How to succeed as a junior doctor.

PubMed

Azad, Michael

2016-10-01

The Royal College of Physicians (RCP) organised an inaugural 1-day conference, the aim of which was to look into some of the key issues that junior doctors need to address when beginning their careers. The target audience was medical students but a few foundation doctors were also in attendance. The conference also helped to increase RCP engagement with medical students and foundation doctors. The day was co-chaired by Professor Kate Thomas (vice dean, University of Birmingham) and Dr Andrew Macleod and Dr Kanwaljit Sandhu (RCP regional advisors for the West Midlands). © Royal College of Physicians 2016. All rights reserved.

How doctors' communication style and race concordance influence African-Caribbean patients when disclosing depression.

PubMed

Adams, A; Realpe, A; Vail, L; Buckingham, C D; Erby, L H; Roter, D

2015-10-01

To determine the impact of doctors' communication style and doctor-patient race concordance on UK African-Caribbeans' comfort in disclosing depression. 160 African-Caribbean and 160 white British subjects, stratified by gender and history of depression, participated in simulated depression consultations with video-recorded doctors. Doctors were stratified by black or white race, gender and a high (HPC) or low patient-centred (LPC) communication style, giving a full 2×2×2 factorial design. Afterwards, participants rated aspects of doctors' communication style, their comfort in disclosing depression and treatment preferences Race concordance had no impact on African-Caribbeans' comfort in disclosing depression. However a HPC versus LPC communication style made them significantly more positive about their interactions with doctors (p=0.000), their overall comfort (p=0.003), their comfort in disclosing their emotional state (p=0.001), and about considering talking therapy (p=0.01); but less positive about considering antidepressant medication (p=0.01). Doctors' communication style was shown to be more important than patient race or race concordance in influencing African Caribbeans' depression consultation experiences. Changing doctors' communication style may help reduce disparities in depression care. Practitioners should cultivate a HPC style to make African-Caribbeans more comfortable when disclosing depression, so that it is less likely to be missed. Copyright © 2015 The Authors. Published by Elsevier Ireland Ltd.. All rights reserved.

Sex Differences in the Missing-Letter Effect: A Question of Reading or Visual-Spatial Skills?

ERIC Educational Resources Information Center

Saint-Aubin, Jean; Voyer, Daniel; Roy, Macha

2012-01-01

When readers must search for a target letter while reading a continuous text, they are more likely to miss targets in frequent function words than in less frequent content words. This missing-letter effect has been found across many languages, methodologies, and types of reading materials. Despite the ubiquity of the missing-letter effect, sex…

[Civil, criminal and ethical liability of medical doctors].

PubMed

Udelsmann, Artur

2002-01-01

In the last years doctors have been the target of a growing number of civil, criminal law suits, as well as ethical procedures. Medicine is a widely targeted career, not only owing to its inherent risks, but also owing to a mistaken approach of the Judiciary Power about the obligations of medical doctors. Decisions of the Medical Board in ethical procedures have an impact in civil and criminal justice and therefore should be followed closely. The purpose of this review is to provide a wide view from a doctor-lawyer perspective of cases involving civil, criminal liability of anesthesiologists as well as ethical procedures against them, in an effort to make them comprehensible to doctors. After a brief historical introduction civil liability foundations and legal articles are examined. Responsibilities of doctors, hospitals and health insurance providers are discussed separately, as well as reparation mechanisms. Crimes possible to occur during medical practice and respective penalties are described; the direct relationship between crime and civil reparation is demonstrated. The administrative nature of ethical procedure is described, emphasizing that the legal character of its penalties often serve as grounds for civil and criminal justice decisions. Prevention is still the best medicine. Good medical practice and a good medical-patient relationship are still the best ways to minimize lawsuits and their repercussions. Doctors should have some knowledge of juridical mechanisms in lawsuits and ethical procedures, but should not take defense initiatives without prior consultation of an attorney. Civil, criminal and ethical liability of physicians.

Spacecraft intercept guidance using zero effort miss steering

NASA Astrophysics Data System (ADS)

Newman, Brett

The suitability of proportional navigation, or an equivalent zero effort miss formulation, for spacecraft intercepts during midcourse guidance, followed by a ballistic coast to the endgame, is addressed. The problem is formulated in terms of relative motion in a general 3D framework. The proposed guidance law for the commanded thrust vector orientation consists of the sum of two terms: (1) along the line of sight unit direction and (2) along the zero effort miss component perpendicular to the line of sight and proportional to the miss itself and a guidance gain. If the guidance law is to be suitable for longer range targeting applications with significant ballistic coasting after burnout, determination of the zero effort miss must account for the different gravitational accelerations experienced by each vehicle. The proposed miss determination techniques employ approximations for the true differential gravity effect. Theoretical results are applied to a numerical engagement scenario and the resulting performance is evaluated in terms of the miss distances determined from nonlinear simulation.

Missing texture reconstruction method based on error reduction algorithm using Fourier transform magnitude estimation scheme.

PubMed

Ogawa, Takahiro; Haseyama, Miki

2013-03-01

A missing texture reconstruction method based on an error reduction (ER) algorithm, including a novel estimation scheme of Fourier transform magnitudes is presented in this brief. In our method, Fourier transform magnitude is estimated for a target patch including missing areas, and the missing intensities are estimated by retrieving its phase based on the ER algorithm. Specifically, by monitoring errors converged in the ER algorithm, known patches whose Fourier transform magnitudes are similar to that of the target patch are selected from the target image. In the second approach, the Fourier transform magnitude of the target patch is estimated from those of the selected known patches and their corresponding errors. Consequently, by using the ER algorithm, we can estimate both the Fourier transform magnitudes and phases to reconstruct the missing areas.

Predicting appointment misses in hospitals using data analytics

PubMed Central

Karpagam, Sylvia; Ma, Nang Laik

2017-01-01

Background There is growing attention over the last few years about non-attendance in hospitals and its clinical and economic consequences. There have been several studies documenting the various aspects of non-attendance in hospitals. Project Predicting Appoint Misses (PAM) was started with the intention of being able to predict the type of patients that would not come for appointments after making bookings. Methods Historic hospital appointment data merged with “distance from hospital” variable was used to run Logistic Regression, Support Vector Machine and Recursive Partitioning to decide the contributing variables to missed appointments. Results Variables that are “class”, “time”, “demographics” related have an effect on the target variable, however, prediction models may not perform effectively due to very subtle influence on the target variable. Previously assumed major contributors like “age”, “distance” did not have a major effect on the target variable. Conclusions With the given data it will be very difficult to make any moderate/strong prediction of the Appointment misses. That being said with the help of the cut off we are able to capture all of the “appointment misses” in addition to also capturing the actualized appointments. PMID:28567409

Suicide In Doctors And Wives Of Doctors

PubMed Central

Sakinofsky, Isaac

1980-01-01

This paper re-examines the widespread belief that doctors have a proneness for suicide greater than the general population. The Standardized Mortality Ratio for male physicians is 335 and for single women doctors 257. Doctors' wives have an even greater risk: their SMR is 458. These rates for doctors are higher than for most other professional groups (except pharmacists) and the rate for doctors' wives far exceeds that for wives of other professionals. The intrinsic causes of the physician's high occupational mortality include his knowledge of toxicology and ready access to lethal drugs, so that impulsive suicide is more often successful. Professional stress and overwork, particularly the unrelenting responsibility for decisions upon which the lives of others may depend, have been inculpated. These stresses interact with the decline in the doctors' self-respect and with a personality that is prestige-oriented and independent. Some physicians turn in their frustration to alcohol/and or drugs, accelerating the process of deterioration. The high suicide rate in doctors' wives appears to be the result of unrequited needs for caring and dependency which the doctors' career demands and personality deny them. PMID:21293651

Suicide in doctors and wives of doctors.

PubMed

Sakinofsky, I

1980-06-01

This paper re-examines the widespread belief that doctors have a proneness for suicide greater than the general population. The Standardized Mortality Ratio for male physicians is 335 and for single women doctors 257. Doctors' wives have an even greater risk: their SMR is 458. These rates for doctors are higher than for most other professional groups (except pharmacists) and the rate for doctors' wives far exceeds that for wives of other professionals. The intrinsic causes of the physician's high occupational mortality include his knowledge of toxicology and ready access to lethal drugs, so that impulsive suicide is more often successful. Professional stress and overwork, particularly the unrelenting responsibility for decisions upon which the lives of others may depend, have been inculpated. These stresses interact with the decline in the doctors' self-respect and with a personality that is prestige-oriented and independent. Some physicians turn in their frustration to alcohol/and or drugs, accelerating the process of deterioration. The high suicide rate in doctors' wives appears to be the result of unrequited needs for caring and dependency which the doctors' career demands and personality deny them.

Outlier and target detection in aerial hyperspectral imagery: a comparison of traditional and percentage occupancy hit or miss transform techniques

NASA Astrophysics Data System (ADS)

Young, Andrew; Marshall, Stephen; Gray, Alison

2016-05-01

The use of aerial hyperspectral imagery for the purpose of remote sensing is a rapidly growing research area. Currently, targets are generally detected by looking for distinct spectral features of the objects under surveillance. For example, a camouflaged vehicle, deliberately designed to blend into background trees and grass in the visible spectrum, can be revealed using spectral features in the near-infrared spectrum. This work aims to develop improved target detection methods, using a two-stage approach, firstly by development of a physics-based atmospheric correction algorithm to convert radiance into re ectance hyperspectral image data and secondly by use of improved outlier detection techniques. In this paper the use of the Percentage Occupancy Hit or Miss Transform is explored to provide an automated method for target detection in aerial hyperspectral imagery.

More Doctors or Better Care?

PubMed Central

Watson, Diane E.; McGrail, Kimberlyn M.

2009-01-01

The Canadian Medical Association's More Doctors, More Care campaign seeks to align physician supply targets with policy decisions elsewhere in the Organisation for Economic Co-operation and Development (OECD). Using OECD data for 19 countries to assess the relationship between physician supply and healthcare outcomes, we have determined that there is no association between avoidable mortality and overall physician supply. Similarly, there is no relationship between avoidable mortality and general practitioners and family physicians per capita, specialists per capita, nurses per capita, doctors and nurses per capita or health expenditures per capita. These findings should move us to recognize that (a) more doctors will not necessarily translate into better healthcare outcomes for Canadians and (b) it is in Canadians' better interests that we instead focus on realizing opportunities to improve access to high-quality care and to ensure that changes in physician turnover do not threaten the current generalist-to-specialist mix. PMID:20676248

Missing data exploration: highlighting graphical presentation of missing pattern

PubMed Central

2015-01-01

Functions shipped with R base can fulfill many tasks of missing data handling. However, because the data volume of electronic medical record (EMR) system is always very large, more sophisticated methods may be helpful in data management. The article focuses on missing data handling by using advanced techniques. There are three types of missing data, that is, missing completely at random (MCAR), missing at random (MAR) and not missing at random (NMAR). This classification system depends on how missing values are generated. Two packages, Multivariate Imputation by Chained Equations (MICE) and Visualization and Imputation of Missing Values (VIM), provide sophisticated functions to explore missing data pattern. In particular, the VIM package is especially helpful in visual inspection of missing data. Finally, correlation analysis provides information on the dependence of missing data on other variables. Such information is useful in subsequent imputations. PMID:26807411

Missing data exploration: highlighting graphical presentation of missing pattern.

PubMed

Zhang, Zhongheng

2015-12-01

Functions shipped with R base can fulfill many tasks of missing data handling. However, because the data volume of electronic medical record (EMR) system is always very large, more sophisticated methods may be helpful in data management. The article focuses on missing data handling by using advanced techniques. There are three types of missing data, that is, missing completely at random (MCAR), missing at random (MAR) and not missing at random (NMAR). This classification system depends on how missing values are generated. Two packages, Multivariate Imputation by Chained Equations (MICE) and Visualization and Imputation of Missing Values (VIM), provide sophisticated functions to explore missing data pattern. In particular, the VIM package is especially helpful in visual inspection of missing data. Finally, correlation analysis provides information on the dependence of missing data on other variables. Such information is useful in subsequent imputations.

Masculinity in the doctor's office: Masculinity, gendered doctor preference and doctor-patient communication.

PubMed

Himmelstein, Mary S; Sanchez, Diana T

2016-03-01

Mortality and morbidity data suggest that men have shorter life expectancies than women and outrank women on several leading causes of death. These gendered disparities may be influenced by psychosocial factors like masculinity. Three studies (Total N=546) examined the role of masculinity in men's doctor choices and doctor-patient interactions. In Studies 1 and 2, men completed measures of masculinity, gender bias, and doctor preference. Using structural equation modeling, we tested the direct relationship between masculinity and male doctor preference and the indirect relationship of masculinity on male doctor preference through an association with gendered competence stereotypes. Participants in Study 3 disclosed symptoms in private followed by disclosure to a male or female interviewer in a clinical setting. Using repeated measures analysis of variance (ANOVA), we examined the interaction among symptom reporting, masculinity and doctor gender, controlling for participant comfort. In Study 1, results suggested that masculinity encouraged choice of a male doctor directly and indirectly via beliefs that men make more competent doctors than women; Study 2 directly replicated the results of Study 1. In Study 3, independent of participant comfort, an interaction between interviewer gender and masculinity emerged such that men scoring higher on masculinity reported symptoms less consistently to male interviewers (relative to higher scoring men reporting to female interviewers); the reverse was found for men scoring low on masculinity. Taken together these studies suggest that masculinity may affect men's health by encouraging choice of a male doctor with whom doctor-patient communication may be impaired. Copyright © 2015 Elsevier Inc. All rights reserved.

University strategy for doctoral training: the Ghent University Doctoral Schools.

PubMed

Bracke, N; Moens, L

2010-01-01

The Doctoral Schools at Ghent University have a three-fold mission: (1) to provide support to doctoral students during their doctoral research, (2) to foster a quality culture in (doctoral) research, (3) to promote the international and social stature and prestige of the doctorate vis-a-vis potential researchers and the potential labour market. The Doctoral Schools offer top-level specialized courses and transferable skills training to doctoral students as part of their doctoral training programme. They establish mechanisms of quality assurance in doctoral research. The Doctoral Schools initialize and support initiatives of internationalization. They also organize information sessions, promotional events and interaction with the labour market, and as such keep a finger on the pulse of external stakeholders.

Using a Treat-to-Target Management Strategy to Improve the Doctor-Patient Relationship in Inflammatory Bowel Disease.

PubMed

Rubin, David T; Krugliak Cleveland, Noa

2015-09-01

The doctor-patient relationship (DPR) in inflammatory bowel disease (IBD) has been facing new challenges, in part due to the substantial progress in medical and surgical management and also due to the rapid expansion of patient access to medical information. Not surprisingly, the complexity of IBD care and heterogeneity of the disease types may lead to conflict between a physician's therapeutic recommendations and the patient's wishes. In this commentary, we propose that the so-called "treat-to-target" approach of objective targets of disease control and serial adjustments to therapies can also strengthen the DPR in IBD by enabling defined trials of alternative approaches, followed by a more objective assessment and reconsideration of treatments. We contend that such respect for patient autonomy and the use of objective markers of disease activity improves the DPR by fostering trust and both engaging and empowering patients and physicians with the information necessary to make shared decisions about therapies.

GSimp: A Gibbs sampler based left-censored missing value imputation approach for metabolomics studies

PubMed Central

Jia, Erik; Chen, Tianlu

2018-01-01

Left-censored missing values commonly exist in targeted metabolomics datasets and can be considered as missing not at random (MNAR). Improper data processing procedures for missing values will cause adverse impacts on subsequent statistical analyses. However, few imputation methods have been developed and applied to the situation of MNAR in the field of metabolomics. Thus, a practical left-censored missing value imputation method is urgently needed. We developed an iterative Gibbs sampler based left-censored missing value imputation approach (GSimp). We compared GSimp with other three imputation methods on two real-world targeted metabolomics datasets and one simulation dataset using our imputation evaluation pipeline. The results show that GSimp outperforms other imputation methods in terms of imputation accuracy, observation distribution, univariate and multivariate analyses, and statistical sensitivity. Additionally, a parallel version of GSimp was developed for dealing with large scale metabolomics datasets. The R code for GSimp, evaluation pipeline, tutorial, real-world and simulated targeted metabolomics datasets are available at: https://github.com/WandeRum/GSimp. PMID:29385130

Hitting and missing targets by ambulance services for emergency calls: effects of different systems of performance measurement within the UK

PubMed Central

Bevan, Gwyn; Hamblin, Richard

2009-01-01

Following devolution, differences developed between UK countries in systems of measuring performance against a common target that ambulance services ought to respond to 75% of calls for what may be immediately life threatening emergencies (category A calls) within 8 minutes. Only in England was this target integral to a ranking system of ‘star rating’, which inflicted reputational damage on services that failed to hit targets, and only in England has this target been met. In other countries, the target has been missed by such large margins that services would have been publicly reported as failing, if they had been covered by the English system of star ratings. The paper argues that this case-study adds to evidence from comparisons of different systems of hospital performance measurement that, to have an effect, these systems need to be designed to inflict reputational damage on those that have performed poorly; and it explores implications of this hypothesis. The paper also asks questions about the adequacy of systems of performance measurement of ambulance services in UK countries. PMID:19381327

Unbiased clustering estimation in the presence of missing observations

NASA Astrophysics Data System (ADS)

Bianchi, Davide; Percival, Will J.

2017-11-01

In order to be efficient, spectroscopic galaxy redshift surveys do not obtain redshifts for all galaxies in the population targeted. The missing galaxies are often clustered, commonly leading to a lower proportion of successful observations in dense regions. One example is the close-pair issue for SDSS spectroscopic galaxy surveys, which have a deficit of pairs of observed galaxies with angular separation closer than the hardware limit on placing neighbouring fibres. Spatially clustered missing observations will exist in the next generations of surveys. Various schemes have previously been suggested to mitigate these effects, but none works for all situations. We argue that the solution is to link the missing galaxies to those observed with statistically equivalent clustering properties, and that the best way to do this is to rerun the targeting algorithm, varying the angular position of the observations. Provided that every pair has a non-zero probability of being observed in one realization of the algorithm, then a pair-upweighting scheme linking targets to successful observations, can correct these issues. We present such a scheme, and demonstrate its validity using realizations of an idealized simple survey strategy.

An assessment of clinical pathways and missed opportunities for the diagnosis of nodular melanoma versus superficial spreading melanoma.

PubMed

Cicchiello, Mark; Lin, Matthew J; Pan, Yan; McLean, Catriona; Kelly, John W

2016-05-01

Missed opportunities in the diagnosis of nodular melanoma (NM) carry high prognostic penalties due to the rapid rate of NM growth. To date, an assessment of the pathways to diagnosis of NM versus superficial spreading melanoma (SSM) specifically comparing numbers of opportunities missed to undertake biopsy has not been performed. A retrospective questionnaire of 120 patients (60 NM patients, age and sex matched to 60 SSM patients) from the Victorian Melanoma Service (VMS) database was undertaken to assess pathways to diagnosis. The numbers of opportunities missed to undertake a biopsy and doctor behaviour at such encounters were recorded. Diagnostic delay (overall, patient's and doctor's delay) in terms of time was assessed. Significant differences in opportunities missed to make a diagnosis of NM compared to SSM were found. In all, 43% of NM were biopsied at a first encounter compared to 70% of SSM. All SSM were diagnosed within three reviews. Overall, 33% of NM required at least three and up six reviews until biopsy. Patients with NM were more likely than those with SSM to be reassured that their lesions were benign. No significant differences in terms of time delay to diagnosis between NM and SSM were found. NM contributes disproportionately to melanoma mortality in Australia. Addressing earlier diagnosis of NM with renewed focus may make the biggest impact on the overall mortality of melanoma. The message that a period of observation is not appropriate for patients re-presenting with lesions of concern must be more effectively communicated. © 2015 The Australasian College of Dermatologists.

The Impact of the Nursing Practice Environment on Missed Nursing Care.

PubMed

Hessels, Amanda J; Flynn, Linda; Cimiotti, Jeannie P; Cadmus, Edna; Gershon, Robyn R M

2015-12-01

Missed nursing care is an emerging problem negatively impacting patient outcomes. There are gaps in our knowledge of factors associated with missed nursing care. The aim of this study was to determine the relationship between the nursing practice environment and missed nursing care in acute care hospitals. This is a secondary analysis of cross sectional data from a survey of over 7.000 nurses from 70 hospitals on workplace and process of care. Ordinary least squares and multiple regression models were constructed to examine the relationship between the nursing practice environment and missed nursing care while controlling for characteristics of nurses and hospitals. Nurses missed delivering a significant amount of necessary patient care (10-27%). Inadequate staffing and inadequate resources were the practice environment factors most strongly associated with missed nursing care events. This multi-site study examined the risk and risk factors associated with missed nursing care. Improvements targeting modifiable risk factors may reduce the risk of missed nursing care.

Age Changes in the Missing-Letter Effect Revisited

ERIC Educational Resources Information Center

Saint-Aubin, J.; Klein, R.M.; Landry, T.

2005-01-01

When participants search for a target letter while reading, they make more omissions if the target letter is embedded in frequent function words than in less frequent content words. Reflecting developmental changes in component language and literacy skills, the size of this effect increases with age. With adults, the missing-letter effect is due…

Missing persons-missing data: the need to collect antemortem dental records of missing persons.

PubMed

Blau, Soren; Hill, Anthony; Briggs, Christopher A; Cordner, Stephen M

2006-03-01

The subject of missing persons is of great concern to the community with numerous associated emotional, financial, and health costs. This paper examines the forensic medical issues raised by the delayed identification of individuals classified as "missing" and highlights the importance of including dental data in the investigation of missing persons. Focusing on Australia, the current approaches employed in missing persons investigations are outlined. Of particular significance is the fact that each of the eight Australian states and territories has its own Missing Persons Unit that operates within distinct state and territory legislation. Consequently, there is a lack of uniformity within Australia about the legal and procedural framework within which investigations of missing persons are conducted, and the interaction of that framework with coronial law procedures. One of the main investigative problems in missing persons investigations is the lack of forensic medical, particularly, odontological input. Forensic odontology has been employed in numerous cases in Australia where identity is unknown or uncertain because of remains being skeletonized, incinerated, or partly burnt. The routine employment of the forensic odontologist to assist in missing person inquiries, has however, been ignored. The failure to routinely employ forensic odontology in missing persons inquiries has resulted in numerous delays in identification. Three Australian cases are presented where the investigation of individuals whose identity was uncertain or unknown was prolonged due to the failure to utilize the appropriate (and available) dental resources. In light of the outcomes of these cases, we suggest that a national missing persons dental records database be established for future missing persons investigations. Such a database could be easily managed between a coronial system and a forensic medical institute. In Australia, a national missing persons dental records database could be

Learning needs in clinical biochemistry for doctors in foundation years.

PubMed

Khromova, Victoria; Gray, Trevor A

2008-01-01

Most medical school curricula have reduced the amount of time available for teaching in pathology despite the fact that junior staff in the early stages of their training were responsible for requesting the majority of pathology tests on acutely ill hospital patients. So, the lack of specific training in this area means that test requesting may be poorly performed and the results ill understood by these staff. This paper describes a questionnaire, which was designed to assist laboratory staff providing targeted teaching in this area. Doctors in Foundation year 1 (F1) and Foundation year 2 (F2) in Sheffield teaching hospitals were given a questionnaire to ascertain how confident they were in requesting and interpreting the results of clinical biochemistry tests. The doctors were also asked about which areas of laboratory medicine they would like to be taught. Responses were received from 82 doctors, about half those in F1 and F2. The survey revealed areas where juniors are less confident in requesting tests and interpreting results. Despite lack of confidence in interpreting the result, 18% were confident about requesting tests. Doctors were also unsure of the effects of common problems like haemolysis on the interpretation of results. More than 70% of the doctors requested specific teaching in these areas. Foundation doctors have learning needs in clinical biochemistry, addressing which would assist them in patient care. While better training in medical school may help in future, there are specific needs for those on the wards now that require targeted teaching.

Targeting safety improvements through identification of incident origination and detection in a near-miss incident learning system.

PubMed

Novak, Avrey; Nyflot, Matthew J; Ermoian, Ralph P; Jordan, Loucille E; Sponseller, Patricia A; Kane, Gabrielle M; Ford, Eric C; Zeng, Jing

2016-05-01

patient positioning and localization of the patient. Incidents were most frequently detected during treatment delivery (30%), and incidents identified at this point also had higher severity scores than other workflow areas (NMRI = 1.6). Incidents identified during on-treatment quality management were also more severe (NMRI = 1.7), and the specific process steps of reviewing portal and CBCT images tended to catch highest-severity incidents. On average, safety barriers caught 46% of all incidents, most frequently at physics chart review, therapist's chart check, and the review of portal images; however, most of the incidents that pass through a particular safety barrier are not designed to be capable of being captured at that barrier. Incident learning systems can be used to assess the most common points of error origination and detection in radiation oncology. This can help tailor safety improvement efforts and target the highest impact portions of the workflow. The most severe near-miss events tend to originate during simulation, with the most severe near-miss events detected at the time of patient treatment. Safety barriers can be improved to allow earlier detection of near-miss events.

Reducing calls missed by the hospital telephone exchange from 26% to less than 10.

PubMed

Bhartia, Saru; Bahlvi, Zorba; Sharma, Irina

2016-01-01

A hospital's telephone exchange is the first point of contact for patients and their attendants to take appointments, to collect healthcare related information and to connect to the hospital in case of emergencies. At Sitaram Bhartia Institute of Science and Research the doctors, patients, and attendants often complained about the inefficiency of the hospital exchange. In February 2012, a doctor raised her concern of calls not being picked up at the exchange with the senior management and a QI project was initiated to tackle the problem. Baseline data showed that about 26% of incoming calls to the hospital during 8am to 8pm were not being picked up. On the basis of the baseline data, call audits, staff interviews, and observations the project team identified the defects. These defects were categorized under four headings - manpower, equipment, processes, and environment. The team proposed several change ideas. Some of these change ideas were implemented immediately. Three proposed change ideas were tested through individual PDSA cycles. The percentage of missed calls dropped from 26% to 18.1% after the first cycle and then to 9.6% and 6.5% after the subsequent cycles which involved testing of two other additional change ideas. These changes were implemented and a benchmark of no more than 10% calls to be missed was set. For nearly three years we have held the gains and have met the benchmark of missing not more than 10% calls coming to the hospital exchange between 8am to 8pm. The contributing factors to the success have been the involvement of frontline workers, an expert and engaged head of department, and senior leadership support.

Follow-up of negative MRI-targeted prostate biopsies: when are we missing cancer?

PubMed

Gold, Samuel A; Hale, Graham R; Bloom, Jonathan B; Smith, Clayton P; Rayn, Kareem N; Valera, Vladimir; Wood, Bradford J; Choyke, Peter L; Turkbey, Baris; Pinto, Peter A

2018-05-21

Multiparametric magnetic resonance imaging (mpMRI) has improved clinicians' ability to detect clinically significant prostate cancer (csPCa). Combining or fusing these images with the real-time imaging of transrectal ultrasound (TRUS) allows urologists to better sample lesions with a targeted biopsy (Tbx) leading to the detection of greater rates of csPCa and decreased rates of low-risk PCa. In this review, we evaluate the technical aspects of the mpMRI-guided Tbx procedure to identify possible sources of error and provide clinical context to a negative Tbx. A literature search was conducted of possible reasons for false-negative TBx. This includes discussion on false-positive mpMRI findings, termed "PCa mimics," that may incorrectly suggest high likelihood of csPCa as well as errors during Tbx resulting in inexact image fusion or biopsy needle placement. Despite the strong negative predictive value associated with Tbx, concerns of missed disease often remain, especially with MR-visible lesions. This raises questions about what to do next after a negative Tbx result. Potential sources of error can arise from each step in the targeted biopsy process ranging from "PCa mimics" or technical errors during mpMRI acquisition to failure to properly register MRI and TRUS images on a fusion biopsy platform to technical or anatomic limits on needle placement accuracy. A better understanding of these potential pitfalls in the mpMRI-guided Tbx procedure will aid interpretation of a negative Tbx, identify areas for improving technical proficiency, and improve both physician understanding of negative Tbx and patient-management options.

[Influence of patients' attitude on doctors' satisfaction with the doctor-patient relationship].

PubMed

Xie, Zheng; Qiu, Ze-qi; Zhang, Tuo-hong

2009-04-18

To describe the doctors' satisfaction of the doctor-patient relationship and find out the influencing factors of the patients, gathering evidence to improve the doctor-patient relationship. This study was a cross-sectional study, in which doctors and nurses in 10 hospitals of Beijing, Shandong and Chongqing were surveyed with structured questionnaires and in-depth interviews. The mean score of the doctors' satisfaction of the doctor-patient relationship was 59.97, which was much lower than the patients'. The patients' socio-demographic characteristics, social economic status (SES) and behavior characteristics influence the interaction of the doctors and the patients. The doctors' satisfaction of the doctor-patient relationship was influenced by the patients' trust. The doctors' perspective is helpful to define the tension and the cause of the doctor-patient relationship. The patients' characteristics have important influence on the doctor-patient relationship. It's necessary to take action on the patients to improve the doctor-patient relationship.

Shrinkage regression-based methods for microarray missing value imputation.

PubMed

Wang, Hsiuying; Chiu, Chia-Chun; Wu, Yi-Ching; Wu, Wei-Sheng

2013-01-01

Missing values commonly occur in the microarray data, which usually contain more than 5% missing values with up to 90% of genes affected. Inaccurate missing value estimation results in reducing the power of downstream microarray data analyses. Many types of methods have been developed to estimate missing values. Among them, the regression-based methods are very popular and have been shown to perform better than the other types of methods in many testing microarray datasets. To further improve the performances of the regression-based methods, we propose shrinkage regression-based methods. Our methods take the advantage of the correlation structure in the microarray data and select similar genes for the target gene by Pearson correlation coefficients. Besides, our methods incorporate the least squares principle, utilize a shrinkage estimation approach to adjust the coefficients of the regression model, and then use the new coefficients to estimate missing values. Simulation results show that the proposed methods provide more accurate missing value estimation in six testing microarray datasets than the existing regression-based methods do. Imputation of missing values is a very important aspect of microarray data analyses because most of the downstream analyses require a complete dataset. Therefore, exploring accurate and efficient methods for estimating missing values has become an essential issue. Since our proposed shrinkage regression-based methods can provide accurate missing value estimation, they are competitive alternatives to the existing regression-based methods.

Missed connections: A case study of the social networks of physics doctoral students in a single department

NASA Astrophysics Data System (ADS)

Knaub, Alexis Victoria

, with students having more connections for the more social purposes. Students are isolated when working on their research, even in their early years. Research discussion does not occur, unless one is providing casual updates to a peer. Findings for student-faculty networks indicate that these relationships are important but complicated. Advisor selection is often done casually, even when one is switching advisors. Faculty have a lot of influence on the doctoral students such as motivating research collaborations among students or aiding in the job search. Most doctoral students feel as though there is a power dynamic that hinders them from socializing with faculty and thus, are not close to the faculty. Opportunities to develop stronger relationships and for professional development are often missed. The total number of peer and faculty ties has significant relationships to whether a student considers leaving the program. Analyzing the qualitative and quantitative data through demographic variables showed how complex these experiences are. All demographic variables indicated there are statistically significant differences in social experience among the groups, though the extent varies. The year in program variable showed the most differences among cohort years, primarily with those in the fifth year. While gender showed few differences, women tended to have more homophilous peer networks than men and women tended to have more connections to higher prestige faculty. The race/ethnicity, student type, undergraduate institute, subfield, and relationship status variables produced few statistically significant results. Peer networks have statistically significant differences in homophily when examining research type. The regression model suggests that being female, having a higher year in the program, and/or completing undergraduate studies from a liberal arts college increases the time to degree. Being in a relationship (dating or married) and/or working on experimental

Recurrent Neural Networks for Multivariate Time Series with Missing Values.

PubMed

Che, Zhengping; Purushotham, Sanjay; Cho, Kyunghyun; Sontag, David; Liu, Yan

2018-04-17

Multivariate time series data in practical applications, such as health care, geoscience, and biology, are characterized by a variety of missing values. In time series prediction and other related tasks, it has been noted that missing values and their missing patterns are often correlated with the target labels, a.k.a., informative missingness. There is very limited work on exploiting the missing patterns for effective imputation and improving prediction performance. In this paper, we develop novel deep learning models, namely GRU-D, as one of the early attempts. GRU-D is based on Gated Recurrent Unit (GRU), a state-of-the-art recurrent neural network. It takes two representations of missing patterns, i.e., masking and time interval, and effectively incorporates them into a deep model architecture so that it not only captures the long-term temporal dependencies in time series, but also utilizes the missing patterns to achieve better prediction results. Experiments of time series classification tasks on real-world clinical datasets (MIMIC-III, PhysioNet) and synthetic datasets demonstrate that our models achieve state-of-the-art performance and provide useful insights for better understanding and utilization of missing values in time series analysis.

Patient-doctor relationship: the practice orientation of doctors in Kano.

PubMed

Abiola, T; Udofia, O; Abdullahi, A T

2014-01-01

Attitude and orientation of doctors to the doctor-patient relationship has a direct influence on delivery of high quality health- care. No study to the knowledge of these researchers has so far examined the practice orientation of doctors in Nigeria to this phenomenon. The aims of this study were to determine the orientation of Kano doctors to the practice of doctor-patient relationship and physicians' related-factors. Participants were doctors working in four major hospitals (i.e., two federal-owned and two state-owned) servicing Kano State and its environs. The Patient-Practitioner Orientation Scale (PPOS) and a socio-demographic questionnaire were completed by the 214 participants. The PPOS has 18 items and measures three parameters of a total score and two dimension of "sharing" and "caring". The mean age of participants was 31.72 years (standard deviation = 0.87), with 22% being females, 40.7% have been practicing for ≥ 6 years and about two-third working in federal-owned health institution. The Cronbach's alpha of total PPOS scores was 0.733 and that of two sub-scale scores of "sharing" and "caring" were 0.659 and 0.546 respectively. Most of the doctors' orientation (92.5%) was towards doctor-centered (i.e., paternalistic) care, majority (75.2%) upheld the view of not sharing much information and control with patients, and showing little interest in psychosocial concerns of patients (i.e., 'caring'=93.0%). Respondents' characteristics that were significantly associated with high doctor 'caring' relationship orientation were being ≥ 30-year-old and practicing for ≥ 6 years. Working in State-owned hospitals was also significantly associated with high doctor "sharing" orientation. This paper demonstrated why patient-centered medical interviewing should be given top priority in medical training in Nigeria, and particularly for federal health institutions saddled with production of new doctors and further training for practicing doctors.

The doctor(s) in house: an analysis of the evolution of the television doctor-hero.

PubMed

Strauman, Elena C; Goodier, Bethany C

2011-03-01

The medical drama and its central character, the doctor-hero have been a mainstay of popular television. House M.D. offers a new (and problematic) iteration of the doctor-hero. House eschews the generic conventions of the "television doctor" by being neither the idealized television doctor of the past, nor the more recent competent but often fallible physicians in entertainment texts. Instead, his character is a fragmented text which privileges the biomedical over the personal or emotional with the ultimate goal of scientifically uncovering and resolving instances of disease. This article examines the implicit and explicit messages in House M.D. and critically analyzes both the show and its lead character in relation to the traditional medical drama genre that highlights the "doctor-hero" as the central character. While at first House seems to completely violate narrative and generic norms, ultimately the program provides a new form that reinforces the presence of the doctor-hero, but highlights House's character as the central figure who is personally and interpersonally problematic but biomedically effective.

A Simulation Study of Missing Data with Multiple Missing X's

ERIC Educational Resources Information Center

Rubright, Jonathan D.; Nandakumar, Ratna; Glutting, Joseph J.

2014-01-01

When exploring missing data techniques in a realistic scenario, the current literature is limited: most studies only consider consequences with data missing on a single variable. This simulation study compares the relative bias of two commonly used missing data techniques when data are missing on more than one variable. Factors varied include type…

A regressive methodology for estimating missing data in rainfall daily time series

NASA Astrophysics Data System (ADS)

Barca, E.; Passarella, G.

2009-04-01

The "presence" of gaps in environmental data time series represents a very common, but extremely critical problem, since it can produce biased results (Rubin, 1976). Missing data plagues almost all surveys. The problem is how to deal with missing data once it has been deemed impossible to recover the actual missing values. Apart from the amount of missing data, another issue which plays an important role in the choice of any recovery approach is the evaluation of "missingness" mechanisms. When data missing is conditioned by some other variable observed in the data set (Schafer, 1997) the mechanism is called MAR (Missing at Random). Otherwise, when the missingness mechanism depends on the actual value of the missing data, it is called NCAR (Not Missing at Random). This last is the most difficult condition to model. In the last decade interest arose in the estimation of missing data by using regression (single imputation). More recently multiple imputation has become also available, which returns a distribution of estimated values (Scheffer, 2002). In this paper an automatic methodology for estimating missing data is presented. In practice, given a gauging station affected by missing data (target station), the methodology checks the randomness of the missing data and classifies the "similarity" between the target station and the other gauging stations spread over the study area. Among different methods useful for defining the similarity degree, whose effectiveness strongly depends on the data distribution, the Spearman correlation coefficient was chosen. Once defined the similarity matrix, a suitable, nonparametric, univariate, and regressive method was applied in order to estimate missing data in the target station: the Theil method (Theil, 1950). Even though the methodology revealed to be rather reliable an improvement of the missing data estimation can be achieved by a generalization. A first possible improvement consists in extending the univariate technique to

A quality improvement project to tackle under-reporting of hazards by doctors by using an anonymous telephone hotline.

PubMed

Johnson, Sarah

2016-01-01

An anonymous hazard reporting hotline was established for doctors to use on two general medical wards at Weston General Hospital (WGH) in North Somerset in England during an eight day period in July/August 2014. Doctors were encouraged to report hazards and near misses or just start a conversation about a concern. The existing computer based significant event system remained alongside the hotline and was to be used where actual harm had come to a patient. A team of consultants and quality improvement administrators monitored the hotline on a daily basis, categorized the level of risk being reported and ensured, where possible, that action was taken to address the doctors' concerns. The hotline increased reporting rates from two per month to 25 in eight days. The system identified 13 amber (medium risk) and five red (high risk) hazards which would otherwise not have been known about. This author believes these five high risk reports alone make the case for a new, quicker, easier, and anonymous reporting system for doctors at WGH urgent and irrefutable.

Impact of missing data strategies in studies of parental employment and health: Missing items, missing waves, and missing mothers.

PubMed

Nguyen, Cattram D; Strazdins, Lyndall; Nicholson, Jan M; Cooklin, Amanda R

2018-07-01

Understanding the long-term health effects of employment - a major social determinant - on population health is best understood via longitudinal cohort studies, yet missing data (attrition, item non-response) remain a ubiquitous challenge. Additionally, and unique to the work-family context, is the intermittent participation of parents, particularly mothers, in employment, yielding 'incomplete' data. Missing data are patterned by gender and social circumstances, and the extent and nature of resulting biases are unknown. This study investigates how estimates of the association between work-family conflict and mental health depend on the use of four different approaches to missing data treatment, each of which allows for progressive inclusion of more cases in the analyses. We used 5 waves of data from 4983 mothers participating in the Longitudinal Study of Australian Children. Only 23% had completely observed work-family conflict data across all waves. Participants with and without missing data differed such that complete cases were the most advantaged group. Comparison of the missing data treatments indicate the expected narrowing of confidence intervals when more sample were included. However, impact on the estimated strength of association varied by level of exposure: At the lower levels of work-family conflict, estimates strengthened (were larger); at higher levels they weakened (were smaller). Our results suggest that inadequate handling of missing data in extant longitudinal studies of work-family conflict and mental health may have misestimated the adverse effects of work-family conflict, particularly for mothers. Considerable caution should be exercised in interpreting analyses that fail to explore and account for biases arising from missing data. Copyright © 2018. Published by Elsevier Ltd.

Choose your doctorate.

PubMed

Jolley, Jeremy

2007-02-01

The development of education options for nurses has been inexorable and it is increasingly the case that senior nurses are considering a doctorate as the logical next step in their educational career. Such individuals need to make important decisions as to whether they should embark on a taught doctorate, professional doctorate or a traditional PhD. Each of these options will necessitate a considerable investment in time and money as well as the sacrifice of quality time and spare time over a significant number of years. A doctorate is not for everyone. Those still reading this text may be asking 'could this possibly be for me'? This paper will try to help the reader decide which if any option to take. It is suggested that nurses will now turn to the doctoral degree as their next adventure in academic study. It is argued that this development is not being controlled by management forces and indeed cannot be controlled by them. This last is chiefly because the move towards doctoral education is led by individuals who choose to study for a doctorate simply because they can. The paper considers what choices are available to nurses who wish to pursue a doctoral programme of study. In particular, this paper considers what new developments in doctoral courses are becoming available and what advantage there may be in studying for one of the newer professional doctorates rather than a traditional PhD. The material here is the result of a review of the literature on recent developments in doctoral education for nurses. The existing provision by UK and other universities was also reviewed, the data being collected by an informal review of universities' advertising material. It is inevitable that some nurses who are already qualified to degree and masters degree will take advantage of the doctoral degree opportunities which now newly present themselves. For nurses in practice, the advantages of the professional doctorate is that it is more structured, enables more peer and

Introduction of a junior doctors' handbook: an essential guide for new doctors

PubMed Central

Ross, Daniella; Petrie, Claire; Tully, Vicki

2016-01-01

The transition period for new junior doctors is a daunting and challenging time, as vast amounts of information specific to each hospital, ward, and job must be learnt while maintaining patient care standards.[1] In NHS Tayside, Scotland, tips and guidance for each job are informally handed over from previous junior doctors to the next, resulting in an unreliable and unsustainable handover of information. Time must then be spent by new doctors learning the intricacies and practicalities of their new job, rather than spending time focusing on patient care. Our aim was to improve this transition period for new junior doctors to NHS Tayside through the creation and implementation of a junior doctors' handbook, which would provide information and practical advice on day to day life as a junior doctor. We hoped to implement this project by August 2015 to coincide with the arrival of these new doctors to NHS Tayside. Through repeat PDSA cycles we created a sustainable and reliable junior doctors' handbook, containing a centralised hub of information for doctors that was accessible through our health board's website. The junior doctors' handbook has been a highly beneficial resource that has been praised for its detailed information on all aspects of day to day life for doctors in NHS Tayside. Feedback also demonstrated that doctors felt the junior doctors' handbook had improved their efficiency. Our hope is that this project can continue to be developed within our hospital, but also to be used as an idea outside our health board to improve the transition period for new doctors on a wider scale. PMID:26893891

Doctor Shopping

PubMed Central

Sansone, Lori A.

2012-01-01

Doctor shopping is defined as seeing multiple treatment providers, either during a single illness episode or to procure prescription medications illicitly. According to the available literature, prevalence rates of doctor shopping vary widely, from 6.3 to 56 percent. However, this variability is partially attributable to research methodology, including the study definition of doctor shopping as well as the patient sample. The reasons for doctor shopping are varied. Some patient explanations for this phenomenon relate to clinician factors, such as inconvenient office hours or locations, long waiting times, personal characteristics or qualities of the provider, and/or insufficient communication time between the patient and clinician. Some patient explanations relate to personal factors and include both illness factors (e.g., symptom persistence, lack of understanding or nonacceptance of the diagnosis or treatment) as well as psychological factors (e.g., somatization, prescription drug-seeking). Importantly, not all doctor shopping is driven by suspect motivations. Being aware of these various patient justifications for doctor shopping is important in understanding and managing these challenging patients in the clinical setting, whether they emerge in psychiatric or primary care environments. PMID:23346518

Missing Modality Transfer Learning via Latent Low-Rank Constraint.

PubMed

Ding, Zhengming; Shao, Ming; Fu, Yun

2015-11-01

Transfer learning is usually exploited to leverage previously well-learned source domain for evaluating the unknown target domain; however, it may fail if no target data are available in the training stage. This problem arises when the data are multi-modal. For example, the target domain is in one modality, while the source domain is in another. To overcome this, we first borrow an auxiliary database with complete modalities, then consider knowledge transfer across databases and across modalities within databases simultaneously in a unified framework. The contributions are threefold: 1) a latent factor is introduced to uncover the underlying structure of the missing modality from the known data; 2) transfer learning in two directions allows the data alignment between both modalities and databases, giving rise to a very promising recovery; and 3) an efficient solution with theoretical guarantees to the proposed latent low-rank transfer learning algorithm. Comprehensive experiments on multi-modal knowledge transfer with missing target modality verify that our method can successfully inherit knowledge from both auxiliary database and source modality, and therefore significantly improve the recognition performance even when test modality is inaccessible in the training stage.

Missed opportunities for immunization.

PubMed

Verma, J; Sachar, R K; Prakash, V; Jain, G D; Sehgal, R

1990-01-01

A survey conducted in the outpatient departments of Dayanand Medical College and Hospital in Ludhiana, India, found that 13.4% of children aged 0-23 months and 33.0% of pregnant women were not being given due immunization. Maximum advantage, however, should be taken of every contact between health workers and clients to provide all available and required health interventions. 80% immunization coverage could be achieved if all children who are brought to clinics for whatever purpose were screened and immunized if necessary. Missed opportunities occur because immunization is not available on all days; there is no uniform contraindication policy; doctors schedule as they please, with only one or two vaccines given to children who are eligible for more; there is an unwillingness to combine vaccines; weak excuses prevent the administration of vaccines; due antigens are not given on discharge from hospitals following recovery; pregnancy of less than 16 weeks is supposed to be a contraindication to tetanus toxoid; there is vaccinator reluctance to open multi-dose BCG/measles vaccine vials for a small number of children for fear of wasting the vaccine; and vaccines may be out of stock. The following suggestions may help minimize missed opportunities for immunization: review of the immunization schedule to provide optimal protection at the earliest age, review of the policy on contraindications to avoid false contraindications, ensuring that all women and children receive all vaccines for which they are eligible, issuing immunization cards to all women and children and checking them on all subsequent visits, making vaccines available in all clinics, educating health care personnel on these issues, packing vaccines in smaller quantities to avoid wastage, and exploiting all contacts with the people to provide maximum health care interventions.

Targeted Treatment of Yaws With Household Contact Tracing: How Much Do We Miss?

PubMed Central

Dyson, Louise; Marks, Michael; Crook, Oliver M; Sokana, Oliver; Solomon, Anthony W; Bishop, Alex; Mabey, David C W; Hollingsworth, T Déirdre

2018-01-01

Abstract Yaws is a disabling bacterial infection found primarily in warm and humid tropical areas. The World Health Organization strategy mandates an initial round of total community treatment (TCT) with single-dose azithromycin followed either by further TCT or active case-finding and treatment of cases and their contacts (the Morges strategy). We sought to investigate the effectiveness of the Morges strategy. We employed a stochastic household model to study the transmission of infection using data collected from a pre-TCT survey conducted in the Solomon Islands. We used this model to assess the proportion of asymptomatic infections that occurred in households without active cases. This analysis indicated that targeted treatment of cases and their household contacts would miss a large fraction of asymptomatic infections (65%–100%). This fraction was actually higher at lower prevalences. Even assuming that all active cases and their households were successfully treated, our analysis demonstrated that at all prevalences present in the data set, up to 90% of (active and asymptomatic) infections would not be treated under household-based contact tracing. Mapping was undertaken as part of the study “Epidemiology of Yaws in the Solomon Islands and the Impact of a Trachoma Control Programme,” in September–October 2013. PMID:29140407

[The motivation to become a medical doctor - doctoral students in a formal academic study program compared with those pursuing their doctorate independently].

PubMed

Pfeiffer, M; Dimitriadis, K; Holzer, M; Reincke, M; Fischer, M R

2011-04-01

Weight and quality of medical doctoral theses have been discussed in Germany for years. Doctoral study programs in various graduate schools offer opportunities to improve quality of medical doctoral theses. The purpose of this study was to demonstrate distinctions and differences concerning motivation, choice of subject and the dissertation process between doctoral candidates completing the doctoral seminar for doctoral students in the Ludwig-Maximilians-University (LMU) Munich and doctoral candidates doing their doctorate individually. All 4000 medical students of the LMU obtained an online-questionnaire which was completed by 767 students (19 % response rate). The theoretical framework of this study was based upon the Self-Determination-Theory by Deci and Ryan. Doctoral candidates completing the doctoral study program were more intrinsically motivated than doctoral candidates doing their doctorate individually; no difference was found in their extrinsic motivation. In regard to choice of subject and dissertation process the doctoral students in the seminar were distinguished from the individual group by having chosen a more challenging project. They anticipated a demanding dissertation process including conference participation, publishing of papers, etc. Intrinsic motivation correlates positively with choosing a challenging project and a demanding dissertation process. High intrinsic motivation seems to be very important for autonomous scholarly practice. Our results suggest that doctoral study programs have a positive impact on intrinsic motivation and interest in research. © Georg Thieme Verlag KG Stuttgart · New York.

Doctoral Women: Managing Emotions, Managing Doctoral Studies

ERIC Educational Resources Information Center

Aitchison, Claire; Mowbray, Susan

2013-01-01

This paper explores the experiences of women doctoral students and the role of emotion during doctoral candidature. The paper draws on the concept of emotional labour to examine the two sites of emotional investment students experienced and managed during their studies: writing and family relationships. Emotion is perceived by many dominant…

MA_MISS: Mars Multispectral Imager for Subsurface Studies

NASA Astrophysics Data System (ADS)

De Sanctis, M. C.; Coradini, A.; Ammannito, E.; Boccaccini, A.; Di Iorio, T.; Battistelli, E.; Capanni, A.

