Evaluation of an online faculty appraisal instrument: comparison of resident and faculty perceptions

RATIONALE AND OBJECTIVES: Our purpose was to compare faculty and resident perceptions regarding an online faculty appraisal instrument and the potential impact of the appraisal process. MATERIALS AND METHODS: Faculty members and residents at an academic medical center diagnostic radiology department were asked to complete anonymous surveys that sought feedback regarding an online faculty appraisal form and process. Questions were asked regarding the relative importance of various faculty performance measures, preferences for narrative versus quantitative components of the instrument, and the likely impact of the evaluation process on future faculty behavior. RESULTS: The survey was completed by 19 (45%) of 42 faculty members and by 16 (80%) of 20 residents who participated in the initial faculty appraisal process. Residents and faculty both assigned generally high rankings to the six measures of faculty performance. The vast majority (86 %) of faculty and residents found the narrative component of the survey (either alone or in combination with quantitative data) most helpful. Based on the appraisal process, 74% of the faculty planned to modify one or two aspects of their behavior, whereas a significant minority (44%) of residents thought that the faculty would not make any changes. CONCLUSION: Faculty and residents generally agree on a core set of faculty performance measures, and both groups show a preference for an appraisal instrument that incorporates a narrative component. Concerning the perceived impact of the appraisal process, faculty members were slightly more optimistic than residents regarding its ability to serve as an impetus for faculty behavioral changes.     

Use of digitized functional angiography to evaluate arterial blood flow

Digital angiography (DA), being a computer-based imaging system, allows for manipulation of the image data. One potential use derived from data manipulation is the production of functional images or images that reflect a physiologic parameter in addition to anatomic information. A discussion is presented of the background work employed to derive blood flow measurements using DA images, including the theoretical and practical limitations of the methodology. While absolute blood flow is hard to determine by any noninvasive and many invasive methods, flow velocity and relative blood flow in large vessels is obtainable with small vlumes of intraarterial contrast injection using the basic principles of indicator dilution techniques and evaluation of the time versus density relationships of contrast bolus. An appraisal of the functional imaging method is provided, including its drawbacks and the potential areas of application.     

Appraisal,coping, emotion,and performance during elite fencing matches: a random coefficient regression model approach

Understanding more about the stress process is important for the performance of athletes during stressful situations. Grounded in Lazarus's (1991, 1999, 2000) CMRT of emotion, this study tracked longitudinally the relationships between cognitive appraisal, coping, emotions, and performance in nine elite fencers across 14 international matches (representing 619 momentary assessments) using a naturalistic, video‐assisted methodology. A series of hierarchical linear modeling analyses were conducted to: (a) explore the relationships between cognitive appraisals (challenge and threat), coping strategies (task‐ and disengagement oriented coping), emotions (positive and negative) and objective performance; (b) ascertain whether the relationship between appraisal and emotion was mediated by coping; and (c) examine whether the relationship between appraisal and objective performance was mediated by emotion and coping. The results of the random coefficient regression models showed: (a) positive relationships between challenge appraisal, task‐oriented coping, positive emotions, and performance, as well as between threat appraisal, disengagement‐oriented coping and negative emotions; (b) that disengagement‐oriented coping partially mediated the relationship between threat and negative emotions, whereas task‐oriented coping partially mediated the relationship between challenge and positive emotions; and (c) that disengagement‐oriented coping mediated the relationship between threat and performance, whereas task‐oriented coping and positive emotions partially mediated the relationship between challenge and performance. As a whole, this study furthered knowledge during sport performance situations of Lazarus's (1999) claim that these psychological constructs exist within a conceptual unit. Specifically, our findings indicated that the ways these constructs are inter‐related influence objective performance within competitive settings.     

Adherence to sport injury rehabilitation programmes: a conceptual review

It is widely acknowledged that the importance of sound theoretical guidance is essential to any academic discipline. A common recommendation within the adherence literature related to sport injury rehabilitation has been the need to establish clear theoretical frameworks to guide research and practice. As such, an increasing amount of literature has employed conceptual models that include protection motivation theory, health action process approach, cognitive appraisal models, and attribution theory. Therefore, the purpose of this review is to critically evaluate these contemporary theoretical approaches that have been utilised within the sport injury rehabilitation adherence literature. Alongside this, practical implications emerging from this research base are outlined and future recommendations are suggested that may be of benefit to sports medicine practitioners and researchers alike.     

