Contemporary Residents Research Articles

A Day in the Life of a Psychiatry Resident: A Pilot Qualitative Analysis

The topic "A Day in the Life of a Psychiatry Resident" is an opportunity to explore residents' experiences to inform the delivery of education. An open-ended, qualitative approach was used in a pilot project to explore contemporary residents' experiences with education, similar to a patient-centered model of health care. Key themes for residents include balancing multiple roles at work, balancing work and home, identity formation, diversity (gender, ethnic, cultural, learner styles, and other dimensions), and challenges in training with advances in the field (e.g., neuroscience, technology, culture, spirituality). Contemporary residents have some issues as did their predecessors, but they also have unique experiences, issues, talents, and interests. A larger qualitative analysis of these issues, followed by testing of theories by quantitative methods, is indicated.

Ecological Praxis and Blackwater Ecosystems: A Case Study From the Brazilian Amazon

This article explores how anthropogenic modifications of soil condition human adaptive processes on the Amazonian uplands. The occurrence of black earth (a nutrient-rich anthrosol) in nutrient-poor blackwater environments and its cultivation by contemporary residents provide a unique opportunity for understanding the ecological praxis of Amazonian groups. Two years of ethnographic, ethnoscientific, and agronomic research among caboclo residents of the Lower Rio Negro and Rio Urubu confirm that unique cognitive and behavioral orientations characterize black earth and adjacent environments. When compared with cognitive and behavioral orientations to these two environments in distant blackwater regions, data suggest that political-economic, technological, cultural, and ecological factors have had~a strong influence on the trajectory of human-environmental interactions. Data in large part illustrate the utility of historical ecological models, yet point to an interactive role of diverse histories in shaping the range of human responses.

Reclaiming Lost Ancestors and Acknowledging Slave Descent: Insights from Madagascar

These three statements regarding personal ancestry were made to me by villagers during life history interviews I conducted a few months into my research in northeastern Madagascar. Each statement is an admission of slave ancestry, and I highlight them to introduce this paper for three reasons. First, such statements are not uncommon in these villages. Many villagers told stories of lost or stolen ancestors, forced labor for “nobles,” and slave ancestry. Second, much of the recent scholarship addressing slavery elsewhere in Madagascar has suggested that slavery is not easily discussed among contemporary residents of this Indian Ocean island. Thus, the fact that the people among whom I studied readily acknowledged their own slave descent by referring to their “lost” or “stolen” grandparents or to their own Makoa identity prompts further comparative inquiry. What factors explain acceptance of slave ancestry among some Malagasy and its concurrent stigmatization among others? Third, examination of variations in Madagascar's responses to slavery can lead us to new insights into the forms of identity and opportunity in other post-slave societies.

Demands on contemporary residence by user's building behaviors of dependents houses in Tachikawa

Demands on contemporary residence by user's building behaviors of dependents houses in Tachikawa

Planning a Wilderness: Regenerating the Great Lakes Cutover Region

One of the least appreciated and most distinctive regions in the United States is the broad arc of land that reaches from the northern portion of Michigan's Lower Peninsula across the Upper Peninsula and northern Wisconsin to northwestern Minnesota. This region, which covers more than fifty-seven million acres and is divided into eighty-six different counties, is known to contemporary residents of the Midwest as “the north woods.” But for the handful of historians who have investigated the region's past it is known as the Great Lakes Cut-over Region. As James Kates has demonstrated in his fine new study, the “cutover region” was the cultural invention of a group of elite writers and scientists in order to manage the devastated forestlands of the upper Great Lakes. Between 1900 and 1939 foresters, novelists, and land economists waged a war of words to move the American public from its commitment to pioneer individualism to the embrace of a collective, scientific management of the region. While remaining centered on the particular challenges of the region, Kates skillfully presents this story within the context of the national growth of the conservation movement. This is a genuine contribution to environmental history.

Mirrors and Metaphors: Contemporary Narratives of the Wolf in Minnesota

This article serves as a case study of how contemporary residents of the Upper Great Lakes states debate the ethics and meanings of living with wolves. An overview of the challenges facing Minnesota wolf management is provided, and the results of a Q-methodology study are presented. The study revealed three primary factors, or shared belief systems, about wolf management in Minnesota. The idealist perspective tells a redemption story of sin and atonement, the institutional perspective endorses scientific management and rationality and the localist perspective promises justice, respect and acknowledgement for its champions. The factors are interpreted as narratives or latent myths that provide a set of tacit directions to its adherents about understanding the complexities of living among carnivores. The intricacies and unique logic of each of the three factors are discussed, and themes of consensus and disagreement are briefly highlighted.