2012-04-01

A Drilling system, coupled with an in situ analysis package, is installed on the ExoMars Pasteur Rover to perform in situ investigations up to 2m in the Mars soil. Ma_Miss (Mars Multispectral Imager for Subsurface Studies) is a spectrometer devoted to observe the lateral wall of the borehole generated by the Drilling system. The instrument is fully integrated with the Drill and shares its structure and electronics. For the first time in Mars exploration experiments the water/geochemical environment will be investigated as function of depth in the shallow subsurface. Samples from the subsurface of Martian soil are unaltered by weathering process, oxidation and erosion. Subsurface access can be the key to look for signs of present and past environmental conditions, associated to the possibility for life (water, volatiles and weathering process). The analysis of uncontaminated samples by means of instrumented Drill and in situ observations is the solution for unambiguous interpretation of the original environment that leading to the formation of rocks. Ma_Miss experiment is perfectly suited to perform multispectral imaging of the drilled layers. Ma_Miss is a miniaturized near-infrared imaging spectrometer in the range 0.4-2.2 µm with 20nm spectral sampling. The task of illuminating the borehole wall and collecting the diffused light from the illuminated spot on the target requires a transparent window on the Drill tool, which shall prevent the dust contamination of the optical and mechanical elements inside. Hardness of sapphire is the closest to diamond one, thus avoiding the risk of scratches on its surface. The Sapphire window is cylindrical, and bounded such as to realize a continuous auger profile. Ma_Miss Optical Head performs the double task of illuminating the borehole wall with a spot around 1 mm diameter and of collecting the scattered light coming from a 0.1 mm diameter spot of the target. The signal from the Optical Head to the spectrometer is transferred

Principled Missing Data Treatments.

PubMed

Lang, Kyle M; Little, Todd D

2018-04-01

We review a number of issues regarding missing data treatments for intervention and prevention researchers. Many of the common missing data practices in prevention research are still, unfortunately, ill-advised (e.g., use of listwise and pairwise deletion, insufficient use of auxiliary variables). Our goal is to promote better practice in the handling of missing data. We review the current state of missing data methodology and recent missing data reporting in prevention research. We describe antiquated, ad hoc missing data treatments and discuss their limitations. We discuss two modern, principled missing data treatments: multiple imputation and full information maximum likelihood, and we offer practical tips on how to best employ these methods in prevention research. The principled missing data treatments that we discuss are couched in terms of how they improve causal and statistical inference in the prevention sciences. Our recommendations are firmly grounded in missing data theory and well-validated statistical principles for handling the missing data issues that are ubiquitous in biosocial and prevention research. We augment our broad survey of missing data analysis with references to more exhaustive resources.

Targeted Social Mobilization in a Global Manhunt

PubMed Central

Dsouza, Sohan; McInerney, James; Naroditskiy, Victor; Venanzi, Matteo; Jennings, Nicholas R.; deLara, J. R.; Wahlstedt, Eero; Miller, Steven U.

2013-01-01

Social mobilization, the ability to mobilize large numbers of people via social networks to achieve highly distributed tasks, has received significant attention in recent times. This growing capability, facilitated by modern communication technology, is highly relevant to endeavors which require the search for individuals that possess rare information or skills, such as finding medical doctors during disasters, or searching for missing people. An open question remains, as to whether in time-critical situations, people are able to recruit in a targeted manner, or whether they resort to so-called blind search, recruiting as many acquaintances as possible via broadcast communication. To explore this question, we examine data from our recent success in the U.S. State Department's Tag Challenge, which required locating and photographing 5 target persons in 5 different cities in the United States and Europe – in under 12 hours – based only on a single mug-shot. We find that people are able to consistently route information in a targeted fashion even under increasing time pressure. We derive an analytical model for social-media fueled global mobilization and use it to quantify the extent to which people were targeting their peers during recruitment. Our model estimates that approximately 1 in 3 messages were of targeted fashion during the most time-sensitive period of the challenge. This is a novel observation at such short temporal scales, and calls for opportunities for devising viral incentive schemes that provide distance or time-sensitive rewards to approach the target geography more rapidly. This observation of ′12 hours of separation' between individuals has applications in multiple areas from emergency preparedness, to political mobilization. PMID:24098660

Targeted social mobilization in a global manhunt.

PubMed

Rutherford, Alex; Cebrian, Manuel; Rahwan, Iyad; Dsouza, Sohan; McInerney, James; Naroditskiy, Victor; Venanzi, Matteo; Jennings, Nicholas R; deLara, J R; Wahlstedt, Eero; Miller, Steven U

2013-01-01

Social mobilization, the ability to mobilize large numbers of people via social networks to achieve highly distributed tasks, has received significant attention in recent times. This growing capability, facilitated by modern communication technology, is highly relevant to endeavors which require the search for individuals that possess rare information or skills, such as finding medical doctors during disasters, or searching for missing people. An open question remains, as to whether in time-critical situations, people are able to recruit in a targeted manner, or whether they resort to so-called blind search, recruiting as many acquaintances as possible via broadcast communication. To explore this question, we examine data from our recent success in the U.S. State Department's Tag Challenge, which required locating and photographing 5 target persons in 5 different cities in the United States and Europe - in under 12 hours - based only on a single mug-shot. We find that people are able to consistently route information in a targeted fashion even under increasing time pressure. We derive an analytical model for social-media fueled global mobilization and use it to quantify the extent to which people were targeting their peers during recruitment. Our model estimates that approximately 1 in 3 messages were of targeted fashion during the most time-sensitive period of the challenge. This is a novel observation at such short temporal scales, and calls for opportunities for devising viral incentive schemes that provide distance or time-sensitive rewards to approach the target geography more rapidly. This observation of '12 hours of separation' between individuals has applications in multiple areas from emergency preparedness, to political mobilization.

Exoatmospheric intercepts using zero effort miss steering for midcourse guidance

NASA Astrophysics Data System (ADS)

Newman, Brett

The suitability of proportional navigation, or an equivalent zero effort miss formulation, for exatmospheric intercepts during midcourse guidance, followed by a ballistic coast to the endgame, is addressed. The problem is formulated in terms of relative motion in a general, three dimensional framework. The proposed guidance law for the commanded thrust vector orientation consists of the sum of two terms: (1) along the line of sight unit direction and (2) along the zero effort miss component perpendicular to the line of sight and proportional to the miss itself and a guidance gain. If the guidance law is to be suitable for longer range targeting applications with significant ballistic coasting after burnout, determination of the zero effort miss must account for the different gravitational accelerations experienced by each vehicle. The proposed miss determination techniques employ approximations for the true differential gravity effect and thus, are less accurate than a direct numerical propagation of the governing equations, but more accurate than a baseline determination, which assumes equal accelerations for both vehicles. Approximations considered are constant, linear, quadratic, and linearized inverse square models. Theoretical results are applied to a numerical engagement scenario and the resulting performance is evaluated in terms of the miss distances determined from nonlinear simulation.

Doctors in Balzac's work.

PubMed

Moulin, Thierry

2013-01-01

Balzac wrote his novels during a time of great literary and scientific change. Romanticism gave way to the school of realism, of which Balzac could be considered the founder. It was via realism, where both the positive and negative aspects of life were depicted, that doctors naturally gained a much more active role in novels. In conjunction with this was the development of science and medicine, which fascinated Balzac, also leading to the significant and prevalent role of doctors in his works. His fascination with the sciences led to him to gain many acquaintances and much knowledge in the medical domain, especially in neuropsychiatry and physiology. His fictional doctors, such as Desplein and Bianchon, thus demonstrate considerable knowledge of pathology, physiology, and neuropsychiatry. The doctors in Balzac's novels can be grouped into four categories: provincial doctors, Parisian doctors, country doctors, and military doctors. They were most often fictitious representations of real individuals (e.g. Guillaume Dupuytren), and often symbolize schools of thought which were in vogue at the time. In addition to the accurate scientific depiction of doctors, it must be noted that his doctors not only played an active role in clinically assessing their patients, but also had a sociological role in assessing society; it is through his doctors that Balzac gave his opinion of the world in which he lived. Copyright © 2013 S. Karger AG, Basel.

A signal detection approach to patient-doctor communication and doctor-shopping behaviour among Japanese patients.

PubMed

Hagihara, Akihito; Tarumi, Kimio; Odamaki, Misato; Nobutomo, Koichi

2005-12-01

As one of the factors related to doctor-shopping behaviour (i.e. consulting multiple doctors with regard to the same illness episode), very little has been revealed about the role of doctor explanation. We examined therefore the association between doctor explanation and doctor-shopping behaviour. The subjects were internist-patient pairs in Japan. Signal detection analysis (SDA) was used for the data analysis. Of the 303 patients, 84 patients engaged in doctor shopping (27.7%). The following results were obtained: (1) of the 19 relevant variables, the 'level of doctor explanation: treatment' was the most significant predictor of doctor-shopping behaviour (P < 0.01), and (2) with regard to their subjective evaluations of the sufficiency of their explanations about treatment or testing, the evaluations of the doctors, rather than those of the patient, were significant predictors of doctor-shopping behaviour. These results imply the following: (1) a patient's inability to understand a doctor's explanation about treatment, which results from a large gap between the perceptions of the patient and those of the doctor, is the most significant predictor of doctor-shopping behaviour, and (2) in the context of favourable patient-doctor interactions, when doctors feel their explanations are insufficient, they may be able to prevent doctor-shopping behaviour by providing relatively thorough explanations about treatment.

Estimated Environmental Exposures for MISSE-3 and MISSE-4

NASA Technical Reports Server (NTRS)

Finckenor, Miria M.; Pippin, Gary; Kinard, William H.

2008-01-01

Describes the estimated environmental exposure for MISSE-2 and MISSE-4. These test beds, attached to the outside of the International Space Station, were planned for 3 years of exposure. This was changed to 1 year after MISSE-1 and -2 were in space for 4 years. MISSE-3 and -4 operate in a low Earth orbit space environment, which exposes them to a variety of assaults including atomic oxygen, ultraviolet radiation, particulate radiation, thermal cycling, and meteoroid/space debris impact, as well as contamination associated with proximity to an active space station. Measurements and determinations of atomic oxygen fluences, solar UV exposure levels, molecular contamination levels, and particulate radiation are included.

Which doctors and with what problems contact a specialist service for doctors? A cross sectional investigation.

PubMed

Garelick, Antony I; Gross, Samantha R; Richardson, Irene; von der Tann, Matthias; Bland, Julia; Hale, Rob

2007-08-28

In the United Kingdom, specialist treatment and intervention services for doctors are underdeveloped. The MedNet programme, created in 1997 and funded by the London Deanery, aims to fill this gap by providing a self-referral, face-to-face, psychotherapeutic assessment service for doctors in London and South-East England. MedNet was designed to be a low-threshold service, targeting doctors without formal psychiatric problems. The aim of this study was to delineate the characteristics of doctors utilising the service, to describe their psychological morbidity, and to determine if early intervention is achieved. A cross-sectional study including all consecutive self-referred doctors (n = 121, 50% male) presenting in 2002-2004 was conducted. Measures included standardised and bespoke questionnaires both self-report and clinician completed. The multi-dimensional evaluation included: demographics, CORE (CORE-OM, CORE-Workplace and CORE-A) an instrument designed to evaluate the psychological difficulties of patients referred to outpatient services, Brief Symptom Inventory to quantify caseness and formal psychiatric illness, and Maslach Burnout Inventory. The most prevalent presenting problems included depression, anxiety, interpersonal, self-esteem and work-related issues. However, only 9% of the cohort were identified as severely distressed psychiatrically using this measure. In approximately 50% of the sample, problems first presented in the preceding year. About 25% were on sick leave at the time of consultation, while 50% took little or no leave in the prior 12 months. A total of 42% were considered to be at some risk of suicide, with more than 25% considered to have a moderate to severe risk. There were no significant gender differences in type of morbidity, severity or days off sick. Doctors displayed high levels of distress as reflected in the significant proportion of those who were at some risk of suicide; however, low rates of severe psychiatric illness were

Interpersonal perception in the context of doctor-patient relationships: a dyadic analysis of doctor-patient communication.

PubMed

Kenny, David A; Veldhuijzen, Wemke; Weijden, Trudy van der; Leblanc, Annie; Lockyer, Jocelyn; Légaré, France; Campbell, Craig

2010-03-01

Doctor-patient communication is an interpersonal process and essential to relationship-centered care. However, in many studies, doctors and patients are studied as if living in separate worlds. This study assessed whether: 1) doctors' perception of their communication skills is congruent with their patients' perception; and 2) patients of a specific doctor agree with each other about their doctor's communication skills. A cross-sectional study was conducted in three provinces in Canada with 91 doctors and their 1749 patients. Doctors and patients independently completed questions on the doctor's communication skills (content and process) after a consultation. Multilevel modeling provided an estimate of the patient and doctor variance components at both the dyad-level and the doctor-level. We computed correlations between patients' and doctors' perceptions at both levels to assess how congruent they were. Consensus among patients of a specific doctor was assessed using intraclass correlation coefficient (ICC). The mean score of the rating of doctor's skills according to patients was 4.58, and according to doctors was 4.37. The dyad-level variance for the patient was .38 and for the doctor was .06. The doctor-level variance for the patient ratings was .01 and for the doctor ratings, .18. The correlation between both the patients' and the doctors' skills' ratings scores at the dyad-level was weak. At the doctor-level, the correlation was not statistically significant. The ICC for patients' ratings was .03 and for the doctors' ratings .76. Overall, this study suggests that doctors and their patients have a very different perspective of the doctors' communication skills occurring during routine clinical encounters. 2009 Elsevier Ltd. All rights reserved.

Re-Imagining Doctoral Education: Professional Doctorates and beyond

ERIC Educational Resources Information Center

Lee, Alison; Brennan, Marie; Green, Bill

2009-01-01

Portents of the demise of the Professional Doctorate have emerged in some recent policy and institutional circles in Australia, raising questions about the meaning and relevance of the Professional Doctorate in an era of "league tables" and research assessment in Australia. This article argues that such portents, based largely on narrow…

Sensitising intern doctors to ethical issues in a doctor-patient relationship.

PubMed

Shah, Nilima D; Mehta, Ritambhara Y; Dave, Kamlesh R

2017-01-01

There is a felt need in India to influence the ethical behaviour of doctors by giving students formal education in ethics in medical colleges. Since internship is the interface between learning and independent practice, it is important to sensitise intern doctors to ethical issues in a doctor-patient relationship at this stage.

Ageing doctors.

PubMed

Lillis, Steven; Milligan, Eleanor

2017-03-01

Doctors are neither more nor less susceptible than the general population to the effects of ageing. The relevance of deterioration with age depends on the nature of the work undertaken. Reduced muscle strength and visual and auditory deterioration can compromise clinical ability. Accumulation of chronic disease further reduces capacity. Cognitive decline is of particular importance, as good medical care requires considerable cognitive function. Patient safety is paramount, yet older doctors are an important part of the medical workforce and their value should be recognised. Changes in patient case mix, work place support systems and individual adjustments can assist safe practice. Deterioration in health should be acknowledged and requires proactive management. Current methods of ensuring competence are inadequate for supporting ageing doctors. A new initiative is recommended comprising collaboration between regulators, colleges and employing institutions to support the ageing doctor in providing safe and effective practice. © 2017 AJA Inc.

Doctors and pharmaceutical industry.

PubMed

Beran, Roy G

2009-09-01

The pharmaceutical industry is seen as seducing doctors by providing expensive gifts, subsidising travel and underwriting practice expenses in return for those doctors prescribing products that otherwise they would not use. This paints doctors in a very negative light; suggests doctors are available to the highest bidder; implies doctors do not adequately act as independent agents; and that doctors are driven more by self-interest than by patient needs. Similar practices, in other industries, are accepted as normal business behaviour but it is automatically assumed to be improper if the pharmaceutical industry supports doctors. Should the pharmaceutical industry withdraw educational grants then there would be: fewer scientific meetings; reduced attendance at conferences; limited post graduate education; and a depreciated level of maintenance of professional standards. To suggest that doctors prescribe inappropriately in return for largesse maligns their integrity but where there is no scientific reason to choose between different treatments then there can be little argument against selecting the product manufactured by a company that has invested in the doctor and the question arises as to whether this represents bad medicine? This paper will examine what constitutes non-professional conduct in response to inducements by the pharmaceutical industry. It will review: conflict of interest; relationships between doctors and pharma and the consequences for patients; and the need for critical appraisal before automatically decrying this relationship while accepting that there remain those who do not practice ethical medicine.

Low Target Prevalence Is a Stubborn Source of Errors in Visual Search Tasks

ERIC Educational Resources Information Center

Wolfe, Jeremy M.; Horowitz, Todd S.; Van Wert, Michael J.; Kenner, Naomi M.; Place, Skyler S.; Kibbi, Nour

2007-01-01

In visual search tasks, observers look for targets in displays containing distractors. Likelihood that targets will be missed varies with target prevalence, the frequency with which targets are presented across trials. Miss error rates are much higher at low target prevalence (1%-2%) than at high prevalence (50%). Unfortunately, low prevalence is…

Contemplate Doctoral Study

ERIC Educational Resources Information Center

Flowers, Jim; Lazaros, Edward

2009-01-01

It takes an honest look for a technology teacher to determine whether he or she should engage in doctoral study. Doctoral programs have a rather high attrition rate, as high as 40 or 50%, and university resources might be better spent on those who have a greater chance of succeeding. However, for those who take the plunge, doctoral studies can be…

Wanted--doctors who care.

PubMed

Lovdal, L T; Pearson, R

1989-03-01

A study was conducted to determine what consumers value in doctors' behavior. Results indicate that consumers in the sample population studied prefer doctors who are friendly and caring as well as those who are technically competent. However, these respondents reported less favorable opinions about doctors' friendliness (i.e., affective behavior) than they did about doctors' competence (i.e., instrumental behavior).

Mechanistic Comparison of "Nearly Missed" Versus "On-Target" Rotor Ablation.

PubMed

Yamazaki, Masatoshi; Avula, Uma Mahesh R; Berenfeld, Omer; Kalifa, Jérôme

2015-08-01

This study used advanced optical mapping techniques to examine atrial fibrillation (AF) dynamics before and after 2 distinct electrogram-based ablation strategies: complex fractionated atrial electrograms (CFAEs) and DFmax/rotor ablation. Among the electrogram analytical features proposed to unravel the atrial regions that perpetuate AF, CFAEs, highest dominant frequency sites (DFmax), and, more recently, phase analysis-enabled rotor mapping have received the largest attention. Still, the mechanisms by which these approaches modulate AF dynamics and lead to AF termination are unknown. In Langendorff-perfused sheep hearts, AF was maintained by the continuous perfusion of acetylcholine and high-resolution endocardial-epicardial optical videos were recorded from the left atrial free wall and the posterior left atrium. Then, DFmax/rotor regions (n = 7), or CFAE regions harboring the highest wavebreak density (HWD) (n = 5), were targeted with a 4F ablation catheter (5 to 15 W, 30 to 60 s/point). Thereafter, we examined the changes in AF dynamics and whether AF terminated. DFmax/rotor point ablation resulted in a significant decrease in DFmax values. In 2 animals AF terminated, whereas in the remaining 5 animals the post-ablation DFmax domain remained in the vicinity of its pre-ablation location. However, after HWD/CFAEs density ablation, DFmax values did not change, AF did not terminate, and post-ablation DFmax domains relocated from the left atrial free wall to the pulmonary vein-posterior left atrium region. In another group of hearts (n = 12), we observed that upon a progressive increase in acetylcholine concentration-mimicking the acute electrophysiological changes occurring after ablation-3-dimensional rotors drifted from one atrial region to another along large gradients of myocardial thickness. "On-target" DFmax/rotor ablation leads to the annihilation of the fibrillation-driving rotor. This translates into large decreases in AF frequency or AF termination. In

Doctor-patient relationship

PubMed Central

Chamsi-Pasha, Hassan; Albar, Mohammed A.

2016-01-01

The doctor-patient relationship is an intricate concept in which patients voluntarily approach a doctor and become part of a contract by which they tend to abide by doctor’s instructions. Over recent decades, this relationship has changed dramatically due to privatization and commercialization of the health sector. A review of the relevant literature in the database of MEDLINE published in English between 1966 and August 2015 was performed with the following keywords: doctor-patient relationship, physician-patient relationship, ethics, and Islam. The Muslim doctor should be familiar with the Islamic teachings on the daily issues faced in his/her practice and the relationship with his/her patients. PMID:26837392

The impact of familiarization strategies on the missing-letter effect.

PubMed

Plamondon, Andréanne; Roy-Charland, Annie; Chamberland, Justin; Quenneville, Joannie; Laforge, Christian

2017-08-01

When reading a text and searching for a target letter, readers make more omissions of the target letter if it is embedded in frequent function words than if it is in rare content words. While word frequency effects are consistently found, few studies have examined the impacts of passage familiarity on the missing-letter effect and studies that have present conflicting evidence. The present study examines the effects of passage familiarity, as well as the impacts of passage familiarization strategy promoting surface or deep encoding, on the missing-letter effect. Participants were familiarized with a passage by retyping a text, replacing all common nouns with synonyms, or generating a text on the same topic as that of the original text, and then completed a letter search task on the familiar passage as well as an unfamiliar passage. In Experiment 1, when both familiar and unfamiliar passages use the same words, results revealed fewer omissions for the retyping and synonyms conditions. However, in Experiment 2, when different words are used in both types of texts, no effect of familiarization strategy was observed. Furthermore, the missing-letter effect is maintained in all conditions, adding support to the robustness of the effect regardless of familiarity with the text.

Testing of NASA LaRC Materials under MISSE 6 and MISSE 7 Missions

NASA Technical Reports Server (NTRS)

Prasad, Narasimha S.

2009-01-01

The objective of the Materials International Space Station Experiment (MISSE) is to study the performance of novel materials when subjected to the synergistic effects of the harsh space environment for several months. MISSE missions provide an opportunity for developing space qualifiable materials. Two lasers and a few optical components from NASA Langley Research Center (LaRC) were included in the MISSE 6 mission for long term exposure. MISSE 6 items were characterized and packed inside a ruggedized Passive Experiment Container (PEC) that resembles a suitcase. The PEC was tested for survivability due to launch conditions. MISSE 6 was transported to the international Space Station (ISS) via STS 123 on March 11. 2008. The astronauts successfully attached the PEC to external handrails of the ISS and opened the PEC for long term exposure to the space environment. The current plan is to bring the MISSE 6 PEC back to the Earth via STS 128 mission scheduled for launch in August 2009. Currently, preparations for launching the MISSE 7 mission are progressing. Laser and lidar components assembled on a flight-worthy platform are included from NASA LaRC. MISSE 7 launch is scheduled to be launched on STS 129 mission. This paper will briefly review recent efforts on MISSE 6 and MISSE 7 missions at NASA Langley Research Center (LaRC).

A study of the relationship between resilience, burnout and coping strategies in doctors.

PubMed

McCain, R Scott; McKinley, Nicola; Dempster, Martin; Campbell, W Jeffrey; Kirk, Stephen J

2017-08-09

The aim of this study was to measure resilience, coping and professional quality of life in doctors. A cross-sectional study using an online questionnaire in a single National Health Service trust, including both primary and secondary care doctors. 283 doctors were included. Mean resilience was 68.9, higher than population norms. 100 (37%) doctors had high burnout, 194 (72%) doctors had high secondary traumatic stress and 64 (24%) had low compassion satisfaction. Burnout was positively associated with low resilience, low compassion satisfaction, high secondary traumatic stress and more frequent use of maladaptive coping mechanisms, including self-blame, behavioural disengagement and substance use. Non-clinical issues in the workplace were the main factor perceived to cause low resilience in doctors. Despite high levels of resilience, doctors had high levels of burnout and secondary traumatic stress. Doctors suffering from burnout were more likely to use maladaptive coping mechanisms. As doctors already have high resilience, improving personal resilience further may not offer much benefit to professional quality of life. A national study of professional Quality of Life, Coping And REsilience, which we are proposing to undertake, will for the first time assess the UK and Ireland medical workforce in this regard and guide future targeted interventions to improve professional quality of life. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

EEG and Eye Tracking Signatures of Target Encoding during Structured Visual Search

PubMed Central

Brouwer, Anne-Marie; Hogervorst, Maarten A.; Oudejans, Bob; Ries, Anthony J.; Touryan, Jonathan

2017-01-01

EEG and eye tracking variables are potential sources of information about the underlying processes of target detection and storage during visual search. Fixation duration, pupil size and event related potentials (ERPs) locked to the onset of fixation or saccade (saccade-related potentials, SRPs) have been reported to differ dependent on whether a target or a non-target is currently fixated. Here we focus on the question of whether these variables also differ between targets that are subsequently reported (hits) and targets that are not (misses). Observers were asked to scan 15 locations that were consecutively highlighted for 1 s in pseudo-random order. Highlighted locations displayed either a target or a non-target stimulus with two, three or four targets per trial. After scanning, participants indicated which locations had displayed a target. To induce memory encoding failures, participants concurrently performed an aurally presented math task (high load condition). In a low load condition, participants ignored the math task. As expected, more targets were missed in the high compared with the low load condition. For both conditions, eye tracking features distinguished better between hits and misses than between targets and non-targets (with larger pupil size and shorter fixations for missed compared with correctly encoded targets). In contrast, SRP features distinguished better between targets and non-targets than between hits and misses (with average SRPs showing larger P300 waveforms for targets than for non-targets). Single trial classification results were consistent with these averages. This work suggests complementary contributions of eye and EEG measures in potential applications to support search and detect tasks. SRPs may be useful to monitor what objects are relevant to an observer, and eye variables may indicate whether the observer should be reminded of them later. PMID:28559807

How To Talk to Your Doctor (and Get Your Doctor To Talk to You!). An Educational Workshop on Doctor Patient Communication = Como Hablarle a su Doctor (iY que su doctor le hable a usted!). Un seminario educativo sobre la comunicacion entre el doctor y el paciente.

ERIC Educational Resources Information Center

Baylor Coll. of Medicine, Houston, TX.

This workshop, written in both English and Spanish, focuses on improving communication between physician and patient. In the workshop, the trainers will talk about "building bridges" between patient and doctor by understanding the doctor's role and his/her duty to the patient. According to the workshop, a person's doctor should…

Emergency supply of doctors by the Mais Médicos (More Doctors) Program and the quality of the structure of primary health care facilities.

PubMed

Giovanella, Ligia; Mendonça, Maria Helena Magalhães de; Fausto, Marcia Cristina Rodrigues; Almeida, Patty Fidelis de; Bousquat, Aylene; Lima, Juliana Gagno; Seidl, Helena; Franco, Cassiano Mendes; Fusaro, Edgard Rodrigues; Almeida, Sueli Zeferino Ferreira

2016-09-01

The health policy context in Brazil has featured a series of measures to improve primary health care (PHC), including a national access and quality improvement program (Programa Nacional de Melhoria do Acesso e Qualidade, PMAQ-AB) and the Mais Médicos Program (More Doctors, PMM) and upgrading PHC centers ('Requalifica UBS'). The paper examines the PMM's placement of doctors, by quality of PHC structure, in an endeavor to identify synergies among the three programs. It reports on a transverse study based on secondary data from PMAQ-AB Cycles 1 and 2, the PMM and 'Requalifica UBS'. The PHC facilities inventoried during PMAQ-AB Cycle 1 were classified, on pre-established typology, into five groups ranked from A (best) to E (failed). They were then compared in terms of PMM personnel allocated and Requalifica UBS proposals. The results point to convergences in investments by the three programs. Incentives targeted predominantly PHC facilities of types B and C, indicating a concentration of efforts on PHC facilities with potential for structural quality improvements. In addition to expanding access, the provision of doctors by the PMM, added to infrastructure upgrades and work process improvements, contributes to addressing high turnover and guaranteeing retention of doctors in PHC.

Cyclists' Anger As Determinant of Near Misses Involving Different Road Users.

PubMed

Marín Puchades, Víctor; Prati, Gabriele; Rondinella, Gianni; De Angelis, Marco; Fassina, Filippo; Fraboni, Federico; Pietrantoni, Luca

2017-01-01

Road anger constitutes one of the determinant factors related to safety outcomes (e.g., accidents, near misses). Although cyclists are considered vulnerable road users due to their relatively high rate of fatalities in traffic, previous research has solely focused on car drivers, and no study has yet investigated the effect of anger on cyclists' safety outcomes. The present research aims to investigate, for the first time, the effects of cycling anger toward different types of road users on near misses involving such road users and near misses in general. Using a daily diary web-based questionnaire, we collected data about daily trips, bicycle use, near misses experienced, cyclist's anger and demographic information from 254 Spanish cyclists. Poisson regression was used to assess the association of cycling anger with near misses, which is a count variable. No relationship was found between general cycling anger and near misses occurrence. Anger toward specific road users had different effects on the probability of near misses with different road users. Anger toward the interaction with car drivers increased the probability of near misses involving cyclists and pedestrians. Anger toward interaction with pedestrians was associated with higher probability of near misses with pedestrians. Anger toward cyclists exerted no effect on the probability of near misses with any road user (i.e., car drivers, cyclists or pedestrians), whereas anger toward the interactions with the police had a diminishing effect on the occurrence of near misses' involving all types of road users. The present study demonstrated that the effect of road anger on safety outcomes among cyclists is different from that of motorists. Moreover, the target of anger played an important role on safety both for the cyclist and the specific road users. Possible explanations for these differences are based on the difference in status and power with motorists, as well as on the potential displaced aggression

BeeDoctor, a versatile MLPA-based diagnostic tool for screening bee viruses.

PubMed

De Smet, Lina; Ravoet, Jorgen; de Miranda, Joachim R; Wenseleers, Tom; Mueller, Matthias Y; Moritz, Robin F A; de Graaf, Dirk C

2012-01-01

The long-term decline of managed honeybee hives in the world has drawn significant attention to the scientific community and bee-keeping industry. A high pathogen load is believed to play a crucial role in this phenomenon, with the bee viruses being key players. Most of the currently characterized honeybee viruses (around twenty) are positive stranded RNA viruses. Techniques based on RNA signatures are widely used to determine the viral load in honeybee colonies. High throughput screening for viral loads necessitates the development of a multiplex polymerase chain reaction approach in which different viruses can be targeted simultaneously. A new multiparameter assay, called "BeeDoctor", was developed based on multiplex-ligation probe dependent amplification (MLPA) technology. This assay detects 10 honeybee viruses in one reaction. "BeeDoctor" is also able to screen selectively for either the positive strand of the targeted RNA bee viruses or the negative strand, which is indicative for active viral replication. Due to its sensitivity and specificity, the MLPA assay is a useful tool for rapid diagnosis, pathogen characterization, and epidemiology of viruses in honeybee populations. "BeeDoctor" was used for screening 363 samples from apiaries located throughout Flanders; the northern half of Belgium. Using the "BeeDoctor", virus infections were detected in almost eighty percent of the colonies, with deformed wing virus by far the most frequently detected virus and multiple virus infections were found in 26 percent of the colonies.

Estimating missing daily temperature extremes in Jaffna, Sri Lanka

NASA Astrophysics Data System (ADS)

Thevakaran, A.; Sonnadara, D. U. J.

2018-04-01

The accuracy of reconstructing missing daily temperature extremes in the Jaffna climatological station, situated in the northern part of the dry zone of Sri Lanka, is presented. The adopted method utilizes standard departures of daily maximum and minimum temperature values at four neighbouring stations, Mannar, Anuradhapura, Puttalam and Trincomalee to estimate the standard departures of daily maximum and minimum temperatures at the target station, Jaffna. The daily maximum and minimum temperatures from 1966 to 1980 (15 years) were used to test the validity of the method. The accuracy of the estimation is higher for daily maximum temperature compared to daily minimum temperature. About 95% of the estimated daily maximum temperatures are within ±1.5 °C of the observed values. For daily minimum temperature, the percentage is about 92. By calculating the standard deviation of the difference in estimated and observed values, we have shown that the error in estimating the daily maximum and minimum temperatures is ±0.7 and ±0.9 °C, respectively. To obtain the best accuracy when estimating the missing daily temperature extremes, it is important to include Mannar which is the nearest station to the target station, Jaffna. We conclude from the analysis that the method can be applied successfully to reconstruct the missing daily temperature extremes in Jaffna where no data is available due to frequent disruptions caused by civil unrests and hostilities in the region during the period, 1984 to 2000.

Effect of missing data on multitask prediction methods.

PubMed

de la Vega de León, Antonio; Chen, Beining; Gillet, Valerie J

2018-05-22

There has been a growing interest in multitask prediction in chemoinformatics, helped by the increasing use of deep neural networks in this field. This technique is applied to multitarget data sets, where compounds have been tested against different targets, with the aim of developing models to predict a profile of biological activities for a given compound. However, multitarget data sets tend to be sparse; i.e., not all compound-target combinations have experimental values. There has been little research on the effect of missing data on the performance of multitask methods. We have used two complete data sets to simulate sparseness by removing data from the training set. Different models to remove the data were compared. These sparse sets were used to train two different multitask methods, deep neural networks and Macau, which is a Bayesian probabilistic matrix factorization technique. Results from both methods were remarkably similar and showed that the performance decrease because of missing data is at first small before accelerating after large amounts of data are removed. This work provides a first approximation to assess how much data is required to produce good performance in multitask prediction exercises.

Associations of Posthemodialysis Weights above and below Target Weight with All-Cause and Cardiovascular Mortality

PubMed Central

Kshirsagar, Abhijit V.; Falk, Ronald J.; Brunelli, Steven M.

2015-01-01

Background and objectives Fluid removal via ultrafiltration is a primary function of hemodialysis, and inadequate volume control is associated with significant morbidity and mortality among chronic dialysis patients. Treatment-to-treatment fluid removal goals are typically calculated on the basis of interdialytic weight gain and prescribed target weight. The clinical effect of frequent missed target weights is unclear. This study was designed to evaluate the associations of postdialysis weights above and below the prescribed target weight (separately) and outcomes. Design, setting, participants, & measurements Data were taken from a national cohort of 10,785 prevalent, thrice-weekly, in-center hemodialysis patients dialyzing from 2005 to 2008 (median time at risk, 2.1 [25th percentile, 75th percentile] years) at a single dialysis organization. Patients were characterized as having an above target weight miss if their postdialysis weight was >2 kg above target weight in at least 30% of baseline treatments (14.6% of cohort), or they were characterized as control otherwise. Below target weight miss characterization was analogous for patients with postdialysis weight >2 kg below target weight (6.6% of cohort). Coprimary endpoints were all-cause and cardiovascular mortality. Results Above target weight miss in at least 30% of treatments (versus not) was associated with greater all-cause mortality (adjusted hazard ratio, 1.28; 95% confidence interval, 1.15 to 1.43); and below target weight miss in at least 30% of treatments (versus not) was associated with greater all-cause mortality (adjusted hazard ratio, 1.22; 95% confidence interval, 1.05 to 1.40). Both above and below target weight misses were also significantly associated with greater cardiovascular mortality. Secondary analyses demonstrated dose-response relationships between target weight misses and mortality. Results from sensitivity analyses considering the difference in postdialysis and target weights as a

Identification of doctors at risk of recurrent complaints: a national study of healthcare complaints in Australia

PubMed Central

Bismark, Marie M; Spittal, Matthew J; Gurrin, Lyle C; Ward, Michael; Studdert, David M

2013-01-01

Objectives (1) To determine the distribution of formal patient complaints across Australia's medical workforce and (2) to identify characteristics of doctors at high risk of incurring recurrent complaints. Methods We assembled a national sample of all 18 907 formal patient complaints filed against doctors with health service ombudsmen (‘Commissions’) in Australia over an 11-year period. We analysed the distribution of complaints among practicing doctors. We then used recurrent-event survival analysis to identify characteristics of doctors at high risk of recurrent complaints, and to estimate each individual doctor's risk of incurring future complaints. Results The distribution of complaints among doctors was highly skewed: 3% of Australia's medical workforce accounted for 49% of complaints and 1% accounted for a quarter of complaints. Short-term risks of recurrence varied significantly among doctors: there was a strong dose-response relationship with number of previous complaints and significant differences by doctor specialty and sex. At the practitioner level, risks varied widely, from doctors with <10% risk of further complaints within 2 years to doctors with >80% risk. Conclusions A small group of doctors accounts for half of all patient complaints lodged with Australian Commissions. It is feasible to predict which doctors are at high risk of incurring more complaints in the near future. Widespread use of this approach to identify high-risk doctors and target quality improvement efforts coupled with effective interventions, could help reduce adverse events and patient dissatisfaction in health systems. PMID:23576774

Predicting drug-target interaction for new drugs using enhanced similarity measures and super-target clustering.

PubMed

Shi, Jian-Yu; Yiu, Siu-Ming; Li, Yiming; Leung, Henry C M; Chin, Francis Y L

2015-07-15

Predicting drug-target interaction using computational approaches is an important step in drug discovery and repositioning. To predict whether there will be an interaction between a drug and a target, most existing methods identify similar drugs and targets in the database. The prediction is then made based on the known interactions of these drugs and targets. This idea is promising. However, there are two shortcomings that have not yet been addressed appropriately. Firstly, most of the methods only use 2D chemical structures and protein sequences to measure the similarity of drugs and targets respectively. However, this information may not fully capture the characteristics determining whether a drug will interact with a target. Secondly, there are very few known interactions, i.e. many interactions are "missing" in the database. Existing approaches are biased towards known interactions and have no good solutions to handle possibly missing interactions which affect the accuracy of the prediction. In this paper, we enhance the similarity measures to include non-structural (and non-sequence-based) information and introduce the concept of a "super-target" to handle the problem of possibly missing interactions. Based on evaluations on real data, we show that our similarity measure is better than the existing measures and our approach is able to achieve higher accuracy than the two best existing algorithms, WNN-GIP and KBMF2K. Our approach is available at http://web.hku.hk/∼liym1018/projects/drug/drug.html or http://www.bmlnwpu.org/us/tools/PredictingDTI_S2/METHODS.html. Copyright © 2015 Elsevier Inc. All rights reserved.

Doctoral Scientists in Oceanography.

ERIC Educational Resources Information Center

National Academy of Sciences-National Research Council, Washington, DC. Assembly of Mathematical and Physical Sciences.

The purpose of this report was to classify and count doctoral scientists in the United States trained in oceanography and/or working in oceanography. Existing data from three sources (National Research Council's "Survey of Earned Doctorates," and "Survey of Doctorate Recipients," and the Ocean Sciences Board's "U.S. Directory of Marine…

Developing Online Doctoral Programmes

ERIC Educational Resources Information Center

Chipere, Ngoni

2015-01-01

The objectives of the study were to identify best practices in online doctoral programming and to synthesise these practices into a framework for developing online doctoral programmes. The field of online doctoral studies is nascent and presents challenges for conventional forms of literature review. The literature was therefore reviewed using a…

Variables associated with seeking information from doctors and the internet after exposure to direct-to-consumer advertisements for prescription medications.

PubMed

Fogel, Joshua; Teichman, Chaim

2014-01-01

This study examines variables associated with seeking information from doctors, the Internet, and a combination of both doctors and Internet after exposure to direct-to-consumer advertisements. Data were analyzed from 462 college students. Younger age, women, and health insurance were associated with greater odds for doctor; women, subjective norms, intentions, and greater time since seen doctor were associated with greater odds for Internet; and African American, Hispanic, subjective norms, intentions, and health insurance were associated with greater odds for both doctor and Internet. Marketers of direct-to-consumer advertisements can use these findings for tailoring and targeting direct-to-consumer advertisements.

MISSE-6 hardware

NASA Image and Video Library

2009-09-02

ISS020-E-037367 (1 Sept. 2009) --- A close-up view of a Materials International Space Station Experiment (MISSE-6) on the exterior of the Columbus laboratory is featured in this image photographed by a space walking astronaut during the STS-128 mission’s first session of extravehicular activity (EVA). MISSE collects information on how different materials weather in the environment of space. MISSE was later placed in Space Shuttle Discovery’s cargo bay for its return to Earth.

Challenges to the Doctoral Journey: A Case of Female Doctoral Students from Ethiopia

ERIC Educational Resources Information Center

Bireda, Asamenew Demessie

2015-01-01

This study aimed to investigate some challenges female doctoral students experience in their doctoral journey. The study used a qualitative design and structured interviews. The theoretical framework that guided the study was that of Urie Bronfenbrenner's ecosystemic theory. A purposely selected sample of five female doctoral students from the…

A survey of pharmaceutical company representative interactions with doctors in Libya

PubMed Central

Alssageer, Mustafa A.; Kowalski, Stefan R.

2012-01-01

Objectives To examine the frequency of pharmaceutical company representative (PCR) interactions with doctors in Libya and review possible associations between these interactions and the personal and practice setting characteristics of doctors. Method An anonymous survey questionnaire was circulated to 1,000 Libyan doctors in selected public and private practice settings in Tripoli, Benghazi and Sebha. Results A questionnaire return rate of 61% (608 returned questionnaires) was achieved. Most respondents (94%) reported that they had been visited by PCRs at least ‘once’ in the last year. Fifty per cent of respondents met with PCRs at least once a month, and 20% at least once a week. The following characteristics were significantly associated with meeting with a representative more than once a week: age, gender (male > female), years of practice, being a specialist (other than an anaesthesiologist) or working in private practice. Ninety-one per cent of doctors reported that they had received at least one kind of relationship gift during the last year. Printed materials (79%), simple gifts (73%) and drug samples (69%) were the most common relationship products given to respondents. Reimbursements or sponsored items were reported by 33% of respondents. Physician specialists were more likely to receive drug samples or sponsored items than residents, general practitioners, anaesthesiologists or surgeons (P<0.01). Participants working in private practice alone or in both sectors were more likely to receive printed materials, simple gifts or free samples from PCRs than doctors working in the public sector (P<0.05). Conclusion Libyan doctors are frequently visited by PCRs. Doctors, working in private practice or specialist practice, are especially targeted by promotional activities. An agreed code of conduct for pharmaceutical promotion in Libya between doctors and PCRs should be created. PMID:23002397

Barriers to effective, safe communication and workflow between nurses and non-consultant hospital doctors during out-of-hours.

PubMed

Brady, Anne-Marie; Byrne, Gobnait; Quirke, Mary Brigid; Lynch, Aine; Ennis, Shauna; Bhangu, Jaspreet; Prendergast, Meabh

2017-11-01

This study aimed to evaluate the nature and type of communication and workflow arrangements between nurses and doctors out-of-hours (OOH). Effective communication and workflow arrangements between nurses and doctors are essential to minimize risk in hospital settings, particularly in the out-of-hour's period. Timely patient flow is a priority for all healthcare organizations and the quality of communication and workflow arrangements influences patient safety. Qualitative descriptive design and data collection methods included focus groups and individual interviews. A 500 bed tertiary referral acute hospital in Ireland. Junior and senior Non-Consultant Hospital Doctors, staff nurses and nurse managers. Both nurses and doctors acknowledged the importance of good interdisciplinary communication and collaborative working, in sustaining effective workflow and enabling a supportive working environment and patient safety. Indeed, issues of safety and missed care OOH were found to be primarily due to difficulties of communication and workflow. Medical workflow OOH is often dependent on cues and communication to/from nursing. However, communication systems and, in particular the bleep system, considered central to the process of communication between doctors and nurses OOH, can contribute to workflow challenges and increased staff stress. It was reported as commonplace for routine work, that should be completed during normal hours, to fall into OOH when resources were most limited, further compounding risk to patient safety. Enhancement of communication strategies between nurses and doctors has the potential to remove barriers to effective decision-making and patient flow. © The Author 2017. Published by Oxford University Press in association with the International Society for Quality in Health Care. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com

[Job satisfaction among Norwegian doctors].

PubMed

Nylenna, Magne; Aasland, Olaf Gjerløw

2010-05-20

Doctors' job satisfaction has been discussed internationally in recent years based on reports of increasing professional dissatisfaction. We have studied Norwegian doctors' job satisfaction and their general satisfaction with life. A survey was conducted among a representative sample of practicing Norwegian doctors in 2008. The validated 10-item Job Satisfaction Scale was used to assess job satisfaction. 1,072 (65 %) doctors responded. They reported a mean job satisfaction of 5.3 on a scale from 1 (very dissatisfied) to 7 (very satisfied). Job satisfaction increased with increasing age. Private practice specialists reported the highest level of job satisfaction (5.8), and general practitioners reported higher job satisfaction (5.5) than hospital doctors (5.1). Among specialty groups, community doctors scored highest (5.6) and doctors in surgical disciplines lowest (5.0). While long working hours was negatively correlated with job satisfaction, the perception of being professionally updated and having part-time affiliation(s) in addition to a regular job were positively correlated with job satisfaction. 52.9 % of doctors reported a very high general satisfaction. Norwegian doctors have a high level of job satisfaction. Satisfaction with life in general is also high and at least in line with that in the Norwegian population.

Foreign science and engineering doctoral attainment at American universities

NASA Astrophysics Data System (ADS)

Hamilton, Robert V.

foreign S&E doctoral attainment, the second model tested for changes in foreign S&E doctoral attainment over the time period 1994 to 2005. Specifically, testing results for the second model indicated that changes in S&E doctoral attainment by students from the lower income nations tended to more closely track changes in education-related R&D funding compared to students from higher income nations. These results suggest that to the extent the US government desires to increase foreign doctoral attainment in specific S&E fields, students from lower income nations might have a greater tendency to "chase" education-related R&D dollars in the targeted S&E fields. Finally, testing results for both models indicate that there was variation between the five S&E fields, and that highly-skilled migration patterns in certain S&E fields changed relatively quickly during the time period 1994 to 2005. These results suggest that foreign S&E doctoral attainment should be disaggregated both temporally and by S&E population in order to adequately measure and understand this phenomenon.

A Qualitative Examination of Challenges Influencing Doctoral Students in an Online Doctoral Program

ERIC Educational Resources Information Center

Deshpande, Anant

2016-01-01

The main purpose of the study was to investigate the challenges faced by students in completion of an online doctoral program at the University of Liverpool, Online Doctoral Business Administration program. We analyse the responses of 91 doctoral students in an online DBA program. Based on the exploratory qualitative study themes were developed…

Should junior doctors strike?

PubMed

Toynbee, Mark; Al-Diwani, Adam Aj; Clacey, Joe; Broome, Matthew R

2016-03-01

An impasse in negotiations between the Department of Health (DoH) and the British Medical Association in November this year led to an overwhelming vote for industrial action (IA) by junior doctors. At the time of writing, a last minute concession by DoH led to a deferment of IA to allow further negotiations mediated by the Advisory, Conciliation and Arbitration Service. However, IA by junior doctors remains a possibility if these negotiations stall again. Would the proposed action be ethically justifiable? Furthermore, is IA by doctors ever ethically defendable? Building on previous work, we explore important ethical considerations for doctors considering IA. The primary moral objection to doctors striking is often claimed to be risk of harm to patients. Other common arguments against IA by doctors include breaching their vocational responsibilities and possible damage to their relationship with patients and the public in general. These positions are in turn countered by claims of a greater long-term good and the legal and moral rights of employees to strike. Absolute restrictions appear to be hard to justify in the modern context, as does an unrestricted right to IA. We review these arguments, find that some common moral objections to doctors striking may be less relevant to the current situation, that a stronger contemporary objection to IA might be from a position of social justice and suggest criteria for ethically permissible doctor IA. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

Mining Missing Hyperlinks from Human Navigation Traces: A Case Study of Wikipedia.

PubMed

West, Robert; Paranjape, Ashwin; Leskovec, Jure

Hyperlinks are an essential feature of the World Wide Web. They are especially important for online encyclopedias such as Wikipedia: an article can often only be understood in the context of related articles, and hyperlinks make it easy to explore this context. But important links are often missing, and several methods have been proposed to alleviate this problem by learning a linking model based on the structure of the existing links. Here we propose a novel approach to identifying missing links in Wikipedia. We build on the fact that the ultimate purpose of Wikipedia links is to aid navigation. Rather than merely suggesting new links that are in tune with the structure of existing links, our method finds missing links that would immediately enhance Wikipedia's navigability. We leverage data sets of navigation paths collected through a Wikipedia-based human-computation game in which users must find a short path from a start to a target article by only clicking links encountered along the way. We harness human navigational traces to identify a set of candidates for missing links and then rank these candidates. Experiments show that our procedure identifies missing links of high quality.

Mining Missing Hyperlinks from Human Navigation Traces: A Case Study of Wikipedia

PubMed Central

West, Robert; Paranjape, Ashwin; Leskovec, Jure

2015-01-01

Hyperlinks are an essential feature of the World Wide Web. They are especially important for online encyclopedias such as Wikipedia: an article can often only be understood in the context of related articles, and hyperlinks make it easy to explore this context. But important links are often missing, and several methods have been proposed to alleviate this problem by learning a linking model based on the structure of the existing links. Here we propose a novel approach to identifying missing links in Wikipedia. We build on the fact that the ultimate purpose of Wikipedia links is to aid navigation. Rather than merely suggesting new links that are in tune with the structure of existing links, our method finds missing links that would immediately enhance Wikipedia's navigability. We leverage data sets of navigation paths collected through a Wikipedia-based human-computation game in which users must find a short path from a start to a target article by only clicking links encountered along the way. We harness human navigational traces to identify a set of candidates for missing links and then rank these candidates. Experiments show that our procedure identifies missing links of high quality. PMID:26634229

Doctoral Studies in Romania: Admission Procedures, Social, and Legal Aspects of Doctoral Training

ERIC Educational Resources Information Center

Miclea, Mircea

2008-01-01

This contribution presents a concise and up-to-date report of doctoral studies in Romania, with a special emphasis on legal and social aspects. The author also argues that in order to be sustainable, the reform of doctoral studies should be substantiated by the differentiation of universities, reliable post-doctoral programmes, and a substantive…

Expanding Doctoral Education in South Africa: Pipeline or Pipedream?

ERIC Educational Resources Information Center

Herman, Chaya

2011-01-01

The purpose of this paper is to discuss both the status of the PhD in South Africa and the feasibility of the country's aspiration to increase by fivefold the production of PhDs by 2025. Based on the first empirical studies on doctoral education in South Africa, it argues that in order to move towards this target, an expanded and coordinated…

A marketing clinical doctorate programs.

PubMed

Montoya, Isaac D; Kimball, Olive M

2007-01-01

Over the past decade, clinical doctorate programs in health disciplines have proliferated amid both support and controversy among educators, professional organizations, practitioners, administrators, and third-party payers. Supporters argue that the explosion of new knowledge and increasing sophistication of technology have created a need for advanced practice models to enhance patient care and safety and to reduce costs. Critics argue that necessary technological advances can be incorporated into existing programs and believe that clinical doctorates will increase health care costs, not reduce them. Despite the controversy, many health disciplines have advanced the clinical doctorate (the most recent is the doctor of nursing practice in 2004), with some professions mandating the doctorate as the entry-level degree (i.e., psychology, pharmacy, audiology, and so on). One aspect of the introduction of clinical doctoral degrees has been largely overlooked, and that is the marketing aspect. Because of marketing considerations, some clinical doctorates have been more successfully implemented and accepted than others. Marketing is composed of variables commonly known as "the four P's of marketing": product, price, promotion, and place. This report explores these four P's within the context of clinical doctorates in the health disciplines.

