Total Ionizing Dose Effects on TiN/Ti/HfO2/TiN Resistive Random-Access Memory Studied via Electrically Detected Magnetic Resonance.

We observe a gamma-irradiation induced change in electrically detected magnetic resonance (EDMR) in TiN/Ti/HfO2/TiN resistive random access memory (RRAM). EDMR measurements exclusively detect electrically active defects which are directly involved in the transport mechanisms within these devices. The EDMR response has an isotropic g-value of 2.001 ± 0.0003. The response increases dramatically with increased gamma-irradiation. We tentatively associate this EDMR response with spin dependent trap assisted tunneling (SDTAT) events at O 2 - centers coupled to hafnium ions. Although our study cannot fully identify the role of these defects in electronic transport, the study does unambiguously identify changes in transport defects caused by the ionizing radiation on defects involved in electronic transport in RRAM devices. This work also contributes more broadly to the RRAM field by providing direct, though incomplete, information about atomic scale defects involved in electronic transport in leading RRAM systems.

Real time exponentially weighted recursive least squares adaptive signal averaging for enhancing the sensitivity of continuous wave magnetic resonance.

This study involves the use of adaptive signal processing techniques to improve the sensitivity of continuous wave electrically detected magnetic resonance. The approach should be of widespread utility in continuous wave magnetic resonance experiments of all kinds. We utilize adaptive signal averaging to expedite the averaging process usually performed in magnetic resonance experiments. We were capable of reducing the noise variance in a single trace by a factor of 11.3 which is equivalent to reduction in time by the same factor. This factor can be quite significant especially when signal averaging must be performed over the span of many hours to days. This technique may also be tailored to conventional electron spin resonance experiments and other techniques where signal averaging is utilized. The approach may offer promise in the eventual development of spin based quantum computing.

Predictors of psychosocial teaching styles in a family practice residency program.

BACKGROUND AND OBJECTIVES: Although physician clinical precepting has been extensively studied, little information exists about the teaching styles of behavioral science faculty. This study investigated group characteristics associated with two styles of teaching--authoritative and collaborative--used by behavioral science faculty in a family practice residency training program. METHODS: A 6-year retrospective study was conducted with 89 family practice residents and 1,228 patients. Unstructured written comments about direct observation of resident-patient encounters in a family practice clinic were coded using a combination of qualitative and quantitative approaches, then analyzed in relationship to variables such as gender perceived resident ability and level of training, ethnicity of patient, and severity of patient diagnosis. RESULTS: Overall, behavioral scientists used twice as many collaborative as authoritative teaching comments. Male behavioral scientists used more authoritative comments than did female behavioral scientists. First-year residents and female residents received more teaching generally than did their more-experienced and male counterparts. Perceived global performance of resident and severity of patient diagnosis were also related to teaching style. CONCLUSIONS: Behavioral science faculty should consider that group characteristics of teachers, residents, and patients may influence teaching style.

Family practice residency behavioral science training: influence on graduate practice activity.

BACKGROUND AND OBJECTIVES: The educational efficacy of family practice residency behavioral science training and how various educational approaches might influence graduate practice activity are poorly understood. In this study, we compare a traditional didactic and clinical block rotation approach to a problem-based learning (PBL) and clinical, experiential behavioral science curriculum. METHODS: Surveys of pre- and post-intervention cohorts were used to assess graduates' perceptions of their understanding of broad behavioral science concepts, their competence to manage specific behavioral conditions, and their behavioral science practice activity. The two cohorts were University of California, Irvine family practice residency program graduates from 1984-1988 (58) and residency graduates from 1993-1995 (27). American Board of Family Practice (ABFP) In-service Training Examination scores were also compared. RESULTS: No significant differences were detected in self-perceived competence and ABFP examination performance. Residency graduates in the post-intervention cohort more often included depression, marital counseling, and eating disorders in their practice and reported more frequent practice activity for situational stress and sexual dysfunction. The post-intervention group reported less involvement with alcohol and substance abuse problems. This group also reported practice activity that exceeded perceived levels of competence for attention deficit disorder, learning disorders, and eating disorders. CONCLUSIONS: Participants in a PBL-clinical experiential curriculum reported higher levels of practice activity for several common behavioral problems. It seems unlikely that these differences were due to curriculum changes. Further investigation of the influence of educational and other factors on residency graduate practice activity is needed.

Family medicine in a culturally diverse world: a solution-oriented approach to common cross-cultural problems in medical encounters.

BACKGROUND: Using cultural sensitivity in the training of family practice residents generally results in positive consequences for patient care. However, certain potential problems associated with cross-cultural educational efforts deserve examination, including patient stereotyping, assumptive bias, and the confounding of ethnicity with class and socioeconomic status. Even awareness of these pitfalls may not guarantee physician avoidance of other barriers to effective patient care, such as communication difficulties, diagnostic inaccuracies, and unintentional patient exploitation. Despite these complications, future family physicians must continue to participate in educational activities that increase sensitivity toward and understanding of patients of different ethnicities. This article discusses certain features characteristic of the ways in which cultural variables operate in the doctor-patient encounter and identifies specific ways in which residents can successfully elicit and use cultural knowledge to enhance patient care.

Ethnogeriatric assessment clinic in family medicine.

BACKGROUND: The Department of Family Medicine at the University of California-Irvine needed a way to teach resident physicians care of ethnic elders and to provide specific training experiences in the use of geriatric assessment tools. The development of the ethnogeriatric assessment clinic presented the opportunity to do both. PROGRAM DESCRIPTION: The clinic is part of a cross-cultural geriatrics curriculum spanning the 3-year residency program that includes didactic learning, clinical experience, and a research project. Residents learn the drawbacks of working with translators, use of validated assessment tools, integration of assessment into practice, how home visits contribute unique information, and research aspects of health care of various ethnic groups. PROGRAM EVALUATION: Residents surveyed about their experience in the clinical and rotation uniformly felt it contributed to their knowledge base. Patients surveyed felt they benefited from the evaluation, especially from reassurance about their condition and information about community services. DISCUSSION: Developing the ethnogeriatric assessment clinic has benefited the family practice residents and patients, and it has helped address cross-cultural and geriatric issues for an expanding minority population.

Psychosocial performance of family physicians.

This study surveyed 30 residency-trained family physicians all currently in practice to determine the nature of their psychosocial interactions with patients. In general, respondents were satisfied with the quality of their psychosocial training in residency and generally evaluated their competency on a range of psychosocial skills as adequate to excellent. Physician psychosocial competency was most strongly related to residency, but not to postresidency, behavioral science training or to psychosocial screening practices. Frequency of performing psychosocial behaviors was also related to behavioral science training, as well as to length of time in practice. Neither frequency nor self-perceived competency related to physician age, gender, patient volume, or type of practice.

Working with the resident in difficulty.

The resident in difficulty is an omnipresent and seemingly intractable problem. Some definitions of this concept are explored, as are means and methods of problem identification. Principles of successful intervention are discussed, as well as some obstacles to successful intervention. Utilization of interpersonal process recall, behavioral techniques, and a more insight-oriented approach in the remediation process are emphasized. The role of the faculty in responding to the resident in difficulty is explored, with special consideration to pitfalls and possibilities. The article concludes with a series of questions and directions for future exploration.