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Popular constituent power, once a concept closely associated with radical critiques of liberal constitutionalism on the left and the right, and with the investigations of such “Continental” topics as political theology, insurgent partisanship, and the sovereign state of exception, has recently become a key concern of Anglo-American democratic and constitutional theorists. As the concept has moved to the center of scholarly debates, it has also become more respectable, the subject of increasingly elaborate attempts to bring it within the fold of liberal constitutionalism itself: popular constituent power has become an important test of liberal constitutionalism’s democratic capaciousness. This has had significant consequences for how its central concept – the constituent people – has been theorized. “As an actor,” Andrew Arato writes, “the people are fictional unless they are redefined in legal terms as the collectivity of citizens or the electorate in which case they become an entity produced by law, rather than the ultimate source of law.” Viewing the people first and foremost as a legal entity rather than exploring their “fictional” status as “an actor” has been a hallmark of much of the recent scholarship on the popular constituent power.
Mentorship is perceived to be an important component of residency education. However, evidence of the impact of mentorship on professional development in Emergency Medicine (EM) is lacking.
Online survey distributed to attending physician members of the Canadian Association of Emergency Physicians (CAEP), using a modified Dillman method. Survey contained questions about mentorship during residency training, and perceptions of the impact of mentorship on career development.
The response rate was 23.5% (309/1314). 63.6% reported having at least one mentor during residency. The proportion of participants with a formal mentorship component during residency was higher among those with mentors (44.5%) compared to those without any formal mentorship component during residency (8.0%, p<0.001). The most common topics discussed with mentors were career planning and work-life balance. The least common topics included research and finances. While many participants consulted their mentor regarding their first job (56.5%), fewer consulted their mentor regarding subspecialty training (45.1%) and research (41.1%). 71.8% chose to work in a similar centre as their mentor, but few completed the same subspecialty (24.8%), or performed similar research (30.4%). 94.1% stated that mentorship was important to success during residency. Participants in a formal mentorship program did not rate their experience of mentorship higher than those without a formal program.
Among academic EM physicians with an interest in mentorship, mentorship during EM residency may have a greater association with location of practice than academic scholarship or subspecialty choice. Formal mentorship programs increase the likelihood of obtaining a mentor, but do not appear to improve reported mentorship experiences.
An impulse response method is carried out to analyze waveguide's information capacity within a coherent communication system. Such capability is typically estimated according to group delay variations (seconds/bandwidth/distance) after carrier-modulated data undergoes a dispersive medium. However, traditional group delay methods often ignore non-linear effects by assuming input data stream only occupies narrow bandwidth such that a propagation constant can be linearized centered at the carrier frequency. Such a constraint can be lifted with a proposed baseband equivalent impulse response method by using frequency domain convolution and multiplication. Once the impulse response in frequency domain is secured, its time domain counterpart can be calculated based on inverse Fourier transformation. Such analysis can fully reveal data pulse's broadening and gauge its inter-symbol interference by simply convolving input data with extracted impulse response, not limited to specific frequency range or type of waveguide.
To develop consensus recommendations for training future clinician educators (CEs) in emergency medicine (EM).
A panel of EM education leaders was assembled from across Canada and met regularly by teleconference over the course of 1 year. Recommendations for CE training were drafted based on the panel’s experience, a literature review, and a survey of current and past EM education leaders in Canada. Feedback was sought from attendees at the Canadian Association of Emergency Physicians (CAEP) annual academic symposium. Recommendations were distributed to the society’s Academic Section for further feedback and updated by a consensus of the expert panel.
Recommendations were categorized for one of three audiences: 1) Future CEs; 2) Academic departments and divisions (AD&D) that support training to fulfill their education leadership goals; and 3) The CAEP Academic Section. Advanced medical education training is recommended for any emergency physician or resident who pursues an education leadership role. Individuals should seek out mentorship in making decisions about career opportunities and training options. AD&D should regularly perform a needs assessment of their future CE needs and identify and encourage potential individuals who fulfill education leadership roles. AD&D should develop training opportunities at their institution, provide support to complete this training, and advocate for the recognition of education scholarship in their institutional promotions process. The CAEP Academic Section should support mentorship of future CEs on a national scale.
These recommendations serve as a framework for training and supporting the next generation of Canadian EM medical educators.
In a time of major medical education transformation, emergency medicine (EM) needs to nurture education scholars who will influence EM education practice. However, the essential ingredients to ensure a career with impact in EM education are not clear.
To describe how to prepare EM educators for a high-impact career.
The Canadian Association of Emergency Physicians (CAEP) Academic Section commissioned an “Education Impact” working group (IWG) to guide the creation of consensus recommendations from the EM community. EM educators from across Canada were initially recruited from the networks of the IWG members, and additional educators were recruited via snowball sampling. “High impact educators” were nominated by this network. The high impact educators were then interviewed using a structured question guide. These interviews were transcribed and coded for themes using qualitative methods. The process continued until no new themes were identified. Proposed themes and recommendations were presented to the EM community at the CAEP 2016 Academic Symposium. Feedback was then incorporated into a final set of recommendations.
Fifty-five (71%) of 77 of identified Canadian EM educators participated, and 170 names of high impact educators were submitted and ranked by frequency. The IWG achieved sufficiency of themes after nine interviews. Five recommendations were made: 1) EM educators can pursue a high impact career by leveraging either traditional or innovative career pathways; 2) EM educators starting their education careers should have multiple senior mentors; 3) Early-career EM educators should immerse themselves in their area of interest and cultivate a community of practice, not limited to EM; 4) Every academic EM department and EM teaching site should have access to an EM educator with protected time and recognition for their EM education scholarship; and 5) Educators at all stages should continuously compile an impact portfolio.