Succeeding with Your Doctorate

ERIC Educational Resources Information Center

Wellington, Jerry; Bathmaker, Ann Marie; Hunt, Cheryl; McCulloch, Gary; Sikes, Pat

2005-01-01

The aim of this book is to support, inform and guide students (and by implication their supervisors) through a doctoral programme. The book is intended for students working towards either a "taught" doctorate (such as an EdD) or a course of study leading to a PhD. The authors recognize that doctoral programmes have changed and these changes are…

Interventions for improving patients' trust in doctors and groups of doctors.

PubMed

Rolfe, Alix; Cash-Gibson, Lucinda; Car, Josip; Sheikh, Aziz; McKinstry, Brian

2014-03-04

Trust is a fundamental component of the patient-doctor relationship and is associated with increased satisfaction, adherence to treatment, and continuity of care. Our 2006 review found little evidence that interventions improve patients' trust in their doctor; therefore an updated search was required to find out if there is further evidence of the effects of interventions that may improve trust in doctors or groups of doctors. To update our earlier review assessing the effects of interventions intended to improve patients' trust in doctors or a group of doctors. In 2003 we searched the Cochrane Central Register of Controlled Trials (CENTRAL, The Cochrane Library), MEDLINE, EMBASE, Health Star, PsycINFO, CINAHL, LILACS, African Trials Register, African Health Anthology, Dissertation Abstracts International and the bibliographies of studies selected for inclusion. We also contacted researchers active in the field. We updated and re-ran the searches on available original databases (Cochrane Central Register of Controlled Trials (CENTRAL, The Cochrane Library issue 2, 2013), MEDLINE (OvidSP), EMBASE (OvidSP), PsycINFO (OvidSP), CINAHL (Ebsco)) as well as Proquest Dissertations and Current Contents for the period 2003 to 18 March 2013. Randomised controlled trials (RCTs), quasi-randomised controlled trials, controlled before and after studies, and interrupted time series of interventions (informative, educational, behavioural, organisational) directed at doctors or patients (or carers) where trust was assessed as a primary or secondary outcome. Two review authors independently extracted data and assessed the risk of bias of included studies. Where mentioned, we extracted data on adverse effects. We synthesised data narratively. We included 10 randomised controlled trials (including 7 new trials) involving 11,063 patients. These studies were all undertaken in North America, and all but two involved primary care.  As expected, there was considerable heterogeneity between

MISSE-6 hardware

NASA Image and Video Library

2009-09-02

ISS020-E-037372 (1 Sept. 2009) --- A close-up view of a Materials International Space Station Experiment (MISSE-6) on the exterior of the Columbus laboratory is featured in this image photographed by a space walking astronaut during the STS-128 mission’s first session of extravehicular activity (EVA). MISSE collects information on how different materials weather in the environment of space. MISSE was later placed in Space Shuttle Discovery’s payload bay for its return to Earth. A portion of a payload bay door is visible in the background.

MISSE-6 hardware

NASA Image and Video Library

2009-09-02

ISS020-E-037369 (1 Sept. 2009) --- A close-up view of a Materials International Space Station Experiment (MISSE-6) on the exterior of the Columbus laboratory is featured in this image photographed by a space walking astronaut during the STS-128 mission’s first session of extravehicular activity (EVA). MISSE collects information on how different materials weather in the environment of space. MISSE was later placed in Space Shuttle Discovery’s payload bay for its return to Earth. A portion of a payload bay door is visible in the background.

Talking to Your Child's Doctor

MedlinePlus

... doctor is unrealistic expectations or an unwillingness to trust a doctor's diagnosis or treatment of a minor ... communication by letting the doctor know that you trust him or her to care for your child. ...

"What do you know?"--knowledge among village doctors of lead poisoning in children in rural China.

PubMed

Huang, Ruixue; Ning, Huacheng; Baum, Carl R; Chen, Lei; Hsiao, Allen

2017-11-23

This study evaluates the extent of village doctors' knowledge of lead poisoning in children in rural China and assesses the characteristics associated with possessing accurate knowledge. A cross-sectional, questionnaire-based survey of 297 village doctors in Fenghuang County, Hunan Province, China was conducted. All village doctors were interviewed face-to-face using a "What do you know" test questionnaire focusing on prevention strategies and lead sources in rural children. A total of 287 (96.6%) village doctors completed the survey in full. Most village doctors had an appropriate degree of general knowledge of lead poisoning; however, they had relatively poor knowledge of lead sources and prevention measures. Village doctors with an undergraduate level education scored an average of 2.7 points higher than those who had a junior college level education (p = 0.033). Village doctors with an annual income ≤ 10,000 RMB yuan scored 1.03 points lower than those whose income was >10,001 RMB yuan. Ethnic Han village doctors scored 1.12 points higher, on average, than ethnic Tujia village doctors (p = 0.027). This study identified important gaps in knowledge concerning lead poisoning in children among a rural population of village doctors. There is a clear need for multifaceted interventions that target village doctors to improve their knowledge regarding lead poisoning in children. The "What do you know" questionnaire is a new tool to evaluate lead poisoning knowledge and education projects.

[Dual-doctor marriages].

PubMed

Gjerberg, Elisabeth

2003-08-28

Dual-doctor marriages are increasingly frequent. The question raised here is whether being married to a fellow physician has a different impact on a doctor's career and family life than having a spouse in a different profession. In 1996 a questionnaire was mailed to physicians who received their authorisation to practise medicine in Norway in the years 1980 through 1983 period; 1142 responded (67 %). They supplied data on their current employment status and data on employment history and marital background. Multivariate analysis was used in order to explore how the educational background of spouses affects a medical career. Female physicians who marry a physician marry and have families at a younger age than other female physicians. Moreover, they more often enter specialties; in some specialities they also qualify earlier than those who marry non-physicians. The same did not hold for male physicians. However, male physicians in dual-doctor marriages more frequently worked part time and they far less frequently had spouses working part time than other male doctors. The results suggest that dual-doctor couples to a higher extent share in giving care to their families, have more interests in common and are more supportive of each other's needs. Female physicians seem to benefit particularly.

Who benefit from school doctors' health checks: a prospective study of a screening method.

PubMed

Nikander, Kirsi; Kosola, Silja; Kaila, Minna; Hermanson, Elina

2018-06-27

School health services provide an excellent opportunity for the detection and treatment of children at risk of later health problems. However, the optimal use of school doctors' skills and expertise remains unknown. Furthermore, no validated method for screening children for school doctors' assessments exists. The aims of the study are 1) to evaluate the benefits or harm of school doctors' routine health checks in primary school grades 1 and 5 (at ages 7 and 11) and 2) to explore whether some of the school doctors' routine health checks can be omitted using study questionnaires. This is a prospective, multicenter observational study conducted in four urban municipalities in Southern Finland by comparing the need for a school doctor's assessment to the benefit gained from it. We will recruit a random sample of 1050 children from 21 schools from primary school grades 1 and 5. Before the school doctor's health check, parents, nurses and teachers fill a study questionnaire to identify any potential concerns about each child. Doctors, blinded to the questionnaire responses, complete an electronic report after the appointment, including given instructions and follow-up plans. The child, parent, doctor and researchers assess the benefit of the health check. The researchers compare the need for a doctor's appointment to the benefit gained from it. At one year after the health check, we will analyze the implementation of the doctors' interventions and follow-up plans. The study will increase our knowledge of the benefits of school doctors' routine health checks and assess the developed screening method. We hypothesize that targeting the health checks to the children in greatest need would increase the quality of school health services. ClinicalTrials.gov Identifier: NCT03178331 , date of registration June 6 th 2017.

What Disengages Doctoral Students in the Biological and Environmental Sciences from Their Doctoral Studies?

ERIC Educational Resources Information Center

Virtanen, V.; Taina, J.; Pyhältö, K.

2017-01-01

This study explored the causes of student disengagement from their doctoral studies in the biological and environmental sciences. The data came from interviews of 40 doctoral students (male = 15, female = 25) and underwent qualitative analysis for content. Our results showed that doctoral studies provide multiple contexts for disengagement, such…

Doctor-patient relationship. Islamic perspective.

PubMed

Chamsi-Pasha, Hassan; Albar, Mohammed A

2016-02-01

The doctor-patient relationship is an intricate concept in which patients voluntarily approach a doctor and become part of a contract by which they tend to abide by doctor's instructions. Over recent decades, this relationship has changed dramatically due to privatization and commercialization of the health sector. A review of the relevant literature in the database of MEDLINE published in English between 1966 and August 2015 was performed with the following keywords: doctor-patient relationship, physician-patient relationship, ethics, and Islam. The Muslim doctor should be familiar with the Islamic teachings on the daily issues faced in his/her practice and the relationship with his/her patients.

Collateral missing value imputation: a new robust missing value estimation algorithm for microarray data.

PubMed

Sehgal, Muhammad Shoaib B; Gondal, Iqbal; Dooley, Laurence S

2005-05-15

Microarray data are used in a range of application areas in biology, although often it contains considerable numbers of missing values. These missing values can significantly affect subsequent statistical analysis and machine learning algorithms so there is a strong motivation to estimate these values as accurately as possible before using these algorithms. While many imputation algorithms have been proposed, more robust techniques need to be developed so that further analysis of biological data can be accurately undertaken. In this paper, an innovative missing value imputation algorithm called collateral missing value estimation (CMVE) is presented which uses multiple covariance-based imputation matrices for the final prediction of missing values. The matrices are computed and optimized using least square regression and linear programming methods. The new CMVE algorithm has been compared with existing estimation techniques including Bayesian principal component analysis imputation (BPCA), least square impute (LSImpute) and K-nearest neighbour (KNN). All these methods were rigorously tested to estimate missing values in three separate non-time series (ovarian cancer based) and one time series (yeast sporulation) dataset. Each method was quantitatively analyzed using the normalized root mean square (NRMS) error measure, covering a wide range of randomly introduced missing value probabilities from 0.01 to 0.2. Experiments were also undertaken on the yeast dataset, which comprised 1.7% actual missing values, to test the hypothesis that CMVE performed better not only for randomly occurring but also for a real distribution of missing values. The results confirmed that CMVE consistently demonstrated superior and robust estimation capability of missing values compared with other methods for both series types of data, for the same order of computational complexity. A concise theoretical framework has also been formulated to validate the improved performance of the CMVE

Reasons for the Slow Completion of Masters and Doctoral Degrees by Adult Learners in a South African Township

ERIC Educational Resources Information Center

Motseke, Masilonyana

2016-01-01

The aim of the study was to investigate the reasons why adult learners took longer than required to complete their Master's and Doctoral degrees. A questionnaire and focus group interviews were used to collect data. Twenty adult learners who registered for the Master's and Doctoral degrees at one township campus of a university were targeted, and…

Persons with dementia missing in the community: is it wandering or something unique?

PubMed

Rowe, Meredeth A; Vandeveer, Sydney S; Greenblum, Catherine A; List, Cassandra N; Fernandez, Rachael M; Mixson, Natalie E; Ahn, Hyo C

2011-06-05

At some point in the disease process many persons with dementia (PWD) will have a missing incident and be unable to safely return to their care setting. In previous research studies, researchers have begun to question whether this phenomenon should continue to be called wandering since the antecedents and characteristics of a missing incident are dissimilar to accepted definitions of wandering in dementia. The purpose of this study was to confirm previous findings regarding the antecedents and characteristics of missing incidents, understand the differences between those found dead and alive, and compare the characteristics of a missing incident to that of wandering. A retrospective design was used to analyse 325 newspaper reports of PWD missing in the community. The primary antecedent to a missing incident, particularly in community-dwelling PWD, was becoming lost while conducting a normal and permitted activity alone in the community. The other common antecedent was a lapse in supervision with the expectation that the PWD would remain in a safe location but did not. Deaths most commonly occurred in unpopulated areas due to exposure and drowning. Those who died were found closer to the place last seen and took longer to find, but there were no significant differences in gender or age. The key characteristics of a missing incident were: unpredictable, non-repetitive, temporally appropriate but spatially-disordered, and while using multiple means of movement (walking, car, public transportation). Missing incidents occurred without the discernible pattern present in wandering such as lapping or pacing, repetitive and temporally-disordered. This research supports the mounting evidence that the concept of wandering, in its formal sense, and missing incidents are two distinct concepts. It will be important to further develop the concept of missing incidents by identifying the differences and similarities from wandering. This will allow a more targeted assessment and

Statewide analysis of missed opportunities for human papillomavirus vaccination using vaccine registry data.

PubMed

Kepka, Deanna; Spigarelli, Michael G; Warner, Echo L; Yoneoka, Yukiko; McConnell, Nancy; Balch, Alfred

2016-12-01

Human papillomavirus (HPV) vaccine 3-dose completion rates among adolescent females in the US are low. Missed opportunities impede HPV vaccination coverage. A population-based secondary data analysis of de-identified vaccination and demographic data from the Utah Statewide Immunization Information System (USIIS) was conducted. Records were included from 25,866 females ages 11-26 years at any time during 2008-2012 who received at least one of the following adolescent vaccinations documented in the USIIS: Tdap (Tetanus, Diphtheria, Pertussis), meningococcal, and/or influenza. A missed opportunity for HPV vaccination was defined as a clinical encounter where the patient received at least one adolescent vaccination, but not a HPV vaccine. Of 47,665 eligible visits, there were 20,911 missed opportunities (43.87%). Age group, race/ethnicity, and rurality were significantly associated with missed opportunity (p<0.0001). In a multivariable mixed-effects logistic regression model that included ethnicity, location and age, as fixed effects and subject as a random effect, Hispanics were less likely to have a missed opportunity than whites OR 0.59 (95% CI: 0.52-0.66), small rural more likely to have a missed opportunity than urban youth OR 1.8 (95% CI: 1.5-2.2), and preteens more likely than teens OR 2.4 (95% CI: 2.2-2.7). Missed clinical opportunities are a significant barrier to HPV vaccination among female adolescents. Interventions targeted at providers who serve patient groups with the highest missed opportunities are needed to achieve adequate protection from HPV-associated illnesses. This is one of the first studies to utilize state immunization information system data to assess missed opportunities for HPV vaccination.

Intolerance and Violence Against Doctors.

PubMed

Singh, Meharban

2017-10-01

Intolerance and grouse against doctors is a global phenomenon but India seems to lead the world in violence against doctors. According to World Health Organization, about 8-38% healthcare workers suffer physical violence at some point in their careers. Many more are verbally abused or threatened. Public is almost behaving like health sector terrorists. The spate of increasing attacks on doctors by damaging their property and causing physical injury is not acceptable by any civilized society. The public is becoming increasingly intolerant to a large number of social issues because of poor governance and vote bank politics. There is a need to arrest the development of further distrust between doctors and their patients/relatives, otherwise it will compromise all achievements of medical science and adversely affect healing capabilities of doctors. Rude and aggressive behavior of the patients or their family members, and arrogant and lackadaisical approach of the doctor, adversely affects the doctor-patient relationship and the outcome of the patient. The doctors, hospital administration and government must exercise "zero tolerance" with respect to acts of violence against healthcare professionals. It is possible to reduce the incidence of intolerance against doctors but difficult to eliminate it completely. The healthcare providers should demonstrate greater compassion and empathy with improved communication skills. The hospitals must have adequate infrastructure, facilities and staff to handle emergencies without delay and with due confidence and skills. The security of healthcare providers, especially in sensitive areas, should be improved by having adequate number of security guards, frisking facilities, extensive CCTV network and availability of "Quick response team" to handle unruly mob. In case of any grievances for alleged mismanagement, the public should handle the situation in a civilized manner and seek redressal through Medical Protection Act and legal

Modeling missing data in knowledge space theory.

PubMed

de Chiusole, Debora; Stefanutti, Luca; Anselmi, Pasquale; Robusto, Egidio

2015-12-01

Missing data are a well known issue in statistical inference, because some responses may be missing, even when data are collected carefully. The problem that arises in these cases is how to deal with missing data. In this article, the missingness is analyzed in knowledge space theory, and in particular when the basic local independence model (BLIM) is applied to the data. Two extensions of the BLIM to missing data are proposed: The former, called ignorable missing BLIM (IMBLIM), assumes that missing data are missing completely at random; the latter, called missing BLIM (MissBLIM), introduces specific dependencies of the missing data on the knowledge states, thus assuming that the missing data are missing not at random. The IMBLIM and the MissBLIM modeled the missingness in a satisfactory way, in both a simulation study and an empirical application, depending on the process that generates the missingness: If the missing data-generating process is of type missing completely at random, then either IMBLIM or MissBLIM provide adequate fit to the data. However, if the pattern of missingness is functionally dependent upon unobservable features of the data (e.g., missing answers are more likely to be wrong), then only a correctly specified model of the missingness distribution provides an adequate fit to the data. (c) 2015 APA, all rights reserved).

Design and implementation of a near-miss reporting system at a large, academic pediatric anesthesia department.

PubMed

Guffey, Patrick; Szolnoki, Judit; Caldwell, James; Polaner, David

2011-07-01

Current incident reporting systems encourage retrospective reporting of morbidity and mortality and have low participation rates. A near miss is an event that did not cause patient harm, but had the potential to. By tracking and analyzing near misses, systems improvements can be targeted appropriately, and future errors may be prevented. An electronic, web based, secure, anonymous reporting system for anesthesiologists was designed and instituted at The Children's Hospital, Denver. This portal was compared to an existing hospital incident reporting system. A total of 150 incidents were reported in the first 3 months of operation, compared to four entered in the same time period 1 year ago. An anesthesia-specific anonymous near-miss reporting system, which eases and facilitates data entry and can prospectively identify processes and practices that place patients at risk, was implemented at a large, academic, freestanding children's hospital. This resulted in a dramatic increase in reported events and provided data to target and drive quality and process improvement. © 2011 Blackwell Publishing Ltd.

200 junior doctors sacked in Zambia.

PubMed

Ahmad, K

2000-07-29

Since December 1999 junior doctors in Zambia have been on strike, demanding from the government better working conditions, better pay, and improvements in hospital services. However, on June 20, 2000, around 200 junior doctors were dismissed by the Zambian government, who asserts that the action was taken in the public¿s interest. Nevertheless, the doctors argue that the move came at a time when the country is struggling with a critical shortage of doctors and with an HIV/AIDS crisis. In addition, health policy experts say that the dismissal could further undermine the alarming conditions of Zambia's health care system. It is noted that there are only 800 doctors registered with the Zambian Medical Council, but WHO estimates that the country needs 1500 clinicians. To meet such a shortage, the government has hired Cuban and Chinese doctors. They are paid more and given more benefits than the Zambian doctors, generating complaints from the president of the junior doctors' representative body.

The good doctor: the carer's perspective.

PubMed

Levine, Carol

2004-01-01

Carers are family members, friends, and neighbours who perform medical tasks and personal care, manage housekeeping and financial affairs, and provide emotional support to people who are ill, disabled, or elderly. From a carer's perspective, the primary requisite for a good doctor is competence. Assuming equal technical skills and knowledge, the difference between 'good' and 'bad' doctors comes down to attitudes and behaviour-communication. An important aspect of communication is what doctors say to carers, and how they interpret what carers say to them. Body language-stances, gestures and expression-communicates as well. Good doctors are surrounded by courteous, helpful and efficient assistants. Doctors can make two types of errors in dealing with carers. Type 1 errors occur when doctors exclude the carer from decision making and information. Type 2 errors occur when doctors speak only to the carer and ignore the patient. Good doctors, patients and carers confront the existential meaning of illness together.

Skill set development of doctoral and post-doctoral graduates in life sciences.

PubMed

Kanwar, R S

2010-01-01

Doctoral and post-doctoral training programs at leading research universities in the USA are highly important in generating the much needed knowledge in science, technology, engineering, and mathematics for keeping rural and urban economies strong and societies healthy and prosperous. In addition, innovative graduate and post doctoral research programs are the driving engines of the success of U.S. economy and have made the U.S. the most successful model of generating new knowledge in the broader areas of life sciences (and agricultural education, research, and extension). We need to do everything in our power to make these training programs innovative, collaborative, independent, and resourceful so that students are trained in different disciplines making them more flexible within a range of challenges and opportunities. The training programs must empower students to solve complex and interdisciplinary problems of the society in 21st century and make our students competitive within a global economic system, to improve the health of the nation's economy. If our land grant schools and institutions of higher learning are not preparing doctoral students to be globally competitive scientists to create new knowledge and technologies to solve complex and interdisciplinary problems of the 21st century, then either we need to redefine the mission of our land grant system or we risk losing our role to serve the public and industry effectively. Doctoral and post doctoral students should be given the needed skills and experiences to prepare them for tenure track faculty jobs at leading US Universities in the 21st century as well as prepare them for the world outside of academia. I would say minimum competency skills are needed as "bare survival skills" for all doctoral students to become successful after obtaining PhD degrees. Today's PhD students will be working in a global but highly competitive, rapidly changing, and complex world. It is no longer enough to be a good

Management of Mass Casualties Using Doctor Helicopters and Doctor Cars.

PubMed

Ohsaka, Hiromichi; Ishikawa, Kouhei; Omori, Kazuhiko; Jitsuiki, Kei; Yoshizawa, Toshihiko; Yanagawa, Youichi

At approximately 10 o'clock in September 2015, a minibus carrying 18 people accidentally slid backwards because of a malfunctioning brake system while climbing a steep incline on Togasayama Mountain, colliding with a van (Toyota HiAce wagon) carrying 11 people that was situated behind the minibus. Togasayama Mountain is located 1 hour by car and 10 minutes by helicopter from our hospital. The minibus slid off a roadside cliff at a height of 0.5 m and rolled over after colliding with the van. There were 7 victims with yellow tags and 22 with green tags. Two Doctor Helicopters and 1 Doctor Car cooperated with the fire departments by providing medical treatments, selection of medical facilities, and dispersion transportation. In this mass casualty event, there were no mortalities, and all of the victims recovered without sequelae. The coordinated and combined use of Doctor Helicopters and Doctor Cars in addition to the activities of the fire department in response to a mass casualty event resulted in appropriate triage, medical treatments, selection of medical facilities, and dispersion transportation. Copyright © 2017 Air Medical Journal Associates. Published by Elsevier Inc. All rights reserved.

Predictors of missed appointments in patients referred for congenital or pediatric cardiac magnetic resonance.

PubMed

Lu, Jimmy C; Lowery, Ray; Yu, Sunkyung; Ghadimi Mahani, Maryam; Agarwal, Prachi P; Dorfman, Adam L

2017-07-01

Congenital cardiac magnetic resonance is a limited resource because of scanner and physician availability. Missed appointments decrease scheduling efficiency, have financial implications and represent missed care opportunities. To characterize the rate of missed appointments and identify modifiable predictors. This single-center retrospective study included all patients with outpatient congenital or pediatric cardiac MR appointments from Jan. 1, 2014, through Dec. 31, 2015. We identified missed appointments (no-shows or same-day cancellations) from the electronic medical record. We obtained demographic and clinical factors from the medical record and assessed socioeconomic factors by U.S. Census block data by patient ZIP code. Statistically significant variables (P<0.05) were included into a multivariable analysis. Of 795 outpatients (median age 18.5 years, interquartile range 13.4-27.1 years) referred for congenital cardiac MR, a total of 91 patients (11.4%) missed appointments; 28 (3.5%) missed multiple appointments. Reason for missed appointment could be identified in only 38 patients (42%), but of these, 28 (74%) were preventable or could have been identified prior to the appointment. In multivariable analysis, independent predictors of missed appointments were referral by a non-cardiologist (adjusted odds ratio [AOR] 5.8, P=0.0002), referral for research (AOR 3.6, P=0.01), having public insurance (AOR 2.1, P=0.004), and having scheduled cardiac MR from November to April (AOR 1.8, P=0.01). Demographic factors can identify patients at higher risk for missing appointments. These data may inform initiatives to limit missed appointments, such as targeted education of referring providers and patients. Further data are needed to evaluate the efficacy of potential interventions.

MISSE-6 hardware

NASA Image and Video Library

2009-09-02

ISS020-E-037371 (1 Sept. 2009) --- A close-up view of a Materials International Space Station Experiment (MISSE-6) on the exterior of the Columbus laboratory is featured in this image photographed by a space walking astronaut during the STS-128 mission’s first session of extravehicular activity (EVA). MISSE collects information on how different materials weather in the environment of space. MISSE was later placed in Space Shuttle Discovery’s payload bay for its return to Earth. A portion of a payload bay door is visible in the background. The blackness of space and Earth’s horizon provide the backdrop for the scene.

Reexamining the Structure of Hemingway's "The Doctor and the Doctor's Wife."

ERIC Educational Resources Information Center

Mulvey, James

2003-01-01

Considers how Hemingway's "The Doctor and the Doctor's Wife" is a model of Edgar Allan Poe's aesthetic of the short story. Examines this work on many levels. Concludes that great writers, such as Ernest Hemingway, challenge readers to find the clues, to connect the dots, to pay attention to the "little details." (SG)

The MISSE-9 Polymers and Composites Experiment Being Flown on the MISSE-Flight Facility

NASA Technical Reports Server (NTRS)

De Groh, Kim K.; Banks, Bruce A.

2017-01-01

Materials on the exterior of spacecraft in low Earth orbit (LEO) are subject to extremely harsh environmental conditions, including various forms of radiation (cosmic rays, ultraviolet, x-ray, and charged particle radiation), micrometeoroids and orbital debris, temperature extremes, thermal cycling, and atomic oxygen (AO). These environmental exposures can result in erosion, embrittlement and optical property degradation of susceptible materials, threatening spacecraft performance and durability. To increase our understanding of space environmental effects such as AO erosion and radiation induced embrittlement of spacecraft materials, NASA Glenn has developed a series of experiments flown as part of the Materials International Space Station Experiment (MISSE) missions on the exterior of the International Space Station (ISS). These experiments have provided critical LEO space environment durability data such as AO erosion yield values for many materials and mechanical properties changes after long term space exposure. In continuing these studies, a new Glenn experiment has been proposed, and accepted, for flight on the new MISSE-Flight Facility (MISSE-FF). This experiment is called the Polymers and Composites Experiment and it will be flown as part of the MISSE-9 mission, the inaugural mission of MISSE-FF. Figure 1 provides an artist rendition of MISSE-FF ISS external platform. The MISSE-FF is manifested for launch on SpaceX-13.

Job satisfaction of village doctors during the new healthcare reforms in China.

PubMed

Zhang, Xiaoyan; Fang, Pengqian

2016-04-01

Objective China launched new healthcare reforms in 2009 and several policies targeted village clinics, which affected village doctors' income, training and duties. The aim of the present study was to assess village doctors' job satisfaction during the reforms and to explore factors affecting job satisfaction. Methods Using a stratified multistage cluster sampling process, 935 village doctors in Jiangxi Province were surveyed with a self-administered questionnaire that collected demographic information and contained a job satisfaction scale and questions regarding their work situation and individual perceptions of the new healthcare reforms. Descriptive analysis, Pearson's Chi-squared test and binary logistic regression were used to identify village doctors' job satisfaction and the factors associated with their job satisfaction. Results Only 12.72% of village doctors were either satisfied or very satisfied with their jobs and the top three items leading to dissatisfaction were pay and the amount of work that had to be done, opportunities for job promotion and work conditions. Marriage, income, intention to leave, satisfaction with learning and training, social status, relationship with patients and satisfaction with the new healthcare reforms were significantly associated with job satisfaction (P<0.05). Conclusions China is facing critical challenges with regard to village doctors because of their low job satisfaction. For future healthcare reforms, policy makers should pay more attention to appropriate remuneration and approaches that incentivise village doctors to achieve the goals of the health reforms. What is known about the topic? Village doctors act as gatekeepers at the bottom tier of the rural health system. However, the policies of the new healthcare reform initiatives in China were centred on improving the quality of care delivered to the rural population and reducing fast-growing medical costs. There have been limited studies on village doctors

The development of online doctor reviews in China: an analysis of the largest online doctor review website in China.

PubMed

Hao, Haijing

2015-06-01

Since the time of Web 2.0, more and more consumers have used online doctor reviews to rate their doctors or to look for a doctor. This phenomenon has received health care researchers' attention worldwide, and many studies have been conducted on online doctor reviews in the United States and Europe. But no study has yet been done in China. Also, in China, without a mature primary care physician recommendation system, more and more Chinese consumers seek online doctor reviews to look for a good doctor for their health care concerns. This study sought to examine the online doctor review practice in China, including addressing the following questions: (1) How many doctors and specialty areas are available for online review? (2) How many online reviews are there on those doctors? (3) What specialty area doctors are more likely to be reviewed or receive more reviews? (4) Are those reviews positive or negative? This study explores an empirical dataset from Good Doctor website, haodf.com—the earliest and largest online doctor review and online health care community website in China—from 2006 to 2014, to examine the stated research questions by using descriptive statistics, binary logistic regression, and multivariate linear regression. The dataset from the Good Doctor website contained 314,624 doctors across China and among them, 112,873 doctors received 731,543 quantitative reviews and 772,979 qualitative reviews as of April 11, 2014. On average, 37% of the doctors had been reviewed on the Good Doctor website. Gynecology-obstetrics-pediatrics doctors were most likely to be reviewed, with an odds ratio (OR) of 1.497 (95% CI 1.461-1.535), and internal medicine doctors were less likely to be reviewed, with an OR of 0.94 (95% CI 0.921-0.960), relative to the combined small specialty areas. Both traditional Chinese medicine doctors and surgeons were more likely to be reviewed than the combined small specialty areas, with an OR of 1.483 (95% CI 1.442-1.525) and an OR of 1

Junior doctors' experiences of personal illness: a qualitative study.

PubMed

Fox, Fiona E; Doran, Natasha J; Rodham, Karen J; Taylor, Gordon J; Harris, Michael F; O'Connor, Michael

2011-12-01

Professional status and working arrangements can inhibit doctors from acknowledging and seeking care for their own ill health. Research identifies that a culture of immunity to illness within the medical profession takes root during training. What happens when trainee doctors become unwell during their formative period of education and training? What support do they receive and how do they perceive that the experience of ill health affects their training trajectory? These research questions were developed by a multidisciplinary team of researchers and health professionals, who adopted a qualitative approach to investigate the experiences of personal illness among trainees in their Foundation Programme (FP) years. Semi-structured interviews were conducted with eight FP trainees from the Severn Deanery in southwest England who had experienced significant illness. Interpretative phenomenological analysis was used to conduct and analyse the interviews, resulting in a comprehensive list of master themes. This paper reports an interpretative analysis of the themes of Support, Illness Experience, Crossing the Line, Medical Culture, Stigma and Disclosure. Ineffective communication within the medical education and employment system underpins many of the difficulties encountered by trainees who are unwell. Coping style plays a key role in predicting how trainees experience support during and after their illness, although this may be influenced by their particular diagnoses. The barriers to disclosure of their illnesses are discussed within the context of mobilising and maintaining support. Concern about the impact of missing training as a result of ill health appears to be significant in the transmitting of an ethos of invulnerability within the medical culture. Suggestions to improve support procedures for trainees who are unwell include the provision of greater flexibility within the rotation system along with independent pastoral support. Promoting the importance of

Low target prevalence is a stubborn source of errors in visual search tasks

PubMed Central

Wolfe, Jeremy M.; Horowitz, Todd S.; Van Wert, Michael J.; Kenner, Naomi M.; Place, Skyler S.; Kibbi, Nour

2009-01-01

In visual search tasks, observers look for targets in displays containing distractors. Likelihood that targets will be missed varies with target prevalence, the frequency with which targets are presented across trials. Miss error rates are much higher at low target prevalence (1–2%) than at high prevalence (50%). Unfortunately, low prevalence is characteristic of important search tasks like airport security and medical screening where miss errors are dangerous. A series of experiments show this prevalence effect is very robust. In signal detection terms, the prevalence effect can be explained as a criterion shift and not a change in sensitivity. Several efforts to induce observers to adopt a better criterion fail. However, a regime of brief retraining periods with high prevalence and full feedback allows observers to hold a good criterion during periods of low prevalence with no feedback. PMID:17999575

The Nature of Exemplary Doctoral Advisors' Expectations and the Ways They May Influence Doctoral Persistence

ERIC Educational Resources Information Center

Barnes, Benita J.

2010-01-01

The high attrition rate from doctoral programs has been called a "hidden crisis" in graduate education (Lovitts & Nelson, 2000). Previous research has identified a constellation of factors that may contribute to doctoral attrition. However, the literature suggests that one of the most powerful influences on doctoral persistence is the relationship…

The Rise of Professional Doctorates: Case Studies of the Doctorate in Education in China, Iceland and Australia

ERIC Educational Resources Information Center

Wildy, Helen; Peden, Sanna; Chan, Karyn

2015-01-01

Doctoral education is going through a period of transition. This transition is evident in the many varieties of doctoral degrees currently offered in higher education institutions worldwide, from the traditional research-based Doctor of Philosophy (PhD) to the Professional Doctorate and the New Route PhD. This article reports on a study which…

Unhappy doctors? A longitudinal study of life and job satisfaction among Norwegian doctors 1994 – 2002

PubMed Central

Nylenna, Magne; Gulbrandsen, Pål; Førde, Reidun; Aasland, Olaf G

2005-01-01

Background General opinion is that doctors are increasingly dissatisfied with their job, but few longitudinal studies exist. This study has been conducted to investigate a possible decline in professional and personal satisfaction among doctors by the turn of the century. Methods We have done a survey among a representative sample of 1 174 Norwegian doctors in 2002 (response rate 73 %) and compared the findings with answers to the same questions by (most of) the same doctors in 1994 and 2000. The main outcome measures were self reported levels of life satisfaction and job satisfaction according to the Job Satisfaction Scale (JSS). Results Most Norwegian doctors are happy. They reported an average life satisfaction of 5.21 in 1994 and 5.32 in 2002 on a scale from 1 (extremely dissatisfied) to 7 (extremely satisfied). Half of the respondents reported a very high level of general life satisfaction (a score of 6 or 7) while only one third said they would have reported this high level of satisfaction five years ago. The doctors thought that they had a higher level of job satisfaction than other comparable professional groups. The job satisfaction scale among the same doctors showed a significant increase from 1994 to 2002. Anaesthesiologists and internists reported a lower and psychiatrists and primary care doctors reported a higher level of job satisfaction than the average. Conclusion Norwegian doctors seem to have enjoyed an increasing level of life and job satisfaction rather than a decline over the last decade. This challenges the general impression of unhappy doctors as a general and worldwide phenomenon. PMID:15943859

[Advancement of the medical doctorate].

PubMed

Baum, C; Förster, R; Schmidt, R E

2009-08-01

The medical doctorate and the subsequent advanced research qualification in medicine have an exceptional position within the natural sciences. While, in the German system, graduation to the degree of a medical doctor is often an initiation into scientific practice, the in-depth scientific education of medical doctors may be achieved in various configurations. In recent years, structured programs for doctorates in medicine and natural sciences have found increasing acceptance, following recommendations of national scientific councils ("Deutsche Forschungsgemeinschaft" and "Hochschulrat"). Hannover Medical School has been offering such programs for a number of years. The StrucMed program increases the quality of medical doctorate studies, typically performed in the third and fourth years of university studies. The Hannover Biomedical Research School (HBRS) combines several programs for a doctorate in natural sciences, creating a platform for an internationally oriented education of post-graduates in various disciplines of life sciences. Evaluating the achievements and career paths of the trainees will contribute to the successful integration of research work in an efficiency-oriented clinical environment.

The Development of Online Doctor Reviews in China: An Analysis of the Largest Online Doctor Review Website in China

PubMed Central

2015-01-01

Background Since the time of Web 2.0, more and more consumers have used online doctor reviews to rate their doctors or to look for a doctor. This phenomenon has received health care researchers’ attention worldwide, and many studies have been conducted on online doctor reviews in the United States and Europe. But no study has yet been done in China. Also, in China, without a mature primary care physician recommendation system, more and more Chinese consumers seek online doctor reviews to look for a good doctor for their health care concerns. Objective This study sought to examine the online doctor review practice in China, including addressing the following questions: (1) How many doctors and specialty areas are available for online review? (2) How many online reviews are there on those doctors? (3) What specialty area doctors are more likely to be reviewed or receive more reviews? (4) Are those reviews positive or negative? Methods This study explores an empirical dataset from Good Doctor website, haodf.com—the earliest and largest online doctor review and online health care community website in China—from 2006 to 2014, to examine the stated research questions by using descriptive statistics, binary logistic regression, and multivariate linear regression. Results The dataset from the Good Doctor website contained 314,624 doctors across China and among them, 112,873 doctors received 731,543 quantitative reviews and 772,979 qualitative reviews as of April 11, 2014. On average, 37% of the doctors had been reviewed on the Good Doctor website. Gynecology-obstetrics-pediatrics doctors were most likely to be reviewed, with an odds ratio (OR) of 1.497 (95% CI 1.461-1.535), and internal medicine doctors were less likely to be reviewed, with an OR of 0.94 (95% CI 0.921-0.960), relative to the combined small specialty areas. Both traditional Chinese medicine doctors and surgeons were more likely to be reviewed than the combined small specialty areas, with an OR of 1

The doctor's dilemma.

PubMed

Irvine, D H; Donaldson, L J

1995-10-01

The close relationship between expenditure on health care and the countless individual judgements made by doctors for their patients means that any discussion about rationing must involve the process of clinical decision-making. Increasingly, doctors are being drawn into rationing by two powerful forces. Firstly, through the corporate responsibilities of those working within a managed health care system in which organisational objectives and budgetary constraints are agreed and specified in a much more explicit way than ever before. Secondly, by the professionally-led movement towards more clinically effective practice. These, in combination, are leading towards a fundamental review of the nature and ethical basis of clinical practice in which the duty of doctors to individual patients must be balanced against the wider considerations.

Perceptions of doctors on being treated by a doctor just completing the house job.

PubMed

Ahmad, Amina; Haque Shaikh, Siraj Ul; Tayyab, Muhammad; Gardezi, Javed Raza

2014-12-01

To determine the percentage of medical teachers and fresh doctors who feel that graduating doctors are competent or incompetent to handle common ailments and to evaluate the reasons for their perceptions. Sequential mixed method. First phase extending from December 2010 to December 2011 and second phase was conducted in March 2014. First phase comprised electronic distribution of questionnaire to 100 medical teachers and fresh doctors working in hospitals attached with 5 private and 5 public sector medical colleges of Lahore and Karachi to rate an average house officer on a frequency scale of 1 - 6 and do self-assessment, in case of a fresh doctor. The second phase included interviews of 20 medical teachers to explore justification for their rating in the survey questionnaire and for triangulation of data. Quantitative data was analyzed through SPSS version 15 to calculate frequencies and percentages and interviews were analyzed through quasi-statistical approach. In survey, 38.36% out of 73 medical teachers and 30% out of 20 medical teachers in interviews confirmed their confidence on consulting fresh doctors for common ailments as opposed to 61.64% and 70% respectively, expressing their dissatisfaction. Self-assessment of fresh doctors indicated that 40% are confident in handling common medical conditions as opposed to 33.3% out of 75 respondents, who are not confident about their clinical skills. Faculty and self-assessment of fresh doctors has a fair overlap, indicating room for further improvement in the house job training program.

Working as a doctor when chronically ill or disabled: comments made by doctors responding to UK surveys.

PubMed

Smith, Fay; Goldacre, Michael J; Lambert, Trevor W

2016-07-01

To report a qualitative study of themes doctors raised spontaneously, in a large-scale prospective cohort study covering many aspects of their medical careers, when referring to their own chronic illness or disability. Questionnaire survey. UK. Questionnaires were sent one, five and 10 years after graduation to 44,539 doctors who qualified between 1993 and 2012 in the UK: 38,613 questionnaires were returned and 11,859 respondents provided comments made by doctors about their training or work. The comments of 123 doctors about their own chronic illness or disability. Main themes raised included poor support for doctors with chronic illness or disability, delays in and changes to careers (either planned ahead or imposed), the impact of pressure at work, difficulties returning to work after illness, limitations on career choices and inadequate careers advice for doctors with chronic illness or disabilities. More needs to be done to ensure that doctors with chronic illness or disability receive appropriate support. Occupational health guidance should be monitored closely, with more support for ill doctors including adjustments to the job, help if needed with morale and mental health, and advice on career options. Further studies should establish the prevalence of long-term health conditions among doctors.

Miss-distance indicator for tank main guns

NASA Astrophysics Data System (ADS)

Bornstein, Jonathan A.; Hillis, David B.

1996-06-01

Tank main gun systems must possess extremely high levels of accuracy to perform successfully in battle. Under some circumstances, the first round fired in an engagement may miss the intended target, and it becomes necessary to rapidly correct fire. A breadboard automatic miss-distance indicator system was previously developed to assist in this process. The system, which would be mounted on a 'wingman' tank, consists of a charged-coupled device (CCD) camera and computer-based image-processing system, coupled with a separate infrared sensor to detect muzzle flash. For the system to be successfully employed with current generation tanks, it must be reliable, be relatively low cost, and respond rapidly maintaining current firing rates. Recently, the original indicator system was developed further in an effort to assist in achieving these goals. Efforts have focused primarily upon enhanced image-processing algorithms, both to improve system reliability and to reduce processing requirements. Intelligent application of newly refined trajectory models has permitted examination of reduced areas of interest and enhanced rejection of false alarms, significantly improving system performance.

Can we prevent doctors being complicit in torture? Breaking the serpent's egg.

PubMed

O'Connor, Mike

2009-12-01

A significant minority of the tortured prisoners who survive report that a doctor was present during their torture. Yet few medical practitioners are ever criminally prosecuted or even disciplined by their regulatory bodies. Can such gross violations of the Hippocratic Code be so easily ignored or are these doctors carefully shielded from detection and prosecution by a grateful state? Mostly doctors act to vet prisoners for their capacity to withstand the torture or resuscitate them to allow torture and interrogation to continue. However, on occasion, the "healers" may be the actual torturers as happened in Russian psychoprisons in the latter part of the 20th century. This article argues that the de facto immunity which complicit doctors currently appear to enjoy must be stripped away and replaced by effective processes to detect and then prosecute criminal behaviour. This will require widespread reporting of cases and action by international bodies, including non-government organisations. Prevention is clearly preferable and this will require improvements in undergraduate and graduate medical education about international humanitarian and human rights law. There is evidence that many medical faculties pay scant attention to this education and their students graduate with serious flaws in their understanding and attitudes towards human rights. Education should target "doctors at risk" in prisons, armed forces and the police. It should address professional behaviour which tolerates or even protects cultures of abuse. A code of professional conduct would assist "doctors at risk" to resist overtures for them to become complicit in torture, Medical Practice Acts should include statements on respecting human rights when defining good professional conduct. Doctors who become complicit in torture betray their profession. Swift action should be taken to stop such abuses and perpetrators should receive strong disciplinary action from regulatory bodies.

[Doctor's attendance in police custody].

PubMed

Chariot, Patrick

2012-06-01

Medical examination is a right for every person detained in police custody in France. Examination of detainees usually takes place in the police station so that the doctor can assess the conditions in which the detainee is being held. In some cases, such as type I diabetes care, detainees need to be examined and treated in a hospital. Doctors are subject to a duty of care and prevention. Description of recent traumatic injuries is part of the doctor's mission. They should prescribe any ongoing treatment which needs to be continued, as well as any emergency treatment required. Custody officers may monitor the detainee and administer medication. Doctor's opinion should be given in a national standard document. If the doctor considers that the custody conditions are disgraceful, they may refuse to express an opinion as to whether the detainee is fit for custody.

Researching Doctoral Pedagogy Close up: Design and Action in Two Doctoral Programmes

ERIC Educational Resources Information Center

Danby, Susan; Lee, Alison

2012-01-01

With growing international interest in diversifying sites for pedagogical work within the doctorate, doctoral programmes of different kinds are being developed in different disciplinary, institutional and national settings. However, little is known about how the pedagogical work of these programmes is designed and enacted, and with what effects.…

Inequality and Doctoral Education: Exploring the "Rules" of Doctoral Study through Bourdieu's Notion of Field

ERIC Educational Resources Information Center

Gopaul, Bryan

2015-01-01

While studies have examined a myriad of issues in doctoral study, much of this research has not employed the tools of major social and cultural thinkers to the dynamics of doctoral education. This paper explores the use of Bourdieu's notion of field to render visible the practices and contexts of doctoral education that produce inequalities across…

Coaching Doctoral Students--A Means to Enhance Progress and Support Self-Organisation in Doctoral Education

ERIC Educational Resources Information Center

Godskesen, Mirjam; Kobayashi, Sofie

2016-01-01

In this paper we focus on individual coaching carried out by an external coach as a new pedagogical element that can impact doctoral students' sense of progress in doctoral education. The study used a mixed-methods approach in that we draw on quantitative and qualitative data from the evaluation of a project on coaching doctoral students. We…

Heartburn - what to ask your doctor

MedlinePlus

... your doctor; GERD - what to ask your doctor; Gastroesophageal reflux disease - what to ask your doctor ... MF. Guidelines for the diagnosis and management of gastroesophageal reflux disease. Am J Gastroenterol . 2013;108(3):308- ...

A Profile of Mexican American, Puerto Rican, and Other Hispanic STEM Doctorates: 1983 TO 1997

NASA Astrophysics Data System (ADS)

Quintana-Baker, Maricel

This article describes the characteristics of Hispanic U. S. citizens who earned doctoral degrees in science, technology, engineering, and mathematics (STEM) from institutions in the United States between 1983 and 1997. The data on this population •were disaggregated by gender and by Hispanic subgroup (i.e., Mexican American, Puerto Rican and other Hispanic). The profile for this population includes parental education, type of financial assistance during time of study, and level of debt on receipt of doctorate. In addition, this research identified and ranked the doctorate-granting institutions according to the absolute number of STEM doctoral degrees they granted to Hispanics during the 15-year period of the study. The results indicate that there are differences among the Hispanic subgroups in this study. Therefore, it is critical thai future researchers understand that studies that analyze Hispanics as one single homogeneous group produce results that are not truly representative and that research, policy, and programmatic efforts must be targeted accordingly.

Persons with dementia missing in the community: Is it wandering or something unique?

PubMed Central

2011-01-01

Background At some point in the disease process many persons with dementia (PWD) will have a missing incident and be unable to safely return to their care setting. In previous research studies, researchers have begun to question whether this phenomenon should continue to be called wandering since the antecedents and characteristics of a missing incident are dissimilar to accepted definitions of wandering in dementia. The purpose of this study was to confirm previous findings regarding the antecedents and characteristics of missing incidents, understand the differences between those found dead and alive, and compare the characteristics of a missing incident to that of wandering. Methods A retrospective design was used to analyse 325 newspaper reports of PWD missing in the community. Results The primary antecedent to a missing incident, particularly in community-dwelling PWD, was becoming lost while conducting a normal and permitted activity alone in the community. The other common antecedent was a lapse in supervision with the expectation that the PWD would remain in a safe location but did not. Deaths most commonly occurred in unpopulated areas due to exposure and drowning. Those who died were found closer to the place last seen and took longer to find, but there were no significant differences in gender or age. The key characteristics of a missing incident were: unpredictable, non-repetitive, temporally appropriate but spatially-disordered, and while using multiple means of movement (walking, car, public transportation). Missing incidents occurred without the discernible pattern present in wandering such as lapping or pacing, repetitive and temporally-disordered. Conclusions This research supports the mounting evidence that the concept of wandering, in its formal sense, and missing incidents are two distinct concepts. It will be important to further develop the concept of missing incidents by identifying the differences and similarities from wandering. This will

Missing Data and Institutional Research

ERIC Educational Resources Information Center

Croninger, Robert G.; Douglas, Karen M.

2005-01-01

Many do not consider the effect that missing data have on their survey results nor do they know how to handle missing data. This chapter offers strategies for handling item-missing data and provides a practical example of how these strategies may affect results. The chapter concludes with recommendations for preventing and dealing with missing…

The characteristics of doctors receiving medical complaints: a cross-sectional survey of doctors in New Zealand.

PubMed

Cunningham, Wayne; Crump, Raewyn; Tomlin, Andrew

2003-10-10

To analyse the incidence and characteristics of medical complaints received by doctors in New Zealand. A cross-sectional survey of New Zealand doctors randomly selected from each of three groups from the New Zealand medical register: vocationally registered general practitioners; vocationally registered hospital-based specialists; and general registrants. Nine hundred and seventy one doctors (11% of registered New Zealand doctors) indicated that 34% had ever received a medical complaint, and 66% had never received one. The rate of complaint in New Zealand is rising. The annual rate of complaint in 2000 was 5.7%, with doctors in the 40-60 age group receiving 68% of complaints. Doctors who were male, vocationally registered general practitioners, and holding higher postgraduate qualifications were more likely to receive a complaint. Time to resolution of a complaint is long, with 74% of dismissed and 59% of upheld complaints being resolved within 12 months. This study finds a high incidence of complaint in New Zealand. It finds differences between doctors based on gender, qualification, and field of practice, and suggests that responsibility for patient care may be an important determinant of the risk of receiving a complaint.

Miss-distance indicator for tank main gun systems

NASA Astrophysics Data System (ADS)

Bornstein, Jonathan A.; Hillis, David B.

1994-07-01

The initial development of a passive, automated system to track bullet trajectories near a target to determine the `miss distance,' and the corresponding correction necessary to bring the following round `on target' is discussed. The system consists of a visible wavelength CCD sensor, long focal length optics, and a separate IR sensor to detect the muzzle flash of the firing event; this is coupled to a `PC' based image processing and automatic tracking system designed to follow the projectile trajectory by intelligently comparing frame to frame variation of the projectile tracer image. An error analysis indicates that the device is particularly sensitive to variation of the projectile time of flight to the target, and requires development of algorithms to estimate this value from the 2D images employed by the sensor to monitor the projectile trajectory. Initial results obtained by using a brassboard prototype to track training ammunition are promising.

Seeking and using intention of health information from doctors in social media: The effect of doctor-consumer interaction.