How to perform a critically appraised topic: part 2, appraise, evaluate, generate, and recommend

OBJECTIVE: This article continues the discussion of a critically appraised topic started in Part 1. A critically appraised topic is a practical tool for learning and applying critical appraisal skills. This article outlines steps 4-7 involved in performing a critically appraised topic for studies of diagnostic tests: Appraise, Appraise the literature; Evaluate, evaluate the strength of the evidence from the literature; Generate, generate graphs of conditional probability; and Recommend, draw conclusions and make recommendations. CONCLUSION: For steps 4-7 of performing a critically appraised topic, the main study results are summarized and translated into clinically useful measures of accuracy, efficacy, or risk.     

Anxiety and burnout in young athletes: The mediating role of cognitive appraisal

This study tested the relationship between trait anxiety, cognitive appraisal, and athletes’ burnout proposing two hypotheses: (a) there is a direct relationship between athletes’ trait anxiety and cognitive appraisal and burnout, and (b) cognitive appraisal mediates the relationship between trait anxiety and burnout, and this mediation occurs despite the competitive level and sport records of athletes. The study included 673 young athletes and provided measures of trait anxiety, cognitive appraisal, and burnout. Structural equation modeling indicated that cognitive appraisal mediates the relationship between trait anxiety and burnout, confirming hypothesis 2, and this model provided better fit than the direct model of hypothesis 1. However, the mediation also indicated that the direct relationship between trait anxiety and burnout should be considered. The mediating model was invariant according to competitive levels and sport records. In conclusion, cognitive appraisal is an important variable in explaining athletes’ burnout.     

An analysis of causative factors in closed criminal medical malpractice cases of the Taiwan Supreme Court: 2000–2014

Most medical malpractice in Taiwan leads to criminal prosecution. This study examined the epidemiologic factors and clinical errors that led to medical malpractice convictions in Taiwanese criminal prosecutions. A retrospective, 15-year population-based review of criminal Supreme Court judgments pertaining to medical malpractice against physicians and nurses was conducted. Eighty-four cases were reviewed, yielding data that included the number and specialty involved, accused hospitals, the diagnosis, the time interval between incidents to closure, result of adjudication, the origin of cases (private vs. public prosecution), the result of medical appraisal, and the primary error. Overall, the cases averaged 7.6 years to achieve final adjudication. Seventy-five percent were settled in favor of the clinician; twenty-three physicians and three nurses were found guilty, but all of these avoided imprisonment via probation or replacement with forfeit. The single most risky specialty was emergency medicine (22.6% of the cases), with 36.8% of those resulting in guilty verdicts. The most common diagnosis groups were infectious diseases (23.8%), intracranial hemorrhages (10.7%), and acute coronary syndrome (9.5%). Public prosecutions had a 41.2% conviction rate; no guilty verdicts resulted from private prosecution. Nineteen (22.6%) cases were commuted, and 73.7% of those had a controversial appraisal result. The characteristics of criminal malpractice prosecution in Taiwan that could be improved to relieve the stress of frivolous lawsuits on the judicial process include lengthy jurisdiction process; low public-prosecution conviction rate; frequent commuted jurisdiction related to a controversial appraisal; and zero imprisonment rate for clinicians.     

Loco-regional recurrences of superficial soft tissue sarcomas and melanoma

Soft-tissue sarcoma and melanoma have a high incidence of loco-regional recurrence some as early as a few months after surgery. As yet, there is little agreement on the investigation of choice to detect recurrence. In this study, a comparison between ultrsonography (US) and computed tomography (CT) in the detection of local superficial recurrences has made. This revealed that US detected the number of lesions more effectively than CT, and gave a better delineation. It also allowed a more reliable appraisal of the relationship between the tumor and contiguous muscular and vascular structures. CT gave a more effective evaluation than US in only one case (liposarcomatous recurrence), and this was attributed to the large density difference between tumor and normal contiguous muscular tissues. It is concluded that US is more suitable than CT for the pre-operative staging of patients with recurrence from soft tissue sarcoma and melanoma.     