We describe a unique set of recommendations to develop educators who will influence EM, derived from a consensus from the EM community. EM leaders, educators, and aspiring educational scholars should consider how to implement this guide towards enhancing our specialty’s educational mission.
Binary stars can interact via mass transfer when one member (the primary) ascends onto a giant branch. The amount of gas ejected by the binary and the amount of gas accreted by the secondary over the lifetime of the primary influence the subsequent binary phenomenology. Some of the gas ejected by the binary will remain gravitationally bound and its distribution will be closely related to the formation of planetary nebulae. We investigate the nature of mass transfer in binary systems containing an AGB star by adding radiative transfer to the AstroBEAR AMR Hydro/MHD code.
The government publishes 3 different public report surgical site infection (SSI) metrics, all called standardized infection ratios (SIRs), that impact perceived hospital quality. We conducted a non-random cross-sectional observational pilot study of 20 California hospitals that voluntarily submitted colon surgery and SSI data. Discordant SIR values, leading to contradictory conclusions, occurred in 35% of these hospitals.
We are developing practical methodologies to characterize pool sizes and residence times for fractions of soil organic matter (SOM) using radiocarbon, with a particular focus on SOM in New Zealand pasture soils that responds to global change on decadal timescales. As single mean residence times for the entire SOM pool can be misleading or uninterpretable, we focus on the use of samples collected about 7 and 40 yr after the bomb14C spike to separate SOM into at least 2 pools. These results from a box model methodology yield sensible estimates of the proportion of “passive” SOM, and the residence time of the dominant pool with approximately decadal residence times. These results are supported by chemical analysis. Approximately 45-yr residence times of light-fraction SOM in a relatively infertile soil contrast with ∼16-yr residence times in a more fertile soil, and correspond to large differences in the proportion of lignin- and polysaccharide-derived SOM in these soils measured using pyrolysis-GC/MS. To achieve greater detail and assess the degree to which “active” SOM with annual turnover rates may bias results from the simple model, we use density as a means of isolating SOM with different degrees of mineral association. Initial results from grazed pasture soils sampled in 2003–4 emphasize that isolating non-mineral-associated light fractions can improve understanding, but may be less important than identifying fractions associated with unique mineralogy. In this soil, a fraction with density ≥2.55 g/mL shows much larger proportions of passive SOM than other fractions.
We explore the direct modification of the pseudo-spectral truncation of two-dimensional, incompressible fluid dynamics to maintain a prescribed kinetic energy spectrum. The method provides a means of simulating fluid states with defined spectral properties, for the purpose of matching simulation statistics to given information, arising from observations, theoretical prediction or high-fidelity simulation. In the scheme outlined here, Nosé–Hoover thermostats, commonly used in molecular dynamics, are introduced as feedback controls applied to energy shells of the Fourier-discretized Navier–Stokes equations. As we demonstrate in numerical experiments, the dynamical properties (quantified using autocorrelation functions) are only modestly perturbed by our device, while ensemble dispersion is significantly enhanced compared with simulations of a corresponding truncation incorporating hyperviscosity.
To characterize the current state of Canadian emergency medicine (EM) resident research and develop recommendations to promote excellence in this area.
We performed a systematic review of MEDLINE, Embase, and ERIC using search terms relevant to EM resident research. We conducted an online survey of EM residency program directors from the Royal College of Physicians and Surgeons of Canada (RCPSC) and College of Family Physicians of Canada (CFPC). An expert panel reviewed these data, presented recommendations at the Canadian Association of Emergency Physicians 2014 Academic Symposium, and refined them based on feedback received.
Of 654 potentially relevant citations, 35 articles were included. These were categorized into four themes: 1) expectations and requirements, 2) training and assessment, 3) infrastructure and support, and 4) dissemination. We received 31 responses from all 31 RCPSC-EM and CFPC-EM programs. The majority of EM programs reported requiring a resident scholarly project; however, we found wide-ranging expectations for the type of resident research performed and how results were disseminated, as well as the degree of completion expected. Although 93% of RCPSC-EM programs reported providing formal training on how to conduct research, only 53% of CFPC-EM programs reported doing so. Almost all programs (94%) reported having infrastructure in place to support resident research, but the nature of support was highly variable. Finally, there was marked variability regarding the number of resident-published abstracts and manuscripts.
Based on the literature, our national survey, and discussions with stakeholders, we offer 14 recommendations encompassing goals, expectations, training, assessment, infrastructure, and dissemination in order to improve Canadian EM resident research.
Outcome feedback is the process of learning patient outcomes after their care within the emergency department. We conducted a national survey of Canadian Royal College emergency medicine (EM) residents and program directors to determine the extent to which active outcome feedback and follow-up occurred. We also compared the perceived educational value of outcome feedback between residents and program directors.
We distributed surveys to all Royal College-accredited adult and pediatric EM training programs using a modified Dillman method. We analyzed the data using student’s t-test for continuous variables and Fisher’s exact test for categorical variables.
We received 210 completed surveys from 260 eligible residents (80.8%) and 21 of 24 program directors (87.5%) (overall 81.3%). Mandatory active outcome feedback was not present in any EM training program for admitted or discharged patients (0/21). Follow-up was performed electively by 89.4% of residents for patients admitted to the hospital, and by 44.2% of residents for patients discharged home. A majority of residents (76.9%) believed that patient follow-up should be mandatory compared to 42.9% of program directors (p=0.002). The perceived educational value of outcome feedback was 5.8/7 for residents and 5.1/7 for program directors (difference 0.7; p=0.002) based on a seven-point Likert scale (1=not important; 7=very important).
While Canadian EM training programs do not mandate follow-up, it is performed electively by the majority of residents surveyed. Residents place a significantly greater educational value on outcome feedback than their program directors, and believe that follow-up should be a mandatory component of EM residencies.