PubMed

Wu, Tailai; Deng, Zhaohua; Zhang, Donglan; Buchanan, Paula R; Zha, Dongqing; Wang, Ruoxi

2018-07-01

The aim of this study is to investigate how doctor-consumer interaction in social media influences consumers' health information seeking and usage intention. Based on professional-client interaction theory and expectation confirmation theory, we propose that doctor-consumer interaction can be divided into instrumental interaction and affective interaction. These two types of interaction influence consumers' health information seeking and usage intention through consumer satisfaction and trust towards doctors. To validate our proposed research model, we employed the survey method. The measurement instruments for all constructs were developed based on previous literatures, and 352 valid answers were collected by using these instruments. Our results reveal that consumers' intention to seek health information significantly predicts their intention to use health information from social media. Meanwhile, both consumer satisfaction and trust towards doctors influences consumers' health information seeking and usage intention significantly. With regards to the impact of the interaction between doctors and consumers, the results show that both types of doctor-consumer interaction significantly affect consumer satisfaction and trust towards doctors. The mediation analysis confirms the mediation role of consumer satisfaction and trust towards doctors. Compared with many intentional intervention programs, doctor-consumer interaction can be treated as an effective intervention with low cost to promote consumers' health information seeking and usage. Meanwhile, both instrumental and affective interaction should be highlighted for the best interaction results. At last, consumer satisfaction and trust towards doctors could be considered as the important working mechanisms for the effect of doctor-consumer interaction. Copyright © 2018 Elsevier B.V. All rights reserved.

Junior doctors and clinical audit.

PubMed

Greenwood, J P; Lindsay, S J; Batin, P D; Robinson, M B

1997-01-01

To assess the extent of junior doctor involvement in clinical audit, the degree of support from audit staff, and the perceived value of the resulting audits. Postal survey of National Health Service (NHS) junior doctors. 704 junior doctors in central Leeds hospitals, June 1996. Questionnaires were returned by 232 respondents (33%), 211 (31%) were completed; 157 respondents (74%) had personally performed audit. Mean (+/- SD) duration since last audit project was 14.9 (14.1) (range 0-84) months. Of the respondents who had personally performed audit, 88 (56%) did not use the hospital audit department, 60 (38%) received no guidance and only 19 (12%) were involved in re-auditing the same project. Mean (+/- SD) time spent per audit project was 27.8 (37.7), (range 2-212) hours. Seventy-five junior doctors (48%) were aware of subsequent change in clinical practice, 41 (26%) perceived a negative personal benefit from audit, 33 (21%) perceived a negative departmental benefit, and 42 (27%) felt that audit was a waste of time. A large proportion of junior doctors are involved in audit projects that do not conform to established good practice and which have a low impact on clinical behaviour. Although junior doctors feel that there is inadequate assistance and poor supervision whilst performing audit, they still support the principle of audit. There is a need to improve the quality and supervision of audit projects performed by junior doctors.

[Murder of the doctor].

PubMed

Lorettu, Liliana; Falchi, Lorenzo; Nivoli, Fabrizia L; Milia, Paolo; Nivoli, Giancarlo; Nivoli, Alessandra M

2015-01-01

To examine possible risk factors for the doctor to be killed by the patient in the clinical practice by examining a series of murders that involved physicians. This aim has been achieved through a retrospective review on clinical cases of doctors killed by patients within the period between 1988 and 2013, in Italy. In this period 18 Italian doctors have been killed in the workplace, with a rate of 0.3/100,000. In 7 cases, the murder resulted in the context of doctor-dissatisfaction; in 7 cases the murder was committed by a psychiatric patient; 1 case in the context of a stalking; 3 cases occurred in a workplace which was not safe enough. Four categories of at-risk contexts have been identified. One category includes a murder in the context of a doctor-dissatisfaction, perceived by patient. The second category concerns murders committed by patients suffering from mental illness. A third category includes homicides in a workplace which is not safe. The last category comprises the murder in the context of stalking. These categories identify specific dangerous situations for physicians, in which are highlighted elements that have played a crucial role in the murder and for which special precautions are suggested preventive.

Factors Associated with Medical Doctors' Intentions to Discriminate Against Transgender Patients in Kuala Lumpur, Malaysia.

PubMed

Vijay, Aishwarya; Earnshaw, Valerie A; Tee, Ying Chew; Pillai, Veena; White Hughto, Jaclyn M; Clark, Kirsty; Kamarulzaman, Adeeba; Altice, Frederick L; Wickersham, Jeffrey A

2018-01-01

Transgender people are frequent targets of discrimination. Discrimination against transgender people in the context of healthcare can lead to poor health outcomes and facilitate the growth of health disparities. This study explores factors associated with medical doctors' intentions to discriminate against transgender people in Malaysia. A total of 436 physicians at two major university medical centers in Kuala Lumpur, Malaysia, completed an online survey. Sociodemographic characteristics, stigma-related constructs, and intentions to discriminate against transgender people were measured. Bivariate and multivariate linear regression were used to evaluate independent covariates of discrimination intent. Medical doctors who felt more fearful of transgender people and more personal shame associated with transgender people expressed greater intention to discriminate against transgender people, whereas doctors who endorsed the belief that transgender people deserve good care reported lower discrimination intent. Stigma-related constructs accounted for 42% of the variance and 8% was accounted for by sociodemographic characteristics. Constructs associated with transgender stigma play an important role in medical doctors' intentions to discriminate against transgender patients. Development of interventions to improve medical doctors' knowledge about and attitudes toward transgender people are necessary to reduce discriminatory intent in healthcare settings.

Factors Associated with Medical Doctors' Intentions to Discriminate Against Transgender Patients in Kuala Lumpur, Malaysia

PubMed Central

Vijay, Aishwarya; Earnshaw, Valerie A.; Tee, Ying Chew; Pillai, Veena; White Hughto, Jaclyn M.; Clark, Kirsty; Kamarulzaman, Adeeba; Altice, Frederick L.

2018-01-01

Abstract Purpose: Transgender people are frequent targets of discrimination. Discrimination against transgender people in the context of healthcare can lead to poor health outcomes and facilitate the growth of health disparities. This study explores factors associated with medical doctors' intentions to discriminate against transgender people in Malaysia. Methods: A total of 436 physicians at two major university medical centers in Kuala Lumpur, Malaysia, completed an online survey. Sociodemographic characteristics, stigma-related constructs, and intentions to discriminate against transgender people were measured. Bivariate and multivariate linear regression were used to evaluate independent covariates of discrimination intent. Results: Medical doctors who felt more fearful of transgender people and more personal shame associated with transgender people expressed greater intention to discriminate against transgender people, whereas doctors who endorsed the belief that transgender people deserve good care reported lower discrimination intent. Stigma-related constructs accounted for 42% of the variance and 8% was accounted for by sociodemographic characteristics. Conclusions: Constructs associated with transgender stigma play an important role in medical doctors' intentions to discriminate against transgender patients. Development of interventions to improve medical doctors' knowledge about and attitudes toward transgender people are necessary to reduce discriminatory intent in healthcare settings. PMID:29227183

Doctoral Students' Perceived Barriers That Slow the Progress toward Completing a Doctoral Dissertation: A Mixed Analysis

ERIC Educational Resources Information Center

Hwang, Eunjin; Smith, Rachel N.; Byers, Valerie Tharp; Dickerson, Shirley; McAlister-Shields, Leah; Onwuegbuzie, Anthony J.; Benge, Cindy

2015-01-01

The non-completion of doctoral degrees has been a concern due to its economic, social, and personal consequences. In the current study, the researchers investigated perceived barriers of select doctoral students in completing their doctoral degrees by utilizing a fully mixed sequential mixed research design. The quantitative and qualitative data…

SU-E-T-310: Targeting Safety Improvements Through Analysis of Near-Miss Error Detection Points in An Incident Learning Database

DOE Office of Scientific and Technical Information (OSTI.GOV)

Novak, A; Nyflot, M; Sponseller, P

2014-06-01

Purpose: Radiation treatment planning involves a complex workflow that can make safety improvement efforts challenging. This study utilizes an incident reporting system to identify detection points of near-miss errors, in order to guide our departmental safety improvement efforts. Previous studies have examined where errors arise, but not where they are detected or their patterns. Methods: 1377 incidents were analyzed from a departmental nearmiss error reporting system from 3/2012–10/2013. All incidents were prospectively reviewed weekly by a multi-disciplinary team, and assigned a near-miss severity score ranging from 0–4 reflecting potential harm (no harm to critical). A 98-step consensus workflow was usedmore » to determine origination and detection points of near-miss errors, categorized into 7 major steps (patient assessment/orders, simulation, contouring/treatment planning, pre-treatment plan checks, therapist/on-treatment review, post-treatment checks, and equipment issues). Categories were compared using ANOVA. Results: In the 7-step workflow, 23% of near-miss errors were detected within the same step in the workflow, while an additional 37% were detected by the next step in the workflow, and 23% were detected two steps downstream. Errors detected further from origination were more severe (p<.001; Figure 1). The most common source of near-miss errors was treatment planning/contouring, with 476 near misses (35%). Of those 476, only 72(15%) were found before leaving treatment planning, 213(45%) were found at physics plan checks, and 191(40%) were caught at the therapist pre-treatment chart review or on portal imaging. Errors that passed through physics plan checks and were detected by therapists were more severe than other errors originating in contouring/treatment planning (1.81 vs 1.33, p<0.001). Conclusion: Errors caught by radiation treatment therapists tend to be more severe than errors caught earlier in the workflow, highlighting the importance of

Psychiatric Prescribers' Experiences With Doctor Shoppers.

PubMed

Worley, Julie; Johnson, Mary; Karnik, Niranjan

2015-01-01

Doctor shopping is a primary method of prescription medication diversion. After opioids, benzodiazepines and stimulants are the next most common prescription medications used nonmedically. Studies have shown that patients who engage in doctor shopping find it fun, exciting, and easy to do. There is a lack of research on the prescriber's perspective on the phenomenon of doctor shopping. This study investigates the experiences of prescribers in psychiatry with patients who engage in doctor shopping. Fifteen prescribers including psychiatrists and psychiatric nurse practitioners working in outpatient psychiatry were interviewed to elicit detailed information about their experiences with patients who engage in doctor shopping. Themes found throughout the interview were that psychiatric prescribers' experience with patients who engage in doctor shopping includes (a) detecting red flags, (b) negative emotional responding, (c) addressing the patient and the problem, and (d) inconsistently implementing precautions. When red flags were detected when prescribing controlled drugs, prescribers in psychiatry experienced both their own negative emotional responses such as disappointment and resentment as well as the negative emotions of the patients such as anger and other extreme emotional responses. Psychiatric prescribers responded to patient's doctor shopping in a variety of ways such as changing their practice, discharging the patients or taking steps to not accept certain patients identified as being at risk for doctor shopping, as well as by talking to the patient and trying to offer them help. Despite experiencing doctor shopping, the prescribers inconsistently implemented precautionary measures such as checking prescription drug monitoring programs. © The Author(s) 2015.

Ma_MISS on ExoMars: Mineralogical Characterization of the Martian Subsurface

NASA Astrophysics Data System (ADS)

De Sanctis, Maria Cristina; Altieri, Francesca; Ammannito, Eleonora; Biondi, David; De Angelis, Simone; Meini, Marco; Mondello, Giuseppe; Novi, Samuele; Paolinetti, Riccardo; Soldani, Massimo; Mugnuolo, Raffaele; Pirrotta, Simone; Vago, Jorge L.; Ma_MISS Team

2017-07-01

The Ma_MISS (Mars Multispectral Imager for Subsurface Studies) experiment is the visible and near infrared (VNIR) miniaturized spectrometer hosted by the drill system of the ExoMars 2020 rover. Ma_MISS will perform IR spectral reflectance investigations in the 0.4-2.2 μm range to characterize the mineralogy of excavated borehole walls at different depths (between 0 and 2 m). The spectral sampling is about 20 nm, whereas the spatial resolution over the target is 120 μm. Making use of the drill's movement, the instrument slit can scan a ring and build up hyperspectral images of a borehole. The main goal of the Ma_MISS instrument is to study the martian subsurface environment. Access to the martian subsurface is crucial to our ability to constrain the nature, timing, and duration of alteration and sedimentation processes on Mars, as well as habitability conditions. Subsurface deposits likely host and preserve H2O ice and hydrated materials that will contribute to our understanding of the H2O geochemical environment (both in the liquid and in the solid state) at the ExoMars 2020 landing site. The Ma_MISS spectral range and sampling capabilities have been carefully selected to allow the study of minerals and ices in situ before the collection of samples. Ma_MISS will be implemented to accomplish the following scientific objectives: (1) determine the composition of subsurface materials, (2) map the distribution of subsurface H2O and volatiles, (3) characterize important optical and physical properties of materials (e.g., grain size), and (4) produce a stratigraphic column that will inform with regard to subsurface geological processes. The Ma_MISS findings will help to refine essential criteria that will aid in our selection of the most interesting subsurface formations from which to collect samples.

The wealth of distinguished doctors: retrospective survey.

PubMed

McManus, I C

2005-12-24

To assess changes in the wealth of distinguished doctors in the United Kingdom between 1860 and 2001. Retrospective survey. The UK. 980 doctors of sufficient distinction to be included in the Oxford Dictionary of National Biography and who died between 1860 and 2001. Wealth at death, based on probate records and adjusted relative to average earnings in 2002. The wealth of distinguished doctors declined substantially between 1860 and 2001, and paralleled a decline in the relative income of doctors in general. The wealth of distinguished doctors also declined relative to other groups of distinguished individuals. In the 19th century, distinction in doctors was accompanied by substantial wealth, whereas by the end of the 20th century, the most distinguished doctors were less wealthy than their contemporaries who had achieved national distinction in other areas.

Why are hospital doctors not referring to Consultation-Liaison Psychiatry? - a systemic review.

PubMed

Chen, Kai Yang; Evans, Rebecca; Larkins, Sarah

2016-11-09

Consultation-Liaison Psychiatry (CLP) is a subspecialty of psychiatry that provides care to inpatients under non-psychiatric care. Despite evidence of benefits of CLP for inpatients with psychiatric comorbidities, referral rates from hospital doctors remain low. This review aims to understand barriers to CLP inpatient referral as described in the literature. We searched on Medline, PsychINFO, CINAHL and SCOPUS, using MESH and the following keywords: 1) Consultation-Liaison Psychiatry, Consultation Liaison Psychiatry, Consultation Psychiatry, Liaison Psychiatry, Hospital Psychiatry, Psychosomatic Medicine, the 2) Referral, Consultation, Consultancy and 3) Inpatient, Hospitalized patient, Hospitalized patient. We considered papers published between 1 Jan 1965 and 30 Sep 2015 and all articles written in English that contribute to understanding of barriers to CLP referral were included. Thirty-five eligible articles were found and they were grouped thematically into three categories: (1) Systemic factors; (2) Referrer factors; (3) Patient factors. Systemic factors that improves referrals include a dedicated CLP service, active CLP consultant and collaborative screening of patients. Referrer factors that increases referrals include doctors of internal medicine specialty and comfortable with CLP. Patients more likely to be referred tend to be young, has psychiatric history, live in an urban setting or has functional psychosis. This is the first systematic review that examines factors that influence CLP inpatient referrals. Although there is research in this area, it is of limited quality. Education could be provided to hospital doctors to better recognise mental illness. Collaborative screening of vulnerable groups could prevent inpatients from missing out on psychiatric care. CLP clinicians should use the knowledge gained in this review to provide quality engagement with referrers.

African International Doctoral Students in New Zealand: Englishes, Doctoral Writing and Intercultural Supervision

ERIC Educational Resources Information Center

Doyle, Stephanie; Manathunga, Catherine; Prinsen, Gerard; Tallon, Rachel; Cornforth, Sue

2018-01-01

While the experiences of international doctoral students, especially those from Asian countries, have been well researched, fewer studies have explored the experiences of African students in Southern countries like Australia and Aotearoa/New Zealand. This article reports on doctoral writing and student and supervisor perspectives on English…

Doctors writing outside the square.

PubMed

Hurley, Thomas H

2011-01-17

Publications written by doctors about subjects outside their professional activities are often widely read and may be more enduring than their technical publications. Dr Graeme Robertson, Sir Clive Fitts and Professor Richard Lovell were three doctors from Victoria who wrote with skill and artistry about subjects outside their professional work. Here I discuss these publications and the reasons these doctors came to write them, and offer some reasons for the enduring interest of these publications.

[Near miss outcomes in gambling games].

PubMed

Pecsenye, Zsuzsa; Kurucz, Gyozo

2017-01-01

Games of chance operate with an intermittent reinforcement schedule in which the number of games takes the player to win differ in each turn thus they can not predict when the next positive reinforcement arrives. The near miss outcome (close to winning but actually a losing outcome) can be interpreted as a secondary (built in) reinforcement within variable ratio reinforcement schedule that presumably contribute to the development and maintanance of gambling addiction. The aim of this publication would be to introduce near miss outcomes and to summarize and critically analyze literature connected to this issue.We searched internet datebases using word "near miss" and analyse articles focusing on gambling games. Based on numerous authors' results a near miss rate set at around 30% increases the desire to continue playing among gamblers and players who have no former gambling experience as well. Some studies have demonstrated that this effect might be related to the extent the player has the situation under control during the gambling session. The hypothetical inhibiting effect of a 45% near miss ratio has not yet been proven. Neurobiological researches show middle-cerebral activity during near miss outcomes furthermore similar physiological patterns have been discovered following a near miss and winning outcomes. Regarding the connection between intrapsychic variables (cognitive and personality factors) and near misses there are very few studies. The fact that different authors interpret near miss outcomes differently even when studying the same game leads to problems in interpreting their results. It follows from the foregoing empirical results that near miss outcomes contribute to the development and maintanance of pathological gambling but we have little information on the factors implementing this effect.

Baseline Predictors of Missed Visits in the Look AHEAD Study

PubMed Central

Fitzpatrick, Stephanie L.; Jeffery, Robert; Johnson, Karen C.; Roche, Cathy C.; Van Dorsten, Brent; Gee, Molly; Johnson, Ruby Ann; Charleston, Jeanne; Dotson, Kathy; Walkup, Michael P.; Hill-Briggs, Felicia; Brancati, Frederick L.

2013-01-01

Objective To identify baseline attributes associated with consecutively missed data collection visits during the first 48 months of Look AHEAD—a randomized, controlled trial in 5145 overweight/obese adults with type 2 diabetes designed to determine the long-term health benefits of weight loss achieved by lifestyle change. Design and Methods The analyzed sample consisted of 5016 participants who were alive at month 48 and enrolled at Look AHEAD sites. Demographic, baseline behavior, psychosocial factors, and treatment randomization were included as predictors of missed consecutive visits in proportional hazard models. Results In multivariate Cox proportional hazard models, baseline attributes of participants who missed consecutive visits (n=222) included: younger age ( Hazard Ratio [HR] 1.18 per 5 years younger; 95% Confidence Interval 1.05, 1.30), higher depression score (HR 1.04; 1.01, 1.06), non-married status (HR 1.37; 1.04, 1.82), never self-weighing prior to enrollment (HR 2.01; 1.25, 3.23), and randomization to minimal vs. intensive lifestyle intervention (HR 1.46; 1.11, 1.91). Conclusions Younger age, symptoms of depression, non-married status, never self-weighing, and randomization to minimal intervention were associated with a higher likelihood of missing consecutive data collection visits, even in a high-retention trial like Look AHEAD. Whether modifications to screening or retention efforts targeted to these attributes might enhance long-term retention in behavioral trials requires further investigation. PMID:23996977

Retheorizing Doctoral Supervision as Professional Work

ERIC Educational Resources Information Center

Halse, Christine; Malfroy, Janne

2010-01-01

A competitive higher education environment marked by increased accountability and quality assurance measures for doctoral study, including the structured training of doctoral supervisors, has highlighted the need to clearly articulate and delineate the work of supervising doctoral students. This article responds to this imperative by examining the…

An audit of the knowledge and attitudes of doctors towards Surgical Informed Consent (SIC).

PubMed

Ashraf, Bushra; Tasnim, Nasira; Saaiq, Muhammad; Zaman, Khaleeq-Uz-

2014-11-01

The Surgical Informed Consent (SIC) is a comprehensive process that establishes an information-based agreement between the patient and his doctor to undertake a clearly outlined medical or surgical intervention. It is neither a casual formality nor a casually signed piece of paper. The present study was designed to audit the current knowledge and attitudes of doctors towards SIC at a tertiary care teaching hospital in Pakistan. This cross-sectional qualitative investigation was conducted under the auspices of the Department of Medical Education (DME), Pakistan Institute of Medical Sciences (PIMS), Shaheed Zulfiqar Ali Bhutto Medical University (SZABMU), Islamabad over three months period. A 19-item questionnaire was employed for data collection. The participants were selected at random from the list of the surgeons maintained in the hospital and approached face-to-face with the help of a team of junior doctors detailed for questionnaire distribution among them. The target was to cover over 50% of these doctors by convenience sampling. Out of 231 respondents, there were 32 seniors while 199 junior doctors, constituting a ratio of 1:6.22. The respondents variably responded to the questions regarding various attributes of the process of SIC. Overall, the junior doctors performed poorer compared to the seniors. The knowledge and attitudes of our doctors particularly the junior ones, towards the SIC are less than ideal. This results in their failure to avail this golden opportunity of doctor-patient communication to guide their patients through a solidly informative and legally valid SIC. They are often unaware of the essential preconditions of the SIC; provide incomplete information to their patients; and quite often do not ensure direct involvement of their patients in the process. Additionally they lack an understanding of using interactive computer-based programs as well as the concept of nocebo effect of informed consent.

Female Physicist Doctoral Experiences

ERIC Educational Resources Information Center

Dabney, Katherine P.; Tai, Robert H.

2013-01-01

The underrepresentation of women in physics doctorate programs and in tenured academic positions indicates a need to evaluate what may influence their career choice and persistence. This qualitative paper examines eleven females in physics doctoral programs and professional science positions in order to provide a more thorough understanding of why…

Doctorate Recipients from U.S. Universities. Summary Report, 2007-08. Survey of Earned Doctorates. Special Report

ERIC Educational Resources Information Center

National Science Foundation, 2009

2009-01-01

"Doctorate Recipients from U.S. Universities: Summary Report 2007-08" is the 41st in a series of reports on research doctorates awarded by universities in the United States. Data presented in this report were collected by the Survey of Earned Doctorates (SED). The SED, which has been conducted annually since 1957, is a census of all…

[Life conditions of Togolese doctors].

PubMed

Koffi-Tessio, Annick Viwalé; Oniankitan, Owonayo; Mijiyawa, Moustafa

2010-09-01

A study has been carried out by Togolese medical doctors in order to determine the perceived and the real life of their profession. The study, which was transversal, has taken in account a sample of 52 medical doctors made on the basis of a cautious choice. Most of these medical doctors (15 general practitioners, 23 specialists and 14 hospitalo-universitaires) work in the medical cares centres of Lomé. A sheet of survey has permitted the collection of demographic data and data relating to the medical studies and career. The 52 medical doctors included in the study (7 women, 45 men) were between 25 and 59 years old; their age of getting their A-level was between 16 and 23 years old, and that of getting the doctorate diploma between 24 and 37. The length of professional experience stands between 8 months and 27 years. The marital status was specified by 47 of the 52 medical doctors: 13 single, one divorced, and 33 married; 5 of the 7 women who took part in the survey were single and without any child. The love of the profession (65%), the social status it confers (37%) and the honour tied to the profession (27%) were the main motives of choosing the profession. The decision of doing medical studies was taken during secondary studies by 45 of the 52 persons. The faculty of medicine of Lomé has been the study frame to general medicine studies of 35 persons (67%). The low payment (83%), the poverty of the patients (83%), the narrowness of the technical platform (79%), the insufficiency of cares structures in paramedical personnel (67%), the insufficiency of continuing education (60%), and the lack or insufficiency of drugs (58%) were the main problems encountered during their professional experience by the people questioned. 22 medical doctors (43%) have estimated that their profession has given them a particular social status. Only 8 medical doctors have found that the real things they have gone trough in the profession matches with the idea they had, while 32 (62

Doctoral Students' Perceptions of the Effects of the Doctoral Experience on Their Health and Health Behaviors

ERIC Educational Resources Information Center

Nelson Russom, Lynn A.

2017-01-01

In many disciplines, the doctorate is the highest academic degree. Doctoral education is a complex process that includes transformation through knowledge acquisition and professional identity development (Gardner, 2009). Typically, the scope of the doctoral experience includes years of coursework, successfully passing a comprehensive or qualifying…

Missed Diagnosis of Syrinx

PubMed Central

Oh, Chang Hyun; Kim, Chan Gyu; Lee, Jae-Hwan; Park, Hyeong-Chun; Park, Chong Oon

2012-01-01

Study Design Prospective, randomized, controlled human study. Purpose We checked the proportion of missed syrinx diagnoses among the examinees of the Korean military conscription. Overview of Literature A syrinx is a fluid-filled cavity within the spinal cord or brain stem and causes various neurological symptoms. A syrinx could easily be diagnosed by magnetic resonance image (MRI), but missed diagnoses seldom occur. Methods In this study, we reviewed 103 cases using cervical images, cervical MRI, or whole spine sagittal MRI, and syrinxes was observed in 18 of these cases. A review of medical certificates or interviews was conducted, and the proportion of syrinx diagnoses was calculated. Results The proportion of syrinx diagnoses was about 66.7% (12 cases among 18). Missed diagnoses were not the result of the length of the syrinx, but due to the type of image used for the initial diagnosis. Conclusions The missed diagnosis proportion of the syrinx is relatively high, therefore, a more careful imaging review is recommended. PMID:22439081

Reasons for Consulting a Doctor on the Internet: Web Survey of Users of an Ask the Doctor Service

PubMed Central

Petersson, Göran; Hamberg, Katarina

2003-01-01

Background In 1998 the Swedish noncommercial public health service Infomedica opened an Ask the Doctor service on its Internet portal. At no charge, anyone with Internet access can use this service to ask questions about personal health-related and disease-related matters. Objective To study why individuals choose to consult previously-unknown doctors on the Internet. Methods Between November 1, 2001, and January 31, 2002 a Web survey of the 3622 Ask the Doctor service users, 1036 men (29%) and 2586 (71%) women, was conducted. We excluded 186 queries from users. The results are based on quantitative and qualitative analysis of the answers to the question "Why did you choose to ask a question at Infomedica's 'Ask the Doctor' service?" Results 1223 surveys were completed (response rate 34%). Of the participants in the survey 322 (26%) were male and 901 (74%) female. As major reasons for choosing to consult previously-unknown doctors on the Internet participants indicated: convenience (52%), anonymity (36%), "doctors too busy" (21%), difficult to find time to visit a doctor (16%), difficulty to get an appointment (13%), feeling uncomfortable when seeing a doctor (9%), and not being able to afford a doctors' visit (3%). Further motives elicited through a qualitative analysis of free-text answers were: seeking a second opinion, discontent with previous doctors and a wish for a primary evaluation of a medical problem, asking embarrassing or sensitive questions, seeking information on behalf of relatives, preferring written communication, and (from responses by expatriates, travelers, and others) living far away from regular health care. Conclusions We found that an Internet based Ask the Doctor service is primarily consulted because it is convenient, but it may also be of value for individuals with needs that regular health care services have not been able to meet. PMID:14713654

Reasons for consulting a doctor on the Internet: Web survey of users of an Ask the Doctor service.

PubMed

Umefjord, Göran; Petersson, Göran; Hamberg, Katarina

2003-10-22

In 1998 the Swedish noncommercial public health service Infomedica opened an Ask the Doctor service on its Internet portal. At no charge, anyone with Internet access can use this service to ask questions about personal health-related and disease-related matters. To study why individuals choose to consult previously-unknown doctors on the Internet. Between November 1, 2001, and January 31, 2002 a Web survey of the 3622 Ask the Doctor service users, 1036 men (29%) and 2586 (71%) women, was conducted. We excluded 186 queries from users. The results are based on quantitative and qualitative analysis of the answers to the question "Why did you choose to ask a question at Infomedica's 'Ask the Doctor' service?" 1223 surveys were completed (response rate 36 %). Of the participants in the survey 322 (26%) were male and 901 (74%) female. As major reasons for choosing to consult previously-unknown doctors on the Internet participants indicated: convenience (52%), anonymity (36%), "doctors too busy" (21%), difficult to find time to visit a doctor (16%), difficulty to get an appointment (13%), feeling uncomfortable when seeing a doctor (9%), and not being able to afford a doctors' visit (3%). Further motives elicited through a qualitative analysis of free-text answers were: seeking a second opinion, discontent with previous doctors and a wish for a primary evaluation of a medical problem, asking embarrassing or sensitive questions, seeking information on behalf of relatives, preferring written communication, and (from responses by expatriates, travelers, and others) living far away from regular health care. We found that that an Internet based Ask the Doctor service is primarily consulted because it is convenient, but it may also be of value for individuals with needs that regular health care services have not been able to meet.

When doctors share visit notes with patients: a study of patient and doctor perceptions of documentation errors, safety opportunities and the patient-doctor relationship.

PubMed

Bell, Sigall K; Mejilla, Roanne; Anselmo, Melissa; Darer, Jonathan D; Elmore, Joann G; Leveille, Suzanne; Ngo, Long; Ralston, James D; Delbanco, Tom; Walker, Jan

2017-04-01

Patient advocates and safety experts encourage adoption of transparent health records, but sceptics worry that shared notes may offend patients, erode trust or promote defensive medicine. As electronic health records disseminate, such disparate views fuel policy debates about risks and benefits of sharing visit notes with patients through portals. Presurveys and postsurveys from 99 volunteer doctors at three US sites who participated in OpenNotes and postsurveys from 4592 patients who read at least one note and submitted a survey. Patients read notes to be better informed and because they were curious; about a third read them to check accuracy. In total, 7% (331) of patients reported contacting their doctor's office about their note. Of these, 29% perceived an error, and 85% were satisfied with its resolution. Nearly all patients reported feeling better (37%) or the same (62%) about their doctor. Patients who were older (>63), male, non-white, had fair/poor self-reported health or had less formal education were more likely to report feeling better about their doctor. Among doctors, 26% anticipated documentation errors, and 44% thought patients would disagree with notes. After a year, 53% believed patient satisfaction increased, and 51% thought patients trusted them more. None reported ordering more tests or referrals. Despite concerns about errors, offending language or defensive practice, transparent notes overall did not harm the patient-doctor relationship. Rather, doctors and patients perceived relational benefits. Traditionally more vulnerable populations-non-white, those with poorer self-reported health and those with fewer years of formal education-may be particularly likely to feel better about their doctor after reading their notes. Further informing debate about OpenNotes, the findings suggest transparent records may improve patient satisfaction, trust and safety. Published by the BMJ Publishing Group Limited. For permission to use (where not already

Sophie's story: writing missing journeys.

PubMed

Parr, Hester; Stevenson, Olivia

2014-10-01

'Sophie's story' is a creative rendition of an interview narrative gathered in a research project on missing people. The paper explains why Sophie's story was written and details the wider intention to provide new narrative resources for police officer training, families of missing people and returned missing people. We contextualize this cultural intervention with an argument about the transformative potential of writing trauma stories. It is suggested that trauma stories produce difficult and unknown affects, but ones that may provide new ways of talking about unspeakable events. Sophie's story is thus presented as a hopeful cultural geography in process, and one that seeks to help rewrite existing social scripts about missing people.

Changing Doctoral Degrees: An International Perspective.

ERIC Educational Resources Information Center

Noble, Keith Allan

This book examines the origin and development of doctoral degrees and offers recommendations for the improvement of doctoral programs and degrees. It discusses the birth of universities and doctoral degrees in medieval Europe and reviews the spread of the degree to the United States, Britain, Canada, and Australia. Contemporary concerns about…

Doctoral Education Reform in Finland -- Institutionalized and Individualized Doctoral Studies within European Framework

ERIC Educational Resources Information Center

Aittola, Helena

2017-01-01

In Europe, doctoral education systems have been systematically reformed. These reforms are aimed at improving the quality of research and the competitiveness of European countries. In Finland, the reform project of doctoral education started vigorously in the mid-1990s which has contributed significantly to the emergence of more structured…

The wealth of distinguished doctors: retrospective survey

PubMed Central

McManus, I C

2005-01-01

Objective To assess changes in the wealth of distinguished doctors in the United Kingdom between 1860 and 2001. Design Retrospective survey. Setting The UK. Participants 980 doctors of sufficient distinction to be included in the Oxford Dictionary of National Biography and who died between 1860 and 2001. Main outcome measures Wealth at death, based on probate records and adjusted relative to average earnings in 2002. Results The wealth of distinguished doctors declined substantially between 1860 and 2001, and paralleled a decline in the relative income of doctors in general. The wealth of distinguished doctors also declined relative to other groups of distinguished individuals. Conclusions In the 19th century, distinction in doctors was accompanied by substantial wealth, whereas by the end of the 20th century, the most distinguished doctors were less wealthy than their contemporaries who had achieved national distinction in other areas. PMID:16373738

EHR adoption among doctors who treat the elderly.

PubMed

Yeager, Valerie A; Menachemi, Nir; Brooks, Robert G

2010-12-01

The purpose of this study is to examine Electronic Health Record (EHR) adoption among Florida doctors who treat the elderly. This analysis contributes to the EHR adoption literature by determining if doctors who disproportionately treat the elderly differ from their counterparts with respect to the utilization of an important quality-enhancing health information technology application. This study is based on a primary survey of a large, statewide sample of doctors practising in outpatient settings in Florida. Logistic regression analysis was used to determine whether doctors who treat a high volume of elderly (HVE) patients were different with respect to EHR adoption. Our analyses included responses from 1724 doctors. In multivariate analyses controlling for doctor age, training, computer sophistication, practice size and practice setting, HVE doctors were significantly less likely to adopt EHR. Specifically, compared with their counterparts, HVE doctors were observed to be 26.7% less likely to be utilizing an EHR system (OR=0.733, 95% CI 0.547-0.982). We also found that doctor age is negatively related to EHR adoption, and practice size and doctor computer savvy-ness is positively associated. Despite the fact that EHR adoption has improved in recent years, doctors in Florida who serve the elderly are less likely to adopt EHRs. As long as HVE doctors are adopting EHR systems at slower rates, the elderly patients treated by these doctors will be at a disadvantage with respect to potential benefits offered by this technology. © 2010 Blackwell Publishing Ltd.

Science and Engineering Doctorate Awards: 1998.

ERIC Educational Resources Information Center

Hill, Susan T.

The data presented in this report shows trends in doctorate awards by science and engineering (S&E) field and recipient characteristics, institutions awarding doctorates, and postgraduation plans of recipients. The source of the data is the Survey of Earned Doctorates (SED). The SED has been conducted annually for the National Science Foundation…

Science and Engineering Doctorate Awards: 1999.

ERIC Educational Resources Information Center

Hill, Susan T.

The data in this report show trends in doctorate awards by science and engineering (S&E) field and recipient characteristics, institutions awarding doctorates, and postgraduation plans of recipients. The source of the data is the Survey of Earned Doctorates (SED). The SED is conducted annually for the National Science Foundation (NSF) and four…

Invisible Roles of Doctoral Program Specialists

ERIC Educational Resources Information Center

Bachman, Eva Burns; Grady, Marilyn L.

2016-01-01

The purpose of this study was to investigate the roles of doctoral program specialists in Big Ten universities. Face-to-face interviews with 20 doctoral program specialists employed in institutions in the Big Ten were conducted. Participants were asked to describe their roles within their work place. The doctoral program specialists reported their…

Advising Doctoral Students in Education Programs

ERIC Educational Resources Information Center

Craft, Christy Moran; Augustine-Shaw, Donna; Fairbanks, Amanda; Adams-Wright, Gayla

2016-01-01

Because almost one half of students enrolled in American doctoral programs do not complete their degrees, the factors that lead to doctoral student attrition need to be identified. Research suggests that the nature of the advisor-advisee relationship contributes to the persistence levels of doctoral students. In this study, we conducted a content…

Doctor's perception of doctor-patient relationships in emergency departments: What roles do gender and ethnicity play?

PubMed Central

Babitsch, Birgit; Braun, Tanja; Borde, Theda; David, Matthias

2008-01-01

Background Emergency departments continuously provide medical treatment on a walk-in basis. Several studies investigated the patient's perception of the doctor-patient relationship, but few have asked doctors about their views. Furthermore, the influence of the patient's ethnicity and gender on the doctor's perception remains largely unanswered. Methods Based on data collated in three gynaecology (GYN)/internal medicine (INT) emergency departments in Berlin, Germany, we evaluated the impact of the patient's gender and ethnicity on the doctors' satisfaction with the course of the treatment they provided. Information was gathered from 2.429 short questionnaires completed by doctors and the medical records of the corresponding patients. Results The patient's ethnicity had a significant impact on the doctors' satisfaction with the doctor-patient relationship. Logistic regression analysis showed that the odds ratio (OR) for physician satisfaction was significantly lower for patients of Turkish origin (OR = 2.6 INT and 5.5 GYN) than for those of German origin. The main reasons stated were problems with communication and a perceived lack of urgency for emergency treatment. The odds ratios for dissatisfaction due to a lack of language skills were 4.48 (INT) and 6.22 (GYN), and those due to perceived lack of urgency for emergency treatment were 0.75 (INT) and 0.63 (GYN). Sex differences caused minor variation. Conclusion The results show that good communication despite language barriers is crucial in providing medical care that is satisfactory to both patient and doctors, especially in emergency situations. Therefore the use of professional interpreters for improved communication and the training of medical staff for improved intercultural competence are essential for the provision of adequate health care in a multicultural setting. PMID:18405351

Did you hear the one about the doctor? An examination of doctor jokes posted on Facebook.

PubMed

Davis, Matthew A; Haney, Carol Sue; Weeks, William B; Sirovich, Brenda E; Anthony, Denise L

2014-02-13

Social networking sites such as Facebook have become immensely popular in recent years and present a unique opportunity for researchers to eavesdrop on the collective conversation of current societal issues. We sought to explore doctor-related humor by examining doctor jokes posted on Facebook. We performed a cross-sectional study of 33,326 monitored Facebook users, 263 (0.79%) of whom posted a joke that referenced doctors on their Facebook wall during a 6-month observation period (December 15, 2010 to June 16, 2011). We compared characteristics of so-called jokers to nonjokers and identified the characteristics of jokes that predicted joke success measured by having elicited at least one electronic laugh (eg, an LOL or "laughing out loud") as well as the total number of Facebook "likes" the joke received. Jokers told 156 unique doctor jokes and were the same age as nonjokers but had larger social networks (median Facebook friends 227 vs 132, P<.001) and were more likely to be divorced, separated, or widowed (P<.01). In 39.7% (62/156) of unique jokes, the joke was at the expense of doctors. Jokes at the expense of doctors compared to jokes not at the expense of doctors tended to be more successful in eliciting an electronic laugh (46.5% vs 37.3%), although the association was statistically insignificant. In our adjusted models, jokes that were based on current events received considerably more Facebook likes (rate ratio [RR] 2.36, 95% CI 0.97-5.74). This study provides insight into the use of social networking sites for research pertaining to health and medicine, including the world of doctor-related humor.

Smart strategies for doctors and doctors-in-training: heuristics in medicine.

PubMed

Wegwarth, Odette; Gaissmaier, Wolfgang; Gigerenzer, Gerd

2009-08-01

How do doctors make sound decisions when confronted with probabilistic data, time pressures and a heavy workload? One theory that has been embraced by many researchers is based on optimisation, which emphasises the need to integrate all information in order to arrive at sound decisions. This notion makes heuristics, which use less than complete information, appear as second-best strategies. In this article, we challenge this pessimistic view of heuristics. We introduce two medical problems that involve decision making to the reader: one concerns coronary care issues and the other macrolide prescriptions. In both settings, decision-making tools grounded in the principles of optimisation and heuristics, respectively, have been developed to assist doctors in making decisions. We explain the structure of each of these tools and compare their performance in terms of their facilitation of correct predictions. For decisions concerning both the coronary care unit and the prescribing of macrolides, we demonstrate that sacrificing information does not necessarily imply a forfeiting of predictive accuracy, but can sometimes even lead to better decisions. Subsequently, we discuss common misconceptions about heuristics and explain when and why ignoring parts of the available information can lead to the making of more robust predictions. Heuristics are neither good nor bad per se, but, if applied in situations to which they have been adapted, can be helpful companions for doctors and doctors-in-training. This, however, requires that heuristics in medicine be openly discussed, criticised, refined and then taught to doctors-in-training rather than being simply dismissed as harmful or irrelevant. A more uniform use of explicit and accepted heuristics has the potential to reduce variations in diagnoses and to improve medical care for patients.

Which Doctor to Trust: A Recommender System for Identifying the Right Doctors.

PubMed

Guo, Li; Jin, Bo; Yao, Cuili; Yang, Haoyu; Huang, Degen; Wang, Fei

2016-07-07

Key opinion leaders (KOLs) are people who can influence public opinion on a certain subject matter. In the field of medical and health informatics, it is critical to identify KOLs on various disease conditions. However, there have been very few studies on this topic. We aimed to develop a recommender system for identifying KOLs for any specific disease with health care data mining. We exploited an unsupervised aggregation approach for integrating various ranking features to identify doctors who have the potential to be KOLs on a range of diseases. We introduce the design, implementation, and deployment details of the recommender system. This system collects the professional footprints of doctors, such as papers in scientific journals, presentation activities, patient advocacy, and media exposure, and uses them as ranking features to identify KOLs. We collected the information of 2,381,750 doctors in China from 3,657,797 medical journal papers they published, together with their profiles, academic publications, and funding. The empirical results demonstrated that our system outperformed several benchmark systems by a significant margin. Moreover, we conducted a case study in a real-world system to verify the applicability of our proposed method. Our results show that doctors' profiles and their academic publications are key data sources for identifying KOLs in the field of medical and health informatics. Moreover, we deployed the recommender system and applied the data service to a recommender system of the China-based Internet technology company NetEase. Patients can obtain authority ranking lists of doctors with this system on any given disease.

Specialties differ in which aspects of doctor communication predict overall physician ratings.

PubMed

Quigley, Denise D; Elliott, Marc N; Farley, Donna O; Burkhart, Q; Skootsky, Samuel A; Hays, Ron D

2014-03-01

Effective doctor communication is critical to positive doctor-patient relationships and predicts better health outcomes. Doctor communication is the strongest predictor of patient ratings of doctors, but the most important aspects of communication may vary by specialty. To determine the importance of five aspects of doctor communication to overall physician ratings by specialty. For each of 28 specialties, we calculated partial correlations of five communication items with a 0-10 overall physician rating, controlling for patient demographics. Consumer Assessment of Healthcare Providers and Systems Clinician and Group (CG-CAHPS®) 12-month Survey data collected 2005-2009 from 58,251 adults at a 534-physician medical group. CG-CAHPS includes a 0 ("Worst physician possible") to 10 ("Best physician possible") overall physician rating. Five doctor communication items assess how often the physician: explains things; listens carefully; gives easy-to-understand instructions; shows respect; and spends enough time. Physician showing respect was the most important aspect of communication for 23/28 specialties, with a mean partial correlation (0.27, ranging from 0.07 to 0.44 across specialties) that accounted for more than four times as much variance in the overall physician rating as any other communication item. Three of five communication items varied significantly across specialties in their associations with the overall rating (p < 0.05). All patients valued respectful treatment; the importance of other aspects of communication varied significantly by specialty. Quality improvement efforts by all specialties should emphasize physicians showing respect to patients, and each specialty should also target other aspects of communication that matter most to their patients. The results have implications for improving provider quality improvement and incentive programs and the reporting of CAHPS data to patients. Specialists make important contributions to coordinated patient

Reasons for Doctoral Non-Completion: One Non-Completing Doctoral Student's Voice on Limitations in the Academic Literature

ERIC Educational Resources Information Center

Philpott, Carey

2015-01-01

Timely completion has recently been an important focus of academic literature on supervising Doctoral students. This paper is a reflection on the academic literature on timely doctoral completion by a former Doctoral student who has been a serial non-completer. This reflection explores whether academics' constructions, reported in the research…

Covariate Selection for Multilevel Models with Missing Data

PubMed Central

Marino, Miguel; Buxton, Orfeu M.; Li, Yi

2017-01-01

Missing covariate data hampers variable selection in multilevel regression settings. Current variable selection techniques for multiply-imputed data commonly address missingness in the predictors through list-wise deletion and stepwise-selection methods which are problematic. Moreover, most variable selection methods are developed for independent linear regression models and do not accommodate multilevel mixed effects regression models with incomplete covariate data. We develop a novel methodology that is able to perform covariate selection across multiply-imputed data for multilevel random effects models when missing data is present. Specifically, we propose to stack the multiply-imputed data sets from a multiple imputation procedure and to apply a group variable selection procedure through group lasso regularization to assess the overall impact of each predictor on the outcome across the imputed data sets. Simulations confirm the advantageous performance of the proposed method compared with the competing methods. We applied the method to reanalyze the Healthy Directions-Small Business cancer prevention study, which evaluated a behavioral intervention program targeting multiple risk-related behaviors in a working-class, multi-ethnic population. PMID:28239457

The Trouble with Doctoral Aspiration Now

ERIC Educational Resources Information Center

Burford, James

2018-01-01

This article attends to the affective-political dimensions of doctoral aspiration. It considers why doctoral students continue to hope for an 'academic good life' in spite of the depressed and precarious features of the academic present. The article emerges from 2013 research with ten doctoral students in the Arts and Social Sciences, at a…

Sri Lankan doctors' and medical undergraduates' attitudes towards mental illness.

PubMed

Fernando, Sunera Mayanthi; Deane, Frank P; McLeod, Hamish J

2010-07-01

Stigmatizing attitudes towards mental illness can impede help-seeking and adversely affect treatment outcomes, especially if such attitudes are endorsed by medical personnel. In order to help identify targets for anti-stigma interventions, we comprehensively examined negative attitudes towards mental illness displayed by Sri Lankan doctors and medical students and compared these with equivalent UK and other international data. A self-report questionnaire originally developed in the UK was completed by medical students (n = 574) and doctors (n = 74) from a teaching hospital in Colombo. The questions assessed the presence and intensity of stigmatizing attitudes towards patients with schizophrenia, depression, panic disorder, dementia and drug and alcohol addiction. The study revealed higher levels of stigma towards patients with depression, alcohol and drug addiction in this Sri Lankan sample compared to UK data but attitudes towards schizophrenia were less stigmatized in Sri Lanka. Blaming attitudes were consistently high across diagnoses in the Sri Lankan sample. Sri Lankan medical students displayed more negative attitudes than doctors (P < 0.001). Overall stigma was greatest towards patients with drug addiction, followed by, alcohol addiction, schizophrenia, depression, panic disorder and dementia. Sri Lankan doctors and undergraduates endorse stigmatizing attitudes towards mental illnesses and are especially prone to see patients as blameworthy. As such attitudes are likely to affect the engagement of patients in treatment and specific interventions that modify negative attitudes towards people with mental illnesses are needed. Ensuring that medical students have contact with recovered patients in community psychiatry settings may be one way of decreasing stigmatizing attitudes.

Do not judge according to appearance: patients' preference of a doctor's face does not influence their assessment of the patient-doctor relationship.

PubMed

Lee, Soon-Ho; Chang, Dong-Seon; Kang, O-Seok; Kim, Hwa-Hyun; Kim, Hackjin; Lee, Hyejung; Park, Hi-Joon; Chae, Younbyoung

2012-12-01

The aim of this study was to investigate whether a patient's preference for a doctor's face is associated with better assessments of relational empathy in the patient-doctor relationship after the first clinical consultation. A total of 110 patients enrolled in a traditional Korean medical clinic participated in the study. Patients' preference for doctors' faces was assessed by a two alternative forced choice (2AFC) task, with 60 different pairs of six different Asian male doctors' faces. One of the six doctors then carried out the initial clinical consultation for these patients. The patient-doctor relationship was assessed using the Consultation and Relational Empathy (CARE) measure. The data of all patients' simulated preferences for a doctor's face and their assessment values of a doctor's relational empathy was compared, and no significant correlation was found between both values (r=-0.024, p>0.809). These findings suggest that the perceived empathy in the patient-doctor relationship is not influenced by the patient's preference for a certain doctor's face. The first impression of a doctor is often determined by his appearance and look. However, whether or not the patient particularly prefers a doctor's face does not seem to matter in developing a good patient-doctor relationship.

Missed nursing care: a concept analysis.

PubMed

Kalisch, Beatrice J; Landstrom, Gay L; Hinshaw, Ada Sue

2009-07-01

This paper is a report of the analysis of the concept of missed nursing care. According to patient safety literature, missed nursing care is an error of omission. This concept has been conspicuously absent in quality and patient safety literature, with individual aspects of nursing care left undone given only occasional mention. An 8-step method of concept analysis - select concept, determine purpose, identify uses, define attributes, identify model case, describe related and contrary cases, identify antecedents and consequences and define empirical referents - was used to examine the concept of missed nursing care. The sources for the analysis were identified by systematic searches of the World Wide Web, MEDLINE, CINAHL and reference lists of related journal articles with a timeline of 1970 to April 2008. Missed nursing care, conceptualized within the Missed Nursing Care Model, is defined as any aspect of required patient care that is omitted (either in part or in whole) or delayed. Various attribute categories reported by nurses in acute care settings contribute to missed nursing care: (1) antecedents that catalyse the need for a decision about priorities; (2) elements of the nursing process and (3) internal perceptions and values of the nurse. Multiple elements in the nursing environment and internal to nurses influence whether needed nursing care is provided. Missed care as conceptualized within the Missed Care Model is a universal phenomenon. The concept is expected to occur across all cultures and countries, thus being international in scope.

Work of female rural doctors.