Ferromanganese phases and the chemistry of contemporary seawater

We report on a correlation between oceanic residence times of chemical elements and their enrichment in marine ferromanganese deposits. When a logarithmic plot of oceanic residence time vs. atomic number is placed above a similar plot of enrichment factor vs. atomic number, the plots exhibit a clear mirror image relationship. We suggest that this relationship is not accidental, but rather implies an important role for ferromanganese phases in the regulation of seawater chemistry, especially the residence times of the minor elements. The formation of ferromanganese phases, as nodules, crusts, particles and coatings on pelagic clays, is dependent upon oxic seawater conditions similar to those existing today. The absence of oxic conditions throughout much of geologic time insures that ferromanganese minerals would have been rare or nonexistent sedimentary deposits. If these phases are as important as contemporary residence time correlations suggest, the minor element chemistry of earlier oceans must have been radically different from that of the present. Moreover, in times of deep water stagnation over the Phanerozic, conditions would have been thermodynamically unsuitable for ferromanganese mineral formation and hence suitable for the accumulation of high concentrations of certain toxic metals. We suggest that metal poisoning resulting from deep water turnover may have contributed to some of the great marine extinctions occurring over Phanerozoic Time.

Perspectives of a cardiac surgery resident in-training on off-pump coronary bypass operation

Background. Contemporary residency training in the cardiac component of cardiothoracic operation is focused mainly on attaining technical proficiency in coronary artery revascularization. Most trainees in cardiothoracic operation are required to perform 35 cases of coronary revascularization in order to fulfill the minimum requirements for certification by the American Board of Thoracic Surgery. Although experience in minimally invasive coronary revascularization is not required for board certification in cardiothoracic operation, it is recognized by both trainees and program directors as an important component of contemporary training in less-invasive surgical approaches (LISA) for coronary artery disease. The objective of this study was to describe the training of residents in off-pump coronary revascularization in an accredited training program.Methods. A retrospective analysis of a single resident’s experience in minimally invasive coronary revascularization over an 18 month period in a 2-year residency program in cardiothoracic operation was carried out.Results. Of the 166 total cases of coronary bypass operation, the resident performed 61 cases (37% of the total) off-pump as primary surgeon with attending supervision. Patients undergoing off-pump coronary bypass had an average of 2.4 grafts (range 1 to 5) and conventional coronary artery surgeon (on cardiopulmonary bypass) performed by the resident had an average of 4 grafts (range 2 to 5). The marginal/circumflex system was bypassed in patients that required revascularization of the marginal/circumflex system, which was 56% (n = 36 of 62) in the off-pump group and 90% for the conventional group using cardiopulmonary bypass. The conversion rate from off-pump technique to conventional coronary bypass using cardiopulmonary bypass was 3.2% in this series.Conclusions. Technical innovations and evolution of techniques to better stabilize the heart for off-pump coronary revascularization have made the procedure both effective and safe. Our experience has shown that cardiothoracic residents can be taught the skills necessary to perform coronary revascularization off cardiopulmonary bypass. There are currently no standards for the training of cardiothoracic residents in off-pump coronary artery operation. We propose that at least 50 cases be performed under supervision by a trained surgeon to obtain adequate credentials in minimally invasive coronary revascularization.

An epidemic of tuberculosis with a high rate of tuberculin anergy among a population previously unexposed to tuberculosis, the Yanomami Indians of the Brazilian Amazon.

A survey of an emerging tuberculosis epidemic among the Yanomami Indians of the Amazonian rain forest provided a unique opportunity to study the impact of tuberculosis on a population isolated from contact with the tubercle bacillus for millennia until the mid-1960s. Within the Yanomami population, an extraordinary high prevalence of active tuberculosis (6.4% of 625 individuals clinically examined) was observed, indicating a high susceptibility to disease, even among bacille Calmette-Guérin-vaccinated individuals. Observational studies on cell-mediated and humoral immune responses of the Yanomami Indians compared with contemporary residents of the region suggest profound differences in immunological responsiveness to Mycobacterium tuberculosis infection. Among the Yanomami, a very high prevalence of tuberculin skin test anergy was found. Of patients with active tuberculosis, 46% had purified protein derivative of tuberculosis reactions <10 mm; similarly 58% of recent bacillus Calmette-Guérin vaccines exhibited skin test reactions <5 mm. The Yanomami also had higher titers of antibodies against M. tuberculosis glycolipid antigens (>70%) than the control subjects comprised of Brazilians of European descent (14%). The antibodies were mostly of the IgM isotype. Among the tuberculosis patients who also produced IgG antibodies, the titers of IgG4 were significantly higher among the Yanomami than in the control population. Although it was not possible to analyze T-cell responses or patterns of lymphokine production in vitro because of the remoteness of the villages from laboratory facilities, the results suggest that the first encounter of the Yanomami Indian population with tuberculosis engenders a diminished cell-mediated immune response and an increased production antibody responses, relative to other populations with extensive previous contact with the pathogen. These findings suggest that tuberculosis may represent a powerful selective pressure on human evolution that over centuries has shaped the nature of human immune responses to infection.

