Identification Of Categories Research Articles

A novel method for intelligent fault diagnosis of rolling bearings using ensemble deep auto-encoders

Abstract Automatic and accurate identification of rolling bearings fault categories, especially for the fault severities and fault orientations, is still a major challenge in rotating machinery fault diagnosis. In this paper, a novel method called ensemble deep auto-encoders (EDAEs) is proposed for intelligent fault diagnosis of rolling bearings. Firstly, different activation functions are employed as the hidden functions to design a series of auto-encoders (AEs) with different characteristics. Secondly, EDAEs are constructed with various auto-encoders for unsupervised feature learning from the measured vibration signals. Finally, a combination strategy is designed to ensure accurate and stable diagnosis results. The proposed method is applied to analyze the experimental bearing vibration signals. The results confirm that the proposed method can get rid of the dependence on manual feature extraction and overcome the limitations of individual deep learning models, which is more effective than the existing intelligent diagnosis methods.

Colombia, Brasil, Argentina y Chile: práctica educativa y orientaciones pedagógicas

El presente artículo discute aspectos de la Práctica Educativa en cuatro universidades oficiales, o del estado, en: Colombia, Brasil, Argentina, y Chile y está en relación con las orientaciones pedagógicas propuestas por Feiman (1990) e Imbernon (2007). El enfoque de la investigación es cualitativo y busca comprender aspectos intrínsecos, regionales, culturales, y políticos de la práctica educativa relacionada con orientaciones pedagógicas, mediante un proceso de preanálisis fluctuante de la información, la codificación e identificación de categorías, y finalmente la descripción, categorización, inferencia e interpretación de la información recogida. En los resultados se evidencia que las orientaciones pedagógicas convergen en la acción, la reflexión, el conocimiento, el uso de las Tecnologías digitales de información y comunicación, y en el desarrollo de la identidad docente. Conclusiones principales: las orientaciones pedagógicas predominantes en la práctica educativa oficial son la académica y la tecnicista, y en las universidades son la tradicional, académica, de eficacia social, hermenéutica y la centrada en procesos. ______________________ Contextualización: Idioma Maya Sakapulteko Contextualizadora: Delfina Arcón Puzul Ministerio de Educación de Guatemala TUNB’AAL TZ’IIJ: E jun wuuj ri ki ch’aw purwe’ ri b’anb’aal tujneem chapam kijab’ namaq taq tub’aal aj choq’on li tinimiit, re: Colombia, Brasil, Argentina, saqara’ Chile, kikan ri pixb’aneem purwe’ tujneem kirya’ Feiman (1990) richb’iil Imbernon (2007). E ri b’eey jun jyneem ri kiril ri b’anb’aal ki k’aslemaal saqara’ kirjiij ri ch’abik riij chetaq junam rib’anik ramaal jun jupuq tinimiit ri, kib’anb’aal purwe’ tujneem chapam jun kyaj pixb’aneem re ri b’anik tujneem, rmaal jun b’anb’aal re ri chomxiik riij li tzujneem, xaqara’ re karaq taj riij ru utzilaal, xaqara’ ki k’istaj kan otz laj rib’ixik, ru utzilaal, xaqara’ ri chomxik riij li chomneem raqtajek. Chapam li chomneem ri kiltaj chapam che li b’ananeem re tujneem kikiraqkib’ chapam li chaak, chapam li chomb’aal, chapam ri kojik ch’ich’ re jyb’aal chomneem xaqara’ tzujneem, xaqara’ kiltaj chapaam ri b’antajiik li tujneel. Namaq taq k’isb’aneem: Jun kyaj pixb’aneem purwe’ tujneem chapam tujb’aal re tinmiit, el li ka k’amb’ik chapam pi tujb’aal, taq tanaj, xaqara’ chapam li namaq taq tujb’aal kab’an chapam ri b’anab’aal re ajar taq tziij, pa tanaj xaqara’, re utzilaal re winaqiil, xaqara’ kirb’aj ri b’anab’aa’l. Retaal tz’iij: Chak pur we’ li Tujneel, Tujneem re Tujneel, B’ananeem-Tujneel, Ru b’antajiik re Tujneel.