PubMed

Wainer, Jo

2004-04-01

To identify the impact of family life on the ways women practice rural medicine and the changes needed to attract women to rural practice. Census of women rural doctors in Victoria in 2000, using a self-completed postal survey. General and specialist practice. Two hundred and seventy-one female general practitioners and 31 female specialists practising in Rural, Remote and Metropolitan Area Classifications 3-7. General practitioners are those doctors with a primary medical degree and without additional specialist qualifications. Interaction of hours and type of work with family responsibilities. Generalist and specialist women rural doctors carry the main responsibility for family care. This is reflected in the number of hours they work in clinical and non-clinical professional practice, availability for on-call and hospital work, and preference for the responsibilities of practice partnership or the flexibility of salaried positions. Most of the doctors had established a satisfactory balance between work and family responsibilities, although a substantial number were overworked in order to provide an income for their families or meet the needs of their communities. Thirty-six percent of female rural general practitioners and 56% of female rural specialists preferred to work fewer hours. Female general practitioners with responsibility for children were more than twice as likely as female general practitioners without children to be in a salaried position and less likely to be a practice partner. The changes needed to attract and retain women in rural practice include a place for everyone in the doctor's family, flexible practice structures, mentoring by women doctors and financial and personal recognition. Women make up less than a quarter of the rural general practice workforce and an even smaller percentage of the specialist rural medical workforce. As a result their experiences are not well articulated in research on rural medical practice and their needs are

Did You Hear the One About the Doctor? An Examination of Doctor Jokes Posted on Facebook

PubMed Central

Haney, Carol Sue; Weeks, William B; Sirovich, Brenda E; Anthony, Denise L

2014-01-01

Background Social networking sites such as Facebook have become immensely popular in recent years and present a unique opportunity for researchers to eavesdrop on the collective conversation of current societal issues. Objective We sought to explore doctor-related humor by examining doctor jokes posted on Facebook. Methods We performed a cross-sectional study of 33,326 monitored Facebook users, 263 (0.79%) of whom posted a joke that referenced doctors on their Facebook wall during a 6-month observation period (December 15, 2010 to June 16, 2011). We compared characteristics of so-called jokers to nonjokers and identified the characteristics of jokes that predicted joke success measured by having elicited at least one electronic laugh (eg, an LOL or “laughing out loud”) as well as the total number of Facebook “likes” the joke received. Results Jokers told 156 unique doctor jokes and were the same age as nonjokers but had larger social networks (median Facebook friends 227 vs 132, P<.001) and were more likely to be divorced, separated, or widowed (P<.01). In 39.7% (62/156) of unique jokes, the joke was at the expense of doctors. Jokes at the expense of doctors compared to jokes not at the expense of doctors tended to be more successful in eliciting an electronic laugh (46.5% vs 37.3%), although the association was statistically insignificant. In our adjusted models, jokes that were based on current events received considerably more Facebook likes (rate ratio [RR] 2.36, 95% CI 0.97-5.74). Conclusions This study provides insight into the use of social networking sites for research pertaining to health and medicine, including the world of doctor-related humor. PMID:24550095

Precision targeting in guided munition using IR sensor and MmW radar

NASA Astrophysics Data System (ADS)

Sreeja, S.; Hablani, H. B.; Arya, H.

2015-10-01

Conventional munitions are not guided with sensors and therefore miss the target, particularly if the target is mobile. The miss distance of these munitions can be decreased by incorporating sensors to detect the target and guide the munition during flight. This paper is concerned with a Precision Guided Munition(PGM) equipped with an infrared sensor and a millimeter wave radar [IR and MmW, for short]. Three-dimensional flight of the munition and its pitch and yaw motion models are developed and simulated. The forward and lateral motion of a target tank on the ground is modeled as two independent second-order Gauss-Markov process. To estimate the target location on the ground and the line-of-sight rate to intercept it an Extended Kalman Filter is composed whose state vector consists of cascaded state vectors of missile dynamics and target dynamics. The line-of-sight angle measurement from the infrared seeker is by centroiding the target image in 40 Hz. The centroid estimation of the images in the focal plane is at a frequency of 10 Hz. Every 10 Hz, centroids of four consecutive images are averaged, yielding a time-averaged centroid, implying some measurement delay. The miss distance achieved by including by image processing delays is 1:45m.

Precision targeting in guided munition using infrared sensor and millimeter wave radar

NASA Astrophysics Data System (ADS)

Sulochana, Sreeja; Hablani, Hari B.; Arya, Hemendra

2016-07-01

Conventional munitions are not guided with sensors and therefore miss the target, particularly if the target is mobile. The miss distance of these munitions can be decreased by incorporating sensors to detect the target and guide the munition during flight. This paper is concerned with a precision guided munition equipped with an infrared (IR) sensor and a millimeter wave radar (MmW). Three-dimensional flight of the munition and its pitch and yaw motion models are developed and simulated. The forward and lateral motion of a target tank on the ground is modeled as two independent second-order Gauss-Markov processes. To estimate the target location on the ground and the line-of-sight (LOS) rate to intercept it, an extended Kalman filter is composed whose state vector consists of cascaded state vectors of missile dynamics and target dynamics. The LOS angle measurement from the IR seeker is by centroiding the target image in 40 Hz. The centroid estimation of the images in the focal plane is at a frequency of 10 Hz. Every 10 Hz, centroids of four consecutive images are averaged, yielding a time-averaged centroid, implying some measurement delay. The miss distance achieved by including image processing delays is 1.45 m.

Missing value imputation strategies for metabolomics data.

PubMed

Armitage, Emily Grace; Godzien, Joanna; Alonso-Herranz, Vanesa; López-Gonzálvez, Ángeles; Barbas, Coral

2015-12-01

The origin of missing values can be caused by different reasons and depending on these origins missing values should be considered differently and dealt with in different ways. In this research, four methods of imputation have been compared with respect to revealing their effects on the normality and variance of data, on statistical significance and on the approximation of a suitable threshold to accept missing data as truly missing. Additionally, the effects of different strategies for controlling familywise error rate or false discovery and how they work with the different strategies for missing value imputation have been evaluated. Missing values were found to affect normality and variance of data and k-means nearest neighbour imputation was the best method tested for restoring this. Bonferroni correction was the best method for maximizing true positives and minimizing false positives and it was observed that as low as 40% missing data could be truly missing. The range between 40 and 70% missing values was defined as a "gray area" and therefore a strategy has been proposed that provides a balance between the optimal imputation strategy that was k-means nearest neighbor and the best approximation of positioning real zeros. © 2015 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.

Identification and Validation of Human Missing Proteins and Peptides in Public Proteome Databases: Data Mining Strategy.

PubMed

Elguoshy, Amr; Hirao, Yoshitoshi; Xu, Bo; Saito, Suguru; Quadery, Ali F; Yamamoto, Keiko; Mitsui, Toshiaki; Yamamoto, Tadashi

2017-12-01

In an attempt to complete human proteome project (HPP), Chromosome-Centric Human Proteome Project (C-HPP) launched the journey of missing protein (MP) investigation in 2012. However, 2579 and 572 protein entries in the neXtProt (2017-1) are still considered as missing and uncertain proteins, respectively. Thus, in this study, we proposed a pipeline to analyze, identify, and validate human missing and uncertain proteins in open-access transcriptomics and proteomics databases. Analysis of RNA expression pattern for missing proteins in Human protein Atlas showed that 28% of them, such as Olfactory receptor 1I1 ( O60431 ), had no RNA expression, suggesting the necessity to consider uncommon tissues for transcriptomic and proteomic studies. Interestingly, 21% had elevated expression level in a particular tissue (tissue-enriched proteins), indicating the importance of targeting such proteins in their elevated tissues. Additionally, the analysis of RNA expression level for missing proteins showed that 95% had no or low expression level (0-10 transcripts per million), indicating that low abundance is one of the major obstacles facing the detection of missing proteins. Moreover, missing proteins are predicted to generate fewer predicted unique tryptic peptides than the identified proteins. Searching for these predicted unique tryptic peptides that correspond to missing and uncertain proteins in the experimental peptide list of open-access MS-based databases (PA, GPM) resulted in the detection of 402 missing and 19 uncertain proteins with at least two unique peptides (≥9 aa) at <(5 × 10 -4 )% FDR. Finally, matching the native spectra for the experimentally detected peptides with their SRMAtlas synthetic counterparts at three transition sources (QQQ, QTOF, QTRAP) gave us an opportunity to validate 41 missing proteins by ≥2 proteotypic peptides.

Prediction of missing common genes for disease pairs using network based module separation on incomplete human interactome.

PubMed

Akram, Pakeeza; Liao, Li

2017-12-06

Identification of common genes associated with comorbid diseases can be critical in understanding their pathobiological mechanism. This work presents a novel method to predict missing common genes associated with a disease pair. Searching for missing common genes is formulated as an optimization problem to minimize network based module separation from two subgraphs produced by mapping genes associated with disease onto the interactome. Using cross validation on more than 600 disease pairs, our method achieves significantly higher average receiver operating characteristic ROC Score of 0.95 compared to a baseline ROC score 0.60 using randomized data. Missing common genes prediction is aimed to complete gene set associated with comorbid disease for better understanding of biological intervention. It will also be useful for gene targeted therapeutics related to comorbid diseases. This method can be further considered for prediction of missing edges to complete the subgraph associated with disease pair.

Predicting missing values in a home care database using an adaptive uncertainty rule method.

PubMed

Konias, S; Gogou, G; Bamidis, P D; Vlahavas, I; Maglaveras, N

2005-01-01

Contemporary literature illustrates an abundance of adaptive algorithms for mining association rules. However, most literature is unable to deal with the peculiarities, such as missing values and dynamic data creation, that are frequently encountered in fields like medicine. This paper proposes an uncertainty rule method that uses an adaptive threshold for filling missing values in newly added records. A new approach for mining uncertainty rules and filling missing values is proposed, which is in turn particularly suitable for dynamic databases, like the ones used in home care systems. In this study, a new data mining method named FiMV (Filling Missing Values) is illustrated based on the mined uncertainty rules. Uncertainty rules have quite a similar structure to association rules and are extracted by an algorithm proposed in previous work, namely AURG (Adaptive Uncertainty Rule Generation). The main target was to implement an appropriate method for recovering missing values in a dynamic database, where new records are continuously added, without needing to specify any kind of thresholds beforehand. The method was applied to a home care monitoring system database. Randomly, multiple missing values for each record's attributes (rate 5-20% by 5% increments) were introduced in the initial dataset. FiMV demonstrated 100% completion rates with over 90% success in each case, while usual approaches, where all records with missing values are ignored or thresholds are required, experienced significantly reduced completion and success rates. It is concluded that the proposed method is appropriate for the data-cleaning step of the Knowledge Discovery process in databases. The latter, containing much significance for the output efficiency of any data mining technique, can improve the quality of the mined information.

Suicides by persons reported as missing prior to death: a retrospective cohort study.

PubMed

Sveticic, Jerneja; Too, Lay San; De Leo, Diego

2012-01-01

A first study to compare suicides by missing persons with other suicide cases. Retrospective cohort study for the period 1994-2007. GEOGRAPHICAL LOCATION: Queensland, Australia. 194 suicides by missing persons and 7545 other suicides were identified through the Queensland Suicide Register and the National Coroners Information System. χ(2) statistics and binary logistic regression were used to identify distinct characteristics of suicides by missing persons. Compared with other suicide cases, missing persons significantly more often died by motor vehicle exhaust gas toxicity (23.7% vs 16.4%; χ(2)=7.32, p<0.01), jumping from height (6.7% vs 3.2%; χ(2)=7.08, p<0.01) or drowning (8.2% vs 1.8%; χ(2)=39.53, p<0.01), but less frequently by hanging (29.4% vs 39.9%; χ(2)=8.82, p<0.01). They were most frequently located in natural outdoors locations (58.2% vs 11.1%; χ(2)=388.25, p<0.01). Persons gone missing were less likely to have lived alone at time of death (OR 0.45, 95% CI 0.26 to 0.76), yet more likely to be institutionalised (OR 3.12, 95% CI 1.28 to 7.64). They were less likely to have been physically ill (OR 0.64, 95% CI 0.43 to 0.95) or have a history of problematic consumptions of alcohol (OR 0.52, 95% CI 0.31 to 0.87). In comparison to other suicide cases, missing persons more often communicated their suicidal intent prior to death (OR 1.58, 95% CI 1.13 to 2.22). Suicides by missing persons show several distinct characteristics in comparisons to other suicides. The findings have implications for development of suicide prevention strategies focusing on early identification and interventions targeting this group. In particular, it may offer assistance to police in designing risk assessment procedures and subsequent investigations of missing persons.

Suicides by persons reported as missing prior to death: a retrospective cohort study

PubMed Central

Sveticic, Jerneja; Too, Lay San

2012-01-01

Objective A first study to compare suicides by missing persons with other suicide cases. Design Retrospective cohort study for the period 1994–2007. Geographical location Queensland, Australia. Population 194 suicides by missing persons and 7545 other suicides were identified through the Queensland Suicide Register and the National Coroners Information System. Main outcome measure χ2 statistics and binary logistic regression were used to identify distinct characteristics of suicides by missing persons. Results Compared with other suicide cases, missing persons significantly more often died by motor vehicle exhaust gas toxicity (23.7% vs 16.4%; χ2=7.32, p<0.01), jumping from height (6.7% vs 3.2%; χ2=7.08, p<0.01) or drowning (8.2% vs 1.8%; χ2=39.53, p<0.01), but less frequently by hanging (29.4% vs 39.9%; χ2=8.82, p<0.01). They were most frequently located in natural outdoors locations (58.2% vs 11.1%; χ2=388.25, p<0.01). Persons gone missing were less likely to have lived alone at time of death (OR 0.45, 95% CI 0.26 to 0.76), yet more likely to be institutionalised (OR 3.12, 95% CI 1.28 to 7.64). They were less likely to have been physically ill (OR 0.64, 95% CI 0.43 to 0.95) or have a history of problematic consumptions of alcohol (OR 0.52, 95% CI 0.31 to 0.87). In comparison to other suicide cases, missing persons more often communicated their suicidal intent prior to death (OR 1.58, 95% CI 1.13 to 2.22). Conclusions Suicides by missing persons show several distinct characteristics in comparisons to other suicides. The findings have implications for development of suicide prevention strategies focusing on early identification and interventions targeting this group. In particular, it may offer assistance to police in designing risk assessment procedures and subsequent investigations of missing persons. PMID:22454187

Handling missing values in the MDS-UPDRS.

PubMed

Goetz, Christopher G; Luo, Sheng; Wang, Lu; Tilley, Barbara C; LaPelle, Nancy R; Stebbins, Glenn T

2015-10-01

This study was undertaken to define the number of missing values permissible to render valid total scores for each Movement Disorder Society Unified Parkinson's Disease Rating Scale (MDS-UPDRS) part. To handle missing values, imputation strategies serve as guidelines to reject an incomplete rating or create a surrogate score. We tested a rigorous, scale-specific, data-based approach to handling missing values for the MDS-UPDRS. From two large MDS-UPDRS datasets, we sequentially deleted item scores, either consistently (same items) or randomly (different items) across all subjects. Lin's Concordance Correlation Coefficient (CCC) compared scores calculated without missing values with prorated scores based on sequentially increasing missing values. The maximal number of missing values retaining a CCC greater than 0.95 determined the threshold for rendering a valid prorated score. A second confirmatory sample was selected from the MDS-UPDRS international translation program. To provide valid part scores applicable across all Hoehn and Yahr (H&Y) stages when the same items are consistently missing, one missing item from Part I, one from Part II, three from Part III, but none from Part IV can be allowed. To provide valid part scores applicable across all H&Y stages when random item entries are missing, one missing item from Part I, two from Part II, seven from Part III, but none from Part IV can be allowed. All cutoff values were confirmed in the validation sample. These analyses are useful for constructing valid surrogate part scores for MDS-UPDRS when missing items fall within the identified threshold and give scientific justification for rejecting partially completed ratings that fall below the threshold. © 2015 International Parkinson and Movement Disorder Society.

[The work of medical doctors on psychiatric wards: an analysis of everyday activities].

PubMed

Putzhammer, A; Senft, I; Fleischmann, H; Klein, H E; Schmauss, M; Schreiber, W; Hajak, G

2006-03-01

In Germany, the economic situation of psychiatric hospitals has markedly changed during the last years. Whilst the number of patients has steadily increased, many clinics considerably reduced the number of therapeutic staff due to an increasing lack of financial support. The German psychiatry personnel regulations act defines the number of therapeutic staff required for an adequate psychiatric treatment, but the requirements of this regulations act nowadays are widely missed in most of the German psychiatric hospitals. This severely affects the therapeutic work on psychiatric wards. This study analyses tasks and activities of medical doctors on psychiatric wards and compares the hours spent with various types of activities with the amount of time that should be spent according to the personnel regulations act. Results show that doctors spend much more time with documentation and administrative work than originally intended by the personnel regulations act. They compensate this mainly by a reduction of time spent in direct contact with the patients. In this context, the number of psychotherapy sessions as well as sessions with the patients' relatives has been considerably reduced, whereas the time spent for emergency intervention and basic treatment still corresponds to the calculations according to the personnel regulations act. All in all, the results show that a reduction of therapeutic staff in psychiatric hospitals directly leads to a change in treatment settings with a focus on less individual treatment options.

Missing clinical information in NHS hospital outpatient clinics: prevalence, causes and effects on patient care.

PubMed

Burnett, Susan J; Deelchand, Vashist; Franklin, Bryony Dean; Moorthy, Krishna; Vincent, Charles

2011-05-23

cases the doctor relied on the patient for the information, making a clinical decision despite the information being missing in 20% of cases. Hospital mergers, temporary staff and non-integrated IT systems were contributing factors. If these findings are replicated across the NHS then almost 10 million outpatients are seen each year without key clinical information, creating over a million unnecessary appointments, and putting nearly 2 million patients at risk of harm. There is a need for a systematic, regular audit of the prevalence of missing clinical information. Only then will we know the impact on clinical decision making and patient care of new technology, service reorganisations and, crucially given the present financial climate, temporary or reduced staffing levels. Further research is needed to assess the relationship between missing clinical information and diagnostic errors; to examine the issue in primary care; and to consider the patients perspective.

Doctors with dyslexia: strategies and support.

PubMed

Locke, Rachel; Alexander, Gail; Mann, Richard; Kibble, Sharon; Scallan, Samantha

2017-10-01

Looking beyond dyslexia as an individual doctor's issue requires adjusting a working environment to better serve the needs of doctors with dyslexia. With an increasing number of doctors disclosing dyslexia at medical school, how can educators best provide this support? Our research looks at the impact of dyslexia on clinical practice and the coping strategies used by doctors to minimise the effect. Qualitative data were collected from 14 doctors with dyslexia using semi-structured interviews and by survey. 'In situ' demonstration interviews were conducted in order to understand how dyslexia is managed in the workplace from first-hand experience. Employers and educators who have responsibility for meeting the needs of this group were also consulted. Even in cases of doctors who had a diagnosis, they often did not disclose their dyslexia to their employer. Study participants reported having developed individual ways of coping and devised useful 'workarounds'. Support from employers comes in the form of 'reasonable adjustments', although from our data we cannot be sure that such adjustments contribute to an 'enabling' work environment. Supportive characteristics included the opportunity to shadow others and the time and space to complete paperwork on a busy ward. How can educators best provide support [for doctors with dyslexia]? Doctors with dyslexia need to be helped to feel comfortable enough to disclose. Educators need to challenge any negative assumptions that exist as well as promote understanding about the elements that contribute to a positive working environment. As a result of the research there is now practice available for educators to identify evidence-based strategies and resources. © 2016 John Wiley & Sons Ltd and The Association for the Study of Medical Education.

Kidney stones - what to ask your doctor

MedlinePlus

Nephrolithiasis - what to ask your doctor; Renal calculi - what to ask your doctor; What to ask your doctor about kidney stones ... Strategies for nonmedical management of upper urinary tract calculi. In: Wein AJ, Kavoussi LR, Partin AW, Peters ...

Epilepsy - what to ask your doctor - adult

MedlinePlus

What to ask your doctor about epilepsy - adult; Seizures - what to ask your doctor - adult; Seizure - what to ask your doctor ... call to find more information about driving and epilepsy? What should I discuss with my boss at ...

Learning through inter- and intradisciplinary problem solving: using cognitive apprenticeship to analyse doctor-to-doctor consultation.

PubMed

Pimmer, Christoph; Pachler, Norbert; Nierle, Julia; Genewein, Urs

2012-12-01

Today's healthcare can be characterised by the increasing importance of specialisation that requires cooperation across disciplines and specialities. In view of the number of educational programmes for interdisciplinary cooperation, surprisingly little is known on how learning arises from interdisciplinary work. In order to analyse the learning and teaching practices of interdisciplinary cooperation, a multiple case study research focused on how consults, i.e., doctor-to-doctor consultations between medical doctors from different disciplines were carried out: semi-structured interviews with doctors of all levels of seniority from two hospital sites in Switzerland were conducted. Starting with a priori constructs based on the 'methods' underpinning cognitive apprenticeship (CA), the transcribed interviews were analysed according to the principles of qualitative content analysis. The research contributes to three debates: (1) socio-cognitive and situated learning, (2) intra- and interdisciplinary learning in clinical settings, and (3), more generally, to cooperation and problem solving. Patient cases, which necessitate the cooperation of doctors in consults across boundaries of clinical specialisms, trigger intra- as well as interdisciplinary learning and offer numerous and varied opportunities for learning by requesting doctors as well as for on-call doctors, in particular those in residence. The relevance of consults for learning can also be verified from the perspective of CA which is commonly used by experts, albeit in varying forms, degrees of frequency and quality, and valued by learners. Through data analysis a model for collaborative problem-solving and help-seeking was developed which shows the interplay of pedagogical 'methods' of CA in informal clinical learning contexts.

Effective doctor-patient communication: an updated examination.

PubMed

Matusitz, Jonathan; Spear, Jennifer

2014-01-01

This article examines, in detail, the quality of doctor-patient interaction. Doctor-patient communication is such a powerful indicator of health care quality that it can determine patients' self-management behavior and health outcomes. The medical visit (i.e., the medical encounter) plays a pivotal role in the health care process. In fact, doctor-patient communication is one of the most essential dynamics in health care, affecting the course of patient care and patient compliance with recommendations for care. Unlike many other analyses (that often look at only one or two specific aspects of doctor-patient relationships), this analysis is more encompassing; it looks at doctor-patient communication from multiple perspectives.

Understanding doctors' ethical challenges as role virtue conflicts.

PubMed

McDougall, Rosalind

2013-01-01

This paper argues that doctors' ethical challenges can be usefully conceptualised as role virtue conflicts. The hospital environment requires doctors to be simultaneously good doctors, good team members, good learners and good employees. I articulate a possible set of role virtues for each of these four roles, as a basis for a virtue ethics approach to analysing doctors' ethical challenges. Using one junior doctor's story, I argue that understanding doctors' ethical challenges as role virtue conflicts enables recognition of important moral considerations that are overlooked by other approaches to ethical analysis. © 2011 Blackwell Publishing Ltd.

Search Methods Used to Locate Missing Cats and Locations Where Missing Cats Are Found

PubMed Central

Huang, Liyan; Coradini, Marcia; Rand, Jacquie; Morton, John; Albrecht, Kat; Wasson, Brigid; Robertson, Danielle

2018-01-01

Simple Summary A least 15% of cat owners lose their pet in a five-year period and some are never found. This paper reports on data gathered from an online questionnaire that asked questions regarding search methods used to locate missing cats and locations where missing cats were found. The most important finding from this retrospective case series was that approximately one third of cats were recovered within 7 days. Secondly, a physical search increased the chances of finding cats alive and 75% of cats were found within a 500 m radius of their point of escape. Thirdly, those cats that were indoor-outdoor and allowed outside unsupervised traveled longer distances compared with indoor cats that were never allowed outside. Lastly, cats considered to be highly curious in nature were more likely to be found inside someone else’s house compared to other personality types. These findings suggest that a physical search within the first week of a cat going missing could be a useful strategy. In light of these findings, further research into this field may show whether programs such as shelter, neuter and return would improve the chances of owners searching and finding their missing cats as well as decreasing euthanasia rates in shelters. Abstract Missing pet cats are often not found by their owners, with many being euthanized at shelters. This study aimed to describe times that lost cats were missing for, search methods associated with their recovery, locations where found and distances travelled. A retrospective case series was conducted where self-selected participants whose cat had gone missing provided data in an online questionnaire. Of the 1210 study cats, only 61% were found within one year, with 34% recovered alive by the owner within 7 days. Few cats were found alive after 90 days. There was evidence that physical searching increased the chance of finding the cat alive (p = 0.073), and 75% of cats were found within 500 m of the point of escape. Up to 75% of

Do doctors accurately assess coronary risk in their patients? Preliminary results of the coronary health assessment study.

PubMed Central

Grover, S. A.; Lowensteyn, I.; Esrey, K. L.; Steinert, Y.; Joseph, L.; Abrahamowicz, M.

1995-01-01

OBJECTIVE--To evaluate the ability of doctors in primary care to assess risk patients' risk of coronary heart disease. DESIGN--Questionnaire survey. SETTING--Continuing medical education meetings, Ontario and Quebec, Canada. SUBJECTS--Community based doctors who agreed to enroll in the coronary health assessment study. MAIN OUTCOME MEASURE--Ratings of coronary risk factors and estimates by doctors of relative and absolute coronary risk of two hypothetical patients and the "average" 40 year old Canadian man and 70 year old Canadian woman. RESULTS--253 doctors answered the questionnaire. For 30 year olds the doctors rated cigarette smoking as the most important risk factor and raised serum triglyceride concentrations as the least important; for 70 year old patients they rated diabetes as the most important risk factor and raised serum triglyceride concentrations as the least important. They rated each individual risk factor as significantly less important for 70 year olds than for 30 year olds (all risk factors, P < 0.001). They showed a strong understanding of the relative importance of specific risk factors, and most were confident in their ability to estimate coronary risk. While doctors accurately estimated the relative risk of a specific patient (compared with the average adult) they systematically overestimated the absolute baseline risk of developing coronary disease and the risk reductions associated with specific interventions. CONCLUSIONS--Despite guidelines on targeting patients at high risk of coronary disease accurate assessment of coronary risk remains difficult for many doctors. Additional strategies must be developed to help doctors to assess better their patients' coronary risk. PMID:7728035

Integrative missing value estimation for microarray data.

PubMed

Hu, Jianjun; Li, Haifeng; Waterman, Michael S; Zhou, Xianghong Jasmine

2006-10-12

Missing value estimation is an important preprocessing step in microarray analysis. Although several methods have been developed to solve this problem, their performance is unsatisfactory for datasets with high rates of missing data, high measurement noise, or limited numbers of samples. In fact, more than 80% of the time-series datasets in Stanford Microarray Database contain less than eight samples. We present the integrative Missing Value Estimation method (iMISS) by incorporating information from multiple reference microarray datasets to improve missing value estimation. For each gene with missing data, we derive a consistent neighbor-gene list by taking reference data sets into consideration. To determine whether the given reference data sets are sufficiently informative for integration, we use a submatrix imputation approach. Our experiments showed that iMISS can significantly and consistently improve the accuracy of the state-of-the-art Local Least Square (LLS) imputation algorithm by up to 15% improvement in our benchmark tests. We demonstrated that the order-statistics-based integrative imputation algorithms can achieve significant improvements over the state-of-the-art missing value estimation approaches such as LLS and is especially good for imputing microarray datasets with a limited number of samples, high rates of missing data, or very noisy measurements. With the rapid accumulation of microarray datasets, the performance of our approach can be further improved by incorporating larger and more appropriate reference datasets.

Missing data and multiple imputation in clinical epidemiological research.

PubMed

Pedersen, Alma B; Mikkelsen, Ellen M; Cronin-Fenton, Deirdre; Kristensen, Nickolaj R; Pham, Tra My; Pedersen, Lars; Petersen, Irene

2017-01-01

Missing data are ubiquitous in clinical epidemiological research. Individuals with missing data may differ from those with no missing data in terms of the outcome of interest and prognosis in general. Missing data are often categorized into the following three types: missing completely at random (MCAR), missing at random (MAR), and missing not at random (MNAR). In clinical epidemiological research, missing data are seldom MCAR. Missing data can constitute considerable challenges in the analyses and interpretation of results and can potentially weaken the validity of results and conclusions. A number of methods have been developed for dealing with missing data. These include complete-case analyses, missing indicator method, single value imputation, and sensitivity analyses incorporating worst-case and best-case scenarios. If applied under the MCAR assumption, some of these methods can provide unbiased but often less precise estimates. Multiple imputation is an alternative method to deal with missing data, which accounts for the uncertainty associated with missing data. Multiple imputation is implemented in most statistical software under the MAR assumption and provides unbiased and valid estimates of associations based on information from the available data. The method affects not only the coefficient estimates for variables with missing data but also the estimates for other variables with no missing data.

Missing data and multiple imputation in clinical epidemiological research

PubMed Central

Pedersen, Alma B; Mikkelsen, Ellen M; Cronin-Fenton, Deirdre; Kristensen, Nickolaj R; Pham, Tra My; Pedersen, Lars; Petersen, Irene

2017-01-01

Missing data are ubiquitous in clinical epidemiological research. Individuals with missing data may differ from those with no missing data in terms of the outcome of interest and prognosis in general. Missing data are often categorized into the following three types: missing completely at random (MCAR), missing at random (MAR), and missing not at random (MNAR). In clinical epidemiological research, missing data are seldom MCAR. Missing data can constitute considerable challenges in the analyses and interpretation of results and can potentially weaken the validity of results and conclusions. A number of methods have been developed for dealing with missing data. These include complete-case analyses, missing indicator method, single value imputation, and sensitivity analyses incorporating worst-case and best-case scenarios. If applied under the MCAR assumption, some of these methods can provide unbiased but often less precise estimates. Multiple imputation is an alternative method to deal with missing data, which accounts for the uncertainty associated with missing data. Multiple imputation is implemented in most statistical software under the MAR assumption and provides unbiased and valid estimates of associations based on information from the available data. The method affects not only the coefficient estimates for variables with missing data but also the estimates for other variables with no missing data. PMID:28352203

Women who doctor shop for prescription drugs.

PubMed

Worley, Julie; Thomas, Sandra P

2014-04-01

Doctor shopping is a term used to describe a form of diversion of prescription drugs when patients visit numerous prescribers to obtain controlled drugs for illicit use. Gender differences exist in regard to prescription drug abuse and methods of diversion. The purpose of this phenomenological study guided by the existential philosophy of Merleau-Ponty was to understand the lived experience of female doctor shoppers. Interviews were conducted with 14 women, which were recorded, transcribed, and analyzed. Included in the findings are figural aspects of the participants' experience of doctor shopping related to the existential grounds of world, time, body, and others. Four themes emerged from the data: (a) feeding the addiction, (b) networking with addicts, (c) playing the system, and (d) baiting the doctors. The findings suggest several measures that nurses can take to reduce the incidence of doctor shopping and to provide better care for female doctor shoppers.

Some Thoughts on Doctoral Preparation in Mathematics Education

ERIC Educational Resources Information Center

Reys, Robert

2016-01-01

Arguments for significantly improving doctoral programs have long been made, both nationally and internationally. The nature and variety of doctoral programs makes it difficult to single out specific changes that would be equally applicable to every discipline-specific doctoral program. Therefore, this commentary will focus on doctoral programs…

Satisfaction among Current Doctoral Students in Special Education

ERIC Educational Resources Information Center

Wasburn-Moses, Leah

2008-01-01

Despite the growing demand for professionals with doctoral degrees in special education, doctoral programs are not producing enough graduates to fulfill this need. Although large attrition rates exist in doctoral study across discipline, very little is known about the attrition or satisfaction of doctoral students in special education. This…

Distinction in Doctoral Education: Using Bourdieu's Tools to Assess the Socialization of Doctoral Students

ERIC Educational Resources Information Center

Gopaul, Bryan

2011-01-01

This conceptual article uses the tools of Pierre Bourdieu (1977, 1986, 1990) to examine the socialization of doctoral students by suggesting that the processes of doctoral study highlight inequities among students. Using Young's (1990) social justice approach as a framework to complement the ideas of Bourdieu, I demonstrate how aspects of academic…

Child Development and the Coworking of Doctor and Teacher: A Waldorf School Doctor's Perspective.

ERIC Educational Resources Information Center

Karnow, Gerald F.

This paper draws on the nearly 20 years' experiences of a school doctor working with teachers at the Rudolf Steiner School in New York City to describe general principles of assessing child development in relation to educational progress. The paper contrasts the customary role of school doctors (related to conducting physical examinations for…

Multi-Target Tracking Using an Improved Gaussian Mixture CPHD Filter.

PubMed

Si, Weijian; Wang, Liwei; Qu, Zhiyu

2016-11-23

The cardinalized probability hypothesis density (CPHD) filter is an alternative approximation to the full multi-target Bayesian filter for tracking multiple targets. However, although the joint propagation of the posterior intensity and cardinality distribution in its recursion allows more reliable estimates of the target number than the PHD filter, the CPHD filter suffers from the spooky effect where there exists arbitrary PHD mass shifting in the presence of missed detections. To address this issue in the Gaussian mixture (GM) implementation of the CPHD filter, this paper presents an improved GM-CPHD filter, which incorporates a weight redistribution scheme into the filtering process to modify the updated weights of the Gaussian components when missed detections occur. In addition, an efficient gating strategy that can adaptively adjust the gate sizes according to the number of missed detections of each Gaussian component is also presented to further improve the computational efficiency of the proposed filter. Simulation results demonstrate that the proposed method offers favorable performance in terms of both estimation accuracy and robustness to clutter and detection uncertainty over the existing methods.

SAS doctors career progression survey 2013.

PubMed

Oroz, Carlos; Sands, Lorna R; Lee, John

2016-03-01

We conducted a national survey of Staff, Associate Specialists and Specialty (SAS) doctors working in sexual health clinics in the UK in 2013 in order to explore their career progression. The aim of the survey was to assess SAS doctors' experience in passing through the thresholds and to gather information about the adherence by SAS doctors and employers to the terms and conditions of service laid out by the new 2008 contract. Out of 185 responders, whom the authors estimate comprise 34% of the total workforce, 159 were on the new contract. Of those, most SAS doctors were women (84%), the majority (67%) worked less than nine programmed activities per week; only a few had intentions to join the consultant grade (15%), and a considerable minority (26%) were older than 54 years of age and likely to retire in the next ten years. The survey showed that most participating SAS doctors had undergone appraisal in the previous 15 months (90%), most had a job planning discussion (83%) with their employer and most had some allocated time for supporting professional activities (86%). However, a significant minority had no appraisal (10%), no job planning discussion (17%) and had no allocated supporting professional activities (14%), which allows time for career development in the specialty. Most SAS doctors, who had the opportunity, had progressed through the thresholds automatically (88%); some experienced difficulties in passing (8%) and only a few did not pass (4%). SAS doctors must ensure that they work together with their employer in order to improve adherence to the terms and conditions of service of the contract, which allow for career progression and benefit both the individual doctors and ultimately service provision. © The Author(s) 2015.

Supervising Doctoral Students: Variation in Purpose and Pedagogy

ERIC Educational Resources Information Center

Åkerlind, Gerlese; McAlpine, Lynn

2017-01-01

International policy changes that have prioritised increasing growth in the numbers of doctoral students have led to wide-ranging debate about the changing purpose of the doctorate. However, there has been little research aimed at investigating doctoral supervisors' views of the purpose of the doctorate, despite the significant role supervisors…

Evaluation of doctoral nursing programs in Japan by faculty members and their educational and research activities.

PubMed

Arimoto, Azusa; Gregg, Misuzu F; Nagata, Satoko; Miki, Yuko; Murashima, Sachiyo

2012-07-01

Evaluation of doctoral programs in nursing is becoming more important with the rapid increase in the programs in Japan. This study aimed to evaluate doctoral nursing programs by faculty members and to analyze the relationship of the evaluation with educational and research activities of faculty members in Japan. Target settings were all 46 doctoral nursing programs. Eighty-five faculty members from 28 programs answered the questionnaire, which included 17 items for program evaluation, 12 items for faculty evaluation, 9 items for resource evaluation, 3 items for overall evaluations, and educational and research activities. A majority gave low evaluations for sources of funding, the number of faculty members and support staff, and administrative systems. Faculty members who financially supported a greater number of students gave a higher evaluation for extramural funding support, publication, provision of diverse learning experiences, time of supervision, and research infrastructure. The more time a faculty member spent on advising doctoral students, the higher were their evaluations on the supportive learning environment, administrative systems, time of supervision, and timely feedback on students' research. The findings of this study indicate a need for improvement in research infrastructure, funding sources, and human resources to achieve quality nursing doctoral education in Japan. Copyright © 2011 Elsevier Ltd. All rights reserved.

40 CFR 98.245 - Procedures for estimating missing data.

Code of Federal Regulations, 2014 CFR

2014-07-01

... 40 Protection of Environment 21 2014-07-01 2014-07-01 false Procedures for estimating missing data... estimating missing data. For missing feedstock and product flow rates, use the same procedures as for missing... contents and missing molecular weights for fuels as specified in § 98.35(b)(1). For missing flare data...

[Practical use of doctor's assistant].

PubMed

Honda, Jiro

2012-07-01

Many researchers have focused on the introduction of mid-level providers (MLP) in order to reduce the number of doctors treating patients in the hospital. However, the establishment of MLPs in Japan still takes time. The process could be accelerated by relieving doctors of clerical work by employing auxiliary personnel. This hospital employs 22 auxiliary people to perform clerical work for the doctors, which are referred to as "doctor's assistants (DA)". The system is connected with the medical treatment fee system. Two DA are assigned cardiovascular surgery and conduct various other activities. These activities include: 1. Temporary creation of various medical documents. 2. Vicarious execution of electronic medical recoding system input. 3. Support of scientific activity. 4. Input of all data into the JACVSD Database. In addition, they participate in a round of cardiovascular surgery and inform the patient or family of the surgical schedule. They also cooperate with personnel from other specialties or department. The DA thus plays a crucial role in "team medical treatment."

Persisting Dreams: The Impact of the Doctoral Socialization Process on Latina Post-Doctoral Career Aspirations

ERIC Educational Resources Information Center

Westerband, Yamissette Milagros

2016-01-01

Latinas are underrepresented within the professorate and within doctoral programs, particularly within Research Intensive Institutions. This dissertation explores how the doctoral socialization process impacts the pipeline from the Ph.D. to scholarly careers for Latinas in Research universities. Given the low numbers of representation and…

Strategies for Dealing with Missing Accelerometer Data.

PubMed

Stephens, Samantha; Beyene, Joseph; Tremblay, Mark S; Faulkner, Guy; Pullnayegum, Eleanor; Feldman, Brian M

2018-05-01

Missing data is a universal research problem that can affect studies examining the relationship between physical activity measured with accelerometers and health outcomes. Statistical techniques are available to deal with missing data; however, available techniques have not been synthesized. A scoping review was conducted to summarize the advantages and disadvantages of identified methods of dealing with missing data from accelerometers. Missing data poses a threat to the validity and interpretation of trials using physical activity data from accelerometry. Imputation using multiple imputation techniques is recommended to deal with missing data and improve the validity and interpretation of studies using accelerometry. Copyright © 2018 Elsevier Inc. All rights reserved.

Which non-technical skills do junior doctors require to prescribe safely? A systematic review.

PubMed

Dearden, Effie; Mellanby, Edward; Cameron, Helen; Harden, Jeni

2015-12-01

Prescribing errors are a major source of avoidable morbidity and mortality. Junior doctors write most in-hospital prescriptions and are the least experienced members of the healthcare team. This puts them at high risk of error and makes them attractive targets for interventions to improve prescription safety. Error analysis has shown a background of complex environments with multiple contributory conditions. Similar conditions in other high risk industries, such as aviation, have led to an increased understanding of so-called human factors and the use of non-technical skills (NTS) training to try to reduce error. To date no research has examined the NTS required for safe prescribing. The aim of this review was to develop a prototype NTS taxonomy for safe prescribing, by junior doctors, in hospital settings. A systematic search identified 14 studies analyzing prescribing behaviours and errors by junior doctors. Framework analysis was used to extract data from the studies and identify behaviours related to categories of NTS that might be relevant to safe and effective prescribing performance by junior doctors. Categories were derived from existing literature and inductively from the data. A prototype taxonomy of relevant categories (situational awareness, decision making, communication and team working, and task management) and elements was constructed. This prototype will form the basis of future work to create a tool that can be used for training and assessment of medical students and junior doctors to reduce prescribing error in the future. © 2015 The British Pharmacological Society.

Successes and challenges in a novel doctoral program in systems agriculture: a case example.

PubMed

Lust, D; Topliff, D; Deotte, R

2010-01-01

A doctoral program in Systems Agriculture was initiated at West Texas A&M University, Canyon, TX, in September, 2003. The stated objective of the program was "..to prepare leaders for the agricultural industry that are trained in a multidisciplinary, research-based curriculum that emphasizes a systems approach to problem solving". The program offers a single doctoral degree in Agriculture and accepts qualified students with a master's or professional degree in agricultural or related disciplines. Courses related to systems methodologies, leadership, agricultural economics, plant and soil science, and animal science are required. Additional program requirements include a systems research project and dissertation, leadership training, and written and oral exams. The program has exceeded enrollment and graduation targets, suggesting interest in this approach to a doctoral degree. Students have entered the program with M.S. backgrounds in education, traditional agricultural disciplines, veterinary medicine, business, and physics. Graduates have gained employment in industry, university teaching and research, government research/administration, and extension. Doctoral student projects in systems agriculture contributed to curriculum changes and to the conceptual framework adopted by a multi-state research group. Designing and teaching courses for students with diverse backgrounds has been challenging. Development of a common understanding of systems agriculture was identified by a third-party program review as an issue for faculty. Development and maintenance of program standards and administrative procedures posed additional challenges. Leadership, administrative support, and timely and continuing program assessment are suggested as necessary components for a nontraditional doctoral program.

Mind the Gap: The Prospects of Missing Data.

PubMed

McConnell, Meghan; Sherbino, Jonathan; Chan, Teresa M

2016-12-01

The increasing use of workplace-based assessments (WBAs) in competency-based medical education has led to large data sets that assess resident performance longitudinally. With large data sets, problems that arise from missing data are increasingly likely. The purpose of this study is to examine (1) whether data are missing at random across various WBAs, and (2) the relationship between resident performance and the proportion of missing data. During 2012-2013, a total of 844 WBAs of CanMEDs Roles were completed for 9 second-year emergency medicine residents. To identify whether missing data were randomly distributed across various WBAs, the total number of missing data points was calculated for each Role. To examine whether the amount of missing data was related to resident performance, 5 faculty members rank-ordered the residents based on performance. A median rank score was calculated for each resident and was correlated with the proportion of missing data. More data were missing for Health Advocate and Professional WBAs relative to other competencies ( P  < .001). Furthermore, resident rankings were not related to the proportion of missing data points ( r  = 0.29, P  > .05). The results of the present study illustrate that some CanMEDS Roles are less likely to be assessed than others. At the same time, the amount of missing data did not correlate with resident performance, suggesting lower-performing residents are no more likely to have missing data than their higher-performing peers. This article discusses several approaches to dealing with missing data.

Search Methods Used to Locate Missing Cats and Locations Where Missing Cats Are Found.

PubMed

Huang, Liyan; Coradini, Marcia; Rand, Jacquie; Morton, John; Albrecht, Kat; Wasson, Brigid; Robertson, Danielle

2018-01-02

Missing pet cats are often not found by their owners, with many being euthanized at shelters. This study aimed to describe times that lost cats were missing for, search methods associated with their recovery, locations where found and distances travelled. A retrospective case series was conducted where self-selected participants whose cat had gone missing provided data in an online questionnaire. Of the 1210 study cats, only 61% were found within one year, with 34% recovered alive by the owner within 7 days. Few cats were found alive after 90 days. There was evidence that physical searching increased the chance of finding the cat alive ( p = 0.073), and 75% of cats were found within 500 m of the point of escape. Up to 75% of cats with outdoor access traveled 1609 m, further than the distance traveled by indoor-only cats (137 m; p ≤ 0.001). Cats considered to be highly curious were more likely to be found inside someone else's house compared to other personality types. These findings suggest that thorough physical searching is a useful strategy, and should be conducted within the first week after cats go missing. They also support further investigation into whether shelter, neuter and return programs improve the chance of owners recovering missing cats and decrease numbers of cats euthanized in shelters.

An Appreciative Inquiry into Educational Administration Doctoral Programs: Stories from Doctoral Students at Three Universities

ERIC Educational Resources Information Center

Calabrese, Raymond L.; Zepeda, Sally J.; Peters, April L.; Hummel, Crystal; Kruskamp, William H.; San Martin, Teresa; Wynne, Stefanie C.

2007-01-01

A case study using appreciate inquiry identified and described the experiences of five educational administration doctoral students representing three universities regarding their doctoral program studies and dissertation process. Data were collected using reflective narratives and the Left Hand Right Hand Column Case Method. Data revealed (a) the…

Treatment of Missing Data in Workforce Education Research

ERIC Educational Resources Information Center

Gemici, Sinan; Rojewski, Jay W.; Lee, In Heok

2012-01-01

Most quantitative analyses in workforce education are affected by missing data. Traditional approaches to remedy missing data problems often result in reduced statistical power and biased parameter estimates due to systematic differences between missing and observed values. This article examines the treatment of missing data in pertinent…

Cultural and musical activity among Norwegian doctors.

PubMed

Nylenna, Magne; Aasland, Olaf Gjerløw

2013-06-25

The cultural and musical activity of Norwegian doctors was studied in 1993. We wished to re-examine their cultural and musical activity, analyse the development and study the correlation with satisfaction, health and other leisure activities. In the autumn of 2010, a survey was undertaken among a representative sample of economically active Norwegian doctors. The survey asked the same questions as in 1993, and the responses were also compared to the population studies conducted by Statistics Norway. We also used a cultural index that we have developed ourselves. Altogether 1,019 doctors (70%) responded to the survey. They reported a higher level of cultural activity in 2010 than in 1993, measured in terms of reading of non-medical literature and visits to the cinema, theatre and concerts. The doctors engaged in musical activity of their own especially frequently: 58% reported to be able to play an instrument, and 21% reported to play on a regular basis, which is more than among other academic professions. We found a significant correlation between the doctors' level of cultural activity and their job satisfaction, general satisfaction, self-reported health and physical activity. The doctors who engage most frequently in cultural activities are thus most satisfied with their work and with life in general. Furthermore, they also have better self-reported health. Norwegian doctors give priority to cultural and musical activities. The assertion that doctors are particularly fond of music is more than just a myth.

The role of mobile devices in doctor-patient communication: A systematic review and meta-analysis.

PubMed

Kashgary, Abdullah; Alsolaimani, Roaa; Mosli, Mahmoud; Faraj, Samer

2017-09-01

Introduction In the last few years, the use of telecommunication and mobile technology has grown significantly. This has led to a notable increase in the utilization of this telecommunication in healthcare, namely phone calls and text messaging (SMS). However, evaluating its global impact on improving healthcare processes and outcomes demands a more comprehensive assessment. In this study, we focused on the role of mobile devices via phone calls and SMS in patient-doctor communication, and aimed to assess its impact on various health outcomes. Methods Major databases, including MEDLINE, EMBASE, PsycINFO, Global Health, and Cochrane CENTRAL, were searched for clinical trials that investigated mobile-device technology in any facet of doctor-patient communication published between 1990 and April 2015. A meta-analysis was performed where appropriate. Results Sixty-two articles met our inclusion criteria. Of those, 23 articles investigated mobile appointment reminder technologies, 19 investigated medication adherence, 20 investigated disease-control interventions, and two investigated test-result reporting. Patients who received an appointment reminder were 10% less likely to miss an appointment (relative risk [RR] = 1.11, 95% confidence interval [CI] 1.08-1.15). Mobile interventions increased medication adherence by 22% (RR = 1.22, 95% CI 1.09-1.36). Ten of 20 studies examining disease control reported statistically significant reductions in clinically meaningful endpoints. The use of mobile-device interventions improved forced expiratory volume in one second and hemoglobin A1c percentage in meta-analyses. Conclusion The use of mobile-device technologies exerted modest improvements in communication and health outcomes. Further research is needed to determine the true effect of these technologies on doctor-patient communication.

The missing impact craters on Venus

NASA Technical Reports Server (NTRS)

Speidel, D. H.

1993-01-01

The size-frequency pattern of the 842 impact craters on Venus measured to date can be well described (across four standard deviation units) as a single log normal distribution with a mean crater diameter of 14.5 km. This result was predicted in 1991 on examination of the initial Magellan analysis. If this observed distribution is close to the real distribution, the 'missing' 90 percent of the small craters and the 'anomalous' lack of surface splotches may thus be neither missing nor anomalous. I think that the missing craters and missing splotches can be satisfactorily explained by accepting that the observed distribution approximates the real one, that it is not craters that are missing but the impactors. What you see is what you got. The implication that Venus crossing impactors would have the same type of log normal distribution is consistent with recently described distribution for terrestrial craters and Earth crossing asteroids.

Doctorate Program Trains Industrial Chemists.

ERIC Educational Resources Information Center

Chemical and Engineering News, 1982

1982-01-01

The University of Texas (Dallas) has initiated a new Ph.D. program specifically to train chemists for doctoral level work in industry (Doctor of Chemistry). Participants will complete three research practica (at an industrial site and in two laboratory settings) instead of the traditional dissertation, emphasizing breadth and flexibility in…

Will Medical Technology Deskill Doctors?

ERIC Educational Resources Information Center

Lu, Jingyan

2016-01-01

This paper discusses the impact of medical technology on health care in light of the fact that doctors are becoming more reliant on technology for obtaining patient information, making diagnoses and in carrying out treatments. Evidence has shown that technology can negatively affect doctor-patient communications, physical examination skills, and…

TargetSpy: a supervised machine learning approach for microRNA target prediction.