Thermal performance of two technically similar super-insulated residences located at 61°N and 41°N latitude

Two super-insulated contemporary residences constructed in 1992 in different climatic regions had the same designer, followed the recommendations of the Alaska Craftsman Home Program and have identical envelope details. One located on a mountainside in Anchorage, AK, has a 180 m 2 floor area and 6100 °C heating degree-day winters while the other with 128 m 2 is in Lebanon, CT, with 3400 °C degree-days. The walls are 29 cm thick ( R=7.2 m 2K/W) and insulation in the roof is 61 cm thick ( R=13.2). Wall construction minimizes thermal bridging and includes a vapor barrier and a polyester fabric air barrier. The Alaskan residence has floor heating while the Connecticut house has baseboard heating, supplied from gas and oil-fired boilers respectively. Both houses have mechanical ventilation with heat recovery and substantial window areas on the south sides for solar heating assistance. The energy consumption normalized for area and weather differences is about 30% less for the Alaskan house. About half of this difference is due to a less-efficient boiler, a quarter to the proportionately smaller roof and the remainder to increased air leakage of a fireplace and additional entrances of the Connecticut house. The Alaskan residence won the 1992 Governor's Award for Excellence in Energy Efficient Design.

?Making? history: The Vikings in the American Heartland

In a field near Sauk Centre, Minnesota rests a large, concentric shaped boulder measuring roughly 27 feet long by 17 feet wide.* The rock bears two sets of holes, a pair drilled horizontally into one end of the rounded interior of the crescent and two more drilled vertically into the top at the other end. When the rock was first found in 1943, many local residents naturally wondered at the origin and purpose of the holes. They finally decided that the horizontal holes were intended to hold sticks to support an altar shelf and that sticks were inserted into the vertical holes to support a protective canopy extending over the altar. In this fashion, they concluded, the rock was used as a place of worship by 14th Century Viking explorers. Such a conjecture is not nearly as fanciful as it might at first appear, for the Sauk Centre Altar Rock (as it is now known) fits neatly into the taken-for-granted assumptions about regional pre? history that are held by many contemporary residents of Minnesota and the eastern Dakotas. Disputing the conventional scholarly view that the Viking presence in North America was limited to the coast of Newfoundland in Canada, many people in the region are con? vinced that Vikings explored and even settled widely throughout the area as early as the mid-1300s. This is a regionally pervasive and often intensely held belief that sometimes borders on religious commitment. For example, in a 1963 poll taken by the Minneapolis Tribune, some 60% of those contacted indicated their belief that Vikings were Minnesota's first European visitors. Although no subsequent polls have been taken, the level of popular belief certainly remains quite high. Local newspaper stories and letters to the editor routinely offer favorable accounts of the Viking presence;1 a considerable number of books and articles have

Psychiatry and the Mental Health Professionals: New Roles for Changing Times. By the Group for the Advancement of Psychiatry, Committee on Governmental Agencies. (Pp. 196; illustrated; $19.50 hb, $13.50 pb.) Brunner/Mazel: New York. 1987. - Teaching Psychotherapy in Contemporary Psychiatric Residency Training. By the Group the Advancement of Psychiatry, Committee on Therapy. (Pp. 72; $14.00.) Raven Press: New York. 1987.

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Lead levels in ancient and contemporary Japanese bones

During the past few centuries, lead production, consumption and emissions, to our total environment have increased remarkably. We have determined the concentrations of lead in 41 well-preserved ancient and 11 contemporary rib bones of a mature age (40-60 y), with a view of historically evaluating lead exposure in humans. The oldest Japanese bones (1000-300 B.C.) were found to contain a mean of 0.58 microgram Pb/g dry wt and a mean molar ratio of lead to calcium of 0.6 x 10(-6), compared with 4.7-5.2 x 10(-6) in the bones of the Edo era (1600-1867 A.D.) and contemporary residents in Japan. The mean molar ratios of female bones were always higher than those of male bones for each era. From this fact we may assume that facial cosmetics were one of the main routes of lead exposure among the ancient Japanese, especially those who lived during the Edo era.

Teaching Psychotherapy in Contemporary Psychiatric Residency Training: Formulated by The Committee on Therapy of the Group for the Advancement of Psychiatry (GAP). Report Number 120. New York: Brunner/Mazel. Pp 56. $9.95. 1987

Teaching Psychotherapy in Contemporary Psychiatric Residency Training: Formulated by The Committee on Therapy of the Group for the Advancement of Psychiatry (GAP). Report Number 120. New York: Brunner/Mazel. Pp 56. $9.95. 1987

Review of Teaching Psychotherapy in Contemporary Psychiatric Residency Training: Report No. 120.

Review of Teaching Psychotherapy in Contemporary Psychiatric Residency Training: Report No. 120.