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Search Results: 1 - 10 of 3483 matches for " Milton Kramer "
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Training Needs of International Medical Graduates [IMGs] in Psychiatry  [PDF]
Milton Kramer
Open Journal of Psychiatry (OJPsych) , 2014, DOI: 10.4236/ojpsych.2014.44036
Abstract: The potential shortage of psychiatrists over the next 5 - 10 years has focused attention on the need to recruit more IMGs to fill the needs rather than use nurse practitioners or physician assistants. IMGs make up about 1/3 of first year psychiatry residents. These individuals have been found to provide services to the poor, the elderly and the psychotic. The quality of their medical work has been found to be satisfactory. The training needs of these physicians require an understanding on the part of their teachers that they come from cultures with different values that we have. The extended families of these primarily Asian residents clash with our strong commitment to individualism. It leads to a We-self rather than our I-Self. This difference coupled with the stress of leaving to come to a new culture is a great stress. Their exposure to psychiatry has been limited. They request and need more interview demonstration and practice, ore feedback and examinations. They should have help in accent reduction. They should be exposed to the working of the hospital by sitting on departmental and hospital committees. The faculty should extend their social opportunities and work as mentors on joint projects. Courses on the history of American culture should be taught. Psychotherapy for them should be encouraged as well as teaching medical ethics. They must become the major educational concern for the department that they are in.
Sleep Loss in Resident Physicians: The Cause of Medical Errors?
Milton Kramer
Frontiers in Neurology , 2010, DOI: 10.3389/fneur.2010.00128
Abstract: This review begins with the history of the events starting with the death of Libby Zion that lead to the Bell Commission, that the studied her death and made recommendations for improvement that were codified into law in New York state as the 405 law that the ACGME essentially adopted in putting a cap on work hours and establishing the level of staff supervision that must be available to residents in clinical situations particularly the emergency room and acute care units. A summary is then provided of the findings of the laboratory effects of total sleep deprivation including acute total sleep loss and the consequent widespread physiologic alterations, and of the effects of selective and chronic sleep loss. Generally the sequence of responses to increasing sleep loss goes from mood changes to cognitive effects to performance deficits. In the laboratory situation, deficits resulting from sleep deprivation are clearly and definitively demonstrable. Sleep loss in the clinical situation is usually sleep deprivation superimposed on chronic sleep loss. An examination of questionnaire studies, the literature on reports of sleep loss, studies of the reduction of work hours on performance as well as observational and a few interventional studies have yielded contradictory and often equivocal results. The residents generally find they feel better working fewer hours but improvements in patient care are often not reported or do not occur. A change in the attitude of the resident toward his role and his patient has not been salutary. Decreasing sleep loss should have had a positive effect on patient care in reducing medical error, but this remains to be unequivocally demonstrated.
Mortality risk associated with insomnia and sleeping pill use
Zvjezdan Nuhic,Milton Kramer
International Journal of Clinical and Health Psychology , 2007,
Abstract: El insomnio y el uso de fármacos para dormir tienen una alta prevalencia a nivel mundial y la evidencia epidemiológica sugiere que tal vez estén asociados con una disminución de la longevidad. Desde este estudio teórico, se efectuó una revisión de la literatura para examinar esa relación entre el insomnio, los fármacos para dormir y la disminución de la longevidad. El insomnio y el uso de fármacos para dormir no resultaron consistentemente asociados con un incremento en la tasa de mortalidad. La definición de insomnio fue insuficiente e inconsistente. En la mayoría de los estudios no fue determinado qué fármacos para dormir tomaron los participantes. El dise o de los estudios, los tama os de las muestras, la edad de los sujetos, y el periodo de seguimiento fueron distintos a través de los estudios, dificultándose así las comparaciones. Ensayos clínicos prospectivos, de doble ciego, aleatorizados, a largo plazo con un adecuado número de participantes y el uso del DSM-IV-TR para definir el insomnio son necesarios para mejorar nuestro entendimiento sobre la relación entre el insomnio, el uso de hipnóticos y la disminución de la longevidad.
Early Childhood Education: Difficulties Creating and Changing Daily Practice  [PDF]
Sonia Kramer
Creative Education (CE) , 2014, DOI: 10.4236/ce.2014.56048

This paper is based on research carried out with children and adults at early childhood education institutions in Rio de Janeiro, Brazil. The research goals were to identify interactions between adults and children and to rethink pedagogical practice. The theoretical-methodological framework was based on language and culture studies, the sociology of childhood and anthropology. After studying children and adults in different contexts and early childhood education public policies and practice, the results present challenges of changing and creating early education practices in difficult contexts, especially with regard to the creation and use of spaces intended for children. This is the focus of the text, which is structured in three sections. Section one presents the theoretical and methodological issues. The second section analyzes three case studies developed in public pre-schools situated in different cities in the state of Rio de Janeiro. Section three presents conclusions and priorities for intervention and change concerning children, adults and their interactions.