PubMed

Sturm, Martin; Hackenberg, Michael; Langenberger, David; Frishman, Dmitrij

2010-05-28

Virtually all currently available microRNA target site prediction algorithms require the presence of a (conserved) seed match to the 5' end of the microRNA. Recently however, it has been shown that this requirement might be too stringent, leading to a substantial number of missed target sites. We developed TargetSpy, a novel computational approach for predicting target sites regardless of the presence of a seed match. It is based on machine learning and automatic feature selection using a wide spectrum of compositional, structural, and base pairing features covering current biological knowledge. Our model does not rely on evolutionary conservation, which allows the detection of species-specific interactions and makes TargetSpy suitable for analyzing unconserved genomic sequences.In order to allow for an unbiased comparison of TargetSpy to other methods, we classified all algorithms into three groups: I) no seed match requirement, II) seed match requirement, and III) conserved seed match requirement. TargetSpy predictions for classes II and III are generated by appropriate postfiltering. On a human dataset revealing fold-change in protein production for five selected microRNAs our method shows superior performance in all classes. In Drosophila melanogaster not only our class II and III predictions are on par with other algorithms, but notably the class I (no-seed) predictions are just marginally less accurate. We estimate that TargetSpy predicts between 26 and 112 functional target sites without a seed match per microRNA that are missed by all other currently available algorithms. Only a few algorithms can predict target sites without demanding a seed match and TargetSpy demonstrates a substantial improvement in prediction accuracy in that class. Furthermore, when conservation and the presence of a seed match are required, the performance is comparable with state-of-the-art algorithms. TargetSpy was trained on mouse and performs well in human and drosophila

TargetSpy: a supervised machine learning approach for microRNA target prediction

PubMed Central

2010-01-01

Background Virtually all currently available microRNA target site prediction algorithms require the presence of a (conserved) seed match to the 5' end of the microRNA. Recently however, it has been shown that this requirement might be too stringent, leading to a substantial number of missed target sites. Results We developed TargetSpy, a novel computational approach for predicting target sites regardless of the presence of a seed match. It is based on machine learning and automatic feature selection using a wide spectrum of compositional, structural, and base pairing features covering current biological knowledge. Our model does not rely on evolutionary conservation, which allows the detection of species-specific interactions and makes TargetSpy suitable for analyzing unconserved genomic sequences. In order to allow for an unbiased comparison of TargetSpy to other methods, we classified all algorithms into three groups: I) no seed match requirement, II) seed match requirement, and III) conserved seed match requirement. TargetSpy predictions for classes II and III are generated by appropriate postfiltering. On a human dataset revealing fold-change in protein production for five selected microRNAs our method shows superior performance in all classes. In Drosophila melanogaster not only our class II and III predictions are on par with other algorithms, but notably the class I (no-seed) predictions are just marginally less accurate. We estimate that TargetSpy predicts between 26 and 112 functional target sites without a seed match per microRNA that are missed by all other currently available algorithms. Conclusion Only a few algorithms can predict target sites without demanding a seed match and TargetSpy demonstrates a substantial improvement in prediction accuracy in that class. Furthermore, when conservation and the presence of a seed match are required, the performance is comparable with state-of-the-art algorithms. TargetSpy was trained on mouse and performs well

Detection of Missing Proteins Using the PRIDE Database as a Source of Mass Spectrometry Evidence.

PubMed

Garin-Muga, Alba; Odriozola, Leticia; Martínez-Val, Ana; Del Toro, Noemí; Martínez, Rocío; Molina, Manuela; Cantero, Laura; Rivera, Rocío; Garrido, Nicolás; Dominguez, Francisco; Sanchez Del Pino, Manuel M; Vizcaíno, Juan Antonio; Corrales, Fernando J; Segura, Victor

2016-11-04

The current catalogue of the human proteome is not yet complete, as experimental proteomics evidence is still elusive for a group of proteins known as the missing proteins. The Human Proteome Project (HPP) has been successfully using technology and bioinformatic resources to improve the characterization of such challenging proteins. In this manuscript, we propose a pipeline starting with the mining of the PRIDE database to select a group of data sets potentially enriched in missing proteins that are subsequently analyzed for protein identification with a method based on the statistical analysis of proteotypic peptides. Spermatozoa and the HEK293 cell line were found to be a promising source of missing proteins and clearly merit further attention in future studies. After the analysis of the selected samples, we found 342 PSMs, suggesting the presence of 97 missing proteins in human spermatozoa or the HEK293 cell line, while only 36 missing proteins were potentially detected in the retina, frontal cortex, aorta thoracica, or placenta. The functional analysis of the missing proteins detected confirmed their tissue specificity, and the validation of a selected set of peptides using targeted proteomics (SRM/MRM assays) further supports the utility of the proposed pipeline. As illustrative examples, DNAH3 and TEPP in spermatozoa, and UNCX and ATAD3C in HEK293 cells were some of the more robust and remarkable identifications in this study. We provide evidence indicating the relevance to carefully analyze the ever-increasing MS/MS data available from PRIDE and other repositories as sources for missing proteins detection in specific biological matrices as revealed for HEK293 cells.

Detection of Missing Proteins Using the PRIDE Database as a Source of Mass Spectrometry Evidence

PubMed Central

2016-01-01

The current catalogue of the human proteome is not yet complete, as experimental proteomics evidence is still elusive for a group of proteins known as the missing proteins. The Human Proteome Project (HPP) has been successfully using technology and bioinformatic resources to improve the characterization of such challenging proteins. In this manuscript, we propose a pipeline starting with the mining of the PRIDE database to select a group of data sets potentially enriched in missing proteins that are subsequently analyzed for protein identification with a method based on the statistical analysis of proteotypic peptides. Spermatozoa and the HEK293 cell line were found to be a promising source of missing proteins and clearly merit further attention in future studies. After the analysis of the selected samples, we found 342 PSMs, suggesting the presence of 97 missing proteins in human spermatozoa or the HEK293 cell line, while only 36 missing proteins were potentially detected in the retina, frontal cortex, aorta thoracica, or placenta. The functional analysis of the missing proteins detected confirmed their tissue specificity, and the validation of a selected set of peptides using targeted proteomics (SRM/MRM assays) further supports the utility of the proposed pipeline. As illustrative examples, DNAH3 and TEPP in spermatozoa, and UNCX and ATAD3C in HEK293 cells were some of the more robust and remarkable identifications in this study. We provide evidence indicating the relevance to carefully analyze the ever-increasing MS/MS data available from PRIDE and other repositories as sources for missing proteins detection in specific biological matrices as revealed for HEK293 cells. PMID:27581094

Tips for Talking to Your Doctor

MedlinePlus

... contributed by: familydoctor.org editorial staff Categories: Healthcare Management, Working With Your Doctor, Your Health ResourcesTags: Doctor-Patient Relationships, Health Maintenance August 1, 2005 Copyright © American Academy of Family ...

Incomplete Early Childhood Immunization Series and Missing Fourth DTaP Immunizations; Missed Opportunities or Missed Visits?

PubMed

Robison, Steve G

2013-01-01

The successful completion of early childhood immunizations is a proxy for overall quality of early care. Immunization statuses are usually assessed by up-to-date (UTD) rates covering combined series of different immunizations. However, series UTD rates often only bear on which single immunization is missing, rather than the success of all immunizations. In the US, most series UTD rates are limited by missing fourth DTaP-containing immunizations (diphtheria/tetanus/pertussis) due at 15 to 18 months of age. Missing 4th DTaP immunizations are associated either with a lack of visits at 15 to 18 months of age, or to visits without immunizations. Typical immunization data however cannot distinguish between these two reasons. This study compared immunization records from the Oregon ALERT IIS with medical encounter records for two-year olds in the Oregon Health Plan. Among those with 3 valid DTaPs by 9 months of age, 31.6% failed to receive a timely 4th DTaP; of those without a 4th DTaP, 42.1% did not have any provider visits from 15 through 18 months of age, while 57.9% had at least one provider visit. Those with a 4th DTaP averaged 2.45 encounters, while those with encounters but without 4th DTaPs averaged 2.23 encounters.

Choosing a doctor and hospital for your cancer treatment

MedlinePlus

... the doctor accepts your plan. Your Cancer Care Team You may already have a primary care doctor. ... doctors. Often, these doctors work together as a team, so you will likely work with more than ...

Investing in learning and training refugee doctors.

PubMed

Ong, Yong Lock; Trafford, Penny; Paice, Elisabeth; Jackson, Neil

2010-06-01

Medically qualified refugees seek to build a new life and return to clinical medicine. The National Health Service (NHS) in the UK needs to develop a workforce to meet the needs of the communities it serves, and refugee doctors have the potential to contribute to the NHS, using their experience and skills to benefit patients. Fifty-four per cent of refugee doctors in the UK live in London, so in response, the London Deanery (Postgraduate Department of Medical and Dental Education, London University) has undertaken a series of initiatives over the past 8 years assisting refugee doctors back into medical employment. Clinical attachments, supernumerary 6-month posts and general practitioner (GP) training rotations have been offered. The projects, doctors involved, educational provision and outcomes are reported. The obstacles and barriers to returning to substantive posts in medicine are also discussed. Fifty-six per cent of the refugee doctors were known to be working after the schemes, 52 per cent gained substantive posts and 39 per cent entered training grades. Investing in innovative and creative work-based training programmes for refugee doctors is worthwhile, but needs to be adequately resourced if refugee doctors are to bring ultimate benefit to the NHS. © Blackwell Publishing Ltd 2010.

Sophie’s story: writing missing journeys

PubMed Central

Stevenson, Olivia

2014-01-01

‘Sophie’s story’ is a creative rendition of an interview narrative gathered in a research project on missing people. The paper explains why Sophie’s story was written and details the wider intention to provide new narrative resources for police officer training, families of missing people and returned missing people. We contextualize this cultural intervention with an argument about the transformative potential of writing trauma stories. It is suggested that trauma stories produce difficult and unknown affects, but ones that may provide new ways of talking about unspeakable events. Sophie’s story is thus presented as a hopeful cultural geography in process, and one that seeks to help rewrite existing social scripts about missing people. PMID:29710880

Headache - what to ask your doctor

MedlinePlus

... Tension-type headache - what to ask your doctor; Cluster headache - what to ask your doctor ... a tension-type headache ? A migraine headache ? A cluster headache ? What medical problems can cause headaches? What ...

Cholesterol - what to ask your doctor

MedlinePlus

... your doctor; What to ask your doctor about cholesterol ... What is my cholesterol level? What should my cholesterol level be? What are HDL ("good") cholesterol and LDL ("bad") cholesterol? Does my cholesterol ...

Women, Men and the Doctorate.

ERIC Educational Resources Information Center

Centra, John A; Kuykendall, Nancy M.

This study describes the current status and professional development of a sample of women doctorates and compares them to a sample of men who have attained the same educational status. Chapters cover the sample and procedures used; employment patterns; doctorates in academe; publications, income, and job satisfaction; marriage and family life;…

Reframing Doctoral Examination as Teaching

ERIC Educational Resources Information Center

Kumar, Vijay; Stracke, Elke

2018-01-01

Doctoral examiners judge the quality of a thesis and give the student assessment feedback if the student fails to reach certain goals. This paper investigates if and how examiners take on the evaluator or teaching role. We analysed doctoral examination reports from three disciplines. Most examiners provided assessment and feedback, but this often…

40 CFR 75.31 - Initial missing data procedures.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 40 Protection of Environment 16 2010-07-01 2010-07-01 false Initial missing data procedures. 75.31... (CONTINUED) CONTINUOUS EMISSION MONITORING Missing Data Substitution Procedures § 75.31 Initial missing data.... For each hour of missing SO2, Hg, or CO2 emissions concentration data (including CO2 data converted...

40 CFR 75.31 - Initial missing data procedures.

Code of Federal Regulations, 2011 CFR

2011-07-01

... 40 Protection of Environment 16 2011-07-01 2011-07-01 false Initial missing data procedures. 75.31... (CONTINUED) CONTINUOUS EMISSION MONITORING Missing Data Substitution Procedures § 75.31 Initial missing data..., or O2 concentration data, and moisture data. For each hour of missing SO2 or CO2 emissions...

40 CFR 75.31 - Initial missing data procedures.

Code of Federal Regulations, 2013 CFR

2013-07-01

... 40 Protection of Environment 17 2013-07-01 2013-07-01 false Initial missing data procedures. 75.31... (CONTINUED) CONTINUOUS EMISSION MONITORING Missing Data Substitution Procedures § 75.31 Initial missing data..., or O2 concentration data, and moisture data. For each hour of missing SO2 or CO2 emissions...

40 CFR 75.31 - Initial missing data procedures.

Code of Federal Regulations, 2012 CFR

2012-07-01

... 40 Protection of Environment 17 2012-07-01 2012-07-01 false Initial missing data procedures. 75.31... (CONTINUED) CONTINUOUS EMISSION MONITORING Missing Data Substitution Procedures § 75.31 Initial missing data..., or O2 concentration data, and moisture data. For each hour of missing SO2 or CO2 emissions...

40 CFR 75.31 - Initial missing data procedures.

Code of Federal Regulations, 2014 CFR

2014-07-01

... 40 Protection of Environment 17 2014-07-01 2014-07-01 false Initial missing data procedures. 75.31... (CONTINUED) CONTINUOUS EMISSION MONITORING Missing Data Substitution Procedures § 75.31 Initial missing data..., or O2 concentration data, and moisture data. For each hour of missing SO2 or CO2 emissions...

Factors Associated With Missed and Cancelled Colonoscopy Appointments at Veterans Health Administration Facilities.

PubMed

Partin, Melissa R; Gravely, Amy; Gellad, Ziad F; Nugent, Sean; Burgess, James F; Shaukat, Aasma; Nelson, David B

2016-02-01

Cancelled and missed colonoscopy appointments waste resources, increase colonoscopy delays, and can adversely affect patient outcomes. We examined individual and organizational factors associated with missed and cancelled colonoscopy appointments in Veteran Health Administration facilities. From 69 facilities meeting inclusion criteria, we identified 27,994 patients with colonoscopy appointments scheduled for follow-up, on the basis of positive fecal occult blood test results, between August 16, 2009 and September 30, 2011. We identified factors associated with colonoscopy appointment status (completed, cancelled, or missed) by using hierarchical multinomial regression. Individual factors examined included age, race, sex, marital status, residence, drive time to nearest specialty care facility, limited life expectancy, comorbidities, colonoscopy in the past decade, referring facility type, referral month, and appointment lead time. Organizational factors included facility region, complexity, appointment reminders, scheduling, and prep education practices. Missed appointments were associated with limited life expectancy (odds ratio [OR], 2.74; P = .0004), no personal history of polyps (OR, 2.74; P < .0001), high facility complexity (OR, 2.69; P = .007), dual diagnosis of psychiatric disorders and substance abuse (OR, 1.82; P < .0001), and opt-out scheduling (OR, 1.57; P = .02). Cancelled appointments were associated with age (OR, 1.61; P = .0005 for 85 years or older and OR, 1.44; P < .0001 for 65-84 years old), no history of polyps (OR, 1.51; P < .0001), and opt-out scheduling (OR, 1.26; P = .04). Additional predictors of both outcomes included race, marital status, and lead time. Several factors within Veterans Health Administration clinic control can be targeted to reduce missed and cancelled colonoscopy appointments. Specifically, developing systems to minimize referrals for patients with limited life expectancy could reduce missed appointments, and use of opt

"Seeing a doctor is just like having a date": a qualitative study on doctor shopping among overactive bladder patients in Hong Kong.

PubMed

Siu, Judy Yuen-Man

2014-02-06

Although having a regular primary care provider is noted to be beneficial to health, doctor shopping has been documented as a common treatment seeking behavior among chronically ill patients in different countries. However, little research has been conducted into the reasons behind doctor shopping behavior among patients with overactive bladder, and even less into how this behavior relates to these patients' illness and social experiences, perceptions, and cultural practices. Therefore, this study examines overactive bladder patients to investigate the reasons behind doctor shopping behavior. My study takes a qualitative approach, conducting 30 semi-structured individual interviews, with 30 overactive bladder patients in Hong Kong. My study found six primary themes that influenced doctor shopping behavior: lack of perceived need, convenience, work-provided medical insurance, unpleasant experiences with doctors, searching for a match doctor, and switching between biomedicine and traditional Chinese medicine. Besides the perceptual factors, participants' social environment, illness experiences, personal cultural preference, and cultural beliefs also intertwined to generate their doctor shopping behavior. Due to the low perceived need for a regular personal primary care physician, environmental factors such as time, locational convenience, and work-provided medical insurance became decisive in doctor shopping behavior. Patients' unpleasant illness experiences, stemming from a lack of understanding among many primary care doctors about overactive bladder, contributed to participants' sense of mismatch with these doctors, which induced them to shop for another doctor. Overactive bladder is a chronic bladder condition with very limited treatment outcome. Although patients with overactive bladder often require specialty urology treatment, it is usually beneficial for the patients to receive continuous, coordinated, comprehensive, and patient-centered support from their

Barefoot-Doctors. Occasional Paper No. 77-4.

ERIC Educational Resources Information Center

Perez, Joel

A description of "barefoot doctors" in the People's Republic of China is presented. These peasant doctors are commune workers who have taken basic courses in medical treatment. Because 80% of the population lives in a rural agricultural setting, and because most doctors and medical services are located in cities, there is a serious need…

Part Marking and Identification Materials on MISSE

NASA Technical Reports Server (NTRS)

Finckenor, Miria M.; Roxby, Donald L.

2008-01-01

Many different spacecraft materials were flown as part of the Materials on International Space Station Experiment (MISSE), including several materials used in part marking and identification. The experiment contained Data Matrix symbols applied using laser bonding, vacuum arc vapor deposition, gas assisted laser etch, chemical etch, mechanical dot peening, laser shot peening, and laser induced surface improvement. The effects of ultraviolet radiation on nickel acetate seal versus hot water seal on sulfuric acid anodized aluminum are discussed. These samples were exposed on the International Space Station to the low Earth orbital environment of atomic oxygen, ultraviolet radiation, thermal cycling, and hard vacuum, though atomic oxygen exposure was very limited for some samples. Results from the one-year exposure on MISSE-3 and MISSE-4 are compared to those from MISSE-1 and MISSE-2, which were exposed for four years. Part marking and identification materials on the current MISSE -6 experiment are also discussed.

Missing value imputation: with application to handwriting data

NASA Astrophysics Data System (ADS)

Xu, Zhen; Srihari, Sargur N.

2015-01-01

Missing values make pattern analysis difficult, particularly with limited available data. In longitudinal research, missing values accumulate, thereby aggravating the problem. Here we consider how to deal with temporal data with missing values in handwriting analysis. In the task of studying development of individuality of handwriting, we encountered the fact that feature values are missing for several individuals at several time instances. Six algorithms, i.e., random imputation, mean imputation, most likely independent value imputation, and three methods based on Bayesian network (static Bayesian network, parameter EM, and structural EM), are compared with children's handwriting data. We evaluate the accuracy and robustness of the algorithms under different ratios of missing data and missing values, and useful conclusions are given. Specifically, static Bayesian network is used for our data which contain around 5% missing data to provide adequate accuracy and low computational cost.

Ileostomy - what to ask your doctor

MedlinePlus

Ostomy - what to ask your doctor; What to ask your doctor about ileostomy or colostomy; Colostomy - what ... the stoma? Does insurance cover the cost of ostomy supplies? What should I do if there is ...

Rural retention of doctors graduating from the rural medical education project to increase rural doctors in Thailand: a cohort study.

PubMed

Pagaiya, Nonglak; Kongkam, Lalitaya; Sriratana, Sanya

2015-03-01

In Thailand, the inequitable distribution of doctors between rural and urban areas has a major impact on access to care for those living in rural communities. The rural medical education programme 'Collaborative Project to Increase Rural Doctors (CPIRD)' was implemented in 1994 with the aim of attracting and retaining rural doctors. This study examined the impact of CPIRD in relation to doctor retention in rural areas and public health service. Baseline data consisting of age, sex and date of entry to the Ministry of Health (MoH) service was collected from 7,157 doctors graduating between 2000 and 2007. There were 1,093 graduates from the CPIRD track and 6,064 that graduated through normal channels. Follow-up data, consisting of workplace, number of years spent in rural districts and years within the MoH service, were retrieved from June 2000 to July 2011. The Kaplan-Meier method of survival analysis and Cox proportional hazards ratios were used to interpret the data. Female subjects slightly outnumbered their male counterparts. Almost half of the normal track (48%) and 33% of the CPIRD doctors eventually left the MoH. The retention rate at rural hospitals was 29% for the CPIRD doctors compared to 18% for those from the normal track. Survival curves indicated a dramatic drop rate after 3 years in service for both groups, but normal track individuals decreased at a faster rate. Multivariate Cox proportional hazards modelling revealed that the normal track doctors had a significantly higher risk of leaving rural areas at about 1.3 times the CPIRD doctors. The predicted median survival time in rural hospitals was 4.2 years for the CPIRD group and 3.4 years for the normal track. The normal track doctors had a significantly higher risk of leaving public service at about 1.5 times the CPIRD doctors. The project evaluation results showed a positive impact in that CPIRD doctors were more likely to stay longer in rural areas and in public service than their counterparts

Reshaping Doctoral Education: International Approaches and Pedagogies

ERIC Educational Resources Information Center

Lee, Alison, Ed.; Danby, Susan, Ed.

2011-01-01

The number of doctorates being awarded around the world has almost doubled over the last ten years, propelling it from a small elite enterprise into a large and ever growing international market. Within the context of increasing numbers of doctoral students this book examines the new doctorate environment and the challenges it is starting to face.…

Doctor and pharmacy shopping for controlled substances.

PubMed

Peirce, Gretchen L; Smith, Michael J; Abate, Marie A; Halverson, Joel

2012-06-01

Prescription drug abuse is a major health concern nationwide, with West Virginia having one of the highest prescription drug death rates in the United States. Studies are lacking that compare living subjects with persons who died from drug overdose for evidence of doctor and pharmacy shopping for controlled substances. The study objectives were to compare deceased and living subjects in West Virginia for evidence of prior doctor and pharmacy shopping for controlled substances and to identify factors associated with drug-related death. A secondary data study was conducted using controlled substance, Schedule II-IV, prescription data from the West Virginia Controlled Substance Monitoring Program and drug-related death data compiled by the Forensic Drug Database between July 2005 and December 2007. A case-control design compared deceased subjects 18 years and older whose death was drug related with living subjects for prior doctor and pharmacy shopping. Logistic regression identified factors related to the odds of drug-related death. A significantly greater proportion of deceased subjects were doctor shoppers (25.21% vs. 3.58%) and pharmacy shoppers (17.48% vs. 1.30%) than living subjects. Approximately 20.23% of doctor shoppers were also pharmacy shoppers, and 55.60% of pharmacy shoppers were doctor shoppers. Younger age, greater number of prescriptions dispensed, exposure to opioids and benzodiazepines, and doctor and pharmacy shopping were factors with greater odds of drug-related death. Doctor and pharmacy shopping involving controlled substances were identified, and shopping behavior was associated with drug-related death. Prescription monitoring programs may be useful in identifying potential shoppers at the point of care.

[Problems of Doctor Judym's peers].

PubMed

Kamiński, J

2000-01-01

This paper is a work on the health conditions of the inhabitants of Rzeszów and the surrounding area in the second half of the 19th century as based on the mortality analysis. A comparison and contrast has been made between the daily work of a doctor nowadays and a hundred years ago. The issues have been presented at various levels, with reference to the political, socio-economic and cultural relations existing at that time. The work is enhanced with additional comments on the doctor's profession and the problem of diagnostic difficulties as well as the possibility of making a mistaken judgement. Additionally, the definition of death at that time and at present has been formulated. The issues of colleague solidarity, ethical and moral issues and the activities of the Doctors' Association over the above mentioned period are also discussed. I noted the "plague" of the time which was the provision of medical treatment by the unqualified. The above considerations may be a starting point for the present, popular discussion on the principles of a doctor's ethics and duty.

Planned Missing Data Designs in Educational Psychology Research

ERIC Educational Resources Information Center

Rhemtulla, Mijke; Hancock, Gregory R.

2016-01-01

Although missing data are often viewed as a challenge for applied researchers, in fact missing data can be highly beneficial. Specifically, when the amount of missing data on specific variables is carefully controlled, a balance can be struck between statistical power and research costs. This article presents the issue of planned missing data by…

Missed Lesions at CT Colonography: Lessons Learned

PubMed Central

Pickhardt, Perry J.

2017-01-01

Misinterpretation at CT colonography (CTC) can result in either a colorectal lesion being missed (false negative) or a false-positive diagnosis. This review will largely focus on potential missed lesions – and ways to avoid such misses. The general causes of false-negative interpretation at CTC can be broadly characterized and grouped into discrete categories related to suboptimal study technique, specific lesion characteristics, anatomic location, and imaging artifacts. Overlapping causes further increase the likelihood of missing a clinically relevant lesion. In the end, if the technical factors of bowel preparation, colonic distention, and robust CTC software are adequately addressed on a consistent basis, and the reader is aware of all the potential pitfalls at CTC, important lesions will seldom be missed. PMID:22539045

Help for Finding Missing Children.

ERIC Educational Resources Information Center

McCormick, Kathleen

1984-01-01

Efforts to locate missing children have expanded from a federal law allowing for entry of information into an F.B.I. computer system to companion bills before Congress for establishing a national missing child clearinghouse and a Justice Department center to help in conducting searches. Private organizations are also involved. (KS)

MISSE-8

NASA Image and Video Library

2013-05-24

iss036e004042 (5/24/2013) --- View of Materials on International Space Station Experiment - 8 (MISSE-8) which is installed on the ExPRESS Logistics Carrier 2 (ELC-2),located on the S3 Truss Outboard Zenith site.

Longitudinal data analysis with non-ignorable missing data.

PubMed

Tseng, Chi-hong; Elashoff, Robert; Li, Ning; Li, Gang

2016-02-01

A common problem in the longitudinal data analysis is the missing data problem. Two types of missing patterns are generally considered in statistical literature: monotone and non-monotone missing data. Nonmonotone missing data occur when study participants intermittently miss scheduled visits, while monotone missing data can be from discontinued participation, loss to follow-up, and mortality. Although many novel statistical approaches have been developed to handle missing data in recent years, few methods are available to provide inferences to handle both types of missing data simultaneously. In this article, a latent random effects model is proposed to analyze longitudinal outcomes with both monotone and non-monotone missingness in the context of missing not at random. Another significant contribution of this article is to propose a new computational algorithm for latent random effects models. To reduce the computational burden of high-dimensional integration problem in latent random effects models, we develop a new computational algorithm that uses a new adaptive quadrature approach in conjunction with the Taylor series approximation for the likelihood function to simplify the E-step computation in the expectation-maximization algorithm. Simulation study is performed and the data from the scleroderma lung study are used to demonstrate the effectiveness of this method. © The Author(s) 2012.

From Doctors' Stories to Doctors' Stories, and Back Again.

PubMed

Childress, Marcia Day

2017-03-01

Stories have always been central to medicine, but during the twentieth century bioscience all but eclipsed narrative's presence in medical practice. In Doctors' Stories, published in 1991, Kathryn Montgomery excavated medicine's narrative foundations and functions to reveal new possibilities for how to conceive and characterize medicine. Physicians' engagement with stories has since flourished, especially through the narrative medicine movement, although in the twenty-first century this has been challenged by the health care industry's business-minded and data-driven clinical systems. But doctors' stories-and Montgomery's text-remain crucial, schooling clinicians in reflection, ethical awareness, and resilience. Physicians who write even short, 55-word reflective stories can hold to humanistic and ethical understandings of patient care and of themselves as healers even as they practice in systematized settings and employ evidence-based expertise. © 2017 American Medical Association. All Rights Reserved.

Methods for Mediation Analysis with Missing Data

ERIC Educational Resources Information Center

Zhang, Zhiyong; Wang, Lijuan

2013-01-01

Despite wide applications of both mediation models and missing data techniques, formal discussion of mediation analysis with missing data is still rare. We introduce and compare four approaches to dealing with missing data in mediation analysis including list wise deletion, pairwise deletion, multiple imputation (MI), and a two-stage maximum…

Regulation of junior doctors' work hours: an analysis of British and American doctors' experiences and attitudes.

PubMed

Jagsi, Reshma; Surender, Rebecca

2004-06-01

Regulations of junior doctors' work hours were first enacted in the United States (US) and United Kingdom (UK) over a decade ago, with the goals of improving patient care and doctors' well-being while maintaining a high quality of medical training. This study examines experiences and attitudes regarding the implementation of these regulations among physicians and surgeons at two teaching hospitals, one in South-East England, and the other in New England, US. This paper presents the findings of a survey questionnaire and a series of in-depth interviews administered to a sample of junior doctors and the consultants responsible for their supervision. The study finds that the different policy mechanisms employed in the two countries have had different degrees of success in reducing the work hours of junior doctors. The results also indicate, however, that even in settings in which hours have been reduced significantly, the regulations have only had limited effects on the quality of medical care, junior doctors' well-being, and the quality of medical education. A number of barriers to the success of the regulations in achieving their objectives are identified, and the relative merits of political action and professional self-regulation are discussed. This research suggests that recently enacted policies requiring further reductions in junior doctors' hours in both the US and UK may face similar barriers when implemented. Understanding the lessons that emerge from implementation of the original regulations is essential if future reforms are to succeed and a high-quality system of health care is to be sustained.

Doctoral Studies in Spain: Changes to Converge with Europe in the Internationalisation of the Doctorate

ERIC Educational Resources Information Center

Ramírez, Magdalena Jiménez

2016-01-01

In Spain, the organisation of doctoral studies has been substantially modified to come into line with the changes introduced by the agenda of the Bologna process. These changes have been specified in a number of statements by European Ministers of Education, and have required alterations to Spanish doctoral regulations. The aim of these changes…

Children and their parents assessing the doctor-patient interaction: a rating system for doctors' communication skills.

PubMed

Crossley, Jim; Eiser, Christine; Davies, Helena A

2005-08-01

Only a patient and his or her family can judge many of the most important aspects of the doctor-patient interaction. This study evaluates the feasibility and reliability of children and their families assessing the quality of paediatricians' interactions using a rating instrument developed specifically for this purpose. A reliability analysis using generalisability theory on the ratings from 352 doctor-patient interactions across different speciality clinics. Ratings were normally distributed. They were highest for 'overall' performance, and lowest for giving time to discuss the families' agenda. An appropriate sample of adults' ratings provided a reliable score (G = 0.7 with 15 raters), but children's ratings were too idiosyncratic to be reproducible (G = 0.36 with 15 raters). CONCLUSIONS AND FURTHER WORK: Accompanying adults can provide reliable ratings of doctors' interactions with children. Because an adult is usually present at the consultation their ratings provide a highly feasible and authentic approach. Sampling doctors' interactions from different clinics and with patients of both genders provides a universal picture of performance. The method is ideal to measure performance for in-training assessment or revalidation. Further work is in progress to evaluate the educational impact of feeding ratings back to the doctors being assessed, and their use in a range of clinical contexts.

Medical barriers to emergency contraception: a cross-sectional survey of doctors in North India.

PubMed

Khan, M E; Dixit, Anvita; Bhatnagar, Isha; Brady, Martha

2014-05-01

Some medical doctors in India have publicly expressed opposition to making emergency contraceptive pills (ECPs) easily accessible, even though ECPs are included in the method mix of the Ministry of Health and Family Welfare program and as an over-the-counter (OTC) product. Such opposition affects access to ECPs by influencing policy, procurement, and distribution, besides stigmatizing the ECP user. This study was conducted to assess ECP knowledge, attitudes, and practices of doctors in North India. A cross-sectional survey of 83 doctors who provide ECPs, randomly selected from 3 cities in the state of Uttar Pradesh, was conducted in 2011. The quantitative data were complemented by 19 in-depth interviews with purposively selected senior gynecologists and other opinion leaders. All surveyed physicians cited the correct dose and regimen for ECPs. However, the large majority of those surveyed believed that ECPs work by preventing implantation. (The best evidence currently indicates that ECPs do not work by preventing implantation.) Most doctors also believed incorrectly that ECPs have several contraindications and side effects. They also had strong reservations against OTC provision of ECPs by pharmacists and community health workers (CHWs) and negative attitudes toward ECP users, which serve as serious medical barriers to mainstreaming use of ECPs. Physicians and their professional associations exert a strong influence on the operationalization of national contraceptive policies. Evidence-based advocacy and educational campaigns targeting doctors are needed to address and resolve their reservations about ECPs, particularly about its provision as an OTC product and its distribution by CHWs. Partnerships with medical associations can help reduce doctors' negative attitudes and create a conducive environment for influencing clinical practices. Such changes are needed to increase the availability and use of ECPs as part of a package of a full range of contraceptive method

Ear tube surgery - what to ask your doctor

MedlinePlus

What to ask your doctor about ear tube surgery; Tympanostomy - what to ask your doctor; Myringotomy - what to ask your doctor ... need ear tubes? Can we try other treatments? What are the risks of the surgery? Is it ...

"Seeing a doctor is just like having a date": a qualitative study on doctor shopping among overactive bladder patients in Hong Kong

PubMed Central

2014-01-01

Background Although having a regular primary care provider is noted to be beneficial to health, doctor shopping has been documented as a common treatment seeking behavior among chronically ill patients in different countries. However, little research has been conducted into the reasons behind doctor shopping behavior among patients with overactive bladder, and even less into how this behavior relates to these patients’ illness and social experiences, perceptions, and cultural practices. Therefore, this study examines overactive bladder patients to investigate the reasons behind doctor shopping behavior. Methods My study takes a qualitative approach, conducting 30 semi-structured individual interviews, with 30 overactive bladder patients in Hong Kong. Results My study found six primary themes that influenced doctor shopping behavior: lack of perceived need, convenience, work-provided medical insurance, unpleasant experiences with doctors, searching for a match doctor, and switching between biomedicine and traditional Chinese medicine. Besides the perceptual factors, participants’ social environment, illness experiences, personal cultural preference, and cultural beliefs also intertwined to generate their doctor shopping behavior. Due to the low perceived need for a regular personal primary care physician, environmental factors such as time, locational convenience, and work-provided medical insurance became decisive in doctor shopping behavior. Patients’ unpleasant illness experiences, stemming from a lack of understanding among many primary care doctors about overactive bladder, contributed to participants’ sense of mismatch with these doctors, which induced them to shop for another doctor. Conclusions Overactive bladder is a chronic bladder condition with very limited treatment outcome. Although patients with overactive bladder often require specialty urology treatment, it is usually beneficial for the patients to receive continuous, coordinated

M$^3$: A New Muon Missing Momentum Experiment to Probe $$(g-2)_{\\mu}$$ and Dark Matter at Fermilab

DOE Office of Scientific and Technical Information (OSTI.GOV)

Kahn, Yonatan; Krnjaic, Gordan; Tran, Nhan

New light, weakly-coupled particles are commonly invoked to address the persistentmore » $$\\sim 4\\sigma$$ anomaly in $$(g-2)_\\mu$$ and serve as mediators between dark and visible matter. If such particles couple predominantly to heavier generations and decay invisibly, much of their best-motivated parameter space is inaccessible with existing experimental techniques. In this paper, we present a new fixed-target, missing-momentum search strategy to probe invisibly decaying particles that couple preferentially to muons. In our setup, a relativistic muon beam impinges on a thick active target. The signal consists of events in which a muon loses a large fraction of its incident momentum inside the target without initiating any detectable electromagnetic or hadronic activity in downstream veto systems. We propose a two-phase experiment, M$^3$ (Muon Missing Momentum), based at Fermilab. Phase 1 with $$\\sim 10^{10}$$ muons on target can test the remaining parameter space for which light invisibly-decaying particles can resolve the $$(g-2)_\\mu$$ anomaly, while Phase 2 with $$\\sim 10^{13}$$ muons on target can test much of the predictive parameter space over which sub-GeV dark matter achieves freeze-out via muon-philic forces, including gauged $$U(1)_{L_\\mu - L_\\tau}$$.« less

The uses of the smartphone for doctors: an empirical study from samsung medical center.

PubMed

Choi, Jong Soo; Yi, Byoungkee; Park, Jong Hwan; Choi, Kyesook; Jung, Jaegon; Park, Seung Woo; Rhee, Poong-Lyul

2011-06-01

In healthcare, mobile computing made possible by smartphones is becoming an important tool among healthcare professionals. However, currently there is very little research into the effectiveness of such applications of technology. This study aims to present a framework for a smartphone application to give doctors mobile access to patient information, then review the consequences of its use and discuss its future direction. Since 2003 when Samsung Medical Center introduced its first mobile application, a need to develop a new application targeting the latest smartphone technology was identified. To that end, an application named Dr. SMART S was officially launched on December 22nd, 2010. We analyzed the usage data of the application for a month until April 25th, 2011. On average, 170 doctors (13% of the entire body of doctors) logged on 2.4 times per day and that number keeps growing. The number was uniformly distributed across all working hours, with exceptions of heavy accesses around 6-8 AM and 4-6 PM when doctors do their regular rounds to see the patients. The most commonly accessed content was inpatient information, this constituted 78.6% of all accesses, within this 50% was to accesses lab results. Looking at the usage data, we can see the use of Dr. SMART S by doctors is growing in sync with the popularity of smartphones. Since u-Health seem an inevitable future trend, a more rigorous study needs to be conducted on how such mobile applications as Dr. SMART S affect the quality of care and patient safety to derive directions for further improvements.

Missing: Children and Young People with SEBD

ERIC Educational Resources Information Center

Visser, John; Daniels, Harry; Macnab, Natasha

2005-01-01

This article explores the issue of missing from and missing out on education. It argues that too little is known with regard to the characteristics of children and young people missing from schooling. It postulates that many of these pupils will have social, emotional and behavioural difficulties which are largely unrecognized and thus not…

Empirical likelihood method for non-ignorable missing data problems.

PubMed

Guan, Zhong; Qin, Jing

2017-01-01

Missing response problem is ubiquitous in survey sampling, medical, social science and epidemiology studies. It is well known that non-ignorable missing is the most difficult missing data problem where the missing of a response depends on its own value. In statistical literature, unlike the ignorable missing data problem, not many papers on non-ignorable missing data are available except for the full parametric model based approach. In this paper we study a semiparametric model for non-ignorable missing data in which the missing probability is known up to some parameters, but the underlying distributions are not specified. By employing Owen (1988)'s empirical likelihood method we can obtain the constrained maximum empirical likelihood estimators of the parameters in the missing probability and the mean response which are shown to be asymptotically normal. Moreover the likelihood ratio statistic can be used to test whether the missing of the responses is non-ignorable or completely at random. The theoretical results are confirmed by a simulation study. As an illustration, the analysis of a real AIDS trial data shows that the missing of CD4 counts around two years are non-ignorable and the sample mean based on observed data only is biased.

Discovery of a missing disease spreader

NASA Astrophysics Data System (ADS)

Maeno, Yoshiharu

2011-10-01

This study presents a method to discover an outbreak of an infectious disease in a region for which data are missing, but which is at work as a disease spreader. Node discovery for the spread of an infectious disease is defined as discriminating between the nodes which are neighboring to a missing disease spreader node, and the rest, given a dataset on the number of cases. The spread is described by stochastic differential equations. A perturbation theory quantifies the impact of the missing spreader on the moments of the number of cases. Statistical discriminators examine the mid-body or tail-ends of the probability density function, and search for the disturbance from the missing spreader. They are tested with computationally synthesized datasets, and applied to the SARS outbreak and flu pandemic.

[Tomorrow's family doctor].

PubMed

Bischoff, T; Herzig, L; Aubert, J; Sommer, J; Haller, D M

2012-05-16

The profession of family doctor will undergo profound changes in the coming decade due to external, political, demographic and societal developments. Changes will also occur from within the profession affecting its content and its functioning. Other influences, in addition to generational developments (reduced working hours, feminisation, revaluation of the work-life balance), will come from collaboration with new professions, news structures as well as technical and human progress. In this transitional period it is important to uphold core values of family medicine, in particular coordination, continuity of care and the global approach to patients. In training future family doctors we must both prepare them for new skills and roles, and continue to share the core values with them.

Reducing Misses and Near Misses Related to Multitasking on the Electronic Health Record: Observational Study and Qualitative Analysis.

PubMed

Ratanawongsa, Neda; Matta, George Y; Bohsali, Fuad B; Chisolm, Margaret S

2018-02-06

Clinicians' use of electronic health record (EHR) systems while multitasking may increase the risk of making errors, but silent EHR system use may lower patient satisfaction. Delaying EHR system use until after patient visits may increase clinicians' EHR workload, stress, and burnout. We aimed to describe the perspectives of clinicians, educators, administrators, and researchers about misses and near misses that they felt were related to clinician multitasking while using EHR systems. This observational study was a thematic analysis of perspectives elicited from 63 continuing medical education (CME) participants during 2 workshops and 1 interactive lecture about challenges and strategies for relationship-centered communication during clinician EHR system use. The workshop elicited reflection about memorable times when multitasking EHR use was associated with "misses" (errors that were not caught at the time) or "near misses" (mistakes that were caught before leading to errors). We conducted qualitative analysis using an editing analysis style to identify codes and then select representative themes and quotes. All workshop participants shared stories of misses or near misses in EHR system ordering and documentation or patient-clinician communication, wondering about "misses we don't even know about." Risk factors included the computer's position, EHR system usability, note content and style, information overload, problematic workflows, systems issues, and provider and patient communication behaviors and expectations. Strategies to reduce multitasking EHR system misses included clinician transparency when needing silent EHR system use (eg, for prescribing), narrating EHR system use, patient activation during EHR system use, adapting visit organization and workflow, improving EHR system design, and improving team support and systems. CME participants shared numerous stories of errors and near misses in EHR tasks and communication that they felt related to EHR

Developing challenges in the urbanisation of village doctors in economically developed regions: A survey of 844 village doctors in Changzhou, China.

PubMed

Chen, Minxing; Lu, Jun; Hao, Chao; Hao, Mo; Yao, Fang; Sun, Mei

2015-03-25

To reveal the challenges of village doctors' survival and training in economically developed areas in eastern China. A field survey was used to assess the challenges of village doctors. The study was conducted in Changzhou, Jiangsu province, which is an economically developed region in eastern China. The participants included 844 village doctors, 15 township hospital staff members and 6 health bureau leaders. The main challenges in Changzhou include an insufficient amount of village doctors, difficulties in obtaining professional qualification for village doctors, low salaries and benefits, and difficulties in recruitment. With increasing urbanisation in China, the gap between actual and expected income and social security has been increasing. Changes to training have influenced the stability of village doctor teams. Declining attachment of young people to their hometown village has contributed to recruitment difficulties. © 2015 National Rural Health Alliance Inc.

Sleepy driver near-misses may predict accident risks.

PubMed

Powell, Nelson B; Schechtman, Kenneth B; Riley, Robert W; Guilleminault, Christian; Chiang, Rayleigh Ping-ying; Weaver, Edward M

2007-03-01

To quantify the prevalence of self-reported near-miss sleepy driving accidents and their association with self-reported actual driving accidents. A prospective cross-sectional internet-linked survey on driving behaviors. Dateline NBC News website. Results are given on 35,217 (88% of sample) individuals with a mean age of 37.2 +/- 13 years, 54.8% women, and 87% white. The risk of at least one accident increased monotonically from 23.2% if there were no near-miss sleepy accidents to 44.5% if there were > or = 4 near-miss sleepy accidents (P < 0.0001). After covariate adjustments, subjects who reported at least one near-miss sleepy accident were 1.13 (95% CI, 1.10 to 1.16) times as likely to have reported at least one actual accident as subjects reporting no near-miss sleepy accidents (P < 0.0001). The odds of reporting at least one actual accident in those reporting > or = 4 near-miss sleepy accidents as compared to those reporting no near-miss sleepy accidents was 1.87 (95% CI, 1.64 to 2.14). Furthermore, after adjustments, the summary Epworth Sleepiness Scale (ESS) score had an independent association with having a near-miss or actual accident. An increase of 1 unit of ESS was associated with a covariate adjusted 4.4% increase of having at least one accident (P < 0.0001). A statistically significant dose-response was seen between the numbers of self-reported sleepy near-miss accidents and an actual accident. These findings suggest that sleepy near-misses may be dangerous precursors to an actual accident.

An interference account of the missing-VP effect

PubMed Central

Häussler, Jana; Bader, Markus

2015-01-01

Sentences with doubly center-embedded relative clauses in which a verb phrase (VP) is missing are sometimes perceived as grammatical, thus giving rise to an illusion of grammaticality. In this paper, we provide a new account of why missing-VP sentences, which are both complex and ungrammatical, lead to an illusion of grammaticality, the so-called missing-VP effect. We propose that the missing-VP effect in particular, and processing difficulties with multiply center-embedded clauses more generally, are best understood as resulting from interference during cue-based retrieval. When processing a sentence with double center-embedding, a retrieval error due to interference can cause the verb of an embedded clause to be erroneously attached into a higher clause. This can lead to an illusion of grammaticality in the case of missing-VP sentences and to processing complexity in the case of complete sentences with double center-embedding. Evidence for an interference account of the missing-VP effect comes from experiments that have investigated the missing-VP effect in German using a speeded grammaticality judgments procedure. We review this evidence and then present two new experiments that show that the missing-VP effect can be found in German also with less restricting procedures. One experiment was a questionnaire study which required grammaticality judgments from participants without imposing any time constraints. The second experiment used a self-paced reading procedure and did not require any judgments. Both experiments confirm the prior findings of missing-VP effects in German and also show that the missing-VP effect is subject to a primacy effect as known from the memory literature. Based on this evidence, we argue that an account of missing-VP effects in terms of interference during cue-based retrieval is superior to accounts in terms of limited memory resources or in terms of experience with embedded structures. PMID:26136698

Recalling the Doctor to Action--Two Requesting Formats Employed by a Nurse for Making Relevant the Doctor's Intervention

ERIC Educational Resources Information Center

Sterie, Anca Cristina

2015-01-01

At the hospital, nurses' telephone calls to doctors mostly revolve around obtaining doctors' intervention in a medical case. To achieve this, nurses need to make the doctor's intervention relevant, by explicitly requesting it or, more indirectly, by reporting a medical problem. Two recorded telephone conversations have been selected for analysis…

Talking to Your Doctor (For Teens)

MedlinePlus

... problems , weight concerns, depression, suicidal thoughts , and even body odor . You should be able to talk to your doctor about everything, but that's easier said than done. Being examined and questioned about your body can also be intimidating, especially when the doctor ...

Burnout and Doctors: Prevalence, Prevention and Intervention

PubMed Central

Kumar, Shailesh

2016-01-01

Doctors are exposed to high levels of stress in the course of their profession and are particularly susceptible to experiencing burnout. Burnout has far-reaching implications on doctors; patients and the healthcare system. Doctors experiencing burnout are reported to be at a higher risk of making poor decisions; display hostile attitude toward patients; make more medical errors; and have difficult relationships with co-workers. Burnout among doctors also increases risk of depression; anxiety; sleep disturbances; fatigue; alcohol and drug misuse; marital dysfunction; premature retirement and perhaps most seriously suicide. Sources of stress in medical practice may range from the emotions arising in the context of patient care to the environment in which doctors practice. The extent of burnout may vary depending on the practice setting; speciality and changing work environment. Understanding dynamic risk factors associated with burnout may help us develop strategies for preventing and treating burnout. Some of these strategies will be reviewed in this paper. PMID:27417625

Doctor-patient communication without family is most frequently practiced in patients with malignant tumors in home medical care settings.

PubMed

Kimura, Takuma; Imanaga, Teruhiko; Matsuzaki, Makoto

2014-01-01

Promotion of home medical care is absolutely necessary in Japan where is a rapidly aging society. In home medical care settings, triadic communications among the doctor, patient and the family are common. And "communications just between the doctor and the patient without the family" (doctor-patient communication without family, "DPC without family") is considered important for the patient to frankly communicate with the doctor without consideration for the family. However, the circumstances associated with DPC without family are unclear. Therefore, to identify the factors of the occurrence of DPC without family, we conducted a cross-sectional mail-in survey targeting 271 families of Japanese patients who had previously received home medical care. Among 227 respondents (83.8%), we eventually analyzed data from 143, excluding families of patients with severe hearing or cognitive impairment and severe verbal communication dysfunction. DPC without family occurred in 26.6% (n = 38) of the families analyzed. A multivariable logistic regression analysis was performed using a model including Primary disease, Daily activity, Duration of home medical care, Interval between doctor visits, Duration of doctor's stay, Existence of another room, and Spouse as primary caregiver. As a result, DPC without family was significantly associated with malignant tumor as primary disease (OR, 3.165; 95% CI, 1.180-8.486; P = 0.022). In conclusion, the visiting doctors should bear in mind that the background factor of the occurrence of DPC without family is patient's malignant tumors.

[Prevention and handling of missing data in clinical trials].

PubMed

Jiang, Zhi-wei; Li, Chan-juan; Wang, Ling; Xia, Jie-lai

2015-11-01

Missing data is a common but unavoidable issue in clinical trials. It not only lowers the trial power, but brings the bias to the trial results. Therefore, on one hand, the missing data handling methods are employed in data analysis. On the other hand, it is vital to prevent the missing data in the trials. Prevention of missing data should take the first place. From the perspective of data, firstly, some measures should be taken at the stages of protocol design, data collection and data check to enhance the patients' compliance and reduce the unnecessary missing data. Secondly, the causes of confirmed missing data in the trials should be notified and recorded in detail, which are very important to determine the mechanism of missing data and choose the suitable missing data handling methods, e.g., last observation carried forward (LOCF); multiple imputation (MI); mixed-effect model repeated measure (MMRM), etc.

The Professional Doctorate in Nursing: A Position Paper

ERIC Educational Resources Information Center

Newman, Margaret A.

1975-01-01

The need for family-centered health care could be met by nurses now if they had a professional doctorate and the recognition and authority that go with it. The author distinguishes between an academic doctorate (Preparation for scholars) and a professional doctorate (a practice degree). (Author/BP)

Explained: Why many surveys of distant galaxies miss 90% of their targets

NASA Astrophysics Data System (ADS)

2010-03-01

the first time we have observed a patch of the sky so deeply in light coming from hydrogen at these two very specific wavelengths, and this proved crucial," says team member Göran Östlin. The survey was extremely deep, and uncovered some of the faintest galaxies known at this early epoch in the life of the Universe. The astronomers could thereby conclude that traditional surveys done using Lyman-alpha only see a tiny part of the total light that is produced, since most of the Lyman-alpha photons are destroyed by interaction with the interstellar clouds of gas and dust. This effect is dramatically more significant for Lyman-alpha than for H-alpha light. As a result, many galaxies, a proportion as high as 90%, go unseen by these surveys. "If there are ten galaxies seen, there could be a hundred there," Hayes says. Different observational methods, targeting the light emitted at different wavelengths, will always lead to a view of the Universe that is only partially complete. The results of this survey issue a stark warning for cosmologists, as the strong Lyman-alpha signature becomes increasingly relied upon in examining the very first galaxies to form in the history of the Universe. "Now that we know how much light we've been missing, we can start to create far more accurate representations of the cosmos, understanding better how quickly stars have formed at different times in the life of the Universe," says co-author Miguel Mas-Hesse. The breakthrough was made possible thanks to the unique camera used. HAWK-I, which saw first light in 2007, is a state-of-the-art instrument. "There are only a few other cameras with a wider field of view than HAWK-I, and they are on telescopes less than half the size of the VLT. So only VLT/HAWK-I, really, is capable of efficiently finding galaxies this faint at these distances," says team member Daniel Schaerer. Notes [1] Lyman-alpha light corresponds to light emitted by excited hydrogen (more specifically, when the electron around

MISSE 1 and 2 Tray Temperature Measurements

NASA Technical Reports Server (NTRS)

Harvey, Gale A.; Kinard, William H.

