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Growth of Auditory Reflexes with Stimulus Level
Get PDFIn the human auditory system, the brainstem can modify how sound is processed in the inner ear (cochlea). The medial olivocochlear efferent reflex (MOCR) is one such inhibitory neural response originating in the brainstem. When activated, this reflex reduces amplification in the cochlea, which is believed to improve hearing in background noise. Previous research has shown that the reflex reduces amplification in the inner ear by different amounts for soft vs. loud acoustic stimuli. We hypothesized that these varying levels of reduction are equivalent to a constant reduction of stimulus input level. To measure these level changes, we used otoacoustic emissions, which are soft sounds emitted from the cochlea that can be measured with a small microphone placed in the ear canal. Otoacoustic emission amplitudes obtained with MOCR activated included a constant reduction of stimulus input; however, they also showed an additional shift. The findings suggested that previous research should be revisited using the new measurements
Archiving the Trauma Diaspora: Affective Artifacts in the Higher Education Arts Classroom
Get PDFThis study offers a close, contextualized reading of classroom observations that contributes to the emerging interdisciplinary discourses around trauma cultures, art education, cultural artifacts and archives. Using a single case from my larger dissertation research, I identify and describe an example of the diaspora of trauma as it emerges in the higher education narrative arts classroom. In the larger research project, I used extended case study methods to investigate conceptual and practical tools for working in arts education settings in which traumatic narratives may emerge and developed a framework for the analysis and archiving of creative artifacts as part of a diasporic trauma archive. Working creatively with trauma diaspora is framed in terms of a de-centered and non-hierarchical production of public archives of culturally contextualized and politically informed personal narratives. The trauma-sensitive artifact is understood as a way of making legible the “unspoken” or “unwritten” aspects of cultural trauma, such as those experienced via the body and interpersonal affect. Archive is considered a locally and historically dispersed, but cohesive body of work that speaks to and about cultural trauma
Time and Space in the Novels of Palestinian Writer Sahar Khalifa
Get PDFThis article seeks to examine the connections between time and space in the novels of the prominent Palestinian writer, Saḥar Khalīfa. In her writing, Khalīfa emphasizes the status of women in society. She describes Palestinian society, and links each of her works to the collective Palestinian struggle and the parallel female struggle. She draws inspiration from her personal identity, and contributes to the development of a cultural discussion and creation of a collective identity. Khalīfa’s works constitute a broad literary corpus, describing through time and space the events of Palestinian society in general and the status of Palestinian women in particular. These events constitute a chronological timeline that reflects processes of forming a Palestinian collective identity, and in a narrower circle it describes the changes that have taken place in Palestinian women’s lives, and the processes that contributed to shaping their identity in light of political-national changes. Thus, the connection created in Khalīfa’s novels between historical time and physical place is an inseparable part of the entire range of literary means that drive the plot and emphasize the role and status of Palestinian women in society
Frequency of preconception education for teenage patients with diabetes attending an academic Pediatric Endocrinology Clinic
Get PDFPurpose: Diabetes mellitus (DM) in pregnancy produces adverse outcomes with significant human and economic costs. Potential lifetime cost savings of preventative preconception counseling for women with diabetes may reach $4.3 billion (U.S.). Preconception education has been shown in prior research to improve knowledge of reproductive risks in an adolescent diabetic population and to improve future health outcomes. This study assessed the current extent of preconception DM-related reproductive risk education at a tertiary academic medical center to better inform the opportunity for a systematic quality improvement intervention.
Methods: We reviewed the electronic medical records (EMR) of females (N=70), ages 16-19, seen in the Pediatric Endocrinology clinic (2013-2016) and diagnosed with type 1 DM, type 2 DM, or insulin resistance. Any reproductive risks education documentation by providers, nursing or educators within Pediatric Endocrinology, or within consults to Nutrition or Obstetrics and Gynecology was reviewed and characterized.
Results: According to EMR documentation, patient education for nonreproductive medical needs and complications of DM were consistently present in this population: 96% of patients received general diabetes education with at least 4/8 components. However, documented education regarding DM reproductive risks occurred for only 18% of the same patients while contraceptive use discussion occurred for 20%.
Conclusion: The potential benefits of preconception education may include achieving recommended glucose control preceding and during pregnancy with fewer downstream maternal and fetal adverse outcomes. Although limited by the single site, retrospective design and the unknown rate of reproductive education documentation failure, our findings reveal a performance gap of potential downstream medical significance. Recognizing this deficiency provides an opportunity for a population-based intervention to create improved health outcomes
New directions in medical student clerkship evaluations
Get PDFPurpose: To compare the number of requested medical student evaluations with mean evaluation scores and final clerkship grades.
Background: The University of Iowa Obstetrics & Gynecology (OBGYN) clerkship requires six evaluations for each student: two assigned and four requested by the student. Many students request more evaluations than required, contributing to a backlog that slows the grading process.
Methods: Medical student evaluations from 2014 to 2016 were analyzed. Three groups were created based on the number of evaluations an individual student received. Group 1 received 3-4 evaluations (73), Group 2 received 5-6 evaluations (240) and Group 3 received 7-16 evaluations (222). A paired T-test compared mean evaluation scores and a chi-square test was used to compare mean shelf exam scores and percentages of pass, near honors, and honors grades.
Results: A total of 535 independent students and their evaluations were reviewed for the study. The difference in mean evaluation scores for groups 1 and 2 and groups 2 and 3 were statistically significant (p \u3c 0.01, p= 0.02, respectively). The differences in mean shelf grades between groups 1 and 2 and groups 2 and 3 were not significant (p \u3e 0.05). Similarly, the differences in rates of pass, near honors, and honors grades between groups were not statistically significant (p \u3e 0.05).