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OBJECTIVES/SPECIFIC AIMS: Translational science supports the continuum of activities from early-stage bench research to implementation of discoveries for better and faster treatments to more patients. Past studies have attempted to clarify our understanding of the spectrum of translational research by categorizing the activities into stages ranging from T0 to T4 using explanatory definitions. Unfortunately, this approach is often vague and relies on a process of manual classification and binning of research publications into predetermined categories. This study aims to provide a big-picture analysis of clinical and translational science (CTS) based on an in-depth analysis of the entire corpus of publications resulting from research funded by Clinical and Translational Science Awards (CTSA) U54 awards (through 2016). METHODS/STUDY POPULATION: We harvested bibliographic metadata from all papers that cited any of the U54 award numbers since the inception of the CTSA program to the most recent award announcement. Natural language processing techniques were used to create term co-occurrence networks based on English-language textual data. Relevant and nonrelevant terms were distinguished algorithmically and processed accordingly to provide the clustered visualization. RESULTS/ANTICIPATED RESULTS: With this approach, we uncovered 6 natural clustered areas of emphasis of published CTS research, the evolution of specific concepts through time, and gained a better understanding of their relative impact as demonstrated by citations. We performed additional analyses including discipline-specific impact assessment; identification of categories of excellence relating to both productivity and citations; characteristics of collaborative networks such as organizational, industry, and international collaborations and network dynamics; and resulting global impact of the CTSA program. DISCUSSION/SIGNIFICANCE OF IMPACT: Ultimately we gained a clearer understanding of the CTSA program, its evolution through scholarly publications, and key areas of impact of the program using computational, data-driven evaluation methods.

Identification of beef cattle categories (cows and calves) and sex based on the near infrared reflectance spectroscopy of their tail hair

Near infrared (NIR) reflectance spectroscopy combined with chemometrics was used to classify tail hair samples from animals of the same breed of cattle (Brahman) into cow or calf and into male or female animals. Tail hair samples (n = 74) were scanned in the NIR region (680–2500 nm) using a fibre optic probe attached to an instrument operating in reflectance mode. Principal component analysis (PCA), and partial least squares discriminant analysis (PLS-DA) were then used to classify the samples according to their origin or sex. Full cross validation (leave-one-out) was used as the validation method when classification models were developed. Correct classification rates of 92% for cow and 100% for calf samples were obtained using PLS-DA. These results demonstrated the ability of NIR spectroscopy to discriminate between the animal categories and sex of animals. Further studies will be carried out to validate the methodology in various categories of beef cattle.

Identification of categories of liquid sounds.

Sounds involving liquid sources are part of everyday life. They form a category of sounds easily identified by human listeners in different experimental studies. Unlike acoustic models that focus on bubble vibrations, real life instances of liquid sounds, such as sounds produced by liquids with or without other materials, are very diverse and include water drop sounds, noisy flows, and even solid vibrations. The process that allows listeners to group these different sounds in the same category remains unclear. This article presents a perceptual experiment based on a sorting task of liquid sounds from a household environment. It seeks to reveal the cognitive subcategories of this set of sounds. The clarification of this perceptive process led to the observation of similarities between the perception of liquid sounds and other categories of environmental sounds. Furthermore, the results provide a taxonomy of liquid sounds on which an acoustic analysis was performed that highlights the acoustical properties of the categories, including different rates of air bubble vibration.

Prerequisites and obstacles for application of the concept of high conservation value forests in Armenia

Abstract The concept of high conservation value forests (HCVF) was proposed by the Forest Stewardship Council to maintain and protect high conservation values in forests. There are six internationally agreed categories of HCVFs and criteria for their identification. Draft national classification and criteria for identification of HCVFs in Armenia were developed in 2016. Their application to the forests in Armenia can identify forest areas with respective values as the basis for defining specific management actions to maintain or protect identified values. The analysis of existing information on forest biodiversity, ecosystems and national framework revealed a number of prerequisites and obstacles for application of the concept at national level in Armenia. There are good prerequisites for identification of respective categories of HCVFs in Armenia as the basis for their protection. The main obstacles need to be solved to apply the concept at national level and protect the forests with high conservation values in Armenia.

Identification of Load Categories in Rotor System Based on Vibration Analysis.

Rotating machinery is often subjected to variable loads during operation. Thus, monitoring and identifying different load types is important. Here, five typical load types have been qualitatively studied for a rotor system. A novel load category identification method for rotor system based on vibration signals is proposed. This method is a combination of ensemble empirical mode decomposition (EEMD), energy feature extraction, and back propagation (BP) neural network. A dedicated load identification test bench for rotor system was developed. According to loads characteristics and test conditions, an experimental plan was formulated, and loading tests for five loads were conducted. Corresponding vibration signals of the rotor system were collected for each load condition via eddy current displacement sensor. Signals were reconstructed using EEMD, and then features were extracted followed by energy calculations. Finally, characteristics were input to the BP neural network, to identify different load types. Comparison and analysis of identifying data and test data revealed a general identification rate of 94.54%, achieving high identification accuracy and good robustness. This shows that the proposed method is feasible. Due to reliable and experimentally validated theoretical results, this method can be applied to load identification and fault diagnosis for rotor equipment used in engineering applications.