Factor B subtyping in sera and bloodstains by isoelectric focusing and immunoblotting

Summary The polymorphism of BF was investigated in 765 unrelated Japanese individuals by isoelectric focusing and immunoblotting. Besides five common subtypes three rare variants were observed. The allele frequencies were: BF^*S=0.8078, BF^*FA=0.1797, BF^*FB=0.0105, BF^*Var.=0.0020. The above method was successfully applied to subtyping BF in stored blood-stains. The determination limits were: at 4°C 8 weeks, at room temperature 2 weeks and at 37°C only 2 days after storage. The BF subtyping is of practical use in medicolegal individualization of unknown bloodstains.     

Polymorphism of EsD by isoelectric focusing: Phenotyping in human tissues,dental pulps,hair roots,and semen

Summary The polymorphism of EsD was investigated in tissues of various human organs, dental pulps, hair roots, and seminal stains by isoelectric focusing. The method yielded an excellent resolution of the isoenzyme components. The time limits of determination were: in organ tissues 3 weeks, in dental pulps 1 week, and in hair roots several days. The 7-1 type was less stable than the common types. Phenotyping was possible from fresh semen samples, but was unsuccessful from dried seminal stains after storage. The results show that the EsD typing by isoelectric focusing is of practical use for medicolegal individualization of organs, teeth, and hairs.     

16层螺旋CT在茎突测量中的应用

目的探讨16层螺旋CT在茎突测量中的应用价值。方法对120例受检者进行16层螺旋CT扫描,在工作站上用VR,MIP及MPR法测量茎突长度、内倾角,并直接测量前倾角及通过测量茎突与颧弓夹角间接测量前倾角。结果VR图像上可以准确测量茎突前倾角（22．56±2．32°）,并间接测得前倾角23．11±2．56°,内倾角为21．89±4．82°。VR,MIP2D工具及3D工具均可测量茎突长度,2D工具与3D工具测量结果有显著差异。MPR图像测得茎突长度为22．98±2．83cm。VR及MIP3D工具与MPR测得茎突长度无显著性差异。结论16层螺旋CT扫描可以准确测量茎突长度及倾斜角度,测量茎突长度以VR3D工具最为实用,而间接法测量茎突前倾角更为简便。     

Refraction Imaging and Histologic Correlation in Excised Tissue from a Normal Human Lung: Preliminary Report

RATIONALE AND OBJECTIVES: The authors performed this study to evaluate the spatial resolution of refraction imaging performed with synchrotron radiation (SR) on 2-mm-thick sections of excised normal human lung. MATERIALS AND METHODS: Refraction images of specimens from a normal human lung were obtained with 19 keV, a 5-second exposure time, and a 2.4 x 2.4-cm field of view. The specimen-detector distance was 83 cm. RESULTS: Structures of secondary pulmonary lobule consisting of pulmonary arteriole, terminal bronchiole, air sac, and venules in the interlobular septum in normal lung were clearly illustrated on refraction images obtained with SR. The imaging findings showed good correlation with those from histologic examination. The spatial resolution of the refraction images was approximately 10-30 microm, as measured with light microscopic analysis of specimens stained with hematoxylin-eosin. CONCLUSION: With refinement, this technique may have some practical purpose for diagnosing lung disease in vivo.     

多指标正交试验优选祖师麻有效部位群的提取工艺

目的优选祖师麻有效部位群的最佳提取工艺。方法以总香豆素、总黄酮和祖师麻甲素提取率为评价指标,用多指标综合评分法进行数据处理,采用正交试验考察乙醇体积分数、乙醇用量、回流时间、回流次数对提取效果的影响。结果祖师麻有效部位群最佳提取工艺为:加8倍量的70%乙醇,加热回流2次,每次2 h。结论该提取工艺设计合理,结果可靠,提取效果较好。     

军队卫生科技装备发展优先度研究

目的探索卫生装备发展论证方法,为决策者提供辅助决策平台。方法基于卫生装备的效能研究,建立卫生装备发展优先决策支持系统,采用最小方差法研究卫生装备体系发展优先度,采用模糊模式识别的模糊综合评估法研究单件卫生装备发展优先度,采用改进的灰色关联度法研究卫生装备指标发展优先度。结果通过卫生装备九类体系进行验证,＂三防装备＂体系具有较高发展优先度,其中＂生物侦察车＂与美军具有较大差距,＂信息化水平＂指标制约了生物侦察车的效能水平,与我军卫生装备客观实际相符。结论该方法能够客观地反映制约卫生装备发展的体系、单件装备和效能指标,所建立的决策支持系统具有应用价值。     