Discussion: Increased number of requested evaluations did not translate to differences in rates of pass, near honors, and honors grades for medical students on their OBGYN clerkship, indicating that decreasing the mandatory evaluations per student would not be detrimental to student outcomes and would potentially expedite the grading process
Vehicle Familiarity and Relative Risk of Fatal Crash Involvement
Get PDFLack of familiarity with a vehicle has been associated with increased crash risk independent of overall driving experience (Perel, 1983). This may pose an underappreciated safety risk in the context of complex and rapidly evolving driver assistance technologies and driver-vehicle interfaces, especially when people drive newly purchased, rented, or borrowed vehicles. The current study estimates the relationship between vehicle ownership and responsibility for crashes using data from 231,056 drivers involved in fatal crashes in the United States in years 2008-2017. A driver was considered responsible for the crash if police indicated that the driver’s pre-crash actions contributed to the occurrence of the crash, and non-responsible otherwise. Driver-, vehicle-, and roadway factors that might also influence crash risk were controlled using logistic regression. Drivers of vehicles registered to another person and drivers of rental vehicles had 1.15 and 1.20 times the odds of responsibility for their crashes, respectively, compared with drivers of their own vehicles. If non-responsible drivers approximate a random sample of all drivers present at the times and places of fatal crashes, these results approximate ratios of responsible involvement in fatal crashes per unit of driving exposure. While ownership is an imperfect proxy for familiarity and may be associated with crash risk by other mechanisms unrelated to familiarity, results are consistent with the hypothesis that drivers of unfamiliar vehicles experience elevated crash risk
Investigating Pedestrians\u27 Crossing Behaviour During Car Deceleration Using Wireless Head Mounted Display: An Application Towards the Evaluation of eHMI of Automated Vehicles
Get PDFThis study investigated pedestrians’ crossing behaviour in a virtual reality environment. One aim was to develop a framework for evaluating external Human-Machine Interfaces (eHMI) used by automated vehicles for future studies. Pedestrians were provided with a series of two approaching cars, which were travelling at either 25mph, 30mph, or 35mph, with eight manipulated time gaps in between cars, where the second car either decelerated or kept pace. These stimuli were presented in 3 blocks. Pedestrians’ task was to cross (or not) naturally between the approaching cars. Data from decelerating trials were analysed. Results showed 51% of crossings happened before deceleration, 31% of crossings after the car had stopped and only 18% of the crossings during deceleration, leaving a great margin for evaluating the effect of eHMI and changing pedestrian crossing behaviour during deceleration. A learning effect was found, demonstrating a shift of decision making across blocks, whereby crossing increasingly occurred during the approaching vehicle’s deceleration, rather than after it had come to a full stop. Further analyses were conducted to investigate the effect of speed on initiation time, crossing time and safety margin. This study provides guidelines in choosing the appropriate time gaps and speeds that may influence pedestrians’ crossing decisions and behaviour while presenting different designs of eHMI in future studies. The results also provide guidance on how to evaluate safety, efficiency/receptivity and learning effects, when comparing different eHMI designs in VR experiments
Age and Secondary Task Engagement in Relation to Safe/Unsafe Driving Behavior and Crash/Non-Crash Events
Get PDFDriver distraction is thought to play a causal role in automobile crashes. Younger and older drivers have the highest crash risk per mile driven. To get a better understanding of the risk associated with conducting secondary tasks while driving the Naturalistic Driving Study (NDS) dataset, part of the Second Strategic Highway Research Program (SHRP2) was used to run a log-linear model comparing age and secondary task involvement and their relation to Event Severity (Balanced Baseline vs Crash), as well as Maneuver Judgement (Safe vs Unsafe). A significant relationship was found between event severity and maneuver judgement. Additionally, age group and secondary task engagement had a significant effect on event severity, but no significant interaction between age and secondary task was found. Age had a significant effect on maneuver judgement, but secondary task did not. Therefore, maneuver judgement may not be a good substitute for event severity as an outcome variable for predicting crashes
Posing Questions and Policy Suggestions: Autonomous Vehicles & Climate Change
Get PDFThe introduction of autonomous vehicles (AVs) is projected to increase safety and efficiency of transportation. However, climate change poses a challenge to the smooth integration of AVs to current transportation infrastructure. Increased extreme weather events, higher precipitation and temperature, and damages to infrastructure are challenges AVs will face. Therefore, the authors advocate for Planned Adaptive Regulation, and raise questions that they feel policymakers and driving assessment should consider
Associations Between Cognitive Distortions in Moral Reasoning and Self-Reported Traffic Violations and Crashes for Different Road User Groups
Get PDFThe use of self-serving cognitive distortions measured by traffic-role specific versions of the Cognitive Distortions in Driving (CDD) test was explored for three Dutch road user groups: cyclists beginning to learn to drive (LDs) who were enrolled in a pro-social driving program (n=138); young novice drivers enrolled in a safety awareness program (n=1660), and; experienced professional bus drivers enrolled in a post-licensing training program (871). Associations between cognitive distortions and self-reported traffic behavior, fines and crashes were analyzed. Results show that about 20 per cent of the young novice drivers used self-serving cognitive distortions, compared to 8 per cent of the LDs and 5 per cent of the bus drivers. In addition, use of cognitive distortions was significantly correlated with speed and traffic violations. Finally, a subgroup of cyclist LDs (n=38) who had been licensed for six months used fewer cognitive distortions when tested as drivers than the licensed young novice drivers without pro-social driver training. This shows that pro-social driver training can reduce cognitive distortions and may possibly increase safety