The identification and analysis of making-do waste: insights from two Brazilian construction sites

Abstract Making-do has been pointed out as an important category of waste in the construction industry. It refers to a situation in which a task starts or continues without having available all the inputs required for its completion, such as materials, machinery, tools, personnel, external conditions, and information. By contrast, the literature points out that improvisation is a ubiquitous human practice even in highly structured business organizations, and plays an important role when rules and methods fail. The aim of this paper is to provide some insights on the nature of making-do as a type of waste, based on two exploratory case studies carried out on construction sites. The main contributions of this research work are concerned with the identification of different categories of making-do and its main causes. This paper also discusses some strategies for reducing making-do on construction sites.

Opioid Abuse: A Detailed Examination of Cost Drivers over a 24-Month Follow-up Period.

Previous work has documented the considerable economic burden associated with opioid abuse, dependence, and overdose/poisoning (hereafter, "abuse"). Recent analyses have provided insights into the trajectory and drivers of the excess costs of abuse both before and after diagnosis, showing the important role of other substance abuse, mental health issues, and painful conditions. To build on the recently published study by Kirson et al. (2017) and extend its findings by (a) evaluating the trajectory of excess costs of abuse for an additional year after an incident abuse diagnosis and (b) exploring the diagnosis-level drivers of excess costs over time in greater detail. Using administrative medical and pharmacy claims, which included payment amounts, for beneficiaries covered by large self-insured companies throughout the United States, abusers were matched to controls using the same methods as in Kirson et al. Excess health care costs were assessed over a 24-month follow-up period, which comprised the 6 months before the initial abuse diagnosis and the 18 months after. Drivers of excess costs were then evaluated by diagnosis (grouped at the 3-digit ICD-9-CM level). This study analyzed 9,345 matched pairs of abusers and non-abusers. Similar to the previous study, mean per-patient excess health care costs were found to rise considerably leading up to and shortly after the incident diagnosis of abuse, reaching $15,764 over the first half of the follow-up period. Over the newly extended follow-up period (months 6 to 18 after diagnosis), excess costs remained elevated ($7,346) and did not return to baseline levels. Over time, an increasing share of excess costs was observed for outpatient services and prescription drug use, relative to acute care settings. A detailed examination of cost drivers suggested elevated costs in several clinical categories (e.g., gastrointestinal, respiratory conditions) beyond those previously identified. This research finds that the excess medical costs of abuse extend for at least 1 more year than previously documented, reflecting the need for considerable follow-up care over time. The identification of several other clinical categories with elevated excess costs suggests important areas for future research into the interaction of opioid abuse with the management of other conditions. This study was funded by Purdue Pharma. Howard was an employee of Purdue Pharma at the time that this study was conducted. Kirson, Scarpati, Jia, and Wen are employees of Analysis Group, which received funding from Purdue Pharma to conduct this study. Study concept and design were contributed by Kirson, Scarpati, and Howard, along with Jia and Wen. Jia and Wen took the lead in data collection, with assistance from Scarpati and Kirson. Data interpretation was performed by Scarpati, Kirson, and Howard, with assistance from Jia and Wen. The manuscript was written and revised by Scarpati, Kirson, and Howard.

Identification of intervention categories for aquatic physical therapy in pediatrics using the International Classification of Functioning, Disability and Health-Children and Youth: a global expert survey

ObjectiveTo identify intervention categories encountered by physical therapists working in aquatic therapy with disabled children, using the International Classification of Functioning, Disability and Health-Children and Youth (ICF-CY). MethodsAquatic physical therapists were asked to describe concepts related to the functioning of disabled children and their contextual factors. Data were collected in three rounds using the Delphi technique. All answers were translated (‘linked’) to the ICF-CY and analyzed to determine the degree of consensus. ResultsAnswers were linked and organized into four diagnostic groups. Overall, in the four groups, 41 Body Functions, 8 Body Structures, 36 Activities and Participation, and 6 Environmental Factors categories were identified as intervention targets. In addition, 8 Environmental Factors that influence aquatic physical therapy were identified. ConclusionsThis study highlights the variety of intervention categories available to aquatic physical therapists when treating children in the water.