Nonlinear Geometric Warping of the Mask Image: A New Method for Reducing Misregistration Artifacts in Digital Subtraction Angiography

Purpose: Misregistration artifact is the major cause of image degradation in digital subtraction angiography (DSA). The purpose of this study was to evaluate the efficacy of a newly developed nonlinear geometric warping method to reduce misregistration artifact in DSA. Methods: The processing of the images was carried out on a workstation with a fully automatic computerized program. After making differential images with a lapracian filter, 49 regions of interest (ROIs) were set in the image to be processed. Each ROI of the live image scanned the corresponding ROI of the mask image searching for the best position to match itself. Each pixel of the mask image was shifted individually following the data calculated from the shifts of the ROIs. Five radiologists compared the images produced by the conventional parallel shift technique and those processed with this new method in 16 series of cerebral DSA. Results: In 14 of 16 series (88%), more radiologists judged the images processed with the new method to be better in quality. Small arteries near the skull base and veins of low density were clearly visualized in the images processed by the new method. Conclusion: This newly proposed method could be a simple and practical way to automatically reduce misregistration artifacts in DSA.     

An examination of the Sport Drug Control Model with elite Australian athletes

Objective: This study presents an opportunistic examination of the theoretical tenets outlined in the Sport Drug Control Model¹ using questionnaire items from a survey of 643 elite Australian athletes. Design and method: Items in the questionnaire that related to the concepts in the model were identified and structural equation modelling was employed to test the hypothesised model. Results: Morality (cheating), benefit appraisal (performance), and threat appraisal (enforcement) evidenced the strongest relationships with attitude to doping, which in turn was positively associated with doping susceptibility. Self-esteem, perceptions of legitimacy and reference group opinions showed small non-significant associations with attitude to doping. The hypothesised model accounted for 30% and 11% of the variance in attitudes to doping and doping susceptibility, respectively. Conclusion: These present findings provide support for the model even though the questionnaire items were not constructed to specifically measure concepts contained in it. Thus, the model appears useful for understanding influences on doping. Nevertheless, there is a need to further explore individual and social factors that may influence athletes’ use of performance enhancing drugs.     

Reduction of arthritic symptoms by low dose radiation therapy (LD-RT) is associated with an anti-inflammatory phenotype

Abstract

Purpose: The aim of this paper was to provide an integrative mechanistic appraisal to account for consistent observations of protective effects of ionizing radiation on the occurrence/ progression of arthritis in multiple animal models.

Materials and methods: A critical analysis of the biomedical literature was undertaken to assess mechanisms by which low doses of ionizing radiation prevent and/or reduce the occurrence of experimental-induced arthritis in animal models.

Results: Detailed mechanistic-related research indicates that low doses of ionizing radiation induce a highly integrated multiple pathway process that results in the formation of a generalized anti-inflammatory phenotype which can both prevent the occurrence of arthritic changes and/or reverse such effects.

Conclusions: The manifestation of the anti-inflammatory features occurred within the context of highly consistent hormetic (i.e., biphasic dose) responses across studies, biological models and mechanisms. The reduction of multiple bioindicators of experimentally-induced arthritis by exposure to low doses of ionizing radiation was associated with the occurrence of a generalized anti-inflammatory phenotype.     

Predictors of pre‐ and post‐competition affective states in male martial artists: a multilevel interactional approach

The aims of this study were to examine (a) the effects of competition‐related and competition‐extraneous concerns on affective states; (b) the relationships of primary and secondary appraisal with affective states and (c) the main and moderating effects of personality traits on pre‐ and post‐competition affects. Thirty‐nine male elite martial artists were assessed on 12 affective states, concerns and dimensions of primary and secondary appraisal at five random times a day across 1 week before and 3 days after a competition. On the competition day, they were assessed 1 h before and immediately after the contest. Competitive trait anxiety, neuroticism and extraversion were measured at the start of the study. The competition was the most significant and stressful event experienced in the examined period and had a pervasive influence on athletes' affective states. All examined appraisal and personality factors were somewhat associated with pre‐ and post‐competition affective states. Competitive trait anxiety was a key moderator of the relationship between cognitive appraisal and affective states. This study supports the idea that cognitive appraisal and situational and personality factors exert main and interactive effects on athletes' pre‐ and post‐competition affects. These factors need to be accounted for in planning of emotion regulation interventions.