distance Instruction
The Turkish Online Journal of Distance Education , 2001,
Combining Synchronous and Asynchronous Learning
The Turkish Online Journal of Distance Education , 2001,
Modularizing the Elimination of r=0 in Kleene Algebra
Christopher Hardin
Computer Science , 2005, DOI: 10.2168/LMCS-1(3:4)2005
Abstract: Given a universal Horn formula of Kleene algebra with hypotheses of the form r = 0, it is already known that we can efficiently construct an equation which is valid if and only if the Horn formula is valid. This is an example of elimination of hypotheses, which is useful because the equational theory of Kleene algebra is decidable while the universal Horn theory is not. We show that hypotheses of the form r = 0 can still be eliminated in the presence of other hypotheses. This lets us extend any technique for eliminating hypotheses to include hypotheses of the form r = 0.
ACL2 Meets the GPU: Formalizing a CUDA-based Parallelizable All-Pairs Shortest Path Algorithm in ACL2
David S. Hardin,Samuel S. Hardin
Electronic Proceedings in Theoretical Computer Science , 2013, DOI: 10.4204/eptcs.114.10
Abstract: As Graphics Processing Units (GPUs) have gained in capability and GPU development environments have matured, developers are increasingly turning to the GPU to off-load the main host CPU of numerically-intensive, parallelizable computations. Modern GPUs feature hundreds of cores, and offer programming niceties such as double-precision floating point, and even limited recursion. This shift from CPU to GPU, however, raises the question: how do we know that these new GPU-based algorithms are correct? In order to explore this new verification frontier, we formalized a parallelizable all-pairs shortest path (APSP) algorithm for weighted graphs, originally coded in NVIDIA's CUDA language, in ACL2. The ACL2 specification is written using a single-threaded object (stobj) and tail recursion, as the stobj/tail recursion combination yields the most straightforward translation from imperative programming languages, as well as efficient, scalable executable specifications within ACL2 itself. The ACL2 version of the APSP algorithm can process millions of vertices and edges with little to no garbage generation, and executes at one-sixth the speed of a host-based version of APSP coded in C – a very respectable result for a theorem prover. In addition to formalizing the APSP algorithm (which uses Dijkstra's shortest path algorithm at its core), we have also provided capability that the original APSP code lacked, namely shortest path recovery. Path recovery is accomplished using a secondary ACL2 stobj implementing a LIFO stack, which is proven correct. To conclude the experiment, we ported the ACL2 version of the APSP kernels back to C, resulting in a less than 5% slowdown, and also performed a partial back-port to CUDA, which, surprisingly, yielded a slight performance increase.
Rectal Duplication Cyst in a 12 year old Female Presenting with Chronic Constipation and Rectal Bleeding: A Case Report  [PDF]
Kimberly Harris, Kishore Vellody
International Journal of Clinical Medicine (IJCM) , 2011, DOI: 10.4236/ijcm.2011.21002
Abstract: Constipation is a common presenting complaint in children. Rectal duplication cysts are rare congenital malformations that need to be considered in patients with chronic constipation that has not responded to typical therapy and in pa-tients presenting with rectal bleeding. It is important to maintain a high index of suspicion when diagnosing this condi-tion as other congenital malformations may be present and rectal duplication cysts have the potential for malignant transformation if they go unrecognized. This case report describes a 12 year old female with chronic constipation and rectal bleeding who was found to have a rectal duplication cyst. It discusses the pathophysiology of the disease and highlights the options available for treatment.
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