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We examine the transmission of internal gravity waves through a non-uniformly stratified fluid with vertically varying background shear. To quantify wave transmission we show that the appropriate measure is the ratio of the flux of transmitted to incident pseudoenergy, T. We derive an analytic prediction of T for the trans-

BackgroundExtended duty hours for residents are associated with negative consequences. Strategies to accommodate duty hour restrictions may also have unintended impacts. To eliminate extended duty hours and potentially lessen these impacts, we developed a senior resident rotation bundle that integrates a night float system, educational sessions on sleep hygiene, an electronic handover tool, and a simulation-based medical education curriculum. The aim of this study was to assess internal medicine residents’ perceptions of the impact of the bundle on three domains: the senior residents’ wellness, ability to deliver quality health care, and medical education experience.MethodsThis prospective study compared eligible residents’ experiences (N = 67) before and after a six-month trial of the bundle at a training program in western Canada. Data was collected using an on-line survey. Pre- and post-intervention scores for the final sample (N = 50) were presented as means and compared using the t-test for paired samples.ResultsParticipants felt that most aspects of the three domains were unaffected by the introduction of the bundle. Four improved and two worsened perception shifts emerged post-intervention: less exposure to personal harm, reduced potential for medical error, more successful teaching, fewer disruptions to other rotations, increased conflicting role demands and less staff physician supervision.ConclusionsThe rotation bundle integrates components that potentially ease some of the perceived negative consequences of night float rotations and duty hour restrictions. Future areas of study should include objective measures of the three domains to validate our study participants’ perceptions.

ObjectivesTo evaluate the format, content, and effectiveness of a newly developed orientation to wellness workshop, and to explore participants’ overall perceptions.MethodsThis was a mixed methods study. Participants consisted of 47 new faculty of medicine members who attended one of the four workshops held between 2011 and 2013. Questionnaires were used to evaluate workshop characteristics (10 survey items; response scale 1=unacceptable to 7=outstanding), intention to change behavior (yes/no), and retrospective pre/post workshop self-efficacy (4 survey items; response scale 1=no confidence to 6=absolute confidence). Mean scores and standard deviations were calculated for the workshop characteristics. Pre/post workshop self-efficacy scores were compared using a Wilcoxon signed-rank test. Participants’ written qualitative feedback was coded using an inductive strategy to identify themes. ResultsThere was strong support for the workshop characteristics with mean scores entirely above 6.00 (N=42). Thirty-one of 34 respondents (91%) expressed intention to change their behavior as a result of participating in the workshop. The post workshop self-efficacy scores (N=38 respondents) increased significantly for all four items (p<0.0001) compared to pre workshop ratings. Participants perceived the key workshop elements as the evidence-based content relevant to academic physicians, incorporation of practical tips and strategies, and an atmosphere conducive to discussion and experience sharing. Conclusions  Participants welcomed wellness as a focus of faculty development. Enhancing instruction around wellness has the potential to contribute positively to the professional competency and overall functioning of faculty of medicine members.

BackgroundA meta-analysis suggested the use of rosiglitazone was associated with an increased risk for cardiovascular (CV) events. Rosiglitazone remained available for use as more definitive safety trials were ongoing. This issue was reported in the lay media.ObjectiveTo review lay media articles to determine the extent of media coverage, the nature of the messaging, and to assess the quality of reporting.MethodsThe Factiva media database was used to identify articles published between May 18 and August 31, 2007. Two reviewers (a lay person and a physician) screened full text articles for eligibility, appraised the articles for their tone (worrisome, neutral, not worrisome), and for the quality of medical data reporting.ResultsThe search identified 156 articles, 95 of which were eligible for our review. Agreement between the lay and medical reviewers in the appraisal of the article tone was 67.4%. Among those with agreement, the articles were often appraised as "worrisome" (75.3%). Among those with disagreement, the lay reviewer was significantly more likely to appraise articles as worrisome compared to the medical reviewer (77.4% vs. 3.2%, X2 = 9.11, P = 0.003). Cardiovascular risk was discussed in 91.6% of the articles, but risk was often reported in qualitative or relative terms.ConclusionThere were many lay media articles addressing the safety of rosiglitazone, and the general messaging of these articles was considered "worrisome" by reviewers. Quality of risk reporting in the articles reviewed was poor. The impact of such media coverage on public anxiety and confidence in treatment should be explored.