Waste in health information systems: a systematic review

PurposeThe purpose of this paper is to discuss a systematic review on waste identification related to health information systems (HIS) in Lean transformation.Design/methodology/approachA systematic review was conducted on 19 studies to evaluate Lean transformation and tools used to remove waste related to HIS in clinical settings.FindingsTen waste categories were identified, along with their relationships and applications of Lean tool types related to HIS. Different Lean tools were used at the early and final stages of Lean transformation; the tool selection depended on the waste characteristic. Nine studies reported a positive impact from Lean transformation in improving daily work processes. The selection of Lean tools should be made based on the timing, purpose and characteristics of waste to be removed.Research limitations/implicationsOverview of waste and its category within HIS and its analysis from socio-technical perspectives enabled the identification of its root cause in a holistic and rigorous manner.Practical implicationsUnderstanding waste types, their root cause and review of Lean tools could subsequently lead to the identification of mitigation approach to prevent future error occurrence.Originality/valueSpecific waste models for HIS settings are yet to be developed. Hence, the identification of the waste categories could guide future implementation of Lean transformations in HIS settings.

Scrap value stream mapping (S-VSM): a new approach to improve the supply scrap management process

In this work, an innovative methodology to improve the Supply Scrap Management Process (SSMP), based on Value Stream Mapping (VSM), is presented. VSM is one of the best tools to map a process and eliminate its critical issues, that produces good results if applied to production processes, but can be ineffective for management processes as the SSMP. Therefore, the main objective of this work is to overcome this limitation. The proposed approach taking the name Scrap Value Stream Mapping (S-VSM) and integrates concepts from VSM and other Lean Production (LP) and World Class Manufacturing tools. It is structured in five steps. The definition of the process borders and the identification of categories of loss through the first four steps of Cost Deployment is the first step. Then, the SSMP is subdivided in its Accounting and Physical Streams and the current state is drawn. Next, wastes and critical issues are analysed and their root causes are determined using some of LP tools. In step four, improvements are proposed and the future state is drawn. Furthermore, potential savings, in terms of €, are estimated. In the last step, a methodology to monitor the effects of implemented improvements is defined. A case study taken from the application of the S-VSM within automotive company is presented.

Development of cancer care episodes to measure costs for breast, colorectal, and non-small cell lung cancer.

29 Background: Cancer care costs are rising, creating concerns about affordability. As a result, delivery systems are creating alternative payment structures to lower costs while maintaining or improving quality. As cancer care delivery often involves multiple provider systems, measuring cost may be difficult. In response, using commercial insurance claims linked to cancer registry records, we constructed broadly applicable, reproducible, clinically relevant episodes to measure costs. Methods: Cancer registry records for patients diagnosed in Western Washington from January 2007-June 2016 were linked with claims from two regional commercial insurers. Patients are age 18+, diagnosed with breast, colorectal (CRC), or non-small cell lung cancer (NSCLC) and enrolled with a single insurance plan. With oncologist input, we constructed three care phases: diagnosis (30 days before diagnosis to first treatment), initial treatment (first treatment through first 4 month treatment gap), and end of life (last 30 days). Costs include all claims paid within the phase (2016 inflation adjusted). Supportive care includes colony-stimulating factors, blood transfusions, antibiotics, antivirals, antifungals, and antiemetics. Results: This study included 8,727 patients at diagnosis, 7,686 during treatment, and 1,736 at end of life. Diagnosis phase averaged 54 days and cost $6,936 (SD $11,761, median $4,021). Treatment averaged 126 days, with costs of $61,148 (SD $75,432, median $35,750). Average end-of-life costs were $15,829 (SD $30,222, median $2,347). The table below provides an example of the variation in costs during the treatment phase using local-stage tumors. Conclusions: Clinically relevant episodes of care and cost measures can be constructed using claims-registry data. This allows for identification of high-cost care categories and areas with large-cost variability, which may be helpful when designing value-based reimbursement programs or identifying areas for potential cost-reduction.[Table: see text]

Focal Segmental Glomerulosclerosis.