2006-01-01

The Materials International Space Station Experiment (MISSE 1 & 2) was deployed August 10,2001 and retrieved July 30,2005. This experiment is a co-operative endeavor by NASA-LaRC. NASA-GRC, NASA-MSFC, NASA-JSC, the Materials Laboratory at the Air Force Research Laboratory, and the Boeing Phantom Works. The objective of the experiment is to evaluate performance, stability, and long term survivability of materials and components planned for use by NASA and DOD on future LEO, synchronous orbit, and interplanetary space missions. Temperature is an important parameter in the evaluation of space environmental effects on materials. The MISSE 1 & 2 had autonomous temperature data loggers to measure the temperature of each of the four experiment trays. The MISSE tray-temperature data loggers have one external thermistor data channel, and a 12 bit digital converter. The MISSE experiment trays were exposed to the ISS space environment for nearly four times the nominal design lifetime for this experiment. Nevertheless, all of the data loggers provided useful temperature measurements of MISSE. The temperature measurement system has been discussed in a previous paper. This paper presents temperature measurements of MISSE payload experiment carriers (PECs) 1 and 2 experiment trays.

Missing observations in multiyear rotation sampling designs

NASA Technical Reports Server (NTRS)

Gbur, E. E.; Sielken, R. L., Jr. (Principal Investigator)

1982-01-01

Because Multiyear estimation of at-harvest stratum crop proportions is more efficient than single year estimation, the behavior of multiyear estimators in the presence of missing acquisitions was studied. Only the (worst) case when a segment proportion cannot be estimated for the entire year is considered. The effect of these missing segments on the variance of the at-harvest stratum crop proportion estimator is considered when missing segments are not replaced, and when missing segments are replaced by segments not sampled in previous years. The principle recommendations are to replace missing segments according to some specified strategy, and to use a sequential procedure for selecting a sampling design; i.e., choose an optimal two year design and then, based on the observed two year design after segment losses have been taken into account, choose the best possible three year design having the observed two year parent design.

Shaping Graduate Education's Future: Improving the Doctoral Experience.

ERIC Educational Resources Information Center

Beeler, Karl J.

A discussion of graduate higher education suggests that shifts in demography of graduate school students and changes in traditional doctoral programs will lead to increased participation in doctoral study by the nation's best and brightest students. Declines in doctoral program participation due to demographic shifts, decreasing financial support,…

State Level Review of Doctoral Programs in Texas.

ERIC Educational Resources Information Center

Whittington, Nil

Review of doctoral degree programs in Texas public colleges and universities is discussed. Attention is directed to review procedures and strengths and weaknesses in the state's doctoral programs in educational psychology, counseling and guidance, and student personnel services. Doctoral programs were reviewed because of their high cost and a…

[Comparison of British and French expatriate doctors' characteristics and motivations].

PubMed

Abbas, R; Carnet, D; D'Athis, P; Fiet, C; Le Breton, G; Romestaing, M; Quantin, C

2015-02-01

Migration of medical practitioners is rarely studied despite its importance in medical demography: the objective of this study was to analyze the characteristics and motivations of the French doctors settled in the United Kingdom and of the British doctors settled in France. This cross-sectional study was conducted using a self-completed questionnaire sent to all French doctors practicing in the United Kingdom (in 2005) and all British medicine doctors practicing in France (in 2009). The doctors were identified with official data from the National Medical Councils: 244 French doctors practicing in the United Kingdom and 86 British doctors practicing in France. The questionnaire was specifically developed to determine the reasons of moving to the other country, and the level of satisfaction after expatriation. A total of 98 French doctors (out of 244) and 40 British doctors (out of 86) returned the questionnaire. Respondents were mainly general practitioners with a professional experience of 8 to 9 years. The sex ratio was near 1 for both groups with a majority of women among physicians under 50 years. The motivations were different between groups: French doctors were attracted by the conditions offered at the National Health Service, whereas British doctors were more interested in opportunities for career advancement, joining husband or wife, or favourable environmental conditions. Overall, the respondents considered expatriation as satisfactory: 84% of French doctors, compared with only 58% of British doctors, were satisfied with their new professional situation. This study, the first in its kind, leads to a clearer understanding of the migration of doctors between France and the United Kingdom. Copyright © 2014 Elsevier Masson SAS. All rights reserved.

40 CFR 75.37 - Missing data procedures for moisture.

Code of Federal Regulations, 2012 CFR

2012-07-01

... 40 Protection of Environment 17 2012-07-01 2012-07-01 false Missing data procedures for moisture... PROGRAMS (CONTINUED) CONTINUOUS EMISSION MONITORING Missing Data Substitution Procedures § 75.37 Missing... system shall substitute for missing moisture data using the procedures of this section. (b) Where no...

40 CFR 75.37 - Missing data procedures for moisture.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 40 Protection of Environment 16 2010-07-01 2010-07-01 false Missing data procedures for moisture... PROGRAMS (CONTINUED) CONTINUOUS EMISSION MONITORING Missing Data Substitution Procedures § 75.37 Missing... system shall substitute for missing moisture data using the procedures of this section. (b) Where no...

40 CFR 75.37 - Missing data procedures for moisture.

Code of Federal Regulations, 2014 CFR

2014-07-01

... 40 Protection of Environment 17 2014-07-01 2014-07-01 false Missing data procedures for moisture... PROGRAMS (CONTINUED) CONTINUOUS EMISSION MONITORING Missing Data Substitution Procedures § 75.37 Missing... system shall substitute for missing moisture data using the procedures of this section. (b) Where no...

40 CFR 75.37 - Missing data procedures for moisture.

Code of Federal Regulations, 2013 CFR

2013-07-01

... 40 Protection of Environment 17 2013-07-01 2013-07-01 false Missing data procedures for moisture... PROGRAMS (CONTINUED) CONTINUOUS EMISSION MONITORING Missing Data Substitution Procedures § 75.37 Missing... system shall substitute for missing moisture data using the procedures of this section. (b) Where no...

40 CFR 75.37 - Missing data procedures for moisture.

Code of Federal Regulations, 2011 CFR

2011-07-01

... 40 Protection of Environment 16 2011-07-01 2011-07-01 false Missing data procedures for moisture... PROGRAMS (CONTINUED) CONTINUOUS EMISSION MONITORING Missing Data Substitution Procedures § 75.37 Missing... system shall substitute for missing moisture data using the procedures of this section. (b) Where no...

Direct imaging search for the "missing link" in giant planet formation

NASA Astrophysics Data System (ADS)

Ngo, Henry; Mawet, Dimitri; Ruane, Garreth; Xuan, Wenhao; Bowler, Brendan; Cook, Therese; Zawol, Zoe

2018-01-01

While transit and radial velocity detection techniques have probed giant planet populations at close separations (within a few au), current direct imaging surveys are finding giant planets at separations of 10s-100s au. Furthermore, these directly imaged planets are very massive, including some with masses above the deuterium burning limit. It is not certain whether these objects represent the high mass end of planet formation scenarios or the low mass end of star formation. We present a direct imaging survey to search for the "missing link" population between the close-in RV and transiting giant planets and the extremely distant directly imaged giant planets (i.e. giant planets between 5-10 au). Finding and characterizing this population allows for comparisons with the formation models of closer-in planets and connects directly imaged planets with closer-in planets in semi-major axis phase space. In addition, microlensing surveys have suggested a large reservoir of giant planets exist in this region. To find these "missing link" giant planets, our survey searches for giant planets around M-stars. The ubiquity of M-stars provide a large number of nearby targets and their L-band contrast with planets allow for sensitivities to smaller planet masses than surveys conducted at shorter wavelengths. Along with careful target selection, we use Keck's L-band vector vortex coronagraph to enable sensitivities of a few Jupiter masses as close as 4 au to their host stars. We present our completed 2-year survey targeting 200 young (10-150 Myr), nearby M-stars and our ongoing work to follow-up over 40 candidate objects.

Doctoral Education in Nursing: Future Directions

ERIC Educational Resources Information Center

Downs, Florence S.

1978-01-01

Problems that confront nursing education and the quality of doctoral preparation are discussed in this article and include the steep rise in requests from nurses for admission into doctoral programs and tight university budgets; other concerns are the development of scholars and sharing research findings. (TA)

Student and faculty perceptions of lecture recording in a doctor of pharmacy curriculum.

PubMed

Maynor, Lena M; Barrickman, Ashleigh Landis; Stamatakis, Mary K; Elliott, David P

2013-10-14

To describe students' and faculty members' perceptions of the impact of lecture recording in a doctor of pharmacy (PharmD) curriculum. Second- and third-year pharmacy students and faculty members completed an anonymous survey instrument regarding their perceptions of lecture recording with 2 classroom lecture capture software programs, Camtasia Studio and Wimba Classroom. Most students (82%) responded that Camtasia was very helpful and almost half (49%) responded that Wimba Classroom was helpful (p<0.001). Forty-six percent of the students reported being more likely to miss a class that was recorded; however, few students (10%) reported using recordings as a substitute for attending class. The most common concern of faculty members was decreased student attendance (27%). Pharmacy students consider lecture recordings beneficial, and they use the recordings primarily to review the lecture. While faculty members reported concerns with decreased attendance, few students reported using recordings as an alternative to class attendance.

Student and Faculty Perceptions of Lecture Recording in a Doctor of Pharmacy Curriculum

PubMed Central

Barrickman, Ashleigh Landis; Stamatakis, Mary K.; Elliott, David P.

2013-01-01

Objective. To describe students’ and faculty members’ perceptions of the impact of lecture recording in a doctor of pharmacy (PharmD) curriculum. Methods. Second- and third-year pharmacy students and faculty members completed an anonymous survey instrument regarding their perceptions of lecture recording with 2 classroom lecture capture software programs, Camtasia Studio and Wimba Classroom. Results. Most students (82%) responded that Camtasia was very helpful and almost half (49%) responded that Wimba Classroom was helpful (p<0.001). Forty-six percent of the students reported being more likely to miss a class that was recorded; however, few students (10%) reported using recordings as a substitute for attending class. The most common concern of faculty members was decreased student attendance (27%). Conclusion. Pharmacy students consider lecture recordings beneficial, and they use the recordings primarily to review the lecture. While faculty members reported concerns with decreased attendance, few students reported using recordings as an alternative to class attendance. PMID:24159206

[Free choice of doctor: patient's right or doctor's power?].

PubMed

Bertens, R M; Huisman, F G

2016-01-01

This article outlines the historical development of the principle of patients' free choice of doctor in the Netherlands. Far from being the result of debates on patients' rights, this principle was used instead as an instrument by the medical profession to gain a foothold in the power relations between doctors and sickness funds back in the early 20th-century. This development created a medical power bloc that lasted for most of that century and forced sickness funds and private insurers to start organizing in this fashion too. Therefore, when the new market ideology of introducing competition in health care was introduced in 1987, the fields of health provision and insurance were already defined by a high degree of cartelization. These relations lingered even after the introduction of regulated competition in 2006. Knowledge of this history therefore leads to a better understanding of current debates and problems in the organization of Dutch health care.

Which Doctor to Trust: A Recommender System for Identifying the Right Doctors

PubMed Central

Yao, Cuili; Yang, Haoyu; Huang, Degen; Wang, Fei

2016-01-01

Background Key opinion leaders (KOLs) are people who can influence public opinion on a certain subject matter. In the field of medical and health informatics, it is critical to identify KOLs on various disease conditions. However, there have been very few studies on this topic. Objective We aimed to develop a recommender system for identifying KOLs for any specific disease with health care data mining. Methods We exploited an unsupervised aggregation approach for integrating various ranking features to identify doctors who have the potential to be KOLs on a range of diseases. We introduce the design, implementation, and deployment details of the recommender system. This system collects the professional footprints of doctors, such as papers in scientific journals, presentation activities, patient advocacy, and media exposure, and uses them as ranking features to identify KOLs. Results We collected the information of 2,381,750 doctors in China from 3,657,797 medical journal papers they published, together with their profiles, academic publications, and funding. The empirical results demonstrated that our system outperformed several benchmark systems by a significant margin. Moreover, we conducted a case study in a real-world system to verify the applicability of our proposed method. Conclusions Our results show that doctors’ profiles and their academic publications are key data sources for identifying KOLs in the field of medical and health informatics. Moreover, we deployed the recommender system and applied the data service to a recommender system of the China-based Internet technology company NetEase. Patients can obtain authority ranking lists of doctors with this system on any given disease. PMID:27390219

40 CFR 98.265 - Procedures for estimating missing data.

Code of Federal Regulations, 2011 CFR

2011-07-01

... 40 Protection of Environment 21 2011-07-01 2011-07-01 false Procedures for estimating missing data... estimating missing data. (a) For each missing value of the inorganic carbon content of phosphate rock or... immediately preceding and immediately following the missing data incident. You must document and keep records...

40 CFR 98.265 - Procedures for estimating missing data.

Code of Federal Regulations, 2013 CFR

2013-07-01

... 40 Protection of Environment 22 2013-07-01 2013-07-01 false Procedures for estimating missing data... estimating missing data. (a) For each missing value of the inorganic carbon content of phosphate rock or... immediately preceding and immediately following the missing data incident. You must document and keep records...

40 CFR 98.265 - Procedures for estimating missing data.

Code of Federal Regulations, 2012 CFR

2012-07-01

... 40 Protection of Environment 22 2012-07-01 2012-07-01 false Procedures for estimating missing data... estimating missing data. (a) For each missing value of the inorganic carbon content of phosphate rock or... immediately preceding and immediately following the missing data incident. You must document and keep records...

Investigation of Hong Kong doctors' current knowledge, beliefs, attitudes, confidence and practices: implications for the treatment of tobacco dependency.

PubMed

Abdullah, Abu Saleh M; Rahman, A S M Mujibur; Suen, Chau Wai; Wing, Lau Sun; Ling, Lau Wai; Mei, Li Yuen; Tat, Lun Chung; Tai, Mak Nin; Wing, Tsai Nga; Yuen, Wu Tsz; Kwan, Yam H

2006-10-01

Physicians play a crucial role in promoting smoking cessation. However, there are lack of data on Chinese doctors' knowledge, beliefs, attitudes, confidence and usual practices in relation to smoking cessation. Understanding of these indicators is important in the design of any effective intervention program targeting doctors. To assess Chinese doctors' knowledge, beliefs, attitudes, confidence and usual practices in relation to smoking cessation, a mailed questionnaire survey was conducted among 4,000 doctors registered with the Hong Kong Medical Association (HKMA) in 2002. Of the 757 respondents (18.9% response rate), 78% were male, 94% were non-smokers and 50% had received no basic training on smoking cessation. More than half of the doctors did not hold adequate knowledge (53%) or favorable attitudes (55%) towards smoking cessation; 44% were less confident in their smoking cessation skills. About 77% of the doctors obtained information on their patients' smoking status and recorded it in their medical record, and 29% advised all smoking patients to quit. Doctors who gave smoking cessation advice were more likely to be aged above 50 years, with more than 30 years' practice experience, working in the private sector, non- or ex-smokers, with more positive beliefs towards smoking cessation, and with higher confidence in smoking cessation skills (p < 0.001). Different factors associated with establishing and recording smoking status, arranging follow-up sessions, acquiring more knowledge and developing a more favorable attitude and greater confidence on smoking cessation-related matters were also identified. The survey has shown that existing smoking cessation service provision in Hong Kong for patients who smoke is inadequate, and has identified a lack of smoking cessation skills among doctors. Action should be taken to train doctors in smoking cessation skills and encourage them to routinely establish the smoking status of their patients and to advise all smokers

Missing drivers with dementia: antecedents and recovery.

PubMed

Rowe, Meredeth A; Greenblum, Catherine A; Boltz, Marie; Galvin, James E

2012-11-01

To determine the circumstances under which persons with dementia become lost while driving, how missing drivers are found, and how Silver Alert notifications are instrumental in those discoveries. A retrospective, descriptive study. Retrospective record review. Conducted using 156 records from the Florida Silver Alert program for October 2008 through May 2010. These alerts were issued in Florida for missing drivers with dementia. Information derived from the reports on characteristics of the missing driver, antecedents to missing event, and discovery of a missing driver. The majority of missing drivers were men aged 58 to 94 who were being cared for by a spouse. Most drivers became lost on routine, caregiver-sanctioned trips to usual locations. Only 15% were driving when found, with most being found in or near a parked car. Law enforcement officers found the large majority. Only 40% were found in the county where they went missing, and 10% were found in a different state. Silver Alert notifications were most effective for law enforcement; citizen alerts resulted in a few discoveries. There was 5% mortality in the study population, with those living alone more likely to be found dead than alive. An additional 15% were found in dangerous situations such as stopped on railroad tracks. Thirty-two percent had documented driving or other dangerous errors, such as driving the wrong way or into secluded areas or walking in or near roadways. © 2012, Copyright the Authors Journal compilation © 2012, The American Geriatrics Society.

Some Activities of MISSE 6 Mission

NASA Technical Reports Server (NTRS)

Prasad, Narasimha S.

2009-01-01

The objective of the Materials International Space Station Experiment (MISSE) is to study the performance of novel materials when subjected to the synergistic effects of the harsh space environment for several months. In this paper, a few laser and optical elements from NASA Langley Research Center (LaRC) that have been flown on MISSE 6 mission will be discussed. These items were characterized and packed inside a ruggedized Passive Experiment Container (PEC) that resembles a suitcase. The PEC was tested for survivability due to launch conditions. Subsequently, the MISSE 6 PEC was transported by the STS-123 mission to International Space Station (ISS) on March 11, 2008. The astronauts successfully attached the PEC to external handrails and opened the PEC for long term exposure to the space environment. The plan is to retrieve the MISSE 6 PEC by STS-128 mission in August 2009.

MISSE 6-Testing Materials in Space

NASA Technical Reports Server (NTRS)

Prasad, Narasimha S; Kinard, William H.

2008-01-01

The objective of the Materials International Space Station Experiment (MISSE) is to study the performance of novel materials when subjected to the synergistic effects of the harsh space environment by placing them in space environment for several months. In this paper, a few materials and components from NASA Langley Research Center (LaRC) that have been flown on MISSE 6 mission will be discussed. These include laser and optical elements for photonic devices. The pre-characterized MISSE 6 materials were packed inside a ruggedized Passive Experiment Container (PEC) that resembles a suitcase. The PEC was tested for survivability due to launch conditions. Subsequently, the MISSE 6 PEC was transported by the STS-123 mission to International Space Station (ISS) on March 11, 2008. The astronauts successfully attached the PEC to external handrails and opened the PEC for long term exposure to the space environment.

[From doctor-patient relationship to a collaborative one].

PubMed

Engeström, Yrjö

2013-01-01

In the historical development, the relationship between the patient and the doctor has gradually become increasingly objectified. Since then, a patient-centered or holistic way of thinking has become a normative model, towards which attempts have been made to change the patient-doctor relationship. The patient-doctor relationship must, however, be widened to a new type of relationship that links several doctors treating the same patient into collaboration and requires a new kind of working culture. We refer to this new concept as negotiated knotworking. Negotiation aims at an adequate, not complete mutual understanding.

Colds and the flu - what to ask your doctor - adult

MedlinePlus

... to ask your doctor about colds and the flu - adult; Influenza - what to ask your doctor - adult; Upper respiratory ... what to ask your doctor - adult; H1N1 (Swine) flu - what to ask your doctor - adult

40 CFR 98.445 - Procedures for estimating missing data.

Code of Federal Regulations, 2011 CFR

2011-07-01

... 40 Protection of Environment 21 2011-07-01 2011-07-01 false Procedures for estimating missing data... Procedures for estimating missing data. A complete record of all measured parameters used in the GHG... following missing data procedures: (a) A quarterly flow rate of CO2 received that is missing must be...

40 CFR 98.245 - Procedures for estimating missing data.

Code of Federal Regulations, 2012 CFR

2012-07-01

... 40 Protection of Environment 22 2012-07-01 2012-07-01 false Procedures for estimating missing data... estimating missing data. For missing feedstock flow rates, product flow rates, and carbon contents, use the same procedures as for missing flow rates and carbon contents for fuels as specified in § 98.35. ...

40 CFR 98.385 - Procedures for estimating missing data.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 40 Protection of Environment 20 2010-07-01 2010-07-01 false Procedures for estimating missing data... Procedures for estimating missing data. You must follow the procedures for estimating missing data in § 98... estimating missing data for petroleum products in § 98.395 also applies to coal-to-liquid products. ...

40 CFR 98.245 - Procedures for estimating missing data.

Code of Federal Regulations, 2011 CFR

2011-07-01

... 40 Protection of Environment 21 2011-07-01 2011-07-01 false Procedures for estimating missing data... estimating missing data. For missing feedstock flow rates, product flow rates, and carbon contents, use the same procedures as for missing flow rates and carbon contents for fuels as specified in § 98.35. ...

40 CFR 98.245 - Procedures for estimating missing data.

Code of Federal Regulations, 2013 CFR

2013-07-01

... 40 Protection of Environment 22 2013-07-01 2013-07-01 false Procedures for estimating missing data... estimating missing data. For missing feedstock flow rates, product flow rates, and carbon contents, use the same procedures as for missing flow rates and carbon contents for fuels as specified in § 98.35. ...

40 CFR 98.385 - Procedures for estimating missing data.

Code of Federal Regulations, 2012 CFR

2012-07-01

... 40 Protection of Environment 22 2012-07-01 2012-07-01 false Procedures for estimating missing data... Procedures for estimating missing data. You must follow the procedures for estimating missing data in § 98... estimating missing data for petroleum products in § 98.395 also applies to coal-to-liquid products. ...

40 CFR 98.385 - Procedures for estimating missing data.

Code of Federal Regulations, 2013 CFR

2013-07-01

... 40 Protection of Environment 22 2013-07-01 2013-07-01 false Procedures for estimating missing data... Procedures for estimating missing data. You must follow the procedures for estimating missing data in § 98... estimating missing data for petroleum products in § 98.395 also applies to coal-to-liquid products. ...

40 CFR 98.385 - Procedures for estimating missing data.

Code of Federal Regulations, 2011 CFR

2011-07-01

... 40 Protection of Environment 21 2011-07-01 2011-07-01 false Procedures for estimating missing data... Procedures for estimating missing data. You must follow the procedures for estimating missing data in § 98... estimating missing data for petroleum products in § 98.395 also applies to coal-to-liquid products. ...

40 CFR 98.385 - Procedures for estimating missing data.

Code of Federal Regulations, 2014 CFR

2014-07-01

... 40 Protection of Environment 21 2014-07-01 2014-07-01 false Procedures for estimating missing data... Procedures for estimating missing data. You must follow the procedures for estimating missing data in § 98... estimating missing data for petroleum products in § 98.395 also applies to coal-to-liquid products. ...

40 CFR 98.245 - Procedures for estimating missing data.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 40 Protection of Environment 20 2010-07-01 2010-07-01 false Procedures for estimating missing data... estimating missing data. For missing feedstock flow rates, product flow rates, and carbon contents, use the same procedures as for missing flow rates and carbon contents for fuels as specified in § 98.35. ...

Exploring the Nexus between Research and Doctoral Education

ERIC Educational Resources Information Center

Pearson, Margot; Evans, Terry; Macauley, Peter

2012-01-01

Exploring the nexus between doctoral education and research, and developments in how research is organised and funded is of significance as doctoral education is both part of the higher education system for teaching and learning, and part of the research enterprise. Doctoral candidates are both students and effectively early career researchers.…

Looking Back at Doctoral Education in South Africa

ERIC Educational Resources Information Center

Herman, Chaya

2017-01-01

This article provides a quantitative picture of doctoral education in South Africa up to 2010, from the time the first doctorate was awarded in 1899. It identifies the different institutional profiles and emphases of doctoral graduation in South African universities at various periods of time in the context of economic, political and social…

[Chromosome examination of missed abortion patients].

PubMed

Hu, Haomei; Yang, Hua; Yin, Zhenhui; Zhao, Lu

2015-09-15

To investigate the relationship between the missed abortion and chromosome abnormality and guide the healthy birth. From June 2014 to April 2015 in Tianjin central hospital of gynecology and obstetrics, we examined venous blood from 90 missed abortion couples for chromosome karyotype by lymphocyte culture method and we also examined their chromosome karyotype of abortion villus samples by high-throughput sequencing technologies. Out of the 90 couples' blood chromosome examinations, 7 were abnormal, and the abnormal rate was 3.89%, including 3 cases reciprocal translocation, 2 cases robertsonian translocation and 2 cases inversion. Abortion villus samples from the same population were also checked, of which 85 cases succeeded, with the success rate of 94.4%. Among them, villi chromosome abnormalities were found in 50 cases, including 39 cases with abnormal chromosome numbers, 11 cases with abnormal chromosome structure, and the total abnormal rate was 58.8%. In addition, the villi chromosome abnormality rate of patients with recurrent missed abortion (≥2 times) and first missed abortion were 61.7% and 55.2%, respectively, and the difference was not significant (P>0.05). The villi chromosome abnormality rate of pregnant women with age≥35 years old was 71.1%, while the pregnant women with aged <35 years old was 45% (P<0.05). Chromosome abnormality is an important cause of missed abortion; villi chromosome abnormality rate has nothing to do with the number of missed abortion; pregnant woman with age≥35 years old is risk factor of the villi chromosome abnormality.

Near-misses and future disaster preparedness.

PubMed

Dillon, Robin L; Tinsley, Catherine H; Burns, William J

2014-10-01

Disasters garner attention when they occur, and organizations commonly extract valuable lessons from visible failures, adopting new behaviors in response. For example, the United States saw numerous security policy changes following the September 11 terrorist attacks and emergency management and shelter policy changes following Hurricane Katrina. But what about those events that occur that fall short of disaster? Research that examines prior hazard experience shows that this experience can be a mixed blessing. Prior experience can stimulate protective measures, but sometimes prior experience can deceive people into feeling an unwarranted sense of safety. This research focuses on how people interpret near-miss experiences. We demonstrate that when near-misses are interpreted as disasters that did not occur and thus provide the perception that the system is resilient to the hazard, people illegitimately underestimate the danger of subsequent hazardous situations and make riskier decisions. On the other hand, if near-misses can be recognized and interpreted as disasters that almost happened and thus provide the perception that the system is vulnerable to the hazard, this will counter the basic "near-miss" effect and encourage mitigation. In this article, we use these distinctions between resilient and vulnerable near-misses to examine how people come to define an event as either a resilient or vulnerable near-miss, as well as how this interpretation influences their perceptions of risk and their future preparedness behavior. Our contribution is in highlighting the critical role that people's interpretation of the prior experience has on their subsequent behavior and in measuring what shapes this interpretation. © 2014 Society for Risk Analysis.

Colds and the flu - what to ask your doctor - child

MedlinePlus

... to ask your doctor about colds and the flu - child; Influenza - what to ask your doctor - child; Upper respiratory ... URI - what to ask your doctor - child; Swine flu (H1N1) - what to ask your doctor - child

Social and professional influences on antimicrobial prescribing for doctors-in-training: a realist review

PubMed Central

Papoutsi, Chrysanthi; Mattick, Karen; Pearson, Mark; Brennan, Nicola; Briscoe, Simon; Wong, Geoff

2017-01-01

Abstract Background Antimicrobial resistance has led to widespread implementation of interventions for appropriate prescribing. However, such interventions are often adopted without an adequate understanding of the challenges facing doctors-in-training as key prescribers. Methods The review followed a realist, theory-driven approach to synthesizing qualitative, quantitative and mixed-methods literature. Consistent with realist review quality standards, articles retrieved from electronic databases were systematically screened and analysed to elicit explanations of antimicrobial prescribing behaviours. These explanations were consolidated into a programme theory drawing on social science and learning theory, and shaped though input from patients and practitioners. Results By synthesizing data from 131 articles, the review highlights the complex social and professional dynamics underlying antimicrobial prescribing decisions of doctors-in-training. The analysis shows how doctors-in-training often operate within challenging contexts (hierarchical relationships, powerful prescribing norms, unclear roles and responsibilities, implicit expectations about knowledge levels, uncertainty about application of knowledge in practice) where they prioritize particular responses (fear of criticism and individual responsibility, managing one’s reputation and position in the team, appearing competent). These complex dynamics explain how and why doctors-in-training decide to: (i) follow senior clinicians’ prescribing habits; (ii) take (or not) into account prescribing aids, advice from other health professionals or patient expectations; and (iii) ask questions or challenge decisions. This increased understanding allows for targeted tailoring, design and implementation of antimicrobial prescribing interventions. Conclusions This review contributes to a better understanding of how antimicrobial prescribing interventions for doctors-in-training can be embedded more successfully in the

The Uses of the Smartphone for Doctors: An Empirical Study from Samsung Medical Center

PubMed Central

Choi, Jong Soo; Yi, Byoungkee; Park, Jong Hwan; Choi, Kyesook; Jung, Jaegon; Park, Seung Woo

2011-01-01

Objectives In healthcare, mobile computing made possible by smartphones is becoming an important tool among healthcare professionals. However, currently there is very little research into the effectiveness of such applications of technology. This study aims to present a framework for a smartphone application to give doctors mobile access to patient information, then review the consequences of its use and discuss its future direction. Methods Since 2003 when Samsung Medical Center introduced its first mobile application, a need to develop a new application targeting the latest smartphone technology was identified. To that end, an application named Dr. SMART S was officially launched on December 22nd, 2010. Results We analyzed the usage data of the application for a month until April 25th, 2011. On average, 170 doctors (13% of the entire body of doctors) logged on 2.4 times per day and that number keeps growing. The number was uniformly distributed across all working hours, with exceptions of heavy accesses around 6-8 AM and 4-6 PM when doctors do their regular rounds to see the patients. The most commonly accessed content was inpatient information, this constituted 78.6% of all accesses, within this 50% was to accesses lab results. Conclusions Looking at the usage data, we can see the use of Dr. SMART S by doctors is growing in sync with the popularity of smartphones. Since u-Health seem an inevitable future trend, a more rigorous study needs to be conducted on how such mobile applications as Dr. SMART S affect the quality of care and patient safety to derive directions for further improvements. PMID:21886874

Root Doctors as Providers of Primary Care

PubMed Central

Stitt, Van J.

1983-01-01

Physicians in primary care recognize that as many as 65 percent of the patients seen in their offices are there for psychological reasons. In any southern town with a moderate population of blacks, there are at least two “root doctors.” These root doctors have mastered the power of autosuggestion and are treating these patients with various forms of medication and psychological counseling. This paper updates the practicing physician on root doctors who practice primary care. PMID:6887277

Nurses' views on challenging doctors' practice in an acute hospital.

PubMed

Churchman, J J; Doherty, C

To explore the extent to which nurses are willing to challenge doctors' practice in everyday situations in an acute NHS hospital. Qualitative data were collected using in-depth interviews with 12 nurses in an acute NHS hospital in England. Participants believed that they challenged doctors' practice and acted as patients' advocates. However, data revealed that nurses questioned doctors' practice only under specific circumstances. Nurses would not challenge doctors if they perceived that this would result in conflict or stress, if they were afraid of the doctor or feared reprisal. Nurses are discouraged from challenging doctors' practice by the structural inequality arising from the gender division of labour and doctors' expert knowledge and status (medical dominance) in the workplace.

Nigerian resident doctors on strike: insights from and policy implications of job satisfaction among resident doctors in a Nigerian teaching hospital.

PubMed

Akinyemi, Oluwaseun; Atilola, Olayinka

2013-01-01

The Nigerian health system has been engulfed in a crisis occasioned by a deluge of strike actions by resident doctors in recent times. Dissatisfaction with conditions of service has been cited as the bone of contention. Job satisfaction studies among doctors have provided insights into the contributory factors to recurrent industrial disputes in other climes. This study aims to determine the predictors of job satisfaction among resident doctors in a tertiary healthcare centre in Nigeria. This is with a view to gain some insights into the possible contributory factors to industrial disputes and to discuss the policy implications of such findings. A semi-structured questionnaire was used to obtain socio-demographic characteristics and job-related determinants of job satisfaction among resident doctors. Logistic regression analysis was carried out to determine predictors of job satisfaction. A total of 163 resident doctors completed the study. Overall, 90 (55.2%) of the resident doctors were satisfied with their jobs. Lower age, career advancement opportunities, autonomy of practice, alignment of job with core personal and professional values, and working environment predicted job satisfaction. To restore satisfaction and possibly stem industrial disputes by resident doctors, government of Nigeria needs to sustain current wages while introducing non-financial benefits. There is a need to adopt policies geared towards increasing government spending on health especially in the area of human capacity and infrastructural development, so as to afford resident doctors opportunities for skill acquisition and career development. Copyright © 2012 John Wiley & Sons, Ltd.

40 CFR 98.145 - Procedures for estimating missing data.

Code of Federal Regulations, 2013 CFR

2013-07-01

... 40 Protection of Environment 22 2013-07-01 2013-07-01 false Procedures for estimating missing data... missing data. A complete record of all measured parameters used in the GHG emissions calculations is... in § 98.144 cannot be followed and data is missing, you must use the most appropriate of the missing...

40 CFR 98.145 - Procedures for estimating missing data.

Code of Federal Regulations, 2014 CFR

2014-07-01

... 40 Protection of Environment 21 2014-07-01 2014-07-01 false Procedures for estimating missing data... missing data. A complete record of all measured parameters used in the GHG emissions calculations is... in § 98.144 cannot be followed and data is missing, you must use the most appropriate of the missing...

40 CFR 98.145 - Procedures for estimating missing data.

Code of Federal Regulations, 2012 CFR

2012-07-01

... 40 Protection of Environment 22 2012-07-01 2012-07-01 false Procedures for estimating missing data... missing data. A complete record of all measured parameters used in the GHG emissions calculations is... in § 98.144 cannot be followed and data is missing, you must use the most appropriate of the missing...

AIDS Clinical Research in Spain-Large HIV Population, Geniality of Doctors, and Missing Opportunities.

PubMed

Soriano, Vicente; Ramos, José M; Barreiro, Pablo; Fernandez-Montero, Jose V

2018-05-30

The first cases of AIDS in Spain were reported in 1982. Since then over 85,000 persons with AIDS have been cumulated, with 60,000 deaths. Current estimates for people living with HIV are of 145,000, of whom 20% are unaware of it. This explains the still high rate of late HIV presenters. Although the HIV epidemic in Spain was originally driven mostly by injection drug users, since the year 2000 men having sex with men (MSM) account for most new incident HIV cases. Currently, MSM represent over 80% of new yearly HIV diagnoses. In the 80s, a subset of young doctors and nurses working at Internal Medicine hospital wards became deeply engaged in attending HIV-infected persons. Before the introduction of antiretrovirals in the earlier 1990s, diagnosis and treatment of opportunistic infections was their major task. A new wave of infectious diseases specialists was born. Following the wide introduction of triple combination therapy in the late 1990s, drug side effects and antiretroviral resistance led to built a core of highly devoted HIV specialists across the country. Since then, HIV medicine has improved and currently is largely conducted by multidisciplinary teams of health care providers working at hospital-based outclinics, where HIV-positive persons are generally seen every six months. Antiretroviral therapy is currently prescribed to roughly 75,000 persons, almost all attended at clinics belonging to the government health public system. Overall, the impact of HIV/AIDS publications by Spanish teams is the third most important in Europe. HIV research in Spain has classically been funded mostly by national and European public agencies along with pharma companies. Chronologically, some of the major contributions of Spanish HIV research are being in the field of tuberculosis, toxoplasmosis, leishmaniasis, HIV variants including HIV-2, drug resistance, pharmacology, antiretroviral drug-related toxicities, coinfection with viral hepatitis, design and participation in

Stress in doctors and dentists who teach.

PubMed

Rutter, Harry; Herzberg, Joe; Paice, Elisabeth

2002-06-01

To explore the relationship between a teaching role and stress in doctors and dentists who teach. Medline, PubMed, BIDS database for social sciences literature, and the ERIC database for educational literature were searched using the key words 'stress' or 'burnout' with the terms doctor, physician, dentist, teacher, lecturer, academic staff, and university staff. Other books and journals known to the authors were also used. Many studies have shown high levels of stress in doctors, dentists, teachers, and lecturers. A large number of factors are implicated, including low autonomy, work overload, and lack of congruence between power and responsibility. Doctors and dentists who take on a teaching role in addition to their clinical role may increase their levels of stress, but there is also evidence that this dual role may reduce job-related stress. Working as a doctor or dentist may entail higher levels of stress than are experienced by the general population. In some situations adding in the role of teacher reduces this stress, but more research is needed to explain this finding.

Examining Solutions to Missing Data in Longitudinal Nursing Research

PubMed Central

Roberts, Mary B.; Sullivan, Mary C.; Winchester, Suzy B.

2017-01-01

Purpose Longitudinal studies are highly valuable in pediatrics because they provide useful data about developmental patterns of child health and behavior over time. When data are missing, the value of the research is impacted. The study’s purpose was to: (1) introduce a 3-step approach to assess and address missing data; (2) illustrate this approach using categorical and continuous level variables from a longitudinal study of premature infants. Methods A three-step approach with simulations was followed to assess the amount and pattern of missing data and to determine the most appropriate imputation method for the missing data. Patterns of missingness were Missing Completely at Random, Missing at Random, and Not Missing at Random. Missing continuous-level data were imputed using mean replacement, stochastic regression, multiple imputation, and fully conditional specification. Missing categorical-level data were imputed using last value carried forward, hot-decking, stochastic regression, and fully conditional specification. Simulations were used to evaluate these imputation methods under different patterns of missingness at different levels of missing data. Results The rate of missingness was 16–23% for continuous variables and 1–28% for categorical variables. Fully conditional specification imputation provided the least difference in mean and standard deviation estimates for continuous measures. Fully conditional specification imputation was acceptable for categorical measures. Results obtained through simulation reinforced and confirmed these findings. Practice Implications Significant investments are made in the collection of longitudinal data. The prudent handling of missing data can protect these investments and potentially improve the scientific information contained in pediatric longitudinal studies. PMID:28425202

Examining solutions to missing data in longitudinal nursing research.

PubMed

Roberts, Mary B; Sullivan, Mary C; Winchester, Suzy B

2017-04-01

Longitudinal studies are highly valuable in pediatrics because they provide useful data about developmental patterns of child health and behavior over time. When data are missing, the value of the research is impacted. The study's purpose was to (1) introduce a three-step approach to assess and address missing data and (2) illustrate this approach using categorical and continuous-level variables from a longitudinal study of premature infants. A three-step approach with simulations was followed to assess the amount and pattern of missing data and to determine the most appropriate imputation method for the missing data. Patterns of missingness were Missing Completely at Random, Missing at Random, and Not Missing at Random. Missing continuous-level data were imputed using mean replacement, stochastic regression, multiple imputation, and fully conditional specification (FCS). Missing categorical-level data were imputed using last value carried forward, hot-decking, stochastic regression, and FCS. Simulations were used to evaluate these imputation methods under different patterns of missingness at different levels of missing data. The rate of missingness was 16-23% for continuous variables and 1-28% for categorical variables. FCS imputation provided the least difference in mean and standard deviation estimates for continuous measures. FCS imputation was acceptable for categorical measures. Results obtained through simulation reinforced and confirmed these findings. Significant investments are made in the collection of longitudinal data. The prudent handling of missing data can protect these investments and potentially improve the scientific information contained in pediatric longitudinal studies. © 2017 Wiley Periodicals, Inc.

Materials International Space Station Experiment (MISSE) Arrival

NASA Image and Video Library

2017-10-02

The Materials International Space Station Experiment-Flight Facility, or MISSE-FF, hardware arrived at the Space Station Processing Facility low bay at NASA's Kennedy Space Center in Florida. MISSE will be unpacked for integration and processing. MISSE will be used to test various materials and computing elements on the exterior of the space station. They will be exposed to the harsh environment of low-Earth orbit, including to a vacuum, atomic oxygen, ultraviolet radiation, direct sunlight and extreme heat and cold. The experiment will provide a better understanding of material durability, from coatings to electronic sensors, which could be applied to future spacecraft designs. MISSE will be delivered to the space station on a future commercial resupply mission.

European Industrial Doctorates: Marie Curie Actions

ERIC Educational Resources Information Center

European Commission, 2012

2012-01-01

European industrial doctorates are joint doctoral training projects funded by the European Union (EU) and open to all research fields. The project brings together an academic participant (university, research institution, etc.) and a company. They have to be established in two different EU Member States or associated countries. Associated partners…

Epilepsy - what to ask your doctor - child

MedlinePlus

What to ask your doctor about epilepsy - child; Seizures - what to ask your doctor - child ... should I discuss with my child's teachers about epilepsy? Will my child need to take medicines during ...

The Plight of the Woman Doctoral Student

ERIC Educational Resources Information Center

Holmstrom, Engin Inel; Holmstrom, Robert W.

1974-01-01

This study investigated factors underlying discrimination against woman doctoral students. Analyses revealed that faculty attitudes and behavior toward woman doctoral students contributed significantly to their emotional stresses and self-doubts. (Author/NE)

The good doctor - strong and persevering.

PubMed

Hertzberg, Tuva Kolstad; Skirbekk, Helge; Tyssen, Reidar; Aasland, Olaf Gjerløw; Rø, Karin Isaksson

2016-10-01

In today’s society, doctors are confronted with a number of opposing interests, from other colleagues, patients and employers. The development and regulation of the medical profession have been widely studied. However, less research has been devoted to the doctors’ own perception of what it means to be a good doctor. We conducted eight focus-group interviews and three individual interviews among senior consultants and specialty registrars in the areas of surgery, psychiatry and internal medicine in two different hospitals. Total N = 48, of which 56  % were women. The interviews were analysed with the aid of systematic text condensation. «Professional dedication» demonstrated through «a high degree of attendance in the workplace» and «a high work capacity» were key topics for good doctors. Having a «high work capacity» was defined as being willing to go to great lengths, work overtime and work effectively. The senior consultants perceived their job as doctors more as a «lifestyle», while the specialty registrars more frequently regarded their work as a «job». Norwegian hospital doctors wish to appear dedicated to their profession. They can demonstrate this by showing great willingness to work intensively and effectively with patients, while also going to great lengths to be available beyond normal working hours.

'Care Under Pressure': a realist review of interventions to tackle doctors' mental ill-health and its impacts on the clinical workforce and patient care.

PubMed

Carrieri, Daniele; Briscoe, Simon; Jackson, Mark; Mattick, Karen; Papoutsi, Chrysanthi; Pearson, Mark; Wong, Geoffrey

2018-02-02

Mental ill-health is prevalent across all groups of health professionals and this is of great concern in many countries. In the UK, the mental health of the National Health Service (NHS) workforce is a major healthcare issue, leading to presenteeism, absenteeism and loss of staff from the workforce. Most interventions targeting doctors aim to increase their 'productivity' and 'resilience', placing responsibility for good mental health with doctors themselves and neglecting the organisational and structural contexts that may have a detrimental effect on doctors' well-being. There is a need for approaches that are sensitive to the contextual complexities of mental ill-health in doctors, and that do not treat doctors as a uniform body, but allow distinctions to account for particular characteristics, such as specialty, career stage and different working environments. Our project aims to understand how, why and in what contexts support interventions can be designed to minimise the incidence of doctors' mental ill-health. We will conduct a realist review-a form of theory-driven interpretative systematic review-of interventions, drawing on diverse literature sources. The review will iteratively progress through five steps: (1) locate existing theories; (2) search for evidence; (3) select articles; (4) extract and organise data and (5) synthesise evidence and draw conclusions. The analysis will summarise how, why and in what circumstances doctors' mental ill-health is likely to develop and what can remediate the situation. Throughout the project, we will also engage iteratively with diverse stakeholders in order to produce actionable theory. Ethical approval is not required for our review. Our dissemination strategy will be participatory. Tailored outputs will be targeted to: policy makers; NHS employers and healthcare leaders; team leaders; support organisations; doctors experiencing mental ill-health, their families and colleagues. CRD42017069870. © Article author

What Is Missing in Counseling Research? Reporting Missing Data

ERIC Educational Resources Information Center

Sterner, William R.

2011-01-01

Missing data have long been problematic in quantitative research. Despite the statistical and methodological advances made over the past 3 decades, counseling researchers fail to provide adequate information on this phenomenon. Interpreting the complex statistical procedures and esoteric language seems to be a contributing factor. An overview of…

Purposes, Diversities, and Futures in MFT Doctoral Education

ERIC Educational Resources Information Center

Woolley, Scott R.

2010-01-01

Doctoral education in marital and family therapy (MFT) plays a crucial role in the future of the field. In this article, I write about the purposes, diversities, and futures of MFT doctoral education from the perspective of having hired 18 full-time MFT faculty over the last 13 years. I argue that the field needs well-rounded doctoral-level…

Task shifting from doctors to non-doctors for initiation and maintenance of antiretroviral therapy.

PubMed

Kredo, Tamara; Adeniyi, Folasade B; Bateganya, Moses; Pienaar, Elizabeth D

2014-07-01

The high levels of healthcare worker shortage is recognised as a severe impediment to increasing patients' access to antiretroviral therapy. This is particularly of concern where the burden of disease is greatest and the access to trained doctors is limited.This review aims to better inform HIV care programmes that are currently underway, and those planned, by assessing if task-shifting care from doctors to non-doctors provides both high quality and safe care for all patients requiring antiretroviral treatment. To evaluate the quality of initiation and maintenance of HIV/AIDS care in models that task shift care from doctors to non-doctors. We conducted a comprehensive search to identify all relevant studies regardless of language or publication status (published, unpublished, in press, and in progress) from 1 January 1996 to 28 March 2014, with major HIV/AIDS conferences searched 23 May 2014. We had also contacted relevant organizations and researchers. Key words included MeSH terms and free-text terms relevant to 'task shifting', 'skill mix', 'integration of tasks', 'service delivery' and 'health services accessibility'. We included controlled trials (randomised or non-randomised), controlled-before and after studies, and cohort studies (prospective or retrospective) comparing doctor-led antiretroviral therapy delivery to delivery that included another cadre of health worker other than a doctor, for initiating treatment, continuing treatment, or both, in HIV infected patients. Two authors independently screened titles, abstracts and descriptor terms of the results of the electronic search and applied our eligibility criteria using a standardized eligibility form to full texts of potentially eligible or uncertain abstracts. Two reviewers independently extracted data on standardized data extraction forms. Where possible, data were pooled using random effects meta-analysis. We assessed evidence quality with GRADE methodology. Ten studies met our inclusion criteria

5 CFR 1651.16 - Missing and unknown beneficiaries.

Code of Federal Regulations, 2012 CFR

2012-01-01

... 5 Administrative Personnel 3 2012-01-01 2012-01-01 false Missing and unknown beneficiaries. 1651... § 1651.16 Missing and unknown beneficiaries. (a) Locate and identify beneficiaries. (1) The TSP record... one or more beneficiaries (and not all) appear to be missing, payment of part of the participant's...

5 CFR 1651.16 - Missing and unknown beneficiaries.

Code of Federal Regulations, 2013 CFR

2013-01-01

... 5 Administrative Personnel 3 2013-01-01 2013-01-01 false Missing and unknown beneficiaries. 1651... § 1651.16 Missing and unknown beneficiaries. (a) Locate and identify beneficiaries. (1) The TSP record... one or more beneficiaries (and not all) appear to be missing, payment of part of the participant's...

5 CFR 1651.16 - Missing and unknown beneficiaries.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 5 Administrative Personnel 3 2010-01-01 2010-01-01 false Missing and unknown beneficiaries. 1651... § 1651.16 Missing and unknown beneficiaries. (a) Locate and identify beneficiaries. (1) The TSP record... one or more beneficiaries (and not all) appear to be missing, payment of part of the participant's...

5 CFR 1651.16 - Missing and unknown beneficiaries.

Code of Federal Regulations, 2011 CFR

2011-01-01

... 5 Administrative Personnel 3 2011-01-01 2011-01-01 false Missing and unknown beneficiaries. 1651... § 1651.16 Missing and unknown beneficiaries. (a) Locate and identify beneficiaries. (1) The TSP record... one or more beneficiaries (and not all) appear to be missing, payment of part of the participant's...

5 CFR 1651.16 - Missing and unknown beneficiaries.

Code of Federal Regulations, 2014 CFR

2014-01-01

... 5 Administrative Personnel 3 2014-01-01 2014-01-01 false Missing and unknown beneficiaries. 1651... § 1651.16 Missing and unknown beneficiaries. (a) Locate and identify beneficiaries. (1) The TSP record... one or more beneficiaries (and not all) appear to be missing, payment of part of the participant's...

40 CFR 75.46 - Missing data substitution criteria.

Code of Federal Regulations, 2013 CFR

2013-07-01

... 40 Protection of Environment 17 2013-07-01 2013-07-01 false Missing data substitution criteria. 75... (CONTINUED) CONTINUOUS EMISSION MONITORING Alternative Monitoring Systems § 75.46 Missing data substitution criteria. The owner or operator shall demonstrate that all missing data can be accounted for in a manner...

40 CFR 75.46 - Missing data substitution criteria.

Code of Federal Regulations, 2014 CFR

2014-07-01

... 40 Protection of Environment 17 2014-07-01 2014-07-01 false Missing data substitution criteria. 75... (CONTINUED) CONTINUOUS EMISSION MONITORING Alternative Monitoring Systems § 75.46 Missing data substitution criteria. The owner or operator shall demonstrate that all missing data can be accounted for in a manner...

40 CFR 75.46 - Missing data substitution criteria.

Code of Federal Regulations, 2011 CFR

2011-07-01

... 40 Protection of Environment 16 2011-07-01 2011-07-01 false Missing data substitution criteria. 75... (CONTINUED) CONTINUOUS EMISSION MONITORING Alternative Monitoring Systems § 75.46 Missing data substitution criteria. The owner or operator shall demonstrate that all missing data can be accounted for in a manner...

40 CFR 75.46 - Missing data substitution criteria.

Code of Federal Regulations, 2012 CFR

2012-07-01

... 40 Protection of Environment 17 2012-07-01 2012-07-01 false Missing data substitution criteria. 75... (CONTINUED) CONTINUOUS EMISSION MONITORING Alternative Monitoring Systems § 75.46 Missing data substitution criteria. The owner or operator shall demonstrate that all missing data can be accounted for in a manner...