Boundaries of Smooth Strictly Convex Sets in the Euclidean Plane R2  [PDF]
Horst Kramer
Open Journal of Discrete Mathematics (OJDM) , 2017, DOI: 10.4236/ojdm.2017.72008
Abstract: We give a characterization of the boundaries of smooth strictly convex sets in the Euclidean plane R2?based on the existence and uniqueness of inscribed triangles.
Genetic and health issues emerging from sperm donation—The experiences and views of donors  [PDF]
Ken Daniels, Wendy Kramer
Advances in Reproductive Sciences (ARSci) , 2013, DOI: 10.4236/arsci.2013.13003
Abstract: 164 previous sperm donors completed an online survey regarding health and genetic experiences and views. Results highlight that donors desire to act responsibly with recruiting facilities is not always possible. Objective: Obtaining the views and experiences of sperm donors regarding health and genetic matters. Design: Online survey. Setting: Not applicable. Participants: 164 previous sperm donors. Interventions: Not applicable. Main outcome measures: Views and experiences on health and genetic issues. Results: A variety of approaches are adopted by recruiting facilities in regard to selection and post-donation factors. The vast majority of donors said they had not been contacted by the facility they donated at to update their medical information, while almost one quarter of donors indicated that a health or genetic risk factor had occurred. A great majority of donors felt that they had not received any education or counselling on the potential curiosities of donor conceived people. Donors sought to be honest and open with staff but often found there were difficulties in doing so. Conclusions: Overall, donors indicate that they see donating as involving responsibilities to the offspring and families. The study highlights however that their ability to act responsibly is limited by some of the interactions or lack of them with the facilities where they donated. Implications for recruiting facilities need to be considered.
On Infrasound Standards, Part 1 Time, Frequency, and Energy Scaling  [PDF]
Milton A. Garces
InfraMatics (InfraMatics) , 2013, DOI: 10.4236/inframatics.2013.22002
Abstract: A standardized, self-similar, multiresolution algorithm is developed for scaling infrasonic signal time, frequency, and power within the framework of fractional octave bands. This work extends accepted fractional octave band schemas to 0.001 Hz (1000 s periods) to facilitate the analysis of broadband signals as well as the deep acoustic-gravity and Lamb waves captured by the global infrasound network. The Infrasonic Energy, Nth Octave (INFERNO) multiresolutionEnergy Estimator is applied to computing the total acoustic energy of the Russian meteor signature recorded in the 45mHz-9 Hz frequency band by IMS array 131KZ, Kazakhstan.

Interacting electrons in a magnetic field in a center-of-mass free basis
Peter Kramer,Tobias Kramer
Physics , 2014, DOI: 10.1088/0031-8949/90/7/074014
Abstract: We present an extension of the spin-adapted configuration-interaction method for the computation of four electrons in a quasi two-dimensional quantum dot. By a group-theoretical decomposition of the basis set and working with relative and center-of-mass coordinates we obtain an analytical identification of all spurious center-of-mass states of the Coulomb-interacting electrons. We find a substantial reduction in the basis set used for numerical computations. At the same time we increase the accuracy compared to the standard spin-adapted configuration-interaction method (SACI) due to the absence of distortions caused by an unbalanced cut-off of center-of-mass excitations.
Exact electron states in 1D (quasi-) periodic arrays of delta-potentials
Peter Kramer,Tobias Kramer
Physics , 1999,
Abstract: Exact one-electron eigenstates in finite parts of 1D periodic and Fibonacci chains of attractive and repulsive delta potentials are computed and analyzed. Bloch and bound state boundary conditions are related in terms of transfer matrices. Scenarios of positive and negative energy are distinguished. The dependence on the potential strength parameter is analyzed. The scattering matrix is computed. Implications for the interpretation of band germs in quasiperiodic chains are discussed.
Building Capacity for Intercultural Citizenship  [PDF]
Ida Castiglioni, Milton J. Bennett
Open Journal of Social Sciences (JSS) , 2018, DOI: 10.4236/jss.2018.63016
Changing national boundaries, migration and mobility, multinational residence, and the cross-border flow of refugees are challenging traditional views of citizenship. The term “intercultural citizenship” is coined to refer to a definition based more on affiliation with a cultural group than on legal ascription to a nation state. The implications of citizenship based on belonging carry some of the same rights and responsibilities as legal citizenship, but in addition they include 1) conscious identification with chosen groups; 2) acceptance of responsibility for sustaining the commonweal in a variety of ways; 3) development of flexible perceptual boundaries that allow for multiple group identifications; and 4) participation in the group coordination of meaning and action that constitutes the maintenance of a living culture. Three major factors in building capacity for intercultural citizenship are explored: 1) capacity for empathy, which involves overcoming the golden rule and its assumption of similarity to embrace the platinum rule and the assumption of difference; 2) capacity for mutual adaptation, which generates virtual third cultures, or forms of communicative intersectionality; and 3) capacity for intercultural ethicality, which demands that judgments be made among viable alternatives revealed by empathic perspective-taking.
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