Focal segmental glomerulosclerosis (FSGS) is a leading cause of kidney disease worldwide. The presumed etiology of primary FSGS is a plasma factor with responsiveness to immunosuppressive therapy and a risk of recurrence after kidney transplant-important disease characteristics. In contrast, adaptive FSGS is associated with excessive nephron workload due to increased body size, reduced nephron capacity, or single glomerular hyperfiltration associated with certain diseases. Additional etiologies are now recognized as drivers of FSGS: high-penetrance genetic FSGS due to mutations in one of nearly 40 genes, virus-associated FSGS, and medication-associated FSGS. Emerging data support the identification of a sixth category: APOL1 risk allele-associated FSGS in individuals with sub-Saharan ancestry. The classification of a particular patient with FSGS relies on integration of findings from clinical history, laboratory testing, kidney biopsy, and in some patients, genetic testing. The kidney biopsy can be helpful, with clues provided by features on light microscopy (e.g, glomerular size, histologic variant of FSGS, microcystic tubular changes, and tubular hypertrophy), immunofluorescence (e.g, to rule out other primary glomerulopathies), and electron microscopy (e.g., extent of podocyte foot process effacement, podocyte microvillous transformation, and tubuloreticular inclusions). A complete assessment of renal histology is important for establishing the parenchymal setting of segmental glomerulosclerosis, distinguishing FSGS associated with one of many other glomerular diseases from the clinical-pathologic syndrome of FSGS. Genetic testing is beneficial in particular clinical settings. Identifying the etiology of FSGS guides selection of therapy and provides prognostic insight. Much progress has been made in our understanding of FSGS, but important outstanding issues remain, including the identity of the plasma factor believed to be responsible for primary FSGS, the value of routine implementation of genetic testing, and the identification of more effective and less toxic therapeutic interventions for FSGS.

Factors influencing physical therapists’ clinical reasoning: qualitative systematic review and meta-synthesis

Background: The capacity of physical therapists to reason effectively in patient management is essential to maximizing outcomes. Although conceptual frameworks of clinical reasoning exist, their theoretical foundations are insufficiently validated to establish those factors that are paramount in guiding physical therapists’ clinical reasoning. Studies on how physical therapists clinically reason constitute important means of identifying constructs of such reasoning.Objective: This systematic review aimed to synthesize and interpret the findings of qualitative studies designed to examine factors that are inherent in physical therapists’ clinical reasoning with respect to their knowledge, experiences, and practices.Methods: Searches of studies were carried out in four databases, gray literature, and reference lists. Two reviewers independently assessed methodological quality of the studies using the Critical Appraisal Skills Program (CASP) and performed the analysis: extraction and comparative appraisal of findings, identification of themes, reciprocal translation synthesis, and identification of categories and subcategories.Results: Ten studies were included. Four themes of factors influencing physical therapists’ clinical reasoning emerged, namely, Physical therapist as a source, Patient as a source, Elements of the reasoning process, and Context.Conclusions: The identified themes validated some constructs underlying existing clinical reasoning frameworks. Most influencing factors were related to the physical therapist, which highlights opportunities to improve effective reasoning at this level. The notion that this process is recurrent, multifaceted, and contextual lends itself to changing in accordance with the needs of the patient, consistent with a biopsychosocial perspective. How clinicians weigh biomedical and psychosocial elements in their reasoning however warrants further study.

"This Is How We Work Here": Informal Logic and Social Order in Primary Health Care Services in Mexico City.

People who work in health care facilities participate in a shared set of tacit agreements, attitudes, habits, and behaviors that contribute to the functioning of those institutions, but that can also cause conflict. This phenomenon has been addressed tangentially in the study of bureaucratic practices in governmental agencies, but it has not been carefully explored in the specific context of public health care centers. To this end, we analyzed a series of encounters among staff and patients, as well as the situations surrounding the services offered, in public primary care health centers in Mexico City, based on Erving Goffman's concepts of social order, encounter, and situation, and on the concepts of formal and informal logic. In a descriptive study over the course of 2 years, we carried out systematic observations in 19 health centers and conducted interviews with medical, technical, and administrative staff, and psychologists, social workers, and patients. We recorded these observations in field notes and performed reflexive analysis with readings on three different levels. Interviews were recorded, transcribed, and analyzed through identification of thematic categories and subcategories. Information related to encounters and situations from field notes and interviews was selected to triangulate the materials. We found the social order prevailing among staff to be based on a combination of status markers, such as educational level, seniority, and employee versus contractor status, which define the distribution of workloads, material resources, and space. Although this system generates conflicts, it also contributes to the smooth functioning of the health centers. The daily encounters and situations in all of these health centers allow for a set of informal practices that provide a temporary resolution of the contradictions posed by the institution for its workers.