40 CFR 75.46 - Missing data substitution criteria.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 40 Protection of Environment 16 2010-07-01 2010-07-01 false Missing data substitution criteria. 75... (CONTINUED) CONTINUOUS EMISSION MONITORING Alternative Monitoring Systems § 75.46 Missing data substitution criteria. The owner or operator shall demonstrate that all missing data can be accounted for in a manner...

The Risky Business of Doctoral Management

ERIC Educational Resources Information Center

McWilliam, Erica; Sanderson, Don; Evans, Terry; Lawson, Alan; Taylor, Peter G.

2006-01-01

Universities are under no less pressure to adopt risk management strategies than other public and private organisations. The risk management of doctoral education is a particularly important issue given that a doctorate is the highest academic qualification a university offers and stakes are high in terms of assuring its quality. However, intense…

Best Practices in Doctoral Retention: Mentoring

ERIC Educational Resources Information Center

Brill, Judie L.; Balcanoff, Karen K.; Land, Denise; Gogarty, Maurice; Turner, Freda

2014-01-01

The aim of this critical literature review is to outline best practices in doctoral retention and the successful approach of one university to improve graduation success by providing effective mentorship for faculty and students alike. The focus of this literature review is on distance learning relationships between faculty and doctoral students,…

Febrile seizures - what to ask your doctor

MedlinePlus

... I do? When should I call the doctor? Alternative Names What to ask your doctor about febrile ... Philadelphia, PA: Elsevier; 2016:chap 593. Read More Epilepsy - overview Febrile seizures Fever Seizures Patient Instructions Epilepsy ...

Concussion - what to ask your doctor - child

MedlinePlus

What to ask your doctor about concussion - child; Mild brain injury - what to ask your doctor - child ... What type of symptoms or problems will my child have? Will my child have problems thinking or ...

Taking Medicines Safely: At Your Doctor's Office

MedlinePlus

... on. Feature: Taking Medicines Safely At Your Doctor's Office Past Issues / Summer 2013 Table of Contents Download ... Articles Medicines: Use Them Safely / At Your Doctor's Office / Ask Your Pharmacist / Now, It's Your Turn: How ...

Missing Drivers with Dementia: Antecedents and Recovery

PubMed Central

Rowe, Meredeth A.; Greenblum, Catherine A.; Boltz, Marie; Galvin, James E.

2013-01-01

OBJECTIVES To determine the circumstance in which persons with dementia become lost while driving, how missing drivers are found, and how Silver Alert notificationsare instrumental in those discoveries. DESIGN A retrospective, descriptive study. SETTING Retrospective record review. PARTICIPANTS Conducted using 156 records from the Florida Silver Alert program for the time period October, 2008 through May 2010. These alerts were issued in Florida for a missing driver with dementia. MEASUREMENTS Information derived from the reports on characteristics of the missing driver, antecedents to missing event and discovery of a missing driver. RESULTS and CONCLUSION The majority of missing drivers were males, with ages ranging from 58’94, who were being cared for by a spouse. Most drivers became lost on routine, caregiver-sanctioned trips to usual locations. Only 15% were in the act of driving when found with most being found in or near a parked car and the large majority were found by law enforcement officers. Only 40% were found in the county they went missing and 10% were found in a different state. Silver Alert notifications were most effective for law enforcement; citizen alerts resulted in a few discoveries. There was a 5% mortality rate in the study population with those living alone more likely to be found dead than alive. An additional 15% were found in dangerous situations such as stopped on railroad tracks. Thirty-two percent had documented driving or dangerous errors such as, driving thewrong way or into secluded areas, or walking in or near roadways. PMID:23134069

[The virtuous doctor in cinema: the final examination].

PubMed

Figueroa, Gustavo

2014-10-01

The virtuous doctor has subscribed an oath and by subscribing to this solemn promise, he is committed to live in accordance with the purposes, obligations and virtues established in the medical profession. Cinematic art has shown only a superficial interest in complex aspects of medical profession. An exception is Ingmar Bergman's film "Wild Strawberries", where Professor Isak Borg, a widowed 76-year-old physician, is to be awarded the Doctor Jubilaris degree, 50 years after he received his doctorate at Lund University. During the trip, Isak is forced by a nightmare to reevaluate his professional life as not being a virtuous doctor.

Doctors and the Armenian and Bosnian Genocides.

PubMed

Kaplan, Robert M

2016-01-01

The extensive degree of mass murder that occurred throughout the twentieth century saw the rate of non-combatant (civilian) deaths rise by over seventy-five percent in the space of seventy years, amounting to a death toll exceeding 170 million. Where genocides are concerned, the central role of doctors is undeniable. Their participation arose from the preoccupation with eugenics for improving the health of the nation. From here, their belief in nationalism overrode the sacred duty to save lives. These doctors descended into moral anarchy, breaching an ethical code of two millennia. This paper examines the role of doctors in the Armenian genocide and that of psychiatrists (notably Radovan Karadzic), in the Bosnian genocide. That medicine contains the seeds of its own destruction is confirmed by the recurrent involvement of doctors in genocide.

Girls' Portraits of Desire: Picturing a Missing Discourse

ERIC Educational Resources Information Center

Allen, Louisa

2013-01-01

This paper revisits the missing discourse of female desire [Fine, M. 1988. Sexuality, schooling and adolescent females: The missing discourse of desire. "Harvard Educational Review" 58, no. 1: 29-53] in secondary schools. Instead of echoing previous studies that have documented how female desire is missing, this research starts from the…

Principled Approaches to Missing Data in Epidemiologic Studies

PubMed Central

Perkins, Neil J; Cole, Stephen R; Harel, Ofer; Tchetgen Tchetgen, Eric J; Sun, BaoLuo; Mitchell, Emily M; Schisterman, Enrique F

2018-01-01

Abstract Principled methods with which to appropriately analyze missing data have long existed; however, broad implementation of these methods remains challenging. In this and 2 companion papers (Am J Epidemiol. 2018;187(3):576–584 and Am J Epidemiol. 2018;187(3):585–591), we discuss issues pertaining to missing data in the epidemiologic literature. We provide details regarding missing-data mechanisms and nomenclature and encourage the conduct of principled analyses through a detailed comparison of multiple imputation and inverse probability weighting. Data from the Collaborative Perinatal Project, a multisite US study conducted from 1959 to 1974, are used to create a masked data-analytical challenge with missing data induced by known mechanisms. We illustrate the deleterious effects of missing data with naive methods and show how principled methods can sometimes mitigate such effects. For example, when data were missing at random, naive methods showed a spurious protective effect of smoking on the risk of spontaneous abortion (odds ratio (OR) = 0.43, 95% confidence interval (CI): 0.19, 0.93), while implementation of principled methods multiple imputation (OR = 1.30, 95% CI: 0.95, 1.77) or augmented inverse probability weighting (OR = 1.40, 95% CI: 1.00, 1.97) provided estimates closer to the “true” full-data effect (OR = 1.31, 95% CI: 1.05, 1.64). We call for greater acknowledgement of and attention to missing data and for the broad use of principled missing-data methods in epidemiologic research. PMID:29165572

Principled Approaches to Missing Data in Epidemiologic Studies.

PubMed

Perkins, Neil J; Cole, Stephen R; Harel, Ofer; Tchetgen Tchetgen, Eric J; Sun, BaoLuo; Mitchell, Emily M; Schisterman, Enrique F

2018-03-01

Principled methods with which to appropriately analyze missing data have long existed; however, broad implementation of these methods remains challenging. In this and 2 companion papers (Am J Epidemiol. 2018;187(3):576-584 and Am J Epidemiol. 2018;187(3):585-591), we discuss issues pertaining to missing data in the epidemiologic literature. We provide details regarding missing-data mechanisms and nomenclature and encourage the conduct of principled analyses through a detailed comparison of multiple imputation and inverse probability weighting. Data from the Collaborative Perinatal Project, a multisite US study conducted from 1959 to 1974, are used to create a masked data-analytical challenge with missing data induced by known mechanisms. We illustrate the deleterious effects of missing data with naive methods and show how principled methods can sometimes mitigate such effects. For example, when data were missing at random, naive methods showed a spurious protective effect of smoking on the risk of spontaneous abortion (odds ratio (OR) = 0.43, 95% confidence interval (CI): 0.19, 0.93), while implementation of principled methods multiple imputation (OR = 1.30, 95% CI: 0.95, 1.77) or augmented inverse probability weighting (OR = 1.40, 95% CI: 1.00, 1.97) provided estimates closer to the "true" full-data effect (OR = 1.31, 95% CI: 1.05, 1.64). We call for greater acknowledgement of and attention to missing data and for the broad use of principled missing-data methods in epidemiologic research.

Doctors and the state: lessons from the Biko case.

PubMed

Silove, D

1990-01-01

The death of the well-known black leader, Steve Biko, in detention in South Africa in 1977 has continued to generate debate in the international medical literature. The three doctors who examined him during his terminal illness made a diagnosis of malingering in spite of overwhelming evidence suggesting that he had suffered extensive traumatic brain injury while in detention. The inquest into his death provided a rare insight into the manner in which state doctors function in relation to the police of a repressive regime. This article documents the relevant testimony from the inquest and explores the reasons for the doctor's mismanagement of Biko. It is suggested that failures in the doctors' judgement were a result of complex influences including the effects of their own social conditioning, the risk of habituation by state doctors to degrading prison conditions, the inroads that Apartheid has made into medical practice, the possibility of reprisal if state doctors oppose the wishes of the police, and, more speculatively, the possibility that the doctors' obedience and passivity were exploited by the Security Police who wished to absolve themselves from responsibility of Biko's injuries. Most importantly, it is argued that the repeated failure of the major medical organizations in South Africa to provide clear guidance and leadership to state-employed doctors increases the risk that individual doctors will continue to succumb to hierarchical pressures to condone acts of state-sanctioned violence against detainees.

Found and Missed: Failing to Recognize a Search Target despite Moving It

ERIC Educational Resources Information Center

Solman, Grayden J. F.; Cheyne, J. Allan; Smilek, Daniel

2012-01-01

We present results from five search experiments using a novel "unpacking" paradigm in which participants use a mouse to sort through random heaps of distractors to locate the target. We report that during this task participants often fail to recognize the target despite moving it, and despite having looked at the item. Additionally, the missed…

Locum doctors in general practice: motivation and experiences.

PubMed Central

McKevitt, C; Morgan, M; Hudson, M

1999-01-01

BACKGROUND: There is evidence of dissatisfaction with locum doctors' performance, but little is known about doctors who work as locums in general practice or about their experiences of this work. AIM: To describe the motivations and experiences of doctors providing locum cover in general practices. METHOD: A postal questionnaire survey distributed to locums through organizations such as locum groups, commercial agencies, and general practices. RESULTS: Questionnaires were returned by 111 doctors currently working as locums in general practice. Four main reasons for working as a locum GP were: as a short-term option while between posts, to gain experience of different practices before commitment to one practice, to balance work and family or other commitments, to continue part-time work after retirement. One-quarter of responders intended to continue working as a locum indefinitely. The drawbacks of locum work included frustration with low status, lack of security, and difficulty accessing structured training and education. CONCLUSION: Locum doctors in general practice are a heterogeneous group that includes those who have chosen this type of work. The doctors who intend to continue as locums indefinitely represent a useful resource in primary care whose ability to provide short-term cover could be maximized. The need to control the quality of 'freelance' doctors should not overshadow the need to control the quality of their working environments. PMID:10621983

Responsiveness-informed multiple imputation and inverse probability-weighting in cohort studies with missing data that are non-monotone or not missing at random.

PubMed

Doidge, James C

2018-02-01

Population-based cohort studies are invaluable to health research because of the breadth of data collection over time, and the representativeness of their samples. However, they are especially prone to missing data, which can compromise the validity of analyses when data are not missing at random. Having many waves of data collection presents opportunity for participants' responsiveness to be observed over time, which may be informative about missing data mechanisms and thus useful as an auxiliary variable. Modern approaches to handling missing data such as multiple imputation and maximum likelihood can be difficult to implement with the large numbers of auxiliary variables and large amounts of non-monotone missing data that occur in cohort studies. Inverse probability-weighting can be easier to implement but conventional wisdom has stated that it cannot be applied to non-monotone missing data. This paper describes two methods of applying inverse probability-weighting to non-monotone missing data, and explores the potential value of including measures of responsiveness in either inverse probability-weighting or multiple imputation. Simulation studies are used to compare methods and demonstrate that responsiveness in longitudinal studies can be used to mitigate bias induced by missing data, even when data are not missing at random.

Different Types of Doctoral Study Processes

ERIC Educational Resources Information Center

Lahenius, Katja; Martinsuo, Miia

2011-01-01

Becoming a doctor can be viewed as a highly personal and unique experience, which is why many factors influence the completion or non-completion of the doctoral degree. The attention in previous research has been on the students' characteristics, and the university faculty role in promoting degree progress. Therefore, more research is needed on…

Is networking different with doctors working part-time? Differences in social networks of part-time and full-time doctors.

PubMed

Heiligers, Phil J M; de Jong, Judith D; Groenewegen, Peter P; Hingstman, Lammert; Völker, Beate; Spreeuwenberg, Peter

2008-10-04

Part-time working is a growing phenomenon in medicine, which is expected to influence informal networks at work differently compared to full-time working. The opportunity to meet and build up social capital at work has offered a basis for theoretical arguments. Twenty-eight teams of medical specialists in the Netherlands, including 226 individuals participated in this study. Interviews with team representatives and individual questionnaires were used. Data were gathered on three types of networks: relationships of consulting, communication and trust. For analyses, network and multilevel applications were used. Differences between individual doctors and between teams were both analysed, taking the dependency structure of the data into account, because networks of individual doctors are not independent. Teams were divided into teams with and without doctors working part-time. Contrary to expectations we found no impact of part-time working on the size of personal networks, neither at the individual nor at the team level. The same was found regarding efficient reachability. Whereas we expected part-time doctors to choose their relations as efficiently as possible, we even found the opposite in intended relationships of trust, implying that efficiency in reaching each other was higher for full-time doctors. But we found as expected that in mixed teams with part-time doctors the frequency of regular communication was less compared to full-time teams. Furthermore, as expected the strength of the intended relationships of trust of part-time and full-time doctors was equally high. From these findings we can conclude that part-time doctors are not aiming at efficiency by limiting the size of networks or by efficient reachability, because they want to contact their colleagues directly in order to prevent from communication errors. On the other hand, together with the growth of teams, we found this strategy, focussed on reaching all colleagues, was diminishing. And our data

Is networking different with doctors working part-time? Differences in social networks of part-time and full-time doctors

PubMed Central

Heiligers, Phil JM; de Jong, Judith D; Groenewegen, Peter P; Hingstman, Lammert; Völker, Beate; Spreeuwenberg, Peter

2008-01-01

Background Part-time working is a growing phenomenon in medicine, which is expected to influence informal networks at work differently compared to full-time working. The opportunity to meet and build up social capital at work has offered a basis for theoretical arguments. Methods Twenty-eight teams of medical specialists in the Netherlands, including 226 individuals participated in this study. Interviews with team representatives and individual questionnaires were used. Data were gathered on three types of networks: relationships of consulting, communication and trust. For analyses, network and multilevel applications were used. Differences between individual doctors and between teams were both analysed, taking the dependency structure of the data into account, because networks of individual doctors are not independent. Teams were divided into teams with and without doctors working part-time. Results and Discussion Contrary to expectations we found no impact of part-time working on the size of personal networks, neither at the individual nor at the team level. The same was found regarding efficient reachability. Whereas we expected part-time doctors to choose their relations as efficiently as possible, we even found the opposite in intended relationships of trust, implying that efficiency in reaching each other was higher for full-time doctors. But we found as expected that in mixed teams with part-time doctors the frequency of regular communication was less compared to full-time teams. Furthermore, as expected the strength of the intended relationships of trust of part-time and full-time doctors was equally high. Conclusion From these findings we can conclude that part-time doctors are not aiming at efficiency by limiting the size of networks or by efficient reachability, because they want to contact their colleagues directly in order to prevent from communication errors. On the other hand, together with the growth of teams, we found this strategy, focussed on

Clustering with Missing Values: No Imputation Required

NASA Technical Reports Server (NTRS)

Wagstaff, Kiri

2004-01-01

Clustering algorithms can identify groups in large data sets, such as star catalogs and hyperspectral images. In general, clustering methods cannot analyze items that have missing data values. Common solutions either fill in the missing values (imputation) or ignore the missing data (marginalization). Imputed values are treated as just as reliable as the truly observed data, but they are only as good as the assumptions used to create them. In contrast, we present a method for encoding partially observed features as a set of supplemental soft constraints and introduce the KSC algorithm, which incorporates constraints into the clustering process. In experiments on artificial data and data from the Sloan Digital Sky Survey, we show that soft constraints are an effective way to enable clustering with missing values.

Restoration of HST images with missing data

NASA Technical Reports Server (NTRS)

Adorf, Hans-Martin

1992-01-01

Missing data are a fairly common problem when restoring Hubble Space Telescope observations of extended sources. On Wide Field and Planetary Camera images cosmic ray hits and CCD hot spots are the prevalent causes of data losses, whereas on Faint Object Camera images data are lossed due to reseaux marks, blemishes, areas of saturation and the omnipresent frame edges. This contribution discusses a technique for 'filling in' missing data by statistical inference using information from the surrounding pixels. The major gain consists in minimizing adverse spill-over effects to the restoration in areas neighboring those where data are missing. When the mask delineating the support of 'missing data' is made dynamic, cosmic ray hits, etc. can be detected on the fly during restoration.

Materials International Space Station Experiment (MISSE) Arrival

NASA Image and Video Library

2017-10-02

The Materials International Space Station Experiment-Flight Facility, or MISSE-FF, hardware arrived at the Space Station Processing Facility low bay at NASA's Kennedy Space Center in Florida. Technicians assist as one of the components is lowered and secured onto another MISSE component. MISSE will be used to test various materials and computing elements on the exterior of the space station. They will be exposed to the harsh environment of low-Earth orbit, including to a vacuum, atomic oxygen, ultraviolet radiation, direct sunlight and extreme heat and cold. The experiment will provide a better understanding of material durability, from coatings to electronic sensors, which could be applied to future spacecraft designs. MISSE will be delivered to the space station on a future commercial resupply mission.

Materials International Space Station Experiment (MISSE) Arrival

NASA Image and Video Library

2017-10-02

The Materials International Space Station Experiment-Flight Facility, or MISSE-FF, hardware arrived at the Space Station Processing Facility low bay at NASA's Kennedy Space Center in Florida. Technicians assist as MISSE is lifted by crane from its shipping container. MISSE will be used to test various materials and computing elements on the exterior of the space station. They will be exposed to the harsh environment of low-Earth orbit, including to a vacuum, atomic oxygen, ultraviolet radiation, direct sunlight and extreme heat and cold. The experiment will provide a better understanding of material durability, from coatings to electronic sensors, which could be applied to future spacecraft designs. MISSE will be delivered to the space station on a future commercial resupply mission.

Materials International Space Station Experiment (MISSE) Arrival

NASA Image and Video Library

2017-10-02

The Materials International Space Station Experiment-Flight Facility, or MISSE-FF, hardware arrived at the Space Station Processing Facility low bay at NASA's Kennedy Space Center in Florida. Technicians assist as one of the components is lowered onto another MISSE component. MISSE will be used to test various materials and computing elements on the exterior of the space station. They will be exposed to the harsh environment of low-Earth orbit, including to a vacuum, atomic oxygen, ultraviolet radiation, direct sunlight and extreme heat and cold. The experiment will provide a better understanding of material durability, from coatings to electronic sensors, which could be applied to future spacecraft designs. MISSE will be delivered to the space station on a future commercial resupply mission.

Materials International Space Station Experiment (MISSE) Arrival

NASA Image and Video Library

2017-10-02

The Materials International Space Station Experiment-Flight Facility, or MISSE-FF, hardware arrived at the Space Station Processing Facility low bay at NASA's Kennedy Space Center in Florida. Technicians assist as a crane is used to lift MISSE out of its shipping container. MISSE will be used to test various materials and computing elements on the exterior of the space station. They will be exposed to the harsh environment of low-Earth orbit, including to a vacuum, atomic oxygen, ultraviolet radiation, direct sunlight and extreme heat and cold. The experiment will provide a better understanding of material durability, from coatings to electronic sensors, which could be applied to future spacecraft designs. MISSE will be delivered to the space station on a future commercial resupply mission.

Materials International Space Station Experiment (MISSE) Arrival

NASA Image and Video Library

2017-10-02

The Materials International Space Station Experiment-Flight Facility, or MISSE-FF, hardware arrived at the Space Station Processing Facility low bay at NASA's Kennedy Space Center in Florida. Technicians work to attach a crane to MISSE for lifting out of its shipping container. MISSE will be used to test various materials and computing elements on the exterior of the space station. They will be exposed to the harsh environment of low-Earth orbit, including to a vacuum, atomic oxygen, ultraviolet radiation, direct sunlight and extreme heat and cold. The experiment will provide a better understanding of material durability, from coatings to electronic sensors, which could be applied to future spacecraft designs. MISSE will be delivered to the space station on a future commercial resupply mission.

Materials International Space Station Experiment (MISSE) Arrival

NASA Image and Video Library

2017-10-02

The Materials International Space Station Experiment-Flight Facility, or MISSE-FF, hardware arrived at the Space Station Processing Facility low bay at NASA's Kennedy Space Center in Florida. Technicians attach a crane to MISSE for lifting out of its shipping container. MISSE will be used to test various materials and computing elements on the exterior of the space station. They will be exposed to the harsh environment of low-Earth orbit, including to a vacuum, atomic oxygen, ultraviolet radiation, direct sunlight and extreme heat and cold. The experiment will provide a better understanding of material durability, from coatings to electronic sensors, which could be applied to future spacecraft designs. MISSE will be delivered to the space station on a future commercial resupply mission.

The feminisation of Canadian medicine and its impact upon doctor productivity.

PubMed

Weizblit, Nataly; Noble, Jason; Baerlocher, Mark Otto

2009-05-01

We examined the differences in work patterns between female and male doctors in Canada to gain insight into the effect of an increased number of female doctors on overall doctor productivity. Data on the practice profiles of female and male doctors across Canada were extracted from the 2007 National Physician Survey. A doctor productivity measure, 'work hours per week per population' (WHPWPP), was created, based on the number of weekly doctor hours spent providing direct patient care per 100,000 citizens. The predicted WHPWPP was calculated for a hypothetical time-point when the female and male doctor populations reach equilibrium. The differences in current and predicted WHPWPP were then analysed. Female medical students currently (2007) outnumber male medical students (at 57.8% of the medical student population). The percentage of practising doctors who are women is highest in the fields of paediatrics, obstetrics and gynaecology, psychiatry and family practice. Female doctors work an average of 47.5 hours per week (giving 30.0 hours of direct patient care), compared with 53.8 hours worked by male doctors (35.0 hours of direct patient care) (P < 0.01, chi(2) test). Female doctors tend to work less on call hours per week and see fewer patients while on-call. Female doctors are also more likely to take parental leave or a leave of absence (P < 0.01, chi(2) test). The difference in current and predicted WHPWPP was found to be 2.6%, equivalent to 1853 fewer full-time female doctors or 1588 fewer full-time male doctors. Gender appears to have a significant influence on the practice patterns of doctors in Canada. If the gender-specific work patterns described in the present study persist, an overall decrease in doctor productivity is to be anticipated.

[The profile training of aviation doctors].

PubMed

Blaginin, A A; Lizogub, I N

2011-11-01

Authors consider the trends of training doctors in the specialty "physician in aerospace medicine". First level is initial training for faculty training of doctors. The higher level is vocational retraining and advanced training in the departments of postgraduate and further education. It solved the issues of preparation of specialists in various areas of aviation medicine: medical-chairman of the Flight Commission, an expert medical doctor-flight expert committee, a specialist laboratory (Cabinet) of Aviation Medicine, the Medical Director of Aviation (enterprise, organization), etc. The highest level of training is residency. The necessity of legislative consolidation of an independent direction for the organization of training and medical support of aviation operations is proved.

Reducing Misses and Near Misses Related to Multitasking on the Electronic Health Record: Observational Study and Qualitative Analysis

PubMed Central

Matta, George Y; Bohsali, Fuad B; Chisolm, Margaret S

2018-01-01

Background Clinicians’ use of electronic health record (EHR) systems while multitasking may increase the risk of making errors, but silent EHR system use may lower patient satisfaction. Delaying EHR system use until after patient visits may increase clinicians’ EHR workload, stress, and burnout. Objective We aimed to describe the perspectives of clinicians, educators, administrators, and researchers about misses and near misses that they felt were related to clinician multitasking while using EHR systems. Methods This observational study was a thematic analysis of perspectives elicited from 63 continuing medical education (CME) participants during 2 workshops and 1 interactive lecture about challenges and strategies for relationship-centered communication during clinician EHR system use. The workshop elicited reflection about memorable times when multitasking EHR use was associated with “misses” (errors that were not caught at the time) or “near misses” (mistakes that were caught before leading to errors). We conducted qualitative analysis using an editing analysis style to identify codes and then select representative themes and quotes. Results All workshop participants shared stories of misses or near misses in EHR system ordering and documentation or patient-clinician communication, wondering about “misses we don’t even know about.” Risk factors included the computer’s position, EHR system usability, note content and style, information overload, problematic workflows, systems issues, and provider and patient communication behaviors and expectations. Strategies to reduce multitasking EHR system misses included clinician transparency when needing silent EHR system use (eg, for prescribing), narrating EHR system use, patient activation during EHR system use, adapting visit organization and workflow, improving EHR system design, and improving team support and systems. Conclusions CME participants shared numerous stories of errors and near misses

Missing data in trauma registries: A systematic review.

PubMed

Shivasabesan, Gowri; Mitra, Biswadev; O'Reilly, Gerard M

2018-03-30

Trauma registries play an integral role in trauma systems but their valid use hinges on data quality. The aim of this study was to determine, among contemporary publications using trauma registry data, the level of reporting of data completeness and the methods used to deal with missing data. A systematic review was conducted of all trauma registry-based manuscripts published from 01 January 2015 to current date (17 March 2017). Studies were identified by searching MEDLINE, EMBASE, and CINAHL using relevant subject headings and keywords. Included manuscripts were evaluated based on previously published recommendations regarding the reporting and discussion of missing data. Manuscripts were graded on their degree of characterization of such observations. In addition, the methods used to manage missing data were examined. There were 539 manuscripts that met inclusion criteria. Among these, 208 (38.6%) manuscripts did not mention data completeness and 88 (16.3%) mentioned missing data but did not quantify the extent. Only a handful (n = 26; 4.8%) quantified the 'missingness' of all variables. Most articles (n = 477; 88.5%) contained no details such as a comparison between patient characteristics in cohorts with and without missing data. Of the 331 articles which made at least some mention of data completeness, the method of managing missing data was unknown in 34 (10.3%). When method(s) to handle missing data were identified, 234 (78.8%) manuscripts used complete case analysis only, 18 (6.1%) used multiple imputation only and 34 (11.4%) used a combination of these. Most manuscripts using trauma registry data did not quantify the extent of missing data for any variables and contained minimal discussion regarding missingness. Out of the studies which identified a method of managing missing data, most used complete case analysis, a method that may bias results. The lack of standardization in the reporting and management of missing data questions the validity of

Evolutionary Characteristics of Missing Proteins: Insights into the Evolution of Human Chromosomes Related to Missing-Protein-Encoding Genes.

PubMed

Xu, Aishi; Li, Guang; Yang, Dong; Wu, Songfeng; Ouyang, Hongsheng; Xu, Ping; He, Fuchu

2015-12-04

Although the "missing protein" is a temporary concept in C-HPP, the biological information for their "missing" could be an important clue in evolutionary studies. Here we classified missing-protein-encoding genes into two groups, the genes encoding PE2 proteins (with transcript evidence) and the genes encoding PE3/4 proteins (with no transcript evidence). These missing-protein-encoding genes distribute unevenly among different chromosomes, chromosomal regions, or gene clusters. In the view of evolutionary features, PE3/4 genes tend to be young, spreading at the nonhomology chromosomal regions and evolving at higher rates. Interestingly, there is a higher proportion of singletons in PE3/4 genes than the proportion of singletons in all genes (background) and OTCSGs (organ, tissue, cell type-specific genes). More importantly, most of the paralogous PE3/4 genes belong to the newly duplicated members of the paralogous gene groups, which mainly contribute to special biological functions, such as "smell perception". These functions are heavily restricted into specific type of cells, tissues, or specific developmental stages, acting as the new functional requirements that facilitated the emergence of the missing-protein-encoding genes during evolution. In addition, the criteria for the extremely special physical-chemical proteins were first set up based on the properties of PE2 proteins, and the evolutionary characteristics of those proteins were explored. Overall, the evolutionary analyses of missing-protein-encoding genes are expected to be highly instructive for proteomics and functional studies in the future.

Psychosocial interventions for managing occupational stress and burnout among medical doctors: a systematic review.

PubMed

Clough, Bonnie A; March, Sonja; Chan, Raymond J; Casey, Leanne M; Phillips, Rachel; Ireland, Michael J

2017-07-17

Occupational stress and burnout are highly prevalent among medical doctors and can have adverse effects on patient, doctor, and organisational outcomes. The purpose of the current study was to review and evaluate evidence on psychosocial interventions aimed at reducing occupational stress and burnout among medical doctors. A systematic review was conducted for original research articles reporting on psychosocial interventions targeting occupational stress or burnout among medical doctors, published in the English language, and with data collected at a minimum of two time points. Searches were conducted across five electronic databases, as well as by manual search of Google Scholar. Data was extracted relating to study characteristics and outcomes, quality and rigour, as well as modes of delivery and engagement. Studies were appraised using the Strength of Recommendation Taxonomy (SORT) and Critical Appraisal Skills Programme (CASP). Twenty-three articles were reviewed, which reported on interventions utilising cognitive-behavioural, relaxation, and supportive discussion strategies. Only 12 studies allowed estimation of pre- to post-intervention effects. Cognitive behavioural interventions demonstrated the strongest evidence, particularly for reducing stress. Some evidence was identified to support the efficacy of relaxation-based approaches, but no such evidence was found for the efficacy of discussion-based interventions, such as Balint groups. There was a lack of quality among reviewed studies, with no studies receiving a quality rating of 1, and the overall body of evidence being rated as level B, according to the SORT. Effect sizes were not pooled due to a lack of quality among the study sample. This review found that despite increased scientific attention, the quality of research examining the benefits of psychosocial/behavioural interventions for occupational stress and burnout in medical doctors remains low. Despite this, interventions focused on cognitive

"Nudge" and the epidemic of missed appointments.

PubMed

Aggarwal, Ajay; Davies, Joanna; Sullivan, Richard

2016-06-20

Purpose - Missed appointments constitute a significant problem in the UK National Health Service (NHS) and this remains an area where improvements could yield substantial efficiency savings. The purpose of this paper is to suggest that nudge policies based on behavioural theories may help target interventions to improve patient motivation to attend appointments. Design/methodology/approach - The authors propose two policies to reduce missed appointments. The first attempts to empower patients through making the appointment system more individualised to them and utilising their intrinsic feelings of social responsibility. The second policy utilises a financial commitment given by the patient at the time of booking. The different mechanisms of influencing patient behaviour are based on two different views of what motivates individuals' actions. The first policy is based on individuals being "knights". They are altruistic and have well-intentioned values. The second policy option is constructed on the premise that an individual is governed by self-interest, and they are in fact "knaves". Findings - A policy, which avoids the use of financial penalties is likely to be more culturally acceptable within the NHS. It could also prevent the phenomenon of "crowding out" whereby the desire to act dutifully gets displaced by the motivation to avoid incurring a monetary fine. Originality/value - Testing both strategies would provide insight into patient attitudes towards health care and society. This would help optimise behavioural strategies which may influence not only appointment attendances but also have wider implications for encouraging rational health care consumption.

Is Spending More Time Associated With Less Missed Care?: A Comparison of Time Use and Missed Care Across 15 Nursing Units at 2 Hospitals.

PubMed

McNair, Norma; Baird, Jennifer; Grogan, Tristan R; Walsh, Catherine M; Liang, Li-Jung; Worobel-Luk, Pamela; Needleman, Jack; Nuckols, Teryl K

2016-09-01

The aim of this study is to examine the relationship between nursing time use and perceptions of missed care. Recent literature has highlighted the problem of missed nursing care, but little is known about how nurses' time use patterns are associated with reports of missed care. In 15 nursing units at 2 hospitals, we assessed registered nurse (RN) perceptions of missed care, observed time use by RNs, and examined the relationship between time spent and degree of missed care at the nursing unit level. Patterns of time use were similar across hospitals, with 25% of time spent on documentation. For 6 different categories of nursing tasks, no association was detected between time use, including time spent on documentation, and the degree of missed care at the nursing unit level. Nursing time use cannot fully explain variation in missed care across nursing units. Further work is needed to account for patterns of missed care.

Encouraging formative assessments of leadership for foundation doctors.

PubMed

Hadley, Lindsay; Black, David; Welch, Jan; Reynolds, Peter; Penlington, Clare

2015-08-01

Clinical leadership is considered essential for maintaining and improving patient care and safety in the UK, and is incorporated in the curriculum for all trainee doctors. Despite the growing focus on the importance of leadership, and the introduction of the Medical Leadership Competency Framework (MLCF) in the UK, leadership education for doctors in training is still in its infancy. Assessment is focused on clinical skills, and trainee doctors receive very little formal feedback on their leadership competencies. In this article we describe the approach taken by Health Education Kent, Sussex and Surrey (HEKSS) to raise the profile of leadership amongst doctors in training in the South Thames Foundation School (STFS). An annual structured formative assessment in leadership for each trainee has been introduced, supported by leadership education for both trainees and their supervisors in HEKSS trusts. We analysed over 500 of these assessments from the academic year 2012/13 for foundation doctors in HEKSS trusts, in order to assess the quality of the feedback. From the analysis, potential indicators of more effective formative assessments were identified. These may be helpful in improving the leadership education programme for future years. There is a wealth of evidence to highlight the importance and value of formative assessments; however, particularly for foundation doctors, these have typically been focused on assessing clinical capabilities. This HEKSS initiative encourages doctors to recognise leadership opportunities at the beginning of their careers, seeks to help them understand the importance of acquiring leadership skills and provides structured feedback to help them improve. Leadership education for doctors in training is still in its infancy. © 2015 John Wiley & Sons Ltd.

Ethical issues concerning New Zealand sports doctors

PubMed Central

Anderson, L; Gerrard, D

2005-01-01

Success in sport can provide a source of national pride for a society, and vast financial and personal rewards for an individual athlete. It is therefore not surprising that many athletes will go to great lengths in pursuit of success. The provision of healthcare for elite sports people has the potential to create many ethical issues for sports doctors; however there has been little discussion of them to date. This study highlights these issues. Respondents to a questionnaire identified many ethical matters, common to other areas of medicine. However they also raised problems unique to sports medicine. Some of these ethical difficulties arise out of the place of the sports doctor within the hierarchy of sport. Yet others arise out of the special relationship between sports doctors and individual players/athletes. This study raises some important questions regarding the governance of healthcare in sport, and what support and guidance is available to sports doctors. As medical and scientific intervention in sport escalates, there is a risk that demands for enhanced performance may compromise the health of the athlete, and the role the sports doctor plays remains a critical question. PMID:15681672

Doctor-Shopping Behavior among Patients with Eye Floaters

PubMed Central

Tseng, Gow-Lieng; Chen, Cheng-Yu

2015-01-01

Patients suffering from eye floaters often resort to consulting more than one ophthalmologist. The purpose of this study, using the Health Belief Model (HBM), was to identify the factors that influence doctor-shopping behavior among patients with eye floaters. In this cross-sectional survey, 175 outpatients who presented floaters symptoms were enrolled. Data from 143 patients (77 first time visitors and 66 doctor-shoppers) who completed the questionnaire were analyzed. Descriptive and logistic regression analyses were performed. We found that women and non-myopia patients were significantly related with frequent attendance and doctor switching. Though the HBM has performed well in a number of health behaviors studies, but most of the conceptual constructors of HBM did not show significant differences between the first time visitors and true doctor-shoppers in this study. Motivation was the only significant category affecting doctor-shopping behavior of patients with eye floaters. PMID:26184266

Doctor-Shopping Behavior among Patients with Eye Floaters.

PubMed

Tseng, Gow-Lieng; Chen, Cheng-Yu

2015-07-13

Patients suffering from eye floaters often resort to consulting more than one ophthalmologist. The purpose of this study, using the Health Belief Model (HBM), was to identify the factors that influence doctor-shopping behavior among patients with eye floaters. In this cross-sectional survey, 175 outpatients who presented floaters symptoms were enrolled. Data from 143 patients (77 first time visitors and 66 doctor-shoppers) who completed the questionnaire were analyzed. Descriptive and logistic regression analyses were performed. We found that women and non-myopia patients were significantly related with frequent attendance and doctor switching. Though the HBM has performed well in a number of health behaviors studies, but most of the conceptual constructors of HBM did not show significant differences between the first time visitors and true doctor-shoppers in this study. Motivation was the only significant category affecting doctor-shopping behavior of patients with eye floaters.

Changes in Doctors' Working Hours: A Longitudinal Analysis.

PubMed

Joyce, Catherine M; Wang, Wei C; Cheng, Terence C

2015-10-01

The study examined changes in doctors' working hours and satisfaction with working hours over five time points and explored the influence of personal characteristics on these outcomes. Latent growth curve modeling was applied to Medicine in Australia: Balancing Employment and Life data, collected from 2008 to 2012. Findings showed that working hours significantly declined over time, with a greater decrease among males, older doctors, and doctors with fewer children. Satisfaction increased faster over time among specialists, doctors with poorer health, those whose partners did not work full-time, and those with older children. The more hours the doctors worked initially, the lower satisfaction reported, and the greater the increase in satisfaction. Findings are consistent with a culture change in the medical profession, whereby long working hours are no longer seen as synonymous with professionalism. This is important to take into account in projecting future workforce supply. © The Author(s) 2015.

Order-restricted inference for means with missing values.

PubMed

Wang, Heng; Zhong, Ping-Shou

2017-09-01

Missing values appear very often in many applications, but the problem of missing values has not received much attention in testing order-restricted alternatives. Under the missing at random (MAR) assumption, we impute the missing values nonparametrically using kernel regression. For data with imputation, the classical likelihood ratio test designed for testing the order-restricted means is no longer applicable since the likelihood does not exist. This article proposes a novel method for constructing test statistics for assessing means with an increasing order or a decreasing order based on jackknife empirical likelihood (JEL) ratio. It is shown that the JEL ratio statistic evaluated under the null hypothesis converges to a chi-bar-square distribution, whose weights depend on missing probabilities and nonparametric imputation. Simulation study shows that the proposed test performs well under various missing scenarios and is robust for normally and nonnormally distributed data. The proposed method is applied to an Alzheimer's disease neuroimaging initiative data set for finding a biomarker for the diagnosis of the Alzheimer's disease. © 2017, The International Biometric Society.

VARIABLE SELECTION FOR REGRESSION MODELS WITH MISSING DATA

PubMed Central

Garcia, Ramon I.; Ibrahim, Joseph G.; Zhu, Hongtu

2009-01-01

We consider the variable selection problem for a class of statistical models with missing data, including missing covariate and/or response data. We investigate the smoothly clipped absolute deviation penalty (SCAD) and adaptive LASSO and propose a unified model selection and estimation procedure for use in the presence of missing data. We develop a computationally attractive algorithm for simultaneously optimizing the penalized likelihood function and estimating the penalty parameters. Particularly, we propose to use a model selection criterion, called the ICQ statistic, for selecting the penalty parameters. We show that the variable selection procedure based on ICQ automatically and consistently selects the important covariates and leads to efficient estimates with oracle properties. The methodology is very general and can be applied to numerous situations involving missing data, from covariates missing at random in arbitrary regression models to nonignorably missing longitudinal responses and/or covariates. Simulations are given to demonstrate the methodology and examine the finite sample performance of the variable selection procedures. Melanoma data from a cancer clinical trial is presented to illustrate the proposed methodology. PMID:20336190

Memory for found targets interferes with subsequent performance in multiple-target visual search.

PubMed

Cain, Matthew S; Mitroff, Stephen R

2013-10-01

Multiple-target visual searches--when more than 1 target can appear in a given search display--are commonplace in radiology, airport security screening, and the military. Whereas 1 target is often found accurately, additional targets are more likely to be missed in multiple-target searches. To better understand this decrement in 2nd-target detection, here we examined 2 potential forms of interference that can arise from finding a 1st target: interference from the perceptual salience of the 1st target (a now highly relevant distractor in a known location) and interference from a newly created memory representation for the 1st target. Here, we found that removing found targets from the display or making them salient and easily segregated color singletons improved subsequent search accuracy. However, replacing found targets with random distractor items did not improve subsequent search accuracy. Removing and highlighting found targets likely reduced both a target's visual salience and its memory load, whereas replacing a target removed its visual salience but not its representation in memory. Collectively, the current experiments suggest that the working memory load of a found target has a larger effect on subsequent search accuracy than does its perceptual salience. PsycINFO Database Record (c) 2013 APA, all rights reserved.

A guide to missing data for the pediatric nephrologist.

PubMed

Larkins, Nicholas G; Craig, Jonathan C; Teixeira-Pinto, Armando

2018-03-13

Missing data is an important and common source of bias in clinical research. Readers should be alert to and consider the impact of missing data when reading studies. Beyond preventing missing data in the first place, through good study design and conduct, there are different strategies available to handle data containing missing observations. Complete case analysis is often biased unless data are missing completely at random. Better methods of handling missing data include multiple imputation and models using likelihood-based estimation. With advancing computing power and modern statistical software, these methods are within the reach of clinician-researchers under guidance of a biostatistician. As clinicians reading papers, we need to continue to update our understanding of statistical methods, so that we understand the limitations of these techniques and can critically interpret literature.

[Doctoral thesis projects for medical students? Retrospective estimation of the fraction of successfully completed medical doctoral thesis projects at Witten/Herdecke University].

PubMed

Scharfenberg, Janna; Schaper, Katharina; Krummenauer, Frank

2014-01-01

The German "Dr med" plays a specific role in doctoral thesis settings since students may start the underlying doctoral project during their studies at medical school. If a Medical Faculty principally encourages this approach, then it should support the students in performing the respective projects as efficiently as possible. Consequently, it must be ensured that students are able to implement and complete a doctoral project in parallel to their studies. As a characteristic efficiency feature of these "Dr med" initiatives, the proportion of doctoral projects successfully completed shortly after graduating from medical school is proposed and illustrated. The proposed characteristic can be estimated by the time period between the state examination (date of completion of the qualifying medical examination) and the doctoral examination. Completion of the doctoral project "during their medical studies" was then characterised by a doctoral examination no later than 12 months after the qualifying medical state examination. To illustrate the estimation and interpretation of this characteristic, it was retrospectively estimated on the basis of the full sample of all doctorates successfully completed between July 2009 and June 2012 at the Department of Human Medicine at the Faculty of Health of the University of Witten/Herdecke. During the period of investigation defined, a total number of 56 doctoral examinations were documented, 30 % of which were completed within 12 months after the qualifying medical state examination (95% confidence interval 19 to 44 %). The median duration between state and doctoral examination was 27 months. The proportion of doctoral projects completed parallel to the medical studies increased during the investigation period from 14 % in the first year (July 2009 till June 2010) to 40 % in the third year (July 2011 till June 2012). Only about a third of all "Dr med" projects at the Witten/Herdecke Faculty of Health were completed during or close to

19 CFR 141.66 - Bond for missing documents.

Code of Federal Regulations, 2011 CFR

2011-04-01

... 19 Customs Duties 2 2011-04-01 2011-04-01 false Bond for missing documents. 141.66 Section 141.66... TREASURY (CONTINUED) ENTRY OF MERCHANDISE Presentation of Entry Papers § 141.66 Bond for missing documents... applicable to incomplete or missing invoices.) [T.D. 73-175, 38 FR 17447, July 2, 1973, as amended by T.D. 84...

19 CFR 141.66 - Bond for missing documents.

Code of Federal Regulations, 2013 CFR

2013-04-01

... 19 Customs Duties 2 2013-04-01 2013-04-01 false Bond for missing documents. 141.66 Section 141.66... TREASURY (CONTINUED) ENTRY OF MERCHANDISE Presentation of Entry Papers § 141.66 Bond for missing documents... applicable to incomplete or missing invoices.) [T.D. 73-175, 38 FR 17447, July 2, 1973, as amended by T.D. 84...

19 CFR 141.66 - Bond for missing documents.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 19 Customs Duties 2 2010-04-01 2010-04-01 false Bond for missing documents. 141.66 Section 141.66... TREASURY (CONTINUED) ENTRY OF MERCHANDISE Presentation of Entry Papers § 141.66 Bond for missing documents... applicable to incomplete or missing invoices.) [T.D. 73-175, 38 FR 17447, July 2, 1973, as amended by T.D. 84...

19 CFR 141.66 - Bond for missing documents.

Code of Federal Regulations, 2014 CFR

2014-04-01

... 19 Customs Duties 2 2014-04-01 2014-04-01 false Bond for missing documents. 141.66 Section 141.66... TREASURY (CONTINUED) ENTRY OF MERCHANDISE Presentation of Entry Papers § 141.66 Bond for missing documents... applicable to incomplete or missing invoices.) [T.D. 73-175, 38 FR 17447, July 2, 1973, as amended by T.D. 84...

19 CFR 141.66 - Bond for missing documents.

Code of Federal Regulations, 2012 CFR

2012-04-01

... 19 Customs Duties 2 2012-04-01 2012-04-01 false Bond for missing documents. 141.66 Section 141.66... TREASURY (CONTINUED) ENTRY OF MERCHANDISE Presentation of Entry Papers § 141.66 Bond for missing documents... applicable to incomplete or missing invoices.) [T.D. 73-175, 38 FR 17447, July 2, 1973, as amended by T.D. 84...

Handling Missing Data in Educational Research Using SPSS

ERIC Educational Resources Information Center

Cheema, Jehanzeb

2012-01-01

This study looked at the effect of a number of factors such as the choice of analytical method, the handling method for missing data, sample size, and proportion of missing data, in order to evaluate the effect of missing data treatment on accuracy of estimation. In order to accomplish this a methodological approach involving simulated data was…

More than Meets the Eye: The Use of Videonarratives to Facilitate Doctoral Students' Reflexivity on Their Doctoral Journeys

ERIC Educational Resources Information Center

Taylor, Carol A.

2011-01-01

This article discusses findings from a UK Higher Education Academy project, which used digital video to promote doctoral students' reflexivity. The project aimed to facilitate doctoral students' research skills through the making of videonarratives; create spaces for reflexivity on the relations between research, narrative and identity; and…

Miss Heroin.

ERIC Educational Resources Information Center

Riley, Bernice

This script, with music, lyrics and dialog, was written especially for youngsters to inform them of the potential dangers of various drugs. The author, who teaches in an elementary school in Harlem, New York, offers Miss Heroin as her answer to the expressed opinion that most drug and alcohol information available is either too simplified and…

Bridges to the Doctorate: mentored transition to successful completion of doctoral study for underrepresented minorities in nursing science.

PubMed

Kim, Mi Ja; Holm, Karyn; Gerard, Peggy; McElmurry, Beverly; Foreman, Mark; Poslusny, Susan; Dallas, Constance

2009-01-01

Nursing has a shortage of doctorally-prepared underrepresented minority (URM) scientists/faculty. We describe a five-year University of Illinois at Chicago (UIC) Bridges program for URM master's students' transition to doctoral study and factors in retention/graduation from the PhD program. Four master' students from two partner schools were recruited/appointed per year and assigned UIC faculty advisors. They completed 10 UIC credits during master's study and were mentored by Bridges faculty. Administrative and financial support was provided during transition and doctoral study. Partner schools' faculty formed research dyads with UIC faculty. Seventeen Bridges students were appointed to the Bridges program: 12 were admitted to the UIC PhD program since 2004 and one graduated in 2007. Eight Bridges faculty research dyads published 5 articles and submitted 1 NIH R03 application. Mentored transition from master's through doctoral program completion and administrative/financial support for students were key factors in program success. Faculty research dyads enhanced the research climate in partner schools.

Concussion - what to ask your doctor - adult

MedlinePlus

... Adult brain injury - what to ask your doctor; Traumatic brain injury - what to ask the doctor ... Begaz T. Traumatic brain injury (adult). In: Adams JG, ed. Emergency Medicine . 2nd ed. Philadelphia, PA: Elsevier Saunders; 2013:chap 73. Giza CC, ...

Knowledge seeking behaviours of pre interns and early career doctors in Sri Lanka: a cross sectional study.

PubMed

Rodrigo, Chaturaka; Maduranga, Sachith; Withana, Milinda; Fernando, Deepika; Rajapakse, Senaka

2015-10-27

Use of reference sources for medical knowledge has changed dramatically over the last two decades with the introduction of online sources of information. This study analyses the medical knowledge seeking behaviours of pre interns and early career doctors in Sri Lanka. This cross sectional survey with a convenience sample was conducted at two sites targeting two groups; pre-intern doctors graduated from the Faculty of Medicine, University of Colombo and early career doctors following a postgraduate course at the National Hospital of Sri Lanka. The data collection tool was an online self-administered questionnaire (paper based questionnaires used on request) that probed the patterns of using reference sources for medical knowledge. The respondents comprised of 52 pre-interns and 34 early career doctors. A majority (98 %) had internet access. Early career doctors preferred online resources significantly more than the pre-interns. However, the utilization of online resources for evidence synthesis and planning research was unsatisfactory in both groups. A significant proportion (35 %) responded that they had never read a systematic review. Only one person in the entire sample had co-authored a review article. The use of online resources by participants seems to be satisfactory with a majority shifting to reliable online resources as a reference point for medical knowledge. However, a closer look at the usage patterns reveal that online resources that can be used for more innovative tasks such as evidence synthesis are grossly under-utilized.

The Doctorate in Chemistry. Carnegie Essays on the Doctorate: Chemistry.

ERIC Educational Resources Information Center

Breslow, Ronald

The Carnegie Foundation commissioned a collection of essays as part of the Carnegie Initiative on the Doctorate (CID). Essays and essayists represent six disciplines that are part of the CID: chemistry, education, English, history, mathematics, and neuroscience. Intended to engender conversation about the conceptual foundation of doctoral…