The new frontier of diagnostics: Molecular assays and their role in infection prevention and control.

Recent advances in technology over the last decade have propelled the microbiology laboratory into a pivotal role in infection prevention and control. The rapid adaptation of molecular technologies to the field of clinical microbiology now greatly influences infectious disease management and significantly impacts infection control practices. This review discusses recent developments in molecular techniques in the diagnosis of infectious diseases. It describes the basic concepts of molecular assays, discusses their advantages and limitations, and characterizes currently available commercial assays with respect to cost, interpretive requirements, and clinical utility.

Development of an algorithm for determining smoking status and behaviour over the life course from UK electronic primary care records

BackgroundPatients’ smoking status is routinely collected by General Practitioners (GP) in UK primary health care. There is an abundance of Read codes pertaining to smoking, including those relating to smoking cessation therapy, prescription, and administration codes, in addition to the more regularly employed smoking status codes. Large databases of primary care data are increasingly used for epidemiological analysis; smoking status is an important covariate in many such analyses. However, the variable definition is rarely documented in the literature.MethodsThe Secure Anonymised Information Linkage (SAIL) databank is a repository for a national collection of person-based anonymised health and socio-economic administrative data in Wales, UK. An exploration of GP smoking status data from the SAIL databank was carried out to explore the range of codes available and how they could be used in the identification of different categories of smokers, ex-smokers and never smokers. An algorithm was developed which addresses inconsistencies and changes in smoking status recording across the life course and compared with recorded smoking status as recorded in the Welsh Health Survey (WHS), 2013 and 2014 at individual level. However, the WHS could not be regarded as a “gold standard” for validation.ResultsThere were 6836 individuals in the linked dataset. Missing data were more common in GP records (6%) than in WHS (1.1%). Our algorithm assigns ex-smoker status to 34% of never-smokers, and detects 30% more smokers than are declared in the WHS data. When distinguishing between current smokers and non-smokers, the similarity between the WHS and GP data using the nearest date of comparison was κ = 0.78. When temporal conflicts had been accounted for, the similarity was κ = 0.64, showing the importance of addressing conflicts.ConclusionsWe present an algorithm for the identification of a patient’s smoking status using GP self-reported data. We have included sufficient details to allow others to replicate this work, thus increasing the standards of documentation within this research area and assessment of smoking status in routine data.

Everything is valid in chronic pain: Interventions by older adults for pain relief

ObjectiveTo describe interventions used by older adults with benign chronic pain. MethodsQualitative study with 25 older adults with benign chronic pain, inhabitants of the cities of Medellín and Bogotá. The technique used to collect information was in-depth interview. The analysis was made using the tools of the theory based on the guidelines of Strauss and Corbin. Using open, axial and selective coding, the constant comparison method allowed the identification of categories and subcategories and simultaneously memos and diagrams were made to reach theoretical saturation. ResultsA number of categories were found in this study, suggesting interventions used by the elderly to address chronic pain. They started looking at a number of options such as: taking medication, self-prescribing, feeling fear of taking pills, identifying the damage caused by drugs, using hot water, staying still, taking right postures, walking and exercising, using attachments that help them and making home remedies; all of them become alternatives that can cause pain relief. ConclusionsThe study allowed describing interventions that older adults use to mitigate their pain. This ranged from pharmacological to non-pharmacological interventions, as simple as posture, cold, heat, massage or distractions among others, which play an important role in pain relief. Knowing these interventions helps healthcare professionals consider care options different to medication intake, proposing strategies that are easily accessible and can operate at the time to address a patient with chronic pain.

How do newly-qualified doctors perceive empathy in medical training and practice?

Objective: Evidence exists of an apparent decline in empathy during medical training which may be detrimental to patient care. This qualitative study explores the reflections of a group of newly-qualified foundation doctors with regard to empathy in medical training and practice. Methods: Doctors in a UK Foundation Training Programme were invited to reflect on the subject of empathy in medical training and practice. Researchers obtained consent to access their anonymous reflective statements and analyze for recurring themes using framework analysis. Results: Coding of 65 trainees’ reflective statements resulted in identification of two thematic categories: (i) preparedness for empathic patient care and (ii) therapeutic effect of empathy. Conclusions: Trainees are aware of the value of empathy as a therapeutic tool. Many use it instinctively but not systematically. Clinical pressures can impact negatively on empathic dealings with patients and relatives. Targeted educational interventions and positive role modeling may assist foundation doctors enhance their skills in patient-centered care.